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Perspectives of nurses' role in interprofessional pharmaceutical care across 14 European countries

Objectives: To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). Design: Qualitative study conducted through semi-structured in-depth interviews. Setting: Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants: In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis: All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results: 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. Conclusions: European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.

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Risk reduction in road and rail LPG transportation bij passive fire protection

The potential reduction of risk in LPG (Liquified Petroleum Gas) road transport due to the adoption of passive fire protectionswas investigated. Experimental data available for small scale vessels fully engulfed by a fire were extended to real scale road and rail tankers through a finite elements model. The results of mathematical simulations of real scale fire engulfment scenarios that may follow accidents involving LPG tankers proved the effectiveness of the thermal protections in preventing the “fired” BLEVE (Boiling Liquid Expanding Vapour Explosion) scenario. The presence of a thermal coating greatly increases the “time to failure”, providing a time lapse that in the European experience may be considered sufficient to allowthe start of effective mitigation actions by fire brigades. The results obtainedwere used to calculate the expected reduction of individual and societal risk due to LPG transportation in real case scenarios. The analysis confirmed that the introduction of passive fire protections turns out in a significant reduction of risk, up to an order of magnitude in the case of individual risk and of about 50% if the expectation value is considered. Thus, the adoption of passive fire protections, not compulsory in European regulations, may be an effective technical measure for risk reduction, and may contribute to achieve the control of “major accidents hazards” cited by the European legislation

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Risk reduction in road and rail LPG transportation bij passive fire protection

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Een beetje straling, is dat goed voor je?

Een fles rode wijn per dag drinken is ongezond, maar een glas per dag reduceert mogelijk de kans op hartkwalen. Dit is een voorbeeld van ‘hormese’: het verschijnsel dat een agens dat in grote hoeveelheden schadelijk is, bij lage doses juist gezond is. Iets vergelijkbaars geldt voor zonlicht: lage doses worden geassocieerd met positieve gezondseffecten, hoge doses met verbranden en een hogere kans op huidkanker. Er zijn onderzoekers die zich op het omstreden standpunt stellen dat ook ioniserende straling hormetische eigenschappen heeft. In dit artikel gaan we nader in op de verschillende standpunten omtrent lage-dosiseffecten, de argumenten voor en tegen hormese en de consequenties van recente inzichten.

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Een beetje straling, is dat goed voor je?

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enhancement of guest experience through technology

this thesis was simply a research done to see how the manor amsterdam can use technologies to enhance its guest eperience. Surveys and intervews were conducted to see what the guest preferences were after which an implementation process was also drawn up.

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enhancement of guest experience through technology

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The application of arbitration in transnational private regulation

This paper investigates the prospective application of arbitration by Transnational Private Regulation (TPR). It builds on the study of TPR developed by Fabrizio Cafaggi et al. TPR addresses the ever-increasing transfer of regulatory power from national to global levels, and from public to private regulators. TPR entails private regulatory co-operation be-yond the jurisdictional boundaries of States through voluntary standards. The regimes of TPR are built by a variety of actors, such as companies, NGOs, independent experts, and epistemic communities. Examples of TPR can be found in food safety, forestry management, trade, and derivatives, among other fields. More specifically, they concern private actors engaging in transnational coordination of standard setting such as the Forest Stewardship Council (FSC) that was developed to foster responsible management of the world’s forests. There are four main characteristics of TPR: legitimacy, quality, effectiveness, and enforcement. I will describe those four characteristics in brief here. First, the legitimacy of TPR is built around consent through voluntary entry, participation, and exit of regulated entities. Important to this contribution is that the legitimacy of TPR goes beyond its legal dimension, measured by purely legal standards. Hence, the legitimacy of TPR is largely determined by standards developed by social and economic institutions relevant to specific TPR regimes. The role of those institutions in standard settings is higher in private TPR regimes than private-public TPR regimes, where some forms of compliance are mandatory. Second, the quality of TPR corresponds to the ex ante and ex post evaluation cycle of regulatory processes. It is also linked with the transparency of TPR. Third, the effectiveness of TPR is measured according to the extent to which the objectives of TPR (or selected TPR regimes) are met. And finally, enforcement of TPRis understood as ‘ensuring compliance with commitments’. Enforcement of TPR can take place through courts, administrative agencies, and private dispute resolution—including the arbitration at the core of this contribution. Cafaggi’s study identified rather selective use of arbitration in TPR, but also recommended changes to make arbitration law more adaptable to TPR. Furthermore, the study recommended that more specialized dispute resolution institutions are created to exclusively serve TPR. Against this background, I shift the main focus of analysis from TPR to arbitration. Whereas Cafaggi argued that arbitration may be suitable for TPR as a means of private enforcement, in this paper I go even further, arguing that arbitration as a means of informal, out-of-court dispute resolution is well suited to strengthen the normativity of TPR. This is so because private arbitration actors (including, inter alia, arbitrators and arbitral institutions) are already equipped with the tools necessary to facilitate cross-border TPR, which is done through informal standards and procedures with origins in the communitarian values and reputational mechanisms used by different communities before the development of modern States. The roots of most private justice regimes—including arbitration—are informed by communitarian values such as collaboration, participation, and personal trust. Those values, together with other core characteristics of arbitration correspond to all core characteristics of TPR, making both systems comparable and complementary. The analytical framework incorporated in this paper follows the four core characteristics of TPR. Hence, the paper is organized into five sections. The first section contains the introduction. In the second section, I analyze the legitimacy of arbitration vis-à-vis the legitimacy of TPR. In the third section, I investigate the accountability of arbitration as a means of quality signaling vis-à-vis TPR. In the fourth section, I focus on the remedies available to arbitrators in a view of TPR’s effectiveness. Finally, in the fifth section, I analyze enforcement through arbitration and its impact on the exclusiveness versus complementarity of TPR regimes. Conclusions follow, including recommendations for future research. Part of topic "The blurring distinction between public and private in international dispute resolution"

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The application of arbitration in transnational private regulation

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Diversity in arbitration

Calls for greater diversity, especially in relation to the appointment of arbitrators, have been prevalent for some time in the international arbitration community, followed by several initiatives being set up to address the issue. While the primary focus of the diversity debate has been on gender, there have also been calls to expand and diversify the profile of the arbitrator pool to include more non-Western and non-White arbitrators. For several years, scholars and practitioners have argued for countless benefits of increased racial diversity, such as an increased acceptability and legitimacy of the arbitration process. There is a consensus that in a deliberative process like ADR, practitioners should reflect their claimants’ demographics. The existence of diverse panels helps further the aims of meticulous and accurate fact-finding approaches. Similarly, they argue that the lack of racial diversity may directly and negatively affect the quality of arbitration awards. This blog post will focus on the lack of diversity of African arbitrators appointed to resolve international arbitration proceedings, as well as initiatives that are being set up to address such issues. The focus on African ethnicity is given for two reasons: 1) African countries are no strangers to arbitration. Nearly 100 arbitral institutions exist across Africa. 2) There has been an increase of arbitration proceedings emanating from African regions, while there has been a minimal growth in the ethnic diversity of arbitrators appointed to resolve these disputes. This article was originally published on https://commercialarbitrationineurope.wordpress.com/2021/06/29/diversity-in-arbitration-the-lack-of-racial-diversity-in-international-arbitral-tribunals/

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The future of investment arbitration in the light of Opinion 1/17

Alternative dispute resolution (ADR) is constantly gaining ground, both at domestic and international level. New forms of dispute settlement with a mix of public and private components are emerging in fields where this was not the case until recent times, as some contributions to this Zoom-out have attempted to demonstrate. In the field of investment law we have witnessed a somehow opposite trend. Traditionally, disputes in this field have been settled by means of arbitral tribunals established mostly on the basis of bilateral or multilateral investment agreements (IAs) under a variety of arbitration facilities, which are collectively referred to as investor-to-State dispute settlement (ISDS). Traditional ISDS presents many characteristics of ADR, starting from the strong role that private parties play in it (for example when it comes to the appointment of arbitrators). The practice has shown that the system has clear advantages but also undeniable disadvantages. The prevailing opinion in recent years has been that the latter considerably outweigh the former, resulting in what has been termed the backlash against investment arbitration in a volume appeared a few years ago. In this contribution, how-ever, I will not dwell on the details of the crisis that has affected investment arbitration, nor will I engage in a discussion of whether that backlash is entirely justified. My focus will be much more modest. One of the most tangible consequences of this growing dissatisfaction towards investment arbitration is the launch on the part of the EU of a court-like system to settle investment disputes –the now famous investment court system (ICS) –as a replacement to old-fashioned ISDS. The ICS now features in all EU IAs, and has become the standard position of the EU when it comes to dispute settlement in this field. Recently, the ICS has also received the green light of the European Court of Justice (ECJ),raising doubts as to whether traditional ISDS has conclusively been sent to oblivion, at least in the EU. From a political and policy perspective, it is undoubtful that there is a strong stance on the part of the EU and of its Member States against traditional ISDS. This article, however, will focus exclusively on the legal dimension, by examining whether the ECJ’s decision should be read as meaning that investment arbitration is incompatible with the EU legal system. While itis clear that Opinion 1/17 means that the ICS is compatible with EU law, it remains to be seen whether the Court’s finding allows an a contrario reading. Namely, whether it entails the incompatibility with EU law of traditional ISDS. The analysis will start with a brief summary of the events and developments that preceded the creation of the ICS and eventually led to the current situation (Section 2), followed by an examination of the relevant parts of Opinion 1/17 (Section 3). This part will be followed by an appraisal of the possible legal implications of the decision (Section 4). Some conclusions will be offered in the closing section (Section 5) in the attempt to look beyond the boundaries of EU law. Part of topic "The blurring distinction between public and private in international dispute resolution"

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The future of investment arbitration in the light of Opinion 1/17

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Returning to the Origins of Multilevel Regulation

The article engages with the recent studies on multilevel regulation. The starting point for the argument is that contemporary multilevel regulation—as most other studies of (postnational) rulemaking—is limited in its analysis. The limitation concerns its monocentric approach that, in turn, deepens the social illegitimacy of contemporary multilevel regulation. The monocentric approach means that the study of multilevel regulation originates in the discussions on the foundation of modern States instead of returning to the origins of rules before the nation State was even created, which is where the actual social capital underlying (contemporary) rules can be found, or so I wish to argue. My aim in this article is to reframe the debate. I argue that we have an enormous reservoir of history, practices, and ideas ready to help us think through contemporary (social) legitimacy problems in multilevel regulation: namely all those practices which preceded the capture of law by the modern State system, such as historical alternative dispute resolution (ADR) practices.

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Perspectives of nurses' role in interprofessional pharmaceutical care across 14 European countries

Risk reduction in road and rail LPG transportation bij passive fire protection

Een beetje straling, is dat goed voor je?

enhancement of guest experience through technology

The application of arbitration in transnational private regulation

Diversity in arbitration

The future of investment arbitration in the light of Opinion 1/17

Returning to the Origins of Multilevel Regulation

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Perspectives of nurses' role in interprofessional pharmaceutical care across 14 European countries

Risk reduction in road and rail LPG transportation bij passive fire protection

Een beetje straling, is dat goed voor je?

enhancement of guest experience through technology

The application of arbitration in transnational private regulation

Diversity in arbitration

The future of investment arbitration in the light of Opinion 1/17

Returning to the Origins of Multilevel Regulation