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This text provide students with a comprehensive guide to Aboriginal and Torres Strait Islander Australia. The result of extensive research and experience, it offers fresh insights into a range of topics and, most importantly, is written by Aboriginal and Torres Strait Islander academics. It addresses topics ranging from history and reconciliation, to literature and politics, to art, sport and health. It presents social, cultural and political perspectives on these areas in a manner that is accessible to undergraduate students from a range of backgrounds and academic disciplines. Each chapter opens with a precis of the author's journey to engage students and offer them an insight into the author's experiences. These authentic voices encourage students to think about the wider issues surrounding each chapter and their real-life implications. This text emphasises the importance of relationships between non-Indigenous and Aboriginal and Torres Strait Islander cultures

This volume presents the most current theoretical advances in the fields of social marketing and public health communications. The volume is divided in two parts. Part 1 contains chapters pertaining to research and theory reflecting improvements and contributions to theories that help improving quality of life. It includes literature reviews, conceptual research and empirical studies on social marketing communications, models to understand individual's risky behaviors, and how to improve social interventions. The second part emphasizes applied research, consisting of best practices, applied experiments, and case studies on social marketing innovative practices with implications for quality of life.

On 1 July 2019, the Royal Malaysian Customs Department began implementing a long anticipated tax on pre-packaged sugar-sweetened beverages (SSBs). Under the new regulations, all ready-to-drink SSBs that are either imported into or manufactured within Malaysia are subjected to a duty of RM0.40/litre (roughly SGD$0.13 under current exchange rates). Other things being equal, a one-litre sugar-sweetened beverage would therefore cost RM0.40 more from 1 July onwards, while a 250-ml bottle would cost RM0.10 extra. Tax exemptions have been granted to pre-packaged SSBs whose sugar content falls within predefined limits. These caps differ based on the kind of beverage under scrutiny. Just as not all sugars are equal (some being more complex than others), SSBs also vary according to the quality and amount of sugar contained. Sugars in sweetened carbonated drinks, for example, tend to consist solely of added sugars (mainly sucrose and high-fructose corn syrup) whereas flavoured milk and fruit and vegetable juices contain highly variable mixtures of added and 'naturally-occurring' sugars. This paper offers an overview of Malaysia's new sugar tax regime to date. It examines the recent background and context in which the tax surfaced and was passed, before going on to outline various criticisms of the tax. While it is still premature to make any definitive statements regarding the results of the tax on government coffers and public health, this paper will also discuss some likely outcomes stemming from the tax's introduction.

Ziel dieser Studie war es zu erläutern, wie die Lebensgeschichten von Frauen mit chronischer Polyarthritis eingebettet sind und geformt werden von für als selbstverständlich angenommenen Praktiken innerhalb des Gesundheitssystems. Eine Sekundäranalyse der Lebensgeschichten von sechs Frauen mit chronischer Polyarthritis wurde durchgeführt. Die Lebensgeschichten der sechs Frauen waren in der Primärstudie (STAMM et al. 2008) einer Typologie mit dem Namen "chronische Polyarthritis als Quelle für neue Herausforderungen" zugeordnet worden. Die feministische Standpunkttheorie und ausgewählte feministische Philosophien dienten als theoretischer Bezugsrahmen für diese Sekundäranalyse.
In der Analyse wurde deutlich, dass jede der sechs Frauen zumindest an einem Punkt in ihrer Lebensgeschichte begann, die Praktiken innerhalb des Gesundheitssystems und die kognitive Autorität der Medizin zu hinterfragen. Dieses Bewusstsein befähigte die Frauen, dem eigenen Wissen zu vertrauen und selbst Entscheidungen für die eigene Gesundheit zu treffen. Die Ergebnisse der Analyse eröffnen für Professionelle aus dem Gesundheitssystem die Möglichkeit, ihre für selbstverständlich genommenen Praktiken kritisch zu hinterfragen. Durch eine solche kritische Auseinandersetzung und das Bewusstsein, wie diese Praktiken in einem breiteren System eingebettet sind, können möglicherweise zukünftige Rahmenbedingungen initiiert werden, die den Dialog zwischen Patient/innen und Professionellen im Gesundheitssystem fördern.

This study simulates the sector impacts of demand-side perturbations on air transport sectors due to the COVID-19 pandemic, focusing on ASEAN members plus Australia, China, Japan, the Republic of Korea, and New Zealand. This study involves (i) the generation of a multiregional input–output table from the latest Global Trade Analysis Project data, (ii) a network analysis to determine the importance of the air transport industry in each country, (iii) multiplier and linkages analyses, (iv) determinations of sector impacts from demand-side perturbations on air transport sectors due to the COVID-19 pandemic, and (v) simulation of the effect of fiscal and monetary measures to mitigate the pandemic's impact. This study demonstrates that the aviation industry is a key sector in domestic and regional economic activities, and the reduction in air transport consumer demand due to the pandemic is estimated to cause gross domestic product (GDP) reductions from 0.4% to 2.1%. Government intervention, through fiscal and monetary policies, has, however, mitigated severe impact, moderating GDP and value-added losses. Thus, a viable policy prescription for the aviation industry is of utmost importance.

The Kamagayan Comprehensive Care Center (KC3) clients report being very satisfied with the comprehensive package of health services offered under the BCP and they feel welcome and accepted at the KC3. Community members in Kamagayan, including family members of the KC3 clients, also praise the service as an excellent intervention. Virtually all key stakeholders interviewed noted that the KC3 team had performed especially well in building trust between clients and their health service providers, families, and community. In that sense, community-based advocacy efforts were successful at generating an enabling environment for service delivery. The KC3 clients, family members, and community representatives also appreciated efforts from the KC3 team to promote demand reduction through counseling, Narcotics Anonymous (NA) sessions, and privileged access to the Argao Treatment and Rehabilitation Center (TRC). There is great demand and genuine interest among the KC3 clients and patients' clients to become peer educators and provide support to PWID. The professionalization of PWID through peer educator roles has also reportedly reduced stigma and discrimination and increased acceptance of PWID in the community. Should services for PWID be scaled up in Cebu and beyond, recruiting a workforce of peer educators should not be a critical challenge, an important lesson learned for future harm reduction projects in the Philippines.

Salmonella enterica serovar Infantis (Salmonella Infantis) is consistently isolated from broiler chickens, pigs, and humans worldwide. This study investigated 93 epidemiologically unrelated Salmonella Infantis strains isolated in Germany between 2005 and 2008 in respect to their transmission along the food chain. Various phenotypic and genotypic methods were applied, and the pathogenicity and resistance gene repertoire was determined. Phenotypically, 66% of the strains were susceptible to all 17 antimicrobials tested, while the others were almost all multidrug-resistant (two or more antimicrobial resistances), with different resistance profiles and preferentially isolated from broiler chickens. A number of phage types (PTs) were shared by strains from pigs, broiler chickens, and humans (predominated by PT 29). One, PT 1, was only detected in strains from pigs/pork and humans. Pulsed-field gel electrophoresis (PFGE) subdivided strains in seven different clusters, named A-G, consisting of 35 various XbaI profiles with coefficient of similarity values of 0.73-0.97. The majority of XbaI profiles were assigned to clusters A and C, and two predominant XbaI profiles were common in strains isolated from all sources investigated. Multi-locus sequence typing (MLST) analysis of selected strains representing the seven PFGE clusters revealed that they all belonged to ST32. The pathogenicity gene repertoire of 37 representative Salmonella Infantis strains analyzed by microarray was also identical. The resistance gene repertoire correlated perfectly with the phenotypic antimicrobial resistance profiles, and multidrug-resistant strains were associated with class 1 integrons. Overall, this study showed that two major closely related genotypes of Salmonella Infantis can transmit in Germany to humans through contaminated broiler meat or pork, and consequently presents a hazard for human health. -® Copyright 2012, Mary Ann Liebert, Inc. 2012

Ali Abbas (" From the Editors… ") is an associate professor in the Department of Industrial and Enterprise Systems Engineering at the University of Illinois at Urbana–Champaign. He received an M.S. in electrical engineering (1998), an M.S. in engineering economic systems and operations research (2001), a Ph.D. in management science and engineering (2003), and a Ph.D. (minor) in electrical engineering, all from Stanford University. He worked as a lecturer in the Department of Management Science and Engineering at Stanford and worked in Schlumberger Oilfield Services from 1991 to 1997, where he held several international positions in wireline logging, operations management, and international training. He has also worked on several consulting projects for mergers and acquisitions in California, and cotaught several executive seminars on decision analysis at Strategic Decisions Group in Menlo Park, California. His research interests include utility theory, decision making with incomplete information and preferences, dynamic programming, and information theory. Dr. Abbas is a senior member of the Institute of Electrical and Electronic Engineers (IEEE) and a member of the Institute for Operations Research and the Management Sciences (INFORMS). He is also an associate editor for Decision Analysis and Operations Research and coeditor of the DA column in education for Decision Analysis Today. Address: Department of Industrial and Enterprise Systems Engineering, College of Engineering, University of Illinois at Urbana–Champaign, 117 Transportation Building, MC-238, 104 South Mathews Avenue, Urbana, IL 61801; e-mail: aliabbas@uiuc.edu . Matthew D. Bailey (" Eliciting Patients' Revealed Preferences: An Inverse Markov Decision Process Approach ") is an assistant professor of business analytics and operations in the School of Management at Bucknell University, and he is an adjunct research investigator with Geisinger Health System. He received his Ph.D. in industrial and operations engineering from the University of Michigan. His primary research interest is in sequential decision making under uncertainty with applications to health-care operations and medical decision making. He is a member of the Institute for Operations Research and the Management Sciences (INFORMS) and the Institute of Industrial Engineers (IIE). Address: School of Management, Bucknell University, 308 Taylor Hall, Lewisburg, PA 17837; e-mail: matt.bailey@bucknell.edu . Anthony M. Barrett (" Cost Effectiveness of On-Site Chlorine Generation for Chlorine Truck Attack Prevention ") is a risk analyst at ABS Consulting in Arlington, Virginia. He holds a Ph.D. in engineering and public policy from Carnegie Mellon University, and he also was a postdoctoral research associate at the Homeland Security Center for Risk and Economic Analysis of Terrorism Events (CREATE) at the University of Southern California. His research interests include risk analysis, risk management, and public policies in a wide variety of areas, including terrorism, hazardous materials, energy and the environment, and natural hazards. Address: ABS Consulting, 1525 Wilson Boulevard, Suite 625, Arlington, VA 22209; e-mail: abarrett@absconsulting.com . Manel Baucells (" From the Editors… ") is a full professor at the Department of Economics and Business of Universitat Pompeu Fabra, Barcelona. He was an associate professor and head of the Managerial Decision Sciences Department at IESE Business School. He earned his Ph.D. in management from the University of California, Los Angeles (UCLA) and holds a degree in mechanical engineering from Polytechnic University of Catalonia (UPC). His research and consulting activities cover multiple areas of decision making including group decisions, consumer decisions, uncertainty, complexity, and psychology. He acts as associate editor for the top journals Management Science, Operations Research, and Decision Analysis. He has received various prizes and grants for his research. In 2001, he won the student paper competition of the Decision Analysis Society. He is the only IESE professor having won both the Excellence Research Award and the Excellence Teaching Award. He has been visiting professor at Duke University, UCLA, London Business School, and Erasmus University. Address: Universitat Pompeu Fabra, Ramon Trias Fargas 25-27, 08005 Barcelona, Spain; e-mail: manel.baucells@upf.edu . J. Eric Bickel (" Scoring Rules and Decision Analysis Education ") is an assistant professor in both the Operations Research/Industrial Engineering Group (Department of Mechanical Engineering) and the Department of Petroleum and Geosystems Engineering at the University of Texas at Austin. In addition, Professor Bickel is a fellow in both the Center for International Energy and Environmental Policy and the Center for Petroleum Asset Risk Management. He holds an M.S. and Ph.D. from the Department of Engineering-Economic Systems at Stanford University and a B.S. in mechanical engineering with a minor in economics from New Mexico State University. His research interests include the theory and practice of decision analysis and its application in the energy and climate-change arenas. His research has addressed the modeling of probabilistic dependence, value of information, scoring rules, calibration, risk preference, education, decision making in sports, and climate engineering as a response to climate change. Prior to joining the University of Texas at Austin, Professor Bickel was an assistant professor at Texas A&M University and a senior engagement manager for Strategic Decisions Group. He has consulted around the world in a range of industries, including oil and gas, electricity generation/transmission/delivery, energy trading and marketing, commodity and specialty chemicals, life sciences, financial services, and metals and mining. Address: Graduate Program in Operations Research, The University of Texas at Austin, 1 University Station, C2200, Austin, TX 78712-0292; e-mail: ebickel@mail.utexas.edu . Vicki M. Bier (" From the Editors… ") holds a joint appointment as a professor in the Department of Industrial and Systems Engineering and the Department of Engineering Physics at the University of Wisconsin–Madison, where she has directed the Center for Human Performance and Risk Analysis (formerly the Center for Human Performance in Complex Systems) since 1995. She has more than 20 years of experience in risk analysis for the nuclear power, chemical, petrochemical, and aerospace industries. Before returning to academia, she spent seven years as a consultant at Pickard, Lowe and Garrick, Inc. While there, her clients included the U.S. Nuclear Regulatory Commission, the U.S. Department of Energy, and a number of nuclear utilities, and she prepared testimony for Atomic Safety and Licensing Board hearings on the safety of the Indian Point nuclear power plants. Dr. Bier's current research focuses on applications of risk analysis and related methods to problems of security and critical infrastructure protection, under support from the Department of Homeland Security. Dr. Bier received the Women's Achievement Award from the American Nuclear Society in 1993, and was elected a Fellow of the Society for Risk Analysis in 1996, from which she received the Distinguished Achievement Award in 2007. She has written a number of papers and book chapters related to uncertainty analysis and decision making under uncertainty, and is the author of two scholarly review articles on risk communication. She served as the engineering editor for Risk Analysis from 1997 through 2001, and has served as a councilor of both the Society for Risk Analysis and the Decision Analysis Society, for which she is currently vice president and president elect. Dr. Bier has also served as a member of both the Radiation Advisory Committee and the Homeland Security Advisory Committee of the U.S. Environmental Protection Agency's Science Advisory Board. Address: Department of Industrial and Systems Engineering, University of Wisconsin–Madison, 1513 University Avenue, Madison, WI 53706; e-mail: bier@engr.wisc.edu . Samuel E. Bodily (" Darden's Luckiest Student: Lessons from a High-Stakes Risk Experiment ") is the John Tyler Professor of Business Administration at the University of Virginia's Darden School of Business and has published textbooks and more than 40 articles in journals ranging from Harvard Business Review to Management Science. His publications relate to decision and risk analysis, forecasting, strategy modeling, revenue management, and eStrategy. He has edited special issues of Interfaces on decision and risk analysis and strategy modeling and analysis. Professor Bodily has published well over 100 cases, including a couple of the 10 best-selling cases at Darden. He received the Distinguished Casewriter Wachovia Award from Darden in 2005 and three other best case or research Wachovia awards. He is faculty leader for an executive program on Strategic Thinking and Action. He is the course head of, and teaches in, a highly valued first-year MBA course in decision analysis, has a successful second-year elective on Management Decision Models, and has taught eStrategy and Strategy. He is a past winner of the Decision Sciences International Instructional Award and has served as chair of the INFORMS Decision Analysis Society. He has taught numerous executive education programs for Darden and private companies, has consulted widely for business and government entities, and has served as an expert witness. Professor Bodily was on the faculties of MIT Sloan School of Management and Boston University and has been a visiting professor at INSEAD Singapore, Stanford University, and the University of Washington. He has a Ph.D. degree and an S.M. degree from the Massachusetts Institute of Technology and a B.S. degree in physics from Brigham Young University. Address: Darden School of Business, 100 Darden Boulevard, Charlottesville, VA 22903; e-mail: bodilys@virginia.edu . David Budescu (" From the Editors… ") is the Anne Anastasi Professor of Psychometrics and Quantitative Psychology at Fordham University. He held positions at the University of Illinois and the University of Haifa, and visiting positions at Carnegie Mellon University, University of Gotheborg, the Kellog School at Northwestern University, the Hebrew University, and the Israel Institute of Technology (Technion). His research is in the areas of human judgment, individual and group decision making under uncertainty and with incomplete and vague information, and statistics for the behavioral and social sciences. He is or was on the editorial boards of Applied Psychological Measurement; Decision Analysis; Journal of Behavioral Decision Making; Journal of Mathematical Psychology; Journal of Experimental Psychology: Learning, Memory and Cognition (2000–2003); Multivariate Behavioral Research; Organizational Behavior and Human Decision Processes (1992–2002); and Psychological Methods (1996–2000). He is past president of the Society for Judgment and Decision Making (2000–2001), fellow of the Association for Psychological Science, and an elected member of the Society of Multivariate Experimental Psychologists. Address: Department of Psychology, Fordham University, Bronx, New York, NY 10458; e-mail: budescu@fordham.edu . John C. Butler (" From the Editors… ") is a clinical associate professor of finance and the academic director of the Energy Management and Innovation Center in the McCombs School of Business at the University of Texas at Austin, and the secretary/treasurer of the INFORMS Decision Analysis Society. Butler received his Ph.D. in management science and information systems from the University of Texas in 1998. His research interests involve the use of decision science models to support decision making, with a particular emphasis on decision and risk analysis models with multiple performance criteria. Butler has consulted with a number of organizations regarding the application of decision analysis tools to a variety of practical problems. Most of his consulting projects involve use of Visual Basic for Applications and Excel to implement complex decision science models in a user-friendly format. Address: Center for Energy Management and Innovation, McCombs School of Business, The University of Texas at Austin, Austin, TX 78712-1178; e-mail: john.butler2@mccombs.utexas.edu . Philippe Delquié (" From the Editors… ") is an associate professor of decision sciences at the George Washington University and holds a Ph.D. from the Massachusetts Institute of Technology. Professor Delquié's teaching and research are in decision, risk, and multicriteria analysis. His work focuses on the interplay of behavioral and normative theories of choice, with the aim of improving managerial decision making and risk taking. His research addresses issues in preference assessment, value of information, nonexpected utility models of choice under risk, and risk measures. Prior to joining the George Washington University, he held academic appointments at INSEAD, the University of Texas at Austin, and École Normale Supérieure, France, and visiting appointments at Duke University's Fuqua School of Business. Address: Department of Decision Sciences, George Washington University, Funger Hall, Suite 415, Washington, DC 20052; e-mail: delquie@gwu.edu . Zeynep Erkin (" Eliciting Patients' Revealed Preferences: An Inverse Markov Decision Process Approach ") is a Ph.D. candidate in the Department of Industrial Engineering at the University of Pittsburgh. She received her M.S. and B.S. degrees in industrial engineering from the University of Pittsburgh and Middle East Technical University, Turkey, in 2008 and 2006, respectively. Her research interests include maintenance optimization and medical decision making. Address: Department of Industrial Engineering, University of Pittsburgh, 3600 O'Hara Street, Pittsburgh, PA 15261; e-mail: zee2@pitt.edu . Peter I. Frazier (" Paradoxes in Learning and the Marginal Value of Information ") is an assistant professor in the School of Operations Research and Information Engineering at Cornell University. He received a Ph.D. in operations research and financial engineering from Princeton University in 2009. His research interest is in the optimal acquisition of information, with applications in simulation, medicine, operations management, neuroscience, and information retrieval. He teaches courses in simulation and statistics. Address: School of Operations Research and Information Engineering, Cornell University, Ithaca, NY 14853; e-mail: pf98@cornell.edu . L. Robin Keller (" From the Editors… ") is a professor of operations and decision technologies in the Merage School of Business at the University of California, Irvine. She received her Ph.D. and M.B.A. in management science and her B.A. in mathematics from the University of California, Los Angeles. She has served as a program director for the Decision, Risk, and Management Science Program of the U.S. National Science Foundation (NSF). Her research is on decision analysis and risk analysis for business and policy decisions and has been funded by NSF and the U.S. Environmental Protection Agency. Her research interests cover multiple-attribute decision making, riskiness, fairness, probability judgments, ambiguity of probabilities or outcomes, risk analysis (for terrorism, environmental, health, and safety risks), time preferences, problem structuring, cross-cultural decisions, and medical decision making. She is currently Editor-in-Chief of Decision Analysis, published by the Institute for Operations Research and the Management Sciences (INFORMS). She is a Fellow of INFORMS and has held numerous roles in INFORMS, including board member and chair of the INFORMS Decision Analysis Society. She is a recipient of the George F. Kimball Medal from INFORMS. She has served as the decision analyst on three National Academy of Sciences committees. Address: The Paul Merage School of Business, University of California, Irvine, Irvine, CA 92697-3125; e-mail: lrkeller@uci.edu . Lisa M. Maillart (" Eliciting Patients' Revealed Preferences: An Inverse Markov Decision Process Approach ") is an associate professor in the Industrial Engineering Department at the University of Pittsburgh. Prior to joining the faculty at the University of Pittsburgh, she served on the faculty of the Department of Operations in the Weatherhead School of Management at Case Western Reserve University. She received her M.S. and B.S. in industrial and systems engineering from Virginia Tech, and her Ph.D. in industrial and operations engineering from the University of Michigan. Her primary research interest is in sequential decision making under uncertainty, with applications in medical decision making and maintenance optimization. She is a member of the Institute for Operations Research and the Management Sciences (INFORMS), the Society of Medical Decision Making (SMDM), and the Institute of Industrial Engineers (IIE). Address: Department of Industrial Engineering, University of Pittsburgh, 3600 O'Hara Street, Pittsburgh, PA 15261; e-mail: maillart@pitt.edu . Jason R. W. Merrick (" From the Editors… ") is an associate professor in the Department of Statistical Sciences and Operations Research at Virginia Commonwealth University. He has a D.Sc. in operations research from the George Washington University. He teaches courses in decision analysis, risk analysis, and simulation. His research is primarily in the area of decision analysis and Bayesian statistics. He has worked on projects ranging from assessing maritime oil transportation and ferry system safety, the environmental health of watersheds, and optimal replacement policies for rail tracks and machine tools, and he has received grants from the National Science Foundation, the Federal Aviation Administration, the United States Coast Guard, the American Bureau of Shipping, British Petroleum, and Booz Allen Hamilton, among others. He has also performed training for Infineon Technologies, Wyeth Pharmaceuticals, and Capital One Services. He is an associate editor for Decision Analysis and Operations Research. He is the information officer for the Decision Analysis Society. Address: Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, Richmond, VA 23284; e-mail: jrmerric@vcu.edu . Phillip E. Pfeifer (" Darden's Luckiest Student: Lessons from a High-Stakes Risk Experiment ") is the Richard S. Reynolds Professor of Business at the University of Virginia's Darden School of Business, where he teaches courses in decision analysis and direct marketing. A graduate of Lehigh University and the Georgia Institute of Technology, his teaching has won student awards and has been recognized in Business Week's Guide to the Best Business Schools. He is an active researcher in the areas of decision making and direct marketing, and he currently serves on the editorial review board of the Journal of Interactive Marketing, which named him their best reviewer of 2008. In 2004 he was recognized as the Darden School's faculty leader in terms of external case sales, and in 2006 he coauthored a managerial book, Marketing Metrics: 50+ Metrics Every Executive Should Master, published by Wharton School Publishing, which was named best marketing book of the year by Strategy + Business. Address: Darden School of Business; 100 Darden Boulevard; Charlottesville, VA 22903; e-mail: pfeiferp@virginia.edu . Warren B. Powell (" Paradoxes in Learning and the Marginal Value of Information ") is a professor in the Department of Operations Research and Financial Engineering at Princeton University, where he has taught since 1981. He is the director of CASTLE Laboratory (Princeton University), which specializes in the development of stochastic optimization models and algorithms with applications in transportation and logistics, energy, health, and finance. The author or coauthor of more than 160 refereed publications, he is an INFORMS Fellow, and the author of Approximate Dynamic Programming: Solving the Curses of Dimensionality, published by John Wiley and Sons. His primary research interests are in approximate dynamic programming for high-dimensional applications and optimal learning (the efficient collection of information), and their application in energy systems analysis and transportation. He is a recipient of the Wagner prize and has twice been a finalist in the Edelman competition. He has also served in a variety of editorial and administrative positions for INFORMS, including INFORMS Board of Directors, area editor for Operations Research, president of the Transportation Science Section, and numerous prize and administrative committees. Address: Department of Operations Research and Financial Engineering, Princeton University, Princeton, NJ 08544; e-mail: powell@princeton.edu . Mark S. Roberts (" Eliciting Patients' Revealed Preferences: An Inverse Markov Decision Process Approach "), M.D., M.P.P., is professor and chair of health policy and management, and he holds secondary appointments in medicine, industrial engineering, and clinical and translational science. A practicing general internist, he has conducted research in decision analysis and the mathematical modeling of disease for more than 25 years, and he has expertise in cost effectiveness analysis, mathematical optimization and simulation, and the measurement and inclusion of patient preferences into decision problems. He has used decision analysis to examine clinical, costs, policy and allocation questions in liver transplantation, vaccination strategies, operative interventions, and the use of many medications. His recent research has concentrated in the use of mathematical methods from operations research and management science, including Markov decision processes, discrete-event simulation, and integer programming, to problems in health care. Address: Department of Health Policy and Management, University of Pittsburgh, Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261; e-mail: robertsm@upmc.edu . Ahti Salo (" From the Editors… ") is a professor of systems analysis at the Systems Analysis Laboratory of Aalto University. His research interests include topics in portfolio decision analysis, multicriteria decision making, risk management, efficiency analysis, and technology foresight. He is currently president of the Finnish Operations Research Society (FORS) and represents Europe and the Middle East in the INFORMS International Activities Committee. Professor Salo has been responsible for the methodological design and implementation of numerous high-impact decision and policy processes, including FinnSight 2015, the national foresight exercise of the Academy of Finland and the National Funding Agency for Technology and Innovations (Tekes). Address: Aalto University, Systems Analysis Laboratory, P.O. Box 11100, 00076 Aalto, Finland; e-mail: ahti.salo@tkk.fi . Andrew J. Schaefer (" Eliciting Patients' Revealed Preferences: An Inverse Markov Decision Process Approach ") is an associate professor of industrial engineering and Wellington C. Carl Fellow at the University of Pittsburgh. He has courtesy appointments in bioengineering, medicine, and clinical and translational science. He received his Ph.D. in industrial and systems engineering from Georgia Tech in 2000. His research interests include the application of stochastic optimization methods to health-care problems, as well as stochastic optimization techniques, in particular, stochastic integer programming. He is interested in patient-oriented decision making in contexts such as end-stage liver disease, HIV/AIDS, sepsis, and diabetes. He also models health-care systems, including operating rooms and intensive-care units. He is an associate editor for INFORMS Journal on Computing and IIE Transactions. Address: Department of Industrial Engineering, University of Pittsburgh, 3600 O'Hara Street, Pittsburgh, PA 15261; e-mail: Schaefer@pitt.edu . George Wu (" From the Editors… ") has been on the faculty of the University of Chicago Booth School of Business since September 1997. His degrees include A.B. (applied mathematics, 1985), S.M. (applied mathematics, 1987), and Ph.D. (decision sciences, 1991), all from Harvard University. Prior to joining the faculty at the University of Chicago, Professor Wu was on the faculty at Harvard Business School. Wu worked as a decision analyst at Procter & Gamble prior to starting graduate school. His research interests include descriptive and prescriptive aspects of decision making, in particular, decision making involving risk, cognitive biases in bargaining and negotiation, and managerial and organizational decision making. Professor Wu is a coordinating editor for Theory and Decision, an advisory editor for Journal of Risk and Uncertainty, on the editorial boards of Decision Analysis and Journal of Behavioral Decision Making, and a former department editor of Management Science. Address: Booth School of Business, University of Chicago, 5807 South Woodlawn Avenue, Chicago, IL 60637; e-mail: wu@chicagobooth.edu .

Part one of an interview with Matilda Koeller. Topics include: Why her parents left Germany and came to the U.S. Her father's work as a barber. How her parents met and were married. Her parents had 13 children, only ten survived to adulthood. Her ear troubles as a result from having scarlet fever as a child. When her parents got a house with a bathroom for the first time. Her work making coffee for teachers at school. ; 1 MATILDA KOELLER: Parents made children go to work and help support the family. My mother, uh, after she was born, her dad – DONALD KOELLER: Before you come back to your mother, let's. why did, why did, uh, your father. that was the [Sigwart] family. MATILDA KOELLER: Uh, no. My father was the Sigwart family. DONALD KOELLER: Why did they leave Germany? Why did they come to America and to Fitchburg? Do you know? MATILDA KOELLER: Well, I never found, really found out why my father's, uh, parents moved to Germany, except I suppose to make a better living. DONALD KOELLER: And in Fitchburg he then was a shoemaker? MATILDA KOELLER: Uh, yes. He had his own, uh, establishment or [unintelligible - 00:00:48]. We don't know much about Dad except that, uh, he had to help, uh, with the shoemaking business. DONALD KOELLER: Is that a shoemaking or shoe repair? MATILDA KOELLER: No, the shoemaking. DONALD KOELLER: And did. that would be your grandfather, did he die in Fitchburg or did he move.? MATILDA KOELLER: No. Grandpa Sigwart was buried and, um, um. I can't remember any Catholic cemetery in Chicago. But his mother was buried in Concordia, uh, Cemetery in River Park, a suburb of Chicago. DONALD KOELLER: What was her maiden name? MATILDA KOELLER: Her name. well, really her name is on the recording in paper that I sent each of the boys. DONALD KOELLER: You can't remember it now? MATILDA KOELLER: I can't remember her name, no. DONALD KOELLER: What was. your dad's name was Jacob. MATILDA KOELLER: Jacob. Yeah. DONALD KOELLER: His father's name was? 2 MATILDA KOELLER: Um. now, that's another thing I can't remember. But there. his, his mother. there was some. uh, or somebody was made a-a widow or a widower and his, um, mother remarried or it must have been his father because they all carried the name of Sigwart because Louis and [Pink] were his stepsister and brother. DONALD KOELLER: Did this whole family live in Fitchburg and then moved west? MATILDA KOELLER: Well, they were. the whole family moved to Chicago. DONALD KOELLER: Do you know. when was that? Do you know? MATILDA KOELLER: Well, it must have been when Dad was 20 years old because that's when he met my mother and [unintelligible - 00:03:16]. DONALD KOELLER: And they courted here in Chicago? MATILDA KOELLER: And they courted here in Chicago and were married. DONALD KOELLER: Tell me about. you said your grandfather. I mean, your father, Jacob Sigwart, he did not have much of an education. MATILDA KOELLER: He had no education. In fact, when his oldest daughter was going to school, which was Lily Anne, they wanted him to study along with his oldest daughter but he was ashamed to know that he couldn't read or write. DONALD KOELLER: What did he do for a living? MATILDA KOELLER: He became a barber. DONALD KOELLER: Did he have any – I mean, was he a barber all his life? MATILDA KOELLER: Yeah, he was a barber. When he came to Chicago, he evidently went to barber school and learned the trade of being barber because that way he didn't have to have any kind of an education. And I know that I asked my mother, "Mother, how come that you married Dad when he couldn't read or write? You know, after all, you had a great education." And she said he used to take the newspaper and he would look and like probably pretend he could read but must have looked at just a picture and got an idea what was going on through the 3 conversations of the customers that came in to have their hair cut. And at those days, the barbers had a bathtub so that the men come in and took a bath because those days they didn't have no bathtubs. DONALD KOELLER: At home? MATILDA KOELLER: At home. And they would come in for a shave and a haircut and a bath. DONALD KOELLER: Did he speak German? MATILDA KOELLER: Yeah. Mother and Dad didn't. they always knew how to talk German but they never talked German at home because my mother worked for a wealthy family when she came to Chicago when she was 14 years old. And he came to work for some wealthy family which I. if I remember correctly was the [unintelligible - 00:05:51] family. And they would not let her talk German. They said, "You come to America. Now, talk English." DONALD KOELLER: You say your mother came to Chicago when she was 14? MATILDA KOELLER: Fourteen, after she graduated and was confirmed because there was no work for a farmer's daughter in a small town. DONALD KOELLER: [Unintelligible - 00:06:15]. MATILDA KOELLER: No, they had moved them. By that time, they had moved to Loganville, Wisconsin, and they got this farm, 160 acres, from the government if they would work it. So the farm was theirs after a certain amount of years. DONALD KOELLER: How many brothers and sisters did you have? MATILDA KOELLER: Anna. there were 12 in the family, and mother. Anna was the second from the oldest. DONALD KOELLER: So the homestead then was Loganville. MATILDA KOELLER: Was Loganville. DONALD KOELLER: [Unintelligible - 00:06:57]. 4 MATILDA KOELLER: Yeah. It's still [unintelligible - 00:06:59] when they. when he gave up farming. When he was I think 72 years old, they sold the farm. DONALD KOELLER: But the family is still in the Loganville area? MATILDA KOELLER: But the family. yeah, the family all dispersed, you know, close by except the oldest son who went to Fargo, North Dakota. DONALD KOELLER: Anna came to Chicago. MATILDA KOELLER: To Chicago. And then when. DONALD KOELLER: She went to the [Fitchburg] home as a live-in maid. MATILDA KOELLER: Yeah, as a live-in – I'm almost sure as a live-in maid. That I cannot say for sure. DONALD KOELLER: Is that where she learned to be a seamstress? MATILDA KOELLER: Well, she must have learned it at home, because being the oldest daughter in the family and so many children that followed, they choose to make their underwear like bloomers and they wore what they called garter belt. It was just a form over their top and then the garters were fastened to hold up their stockings. In those days, they wore nothing but black stockings. So she used to send made clothes and send home money. And then when Bertha, who was the second oldest daughter, when she graduated and was confirmed, she came to Chicago also. And now, I don't know just what Anne's purpose is, but they were both good teachers. DONALD KOELLER: Let's see. When she was 14, I would have been about a year. MATILDA KOELLER: Well, the dates are all on there. DONALD KOELLER: You have that on there. MATILDA KOELLER: Yeah. Well, I've got their dates of birth and the date of their deaths, but when they moved to Chicago, you would have to figure that out, 14 years. Because they went to a one-room 5 schoolhouse, which was connected with the church, the minister was the teacher and their minister. DONALD KOELLER: This is in Loganville? MATILDA KOELLER: This is in Loganville. DONALD KOELLER: Tell me a little bit about the Sigwart and [Forrest] family relationship with the church? MATILDA KOELLER: Well, Dad Sigwart was originally a Catholic but when he married my mother, Anna, Dad said, "You're with the children all the time. You bring them up Lutheran." And that's how we all became Lutherans. And then when Dad was about 50 years old, he got blood poisoning in a finger and I guess in order to save his arm, they amputated his finger. And I remember him walking, pacing the floor and crying, just thinking he could not earn a living anymore because he's losing his main finger that he would use with the scissors. But eventually, he practiced so much that he went back into the barber business and opened his own shop because he was past 45 and they wouldn't hire anymore old men. And that's how Dad opened his own business. And when he made it good at the barber shop, then always somebody else would come along and make a barber shop which may be a block or block and a half away and, of course, then the people would go there and there was not enough trade for two barbers, so he would move to find another good spot. And that happened to him twice that I remember. DONALD KOELLER: Did the family move then also? MATILDA KOELLER: No, the family. he had a business a half a block away from where we lived. So he could come home for dinner. And then I remember one place that he had opened that was just maybe around the corner, a block, you know, maybe a block and a half. 6 DONALD KOELLER: Let's go back then. let's talk about when Jacob Sigwart and Anna [Forrest] met. How did they meet and how did their courtship go? MATILDA KOELLER: Well, I don't know where they met but I suppose, you know. I don't know how they met but I often asked. you know, I said to Dad one time, "Why did you marry mother?" And he said, "Because she was so beautiful." She was a beautiful person and had lovely hair and rosy cheeks. DONALD KOELLER: Did they court long or. do you know anything about their courtship? MATILDA KOELLER: I really don't know how long they courted. DONALD KOELLER: And they were married in a Lutheran church in Chicago. MATILDA KOELLER: Yeah. They were married. at that time, all the Germans flocked in this one neighborhood. DONALD KOELLER: Where was that? MATILDA KOELLER: And that was what they called. Goose Island is where Mother and Dad must have met. Of course now, Goose Island is all factories, all of it. DONALD KOELLER: Except for along the eastern part of the river. [Unintelligible - 00:13:30] MATILDA KOELLER: Yeah. Yeah. And then they were. the church was First Bethlehem which was located on Paulina and Hoyne, which was not too far from Goose Island. And all the German people flocked in that neighborhood and went to church there and were married. DONALD KOELLER: The First Bethlehem couldn't have been Paulina and Hoyne. MATILDA KOELLER: Paulina and. well, it's on Paulina. DONALD KOELLER: Farther north, somewhere there. MATILDA KOELLER: Let's see now. Paulina is one way. LeMoyne maybe – DONALD KOELLER: Lemoyne. That must've been the one. MATILDA KOELLER: Yeah, LeMoyne. 7 DONALD KOELLER: LeMoyne and Paulina run parallel. MATILDA KOELLER: Yeah. There is where the Koellers were married. The Koellers, the Walters, you know. My husband. well, let's see what I think. Grandpa, Frederick Koeller, and Clara were married in the same church because they came over. DONALD KOELLER: We'll get that side of the family a little later. Do you remember your mother and father ever talking about the wedding in the church or the reception or what kind of wedding they had? MATILDA KOELLER: No, they. my mother was married in brown. I don't know whether she made her own dress which I imagine she did. She had a white veil and you have a picture of that, too. I sent that to you. DONALD KOELLER: Well, that's going to be fun, to put pictures and your records thing together with this. MATILDA KOELLER: Yeah. Oh, they were married. Now, whether they had any kind. I don't imagine they had any kind of a reception because those days they probably just went to church because most everybody's gotten married in church in those days. DONALD KOELLER: But at the time, was Anna living. where was Anna living prior to when she was married to your father? MATILDA KOELLER: You know, I never. you know, that part I never asked Mother, only that she worked with these wealthy people and every Friday was silver day. They spent all day Friday cleaning silverware so you know they were wealthy people. But I suppose they didn't get much pay either. DONALD KOELLER: Do you know where they lived or what their circumstances once they got married? MATILDA KOELLER: Well, once they got married, I really don't know where they lived but I knew that when I was 4 or 5 years old, we lived close to First Bethlehem and the street names are all changed. 8 But Aunt Lil knows the address of the house and it's still standing, 800 or something. DONALD KOELLER: So they got married. How long was it before they started a family? MATILDA KOELLER: Within a year. DONALD KOELLER: And that was Lily Anne. MATILDA KOELLER: That was Lily Anne. Lily Anne was the oldest, yeah. DONALD KOELLER: And then altogether there were 10? MATILDA KOELLER: Ten living children, three died before they were married. So mother had 13 children altogether. DONALD KOELLER: And you were number.? MATILDA KOELLER: I think I was number six or seven. I was in the middle. DONALD KOELLER: Tell me now what you can remember about a couple of things about your childhood? MATILDA KOELLER: Well, when I was two and a half, Grandma Forrest came to Chicago because there was an outbreak of hysteria or scarlet fever and oranges were very, very scarce. And mother always talked about Ruth being delirious and crawling under the bed looking for an orange because that seems to be one of the remedies. or not remedy but was something new. Oranges were something new at that time. And I was two and a half years old and I had it so bad that they carried me around in a pillow and I didn't eat for a whole month. And from the medicine, I got scars on my lips and Grandma Forrest prayed that I would die because I was so sick that there was nothing to me. I lost all my hair but some of my. DONALD KOELLER: The doctors couldn't do anything? MATILDA KOELLER: Well. DONALD KOELLER: What kind of doctoring was there? That would have been 1923, 1924? 9 MATILDA KOELLER: Well, there wasn't enough doctoring. They quarantined you. They couldn't even get a nurse and people wouldn't go near. DONALD KOELLER: Your Dad couldn't come home? [Unintelligible - 00:19:32] MATILDA KOELLER: No. And I think that Dad probably stayed home and took care or helped take care of us because there were five of us, I think. There was little Henry, and Ruth was very bad, and I was bad as well, and Margaret. So evidently, dad must have stayed home, had to stay home to take care because we were quarantined. You couldn't get anybody to come near us. DONALD KOELLER: Grandma Forrest came down to Loganville to help out. MATILDA KOELLER: Yeah. She came down to help us. DONALD KOELLER: That must have been very difficult. MATILDA KOELLER: Yeah. It was. and there were a lot of people that died because they didn't have no antibiotics then. DONALD KOELLER: Do you ever remember going to the doctor's office? [Unintelligible - 00:20:33] MATILDA KOELLER: Oh, yes, plenty, [laughs] plenty for my ear. From the scarlet fever, I got trouble with my ear. DONALD KOELLER: Do you want some coffee? MATILDA KOELLER: Yeah, we might just as well have the rest of the coffee. DONALD KOELLER: Go ahead. MATILDA KOELLER: Well, I had a running ear from the scarlet fever and of course the parents being poor, Dad only making $7 a week. well, I got coffee in there… yeah, just the water. The doctors would…so I went to a clinic, to an eye, ear, nose, and throat clinic. On Wednesday, Dad didn't work. That was his day off, and he would take me to this clinic. The clinic didn't seem – I don't remember too much about it, except squirting a lot of water in my ear to clear out the decaying bone that was forming. But when I was 23 years old, I got hold of an ear specialist and he said, "Absolutely no water," and he used this 10 x-ray in my ear for less than a minute to see, I think only two times. And with the medicine that he had, cleared up this running ear, which in my whole 20… in my years, I had syringed it and I was doing more harm to it than good. And, of course, time came in with medicine and dried out the decayed bone that was pretty well gone. DONALD KOELLER: The doctor just kept draining and. MATILDA KOELLER: Draining and. DONALD KOELLER: In all your teenage years. MATILDA KOELLER: And it had a terrible odor that before I had a date with a fellow, that was the very last thing I would do, was syringe it to clear it out, but before the evening [was], it was drippy, draining on me. It was terrible. DONALD KOELLER: [Unintelligible - 00:23:46]. MATILDA KOELLER: Yeah. It was really something, you know. DONALD KOELLER: Where did you go to school? MATILDA KOELLER: I went to. first, I went to [Perse] School near the church, near Paulina and I went. I was in first grade. I was only five years old. And one week or day, some boy rolled a snowball, rolled it in water, in melted snow and threw it and it landed right on my ear and I fainted. So they carried me in my sister's room and her girlfriend carried me into the room and there I had my head on the desk, I guess, half of the day. But I was plagued with earaches and headaches up until I was about. Well, every week, I had either a headache or an earache. DONALD KOELLER: Let's go back and talk more about the home and marriage of Jacob and Anna. MATILDA KOELLER: Well, when we lived around [Perse] School, nobody had bathrooms. You had your toilet in the hallway. And I still. DONALD KOELLER: This was a multifamily house. 11 MATILDA KOELLER: Yeah. Yeah. There were either two or four in the – I think in this place, it was four. DONALD KOELLER: Front and back and one upper story? MATILDA KOELLER: Yeah. Yeah. And we had a [unintelligible - 00:25:45], the toilets were, and there was no bath. But when. Dad, being a barber and seeing all these men coming home, you know, coming into the barber shop and needed a bath, so when he moved from around Paulina, he insisted about having a bathroom because then they were building the bathrooms in the house. DONALD KOELLER: This would be, say, 1910 or so? MATILDA KOELLER: This is. no, when I was 6 years old, in 1907. And we did. It must have been a bedroom because it was a big bathroom and a big tub. And from then on, we always had a bathroom, a bathtub and a toilet. Not a washstand, but just a bathtub and a toilet. That's one thing my father insisted upon, whenever we moved, was the bathroom. DONALD KOELLER: At that point in that house, there was electric light? MATILDA KOELLER: No. There was kerosene lamps then. We had kerosene lamps then. DONALD KOELLER: On the wall of the room? MATILDA KOELLER: Well, all I can remember is carrying the kerosene lamp, especially going to the bedroom. When we moved from there, we moved about two blocks away, above a grocery store, and then we had kerosene lamps. DONALD KOELLER: Do you remember getting electricity when you were still there? MATILDA KOELLER: Well, I think the first electricity was on Salem because I don't remember cleaning lamps there. DONALD KOELLER: How old were you when you moved to Salem? MATILDA KOELLER: I was about 13, 12 or 13 years old, when I moved to Salem because I went out of the district, the school. In those days, 12 you had to go to a school in your neighborhood. That was the law. But because my sister, Margaret, made coffee for the teachers and she had graduated in February, they asked me to take over the job of making coffee, and so I got a special permit to go out of the district to [drive] to school, you know, for the last year and a half of my schooling. And I made 10 cents a day. I think about a dollar a week they gave me for the. I used to get out of school at lunchtime, a half hour early, and made coffee for the school teachers. I carried my lunch because I was out of the district. I couldn't go home to eat. It's a little bit too far to walk. That was a. you had to go in your district. For instance, my brother, Ed, who was the next youngest, next to me, he only had a half a year of schooling to graduate and they wouldn't let him finish there. He had to go to the school in his district where Mother and Dad moved. But then he would have to start the whole eighth grade over and then he thought he wouldn't go to school anymore. So he. DONALD KOELLER: He never finished the eighth grade? MATILDA KOELLER: He never finished, never graduated because he wasn't going to take that half a year over again. DONALD KOELLER: But of the 10 children, brothers and sisters, almost all of your brothers and sisters finished? MATILDA KOELLER: No. Henry didn't, the second from the oldest. He did not finish. And then Ed did not finish./AT/mb/ee

This paper starts with a dilemma. How to ensure the adequate protection of individual health data and privacy in a global pandemic, which has intensified the use of digital applications for the purposes of data sharing and contact-tracing? There is no simple answer to this question when choosing between the protection of public health and individual privacy. However, the history of the existing case-law regarding infectious diseases control, both Polish and European, teaches about numerous examples in which health data and privacy were not adequately protected, but, on the contrary, were misused leading to human rights infringements. In light of this case law and public health ethics, this paper argues radically that the use of digital applications to fight the Covid-19 pandemic has not been sufficiently justified at least in the Polish context. Especially, unconvincing benefits from the use of these tools do not outweigh the likelihood of human rights infringements with far-reaching consequences for political, social and economic rights now and in the future. In its novelty, this article combines a historical-legal method with the concept of public health ethics and a human rights-based approach and to foster further research and discussion. 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Background Having investigated avoidable deaths and other occurrences of harm to patients at Mid-Staffordshire Hospital, the Francis Inquiry made 290 recommendations for actions to reduce the likelihood of such events recurring. A prominent part of the government's response was to ask Don Berwick to chair a National Patient Safety Advisory Group to advise the government on a 'whole-system' Patient Safety Improvement Programme. The Group proposed establishing Patient Safety Collaboratives (PSC), drawing upon the experience of Quality Improvement Collaboratives, particularly the Institute of Healthcare Improvement (IHI) 'Breakthrough Series' From 2014, Collaboratives in the NHS were implemented through the regional Academic Health Science Networks (AHSN). Most research about the effects of Collaboratives has been uncontrolled and fragmented across a range of activities and target outcomes, often self-reported. Few studies report clearly how Collaboratives carried their work out, making it hard to identify what the 'active ingredient' is. Few contained evidence about the determinants of 'success' (as opposed to abundant hypotheses and conjectures). Neither is it known what kinds of clinical work (e.g. for which care groups) may be more amenable than others to improvement by PSC methods, although Collaboratives based hospitals have been most widely reported. We evaluated how this action taken in response to the Francis Inquiry was implemented and some of the consequences, and used our findings as the evidence base to present some some policy implications and further research proposals. Research Questions (RQ) This study addressed six research questions: RQ1: How has PSC implementation varied across the 15 Academic Health Science Network (AHSN) regions? RQ2: What organisational changes have providers made? How have they done this and what have they learned from the PSCs? RQ3: How were resources used for PSCs' implementation activities? What are the costs of participation and implementation? RQ4: Have the PSCs made a detectable difference on rates of harm and adverse events involving patients as measured using routine data? RQ5: Has change in practice taken place on the front-line of services? RQ6: What generalisable knowledge can be shared about this? Methods We made a mixed methods observational comparison of PSC mechanisms, contexts and outcomes. We combined three methods each of which broadly corresponded to one stage of PSC implementation: 1. An Implementation study of how PSCs were set up, of AHSN roles in establishing and maintaining regional networks, and of how provider-level NHS managers and clinicians used PSC-initiated ideas and resources to influence clinical practice, monitor and improve clinical quality and safety. Our study looked at all 15 PSCs, studied three of them in greater detail, and within them selected different types of provider for in-depth study. 2. Patient safety culture surveys. The Francis and Berwick reports emphasised strengthening safety culture as a method for making clinical practice safer. Using the Safety, Communication, Operational Reliability and Engagement (SCORE) survey, we measured changes in patient safety 'culture' in six clinical teams undertaking PSC-initiated activities. We also analysed NHS Staff Survey data. 3. Analysis of routine administrative data. To assess how much patient safety and outcomes had changed we quantitatively analysed routinely collected administrative data relevant to PSCs' intended outcomes. Our data sources were 61 semi structured in-depth interviews of key informants: SCORE survey data from 72 sites (first round) and from the six of these sites which had also made a second-round (repeat) survey during the study period: and England-wide data on in-patient satisfaction, quality improvement, managerial support for staff, fairness and effectiveness of procedures for reporting errors, recommendation of one's own work-place, incident reporting and hospital mortality. Findings How PSC implementation varied across the 15 AHSNs (RQ1) Each AHSN applied elements of three strategies for improving patient quality and safety at provider level: • A facilitative strategy, which built where possible on existing QI and safety work in healthcare providers, but was constrained by the local history and resources – or lack of them – in these areas of work. A facilitative strategy made it harder to attribute any changes in working practices and outcomes unequivocally to PSC activities. • An educative strategy of educating, training and developing individual 'change agents' to implement changed working practices to improve patient safety at clinic level. • A national priority focussed strategy of adopting 'work-streams' from among the current national priorities, resulting in several PSCs developing similar work-streams (e.g. sepsis prevention). There were tensions between the facilitative approach and the national priority focus, which some informants thought was closer to a performance management approach. In general, PSCs and NHS staff favoured shifting from a 'blame' culture to learning culture focused on service development as more conducive to activities to improve patient safety. Where SCORE surveys were used (which was increasingly, but from a small base), they were implemented the same way everywhere. PSCs differed in terms of which elements and mechanisms of collaboratives they emphasised. Partly because the Francis report was a response to problems in hospital services, and because Collaboratives originated in (US) hospitals, participation was proportionately greater among acute hospitals than elsewhere, which partly reflected the technical challenges of making the Collaborative model relevant to non-hospital services. General practices apart, the only non-NHS providers participating were some care homes and pharmacies. Organisational changes that providers made and what they have learned from the PSCs (RQ2) Not all provider organisations participated in the PSCs. The willingness of NHS senior managers to engage with PSCs varied across setting. When they were willing, organisational upheaval including leadership changes made trusts' engagement harder to sustain. In providers that did participate, the main organisational factors reported to aid PSC implementation were: • Initial expenditure for start-up training and preparing management information systems to serve (also) as a measurement system for clinical teams' QI work • Recruiting trained QI and safety experts or 'champions' at all organisational levels, most critically at Board and clinical team levels; this was often done with PSC support and encouragement. • Ensuring that these champions had the leadership skills to motivate and empower clinical teams and to create safe spaces for staff to speak up or suggest changes. • Building structures and processes, at both whole-organisation and at clinical team levels, to sustain the changed working practices. • Allocating staff time not only to engage in QI and learning events, but so that they can subsequently utilise their learning at work. • 'Bottom-up' approaches to safety improvement promoted provider-level engagement and motivation by adapting the activities that PSCs were promoting to local needs. • Measurement support for front-line staff At the time of this study, the development and use of formal measurement systems to support QI activities had not yet materialised. The other change we had expected but did not observe was in safety climate, particularly at clinical team level. Although PSC activity, including the SCORE surveys, had impacts upon clinical teams' working practices in the sites we studied (see below) these changes occurred without measurable changes in workplace safety climate. In summary, we found: 1. Some qualitative evidence of safety climate change in the intended direction, including increased staff engagement and shifts away from a blame culture towards a more 'open learning culture'. 2. No significant change safety climate in six study sites by early 2018 on most of the SCORE survey domains. 3. Change in the intended direction in the relevant NHS staff survey data domains, but evidence that this change began before PSCs existed. To suggest that any safety culture changes in particular clinical teams are diluted within much larger NHS Digital data-sets might be valid for the NHS Staff Survey but is not applicable for the SCORE survey results, which were precisely localised to the relevant clinical teams. A possible explanation is that safety climate changes are as much a consequence as a cause of changes in working practices, in a virtuous circle of mutual reinforcement. Organisational changes do not occur straight away; sufficient time is required to implement a complex set of activities across all levels of the NHS: 1. At least 18 months for PSCs and then providers to establish themselves and start to change working practices. In practice this can take a lot longer before any impact is seen at the patient level. 2. Allowing individual staff members time at work to attend learning events and then put what they learnt into practice. 3. Continuing the PSCs long enough to engage 'late adopters' besides 'early adopters'. 4. Time for plan-do-study-act (PDSA) cycles and other QI activities be repeated and become institutionalised on an open-ended time-scale. Other major constraints surrounding the activities of PSCs we found were NHS providers' concurrent operational pressures and the concomitant resource and financial constraints, staff shortages and turnover. At an individual level the barriers included difficulties utilising expertise post training due to factors including a performance culture (i.e. conflicting priorities in the work-place), lack of time, high staff turnover (including shift rotations and moves between work locations), and psychological resistance to change. Costs of participation in and implementation of PSCs (RQ3) One of our study PSCs provided broad information how spending on PSCs had been allocated at AHSN level (to which programmes, and to broad categories such as support staff, training etc.). At the time of our fieldwork detailed information to account for; the training and network activity the PSCs provided, monetary flows from PSCs to providers, as well as indirect opportunity costs the provider organisations incurred was not completely available. The same applied to information about how these extra resources impacted on health benefits for the patients due to changes in working practices noted below, making it unfeasible to evaluate the cost effectiveness of the PSC programme. Have the PSCs made a detectable difference to rates of harm and adverse events involving patients as measured using routine data? (RQ4) We analysed routine administrative data about relevant safety outcomes and found that: 1. Qualitative evidence of changed working practices which one would expect (given their supporting evidence) to improve patient safety and service quality. 2. Quantitative analysis of administrative data showed no significant change by early 2018 that could plausibly be attributed to PSCs alone. 3. Longer-term changes in the intended direction were occurring. In our judgement the reasons for these paradoxical patterns are: 1. Dilution of any effects of PSCs upon service outcomes because the available datasets combine data about activities in which PSCs were involved with data about much larger activities in which PSCs were not yet involved,such as trust-level data. 2. PSCs' effects were constrained by countervailing factors: demand overloads, insufficient staffing relative to demand, staff turnover and financial constraints. 3. Time lags: when our fieldwork finished PSCs were about half-way through their initially-planned life-span and had spent much of it getting their activities started. This meant the period for which routine data could have captured any relevant effects was a year or less. We infer that PSC activity had many of its intended effects but they were too localised and diluted to be measurable in the larger-scale routinely-reported administrative datasets. Change in practice on the front-line of services (RQ5) In our case study sites we found evidence of changes in practice at front-line, clinical team level. In practice the participating clinical teams had become more multidisciplinary. They had also started to undertake what in effect was the Model for Improvement: collecting information about their working practices, changing the latter, reviewing the effects, then making further adjustments: the quality improvement cycle. The SCORE survey, and its practical impacts, can be understood as a special case of such activity, and one with a relatively quick impact upon working practices. SCORE surveys developed beyond measurement activity into a practical intervention on the part of PSCs. Changes in working practices were both clinical (e.g. falls reduction) and organisational (e.g. pathway re-design) and were reported in both hospitals and general practices. Conclusions: Policy and management implications The findings summarised above tend to support some of the policy-makers' original assumptions about how PSCs would work but suggests revisions to other policy assumptions that would lead to more effective PSCs and thus safer care for patients:- 1. PSCs have not yet had sufficient time to establish and sustain the clinical team-level safety improvement activities and outcomes that current policy intends. Our evidence suggests three years from the outset is in practice too short a time for that. In our opinion (albeit an opinion consistent with our findings so far) PSCs should continue in their current form for longer before any judgement can be meaningfully made about their impact on patients. 2. The PSCs are complex adaptive systems, reacting and responding to different local situations in varied ways. Attempts to manage PSCs uniformly and force them into particular directions (including work streams) are likely to hamper their ability to promote the locally-originating work that will ultimately lead to better patient care. In our opinion NHSI should study the emergent systems, support positive behaviours and resist the temptation to apply a 'one size fits all' managerial approach. 3. NHSI and the Department of Health need to provide clear and supportive timelines and financial arrangements for the PSCs. One disruptive aspect of the implementation of the PSCs was the lack of clear direction from the central NHS bodies, partly due to the perceived chaos surrounding the change from NHSE to NHSI, and to the financial uncertainly that PSC leads felt. At the time of writing there are suggestions that NHSI should review the PSCs. In our opinion it is too soon for that and it will again create an impeding uncertainty. 4. Recognition of the influence of the wider evidence-based medicine (EBM) movement and institutions (e.g. NICE) in promoting safety culture, something PSCs' activity reinforced and exploited. However development of EBM is uneven (for example, it is better developed in general medicine than mental health). Start-up support for Collaboratives may be especially important in domains where EBM remains less developed and embedded. 5. Culture change is too big for PSCs alone to achieve without a massive increase in their scale. Learning by clinical teams is a discrete step linking culture change to changed working practices and this has implications for the kind of training required. The necessary kernels for this training are quality improvement methodologies and the psychology of change ('human factors'). As PSCs have shown, clinical teams are the critical audience for this training. 6. If providers are to become 'learning organisations' for PSC purposes the requirements include: a 'bottom-up' approach to safety management; that provider managers allow clinical teams discretion to adapt QI activities to their local needs; that clinical teams are allowed to take ownership of a given project or changes in work processes, something our evidence suggests also promotes staff engagement and motivation. This is a different approach from the work-stream specific collaboratives; mandating clinical teams to work on areas they have not chosen will probably not have as effective outcomes for patient care. 7. NHSI is now addressing the absence of cross-provider measurement systems for PSC purposes (for clinical teams across different providers to compare activities and learn from each other). Caution will be needed in how these cross-provider data are used. The focus has to be on data for improvement; if the data are used for performance management (or even perceived as such) the benefits of the collaborative approach will diminish.

The European Union (EU) initiative on the Digital Transformation of Health and Care (Digicare) aims to provide the conditions necessary for building a secure, flexible, and decentralized digital health infrastructure. Creating a European Health Research and Innovation Cloud (HRIC) within this environment should enable data sharing and analysis for health research across the EU, in compliance with data protection legislation while preserving the full trust of the participants. Such a HRIC should learn from and build on existing data infrastructures, integrate best practices, and focus on the concrete needs of the community in terms of technologies, governance, management, regulation, and ethics requirements. Here, we describe the vision and expected benefits of digital data sharing in health research activities and present a roadmap that fosters the opportunities while answering the challenges of implementing a HRIC. For this, we put forward five specific recommendations and action points to ensure that a European HRIC: i) is built on established standards and guidelines, providing cloud technologies through an open and decentralized infrastructure; ii) is developed and certified to the highest standards of interoperability and data security that can be trusted by all stakeholders; iii) is supported by a robust ethical and legal framework that is compliant with the EU General Data Protection Regulation (GDPR); iv) establishes a proper environment for the training of new generations of data and medical scientists; and v) stimulates research and innovation in transnational collaborations through public and private initiatives and partnerships funded by the EU through Horizon 2020 and Horizon Europe.

The military situation in Ukraine is pushing the United States and NATO towards a fateful moment of decision — and it is doing so more quickly than most analysts predicted even a month ago.The Ukrainian defeat at Avdiivka is an indication of just how far the balance of forces has swung in Russia's favor. The collapse of an outnumbered, exhausted, and outgunned Ukrainian army is now a real possibility.In response to this looming threat, some NATO governments are now talking about the possibility of sending their own troops to Ukraine — something that all of them had previously ruled out. Speaking after a conference of European leaders in Paris on Monday, President Emmanuel Macron of France said that ground intervention was "one of the options" they had discussed. The Kremlin responded that this would "inevitably" mean war between NATO and Russia — as indeed it would, if Western forces went into action against Russian troops. To recognize the extent of the danger, it is important to understand the extent of the Ukrainian defeat at Avdiivka. This was not a planned and orderly retreat, like the Ukrainian withdrawal from Bakhmut in May 2023 or the Russian withdrawal from Kherson in November 2022. The Ukrainian forces had to leave behind their seriously wounded and much of their heavy weaponry. The Russians took hundreds of prisoners. Avdiivka, which is virtually a suburb of the Russian-occupied city of Donetsk, had also been fortified by the Ukrainians since 2014, and was one of the strongest points in their line.Of course, the Russians have also suffered very major defeats in this war: most notably, the rout of Russian forces in eastern Kharkiv in September 2022. The difference is that with more than four times Ukraine's population and 14 times its economy, Russia had the resources to recover from this defeat. Ukraine has no such resources of its own to draw on; and while the West can — up to a point — provide more weaponry, it cannot provide Ukraine with the troops to reinforce its severely depleted army — unless, as President Macron suggested, it sends its own troops into battle.Western supplies of weaponry on a sufficient scale to enable Ukraine to hold out are also now in doubt, with the U.S. aid package still held up in Congress, and European officials admitting that the EU can meet only half of its target of million artillery shells to Ukraine by this spring. As the Biden administration has stated, without continued U.S. military aid, the collapse of the Ukrainian army is a certainty.Part of the goal of the European discussions on Monday and Macron's statement about them does indeed seem to be to galvanize U.S. Republican congressmen into passing a long-delayed Ukraine aid package, and pressuring the German government into dropping its opposition to sending German long-range Taurus cruise missiles to Ukraine. The provision of these missiles would appear a safer way of helping Ukraine than sending NATO troops, and Chancellor Olaf Scholz in any case promptly ruled out sending soldiers to Ukraine, as did officials from other European NATO states, including Ukraine's strongest supporters, Poland and the United Kingdom.Safer however is not the same as safe. In the first place, if the Russians actually break through and advance rapidly, then long range missiles will not stop them and NATO will still be faced with pressure to send its own troops. If on the other hand the Ukrainians manage to hold out for months to come, then — based on their record so far — it seems certain that they would use these weapons (and the F-16 warplanes provided by NATO) to strike deep inside Russian territory, including probably Moscow itself.Of course, the Ukrainians have a perfect legal and moral right to do this, given two years of Russian missile strikes on Ukrainian cities, and there is a mood both in Ukraine and among some Western establishments that the Russian people should be given a taste of their own medicine. Indeed, NATO Secretary General Jens Stoltenberg and other Western officials have publicly encouraged the Ukrainians to do this. Legal and moral is however not the same thing as sensible and wise.In terms of practical economic effect, such Ukrainian strikes would be mere pinpricks, given Russia's huge size and resources. In terms of moral and political effect, we know from Russia's campaign against Ukrainian cities — and have known since the German bombing campaign against Britain in 1940-41 and the U.S. campaign against North Vietnam — that heavier attacks have the effect of infuriating the populations on the other side and strengthening their will to fight. Meanwhile, devastating the Russian economy would require bombardment on the scale of the campaigns against Germany and Japan in 1943-45, which is completely beyond NATO's means unless we simultaneously destroy ourselves by launching a nuclear war.The danger is, however, that if the Ukrainians managed to hit a very high profile target (like the Kremlin), or killed a large number of Russian civilians in a single strike, the Russian government might feel impelled to escalate quite radically in response. Already, many Russian hardliners are asking publicly how long Putin will tolerate NATO massively arming Ukraine without retaliating directly against NATO countries. The West could then find itself with the worst of all worlds: direct clashes with Russia (and a probable world economic crisis) that would not save Ukraine from defeat. In these circumstances, the pressure to dispatch NATO ground troops would return.It should be noted however that sending NATO troops to Ukraine does not inevitably mean sending them into battle with Russia. Should the Russians break through, it is possible to imagine NATO-nation troops being sent to preserve a rump Ukraine by holding Kyiv and a line well to the east of the Russian advance, as the basis for proposing a ceasefire and peace negotiations without preconditions. This would however imply the loss of much greater Ukrainian territories. To prevent an unintended battle with Russian forces would take extremely careful and transparent talks with Moscow. Western generals would be deeply unwilling to see their troops deployed without air cover, but with NATO and Russian air forces both operating over Ukraine the chances of an aerial clash would be very high indeed. To eliminate the risk of NATO being drawn into war with Russia, Western governments would not only have to compel Ukraine to accept a ceasefire, but most likely order the Ukrainian army to fall back to NATO lines (which many Ukrainian soldiers would probably be doing anyway). There would then have to be a wide demilitarized zone between the two sides, patrolled by United Nations troops.Should a limited NATO presence in fact lead to full-scale war with Russia and the intervention of the U.S. armed forces, then the danger of escalation to the use of (initially limited and tactical) nuclear weapons would grow immensely, bringing the world to the brink of Armageddon. One possible scenario is that after a demonstration nuclear explosion (for example, over the Black Sea), Russia would threaten to target not U.S. or European cities, but American military bases in Western Europe. How long would the nerves of European publics and governments hold out before they sued for peace?Faced with the alternative of Ukrainian defeat and running these literally existential risks, it is essential — as we have argued in a recent paper for the Quincy Institute — that pressure for continued aid to Ukraine, and statements like those of Macron, be accompanied by a serious and credible push for a compromise peace with Russia now, while we still have leverage to bring to talks. Complete victory for Ukraine is now an obvious impossibility. Any end to the fighting will therefore end in some form of compromise, and the longer we wait, the worse the terms of that compromise will be for Ukraine, and the greater the dangers will be for our countries and the world.

Am vorgegangenen Freitag die Schlappe bei der Exzellenzstrategie, am darauffolgenden Mittwoch berichteten regionale Medien über schwerwiegende Manipulationsvorwürfe gegen die Kieler
Universitätspräsidentin Simone Fulda. Von da an überschlugen sich die Ereignisse. 







Große Ambitionen: Simone Fulda bei ihrer Amtseinführung im Oktober 2020. Foto: CAU,
Flickr. CC BY-NC-SA 2.0.






EIGENTLICH HATTE SIE am Montag eine Erklärung abgeben wollen, hieß es intern, doch dann schaffte Simone Fulda bereits am Samstag Tatsachen und erklärte ihren Rücktritt als Präsidentin der Kieler
Christian-Albrechts-Universität (CAU). "In Verantwortung für die Universität und schweren Herzens gehe ich diesen Schritt", sagte die 55 Jahre alte Medizinerin, und Wissenschaftsministerin
Karin Prien (CDU) kommentierte, sie habe "großen Respekt für diese Entscheidung". 



 



Zu dem Zeitpunkt waren gerade einmal gut drei Tage vergangen, seit die Kieler
Nachrichten erstmals über Vorwürfe der Datenmanipulation und gefälschter Abbildungen berichtet hatten, erhoben von Leonid Schneider in seinem Blog "For Better Science". Der
Wissenschaftsjournalist hatte bereits am 22. Januar einen umfangreichen Artikel über mutmaßliche und nach seinem Recherchen tiefgreifende Verstöße Fuldas und anderer Wissenschaftler gegen die
gute wissenschaftliche Praxis veröffentlicht, die er dort im Einzelnen aufführt.



 



Die betreffenden Forschungsarbeiten auf dem Gebiet der molekularen Onkologie fallen in die Zeit, bevor Fulda in Kiel Präsidentin wurde. Bis 2010 forschte sie an der Universität Ulm,
wo ihr Kollege und Mentor Klaus-Michael Debatin seit 1997 als Ärztlicher Direktor der Universitätsklinik für Kinder- und Jugendmedizin fungiert. Debatin wird in Schneiders Blogbeitrag
ebenfalls scharf angegangen. 2010 ging Fulda als Professorin für Experimentelle Tumorforschung an die Goethe-Universität Frankfurt und wurde Direktorin des dortigen Instituts für Experimentelle
Tumorforschung in der Pädiatrie.



 



Die Vorwürfe aus Schneiders Blog waren schon in den Tagen und Wochen zuvor allmählich an der Universität durchgesickert, seit dem ersten Artikel in den Kieler Nachrichten am
Mittwoch überschlugen sich dann die Ereignisse. Während die Deutsche Forschungsgemeinschaft (DFG) mitteilte, zunächst Vorprüfungen eingeleitet zu haben, die über die Einleitung eines förmlichen
Untersuchungsverfahrens entscheiden, zitierte der NDR
Schleswig-Holstein bereits zwei "unabhängig voneinander angefragte Professoren von anderen Hochschulen", die zwar namentlich nicht genannt werden wollten, aber anhand der vorliegenden
Abbildungen "die Möglichkeit von Unregelmäßigkeiten" bestätigten. Wörtlich sagte einer der Professoren demzufolge: "Ohne alle Details geprüft zu haben, sieht es so aus, als wenn ein großer Teil
der Vorwürfe berechtigt sein könnte." 



 



Misstrauenserklärung
von Kieler Medizinern



 



Ebenfalls am Mittwoch forderten Professoren der Fakultät für Medizin in einem Brief mit Bezug zu den Vorwürfen und dem jüngsten Scheitern bei der Exzellenzstrategie faktisch Fuldas
Rücktritt: Sie solle "weiteren Schaden" von der Universität abwenden. Und kurz nachdem Fulda sich am Mittwochabend in einer nichtöffentlichen Sitzung des Universitätssenats gegen die
Vorwürfe der Datenmanipulation verwahrt hatte, sprachen ihr unter anderem die Dekane aller acht Fakultäten das Misstrauen aus. 



 



Gerade einmal 48 Stunden nach ihrem ersten Artikel kommentierten die Kieler Nachrichten dann: Es gehe in Kiel "längst nicht mehr" um die Frage, ob die Präsidentin der CAU vor vielen
Jahren während ihrer Forschungsarbeit Daten manipuliert habe. Wenn die Spitzenforscher von Fulda verlangten, "Verantwortung gegenüber der Universität" zu übernehmen und darauf verwiesen, die
wissenschaftlichen Vorwürfe gegen sie "im Detail zur Kenntnis genommen zu haben", dann habe sie "keinen Spielraum mehr. Simone Fulda muss zurücktreten."



 



Am selben Tag berichtete die Zeitung unterdessen auch von zwei Professorinnen, die Fulda auf der Plattform "X" verteidigten. Die Historikerin Martina Winkler warnte davor, die
Präsidentin "jetzt zur Buhfrau für das Scheitern der CAU in der Exzellenzinitiative zu machen", die Mikrobiologin Christina Hölzel meinte, die Auffälligkeiten in den
Forschungsarbeiten von Fulda könnten durchaus erklärbar sein.



 



Wissenschaftsministerin Prien wiederum sagte am Freitag, die im Raum stehenden Vorwürfe hätten "das Potenzial, die nun dringend notwendigen Anstrengungen der CAU zu überschatten, im weiteren
Verfahren der beiden bestehenden Exzellenzcluster erfolgreich zu sein". 



 



Fulda hatte in der Zwischenzeit nicht nur im Senat, sondern auch gegenüber dem NDR ihre Unschuld mit allem Nachdruck betont: Es gebe keine Tatsachengrundlage, die den Vorwurf
der Datenmanipulation rechtfertigen würde. Trotzdem titelten die Kieler Nachrichten am Samstag: "Fulda schweigt zu den Vorwürfen." Tatsächlich hatte sie am
Freitagnachmittag nämlich eine Mail an alle Universitätsmitarbeiter geschrieben, zusammen mit dem für Forschung zuständigen Vizepräsident Eckhard Quandt, sich darin aber allein zu den
kurz zuvor durchgefallenen drei Antragsskizzen für neue Exzellenzcluster geäußert. 



 



Die Zahl der drängenden
Fragen wächst weiter




Nachdem zuletzt auch die übrigen Mitglieder der Hochschulleitung ihr schriftlich das Vertrauen entzogen, folgte am Samstagabend der Rücktritt. Mit dem die Causa Fulda nicht zu Ende ist, doch
die Zahl der drängenden Fragen weiter wächst. Wie lange dauert es, bis die mutmaßlichen Manipulationen seriös aufgeklärt sind? Und wen interessiert das Ergebnis zu dem
Zeitpunkt noch? Wie lange wusste Fulda schon von den Vorwürfen gegen sie? Wer wusste sonst noch davon und ab wann? Warum hat die Universität, angefangen mit ihren Dekanen und
Medizinern, die Präsidentin, gerechnet ab dem breiten Bekanntwerden der Vorwürfe, in solch einer Rekordzeit fallen lassen? Welchen Vorlauf dazu gab es und ab wann? Welche Rolle spielte
die Berichterstattung in den regionalen Medien? Und wieviel der atemberaubenden Dynamik der vergangenen Tage, wieviel von den Verwerfungen, auf die Fulda nur noch mit ihrem Rücktritt zu
reagieren können glaubte, lässt sich überhaupt vorrangig durch die Vorwürfe erklären? 



 



Fest steht: Die im Oktober 2020 ins Amt gekommene Fulda hatte ihren Erfolg von Anfang an strategisch und rhetorisch eng, sehr eng mit dem Abschneiden in der Exzellenzstrategie verbunden. Ihr
war allerdings auch kaum etwas Anderes übrig geblieben. 2018 hatte die einzige Volluniversität Schleswig-Holsteins zwei Exzellenzcluster erringen können, ein hervorragendes Ergebnis, das der
Wissenschaft im nördlichsten Bundesland Hoffnung auf mehr machte: auf den begehrten Status einer Exzellenzuniversität. Doch scheiterte Kiels diesbezügliche Bewerbung 2019 – mit der Aussicht, es
sieben Jahre später erneut zu versuchen.



 



Drei neue Clusteranträge zusätzlich zu den bestehenden sollten dafür die Grundlage legen, die beteiligten Forscher, die Fakultäten und allen voran Präsidentin Fulda steckten jede Menge Energie,
Herzblut und Ressourcen hinein, die Landesregierung gab zusätzliches Geld. Doch am vorvergangenen Freitag kam die große Enttäuschung: Alle drei neuen Projekte fielen schon als
Antragsskizzen durch. Die größtmögliche Pleite. Fünf Tage später erschien der erste Bericht über die Vorwürfe in den Kieler Nachrichten, acht Tage später trat Fulda zurück.



 



Unterschätzte die Unipräsidentin die
wissenschaftspolitische Dimension?



 



Vor dem Hintergrund des Wettbewerbs wird auch erklärbar, warum nicht nur Fulda, sondern die gesamte Universität lange kein Interesse daran hatten, dass die kursierenden Vorwürfe gegen sie
öffentlich wurden. Und warum diese nach dem Scheitern bei der Exzellenzstrategie umso heftiger in die Schlagzeilen drängten. Die Kommunikation der Unipräsidentin tat in dieser Konstellation
ihr Übriges: Laut Schneider hat sie auf seine schon vor Wochen gestellten Anfragen nicht reagiert. Und womöglich in der Annahme, durch öffentliche Kommentare werde sie der Debatte nur
weiteren Vorschub leisten, beschränkte Fulda, die normalerweise sehr zugewandt und direkt auftritt, ihre Reaktion nach außen bis zuletzt auf das Allernötigste. Konzentriert auf die
wissenschaftliche Dimension der Vorwürfe gegen sie persönlich, überschätzte sie offenbar ihren Rückhalt bei den Mächtigen der Universität und unterschätzte zugleich die
wissenschaftspolitischen Dimensionen, die weit über sie, die Hochschulleitung oder gar die Universität Kiel hinausreichten. Etwa als die Landes-SPD der Wissenschaftministerin Prien vorwarf, sich
in der Angelegenheit zu passiv zu verhalten.



 



Die erhobenen Vorwürfe sind ernst. Bei ihrer Aufklärung sind neben der DFG auch die Universitäten Ulm und Frankfurt gefragt. Doch ganz gleich, was ihre Untersuchungen am Ende ergeben: Die
Art und Weise, wie Fulda in Rekordzeit jetzt abtreten musste, obwohl, wie Kanzlerin Claudia Ricarda Meyer am Samstag betone, "weiterhin die Unschuldsvermutung" gelte, stimmt nachdenklich, genau
wie das sich gegenseitig verstärkende Wechselspiel zwischen Wissenschaft und Medien. Und könnte Spuren hinterlassen. Spätestens, wenn es jetzt darum gehen wird, eine qualifizierte Nachfolge für
Fulda zu finden.



 



Zunächst soll die CAU jetzt durch ein Interims-Präsidium geleitet werden. "Damit ist, bis zur Wahl einer neuen Präsidentin oder eines neuen Präsidenten der CAU, die Hochschulleitung
weiterhin voll funktionsfähig", versicherte die Universität per Pressemitteilung.  Ein Arbeitsschwerpunkt werde
die Vorbereitung der Folgeanträge für die bestehenden Exzellenzcluster "Precision Medicine in Chronic Inflammation, PMI" und "ROOTS – Konnektivität von Gesellschaft, Umwelt und Kultur in
vergangenen Welten" sein.



 



Nachtrag am 12. Februar: Leider musste ich in meiner Verantwortung als Betreiber dieses Blogs die Kommentarfunktion zu diesem Artikel grundsätzlich ausschalten, da
zahlreiche Beiträge einerseits anonym abgefasst wurden, andererseits aber persönliche Anschuldigungen und Wertungen gegenüber Personen enthielten. Ich bitte um Ihr Verständnis.



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