Katie Barnes, Philip Longfield, Katie Jones, Gill Littlemore, Claire McDonough, Archie McIntyre, Jo Robertson, Neil Turton, Kevin Urdhin and Melanie McLaughlin
The purpose of this paper is to show how the new arrangements for commissioning services in the English NHS can facilitate innovations in service delivery leading to improvements…
Abstract
Purpose
The purpose of this paper is to show how the new arrangements for commissioning services in the English NHS can facilitate innovations in service delivery leading to improvements in outcomes and cost effectiveness.
Design/methodology/approach
The study uses cost modelling based upon the Hospital Episodes Statistics compiled by the NHS Information Centre to calculate recent expenditure upon treatment of routine childhood illnesses managed as short stay hospital admissions, and then uses a case study of a children's walk‐in centre to show how an alternative service can be provided, and a new service embedded in general practice to show a further alternative type of provision.
Findings
The study finds that large sums are currently being spent on inappropriate treatment of routine childhood conditions, especially in large urban conurbations. It demonstrates that in the case studies, the alternative provision can provide a viable and effective alternative.
Research limitations/implications
The research is based upon historical data by necessity. The new commissioning groups are not co‐located with the historical PCTs on which this study is based. The data are collected by providers and co‐ordinated by the NHS Information Centre. Therefore the investigators do not have control over the data quality. The second case study is a new service and therefore is used as an illustration of other service types.
Practical implications
This study suggests that paediatric ambulatory services can be provided at lower cost with better outcomes.
Social implications
This study provides the basis for a pilot study in Salford, where additional social benefits are targeted including better school attendance and increased self‐awareness over child health amongst local families.
Originality/value
The study provides quantitative evidence for commissioning alternative paediatric ambulatory services.
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Claire Kearns Murphy, Louise Kemps, Catherine McDonough and Suzanne McDonough
Early interventions focusing on exercise and lifestyle are important for individuals with a diagnosis of psychosis due to increased risk of poor physical health and reduced life…
Abstract
Purpose
Early interventions focusing on exercise and lifestyle are important for individuals with a diagnosis of psychosis due to increased risk of poor physical health and reduced life expectancy. This study aims to test the feasibility of a multicomponent lifestyle intervention for individuals with first episode psychosis (FEP).
Design/methodology/approach
Individuals attending an Irish FEP service were invited to engage in an eight-week programme including individual and group exercise sessions, group educational sessions and one dietician consultation. Physical activity, physical health, mental health, cognition and personal goals measures were completed pre- and post-intervention and analysed using descriptive statistics. Feasibility data was collected via a non-standardised participant questionnaire and informal data on completion of measures and engagement with the programme.
Findings
Ten participants with a diagnosis of FEP completed the intervention. Participants were satisfied with the intervention and adherence rates were high for weekly individual gym sessions but lower for group exercise and education sessions. Mean time spent engaging in physical activity increased and sedentary behaviours decreased. Participants indicated increased readiness for change with 90% moving to the action or maintenance stages of change. Participants attained 74% of their personal goals. There were no changes in average body mass index, cognition or mental health. Data relating to blood pressure, blood tests and steps was missing or incomplete.
Originality/value
This study indicates an eight-week exercise and lifestyle programme is feasible and acceptable in a clinical setting. Recommendations relating to satisfaction, clinical markers and resource requirements are made for future studies.
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Paul Hong, Abraham Y. Nahm and William J. Doll
Product development is recognized as cross‐functional teamwork that has become important in the fast‐paced, globally competitive environment. Despite an extant body of knowledge…
Abstract
Product development is recognized as cross‐functional teamwork that has become important in the fast‐paced, globally competitive environment. Despite an extant body of knowledge on the importance of fuzzy front‐end planning and functions of goals in the management literature, the impact of uncertain project environment and goal setting mechanisms in front‐end planning is not fully understood. Product development literature presents numerous case studies or conceptual papers that emphasize the importance of upfront planning and a need for team building; however, large‐scale empirical studies are rare. This paper presents a model linking uncertain project environment, project target clarity, teamwork and its outcome measures (i.e. a product's value to customer and time to market). The data were analyzed from 205 product development projects of firms from the USA and Canada. Valid and reliable instruments were developed to assess the nature and impact of inter‐relationships of these variables. Results from structural model tests indicate that uncertain project environment influences the nature of project targets which in turn affects the level of teamwork. Teamwork is an important process outcome for enhancing value to customer and time to market. Management implications are discussed as well.
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This chapter suggests that moving beyond positivism entails a recognition that the social world is made up of complex phenomena that are heterogeneous, and events are caused by…
Abstract
This chapter suggests that moving beyond positivism entails a recognition that the social world is made up of complex phenomena that are heterogeneous, and events are caused by contingent conjunctures of causal mechanisms. To theorize the social world as heterogeneous is to recognize that social causes, categories, and groups combine different kinds of phenomena and processes at various levels and scales across time. To speak of conjunctural causation implies not only that events are caused by concatenations of multiple, intersecting forces but also that these combinations are historically unique and nonrepeatable. Both the historical materialist conception of the “conjuncture” and the poststructuralist theory of “assemblages” take heterogeneity and multicausality seriously. I compare and contrast these formulations across three dimensions: the structure of the apparatus, causation, and temporality. I argue that these theories offer useful tools to social scientists seeking to engage in complex, multicausal explanations. I end the article with an example of how to use these concepts in analyzing a complex historical case.
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Petra Chaloupkova, Miloslav Petrtyl, Claire Durand, Charoula Konstantia Nikolaou, Guido Mangione and Ladislav Kokoska
This study examined the relationship between adult respondents' COVID-19 risk perception and its impact on changes in eating habits, physical activity, alcohol consumption, and…
Abstract
Purpose
This study examined the relationship between adult respondents' COVID-19 risk perception and its impact on changes in eating habits, physical activity, alcohol consumption, and smoking.
Design/methodology/approach
A cross-sectional online questionnaire was used to collect data during the first wave of the pandemic, in the European spring and summer of 2020. Kruskal–Wallis and Pearson chi-squared tests were used to determine the associations between the consumers' COVID-19 risk perception and the respondents' country of origin. The respondents were primarily university employees and students from four European countries (the Czech Republic, France, the United Kingdom, and Italy).
Findings
The study showed significant changes in lifestyle behaviours of the respondents during the COVID-19 pandemic compared with the pre-outbreak period. Approximately half of all respondents reported a decrease in alcohol consumption, smoking, and physical activity, while eating habits among European consumers showed trends towards both healthier and less healthy dietary patterns. The most significant changes were recorded in reducing alcohol consumption, smoking, and physical activity among almost half of the respondents. Positive COVID-19 test experience, age, and country of the respondents had a negative influence, whereas healthy food consumption and alcohol consumption had a positive influence on the COVID-19 related risk perception.
Originality/value
The fear of the COVID-19 outbreak together with the restrictions imposed by national governments in response to the pandemic fundamentally affected the respondents' lifestyles. Understanding these changes can help establish interventions to alleviate the adoption of negative lifestyles and attitudes in subsequent waves of the COVID-19 pandemic or other similar situations.
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The purpose of this paper is to set out to explore the similarities and differences between jargon used to describe future‐focussed commercial building product. This is not so…
Abstract
Purpose
The purpose of this paper is to set out to explore the similarities and differences between jargon used to describe future‐focussed commercial building product. This is not so much an exercise in semantics as an attempt to demonstrate that responses to challenges facing the construction and property sectors may have more to do with language than is generally appreciated.
Design/methodology/approach
This is a conceptual analysis which draws upon relevant literature.
Findings
Social responsibility and sustainability are often held to be much the same thing, with each term presupposing the existence of the other. Clearly, however, there are incidences where sustainable commercial property investment (SCPI) may not be particularly socially responsible, despite being understood as an environmentally friendly initiative. By contrast, socially responsible assets, at least in theory, should always be more sustainable than mainstream non‐ethically based investment. Put simply, the expression of social responsibility in the built environment may evoke, and thereby deliver, a more sustainable product, as defined by wider socially inclusive parameters.
Practical implications
The findings show that promoting an ethic of social responsibility may well result in more SCPI. Thus, the further articulation and celebration of social responsibility concepts may well help to further advance a sustainable property investment agenda, which is arguably more concerned about demonstrability of efficiency than wider public good outcomes.
Originality/value
The idea that jargon affects outcomes is not new. However, this idea has rarely, if ever, been applied to the distinctions between social responsibility and sustainability. Even a moderate re‐emphasis on social responsibility in preference to sustainability may well provide significant future benefits with respect to the investment, building and refurbishment of commercial property.
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The misuse of pharmaceutical opioid analgesics is identified as a global public health concern. Codeine represents an interesting quandary in terms of its regulated status, with…
Abstract
Purpose
The misuse of pharmaceutical opioid analgesics is identified as a global public health concern. Codeine represents an interesting quandary in terms of its regulated status, with individuals varying in their metabolism of codeine, estimation of safe dosages, risk of adverse health consequences and abuse potential. Efforts to quantify and address hidden non-compliant medical codeine use, overuse and intentional misuse is compromised by availability to the public in prescribed and over the counter forms. The paper aims to discuss these issues.
Design/methodology/approach
A review of literature on codeine use, misuse and dependence, and associated innovative medical and pharmacy interventions is presented, and was conducted as part of a larger scoping review on codeine.
Findings
The review highlights the complexities associated with monitoring public health awareness of codeine's abuse potential, and customer/patients trends in non-compliant codeine use for therapeutic and recreational purposes. Aberrant codeine behaviours centre on visiting multiple doctors for prescriptions, repeated lost or stolen prescriptions, forging prescriptions and use of multiple pharmacies. Innovations to monitor misuse of codeine include national prescription databases and recent developments in real-time monitoring of dispensing activity.
Practical implications
Further development of real-time monitoring processes with process evaluation is advised.
Originality/value
This viewpoint is intended to demonstrate how efforts to quantify and address codeine use are compromised by its availability. It intends to encourage further policy and practitioner dialogue on how to monitor, support and intervene with consumers misusing codeine.
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Claire Hutchinson, Leanne Lester, Veronica Coram, Paul Flatau and Ian Goodwin-Smith
Though qualitative evidence of social impact exists for disability-inclusive social enterprise, there is a dearth of quantitative economic impact on their social impact. This…
Abstract
Purpose
Though qualitative evidence of social impact exists for disability-inclusive social enterprise, there is a dearth of quantitative economic impact on their social impact. This study aims to address this gap and investigate the appropriateness and usefulness of social return on investment (SROI) methodology in this context.
Design/methodology/approach
Primary data was collected from people with disabilities, their families, staff at the parent company (an Australian Disability Enterprise [ADE]), social investors and other key stakeholders (n = 17). The study was also informed by the literature and a steering group to provide expert opinion when no other data existed to inform estimates. Sensitivity analysis was performed to check the robustness of the analysis.
Findings
Social return was estimated at $1.47–$2.65 for every $1 invested (over 3 years) and $8.48–$12.63 (20 years). Some forecast assumptions significantly impacted upon final ratios and need to be tested. How SROI ratios are received by social investors, the ADE sector and government remains untested. However, the political climate suggests ADEs adopting social enterprise models will be well received if they can deliver, and demonstrate through robust measurement, sustainable open employment opportunities.
Originality/value
Few studies exist that estimate the social impact of social enterprises supporting open employment of people with disabilities. At a time when ADEs (sheltered workshops) have been heavily criticised for providing repetitive, menial work for top up wages on welfare payments, the outputs from this research may provide valuable data to an ADE sector in transition as well as social investors and policy makers who increasingly require robust measurement of impact.
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The purpose of this paper is to understand the emergence of digital reformatting as a technique for preserving information within the cultural heritage preservation community by…
Abstract
Purpose
The purpose of this paper is to understand the emergence of digital reformatting as a technique for preserving information within the cultural heritage preservation community by reviewing historical trends in modern preservation research.
Design/methodology/approach
This paper analyzes secondary sources, reviews and historical texts to identify trends in the intellectual and technological histories of preservation research, beginning with the first applications of the scientific method to combating book decay in the early nineteenth to the emergence of digitization techniques in the late twentieth and early twenty-first centuries.
Findings
This paper identifies five major historical periods in the development of preservation knowledge: the early experimental era; era of microfilm experimentation; era of professionalization; era of digital library research; and the era of digital reformatting and mass digitization; and identifies three major trends in its development: empirical inquiry, standardization and centralization.
Research limitations/implications
Findings reflect broad trends in the field of preservation, primarily in a United States context and are limited to the modern era of preservation research.
Practical implications
This paper's broad historical overview provides a reference for preservation professionals and students in library science or archives programs. Identifying historical trends enables practitioners to critically examine their own preservation techniques and make better decisions when adopting and using new preservation technologies.
Originality/value
This paper provides a unique perspective on the history of preservation knowledge that synthesizes existing historical research in order to identify periods and trends that enable a clearer understanding of digital reformatting in its historical emergence.
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Angela Gracia B. Cruz, Elizabeth Snuggs and Yelena Tsarenko
While theories of complex service systems have advanced important insights about integrated care, less attention has been paid to social dynamics in systems with finite resources…
Abstract
Purpose
While theories of complex service systems have advanced important insights about integrated care, less attention has been paid to social dynamics in systems with finite resources. This paper aims to uncover a paradoxical social dynamic undermining the objective of integrated care within an HIV care service system.
Design/methodology/approach
Grounded in a hermeneutic analysis of depth interviews with 26 people living with HIV/AIDS (PLWHA) and drawing on Bourdieu’s (1984) theory of capital consumption to unpack dynamics of power, struggle and contestation, the authors introduce the concept of the service labyrinth.
Findings
To competently navigate the service labyrinth of HIV care, consumers adopt capital consumption practices. Paradoxically, these practices enhance empowerment at the individual level but contribute to the fragmentation of the HIV care labyrinth at the system level, ultimately undermining integrated care.
Research limitations/implications
This study enhances understanding of integrated care in three ways. First, the metaphor of the service labyrinth can be used to better understand complex care-related service systems. Second, as consumers of care enact capital consumption practices, the authors demonstrate how they do not merely experience but actively shape the care system. Third, fragmentation is expectedly part of the human dynamics in complex service systems. Thus, the authors discuss its implications. Further research should investigate whether a similar paradox undermines integrated care in better resourced systems, acute care systems and systems embedded in other cultural contexts.
Originality/value
Contrasted to provider-centric views of service systems, this study explicates a customer-centric view from the perspective of heterosexual PLWHA.