Debbie Vermond, Esther de Groot, Niek de Wit and Dorien Zwart
In response to the COVID-19 pandemic, in 2020–2022, the immutable and fragmented character of our healthcare system changed. Healthcare professionals and their institutional leads…
Abstract
Purpose
In response to the COVID-19 pandemic, in 2020–2022, the immutable and fragmented character of our healthcare system changed. Healthcare professionals and their institutional leads proved remarkably agile and managed to change toward collaborative care. The purpose of this paper is to examine experiences with collaborative practice in healthcare during the COVID-19 pandemic in two regions in the Netherlands, to explore and understand the relationship between policy and practice and the potential development of new collaborative care routines.
Design/methodology/approach
Using a methodology informed by theories that have a focus on professional working practice (so called “activity theory”) or the institutional decision-makers (discursive institutionalism), respectively, the perspective of physicians on the relationship between policy and practice was explored. Transcripts of meetings with physicians from different institutions and medical specialities about their collaborative COVID-19 care were qualitatively analysed.
Findings
The findings show how change during COVID-19 was primarily initiated from the bottom-up. Cultural-cognitive and normative forces in professional, collaborative working practice triggered the creation of new relationships and sharing of resources and capacity. The importance of top-down regulatory forces from institutional leads was less evident. Yet, both (bottom-up) professional legitimacy and (top-down) institutional support are mentioned as necessary by healthcare professionals to develop and sustain new collaborative routines.
Practical implications
The COVID-19 crisis provided opportunity to build better healthcare infrastructure by learning from the responses to this pandemic. Now is the time to find ways to integrate new ways of working initiated from the bottom-up with those longstanding ones initiated from top-down.
Originality
This paper presents a combination of theories for understanding collaboration in healthcare, which can inform future research into collaborative care initiatives.
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Nadia Roos Spaan, Anne R.J. Dekker, Alike W. van der Velden and Esther de Groot
The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general…
Abstract
Purpose
The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general practitioners (GPs) with respect to prescription of antibiotics.
Design/methodology/approach
To obtain insight in various learning processes, semi-structured interviews were conducted with 19 GPs. These interviews were transcribed and analysed with a theory-based template, that had been defined beforehand, but with an open mind for emerging themes.
Findings
The web-based training was perceived by GPs to change their prescription behaviour, mostly as a result of informal learning processes. Being a research participant and being a supervisor appeared to create most opportunities for informal learning.
Practical implications
The current research shows that being a research participant and/or a supervisor enhance informal learning activities, for example, reflection and social interaction, and thereby formal training becomes more effective. It is recommended to remind GPs regularly to reflect on their prescribing behaviour and to stimulate them to reflect and seek social interaction besides participating in formal training.
Originality/value
Our study adds to the existing literature by considering informal learning processes in an evaluation of the perceived effects of formal training. Our findings have implications for the design and evaluation of formal trainings with the purpose of behavioural change of doctors.
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Body weight has a long history of functioning as a symbol of one’s beauty, social status, morality, discipline, and health. It has also been a standard inflicted much more…
Abstract
Body weight has a long history of functioning as a symbol of one’s beauty, social status, morality, discipline, and health. It has also been a standard inflicted much more intensely on women than men. While US culture has long idealized thinness for women, even at risky extremes, there is growing evidence that weight standards are broadening. Larger bodies are becoming more visible and accepted, while desire for and approval of a thin ideal has diminished. However, the continued widespread prevalence of anti-fat attitudes and stigma leaves uncertainty about just how much weight standards are changing. This study used an online survey (n = 320) to directly compare evaluations of thin, fat, and average size women through measures of negative stereotypes, prejudicial attitudes, and perceptions about quality of life. Results indicated that, as hypothesized, thin women were perceived less favorably than average weight women. However, fat women were perceived less favorably than both average and thin women. Men were harsher than women in their evaluations of only fat women. Additionally, participants being underweight or overweight did not produce an ingroup bias in their evaluations of underweight and overweight targets, respectively. That is, participants did not rate their own group more favorably, with the exception of overweight participants having lower prejudice toward overweight targets. These findings add to the emerging evidence that women’s weight standards are in transition, marked by an increasingly negative perception of thin women, though not necessarily growing positivity toward fat women. This evidence further points toward the need for more extensive research on attitudes of people across the entire weight spectrum.
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There are very few individuals who have studied the question of weights and measures who do not most strongly favour the decimal system. The disadvantages of the weights and…
Abstract
There are very few individuals who have studied the question of weights and measures who do not most strongly favour the decimal system. The disadvantages of the weights and measures at present in use in the United Kingdom are indeed manifold. At the very commencement of life the schoolboy is expected to commit to memory the conglomerate mass of facts and figures which he usually refers to as “Tables,” and in this way the greater part of twelve months is absorbed. And when he has so learned them, what is the result? Immediately he leaves school he forgets the whole of them, unless he happens to enter a business‐house in which some of them are still in use; and it ought to be plain that the case would be very different were all our weights and measures divided or multiplied decimally. Instead of wasting twelve months, the pupil would almost be taught to understand the decimal system in two or three lessons, and so simple is the explanation that he would never be likely to forget it. There is perhaps no more interesting, ingenious and useful example of the decimal system than that in use in France. There the standard of length is the metre, the standard of capacity the cubic decimetre or the litre, while one cubic centimetre of distilled water weighs exactly one gramme, the standard of weight. Thus the measures of length, capacity and weight are most closely and usefully related. In the present English system there is absolutely no relationship between these weights and measures. Frequently a weight or measure bearing the same name has a different value for different bodies. Take, for instance, the stone; for dead meat its value is 8 pounds, for live meat 14 pounds; and other instances will occur to anyone who happens to remember his “Tables.” How much simpler for the business man to reckon in multiples of ten for everything than in the present confusing jumble. Mental arithmetic in matters of buying and selling would become much easier, undoubtedly more accurate, and the possibility of petty fraud be far more remote, because even the most dense could rapidly calculate by using the decimal system.
Lord Woolton, the Minister of Food, stated in the House of Lords, on March 11th, that “to reduce the tonnage used for the transport of wheat” the Government had decided to…
Abstract
Lord Woolton, the Minister of Food, stated in the House of Lords, on March 11th, that “to reduce the tonnage used for the transport of wheat” the Government had decided to increase to 85 per cent. the ratio of flour from the wheat milled in this country; and that it will be illegal to sell, except under licence, any “white” bread from April 6th. In the discussion that followed, Lord Horder stated that he and his medical colleagues were satisfied that no other step concerning the nation's food was so calculated to raise the level of the nation's nutrition. He added that there was no evidence that 85 per cent. extraction flour is indigestible; and that where bread of any kind is permissible in diseases of the digestive system, it may be given with impunity. Moreover, Sir Ernest Graham Little, M.D., has rendered a great service to the public by his oft‐repeated and strong advocacy, in the House of Commons, of better bread than that which constitutes the “white loaf.” The unanimous verdict of those who are best qualified to express an opinion supports the conclusion that adequate nutrition is the prime requirement for the physical well‐being of mankind. Neglect this and all other hygienic props fail to support us. It is deplorable, therefore, that so little has been done hitherto in the sphere of national welfare to support the findings of science in favour of the more adequate loaf which has been so powerfully advocated for years. It is no exaggeration to state that the “white loaf” has been a real impediment to an improvement in the hygienic development of the growing child; as the “national loaf” (which will be superior to the “standard bread” of the last war) will not only reduce the tonnage for the transport of wheat, but will also greatly benefit the children, more especially those of the poorer section of the community with whom bread is the main food. Although from a standpoint of nutrition the “National” loaf falls short of the desirable “Wholemeal” loaf, it certainly represents a valuable step in the right direction. As the much impoverished wheat of the “white loaf” is a matter for considerable national concern, it is an anomaly that it should be permitted, seeing that similar impoverishments of natural foodstuffs have for long been punishable by law. For instance, prosecutions and fines for the watering of milk occupy pages of most issues of The British Food Journal. Why, then, should the serious reduction of the valuable mineral matter and vitamins of the wheat used for the wheaten loaf be suffered to continue? The general public do not readily accept guidance upon what they should eat, and it is unlikely that they will have displayed a concerted predilection for the “national loaf” by the time the war ends. But by then much will have been gained by the reduction of prejudice and the increased accommodation which even short phases of custom can confer. Therefore the war‐time expedient of a “national loaf” may very usefully contribute to the perpetuity of its advantages. If we are wise, propaganda to this end will be maintained meanwhile, and be made to develop in power and authority during the early clays of peace. If the Government and the Local Health Authorities are in default in impressing, and (if need be) imposing such a major interest to the nation, the passing of the “white loaf” will soon be followed by its return. Especially is it to be hoped that the Ministry of Health will then give greater support to the advocacy of a better loaf than hitherto. The British Food Journal has often given expression to the public need for an improved loaf, and if this is destined to become an accomplished fact it will partake of the nature of a crowning event to our modest efforts.
Douglas A. Schuler, Reginald Young, Asiya K. Kazi and Jeffrey de Groot
This chapter explores Food for Change, a social entrepreneurial program created by the Houston Food Bank. Food for Change explicitly considers the interlinkages of social problems…
Abstract
This chapter explores Food for Change, a social entrepreneurial program created by the Houston Food Bank. Food for Change explicitly considers the interlinkages of social problems within an individual. Food for Change collaborates with educational and training organizations and healthcare providers to use supplemental food resources to address clients' needs antecedent to food insecurity. We propose a model to conceptualize how food insecurity is influenced by multiple levels of social determinants. We then describe the Food for Change program and offer lessons about the holistic nature of clients, the productivity and challenges of interorganizational collaborations to address the roots of social problems, and the forethought and courage of organizational leadership to try to create self-sufficient clients who might become liberated from their services.
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María Carolina Rodríguez-Donate, Margarita Esther Romero-Rodríguez, Víctor Javier Cano-Fernández and Ginés Guirao-Pérez
The globalization of wine markets together with a prolonged decline in wine consumption, especially in traditional wine-producing countries such as Spain, make it more relevant…
Abstract
Purpose
The globalization of wine markets together with a prolonged decline in wine consumption, especially in traditional wine-producing countries such as Spain, make it more relevant than ever to study population segments such as female wine consumers. Such segments could contribute to increasing consumption. The purpose of this paper is to investigate the distinctive features of wine consumption according to gender, identifying sociodemographic profiles of female wine consumers and non-consumers in Tenerife (Canary Islands). The Canarian archipelago is one of the Spanish regions with a long tradition in wine production.
Design/methodology/approach
This study uses data from a survey carried out on a representative sample of 1,028 Tenerife residents. Independent tests and correspondence analyses were performed. Moreover, an ordered mixed logit model was estimated.
Findings
Gender is a determining factor when analysing the frequency of wine consumption. The profiles of female consumers and female non-consumers differ substantially. Considering unobserved heterogeneity in the estimated model also allows us to verify the variability of the effects on the probability of women with the same sociodemographic characteristics having the same consumption pattern.
Research limitations/implications
Non-sociodemographic variables could be considered in this paper.
Practical implications
Marketing strategies should not consider women as a homogenous group.
Originality/value
This study examines in depth the sociodemographic factors that influence the frequency of wine consumption according to gender. It is relevant given the scarcity of studies that analyse these factors. Likewise, unobserved heterogeneity in consumer decisions is taken into account, an aspect that has not been sufficiently considered in wine consumption literature so far.
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M. Carolina Rodríguez-Donate, Margarita Esther Romero-Rodríguez, Víctor Javier Cano-Fernández and Ginés Guirao-Pérez
The Spanish wine sector has gained ever greater relevance not only in economic terms but also from a social and environmental perspective. One Spanish region with a deeply rooted…
Abstract
Purpose
The Spanish wine sector has gained ever greater relevance not only in economic terms but also from a social and environmental perspective. One Spanish region with a deeply rooted history of growing and producing wine is the Canary Islands, and specifically the island of Tenerife. The wine sector there has undergone notable evolution since the end of the past century. The main aim of these changes has been to improve the quality of Canarian wines, although it is also crucial to design marketing strategies that contribute to maintaining and increasing market share. In this context, it is essential to improve our knowledge of wine consumption among the population, especially given the scarcity of studies that analyze consumption preferences. Thus, the aim of this study is to identify wine consumption profiles.
Design/Methodology/Approach
This study uses data from a survey carried out on a representative sample of 1,028 Tenerife residents. Discrete choice models are estimated to identify profiles of wine consumers.
Findings
The main results show that the probability of consuming wine is the greatest among adult men compared to a lower consumption by younger individuals and women. Furthermore, it was shown that the probability of occasional consumption increases with higher educational levels.
Originality/value
This study examines in depth the individual factors that influence decisions on wine consumption (frequency and amount) in Tenerife (Canary Islands), which has a wine-growing landscape that produces several unique grape varieties. The study quantifies the probability of wine consumption depending on resident individuals’ sociodemographic characteristics. Thus, it contributes to a greater understanding of demand and consumption patterns in the island´s wine sector and allows comparisons to be made with studies for other geographical areas. It is, therefore, a valuable framework for designing targeted marketing strategies to increase consumption and attract demand from potential consumers with specific characteristics.
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Sundeep Sahay and Esther N. Landen
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Abstract
Purpose
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Design/methodology/approach
This paper analyzes the everyday work of CHWs in two low- and middle-income country (LMIC) contexts (Uganda and Malawi) and seeks to understand changes in collective identity and the role of Information and Communication Technologies (ICTs) in mediating this “identity work”. As CHWs conduct their everyday tasks of care giving, data reporting and maintaining social interactions, they play two primary roles. One is the care giving role oriented towards the community, and two, is reporting and administrative work by virtue of them being affiliated with the Ministry of Health, either in formal or voluntary capacity. The ambivalence which they experience as they move back and forth between these two worlds of work is significantly now mediated through ICTs. The paper analyzes these dynamics and identifies three key sets of ambivalence in identity work: (1) role embracing-institutional distancing; (2) conformist-resistant and (3) dramaturgical-transformative. The paper makes unique contributions to information systems (IS) and ICT for development (ICT4D) studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system. This contrasts with dominant research in the field which focuses on professional groups, largely based in Western business organizations.
Findings
The paper identifies identity related tensions that emerge with the mediation of digital technologies in the work world of CHWs. These include tensions of conformist-resistant; and (3) dramaturgical-transformative. These findings are relevant and unique to the field of IS and ICT4D studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system.
Research limitations/implications
While acknowledging identity construction and negotiation is a function of both work and social lives, in this paper we could only focus on the work lives.
Practical implications
As digital interventions in the health sector of low and middle income countries is becoming increasingly widespread, often the focus is more on the supply side (the supply of the technology) rather than on the demand side (users experiences and aspirations). Identity becomes a lens to understand these demand side dynamics, which helps provides practical guidance on implementation approaches to ensure that the technology adds value to user work processes and there is a seamless and not a disruptive transition.
Social implications
CHWs are the most neglected cadre in the health system of low and middle income countries, even though they provide the cutting edge in care provision work to the most marginalized populations, living in rural and underserved areas. By focusing on how technologies can be more effectively implemented to support these care processes, the paper provides important social implications both for practice and research.
Originality/value
Analysis of identity construction and negotiation of informal groups in the unorganized sector of low and middle income countries has not received adequate attention in IS research. The paper seeks to fill this important gap.