Geoff McCombe, Anne Marie Henihan, Jan Klimas, Davina Swan, Dorothy Leahy, Rolande Anderson, Gerard Bury, Colum Dunne, Eamon Keenan, David Meagher, Clodagh O’Gorman, Tom O’Toole, Jean Saunders, Bobby P. Smyth, John S. Lambert, Eileen Kaner and Walter Cullen
Problem alcohol use (PAU) is common and associated with considerable adverse outcomes among patients receiving opioid agonist treatment (OAT). The purpose of this paper is to…
Abstract
Purpose
Problem alcohol use (PAU) is common and associated with considerable adverse outcomes among patients receiving opioid agonist treatment (OAT). The purpose of this paper is to describe a qualitative feasibility assessment of a primary care-based complex intervention to promote screening and brief intervention for PAU, which also aims to examine acceptability and potential effectiveness.
Design/methodology/approach
Semi-structured interviews were conducted with 14 patients and eight general practitioners (GPs) who had been purposively sampled from practices that had participated in the feasibility study. The interviews were transcribed verbatim and analysed thematically.
Findings
Six key themes were identified. While all GPs found the intervention informative and feasible, most considered it challenging to incorporate into practice. Barriers included time constraints, and overlooking and underestimating PAU among this cohort of patients. However, the intervention was considered potentially deliverable and acceptable in practice. Patients reported that (in the absence of the intervention) their use of alcohol was rarely discussed with their GP, and were reticent to initiate conversations on their alcohol use for fear of having their methadone dose reduced.
Research limitations/impelications
Although a complex intervention to enhance alcohol screening and brief intervention among primary care patients attending for OAT is likely to be feasible and acceptable, time constraints and patients’ reticence to discuss alcohol as well as GPs underestimating patients’ alcohol problems is a barrier to consistent, regular and accurate screening by GPs. Future research by way of a definitive efficacy trial informed by the findings of this study and the Psychosocial INTerventions for Alcohol quantitative data is a priority.
Originality/value
To the best of the knowledge, this is the first qualitative study to examine the capability of primary care to address PAU among patients receiving OAT.
Details
Keywords
Jan Klimas, Kevin Lally, Lisa Murphy, Louise Crowley, Rolande Anderson, David Meagher, Geoff McCombe, Bobby P. Smyth, Gerard Bury and Walter Cullen
The purpose of this paper is to describe the development and process evaluation of an educational intervention, designed to help general practitioners (GPs) identify and manage…
Abstract
Purpose
The purpose of this paper is to describe the development and process evaluation of an educational intervention, designed to help general practitioners (GPs) identify and manage problem alcohol use among problem drug users.
Design/methodology/approach
The educational session was developed as part of a complex intervention which was informed by the Medical Research Council framework for complex interventions. A Cochrane review and a modified Delphi-facilitated consensus process formed the theoretical phase of the development. The modelling phase involved qualitative interviews with professionals and patients. The training's learning outcomes included alcohol screening and delivery of brief psychosocial interventions and this was facilitated by demonstration of clinical guidelines, presentation, video, group discussion and/or role play.
Findings
Participants (n=17) from three general practices and local medical school participated in four workshops. They perceived the training as most helpful in improving their ability to perform alcohol screening. Most useful components of the session were the presentation, handout and group discussion with participants appreciating the opportunity to share their ideas with peers.
Originality/value
Training primary healthcare professionals in alcohol screening and brief psychosocial interventions among problem drug users appears feasible. Along with the educational workshops, the implementation strategies should utilise multi-level interventions to support these activities among GPs.
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Peter Sergeant, Luc Dupré and Jan Melkebeek
To study the magnetic shielding of buried high‐voltage (HV) cables by adding conductive metal plates on the ground surface above the cables.
Abstract
Purpose
To study the magnetic shielding of buried high‐voltage (HV) cables by adding conductive metal plates on the ground surface above the cables.
Design/methodology/approach
The field is calculated with eight rectangular conductive plates above the cables, positioned with their long edge either parallel to the cables or transversal to the cables. Here, the circuit method is used. In this method, the shield is replaced by a grid of straight filaments in which the unknown currents are searched by solving an electrical circuit.
Findings
It is observed from the calculation results that it is important to have a perfect electrical connection between adjacent plates. In the area above the shield, an “infinite” contact resistance between neighbouring plates results roughly in double field amplitude compared to the situation with contact resistance zero. The positioning of the rectangular plates (parallel or transversal to the cables) has not much influence on the shielding. The shielding efficiency as a function of the shield size is studied as well. The circuit method is validated by measurements on an experimental setup at reduced scale.
Research limitations/implications
The circuit method is applied to conductive objects and not to ferromagnetic objects.
Practical implications
As the circuit method is rather fast also for 3D geometries with thin plates, the shielding of HV cables can be evaluated in a computationally more efficient way than by using, e.g. finite elements.
Originality/value
The circuit method is already described in the literature. The originality of this paper is the study – by this circuit method – of the effect of several parameters (size of the shield, contact resistance, orientation of the plates) on the shielding efficiency.
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Anne Sigismund Huff, Frances J. Milliken, Gerard P. Hodgkinson, Robert J. Galavan and Kristian J. Sund
This book on uncertainty comprises the initial volume in a series titled “New Horizons in Managerial and Organizational Cognition”. We asked Frances Milliken and Gerard P…
Abstract
This book on uncertainty comprises the initial volume in a series titled “New Horizons in Managerial and Organizational Cognition”. We asked Frances Milliken and Gerard P. Hodgkinson, two well-known scholars who have made important contributions to our understanding of uncertainty to join us in this opening chapter to introduce this project. The brief bios found at the end of this volume cannot do justice to the broad range of their contributions, but our conversation gives a flavor of the kind of insights they have brought to managerial and organizational cognition (MOC). The editors thank them for helping launch the series with a decisive exploration of what defining uncertainty involves, how that might be done, why it is important, and how the task is changing. We were interested to discover that all five of us are currently involved in research that considers the nature and impact of uncertainty, and we hope that readers similarly find that paying attention to uncertainty contributes to their current projects. Working together, we can advance understanding of organizational settings and effective action, both for researchers and practitioners.
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In their recent book, Dead Man Working, Carl Cederström and Peter Fleming paint a haunting picture of the contemporary employee: sleep deprived and overworked, exhausted and…
Abstract
In their recent book, Dead Man Working, Carl Cederström and Peter Fleming paint a haunting picture of the contemporary employee: sleep deprived and overworked, exhausted and strung out, unable to tell where work ends and where life begins, hardly alive and yet unable to die. In this paper, the author widens the picture by examining the systemic effects of contemporary work on the family. Drawing upon ideas from psychoanalysis and critical theory, the author reveals how the extraction of life by work reverberates across generations and seeps into the home environment. The author also reveals how new constellations of family reinforce deadening work. What emerges is a family portrait known as the “dead family working.”
Stephen O’ Reilly, John Flannery, Terence O’ Donnell, Andrew Muddiman, Gerard Healy, Michael Byrne and Sean Cian Ó Mathúna
Multilayer aircore inductors fabricated in a range of interconnection technologies which are MCM compatible are presented and compared. These consist of thick‐film, low…
Abstract
Multilayer aircore inductors fabricated in a range of interconnection technologies which are MCM compatible are presented and compared. These consist of thick‐film, low temperature cofired ceramic (LTCC), printed circuit board (PCB) and fine‐line plated copper on ceramic (copper plating). From a comparison of simulated and measured results, it can be concluded that a predictive design capability has been achieved for inductance and self‐resonant frequency (SRF). Modelling of AC resistance and Q requires further investigation.
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The purpose of this paper is to argue for a revision of the concept of compassion fatigue in light of both its history and psychodynamics.
Abstract
Purpose
The purpose of this paper is to argue for a revision of the concept of compassion fatigue in light of both its history and psychodynamics.
Design/methodology/approach
This paper calls into question conventional interpretations of compassion fatigue and the assumptions underlying them. As an alternative, a psychoanalytic interpretation is offered that sheds light on the phenomenon’s unconscious and organizational dynamics. This interpretation also aligns with the concept’s historical use in media and politics.
Findings
In contrast to the assumption that compassion fatigue arises from too much compassion, historical use of the term suggests just the opposite: compassion fatigue is the result of too little compassion. Healthcare literature on compassion fatigue has not only failed to account for this opposing view, but also the underlying psychodynamics at play. By attending to these neglected dimensions, healthcare scholars and practitioners can gain new insights into compassion fatigue and devise more sustainable interventions.
Originality/value
This paper reveals hidden dimensions to compassion fatigue that call into question conventional interpretations and offer novel perspectives on a core concern of healthcare work.