Annegret Hella Dahlmann‐Noor, Nitin Gupta, Gordon R. Hay, Caroline A. Cates, Gavin Galloway, Kerry Jordan, Robert J. Lamb, Andrew S. Ramsay and Anthony J. Vivian
The patient journey from detection of an eye problem by optometrists to assessment and treatment by ophthalmologists can be streamlined by direct referral from optometrist to…
Abstract
Purpose
The patient journey from detection of an eye problem by optometrists to assessment and treatment by ophthalmologists can be streamlined by direct referral from optometrist to hospital eye service (HES). This requires locally agreed guidelines and training and feedback for optometrists to ensure high diagnostic competence. The purpose of this paper is to evaluate the quality of the West Suffolk Direct Referral Scheme, one of the first direct referral schemes in the UK to include all ophthalmic sub‐specialties.
Design/methodology/approach
Two‐cycle audit of existing practice, including all new patients referred by optometrists and seen at West Suffolk Hospital during a three‐month period in 2003 and a seven‐week period in 2006. Three interventions: direct referral clinics for urgent patients; introduced in 2003; six‐monthly training sessions for optometrists; and regular, prompt feedback via letter about individual consultation outcome. Prospective data collection via proforma in both cycles; additional retrospective data collection in the second cycle. Diagnostic accuracy, perception of urgency and request of subspecialty clinic were evaluated.
Findings
The direct referral scheme streamlines the patient journey, and patients with acute problems have fast access to HES. In total, 99 per cent of referrals are appropriate. Diagnostic competence is high (87 per cent), and has improved with tighter communication between HES and optometrists. Agreement is less for referral urgency (75 per cent) and choice of subspecialty clinic (74 per cent).
Originality/value
The West Suffolk Direct Referral Scheme provides an efficient service of high quality. Good communications and continued feedback between community‐ and hospital‐based eye care services improve standards and facilitate efficient use of resources.
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Hannah Timpson, Lindsay Eckley, Harry Sumnall, Marissa Pendlebury and Gordon Hay
Recovery is a central component of UK substance misuse policy, however, relatively little is known about the views and meanings of recovery by those experiencing it. The purpose…
Abstract
Purpose
Recovery is a central component of UK substance misuse policy, however, relatively little is known about the views and meanings of recovery by those experiencing it. The purpose of this paper is to explore these factors, and understand how service user experiences align to current understandings of “recovery capital”.
Design/methodology/approach
This paper draws on qualitative interviews with 32 individuals from six UK recovery communities, including those commissioned by a statutory service (n=8) and a peer-led recovery community (n=24).
Findings
Meanings of recovery differed between people in abstinence-based communities and those not; however, all had consistent views on their own recovery outcomes and the benefits they believed recovery brought. All viewed recovery as a process; a continuous journey with no end-point. Internal motivation, peer support, social networks and daily structure were integral to supporting individuals achieve and maintain recovery. Key benefits of recovery reflected recovery capital and included positive relationships, sense of belonging, increased self-worth and confidence, employment and education.
Research limitations/implications
This research shows that recovery experiences and outcomes are not centred entirely on the individual but are wider, more holistic. Maintaining recovery involves being connected to themselves and to the wider environment: family, friends, peers and society. Although the recovery capital model has many elements that were discussed by the participants of this research, the discourse they used does not align with the model. To validly measure and quantify recovery outcomes, individuals need to identify with the measures themselves.
Practical implications
From policy and commissioning perspectives, these findings suggest benefits of recovery that were viewed by participants as indicators of success: demonstrate elements which support recovery; and highlight key social value outcomes which people attribute to recovery.
Social implications
These “softer”, qualitative benefits should be considered by policy-makers, commissioners, statutory and non-statutory services in order to evidence outcomes. However, it should also be recognised that a temporally static approach to assessing recovery may be in contradiction to the meaning and perspectives held by those in recovery communities who conceptualise it as a long term and ongoing process.
Originality/value
This paper adds to understandings of experiences and meanings of recovery, with a particular focus on the measurement of outcomes and their meanings, and the role of abstention and continued drug use within the recovery process.
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Hsuanwei Michelle Chen and Tawa Ducheneaux
The purpose of this paper is to investigate the operation and management as well as the activities of tribal libraries in general, providing insights and implications in five…
Abstract
Purpose
The purpose of this paper is to investigate the operation and management as well as the activities of tribal libraries in general, providing insights and implications in five areas: general operations and management, staffing and human resource management, financial operations, service and program management, and technology-related activities, using Oglala Lakota College (OLC) Library as a case study.
Design/methodology/approach
This paper uses information visualization techniques to create visual displays of report data collected from OLC Library. Visualizations were created using Tableau software to provide a quantitative, analytical, and evidence-based view of how tribal libraries operate and are managed.
Findings
Tribal populations can be well served despite limited funding and staff resources, providing academic and public library services on par with urban libraries.
Research limitations/implications
Drawing a story from the data proved to be difficult because a bias had been created by the legal service area that most tables of the state data set used to compare reported data. How tribal libraries translate value also posed another challenge. Because the research was conducted in a single tribal library, further research in different, expanded settings and contexts is suggested.
Originality/value
This study is one of the first to investigate tribal library activities by exploring report data and quantitatively using information visualization techniques.
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A computer environment to support the strategic decision‐making process in construction firms is presented. The system implements modelling concepts originally developed to…
Abstract
A computer environment to support the strategic decision‐making process in construction firms is presented. The system implements modelling concepts originally developed to evaluate project execution strategies, extending and generalizing the modelling methodology to a broader range of strategic decisions. An application to a construction firm's strategic planning is used in this paper to illustrate the modelling process. The computer system is designed to help the users in building a conceptual model for the decision problem, this model is a simplified structure of the variables and interactions that influence the decisions being analysed, including internal as well as external factors. An analytical model is then designed to predict the impact of these strategies, integrating expert knowledge and assessments of the strategic planning team into a mathematical model. The mathematical component uses concepts of cross‐impact analysis and probabilistic inference to capture uncertainties and interactions among project variables. The system provides multiple analysis capabilities, including sensitivity analysis, selected outcome prediction, isolated or combined effect of strategies and changes in performance due to changes in the external environment. The system allows management to test different combinations of long‐term strategies and predict expected sales, market share or other measures of performance.
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The aim of this paper is to review the policy literature on green jobs and green jobs training in the USA and to present findings of a qualitative study on the start-up of two…
Abstract
Purpose
The aim of this paper is to review the policy literature on green jobs and green jobs training in the USA and to present findings of a qualitative study on the start-up of two Energy Training Partnerships (ETP) funded by the US Department of Labour to train workers for green jobs.
Design/methodology/approach
The paper includes a review of the policy literature, document reviews, and interviews with administrators, employers, educators, workforce officials. The literature presumes green jobs training will help create jobs and that these jobs will provide opportunities for the poor. This study examined these propositions within the context of the ETPs.
Findings
Stakeholders faced challenges related to a misaligned infrastructure, lack of synchronization in the labour market, and workforce gaps. They responded by coordinating available resources in innovative ways. Though many policy propositions were confirmed, the premise that green jobs are a pathway of poverty was not. Entry requirements were high and programmes lacked funds for long-term education.
Research limitations/implications
Because the sample was small and little was known about the nature of emerging jobs, more research is needed on green jobs and their skill requirements.
Practical implications
The study found that coordination on the policy and programme levels helped stakeholders respond to challenges. Also, new opportunities for the poor may be realized by embedding short-term training in a broad continuum of education and strategically linking both to economic development activities.
Originality/value
Little is known about how training aligns with emerging industries. This study helped fill this gap by examining how stakeholders responded to the demands of the green sector.
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Ann-Marie Kennedy, Joya A. Kemper and Andrew Grant Parsons
This paper aims to provide guidelines for upstream social marketing strategy on to whom, how and when social marketers can undertake upstream social marketing.
Abstract
Purpose
This paper aims to provide guidelines for upstream social marketing strategy on to whom, how and when social marketers can undertake upstream social marketing.
Design/methodology/approach
This article is a conceptual piece using academic literature to justify and conceptualise an approach to communicating with and influencing upstream actors.
Findings
Specifically, it looks at the characteristics of policymakers targeted, then targeting methods, with a special focus on the use of media advocacy. Finally, a process of government decision-making is presented to explain message timing and content.
Practical implications
Specific criteria to judge time of decision-making and implementation guidelines are provided for social marketers.
Originality/value
In the case of complex social problems, such as obesity and environmental degradation, structural change is needed to provide people with the ability to change (Andreasen, 2006). Strategic social marketing has identified upstream social marketing as a method to influence structural change through policymakers (French and Gordon, 2015); however, literature in the area tends to be descriptive and there are no clear guidelines to its implementation (Dibb, 2014). This article seeks to provide those guidelines.
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Although the extant literature widely recognizes the impact of corporate culture on performance, such findings are either speculative or mostly based on US companies, thus may not…
Abstract
Although the extant literature widely recognizes the impact of corporate culture on performance, such findings are either speculative or mostly based on US companies, thus may not be generalisable to other national settings. In addition, while industry effect is considered in a few studies, its combined effect with other factors on performance has not been explored. This study modifies the existing model of corporate culture on performance by adding industry effect to the model. This is also the first study that tests such a relationship in a Middle East setting. Due to its unique culture, data collection in the Middle East region has been difficult if not impossible. More research in this region is needed since most of it is still in its infancy. This study investigates firms in Bahrain, the financial hub of the Arab World, to shed some insight onto this region. The results confirm a positive relation between Culture and performance and marginal industry effect between banks and hotels.
Paul Clarkson, Rebecca Hays, Sue Tucker, Katie Paddock and David Challis
A growing ageing population with complex healthcare needs is a challenge to the organisation of healthcare support for older people residing in care homes. The lack of specialised…
Abstract
Purpose
A growing ageing population with complex healthcare needs is a challenge to the organisation of healthcare support for older people residing in care homes. The lack of specialised healthcare support for care home residents has resulted in poorer outcomes, compared with community-dwelling older people. However, little is known about the forms, staff mix, organisation and delivery of such services for residents’ physical healthcare needs. The paper aims to discuss these issues.
Design/methodology/approach
This systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to provide an overview of the range of healthcare services delivered to care homes and to identify core features of variation in their organisation, activities and responsibilities. The eligibility criteria for studies were services designed to address the physical healthcare needs of older people, permanently residing in care homes, with or without nursing. To search the literature, terms relating to care homes, healthcare and older people, across ten electronic databases were used. The quality of service descriptions was appraised using a rating tool designed for the study. The evidence was synthesised, by means of a narrative summary, according to key areas of variation, into models of healthcare support with examples of their relative effectiveness.
Findings
In total, 84 studies, covering 74 interventions, identified a diverse range of specialist healthcare support services, suggesting a wide variety of ways of delivering healthcare support to care homes. These fell within five models: assessment – no consultant; assessment with consultant; assessment/management – no consultant; assessment/management with consultant; and training and support. The predominant model offered a combination of assessment and management. Overall, there was a lack of detail in the data, making judgements of relative effectiveness difficult. Recommendations for future research include the need for clearer descriptions of interventions and particularly of data on resident-level costs and effectiveness, as well as better explanations of how services are implemented (review registration: PROSPERO CRD42017081161).
Originality/value
There is considerable debate about the best means of providing healthcare to older people in care homes. A number of specialist initiatives have developed and this review seeks to bring these together in a comparative approach deriving models of care of value to policy makers and commissioners.
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A Joint Committee representing both Houses of Parliament, on July 4th, considered, under the chairmanship of Lord Muir‐Mackenzie, the Food and Drugs (Adulteration) Bill, which…
Abstract
A Joint Committee representing both Houses of Parliament, on July 4th, considered, under the chairmanship of Lord Muir‐Mackenzie, the Food and Drugs (Adulteration) Bill, which embodies in consolidated form the Sale of Food and Drugs Acts. The Bill is the first consolidation of these Acts, which date from 1875. Sir Frederick Liddell, Parliamentary counsel, who was accompanied by Mr. J. N. Beckett, of the Ministry of Health, was examined. He said the language of the sections had been harmonised. It was pointed out by members of the Committee that several things were not included in the consolidating Bill. The Chairman said it was a matter for consideration whether it was not for the Minister to say what were the limits of the proposed consolidations. The Minister was entitled to bring in whatever Bill he thought he would. The witness said he thought the Minister would accept the views of the Committee. Sir Henry Slesser, K.C., said, if there was any difficulty about these things, he would rather have the Bill in its present form. It was pointed out that the matters dealt with in a consolidated form did not include, for instance, horseflesh.—The Chairman said there was an unfortunate ambiguity in some of the old Acts. One or two of these matters were left alone for fear of introducing further ambiguity as to intention when they were being considered by the Courts. “Butter fat” and “milk fat” were considered the same thing, so the Committee adopted the phrase “Butter fat derived from milk.” Bread, tea, coffee, chicory, as well as horseflesh, are not mentioned specifically in the Bill, as these were left over for further consideration. It was suggested that all obsolete statutes should be included in a separate clause of the Bill. It was decided to obtain the views of the Minister on this and other points. Provisions are included in the Bill placing restrictions on mixing food and drugs with other ingredients, and giving protection from liability where articles are properly labelled, and there are restrictions on the importation of agricultural and other produce. One of the schedules makes special provisions as to milk. It is laid down that where a sample of milk is procured from a purveyor of milk, he shall, on being required to do so by the person by whom the sample is taken, state the name and address of the seller or consignor from whom he received the milk.