Jeff Fernandez, David Robertson, Vicky Dunlop and ISIS Primary Care Service
This paper looks at ISIS, the primary care service that was set up in the London borough of Islington to improve throughput into GP prescribing services from the drug‐using…
Abstract
This paper looks at ISIS, the primary care service that was set up in the London borough of Islington to improve throughput into GP prescribing services from the drug‐using population. ISIS is a service developed from a statutory and voluntary sector initiative that was developed with a GP shared‐care model in its design. It is led by a GP and two non‐medical prescribing nurses to service a population that would not stay with the service but would be managed through the project to GP prescribing services.Over the course of the first year, however, while throughput to GP services improved, the numbers were still too low for the model to work effectively. Just under half of GPs were not offering services to this population, and there were a number of more complex patients who needed to be referred to a specialist drug agency.Results from the annual audit showed that there was a population of clients who were responding well to treatment but did not have a prescribing GP to be referred on to. This paper highlights these stable patients and argues that this population can be managed in a GP‐led service such as ISIS. Revisions to service design and commissioning objectives may be required, but should be easy to implement.
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Tessa Withorn, Jillian Eslami, Hannah Lee, Maggie Clarke, Carolyn Caffrey, Cristina Springfield, Dana Ospina, Anthony Andora, Amalia Castañeda, Alexandra Mitchell, Joanna Messer Kimmitt, Wendolyn Vermeer and Aric Haas
This paper presents recently published resources on library instruction and information literacy, providing an introductory overview and a selected annotated bibliography of…
Abstract
Purpose
This paper presents recently published resources on library instruction and information literacy, providing an introductory overview and a selected annotated bibliography of publications covering various library types, study populations and research contexts.
Design/methodology/approach
This paper introduces and annotates English-language periodical articles, monographs, dissertations, reports and other materials on library instruction and information literacy published in 2020.
Findings
The paper provides a brief description of all 440 sources and highlights sources that contain unique or significant scholarly contributions.
Originality/value
The information may be used by librarians, researchers and anyone interested in a quick and comprehensive reference to literature on library instruction and information literacy.
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This paper examines a common presentation to primary care and specialist drug services. Often patients who are experiencing opioid dependencies when stabilising on methadone often…
Abstract
This paper examines a common presentation to primary care and specialist drug services. Often patients who are experiencing opioid dependencies when stabilising on methadone often increase their consumption of alcohol. Also, increasingly so, polydrug use is a growing presentation with heroin, crack and alcohol use used in dependent patterns when presenting for treatment.There is often a lack of alcohol detoxification treatment packages given to those who are on methadone, and often some prescribers in the area of substance use regard an alcohol detoxification programme when prescribing methadone as too risky. This has led to a reluctance in general to prescribe an alcohol detoxification programme for many patients who request it. This is the case in Islington, London.This paper looks at a new service set up in Islington, London and looks at the way it has treated the cohort of patients who have presented with polydrug use, including alcohol. It has seen that patients who were more stable on their methadone and had longer histories in treatment were more likely to complete an alcohol detoxification programme with some ‘dry’ time off alcohol. It proposes that while there is a risk of prescribing alcohol detoxification regimes with methadone, there is a cohort of patients were this can be prescribed with a favourable outcome.
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The purpose of this paper is to illustrate how local drug services use their senior staff to respond to emerging ethnic groups presenting to treatment using flexible thinking and…
Abstract
Purpose
The purpose of this paper is to illustrate how local drug services use their senior staff to respond to emerging ethnic groups presenting to treatment using flexible thinking and innovative processes.
Design/methodology/approach
The methodology was a case study design that used a semi-structured questionnaire that looked at two drug services and their staff’s influence on service delivery in different boroughs of east London.
Findings
The research found very innovative findings from the two boroughs. The boroughs had different racial mixes and therefore differing populations presenting to their local drug services. However, they used flexible approaches to structure their services to engage with emerging ethnic minority populations in drug treatment. From the findings, these different approaches and structures of providing drug treatment were very important. Approaches, for example, of clinical staff offering a “rapid assessment” are particularly important in engaging and retaining ethnic minority populations. Also, using flexible thinking within the staff team enables drug services to adapt treatments to be flexible in responding to emerging ethnic populations.
Practical implications
This paper shows that thinking in designing approaches to drug treatment shows that ethnic minority populations can be successfully engaged in drug treatment. This has implications for drug treatment nationally and across Europe where there are “emerging” ethnic populations presenting for drug treatment.
Originality/value
This paper shows that drug services can adapt and change to their different ethnic minority populations if they can able to be flexible in their clinical approach to service provision.
Helen Jane Liebling, Hazel Rose Barrett and Lillian Artz
This British Academy/Leverhulme-funded research (Grant number: SG170394) investigated the experiences and impact of sexual and gender-based violence (SGBV) and torture on South…
Abstract
Purpose
This British Academy/Leverhulme-funded research (Grant number: SG170394) investigated the experiences and impact of sexual and gender-based violence (SGBV) and torture on South Sudanese refugees’ health and rights and the responses of health and justice services in Northern Uganda.
Design/methodology/approach
It involved thematic analysis of the narratives of 20 men and 41 women refugees’ survivors of SGBV and torture; this included their experiences in South Sudan, their journeys to Uganda and experiences in refugee settlements. In total, 37 key stakeholders including health and justice providers, police, non-government and government organisations were also interviewed regarding their experiences of providing services to refugees.
Findings
All refugees had survived human rights abuses carried out in South Sudan, on route to Uganda and within Uganda. Incidents of violence, SGBV, torture and other human rights abuses declined significantly for men in Uganda, but women reported SGBV incidents. The research demonstrates linkages between the physical, psychological, social/cultural and justice/human rights impact on women and men refugees, which amplified the impact of their experiences. There was limited screening, physical and psychological health and support services; including livelihoods and education. Refugees remained concerned about violence and SGBV in the refugee settlements. While they all knew of the reporting system for such incidents, they questioned the effectiveness of the process. For this reason, women opted for family reconciliation rather than reporting domestic violence or SGBV to the authorities. Men found it hard to report incidences due to high levels of stigma and shame.
Research limitations/implications
Refugees largely fled South Sudan to escape human rights abuses including, persecution, SGBV and torture. Their experiences resulted in physical, psychological, social-cultural and justice effects that received limited responses by health and justice services. An integrated approach to meeting refugees’ needs is required.
Practical implications
The authors make recommendations for integrated gender sensitive service provision for refugees including more systematic screening, assessment and treatment of SGBV and torture physical and emotional injuries combined with implementation of livelihoods and social enterprises.
Social implications
The research demonstrates that stigma and shame, particularly for male refugee survivors of SGBV and torture, impacts on ability to report these incidents and seek treatment. Increasing gender sensitivity of services to these issues, alongside provision of medical treatment for injuries, alongside improved informal justice processes, may assist to counteract shame and increase disclosure.
Originality/value
There is currently a lack of empirical investigation of this subject area, therefore this research makes a contribution to the subject of understanding refugees’ experiences of SGBV and torture, as well as their perceptions of service provision and response. This subject is strategically important due to the pressing need to develop integrated, gendered and culturally sensitive services that listen to the voices and draw on the expertise of refugees themselves while using their skills to inform improvements in service responses and policy.
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Brian Euesden, Colin Gough and Jean Whittaker
The Education Reform Act and, in particular, the Local Managementof Schools will demand different skills, understanding and differingroles of senior management in educational…
Abstract
The Education Reform Act and, in particular, the Local Management of Schools will demand different skills, understanding and differing roles of senior management in educational establishments. This text draws on written assignments and experience of teachers and headteachers who piloted an MBA programme, designed specifically for senior teachers. Topics such as customers, product, price, promotion and the notion of teachers as a salesforce are unfamiliar to educators. They draw attention to the kind of strategic planning which will take place in schools as they take over responsibility for delegated budgets. All of this is new territory for the majority of state schools and this collection hopefully provides a useful resource.
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Lisa-Marie Larisch, Isis Amer-Wåhlin and Patrik Hidefjäll
There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider…
Abstract
Purpose
There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs).
Design/methodology/approach
The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed.
Findings
The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations.
Research limitations/implications
In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities.
Social implications
Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring.
Originality/value
This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public policy making. A better understanding of ISs in general, and in healthcare in particular, may provide the basis for designing and evaluating innovation policy.
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Sara Korlén, Anna Essén, Peter Lindgren, Isis Amer-Wahlin and Ulrica von Thiele Schwarz
Policy makers are applying market-inspired competition and financial incentives to drive efficiency in healthcare. However, a lack of knowledge exists about the process whereby…
Abstract
Purpose
Policy makers are applying market-inspired competition and financial incentives to drive efficiency in healthcare. However, a lack of knowledge exists about the process whereby incentives are filtered through organizations to influence staff motivation, and the key role of managers is often overlooked. The purpose of this paper is to explore the strategies managers use as intermediaries between financial incentives and the individual motivation of staff. The authors use empirical data from a local case in Swedish specialized care.
Design/methodology/approach
The authors conducted an exploratory qualitative case study of a patient-choice reform, including financial incentives, in specialized orthopedics in Sweden. In total, 17 interviews were conducted with professionals in managerial positions, representing six healthcare providers. A hypo-deductive, thematic approach was used to analyze the data.
Findings
The results show that managers applied alignment strategies to make the incentive model motivating for staff. The managers’ strategies are characterized by attempts to align external rewards with professional values based on their contextual and practical knowledge. Managers occasionally overruled the financial logic of the model to safeguard patient needs and expressed an interest in having a closer dialogue with policy makers about improvements.
Originality/value
Externally imposed incentives do not automatically motivate healthcare staff. Managers in healthcare play key roles as intermediaries by aligning external rewards with professional values. Managers’ multiple perspectives on healthcare practices and professional culture can also be utilized to improve policy and as a source of knowledge in partnership with policy makers.
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Computer technology in libraries has revolutionised the concept of rapid and accurate information services. In Pakistan, though, computer technology is new and is being…
Abstract
Computer technology in libraries has revolutionised the concept of rapid and accurate information services. In Pakistan, though, computer technology is new and is being successfully introduced in all types of libraries and information centres. This article reviews the literature on the use of computers in Pakistan’s libraries. The literature includes monographs, journal articles, reports, etc. published inside and outside Pakistan, discussing information technology, specific library applications, the activities of individual libraries and automation education. The need for library automation and the problems faced by Pakistani professionals in this respect are also discussed.
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Perinatal mental health is a major concern among women of childbearing age. Women from a black and minority ethnic background are widely believed to have particular needs that are…
Abstract
Perinatal mental health is a major concern among women of childbearing age. Women from a black and minority ethnic background are widely believed to have particular needs that are often not given the attention they deserve. NHS Croydon launched a perinatal mental health project to develop a closer and better partnership between the Primary Care Trust (PCT), Croydon Council and black and minority ethnic (BME) voluntary organisations through an action learning approach. Experience was shared to improve engagement and use of health services by mothers from BME communities in Croydon who had encountered mental health problems during pregnancy or following childbirth. By exploring and identifying such issues and problems, the action learning set endeavoured to find solutions for a joined‐up approach to achieve identifiable benefits. Some problems were encountered, such as a lack of communication between health professionals and BME community groups. The learning outcomes were to raise awareness and to recognise the cultural differences with mothers of BME background experiencing perinatal mental health problems. The learning from the project will be disseminated to a wider audience to promote best practice.