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.
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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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Concerns about a slowdown in the sports marketing business have recently been expressed. A major conference, SportBusiness 2001, included a session asking if the boom was over…
Abstract
Concerns about a slowdown in the sports marketing business have recently been expressed. A major conference, SportBusiness 2001, included a session asking if the boom was over. Assuming that the level of sponsorship activity is a key indicator of the real state of the industry, we conducted an analysis of the amount spent worldwide on acquiring sponsorship rights in 2000. This confirms that the recent spectacular growth has halved to a still-robust seven per cent. Further analysis undertaken of sponsorship agreements reported in the European press in 2000 provides evidence that the sponsorship medium is still fundamentally valid.
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Jefferson Marlon Monticelli, Tatiane Pellin Cislaghi and Kettrin Farias Bem Maracajá
Our research aims to understand how coopetition can create barriers to tourism by focussing on the collective interests that seek to preserve the identity of a geographical…
Abstract
Our research aims to understand how coopetition can create barriers to tourism by focussing on the collective interests that seek to preserve the identity of a geographical indication (GI). We conducted a qualitative longitudinal study that analyses a Brazilian wine industry, specifically the Vale dos Vinhedos (a GI region in Southern Brazil), because it provides examples of leveraging coopetition to develop the area. The study was conducted over 10 years (2012–2022), collecting primary data from representatives of the Brazilian wine industry in 36 semi-structured interviews. Interviewees emphasised how the Vale dos Vinhedos vocation is founded on natural beauty and tranquillity, aiming to preserve aspects that value wine culture. The study found that wineries and formal institution agents established a coopetition strategy to stop uncontrolled expansion in real-estate development, blocking the entry of new ventures such as hotels and timeshares that could distort the region's character. Consequently, coopetition does not merely hinder the progression of tourism to real estate ventures; instead, it functions as an informal, and occasionally a formal, regulatory mechanism. While initially perceived as a drawback, upon examining the social, cultural, and economic advantages, this phenomenon emerges as a market control strategy that enhances the region.
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This chapter prepares expatriates and businesses to live and work in Central Europe. It draws on intercultural relations, international relations, Central and Eastern European…
Abstract
This chapter prepares expatriates and businesses to live and work in Central Europe. It draws on intercultural relations, international relations, Central and Eastern European studies, interviews with people who are from or living in the region and the American author's experiences as an international student and expat in Kraków, Poland. It begins by introducing the concept of culture and cautioning that Central European culture is not monolithic but contains variety and layers. Second, it explains that the boundaries of Central Europe are hard to define and warns that the labels Central and Eastern European may carry significant meaning for locals. Third, it argues that history is essential to understanding contemporary life in the region and outlines major trends and patterns that remain relevant. It also suggests ways that outsiders can make sense of the relationship between the past and present, with advice on how to talk to locals and a list of questions they can use to integrate and advance their learning. Fourth, it uses Hofstede Insights' (n.d.) model to explore three key dimensions of Central European culture, including indulgence, power distance and uncertainty avoidance. It also presents additional cultural tips from locals and expats for how outsiders can adapt when they move to the region. It concludes by noting that although expats and businesses may find certain elements of Central European culture challenging, they will also likely find their time here moving and memorable.
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Luciana Marques Vieira, Jefferson Marlon Monticelli and Tatiane Pellin Cislaghi
This paper aims to understand how institutions influence a Geographical Indication (GI) region to create value over time. The study examines a Brazilian wine industry that has…
Abstract
Purpose
This paper aims to understand how institutions influence a Geographical Indication (GI) region to create value over time. The study examines a Brazilian wine industry that has lasted for about a century, using ten recent years of primary data collection (2012–2022).
Design/methodology/approach
This paper developed a qualitative study that looks at coopetition and institutions and considers the GI as an institution. It collected the data from 33 representatives of the Brazilian wine industry in three stages (2012–2013, 2017 and 2022).
Findings
The results show that coopetitive strategies between Brazilian wineries are encouraged by both formal and informal institutions, which results in a GI becoming a collective institution. Value creation, however, drives new entrants aiming to achieve gains, and this risks destroying the GI due to the perception of lack of balance on value capture over time.
Originality/value
This study describes the creation and evolution of a GI for developing wine production in a particular grape-growing region in Brazil, which has, consequently, encouraged coopetition between supply chain agents leading to value creation. Most wineries, however, lack a value capture perception, which has resulted in the risk of value being destroyed by allowing new entrants into the cluster. The three stages of data collection and analysis provide an understanding of coopetitive strategies over the long term.
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This paper examines localized conditions and responses to what people see as ordinary variations in the weather, drawing on their own archive of knowledge and practice for…
Abstract
Purpose
This paper examines localized conditions and responses to what people see as ordinary variations in the weather, drawing on their own archive of knowledge and practice for “coping” with it, as distinct from year-to-year climate patterns that may entail “adaptation.”
Design
This paper draws on ethnographic field research and rainfall statistics collected in 1968–1969 and 1987–1988, in a rural area of Western Nigeria where guinea-savannah small-scale farmers now grow increasingly for the market. Research in the 1980s was designed to track all changes since the 1960s. It is revisited here to draw out the rainfall variable.
Findings
In the 1980s, farmers noted a decline in the first rains of the early growing season, and a change in the short dry season, over a period of three years, in a way that differed from the expected patterns of twenty years previously. The shift is confirmed by rainfall statistics. Their crop repertoire choices are noted.
Limitations and research implications
The paper’s themes are culled from a broader range of observations over the 20 years. The interweaving of the variables in complex change over several decades is noted as a research challenge.
Originality
Local time series, interpreted through the local archive of social and technical practice, offers a rich entry point into what the recent AAA climate change review refers to as coping and adaptation, with respect to what I call “weather” and “climate.”
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Denise M. Cumberland, Andrea D. Ellinger, Tara McKinley, Jason C. Immekus and Andrew McCart
Leadership development programs (LDPs) have emerged relatively recently in the healthcare context as a mechanism not only to develop capable and competent leaders but also to…
Abstract
Purpose
Leadership development programs (LDPs) have emerged relatively recently in the healthcare context as a mechanism not only to develop capable and competent leaders but also to retain them. The purpose of this paper is to describe a perspective on practice by illustrating a case example that showcases a pilot LDP for newly promoted healthcare leaders. The details about how it was developed and implemented collaboratively by a healthcare consortium and higher education institution (HEI) to address shared healthcare leadership talent pipeline and retention challenges are provided.
Design/methodology/approach
This perspective on practice describes how a consortium of competitive healthcare organizations, a type of branded Inter-organizational Relationship referred to as “Coopetition,” contracted with a HEI to design, develop and launch a pilot LDP, referred to as the Academy for Healthcare Education and Development program, using the analyze, design, develop, implement and evaluate model.
Findings
The significance of this illustrative case example is discussed along with some initial lessons learned based upon this pilot LDP that 24 program participants completed. Implications for research, theory and practice are presented, followed by limitations and a conclusion.
Originality/value
Inter-organizational relationships, particularly coopetition, are relatively new in the healthcare sector, along with collaboration with HEIs to develop interventions to solve compelling industry problems. This illustrative case example offers insights that address scholars’ calls and practitioners’ needs to explicate different approaches for LDPs to build the healthcare leadership talent pipeline.