This paper aims to identify variation in the introduction of New Public Management reforms in healthcare and how this variation is related to country‐specific healthcare states.
Abstract
Purpose
This paper aims to identify variation in the introduction of New Public Management reforms in healthcare and how this variation is related to country‐specific healthcare states.
Design/methodology/approach
The analysis uses the introduction of clinical standards in Britain and Germany as cases. The two countries are characterised by interesting differences in relation to the institutional set‐up of healthcare states and as such present ideal cases to explore the specific ways of how healthcare states filter clinical standards as tools of a generic managerialism.
Findings
Both countries have introduced clinical standards but, importantly, the substantive nature of clinical standards differs, reflecting differences in initial institutional conditions. More specifically, in Britain clinical standards have taken the form of two parallel policies, which strengthen hierarchy‐based governing and redefine professional self‐regulation. In Germany, by contrast, clinical standards come in one single policy, which strengthens the hybrid of network‐ and hierarchy‐based governing and to some extent also pure hierarchy‐based forms of governing.
Originality/value
First, with its cross‐country comparative focus, the analysis is able to identify systematic variations across healthcare states and the specific ways in which they impact on the introduction of New Public Management. Second, with its focus on clinical standards, the analysis deals with the governance of medical practice as one of the central areas of healthcare states.
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Vibha Kapuria-Foreman and Charles R. McCann
Prior to the passage of the 20th amendment to the US Constitution in 1920, several states had extended the suffrage to women. Helen Laura Sumner (later Woodbury), a student of…
Abstract
Prior to the passage of the 20th amendment to the US Constitution in 1920, several states had extended the suffrage to women. Helen Laura Sumner (later Woodbury), a student of John R. Commons at Wisconsin, undertook a statistical study of the political, economic, and social impacts of the granting of voting rights to women in the state of Colorado, and subsequently defended the results against numerous attacks. In this paper, we present a brief account of the struggle for women’s equality in the extension of the suffrage and examine Sumner’s critical analysis of the evidence as to its effects, as well as the counterarguments to which she responded.
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There is limited research documenting recovery experiences of residential service users. The purpose of this paper is to explore the perceptions service users on methadone have…
Abstract
Purpose
There is limited research documenting recovery experiences of residential service users. The purpose of this paper is to explore the perceptions service users on methadone have about recovery. In depth, semi structured 1-1 interviews with seven poly drug using homeless males between the ages of 37 and 46 and analysed using NVivo software. Results are presented thematically. Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to former addict identities. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms that equate recovery with abstinence. Tensions were revealed in true motivations for active rather than passive participation in adopting group work norms.
Design/methodology/approach
A qualitative design utilises small numbers of participants to gather rich data. In depth, semi structured 1-1 interviews conducted with seven poly drug using homeless males who have completed between ten and 15 weeks of a minimum 26-week residential treatment programme. Participants were aged 37-46. Results were analysed thematically using NVivo software.
Findings
Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to a former stigmatised addict identity. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms regards recovery and abstinence. A significant process of recovery involved adopting the norms of 12-step groups and TC therapy to gain enough trust to leave the therapeutic community (TC) unsupervised. This created tension regards motivation, were these individuals in recovery, or merely “faking it”?
Research limitations/implications
A female perspective may have provided a more balanced discussion and yielded greater depth in results. Only one service was studied and the findings may be specific to that cohort. The duration of stay at the service of ten to 15 weeks is a relatively short time and excluded participants resident for six months or more. Longer term residents may have been more reflective and informative.
Practical implications
Encourage active options and increased debate on the variety of treatment options available to long term homeless opiate users who have failed to comply with previous treatments. While this is a small modest study, the rich data yields practical advice for policy makers and service providers.
Social implications
This research study adds to an informed perspective by encouraging debate on methadone as a challenge to definitions of recovery that infer abstinence as a key definition of success.
Originality/value
There is a paucity of research documenting a Scottish TC service user perspective using qualitative methods on experiences of addiction, treatment and recovery.
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Kathryn Greenwood, Christine Carroll, Lucie Crowter, Kim Jamieson, Laura Ferraresi, Anna-Marie Jones and Rupert Brown
Stigma towards severe mental illness (SMI) is widespread, exacerbating mental health problems, and impacting on help-seeking and social inclusion. Anti-stigma campaigns are…
Abstract
Purpose
Stigma towards severe mental illness (SMI) is widespread, exacerbating mental health problems, and impacting on help-seeking and social inclusion. Anti-stigma campaigns are meeting with success, but results are mixed. Earlier intervention to promote positive mental health literacy rather than challenge stigma, may show promise, but little is known about stigma development or interventions in younger children. The purpose of this paper is to investigate children’s knowledge, attitudes and behaviour towards SMI and whether we can positively influence children’s attitudes before stigma develops.
Design/methodology/approach
A cross-sectional study investigated mental health schema in 7-11 year olds. An experimental intervention investigated whether an indirect contact story-based intervention in 7-8 year olds led to more positive mental health schema.
Findings
Young children’s schema were initially positive, and influenced by knowledge and contact with mental illness and intergroup anxiety, but were more stigmatising in older girls as intergroup anxiety increased. The indirect contact intervention was effective in promoting positive mental health schema, partially mediated by knowledge.
Social implications
Intervening early to shape concepts of mental illness more positively, as they develop in young children, may represent a more effective strategy than attempting to challenge and change mental health stigma once it has formed in adolescents and adults.
Originality/value
This study is the first to investigate an intervention targeted at the prevention of stigma towards SMI, in young children, at the point that stigma is emerging.
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Gina Costello, Christopher Cox, Alice L. Daugherty, Connie Haley, Millie Jackson, S.G. Ranti Junus and Fu Zhuo
To highlight content of interest to this journal’s readership that promotes current thinking and activities in Information Technology.
Abstract
Purpose
To highlight content of interest to this journal’s readership that promotes current thinking and activities in Information Technology.
Design/methodology/approach
Selective conference report of the annual meeting of the American Library Association and pre‐conference.
Findings
The largest conference of librarians, the variety of programs, activities, exhibit halls, creates one of the best professional development opportunities for librarians. Attracting librarians from all sectors and work environments from around the globe, this conference is hard to describe in a brief way except to say it is an experience. The article documents relevant programs about information technology was the goal of this contribution.
Originaligy/value
Contains information of particular interest to readers who did not attend these sessions. Introducers them to presenters and important hot topics. Provides an alternative to not being present while gaining some information and coverage.
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Pamela O’Callaghan, Maureen P. M. Hall, Laura N. Cobb and Melanie Jacobson
US citizens who attend international medical schools (US IMGs) are more likely to be of Hispanic, Black American, or Asian descent compared to US medical students. As physicians…
Abstract
US citizens who attend international medical schools (US IMGs) are more likely to be of Hispanic, Black American, or Asian descent compared to US medical students. As physicians, US IMGs contribute diversity to the health-care workforce; their experiences and perspectives have improved the health outcomes for populations typically underserved. To become a competent medical professional is a challenging experience, especially for IMGs who may have entered medical school with less than optimal academic histories. During this journey, some students develop academic and clinical deficiencies. Addressing these deficits through remediation interventions are critical to the student’s performance as a physician. This study measured the resiliency, self-efficacy, and self-compassion of IMGs who completed remediation while in medical school. Results indicate older students experienced failure more often and were found to have significantly higher levels of self-compassion compared to younger students. Males were assigned significantly more remedial interventions compared to the female participants. Finally, strong positive correlations suggested that the more remediation interventions students were provided, the more likely they were satisfied with their overall remediation experience. These findings indicate that by varying support strategies and encouraging student’s orientation to resiliency, self-efficacy, and self-compassion may assist them in overcoming their deficits.