Steven Wyatt, Robin Miller, Peter Spilsbury and Mohammed Amin Mohammed
In 2011, community nursing services were reorganised in England in response to a national policy initiative, but little is known about the impact of these changes. A total of…
Abstract
Purpose
In 2011, community nursing services were reorganised in England in response to a national policy initiative, but little is known about the impact of these changes. A total of three dominant approaches emerged: (1) integration of community nursing services with an acute hospital provider, (2) integration with a mental health provider and (3) the establishment of a stand-alone organisation, i.e. without structural integration. The authors explored how these approaches influenced the trends in emergency hospital admissions and bed day use for older people.
Design/methodology/approach
The methodology was a longitudinal ecological study using panel data over a ten-year period from April 2006 to March 2016. This study’s outcome measures were (1) emergency hospital admissions and (2) emergency hospital bed use, for people aged 65+ years in 140 primary care trusts (PCTs) in England.
Findings
The authors found no statistically significant difference in the post-intervention trend in emergency hospital admissions between those PCTS that integrated community nursing services with an acute care provider and those integrated with a mental health provider (IRR 0.999, 95% CI 0.986–1.013) or those that did not structurally integrate services (IRR 0.996, 95% CI 0.982–1.010). The authors similarly found no difference in the trends for emergency hospital bed use.
Research limitations/implications
PCTs were abolished in 2011 and replaced by clinical commissioning groups in 2013, but the functions remain.
Practical implications
The authors found no evidence that any one structural approach to the integration of community nursing services was superior in terms of reducing emergency hospital use in older people.
Originality/value
As far as the authors are aware, previous studies have not examined the impact of alternative approaches to integrating community nursing services on healthcare use.
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Containing as it does many of the finest books published in the eighteenth and nineteenth centuries, the Garrison Library of Gibraltar is no ordinary services' library. Its…
Abstract
Containing as it does many of the finest books published in the eighteenth and nineteenth centuries, the Garrison Library of Gibraltar is no ordinary services' library. Its founding was due to that perceptive Captain (later Colonel) John Drinkwater, author of one of the most famous histories of the Great Siege of Gibraltar which lasted from 1779–1783, the History of the late siege (Spilsbury, 1785). Having suffered from a lack of reading material during the siege, Colonel Drinkwater saw the need for a good circulating library and club as a means of saving the officers of the garrison from “having their minds enervated and vitiated by dissipitation”. His appeal for books, shortly after the seige, attracted nearly 500 gifts which enabled the library to open pending the arrival of the 674 volumes on order from London, there being no bookshop in Gibraltar at that time.
Peter Tatham, Frank Stadler, Abigail Murray and Ramon Z. Shaban
Whilst there is a growing body of research which discusses the use of remotely piloted aircraft systems (RPAS) (otherwise known as “drones”) to transport medical supplies, almost…
Abstract
Purpose
Whilst there is a growing body of research which discusses the use of remotely piloted aircraft systems (RPAS) (otherwise known as “drones”) to transport medical supplies, almost all reported cases employ short range aircraft. The purpose of this paper is to consider the advantages and challenges inherent in the use of long endurance remotely piloted aircraft systems (LE-RPAS) aircraft to support the provision of medical supplies to remote locations – specifically “medical maggots” used in maggot debridement therapy (MDT) wound care.
Design/methodology/approach
After introducing both MDT and the LE-RPAS technology, the paper first reports on the outcomes of a case study involving 11 semi-structured interviews with individuals who either have experience and expertise in the use of LE-RPAS or in the provision of healthcare to remote communities in Western Australia. The insights gained from this case study are then synthesised to assess the feasibility of LE-RPAS assisted delivery of medical maggots to those living in such geographically challenging locations.
Findings
No insuperable challenges to the concept of using LE-RPAS to transport medical maggots were uncovered during this research – rather, those who contributed to the investigations from across the spectrum from operators to users, were highly supportive of the overall concept.
Practical implications
The paper offers an assessment of the feasibility of the use of LE-RPAS to transport medical maggots. In doing so, it highlights a number of infrastructure and organisational challenges that would need to be overcome to operationalise this concept. Whilst the particular context of the paper relates to the provision of medical support to a remote location of a developed country, the core benefits and challenges that are exposed relate equally to the use of LE-RPAS in a post-disaster response. To this end, the paper offers a high-level route map to support the implementation of the concept.
Social implications
The paper proposes a novel approach to the efficient and effective provision of medical care to remote Australian communities which, in particular, reduces the need to travel significant distances to obtain treatment. In doing so, it emphasises the importance in gaining acceptance of both the use of MDT and also the operation of RPAS noting that these have previously been employed in a military, as distinct from humanitarian, context.
Originality/value
The paper demonstrates how the use of LE-RPAS to support remote communities offers the potential to deliver healthcare at reduced cost compared to conventional approaches. The paper also underlines the potential benefits of the use of MDT to address the growing wound burdens in remote communities. Finally, the paper expands on the existing discussion of the use of RPAS to include its capability to act as the delivery mechanism for medical maggots.
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Kogila Vani Annammala, Anand Nainar, Abdul Rahim Mohd Yusoff, Zulkifli Yusop, Kawi Bidin, Rory Peter Dominic Walsh, William H. Blake, Faizuan Abdullah, Dhinesh Sugumaran and Khuneswari Gopal Pillay
Although there have been extensive studies on the hydrological and erosional impacts of logging, relatively little is known about the impacts of conversion into agricultural…
Abstract
Although there have been extensive studies on the hydrological and erosional impacts of logging, relatively little is known about the impacts of conversion into agricultural plantation (namely rubber and oil palm). Furthermore, studies on morphological impacts, sediment-bound chemistry and forensic attribution of deposited sediment to their respective sources are scarcer. This chapter introduces the potential for using the multi-proxy sediment fingerprinting technique in this context. Featuring pilot projects in two major flood-prone river systems in Malaysia, the studies explore application of geochemistry-based sediment source ascription. The geochemical signatures of sediment mixtures on floodplains were compared to sediments from upstream source tributaries. The tributaries were hypothesised to have different geochemical signatures in response to dominant land management. The first case study took place in the Segama River system (4,023 km2) of Sabah, Malaysian Borneo where a mixture of primary forest, logged-forests and oil palm plantations were predominant. The second case study was in the Kelantan River Basin (13,100 km2) with two major tributaries (Galas River and Lebir River) where logged-forests and rubber and oil palm plantations are dominant land-uses. Both case studies demonstrated the applicability of this method in ascribing floodplain deposited sediment to their respective upstream sources. Preliminary results showed that trace elements associated with fertilisers (e.g. copper and vanadium) contribute to agricultural catchment signatures. Alkaline and alkaline-earth elements were linked to recently established oil palm plantations due to soil turnover. Mixing model outputs showed that contributions from smaller, more severely disturbed catchment are higher than those from larger but milder disturbed catchments. This method capitalises on flood events to counter its adverse impacts by identifying high-priority sediment source areas for efficient and effective management.
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This paper seeks to investigate the extent to which IiP is a useful method for managing change in local government. In order to do this considers the relative merits and…
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This paper seeks to investigate the extent to which IiP is a useful method for managing change in local government. In order to do this considers the relative merits and limitations of IiP by examining its ability to encourage learning transfer, learning capability and strategic human resource development. By examining data from a postal survey of all 120 UK local authorities that had achieved the award by August 2001 questions the extent to which IiP can be viewed as a change management tool, as many advocates of IiP claim. Concludes with suggestions for future development.
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Michael Quayle and John Murphy
The initial enthusiasm for further and higher education institutions to achieve the Investors in People (IiP) award appears to have faded. The reasons for this are many, and…
Abstract
The initial enthusiasm for further and higher education institutions to achieve the Investors in People (IiP) award appears to have faded. The reasons for this are many, and varied, and this paper examines the critical issues being encountered. It considers the need for strategic development and effectiveness, and suggests a new management paradigm is necessary if IiP accreditation is to be achieved.