Ashley J. Maister, Caitlin McCarthy, Lee G. Ruszczyk, Rachael Evans and Megan E. Maroney
Integrated health care occurs when specialty and general care providers work together to address both the physical and mental health needs of their patients. The Substance Abuse…
Abstract
Purpose
Integrated health care occurs when specialty and general care providers work together to address both the physical and mental health needs of their patients. The Substance Abuse and Mental Health Services Administration model of integration is broken into six levels of coordinated, co-located and integrated care. Our institution offers both co-located and integrated care among eight clinic sites. The care team is typically composed of the primary care provider, nurse and medical assistant, but other professionals may be introduced based on the patient’s medical and psychiatric conditions. The purpose of this prospective, quality improvement study was to compare the rates of adherence to long-acting injectable antipsychotics (LAIAs) between both types of integrated primary care settings at our institution. The comparison of the two settings sought to determine which environment provides improved outcomes for patients with serious psychiatric illnesses. Additionally, we aimed to assess the quality of medication-related monitoring and care team composition between care settings, and the ability of pharmacists to deliver interprofessional care team training and education on LAI use in clinical practice.
Design/methodology/approach
Subjects were identified and included in the study if they had received primary care services from our institution within the previous 12 months. Patient demographic and laboratory variables were collected at baseline and when clinically indicated. The rates of adherence between care settings were assessed at intervals that align with the medication’s administration schedule (e.g. every four weeks). Medication-related monitoring parameters were collected at baseline and when clinically indicated. The interprofessional care team completed Likert scale surveys to evaluate the pharmacist’s LAIA education and training.
Findings
There was not a statistically significant difference detected between integrated primary care settings on the rates of adherence to LAIAs. Additionally, there was not a statistically significant difference between rates of adherence to medication-related monitoring parameters or the effect of the patient treatment team composition. There was a statistically significant difference between pre- and post-session survey scores following interprofessional education and training provided by a pharmacist.
Originality/value
Because overall rates of adherence were low, both primary care settings were found to be equivalent. Our study may have been underpowered to detect a difference in the primary endpoint because of the small sample size. However, our study demonstrates that interprofessional education and training may lend itself to changes in practice, which is evident by the clinically significant relative increase in adherence. The Henry J. Austin Health Center network will be implementing a standard operating procedure regarding LAIA management within the primary care setting. Further studies are needed to assess a larger number of patients between both types of primary care settings, as well as the impact of the clinical psychiatric pharmacist as a member of the treatment team.
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Catarina Peixoto Carvalho and Antonio Azevedo
The purpose of this paper is to discuss the influence of glamour, scopophilia and self-sexualisation in luxury celebrity endorsement.
Abstract
Purpose
The purpose of this paper is to discuss the influence of glamour, scopophilia and self-sexualisation in luxury celebrity endorsement.
Design/methodology/approach
In step 1, an experimental study was conducted with 100 respondents assessing the response towards manipulated print ad stimuli operationalizing the influence (in general terms) of lay out, endorser’s beauty pattern, body language (cool, smile appeal, sex appeal and disruptive), gazing and landscape. In step 2, respondents evaluated their response towards five perfume print ads retrieved from real advertising campaigns with different brand personalities (DKNY, Moschino, Chanel, Gucci and Boss).
Findings
The ideal copy strategy is: a couple of brunette Caucasian endorsers; “close-up” photo; sexy body language; indirect smiling gaze; and urban landscape. Multiple regression models were built for each ad/brand (personality) in order to predict the willingness to pay for a bottle of perfume.
Research limitations/implications
The paper suggests a holistic theoretical framework describing the influence of celebrity characteristics, advertising copy strategy, social-cultural trends and brand variables in the advertising processing.
Practical implications
Advertising copywriters and brand managers must control the role of glamour and the self-consciousness of women seduction power in branding advertising.
Social implications
Glamour, scopophilia or self-sexualisation are three different concepts which have a lot of sociological implications because they influence the way as the society perceive the role of women as endorsers in advertising, but also in other life dimensions.
Originality/value
This paper fills a gap in the literature, since this paper make an innovative analysis of the influence of these recent post-modernist socio-cultural trends.
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Stuart A. Green, Liz Evans, Rachel Matthews, Sandra Jayacodi, Jenny Trite, Anton Manickam, Rachel Evered, John Green, Joanna Williams, Ed Beveridge, Caroline Parker and Bill Tiplady
National and local policy supports the involvement of patients at all levels in the design, delivery and improvement of health services. Whilst existing approaches to support…
Abstract
Purpose
National and local policy supports the involvement of patients at all levels in the design, delivery and improvement of health services. Whilst existing approaches to support involvement have been described and disseminated, including the 4Pi National Involvement Standards, their application in quality improvement is rarely reported. The paper aims to discuss this issue.
Design/methodology/approach
A quality improvement initiative within a mental health trust was developed with a multi-disciplinary team, including those with professional experience of delivering or improving care and those with lived experience. The aim of the initiative was to improve the physical health of inpatients within an acute mental health unit. This case study aims to describe how the integration of concepts from the 4Pi National Involvement Standards (Principles, Purpose, Presence, Process and Impact) provided a framework for engaging and involving service users. The case study also aims to describe how co-design was included within the 4Pi approach and supported the development of a tool to aid improving physical healthcare.
Findings
The 4Pi National Involvement Standards provided a guiding framework for the involvement of service users within a quality improvement initiative. Value of the approach was realised through the co-design of a tool developed by service users, along with healthcare professionals, to facilitate discussion and support shared-decision making about inpatients’ physical health.
Practical implications
Identifying “ways that work” for service user involvement is crucial to move beyond the policy rhetoric or tokenistic involvement. Involvement in quality improvement initiatives can bring benefits both to services and the service users themselves.
Originality/value
Whilst the 4PI approach is recognised as a useful framework for involvement, few examples exist of its practical applications within a quality improvement setting.
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Paul Soper, Alex G. Stewart, Rajan Nathan, Sharleen Nall-Evans, Rachel Mills, Felix Michelet and Sujeet Jaydeokar
This study aims to evaluate the quality of transition from child and adolescent services to adult intellectual disability services, using the relevant National Institute for…
Abstract
Purpose
This study aims to evaluate the quality of transition from child and adolescent services to adult intellectual disability services, using the relevant National Institute for Health and Care Excellence (NICE) standard (QS140). In addition, this study also identifies any differences in transition quality between those young people with intellectual disability with and without autism.
Design/methodology/approach
Using routinely collected clinical data, this study identifies demographic and clinical characteristics of, and contextual complexities experienced by, young people in transition between 2017 and 2020. Compliance with the quality standard was assessed by applying dedicated search terms to the records.
Findings
The study highlighted poor recording of data with only 22% of 306 eligible cases having sufficient data recorded to determine compliance with the NICE quality standard. Available data indicated poor compliance with the standard. Child and adolescent mental health services, generally, did not record mental health co-morbidities. Compliance with three out of the five quality statements was higher for autistic young people, but this only reached statistical significance for one of those statements (i.e. having a named worker, p = 0.02).
Research limitations/implications
Missing data included basic clinical characteristics such as the level of intellectual disability and the presence of autism. This required adult services to duplicate assessment procedures that potentially delayed clinical outcomes. This study highlights that poor compliance may reflect inaccurate recording that needs addressing through training and introduction of shared protocols.
Originality/value
To the best of the authors’ knowledge, this is the first study to examine the transition process between children’s and adults’ intellectual disability health services using NICE quality standard 140.
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Rachel Marie Adams, Candace Evans, Amy Wolkin, Tracy Thomas and Lori Peek
Social vulnerability in the context of disaster management refers to the sociodemographic characteristics of a population and the physical, social, economic, and environmental…
Abstract
Purpose
Social vulnerability in the context of disaster management refers to the sociodemographic characteristics of a population and the physical, social, economic, and environmental factors that increase their susceptibility to adverse disaster outcomes and capacity to anticipate, cope with, resist, and recover from disaster events. Because disasters do not impact people equally, researchers, public health practitioners, and emergency managers need training to meet the complex needs of vulnerable populations.
Design/methodology/approach
To address gaps in current education, the CONVERGE initiative, headquartered at the Natural Hazards Center at the University of Colorado Boulder, developed the Social Vulnerability and Disasters Training Module. This free online course draws on decades of research to examine the factors that influence social vulnerability to disasters. Examples of studies and evidence-based programs are included to illuminate common methods for studying social vulnerability and ways that research can guide practice. To evaluate the module, all trainees completed a pre- and post-training questionnaire.
Findings
Between July 2019 and September 2021, 1,089 people completed the module. Wilcoxon signed rank tests demonstrated a significant perceived increase in self-rated knowledge, skills, and attitudes (KSA). Students, members of historically underrepresented populations, and those new to or less experienced in the field, had the greatest perceived increase.
Practical implications
This training module can help participants understand the specific needs of socially vulnerable populations to help reduce human suffering from disasters.
Originality/value
This article describes a novel web-based training and offers evaluation data showing how it can help educate a broad hazards and disaster workforce on an important topic for disaster management.
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Stephen A. Zeff and Rachel F. Baskerville
The purpose of this paper is to identify the circumstances that gave rise to an adverse audit opinion by a New Zealand (Christchurch) accounting firm, Hicks and Ainger, on the…
Abstract
Purpose
The purpose of this paper is to identify the circumstances that gave rise to an adverse audit opinion by a New Zealand (Christchurch) accounting firm, Hicks and Ainger, on the annual financial report of the local firm, T.J. Edmonds Ltd, in 1976. In so doing, this study revealed not only previously undocumented issues surrounding major asset purchases but also the impact of key personalities before and after the adverse opinion decision.
Design/methodology/approach
The study is located within the Cultural Theory of History, to theorize the narratives within the wider contextual perspective. The issues surrounding the use of memory from such interviews are also considered. The key material offered in this study is sourced from a 2015 interview with the two key audit partners in this audit engagement.
Findings
The accounting standard on depreciation at that time, SSAP 3, had not been applied properly to the accounting treatment of four helicopters for wild deer operations, purchased a week before balance date. Neither the artificial suppression of profits by this purchase decision and accounting choice nor the fall in profits nor the adverse opinion, influenced share prices or shareholder perceptions long term.
Originality/value
The significance of this project is that it informs the appreciation of the importance of contextual understanding of a singular adverse audit opinion.
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Rachael E. Rees-Jones, Ross Brown and Dylan Jones-Evans
Research on high growth firms is booming yet a strong conceptual understanding of how these firms obtain (and sustain) rapid growth remains (at best) partial. The main purpose of…
Abstract
Purpose
Research on high growth firms is booming yet a strong conceptual understanding of how these firms obtain (and sustain) rapid growth remains (at best) partial. The main purpose of this paper is to explore the role founders play in enabling episodes of rapid growth and how they help navigate this process.
Design/methodology/approach
This paper reports the findings from a qualitative study involving in-depth interviews with entrepreneurs enlisted onto a publicly funded high growth business accelerator programme in Wales. These interviews explored the causes of the firms rapid growth, their key growth trigger points and the organisational consequences of rapid growth.
Findings
The research reveals that periods of high growth are intrinsically and inextricably inter-linked with the entrepreneurial traits and capabilities of their founders coupled with their ability to “sense” and “seize” pivotal growth opportunities. It also demonstrates founder-level dynamic capabilities enable firms to capitalise on pivotal “trigger points” thereby enabling their progression to a new “dynamic state” in a firm’s temporal evolution.
Originality/value
The novel approach towards theory building deployed herein is the use of theoretical elaboration as means of extending important existing theoretical constructs such as growth “trigger points” and founder dynamic capabilities. To capitalise on these trigger points, founders have to undergo a process of “temporal transitioning” to effectively manage and execute the growth process in firms. The work also has important policy implications, underlining the need for more relational forms of support for entrepreneurial founders.
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The focus in professional learning is often on formal activities such as workshops, conferences and courses. There is also a tendency to focus on formal programmes of coaching and…
Abstract
Purpose
The focus in professional learning is often on formal activities such as workshops, conferences and courses. There is also a tendency to focus on formal programmes of coaching and mentoring in teacher education. Emphasising the formal activities means that everyday informal learning in educational settings is overlooked. Informal coaching and mentoring could be utilised to support teachers' career-long professional learning.
Design/methodology/approach
This is a conceptual paper which draws on the author's research and seeks to expand what is considered as professional learning within teacher education – namely, informal coaching and mentoring. To understand how to support this professional learning, the lens of social practice is used with an emphasis on learning environments and learning practices.
Findings
Coaching and mentoring can be identified in informal encounters in the staffroom, school corridors and many places and situations. Findings are presented in relation to the importance of informal learning from and with colleagues and the role of headteachers.
Originality/value
More attention has been paid to informal learning, but there is still a need for what could be termed an “informal turn”. Understanding that informal coaching and mentoring afford professional learning opportunities to the teachers who both provide and receive coaching and mentoring can help to support their learning. Recommendations are provided on how educational settings can facilitate and support these professional learning opportunities while preserving their informality.
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To meet the multidimensional needs of patients, health services are increasingly implementing complex programmes of care through partnerships between public, private and voluntary…
Abstract
Purpose
To meet the multidimensional needs of patients, health services are increasingly implementing complex programmes of care through partnerships between public, private and voluntary sector organisations. The purpose of this paper is to explore the implementation process of a complex, multi-innovative regional health and social care partnership to coordinate end-of-life care in the South East of England.
Design/methodology/approach
The study adopted a pragmatic, pluralist design using primarily qualitative methods including observations, interviews, focus group and document review. Implementation theory provided the research framework.
Findings
While progress was made towards greater collaboration in the provision of end-of-life care, regional coordination of care among the 13 partner organisations was not achieved as envisioned. Low engagement stemming from national health system changes delayed decision making and shifted partners’ priorities. Individual stakeholder interest and motivation carried the elements that were successful.
Practical implications
The external political and economic environment hindered the involvement of some of the partners and suggests that a concept of “project resiliency” is particularly important for complex, multi-organisational projects which are implemented over time and by multiple stakeholders from different sectors. Future research should look further at what contributes to project resiliency and whether it might be operationalized so that projects can develop resilient factors for success.
Originality/value
Project resiliency is a new concept that bridges a gap in understanding how time-limited multi-organisational projects function amid a changing environment.
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Ridley Scott’s 1982 cinematic production of Blade Runner, based loosely on a 1968 story by Philip Dick (Do Androids Dream of Electric Sheep?), is read within a general context of…
Abstract
Ridley Scott’s 1982 cinematic production of Blade Runner, based loosely on a 1968 story by Philip Dick (Do Androids Dream of Electric Sheep?), is read within a general context of critical theory, the purpose being twofold: first, to highlight the film’s fit with, and within, several issues that have been important to critical theory and, second, to explore some questions, criticisms, and extensions of those issues – the dialectic of identity/difference most crucially – by speculations within and on the film’s text. The exploration is similar in approach to studies of specific films within the context of issues of social, cultural, and political theory conducted by the late Stanley Cavell. Interrogations of dimensions of scenarios and sequences of plotline, conceptual pursuit of some implications, and assessments of the realism at work in cinematic format are combined with mainly descriptive evaluations of character portrayals and dynamics as these relate to specified thematics of the identity/difference dialectic. The film puts in relief evolving meanings of prosthetics – which is to say changes in the practical as well as conceptual-semantic boundaries of “human being”: what counts as “same” versus “other”? “domestic” versus “foreign”? “integrity” versus “dissolution”? “safety” versus “danger”? And how do those polarities, understood within a unity-of-opposites dialectic, change, as human beings are confronted more and more stressfully by their own reproductions of “environment” – that is, the perspectival device of “what is ‘text’ and what is context’?” – and variations of that device by direct and indirect effects of human actions, as those actions have unfolded within recursive sequences of prior versions of perspectival device, a device repeatedly engaged, albeit primarily and mainly implicitly, as a “prosthetic that could not be a prosthetic.”