Pauline Dibben, Geoffrey Wood and Rachel O’Hara
The purpose of this paper is to evaluate existing evidence on whether return to work interventions achieve employment outcomes and are cost effective in order to better inform…
Abstract
Purpose
The purpose of this paper is to evaluate existing evidence on whether return to work interventions achieve employment outcomes and are cost effective in order to better inform those needing accommodations at work, as well as their line managers and trade union representatives, occupational health specialists and HR managers.
Design/methodology/approach
The paper uses a systematic narrative review to evaluate the evidence on the employment outcomes and cost effectiveness of return to work initiatives.
Findings
Evidence on interventions for musculoskeletal conditions such as lower back pain indicates that certain forms of intervention such as vocational rehabilitation and workplace-based rehabilitation facilitate outcomes such as employment, reduced sick leave and effective return to work. However, there is very little evidence on whether these interventions are cost effective. More generally there are glaring gaps in evidence on cardio-respiratory (heart and breathing) and mental health conditions with regard to both employment outcomes and the cost of interventions.
Research limitations/implications
This systematic review has critical and timely implications for both knowledge development and practice. While highlighting methodological limitations in the existing research base, it also presents avenues for further research on return work strategies and the factors inhibiting and facilitating their adoption and effective operation.
Originality/value
Although there is much existent literature on the return to work process, far less attention has been paid to the employment outcomes and cost effectiveness of interventions. This paper highlights the interventions for musculoskeletal conditions such as lower back conditions that may result in positive employment outcomes, with implications for practice. However, it also highlights gaps in evidence on the employment outcomes and cost effectiveness of interventions for cardio-respiratory (heart and breathing) and mental health conditions.
Details
Keywords
Loren De Freitas, Steve Goodacre, Rachel O'Hara, Praveen Thokala and Seetharaman Hariharan
A process that does not include the customer's value may not be effective in providing care. This study aimed to identify value and waste in an emergency department (ED) patient…
Abstract
Purpose
A process that does not include the customer's value may not be effective in providing care. This study aimed to identify value and waste in an emergency department (ED) patient flow process from a patient and clinician perspective.
Design/methodology/approach
A qualitative case study was conducted in an ED in Trinidad and Tobago. Observations and informal conversational interviews with clinicians (n = 33) and patients (n = 50) explored patient flow, value and waste. Thematic analysis was used to create a framework on valuable and wasteful aspects in the ED patient flow process.
Findings
Valuable aspects led to direct improvements in the patient's health or an exchange of information in the process. Wasteful aspects were those with no patient activity, no direct ED clinical involvement, or resulted in a perceived inappropriate use of ED resources. However, there was a disparity in responses between clinicians and patients with clinicians identifying more features in the process.
Research limitations/implications
The single case study design limits the generalizability of findings to other settings. This study did not specifically explore the influence of age and gender on what mattered to patients in ED services. Future studies would benefit from exploring whether there are any age and gender differences in patient perspectives of value and waste. Further research is needed to validate the usefulness of the framework in a wider range of settings and consider demographic factors such as age and gender.
Practical implications
The study has produced a framework which may be used to improve patient flow in a way that maximized value to its users. A collaborative approach, with active patient involvement, is needed to develop a process that is valuable to all. The single case study design limits the generalizability of findings to other settings.
Originality/value
Qualitative methods were used to explicitly explore both value and waste in emergency department patient flow, incorporating the patient perspective. This paper provides an approach that decision makers may use to refine the ED patient flow process into one that flows well, improves quality and maximizes value to its users.
Details
Keywords
Mark Piney, Diane Llewellyn, Rachel O'Hara, John Saunders, John Cocker, Kate Jones and David Fishwick
Exposure to isocyanates was the leading cause of occupational asthma in the UK. Motor vehicle repair (MVR) bodyshop paint sprayers were at greatest risk, despite widespread use of…
Abstract
Purpose
Exposure to isocyanates was the leading cause of occupational asthma in the UK. Motor vehicle repair (MVR) bodyshop paint sprayers were at greatest risk, despite widespread use of air-fed breathing apparatus and ventilated booths. Most paint sprayers work in small and medium enterprises (SMEs). The purpose of the Health and Safety Executive (HSE) project, described in this paper, is to improve exposure control measures in at least 20 per cent of MVR bodyshops, and reduce the risk of occupational asthma. The paper aims to discuss this issue.
Design/methodology/approach
A three-stranded plan consisted of: Safety and Health Awareness Days (SHADs); workplace inspections; and third-party stakeholder communications. The impact of various parts of the project were evaluated.
Findings
Approximately 18 per cent of bodyshops in the UK attended one of 32 SHADs, following which over 90 per cent of delegates expressed an “intention to act” to improve exposure control measures. A local assessment showed that at least 50 per cent of bodyshops improved exposure control measures. An evaluation of 109 inspections found that enforcement action was taken at 40 per cent of visits. Third-party engagement produced a joint HSE-industry designed poster, new agreed guidance on spray booths and dissemination of SHAD material. Knowledge of booth clearance time has become widespread, and 85 per cent of booths now have pressure gauges. Biological monitoring data show that, post-SHAD, exposures were lower.
Originality/value
A sustained national project using clear, relevant, tested messages delivered via different routes, had a sector-wide impact in bodyshops. It is probable that the project has improved isocyanate exposure control in at least 20 per cent of bodyshops. The generic lessons could be applied to other widespread SME businesses.
Details
Keywords
Giulia Signorini, Nikolina Davidovic, Gwen Dieleman, Tomislav Franic, Jason Madan, Athanasios Maras, Fiona Mc Nicholas, Lesley O'Hara, Moli Paul, Diane Purper-Ouakil, Paramala Santosh, Ulrike Schulze, Swaran Preet Singh, Cathy Street, Sabine Tremmery, Helena Tuomainen, Frank Verhulst, Jane Warwick, Dieter Wolke and Giovanni de Girolamo
Young people transitioning from child to adult mental health services are frequently also known to social services, but the role of such services in this study and their interplay…
Abstract
Purpose
Young people transitioning from child to adult mental health services are frequently also known to social services, but the role of such services in this study and their interplay with mental healthcare system lacks evidence in the European panorama. This study aims to gather information on the characteristics and the involvement of social services supporting young people approaching transition.
Design/methodology/approach
A survey of 16 European Union countries was conducted. Country respondents, representing social services’ point of view, completed an ad hoc questionnaire. Information sought included details on social service availability and the characteristics of their interplay with mental health services.
Findings
Service availability ranges from a low of 3/100,000 social workers working with young people of transition age in Spain to a high 500/100,000 social workers in Poland, with heterogeneous involvement in youth health care. Community-based residential facilities and services for youth under custodial measures were the most commonly type of social service involved. In 80% of the surveyed countries, youth protection from abuse/neglect is overall regulated by national protocols or written agreements between mental health and social services, with the exception of Czech Republic and Greece, where poor or no protocols apply. Lack of connection between child and adult mental health services has been identified as the major obstacles to transition (93.8%), together with insufficient involvement of stakeholders throughout the process.
Research limitations/implications
Marked heterogeneity across countries may suggest weaknesses in youth mental health policy-making at the European level. Greater inclusion of relevant stakeholders is needed to inform the development and implementation of person-centered health-care models. Disconnection between child and adult mental health services is widely recognized in the social services arena as the major barrier faced by young service users in transition; this “outside” perspective provides further support for an urgent re-configuration of services and the need to address unaligned working practices and service cultures.
Originality/value
This is the first survey gathering information on social service provision at the time of mental health services transition at a European level; its findings may help to inform services to offer a better coordinated social health care for young people with mental health disorders.
Details
Keywords
There is limited research on the mental health of pregnant women in prison in England, mother and baby unit (MBU) applications and associated factors. Eighty-five pregnant women…
Abstract
There is limited research on the mental health of pregnant women in prison in England, mother and baby unit (MBU) applications and associated factors. Eighty-five pregnant women were interviewed in eight different prisons in England, UK. Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) and Edinburgh Postnatal Depression Scale (EPDS) were used to assess mental health; Severity of Dependence Questionnaire (SOD-Q) for drug misuse; Alcohol Use Identification Test (AUDIT) for hazardous drinking and the Structured Clinical Interview for DSM-IV (SCID-II) to identify personality disorder. About 51% of participants had depression and 57% had anxiety. Those with prior social services involvement, diagnosis of personality disorder or history of suicidality were less likely to be admitted to MBUs. The high levels of depression and anxiety can have negative impacts on both the mother and her unborn child. Factors which influence MBU admission suggest those who might benefit most from MBU placement are least likely to be admitted. Other countries offer feasible alternatives to imprisonment for pregnant women and mothers which could be implemented in England.
Details
Keywords
Bryan Foltice and Rachel Rogers
This paper evaluates potential methods for reducing ambiguity surrounding returns on equity to improve long-term savings decisions.
Abstract
Purpose
This paper evaluates potential methods for reducing ambiguity surrounding returns on equity to improve long-term savings decisions.
Design/methodology/approach
We evaluate 221 undergraduate students in the US and first assess the degree of ambiguity aversion exhibited by individuals in the sample population as they decide between a risky (known probability) option and ambiguous (unknown probability) option pertaining to their chances of winning $0 or $1 in a hypothetical lottery. Similarly, we test whether sampling historical return data through learning modules influences long-term decision making regarding asset allocation within a retirement portfolio.
Findings
Allowing participants to experience the underlying probability through sampling significantly influences behavior, as participants were more likely to select the ambiguous option after sampling. Here, we also find that participants who receive interactive learning modules – which require users to manually alter the asset allocation to produce a sample of historical return data based on the specific allocation entered in the model – increase their post-learning equity allocations by 10.1% more than individuals receiving static modules. Interestingly, we find no significant evidence of ambiguity aversion playing a role in the asset allocation decision.
Originality/value
We find that decision-making related to ambiguous and risky options can be substantially influenced by experiential learning. Our study supplements previous literature, providing a link between research on the effect of ambiguity on stock market participation and implementation of educational programs to improve the asset allocation decision for young adults.
Details
Keywords
Carole Collins-Ayanlaja, Warletta Brookins and Alison Taysum
Superintendents’ agency in the US is shaped by governance systems within education systems. These Education Governance Systems have been in a state of flux and experienced…
Abstract
Superintendents’ agency in the US is shaped by governance systems within education systems. These Education Governance Systems have been in a state of flux and experienced turbulence for twenty years. The professional challenge this research addresses is how do 14 credentialed educational professional African American women superintendents with doctorates and track records of school improvement, navigate the turbulence to empower families, and Empower Young Societal Innovators for Equity, Renewal (EYSIER), Social Mobility, and Peace.
This chapter identifies three aspects of a theory of knowledge to action to emerge from the empirical evidence presented. First, African American women superintendents need to know how to access policy and legislation, how to stay up to date with policy and need to be empowered to challenge policy. Policy has the back of African American women fighting institutionalised racism. Second, African American women superintendents need role models, and mentors with wisdom who can create proactive and mobilising networks across the state and the nation to advocate for and to support the teachers’ and leaders’ professional learning to be the best teachers, leaders and superintendents they can be. Finally, the African American women superintendents who have been self-selecting, or identified as potential future superintendents by current superintendents and schoolboards, need to be part of succession planning that transcends the short elected lives of district school boards. Newly incumbent African American women superintendents need to be empowered by Education Governance Systems to enable them to deliver on their manifestos and track records of outstanding school improvement with the impact strategies they were employed to implement. The impact strategies include promoting high-quality home–school engagement and ensuring all students learn how to learn, are culturally sensitive, ask good questions and solve problems as Young Societal Innovators for Equity and Renewal. The chapter recommends a network of African American women superintendents implements this theory of knowledge to action and that their work is documented, and if successful in optimising students’ learning, and outcomes, disseminated to build capacity for EYSIER.
Details
Keywords
Michelle Bauml and Sherry L. Field
Notable Social Studies Trade Book (NSSTB) lists include books selected annually by the Book Review Committee of the National Council for the Social Studies in conjunction with the…
Abstract
Notable Social Studies Trade Book (NSSTB) lists include books selected annually by the Book Review Committee of the National Council for the Social Studies in conjunction with the Children’s Book Council. These lists are excellent resources for teachers who use children’s literature to support social studies instruction in their classrooms. We report our analysis of award-winning titles for primary grades published from 2001-2011. Biographies and books that address topics about families are featured as a starting place for primary grades teachers to begin incorporating NSSTB into their social studies instruction. We conclude by suggesting ways for primary grade teachers to utilize the book lists each year.
Details
Keywords
The Modern Language Association of America recently sent a circular to all its members, beginning, “Where would you look if you wanted to find articles, written in Spanish…
Abstract
The Modern Language Association of America recently sent a circular to all its members, beginning, “Where would you look if you wanted to find articles, written in Spanish, documenting speech pathology in six‐year‐old children?” For myself, I would have to answer “I don't know,” and in the back of my mind lurk Rhett Butler's famous parting words to Scarlett O'Hara. No doubt any scrap of knowledge is preferable to complete ignorance, but creative research requires that the same mind frame the questions, recognize the answers, and perceive their relevance.