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A growing ageing population with complex healthcare needs is a challenge to the organisation of healthcare support for older people residing in care homes. The lack of specialised healthcare support for care home residents has resulted in poorer outcomes, compared with community-dwelling older people. However, little is known about the forms, staff mix, organisation and delivery of such services for residents’ physical healthcare needs. The paper aims to discuss these issues.

This systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to provide an overview of the range of healthcare services delivered to care homes and to identify core features of variation in their organisation, activities and responsibilities. The eligibility criteria for studies were services designed to address the physical healthcare needs of older people, permanently residing in care homes, with or without nursing. To search the literature, terms relating to care homes, healthcare and older people, across ten electronic databases were used. The quality of service descriptions was appraised using a rating tool designed for the study. The evidence was synthesised, by means of a narrative summary, according to key areas of variation, into models of healthcare support with examples of their relative effectiveness.

In total, 84 studies, covering 74 interventions, identified a diverse range of specialist healthcare support services, suggesting a wide variety of ways of delivering healthcare support to care homes. These fell within five models: assessment – no consultant; assessment with consultant; assessment/management – no consultant; assessment/management with consultant; and training and support. The predominant model offered a combination of assessment and management. Overall, there was a lack of detail in the data, making judgements of relative effectiveness difficult. Recommendations for future research include the need for clearer descriptions of interventions and particularly of data on resident-level costs and effectiveness, as well as better explanations of how services are implemented (review registration: PROSPERO CRD42017081161).

There is considerable debate about the best means of providing healthcare to older people in care homes. A number of specialist initiatives have developed and this review seeks to bring these together in a comparative approach deriving models of care of value to policy makers and commissioners.

UK policy seeks to shift commissioning of services ‘closer to the people’ with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. The participation of older people with mental health problems and their carers in the strategic planning process has been patchy, however. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.

The purpose of this paper is to identify features of community mental health teams (CMHTs) for older people valued by their managers, and those they would most like to change.

Content analysis was used to analyse “free text” responses to open questions from a national survey about CMHTs’ organisational structures and processes. Responses were sorted into statements which were categorised into content areas and higher level dimensions.

Free text information was provided by 376 teams (an 88 per cent response rate). Eight higher level dimensions were identified. One related specifically to integration with social care services, whilst several more included material about other aspects of intra-team integration (e.g. documentation and location). The largest proportion of statements related to staffing and teamwork. Statements about inter-personal and inter-professional issues were largely positive, whilst statements about resources, bureaucracy and integration with social care services typically detailed desired changes.

Four key issues emerged comprising a high level of support from managers to develop integrated practices; a need to define the focus of CMHTs for older people and to be fully resourced; and the importance of a nurturing and supportive team environment.

The methodology provides a bridge between qualitative and quantitative research, exploring the volume of statements on particular topics and their meaning.

The purpose of this paper is to raise issues around the involvement of clinicians relevant to current policies for integrated care by reviewing a previous policy to integrate assessments.

This paper is a review of data from a survey of specialist clinicians' involvement in the single assessment process for older people.

The paper finds that clinician involvement was limited, with assessments not changing to a discernable degree and little involvement of older people. Changes to assessment were predominantly related to paperwork. However, the use of standardised tools by clinicians did increase. The use of shared record systems with social services was significantly associated with involvement.

Clinicians have previously not been engaged in policies around integrated assessments. Factors that can help engagement include development of a shared vision, drawing on the traditions of particular groups of clinicians in informing integrated assessment policies, and appropriate IT systems to promote information sharing. Factors hindering engagement include national policy implementation, viewed as inimical to clinical practice and low involvement by service users/patients.

Reviewing such previously implemented polices around integration, particularly at the assessment stage, offers lessons to learn in terms of the factors that may help or hinder the achievement of integrated practice, particularly regarding current policies around clinical leadership.

The purpose of this article is expository in the main; critical to a lesser degree. It will attempt to show how Karl Marx, enraged by the imperfections and inhumanity of the capitalist society, “fought” for its supersession by the communist society on which he dwelt so fondly, that society which would emerge from the womb of a dying capitalism. It asks such questions as these: Is it possible to create the truly human society envisaged by Marx? Is perfection of man and society a mere will‐o'‐the‐wisp? A brief analysis, therefore, of the imperfections of capitalism is undertaken for the purpose of revealing the evils which Marx sought to eliminate by revolution of the most violent sort. In this sense, the nature of man under capitalism is analysed. Marx found the breed wanting, in a word, dehumanised. An attempt is, therefore, made to discuss the new man of Marxism, man's own creation, and the traits of that new man, one freed at last from the alienating effects of private property, division of labour, money, and religion. Another question that springs to mind is this: how does Marx propose to transcend alienation?

This chapter focusses on the ethical issues raised by different types of surveillance and the varied ways in which surveillance can be covert. Three case studies are presented which highlight different types of surveillance and different ethical concerns. The first case concerns the use of undercover police to infiltrate political activist groups over a 40-year period in the UK. The second case study examines a joint operation by US and Australian law enforcement agencies: the FBI’s operation Trojan Shield and the AFP’s Operation Ironside. This involved distributing encrypted phone handsets to serious criminal organisations which included a ‘backdoor’ secretly sending encrypted copies of all messages to law enforcement. The third case study analyses the use of emotional artificial intelligence systems in educational digital learning platforms for children where technology companies collect, store and use intrusive personal data in an opaque manner. The authors discuss similarities and differences in the ethical questions raised by these cases, for example, the involvement of the state versus private corporations, the kinds of information gathered and how it is used.

Post-diagnostic dementia care is often fragmented in the United Kingdom, with great variation in provision. Recent policies suggest moving towards better community-based care for dementia; however, little is known on how this care is delivered. This study aimed to map the post-diagnostic dementia support provided in England a decade after the introduction of a National Dementia Strategy.

A mixed-methods e-survey (open Nov 2018–Mar 2019) of dementia commissioners in England recruited through mailing lists of relevant organisations was conducted. The authors descriptively summarised quantitative data and carried out thematic analysis of open-ended survey responses.

52 completed responses were received, which covered 82 commissioning bodies, with representation from each region in England. Respondents reported great variation in the types of services provided. Information, caregiver assessments and dementia navigation were commonly reported and usually delivered by the voluntary sector or local authorities. Integrated pathways of care were seen as important to avoid overlap or gaps in service coverage. Despite an increasingly diverse population, few areas reported providing dementia health services specifically for BME populations. Over half of providers planned to change services further within five years.

There is a need for greater availability of and consistency in services in post-diagnostic dementia care across England.

Post-diagnostic dementia care remains fragmented and provided by a wide range of providers in England.

Reports research statistics that reveal that half of all working women are likely to suffer some form of sexual harassment during their careers, particularly those in non‐traditional posts. Outlines different explanatory theories for sexual harassment proposed in current literature, focusing in particular on socio‐cultural, organizational and individual differences models, and seeks to examine the interaction between various factors identified. Discusses the main effects of power distance, attitudes towards women and gender/job match on sexual harassment, and develops models of sexual harassment behaviour to examine the interaction between these three factors for women with male supervisors in traditional and non‐traditional roles, identifying the circumstances in which quid pro quo and hostile environment sexual harassment are most likely and most unlikely to occur. Illustrates how the different factors involved foster different kinds of sexual harassment at different levels of severity, and concludes that multiple strategies are required to address such behaviour.

Explains the auditing problems encountered by multinational companies under the US Foreign Corrupt Practices Act and the Regulation of Technology Transfers and the complications of resource allocation in countries with different cultures to the USA. Highlights currency fluctuations, human resources and environmental audit. Lists some of the differences between US and foreign auditor independence and auditing standards. Lays down the requirements for an auditor on foreign assignment.