Kevin P. Balanda, John B. Lowe, Warren R. Stanton, Alexandra M. Clavarino, Christopher B. Del Mar and Amaya M. Gillespie
A three group randomised control trial assessed the impact of a self‐help booklet and a community skin check competition on the frequency and coverage of skin examinations…
Abstract
A three group randomised control trial assessed the impact of a self‐help booklet and a community skin check competition on the frequency and coverage of skin examinations conducted upon Queenslanders who already report that they check their skin. Attitudinal and behavioural measures were collected in pre‐test and post‐test postal surveys.
Details
Keywords
Richard Jefferies, Ibrahim H.N. Sheriff, Jacob H. Matthews, Olivia Jagger, Sarah Curtis, Peter Lees, Peter C. Spurgeon, Alex Oldman, Ali Habib, Azam Saied, Jessica Court, Marilena Giannoudi, Meelad Sayma, Nicholas Ward, Nick Cork, Olamide Olatokun, Oliver Devine, Paul O'Connell, Phoebe Carr, Rafail Angelos Kotronias, Rebecca Gardiner, Rory T Buckle, Ross J Thomson, Sarah Williams, Simon J. Nicholson, Usman Goga and Daniel Mark Fountain
Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of…
Abstract
Purpose
Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues.
Design/methodology/approach
This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement.
Findings
Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods.
Research limitations/implications
There is widespread inclusion of MLM in UK medical schools’ curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students’ desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these.
Originality/value
This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.
Details
Keywords
Lorraine Warren, Alistair Anderson and Jo Bensemann
In this chapter, the authors explore entrepreneurial change in Stanton, a rural small town in New Zealand. This once-prosperous place has suffered economically and socially as its…
Abstract
In this chapter, the authors explore entrepreneurial change in Stanton, a rural small town in New Zealand. This once-prosperous place has suffered economically and socially as its past core industries have vanished, and it can now be considered as a depleted community. Yet in recent years, the town has seen a rejuvenation, in part due to the endeavours of Sue, a high-profile entrepreneur from outside the town who has set up several businesses in the town and indeed in other small towns in the region. Theoretically, the authors take an entrepreneurial identity perspective in examining how Sue’s arrival has changed the town; the authors examine how her entrepreneurship was perceived as legitimate. The authors use a qualitative methodology based on semi-structured interviews. The authors contribute in demonstrating how an ascribed entrepreneurial identity can not only enable but also hinder change in this community, generating confidence and emotional contagion around entrepreneurship, and also uncertainty and resentment. In doing so, the authors challenge the universality of entrepreneurship benefits.
Details
Keywords
Edward C. Fletcher, Turhan Carroll, Erik M. Hines, James L. Moore and Donna Y. Ford
Based on the theoretical and scientific literature, academic and career decisions to pursue STEM fields are made at the high school level, and Black high school students are more…
Abstract
Based on the theoretical and scientific literature, academic and career decisions to pursue STEM fields are made at the high school level, and Black high school students are more likely to participate in career and technical education (CTE) programs but are less likely to participate in CTE programs related to STEM. Additionally, Black male students are less likely to have taken the necessary prerequisites to pursue STEM fields in postsecondary education. As a result, Black male high school students are underprepared to pursue STEM college majors and careers.
However, when students participate in STEM high school CTE programs (e.g., career academies), they eventually attain STEM occupations. In this chapter, we will examine the role that high school career academies play, from the perspectives of school stakeholders, in addressing the talent pipeline by broadening the participation of Black males in STEM majors and careers.
Details
Keywords
Edward P. Lazear, Kathryn Shaw, Grant Hayes and James Jedras
Wages have been spreading out across workers over time – or in other words, the 90th/50th wage ratio has risen over time. A key question is, has the productivity distribution also…
Abstract
Wages have been spreading out across workers over time – or in other words, the 90th/50th wage ratio has risen over time. A key question is, has the productivity distribution also spread out across worker skill levels over time? Using our calculations of productivity by skill level for the United States, we show that the distributions of both wages and productivity have spread out over time, as the right tail lengthens for both. We add Organization for Economic Co-Operation and Development (OECD) countries, showing that the wage–productivity correlation exists, such that gains in aggregate productivity, or GDP per person, have resulted in higher wages for workers at the top and bottom of the wage distribution. However, across countries, those workers in the upper-income ranks have seen their wages rise the most over time. The most likely international factor explaining these wage increases is the skill-biased technological change of the digital revolution. The new artificial intelligence (AI) revolution that has just begun seems to be having similar skill-biased effects on wages. But this current AI, called “supervised learning,” is relatively similar to past technological change. The AI of the distant future will be “unsupervised learning,” and it could eventually have an effect on the jobs of the most highly skilled.
Details
Keywords
Jack G. Kaikati and Warren B. Nation
The proliferation of various interpretations of the marketing concept suggests a lack of unanimity as to its meaning. This article outlines five definitional “schools” of the…
Kirsten Russell, Fiona Barnett, Sharon Varela, Simon Rosenbaum and Robert Stanton
The mental and physical health of those residing in Australian rural and remote communities is poorer compared to major cities. Physical health comorbidities contribute to almost…
Abstract
Purpose
The mental and physical health of those residing in Australian rural and remote communities is poorer compared to major cities. Physical health comorbidities contribute to almost 80% of premature mortality for people living with mental illness. Leisure time physical activity (LTPA) is a well-established intervention to improve physical and mental health. To address the physical and mental health of rural and remote communities through LTPA, the community’s level of readiness should be first determined. This study aims to use the community readiness model (CRM) to explore community readiness in a remote Australian community to address mental health through LTPA.
Design/methodology/approach
Individual semi-structured interviews were conducted using the CRM on LTPA to address mental health. Quantitative outcomes scored the community’s stage of readiness for LTPA programmes to address mental health using the CRM categories of one (no awareness) to nine (high level of community ownership). Qualitative outcomes were thematically analysed, guided by Braun and Clark.
Findings
The community scored six (initiation) for community efforts and knowledge of LTPA programmes and seven (stabilisation) for leadership. The community’s attitude towards LTPA and resources for programmes scored four (pre-planning), and knowledge of LTPA scored three (vague awareness).
Originality/value
To the best of the authors’ knowledge, this is the first Australian study to use CRM to examine community readiness to use LTPA to improve mental health in a remote community. The CRM was shown to be a useful tool to identify factors for intervention design that might optimise community empowerment in using LTPA to improve mental health at the community level.
Details
Keywords
A recent symposium was given by Sir William Savage, M.D., B.Sc., D.P.H., Mr. Morley Parry, M.R.San.I., M.S.I.A., Ministry of Food Hygiene Division, and Mr. A. Tyler, M.B.E., F.R…
Abstract
A recent symposium was given by Sir William Savage, M.D., B.Sc., D.P.H., Mr. Morley Parry, M.R.San.I., M.S.I.A., Ministry of Food Hygiene Division, and Mr. A. Tyler, M.B.E., F.R.San.I., F.S.I.A., Chief Sanitary Inspector, Bath, to a meeting of health officers and representatives of the food trades. The subsequent discussion demonstrated the divergent views held in relation to food hygiene legislation and the conflict between ideals and practicability. Sir William, in his opening observations, speaking from the scientific aspect, showed a remarkably realistic approach to the problem. He referred primarily to the report of the Catering Trade Working Party and what are generally considered to be the three most valuable recommendations, the most important of which is that all catering establishments should be required to register with the appropriate authority; the second is that a special code of practice, called the Standard Code, should be defined and made legally enforceable; the third is that the existing deficiencies in legal powers as set out in the report should be removed by legislation. In dwelling for a short while on the Model Byelaws which the Ministry of Food issued in 1949, reference was made to the fact that, whilst it is appreciated that they cannot go beyond their limited purpose, many deficiencies are obvious. They have very limited practicability, being mainly concerned with requirements as to personal cleanliness of those who handle food, the protection of food from various possible sources of contamination, and certain requirements as to the wrapping of foods. These are all sound enough, but only touch the fringe of the problem. Whilst precise definitions are always most difficult in legal documents, especially when dealing with hygienic factors, the byelaws are particularly vague, as will be seen from the following examples: A person who handles food “ shall observe cleanliness both in regard to himself and his clothing ”. There is no definition of cleanliness and no subsequent requirements to attain it, such as the Catering Report sets out in its Target Code. Food should be covered in certain circumstances with “ suitable, clean material ”. Does a newspaper comply? Counters, floors, food utensils have to be cleaned “ as often as may be reasonably necessary ”. In the Standard and Target Codes these requirements are usually detailed, and so uniform, standard meanings can be accepted. In addition, the byelaws entirely fail to deal with the essentials of sound food hygiene. As the powers of the original Act were effected long before 1938, the standards are primarily those of visible cleanliness. We know now, however, that clean food is not necessarily safe food. This is abundantly demonstrated by the enormous increase, year by year, of recorded cases of food poisoning, most of it by food which would pass every standard of cleanliness for sight, smell and taste. All experts agree that, in the catering establishments, as the standard code requires, “ abundant supplies of water, both hot and cold, must be available ”. It is obvious that cleanliness to the point of freedom from pathogenic bacteria cannot be obtained otherwise, and sufficient sinks for washing must be available. Neither the Act nor the byelaws can enforce powers in this respect. It is sufficient, at present, to provide a gas‐ring and bucket of water in a food manufacturing room, and nothing more can be legally demanded. Sir William stressed that, if safe food was wanted and it was desired to reduce the present high toll of food poisoning, Local Authorities must be given adequate powers. Mr. Morley Parry confined his observations primarily to the defence of the model byelaws of the Ministry of Food, and his remarks admirably reflected the attitude of his particular division. He stated that, generally, we must admit that, within the past few years, the Public Health outlook of the man in the street has been developed along lines and to a degree for which sanitarians might have prayed, but for which they dared not hope, and that, for once, their opinions did not, in the main, lag behind the ideals of health officers. He qualified this, however, by stating that he was apprehensive of the fact that food hygiene might become a matter of glib phrases and catchwords, and that the public had quite readily seized on a few frequently repeated phrases that are but part of the food hygiene facts. He said that in the present position, at least theoretically, it should not be difficult to advance quickly to complete success. He deplored the entirely restrictive character of the previous set of model byelaws issued by the Ministry of Health in 1939, and said that the era of the sanitary policeman had gone, and thought it surprising that suggestions of punitive and restrictive legislation should be essential to success. He did not state how, with only permissive legislation, one would deal with the recalcitrant trader who would spend considerable amounts of money on a splendid shop‐front, but would remain content with a bucket and gas‐ring in his food manufacturing room; or how the progressive trader would view this unfair competition. In support of his argument he quoted what he termed the wonderful old phrase “ any premises in such a state as to be prejudicial to health ” and declared that the whole basis of the success of a sanitary officer's work in Public Health was built up by their predecessors on this one ambiguous phrase. He stated that the Ministry had three standards of judgment when any deviation or new byelaw was adjusted. The first was the essential practicability and reasonableness of the demand; secondly, whether the demand could be enforced with existing public health establishments; and, thirdly, that the deviation and new byelaw meet with general acceptance in the locality or be a prime necessity because of some specific local circumstance. Mr. Tyler reviewed the problem, and, having dealt with the wide adoption of the new byelaws, stated that this demonstrated that Local Authorities were prepared to make full use of the powers available. He also put some very pregnant questions as to whether the new food byelaws were an improvement on the powers possessed prior to their coming into operation, and whether they were adequate to deal effectively with the problem. He stated that the consensus of opinion among sanitary officers and food manufacturers in general was that the policeman attitude was certainly not enough. The majority of Authorities, however, were running extensive food hygiene courses for personnel employed in such work, the public, and, in some cases, children of school‐leaving age. He cited the stringent legislation in other countries which had resulted in an extremely high standard in food premises, and, although the legal penalties were extremely severe, they were rarely invoked. The subsequent discussion on this symposium showed that the opinions of the meeting, including many representatives of the food trades, were in favour of effective legislation, providing that this was lucid and equitable, and that Local Authorities must have adequate powers to deal with the very small minority of traders and manufacturers on whom advice and requests were wasted, and from whom the public must be protected. It is undoubtedly preferable to have legislation capable of a specific interpretation than a series of vague terms, such as “ reasonably necessary ”, “ suitable and efficient”, or “ a reasonable distance ”, which entail court cases to determine what exactly is meant by them. Such terms are capable of wide variations of interpretation, not only by the food trade but by the Public Health officers, resulting in a wide divergence of interpretation amongst Local Authorities.