Search results

Clinical leadership, researcher capacity and a culture of clinical inquiry are needed in the clinical workforce. The purpose of this paper is to report on a program which was used to develop and support clinicians to explore practice, implement innovation, translate evidence and build researcher capacity.

This pragmatic paper presents a case study of a nursing and midwifery clinician-researcher development program. The multi-site, multi-modal program focused on education, mentoring and support, communication networks, and clinician-university partnerships strategies to build workforce capacity and leadership.

Over 2,000 staff have been involved in the program representing a range of health disciplines. The study day program has been delivered to 500 participants with master classes having over 1,500 attendees. The research mentor program has demonstrated that participants increased their confidence for research leadership roles and are pursuing research and quality assurance projects. Communication strategies improved the visibility of nursing and midwifery.

This case study was conducted in one health district, which may not have relevance to other geographical areas. The small numbers involved in the research mentor program need to be considered when reviewing the findings.

The program has been a catalyst for developing a research culture, clinical leadership and research networks that strengthen workforce capacity. Building researcher skills in the workforce will better support quality healthcare and the examination of everyday practice.

Building a culture of healthcare that is based on inquiry and evidence-based practice will lead to more appropriate and consistent healthcare delivery. Consumers have the right to expect health clinicians will challenge everyday practice and have the skills and capability to translate or generate best evidence to underpin professional and service delivery.

This paper provides strategies for building workforce researcher capacity and capability. The program provides opportunity for building research networks and role modeling the value and importance of research to practice and quality improvement.

The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of empirical studies in healthcare that have defined flexibility as an outcome, the purpose of this paper is to draw on classic management and sociological theory to reduce this ambiguity.

The paper uses the Weberian tool of “ideal types”. Key workforce reforms are held against Atkinson’s model of functional flexibility which aims to increase responsiveness and adaptability through multiskilling, autonomy and teams; and Taylorism which seeks stability and reduced costs through specialisation, fragmentation and management control.

Appeals to an amorphous goal of increasing workforce flexibility make an assumption that any reform will increase flexibility. However, this paper finds that the work of healthcare professionals already displays most of the essential features of functional flexibility but many widespread reforms are shifting healthcare work in a Taylorist direction. This contradiction is symptomatic of a failure to confront inevitable trade-offs in reform: between the benefits of specialisation and the costs of fragmentation; and between management control and professional autonomy.

The paper questions the conventional conception of “the problem” of workforce reform as primarily one of professional control over tasks. Holding reforms against the ideal types of Taylorism and functional flexibility is a simple, effective way the costs and benefits of workforce reform can be revealed.

The purpose of this paper is to examine the impact of a practice development program, “Essentials of Care” (EOC), on patient and staff outcomes, workplace culture and service delivery.

A descriptive study design was used to explore the impact of EOC in a district hospital rehabilitation ward. EOC focuses on embedding a person-centered culture within clinical areas and is structured from practice development methodologies. EOC was implemented in a metropolitan district hospital rehabilitation, older person 20-bed, ward.

Two projects were implemented during EOC. These projects led to nine significant patient and staff outcomes for medication and continence care practices. Outcomes included a reduction in older person complaints by 80 percent, pressure injuries by 62 percent, ward multi resistant staphylococcus aureus infection rates by 50 percent, clinical incidents by 22 percent, older person falls by 14 percent (per 1,000 bed days) and nursing sick leave by 10 percent. There was also a 13 percent improvement in the post nursing workplace satisfaction survey.

This is a single site study and findings may not be suitable for generalizing across ward settings and broader population groups.

The EOC program led to significant improvements for and in clinical practices, staff satisfaction and ward culture. Specifically, the EOC program also identified significant cost savings and brought together the healthcare team in a cohesive and integrated way not previously experienced by staff. Practice development strategies can champion service quality improvement, optimal patient outcomes and consistency within healthcare.

This paper seeks to provide an analysis of historic and current criminal injuries compensation schemes in Great Britain.

The paper aims to explain the nature of the Criminal Injuries Compensation Authority (CICA) that administers the present scheme and to identify the qualifying criteria to establish eligibility for awards of compensation and obstacles to success. It deals with the nature and amounts of the awards available, the evidence gathering process, causes of delay and impediments to the achievement of fair outcomes. In the context of cases of serious injury, including acquired brain injury, it examines specific problems that are likely to be encountered and a perceived inadequacy of the compensation available to victims of such injury. The paper considers the involvement of the National Health Service in cases where applications for compensation are made and the possibility that medical professionals might inadvertently hinder the chances of a fair award. The position of local authorities and social services departments is also addressed, as is the danger that proper claims for injured victims might not be identified.

From the point of view of the victim of crime who is faced with making an application to CICA, the problems that they face lie with the process, the possibility of being refused on technical grounds, limits on compensation, gaps in the scheme – which might leave victims or their relatives going uncompensated or under‐compensated, and finally the lack of financial support with the cost of representation where it is needed. Of equal concern is the fact that the description of the circumstances of the assault and the injuries suffered can be crucial to ensure that full, proper, and relevant evidence gathering is undertaken. Without suitable skills, it is very easy for the lay applicant inadvertently to mislead, or to give the CICA the opportunity to reject or under‐compensate.

This paper provides a detailed analysis of CICA and reflects upon what the future might hold for injured victims of crime.

This research examined the relationships among a number of outcomes of mediation. The sample consisted of 73 hearings at two dispute settlement centers in New York State. Predictions from goal achievement theory were contrasted with predictions from procedural justice theory. In accordance with goal achievement theory, disputants who attained their goals in the agreement indicated immediate satisfaction with that agreement and with the conduct of the hearing. However, goal achievement was unrelated to long‐run success or long‐run satisfaction with the agreement, a result which may apply primarily to the mediation of interpersonal disputes. The predictions from procedural justice theory were more successful. Disputants who perceived that the underlying problems had been aired, that the mediator had understood what they said and that they had received a fair hearing also showed immediate satisfaction with the agreement and with the conduct of the hearing. In addition, these and related perceptions—especially in the eyes of the respondent—were predictive of several aspects of long‐run success.

This observational and interview study investigated the role of caucusing (private meetings between the mediator and a disputant) in community mediation. The results from 73 cases at two mediation centers indicate that mediators are more likely to caucus when disputants have a history of escalation, are hostile toward each other during the hearing, and fail to engage in joint problem solving. Caucus sessions were found to discourage direct hostility between the disputants but to encourage indirect hostility. There was also evidence that caucus sessions foster disputant flexibility and problem solving between the disputant and the mediator. However, no relationship was found between the occurrence or nature of caucusing and the likelihood of agreement or the quality of the mediated outcome.

The current pilot study explored food insecurity, food waste, food related behaviours and cooking confidence of UK consumers following the COVID-19 lockdown.

Data were collected from 473 UK-based consumers (63% female) in March 2020. A cross-sectional online survey measured variables including food insecurity prevalence, self-reported food waste, food management behaviours, confidence and frequency of use of a range of cooking methods, type of food eaten (ultra-processed, semi-finished, unprocessed) and packaging type foods are purchased in.

39% of participants have experienced some food insecurity in the last 12 months. Being younger, having a greater BMI and living in a smaller household were associated with food insecurity. Green leaves, carrots, potatoes and sliced bread are the most wasted of purchased foods. Polenta, green leaves and white rice are the most wasted cooked foods. Food secure participants reported wasting a smaller percentage of purchased and cooked foods compared to food insecure participants. Overall, participants were most confident about boiling, microwaving and stir-frying and least confident with using a pressure cooker or sous vide. Food secure participants were more confident with boiling, stir-frying, grilling and roasting than insecure food participants.

This has implications for post lockdown policy, including food policies and guidance for public-facing communications.

We identified novel differences in self-report food waste behaviours and cooking confidence between the food secure and insecure consumers and observed demographics associated with food insecurity.

Young adults frequently engage in sub-optimal dietary behaviours, such as inadequate intakes of fruits and vegetables and excessive consumption of take-out meals. Theory-based interventions are suggested to promote dietary change. The transtheoretical model is an example that stages an individual’s readiness to change behaviours as precontemplation, contemplation, preparation, action and maintenance, and includes a series of processes that help people move between stages. The purpose of this study is to investigate whether self-reported usual dietary intakes of fruits and vegetables and take-out foods differ by reported stage-of-change.

Cross-sectional data from 250 overweight young adults, aged 18-35 years, who enrolled in a lifestyle intervention to prevent weight gain are analysed. Participant’s stage-of-change for increasing fruit and vegetable intakes and reducing take-out foods is determined using staging algorithms. This is compared with self-reported dietary intakes over the past month using a food frequency questionnaire. Differences in intakes and variety by stage-of-change are compared for fruits, vegetables and take-out foods.

Take-out foods differed between stages (p < 0.0001), with lower weekly intakes in action (309 g) and maintenance (316 g) compared with preparation (573 g). Daily fruit intakes and variety scores varied by stage-of-change (p < 0.0001), being highest for action and maintenance (261 g and 263 g, respectively, and variety scores of 1 and 2) compared with precontemplation, contemplation and preparation (all = 100 g and 0 for variety). Daily vegetable consumption and variety scores differed by stage (p = 0.009 and p = 0.025, respectively) being highest for action/maintenance (204 g and 2 for variety) versus precontemplation and preparation (<110 g daily and Variety 1).

The finding of no differences in intakes between precontemplation, contemplation or preparation stages implies that the adoption of the dietary behaviours is not a continuum but a move from pre-action to actioning the target intakes. This means that for planning health promotion and dietary counselling, assigning people to the three different pre-action stages may be unnecessary.

This study is the first to examine the congruence of self-reported readiness to change behaviour with dietary intakes of take-out foods as well as variety of fruit and vegetables in overweight young adults.

Heavy episodic drinking in young women has caused concern among many groups including public health professionals. The purpose of this paper is to investigate the experiences of young women’s alcohol consumption so as to facilitate better health education targeting.

This qualitative descriptive study examines the narratives of 16 young women’s experience of a “night out” framed as the Alcohol Consumption Journey.

The young women’s Alcohol Consumption Journey is a ritual perpetuated by the “experienced” and “anticipated” pleasure from social bonding and collective intoxication. The data showed three sequential phases; preloading, going out and recovery, which were repeated regularly. The young women perceived that going out was riskier than preloading or recovery and employed protective strategies to minimise risk and maximise pleasure. Alcohol was consumed collectively to enhance the experience of pleasure and facilitate enjoyment in the atmosphere of the night time economy. Implications for health interventions on collective alcohol consumption and perceived risk are presented.

The concept of socio-pleasure is valuable to explain the perpetuation of the young’s women ritualised Alcohol Consumption Journey. The binary concepts of mundane/celebration, individual/collective and insiders/outsiders are useful to illustrate the balancing of collective intoxication with group protective strategies in navigating the edge between risk and pleasure.

In 1920 Margaret Sanger called voluntary motherhood “the key to the temple of liberty” and noted that women were “rising in fundamental revolt” to claim their right to determine their own reproductive fate (Rothman, 2000, p. 73). Decades later Barbara Katz Rothman reflected on the social, political and legal changes produced by reproductive-rights feminists since that time. She wrote: So the reproductive-rights feminists of the 1970s won, and abortion is available – just as the reproductive-rights feminists of the 1920s won, and contraception is available. But in another sense, we did not win. We did not win, could not win, because Sanger was right. What we really wanted was the fundamental revolt, the “key to the temple of liberty.” A doctor’s fitting for a diaphragm, or a clinic appointment for an abortion, is not the revolution. It is not even a woman-centered approach to reproduction (2000, p. 79).