Search results

This chapter examines the extent to which place based and research oriented university-community engagement (UCE) models can sustain UCE in “non-campus” rural settings. It examines how effective partnerships function in non-campus rural settings, and their contributions to achieving the reciprocal aims of communities and universities. It highlights the key successes, challenges, and opportunities experienced through case studies in non-campus locations in rural Australia (Flinders University Rural Clinical School), rural Sweden (Centre for Rural Health, Storuman), and rural Canada (Northern Ontario School of Medicine). Information provided about the discussed case studies has been provided by the organizations themselves, and the chapter authors are heads of these organizations. The authors share their knowledge of the history, the challenges, the opportunities, and the mechanisms through which the models interact with the partners.

Research on patient-centred professionalism in pharmacy is scarce compared with other health professions and in particular with pharmacists early in their careers. The purpose of this paper is to explore patient-centred professionalism in early career pharmacists and to describe reported behaviours.

This study explored patient-centred professional values and reported behaviours, taking a qualitative approach. In all, 53 early-career pharmacists, pharmacy tutors and pharmacy support staff, practising in community and hospital pharmacy in England took part; the concept of patient-centred professionalism was explored through focus group interviews and the critical incident technique was used to elicit real-life examples of professionalism in practice.

Triangulation of the data revealed three constructs of pharmacy patient-centred professionalism: being professionally competent, having ethical values and being a good communicator.

It is not known whether our participants’ perspectives reflect those of all pharmacists in the early stages of their careers. The data provide meaning for the concept of patient-centred professionalism. The work could be extended by developing a framework for wider application. Patient-centred professionalism in pharmacy needs further investigation from the patient perspective.

The findings have implications for pharmacy practice and education, particularly around increased interaction with patients.

The data contribute to a topic of importance to patients and in relation to UK health policy, which allocates more directly clinical roles to pharmacists, which go beyond the dispensing and supply of medicines.

The methods included a novel application of the critical incident technique, which generated empirical evidence on a previously under-researched topic.

The purpose of this paper is to examine the relevance of Cuba’s medical system, its health tourism and related diplomacy in the context of the recent COVID-19 pandemic for the global response to disease outbreaks. In addition to Cuba being a destination for leisure tourists in the Caribbean, the renowned Cuban medical system attracts thousands of health tourists seeking low-cost but high-quality treatment. This paper demonstrates how Cuba’s unique response to the pandemic, which included sending thousands of medical staff abroad, can inform structural and global issues and contribute to a more sustainable future.

The research in this study is primarily drawn from published academic and media sources that address Cuba’s medical system, its health tourism and the government’s response to the recent pandemic. The author, a political scientist and an author of many publications on Cuba, and the PI of a study focused on Cuban tourism, will also draw on her expertise.

This paper addresses the Cuban Government’s ongoing response to the COVID-19 pandemic and places this response in the context of Cuba’s medical system, its health tourism and related diplomacy. It reveals key lessons from Cuba’s response for other tourist destination states and, more broadly, for the worldwide response to global outbreaks and the management of health systems. The findings will further research in diplomacy and tourism as well as inform policy and practice.

This paper explores an ongoing topic and thus further research will be required following the pandemic.

This research note offers important implications for practice including providing accurate, research-based information that challenges misinformation about Cuba’s health system, its medical diplomacy program, health tourism and its response to COVID-19. It offers valuable lessons for public health authorities including the importance of preventative health measures, community medicine and the benefits of working globally to combat outbreaks through the sharing of medical staff and resources.

This research note reveals the health, political and social implications of Cuba’s response in this time of crisis. It shows the benefits of a robust but low-cost community-based medicine program, medical diplomacy and how a state’s response during crisis can moderate the global inequities and injustices such as unequal access to care that often accompany disease outbreaks such as COVID-19.

This research note is an early analysis of a response by an important tourist destination country to the pandemic. The author anticipates that the information provided to the international community via this open access journal will offer practical implications for the ongoing global efforts to manage this crisis and contribute to the research on tourism, diplomacy, justice and health policy.

This paper aims to describe the context, process and findings of a qualitative review of Walsall Arts into Health Partnership, which is widely acknowledged to be one of the most progressive community‐based arts and health programmes in the UK.

The research adopted a multi‐method qualitative approach to gathering data, using a combination of documentary analysis and semi‐structured interviews and focus groups with a range of stakeholders.

The findings highlight a number of emerging themes categorised under four broad headings: impact of the Arts into Health work on health and wellbeing of the people of Walsall; effectiveness; key characteristics; and future development of the Arts into Health Partnership.

The research findings point to the value of community arts and health work and to the importance of a partnership approach. However, current debates regarding evaluation approaches within the field point to the need for clarification regarding values, the use of multiple methodologies and engagement with a diversity of stakeholders.

This paper provides an overview of the local and national arts and health policy contexts within which the review took place – shortly before a major restructuring of the health service; outlines the research methodology; presents and discusses the key findings, outlines recommendations; and discusses subsequent action and the impact of the research.

As it is now some time since the publication of the Health White Paper, and there is currently a pause in the progress of the Health and Social Care Bill through Parliament, it seems timely to look at how the proposed changes to patient and public involvement (PPI) may develop. This paper seeks to address these issues.

The paper examines the proposals for PPI set out in the legislation and uses the findings of the authors' recent research to examine them.

The paper argues that the legislation, as currently written, contains nothing that will guarantee a more effective engagement with either patients or the public.

This is a fast moving field at present, and the eventual outcome of this major reorganisation is unclear. This paper uses evidence from previous studies to provide an overview of the issues relating to patient and public involvement in the National Health Service and highlights the potential problems in the proposals as they stand at present.

The purpose of this paper is to reflect on research evidence and practice experience of transforming primary care to a more integrated and holistic model.

It is based on a scoping review which has been guided by primary care stakeholders and synthesises research evidence and practice experience from ten international case studies.

Adopting an inter-professional, community-orientated and population-based primary care model requires a fundamental transformation of thinking about professional roles, relationships and responsibilities. Team-based approaches can replicate existing power dynamics unless medical clinicians are willing to embrace less authoritarian leadership styles. Engagement of patients and communities is often limited due to a lack of capacity and belief that will make an impact. Internal (relationships, cultures, experience of improvement) and external (incentives, policy intentions, community pressure) contexts can encourage or derail transformation efforts.

Transformation requires a co-ordinated programme that incorporates the following elements – external facilitation of change; developing clinical and non-clinical leaders; learning through training and reflection; engaging community and professional stakeholders; transitional funding; and formative and summative evaluation.

This paper combines research evidence and international practice experience to guide future programmes to transform primary care.

This study aims to describe the treatment preference, especially in relation to traditional medicine, modern health care and a combination of both, in diarrheal cases among the Tengger ethnic minority group.

A cross-sectional survey was conducted in all eight villages of Tosari District, Pasuruan Regency, East Java Province. Tengger people were major resident in the area for generations. Convenience sampling and a face-validated structured questionnaire were used to recruit and face-to-face interview 377 Tengger people.

The study found that modern health care was the dominant preference (52%, n = 196) selected by Tengger people when they have an episode of diarrhea, compared to traditional medicines and mixed approach. Most respondents opted to visit one facility or to stay at home (64.3%, n = 242). Statistical significant relationships were found between treatment choice and age (p < 0.001), sex (p < 0.001), religion (p = 0.011), distance (p < 0.001), educational background (p < 0.001) and job (p < 0.001). A clear pattern between treatment choice and age was revealed with younger groups tended to choose modern health care, while older groups more preferred the traditional approach.

This work could provide an insight that when the young Tengger people are having uncomplicated and common health illness, such as diarrhea, they tend to use modern treatment approach.

This study fulfilled an identified need to explore the trend of treatment approach across generations in the Tengger society as a model of the minor ethnic group in Indonesia.

This paper aims to propose an integrative and result-driven health-care knowledge management (HKM) model and discuss the findings of a research that examines how the KM initiatives of a major private Brazilian hospital system are linked to its health-care performance outcomes.

Data were collected from a top-level Brazilian private hospital system (Mater Dei Healthcare System – MDHS), which is composed of three large hospitals internationally accredited by ISO 9001/2000, NIAHO and JCI. Multiple qualitative approaches were used to collect data such as 16 in-depth interviews with health professionals and managers, document analysis, participatory observation and benchmarking interviews with two reference hospital networks in Brazil.

The proposed health-oriented KM model is an expansion of the organizational knowing cycle model (Choo, 1996), adding absorptive capacity (ACAP) as a new construct. The paper discusses how ACAP integrates with sense-making, knowledge creation and decision-making processes within the health-care context. Information technology and clinical governance were identified as support factors to the HKM processes.

The paper presents a pragmatic and result-driven knowledge management (KM) model using health-care-welfare key performance indicators, as well as the emergence of KM as an integrative and strategic approach to hospital management.

The present study presents a knowledge-based perspective to clinical staff management, demonstrating the tangible results of KM initiatives that contribute to health and management performance outcomes.

Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate challenges, opportunities and potential solutions from a primary healthcare provider perspective.

Fifty-seven participants joined in group discussions on challenges and opportunities of working with advanced age. Participants included general practitioners (GPs), practice nurses, students and administration staff working in ten general practices. A thematic analysis was developed, supported by NVivo software.

Poor lines of communication and fragmentation of services between differing levels of health care services available for older people were highlighted. This has implications for quality of care and equity of services. Participants also reported challenges in treatment and funding regimes.

The small sample size and regional nature of the study, along with the semi-structured nature of the group discussions and rigorous thematic analysis, indicate that this qualitative data is transferable, dependable, confirmable and credible. Comparing the views of tertiary and community services would be useful.

A range of potential strategies and solutions to the current fragmented services was offered by GPs. For example, adequately funded and staffed community-based health hubs; IT platforms enabling timely flow of patient information between primary and tertiary health providers and creation of medical, nursing and allied health roles aimed at improving synergy between GP and tertiary services.

Obtaining the perspectives of general practice highlights the challenges and complexities of caring for those in advanced age brings. These insights have not been previously been explored in-depth within this setting in New Zealand.

Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and chronic mental health problems. Maternal mental illness can also adversely impact the cognitive, physical, and psychological health and development of children. In light of known psychosocial risks, there is concern that fewer than expected women from black and minority ethnic (BME) backgrounds access care and treatment. This paper aims to address this issue.

Responding to persistent reports of patchy service provision across the UK more generally and particular concerns about potentially unmet needs among BME women, mixed‐method research was undertaken between September 2009 and March 2010. Using survey questionnaires and telephone interviews, the study sought to explore professional stakeholders' perspectives on current perinatal mental health provision and the extent to which it meets the needs of BME women. Findings from the study were intended to inform policy and plans to improve provision by establishing managed care networks (MCNs) for perinatal mental healthcare.

In total, 45 questionnaires were returned from the national survey. One‐third of respondents (n=14) consented to follow‐up telephone interviews. There was evidence of multi‐agency working among the 27 professional groups which respondents reported as being directly involved in delivering perinatal mental healthcare across the country. However, there was also evidence of disjuncture and poor communication – particularly between statutory and voluntary sectors and NHS primary and secondary care. Some respondents had difficulty defining “BME” or identifying the women to whom the acronym might be applied. They also questioned the validity of providing “BME‐specific” services. Instead, they endorsed more ethnically “inclusive models” of provision and “signposting” women to appropriate “community” services.

Taken together, these findings suggests that whilst there might be a theoretical argument for perinatal mental health MCNs, considerable effort is required if policy‐makers' aspirations for more “joined‐up” services capable of meeting the needs of all women are to be fully realised. Furthermore, current proposals for public sector reform coupled with reduction in voluntary sector provision is likely to disproportionately affect women from BME and other marginalised communities as they provide significant amounts of “below the radar” care and support.

This paper is of particular relevance to policy makers and practitioners. Findings suggest that women from BME backgrounds might be particularly vulnerable to perinatal mental illness. Contraction of voluntary sector provision increases the likelihood that the needs of BME women will remain unmet with deleterious consequences for their health and wellbeing of their families. This has potentially serious public health implications. MCNs/clinical networks have the potential to reduce inequalities by providing more “joined up” care for all women. However, the evidence base for levels of need and appropriate service response to perinatal mental illness among BME women is weak. Further research is required to bridge the evidence gap and to evaluate the impact of health and social care reform on vulnerable groups.