Search results
1 – 10 of over 1000Sujeet Jaydeokar, Mahesh Odiyoor, Faye Bohen, Trixie Motterhead and Daniel James Acton
People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This…
Abstract
Purpose
People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This paper aims to detail the process of developing a risk stratification tool to identify those individuals who are higher risk of premature mortality.
Design/methodology/approach
This study used population health management principles to conceptualise a risk stratification tool for avoidable deaths in people with intellectual disability. A review of the literature examined the existing evidence of causes of death in people with intellectual disability. A qualitative methodology using focused groups of specialist clinicians was used to understand the factors that contributed towards avoidable deaths in people with intellectual disability. Delphi groups were used for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for Physical Health).
Findings
A pilot of the Decision Support Tool for Physical Health within specialist intellectual disability service demonstrated effective utility and acceptability in clinical practice. The tool has also demonstrated good face and construct validity. A further study is currently being completed to examine concurrent and predictive validity of the tool.
Originality/value
To the best of the authors’ knowledge, this is the only study that has used a systematic approach to designing a risk stratification tool for identifying premature mortality in people with intellectual disability. The Decision Support Tool for Physical Health in clinical practice aims to guide clinical responses and prioritise those identified as at higher risk of avoidable deaths.
Details
Keywords
Amos Gavi, Emma Plugge and Marie Claire Van Hout
The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with…
Abstract
Purpose
The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with cardiovascular disease representing a significant contributor to the regional burden of disease. Very little is known about the cardiovascular health of people deprived of their liberty in the region. The purpose of this study was to collate extant literature on the topic.
Design/methodology/approach
A scoping review mapped and described what is known about cardiovascular disease in prison populations in Sub-Saharan Africa. A systematic search of empirical literature with no date limitation was conducted in English. Sixteen studies representing six Sub-Saharan African countries (Cameroon, Nigeria, Guinea, Burkina Faso, Ghana and Ethiopia) were charted, categorised and thematically analysed.
Findings
Seven key themes were identified: custodial deaths and autopsy; cardiorespiratory fitness and exercise; cardiovascular disease and elderly people in prison; cardiovascular disease and women in prison; dietary deficiencies; influence of sleep patterns on cardiovascular disease; and other associated risk factors. Most natural deaths at autopsy of custodial deaths were due to cardiovascular disease. Cardiorespiratory fitness was low in prisons, and poor sleep patterns and dietary deficiencies are likely contributors to the burden of cardiovascular disease in prisons. The needs of elderly and female prison populations are ill-considered.
Originality/value
To the best of the authors’ knowledge, this is the first known attempt to scope extant literature on cardiovascular disease in Sub-Saharan African prisons. A strategic focus on the cardiovascular health of people in prison is warranted. Routine monitoring and expansion of existing prison health-care services and integration of NCD services with infectious disease (HIV and tuberculosis) programmes in prisons are required.
Details
Keywords
The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health…
Abstract
Purpose
The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.
Design/methodology/approach
This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.
Findings
Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.
Research limitations/implications
The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.
Practical implications
It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.
Social implications
Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.
Originality/value
The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.
Details
Keywords
Adesola Olalekan, Victor Igweike, Oloruntoba Ekun, Abosede Adegbite and Olayinka Ogunleye
Pre-eclampsia and eclampsia (PE/E) are rising in Sub-Saharan Africa, including Nigeria. This study aims to evaluate the availability and logistics management of sixteen items from…
Abstract
Purpose
Pre-eclampsia and eclampsia (PE/E) are rising in Sub-Saharan Africa, including Nigeria. This study aims to evaluate the availability and logistics management of sixteen items from the Nigerian essential medicine list required for managing these conditions.
Design/Methodology/approach
A cross-sectional study in 50 health-care facilities in Lagos State, Nigeria, at the beginning of the COVID-19 pandemic by interviewing the facility’s main person in charge of health commodities. Data were recorded during the visit and in the previous six months using the adapted Logistics Indicators Assessment Tool (LIAT). In addition, descriptive analysis was conducted based on the World Health Organization availability index.
Findings
The availability of 13 (81%) of the commodities were high, and 3 (19%) were relatively high in the facilities, stock out rate during the visitation and previous six months varied with the commodities: urinalysis strip (22%) and (40%), hydralazine (20%) and (20%), labetalol injection (8%) and (20%), labetalol tablet (24%) and (24%) and sphygmomanometer (8%) and (8%). No stock out was recorded for 11 (69%) commodities. All the facilities observed 9 (75%) out of the 12 storage guidelines, and 36 (72%) had a perfect storage condition score.
Limitations/Implications
Current state of PE/E health commodities in the selected facilities is highlighted, and the strengths and weaknesses of the supply chain in these health facilities were identified and discussed.
Originality/value
These commodities’ availability ranged from reasonably high to very high. Regular supportive supervision is germane to strengthening the logistics management system for these commodities to prevent the negative impact on the health and well-being of the people during the COVID-19 pandemic and post-pandemic.
Details
Keywords
The purpose of this paper is to analyze the prejudice and discrimination constructs through the lens of a transcendent knowledge concept.
Abstract
Purpose
The purpose of this paper is to analyze the prejudice and discrimination constructs through the lens of a transcendent knowledge concept.
Design/methodology/approach
The paper seeks to demonstrate that Spiritism or Spiritist Doctrine (SD) – regarded here as a source of transcendent knowledge – offers compelling arguments and provides suitable explanations (i.e. transcendent ontology) in relation to the issue of discrimination
Findings
Overall, this paper contributes to a better understanding of diversity and inclusive perspectives by examining the antecedents and consequences of discrimination through the insightful lens of SD tenets. In this sense, the findings suggest that the discriminators and prejudiced people may ironically pass through – as a result of the law of cause and effect – the same hard situations (i.e. ordeals or nightmares) – even though in their future lives – that they impose in their current victims to forcefully open their minds, support universal values, enhance their own feelings and spiritual intelligence.
Practical implications
Evidence presented here (although conceptually in nature) could be somewhat integrated into training sections of diversity management. At a minimum, it may encourage the shift of attitudes, revision of embedded values and reflections about the spiritual consequences to the perpetrators of discrimination against minorities.
Originality/value
Taken as a whole, the SD tenets prompt us to understand that the acts of prejudice, stereotyping and discrimination engender suffering for their perpetrators, even in their future lives (i.e. reincarnations). Broadly speaking, the SD principles compel us to consider transcendent knowledge even in the context of organizational life.
Details
Keywords
The vast bulk of the discourse surrounding reproduction is centered on women. Yet, the rate of childlessness in the United Kingdom (and much of the world) is higher among men…
Abstract
The vast bulk of the discourse surrounding reproduction is centered on women. Yet, the rate of childlessness in the United Kingdom (and much of the world) is higher among men. Recently, there has been an increased focus on fatherhood and fathering in academia, policy, practice, and the general media. However, data on men who do not become fathers has been excluded and their experiences minimized and dismissed. Infertility research has shown that failure to achieve the high social status of parenthood has the similar effects on mental and physical health as a diagnosis of life-threatening illness. In this chapter, I will draw on two qualitative research studies to show how not achieving the pronatalist ideal of parenthood impacts on men’s identity, sense of self, behaviors, health and well-being and social networks across the life course. The workplace is an arena where people who do not fit socio-cultural norms and expectations are overtly and/or covertly stigmatized and discriminated against through policy, working practices and everyday interaction between groups and individuals. I will argue that failing to acknowledge men’s experience of non-reproduction has a significant impact on both individuals and institutions alike.
Details