Search results

Reports on a study which explored the views of key stakeholders regarding the meaning and implementation of effective health care and clinical governance in NHS Trusts, and the role for public health professionals. The authors used a national questionnaire survey to derive a sample for qualitative telephone interviews and two area case studies. The authors found that the meaning of effective health care and the means employed for implementation varied. Mergers were seen as hindrances to gaining organisational engagement whilst others, such as the White Paper on quality and the notion of clinical governance, were seen as facilitating. A widespread aspiration was a more integrated and corporate quality culture where quality was central, not marginal. The authors conclude that there is widespread concern among Trusts to change their culture and assert effective health care as a central value. Public health skills, rather than the discipline itself, are seen as important for such culture change.

This preliminary small-scale research aims to achieve an insight into drug use offenders’ rehabilitation experiences both in and out of prison, as well as considering how perceptions of the public may inhibit their successful reintegration into society.

A mixed-methods approach was used, with five semi-structured interviews conducted alongside the distribution of the Attitude towards prisoners questionnaire among the general public (n = 106) in the North-West region of England.

Participants recalled a mixture of experiences, highlighting the presence of contraband in prisons to be an inhibiting factor of successful rehabilitation. Additionally, participants expressed the need for more support when preparing for release such as confirmation of accommodation and possible employment. Questionnaires also indicated the public to perceive offenders negatively (M = 76, SD = 16.99), thus presenting a further challenge in the resettlement of drug use offenders.

Findings highlight that improving practices to decrease the presence of contraband in prisons, monitoring an individual’s use of methadone, preparing an individual for their release from prison and educating the public would reduce some of the obstacles experienced by drug use offenders.

This study outlines some of the obstacles that drug use offenders experience when attempting to end their drug use activity and criminal engagement.

Following publication of a new vision for the English National Health Service (NHS) in 2014, known as the NHS Five-Year Forward View, a Vanguard programme was introduced by NHS England charged with the task of designing and delivering a range of new care models (NCMs) aimed at tackling deep-seated problems of a type facing all health systems to a greater or lesser degree. Drawing upon recent theoretical developments on the multilevel nature of context, we explore factors shaping the implementation of five NCM initiatives in the North East of England.

Data collection was based on semi-structured interviews (66 in total) between December 2016 and May 2017 with key informants at each site and a detailed review of Trusts' internal documents and policies related to the implementation of each NCM. Our analysis explores factors shaping the implementation of five NCM pilot sites as they touched on the multiple levels of context ranging from the macro policy level to the micro-level setting of workforce redesign.

It is far too early to conclude with any confidence that a successful outcome for the NCM programme will be forthcoming although the NHS Long-Term Plan seeks to build on the earlier vision set out in the Five-Year Forward View. Early indications show some signs of promise, especially where there is evidence of the ground having been prepared and changes already being put in place prior to the official launch of NCM initiatives. At the same time our findings demonstrate that all five pilot sites experienced, and were subject to, unrealistic pressure placed upon them to deliver outcomes.

Our findings demonstrate the need for a deeper understanding of the multilevel nature of context by exploring factors shaping the implementation of five NCMs in the North East of England. Exploring the wider national policy context is desirable as well as understanding the perceptions of front-line staff and service users in order to establish the degree of alignment or, conversely, to identify where policy and practice are at risk of pushing and pulling against each other.

The National Labor Relations Act (NLRA) creates rights for covered employees, defines conduct that violates those rights, and deems that conduct an unfair labor practice. But while given broad remedial powers under the Act, the Board's options were curtailed by the Supreme Court's limit on the use of deterrence as an express remedial justification. The Board was left with a strongly make-whole, i.e., ex-post, focus to undo the consequences of a violation.

Put differently, the current NLRA remedies reflect a pay-or-play philosophy. The goal is restoration after the fact, using ex-post remedies to give parties the benefit or status quo that they expected. An actor willing to pay may use a cost–benefit analysis and strategically choose to violate the Act, accepting the make-whole remedies later. But the Act created ex-ante statutory rights, not agreed-upon contractual terms. By statutory enactment, employees are given something of value deemed worthy of protection. Assigning value to compliance with the law in the first instance not only prevents sometimes irreparable harm but also reaffirms the inherent value of the right itself.

The impact of the Board's limited remedies is therefore a broad value-driven one. Without ex-ante deterrence, the available ex-post make-whole remedial options make a normative statement about individuals' rights under the Act: those rights may not be inherently worth enough to incentivize legal compliance. The make-whole focus can imply that financial compensation for the portion of harm that can be calculated and “undoing” some nonfinancial effects is sufficient. There is little drive to deter infringement before the fact. By examining the remedial philosophy behind contrasting approaches in the common law of torts and contract, this Article asserts that the current remedial strictures and framework undermine both the Act and the worth of its rights in the eyes of the public and the employees who hold them.

With confidence in the British Political system in decline, it is more important than ever that the top-down approach to decision-making and service strategy in public services is challenged. In this chapter, we examine how coproduction of services can be achieved using Get Talking, an approach to participatory action research that utilizes creative consultation techniques to engage with publics. We explain how the approach enabled Staffordshire Fire and Rescue Service (SFRS) to involve young people in the development of a Children and Young People’s Strategy. The case study approach, building on qualitative methods including focus groups and semi-structured interviews, demonstrates how creative approaches were used by public sector staff to engage young people and partners in strategy development. Creative consultation techniques were used to facilitate the focus group activity. While using Get Talking as an approach to policy development required a resource investment in terms of staff time, it provided SFRS with insight into the needs of service users. This resulted in a more relevant strategy being developed and a cultural shift in how the organization works with young people. Engagement with the Get Talking process had a positive effect on staff, providing them with a sense of ownership over the resulting strategy, enhanced the reputation of SFRS with partners, and improved relationships with young people through demonstrating that they were valued partners in coproduction. While the approach was well received by all parties, challenges of using Get Talking in a public service setting resulted in pragmatic adaptations to a traditional PAR approach.

The degreening process for citrus accelerates natural colour break which changes fruit from an “unripe” green colour to the characteristically ripe orange/yellow colour. Degreening is used by producers both to extend the citrus season to make short‐term financial gains and to make fruit more attractive to consumers. This study reviews how, in an attempt to improve fruit appearance, other quality attributes may be sacrificed. The process is known to be detrimental to external fruit quality and is also suspected to be detrimental to consumption quality and shelf life. In the context of a dynamic and competitive fruit market, any reduction in product quality and consequent loss consumer satisfaction inevitably will have a negative economic impact on producers and traders. Further technical and marketing research is necessary, but among the conclusions drawn is that there is sufficient evidence already to be cautious about the widespread use of degreening.

The authors reflect on the academic bachelor and master programs of architecture. From the perspective of higher education policy in Flanders, Belgium, they examine the intrinsic challenges of the academic educational setting, and the way architectural education can fit in and benefit from it, without losing its specific design oriented qualities. Therefore, they unravel the process of architectural design research, as a discipline-authentic way of knowledge production, leading to the identification of a number of implicit features of an academic architectural learning environment. The disquisition is based on educational arguments pointed out by literature and theory. Furthermore, the authors analyze whether this learning environment can comply with general standards of external quality assurance and accreditation systems. Doing so, they reveal the Achilles’ heel of architectural education: the incompatibility of the design jury with formalized assessment frameworks. Finally, the authors conclude with an advocacy for academic freedom. To assure the quality of academic architectural programs, it is necessary that universities maintain a critical attitude towards standardized policy frameworks.