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Mental health care in England has been subject to a great deal of scrutiny in recent years for its equality of access, experience and outcome. Five years of the Delivering Race Equality programme produced momentum, learning and improvements. It is clear, though, that efforts need to consider a continuous quality improvement approach and consciously use all new initiatives to further drive more equal services. A current initiative in England is the care clusters model for mental health, along with associated moves to commission services on a payment by results basis. This paper examines these developments and the possible implications for supporting greater equality in mental health care.

The purpose of this paper is to explore physical environmental, medical environmental, and individual factors in a sample of ethnic minority adults with or at-risk for type 2 diabetes (T2D) on the Atlantic Coast of Nicaragua.

The study used a cross-sectional descriptive design guided by a community-based participatory research framework. Three coastal communities in the South Atlantic Autonomous Region (RAAS) of Nicaragua were sampled. Inclusion criteria were: lay adult with or at-risk for T2D, ⩾21 years of age, self-identification as Creole or Miskito, and not pregnant. Convenience sampling procedures were followed. Data were collected via objective (A1C, height, and weight) and self-report (Pan American Health Organization surveys, Diabetes Care Profile subscales, and Medical Outcomes Survey Short Form-12 (MOS SF-12) measures. Univariate and bivariate statistics were computed according to level of measurement.

The sample (N=112) was predominately comprised of Creoles (72 percent), females (78 percent), and mid-age (M=54.9, SD±16.4) adults with T2D (63 percent). For participants with T2D, A1C levels, on average, tended to be elevated (M=10.6, SD±2.5). Those with or at-risk for T2D tended to be obese with elevated body mass indices (M=31.7, SD±8.1; M=30.2, SD±6.0, respectively). For many participants, fresh vegetables (63 percent) and fruit (65 percent) were reported as ordinarily available but difficult to afford (91 and 90 percent, respectively). A majority reported that prescribed medication(s) were available without difficulty (56 percent), although most indicated difficulty in affording them (73 percent). A minority of participants with T2D reported receipt of diabetes education (46 percent). A1C levels did not significantly vary according to diabetes education received or not (M=10.9, SD±2.9; M=10.4, SD±2.5; t=−0.4, p=0.71). Participants at-risk for T2D were infrequently instructed, by a provider, to follow an exercise program (4.8 percent) or meal plan (4.8 percent) and receive diabetes education (2.38 percent). MOS SF-12 findings revealed participants with T2D (M=41.84, SD=8.9; M=37.8, SD±8.5) had significantly poorer mental and physical health quality of life relative to at-risk participants (M=45.6, SD±8.4; M=48.1, SD±9.5) (t=−2.9, p<0.01; t=−2.5, p=0.01).

Salient physical environmental, medical environmental, and individual factors were identified in a sample of adults with or at-risk for T2D on Nicaragua’s Atlantic Coast.

Findings informed the development of community-based clinics to address the problem of T2D locally.

The community-based clinics, housed in trusted church settings, provide culturally competent care for underserved ethnic minority populations with or at-risk for T2D.

This is the first quantitative assessment of the T2D problem among diverse ethnic groups in Nicaragua’s underserved RAAS.

The electronic library is emerging as the library of the foreseeable future but its user aspect, particularly the usability, requires more research. This article describes the ELINOR (Electronic Library and Information Online Retrieval) developments at De Montfort University from the user's perspective. It firstly shows the main features of the ELINOR user interface which illustrates how a user can find a document in the Electronic Library and subsequently read the retrieved document on the screen. This is then followed by a discussion of the methodology and findings of a user study based on a random sample of eight ELINOR users conducted in the Autumn term of 1993. The user study included searching/reading/browsing tasks and a questionnaire. The former is a controlled experiment designed to gauge objectively the usability of ELINOR by comparing the use of the electronic books with that of printed books. The questionnaire shows the user's subjective reaction to ELINOR. Future work on the user study will expand the sample to include all the first‐ and second‐year students doing the Business Information Systems Course at the University's Milton Keynes campus.

The ELINOR electronic library system is a well integrated, fully functioning system implemented at De Montfort University in 1993. The system currently contains the full contents of some 35 000‐page course materials assisting the teaching and learning of one undergraduate course. The core software for the system is PixTex/EFS, a free text retrieval system with well integrated imaging functions. A usage statistics collection and management subsystem and a printing control subsystem were developed in‐house later for copyright management and other management purposes. This paper presents the various aspects of the ELINOR electronic library system including its database, browsing, searching, printing, document capturing, managing, architecture, the user aspect, and the pros and cons of the system.

In many regions, the potential of social entrepreneurship and social innovation are not fully used. The purpose of this study is to explore issues and challenges in the business advisory support offered to social entrepreneurs and, from this background, give suggestions on how the advisory process to social entrepreneurs could be modified to better gain society.

Representatives from 15 business advisory organisations in Sweden were interviewed to examine how their support to social enterprises meets the needs of the companies, and to discover possible problems encountered regarding the business advice available to social enterprises. Using thematic analysis, six different overarching themes were identified that characterise issues and challenges in the business advisory support offered to social enterprises.

The results show that many advisers lack experience in social entrepreneurship, yet they consider that social enterprises are not “genuine” entrepreneurs, and that they, therefore, refer them to advisers focussing on co-operative enterprises. Furthermore, the absence of sustainable business models, the lack of financial resources and the existence of municipal monopoly are identified by the advisers as challenges.

This paper reveals an Achilles’ heel in the business advisory support offered to social enterprises, namely, the lack of experience and knowledge of social entrepreneurship amongst current business advisers, as well as a prioritisation of advice to more “commercial” entrepreneurs because of policy instruments and the expectations from the public funders of increased profitability and growth in the companies that receive advice. The mainstream business advisory service could play a key role by bringing together the various stakeholders in this shared value process. This would, however, require increased knowledge and new government policies and directives that ensure that social entrepreneurs are prioritised in the business advisory situation.

This paper demonstrates that the current advisory system is not adapted to fit the needs of social enterprises. It also proposes the need to include participation and proximity in the business model design.

Local Chambers of Commerce networks provide small- and medium-sized enterprises (SMEs) with an opportunity to access essential information and networking with other businesses, resulting in improved business performance. However, rural SMEs are less likely to participate in these networks and often possess lower performance. This paper aims to examine the relationship between being members of local Chambers of Commerce networks and rural SMEs’ performance by comparing business performance between rural SMEs who are members and non-members of local Chambers of Commerce networks. This paper also further explores difference in business growth plans between rural SMEs members and non-members.

The empirical analysis draws on cross-sectional data of 3,769 rural SMEs in England and Wales from the UK's Government Longitudinal Small Business Survey 2015. Propensity score matching (PSM) is applied to control for selection bias and variations in business characteristics before comparing business performance, measured in terms of annual turnover, sale growth and profitability, between rural SMEs that are members and non-members of local Chambers of Commerce networks.

Our results show that rural SME members of local Chambers of Commerce networks are more likely to grow their sales than non-members. However, they perform as good as non-members in terms of turnover and profitability. The results also emphasise that local Chambers of Commerce networks are crucial for rural SMEs to develop the skills of the workforce and leadership capability of managers, new product/service development and new working practices. Therefore, to enhance rural SMEs' performance, tailoring the services of local Chambers of Commerce to support rural businesses' needs and encouraging rural SMEs to make use of business networks are recommended.

The paper unpacks the relationships between being local Chamber of Commerce membership and business performance, offering lessons for rural SMEs to boost their business performance and growth through participating in local business association networks.

This paper is the first study that explores the comparative analysis of business performance and growth plans between rural SMEs that are members and non-members of the local Chamber of Commerce networks. We provide an empirical evidence-based analysis to existing literature regarding the advantages of being local Chamber of Commerce memberships to enhance business performance in rural areas.

There is a substantial body of empirical literature on university students' self‐perceived approaches to learning, but evidence on instructors' perceptions of the way they facilitate their students' learning approaches is less evident. This study aims to investigate the extent of the gap between students' learning approaches and instructors' teaching orientations towards facilitating these approaches. The subsequent employability of accounting graduates depends in part on the nature and extent of this gap. Student learning approaches are measured on two dimensions ‐ deep and strategic approaches ‐ drawn from Tait's and Entwistle's (1995) Revised Approaches to Studying Inventory (RASI). Instructors' facilitation of students' learning is measured by a re‐orientation of the same RASI instrument towards teaching approaches. The results reveal several significant differences of emphasis between instructors and students in terms of deep and strategic approaches. Students are falling short of what their instructors believe they are facilitating in terms of the development of their employability competencies and characteristics for a professional career. When students are grouped according to gender, further significant differences are found. Implications of these findings for future change in accounting education are discussed.

This chapter examines the interactions of formal and informal forms of small and medium-sized enterprise (SME) business support, characterised as interactions within an ‘enterprise industry’. An analysis of the interactions revealed in the existing literature for different forms of business support develops a new conceptual framework for understanding those varied forms of external influence targeted at SMEs that constitute and extend a ‘patchwork quilt’ of provision. This chapter focusses on how different forms of support and advice interact, the centrality of state influence and how such interactions can be considered part of a firm’s regulatory context. This conceptualisation allows the consideration of both business support and state regulations to move beyond conceptions of positive or negative impacts on factors such as firm growth. Instead, it establishes a conceptual lens for considering how the different forms of external influence can shape the practices and attitudes of SMEs and their owner-managers. Policy makers and organisations within the enterprise industry seeking to develop effective forms of support or regulation should not consider such activities in isolation or in simple, decontextualised positive or negative terms.

Education, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector.

A scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases – Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac et al. (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature.

The literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found – Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals.

To date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.

A monthly feature giving news of recent Government and professional appointments, industrial developments and business changes, etc. Three changes among the executives of Armstrong Siddeley Motors Limited of Coventry, Warwickshire, are announced by the Hawker Siddeley Group of 18 St. James's Square, S.W.I.