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Book part
Publication date: 15 December 2017

Abstract

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The Emerald Handbook of Modern Information Management
Type: Book
ISBN: 978-1-78714-525-2

Abstract

Details

The Emerald Handbook of Modern Information Management
Type: Book
ISBN: 978-1-78714-525-2

Keywords

Article
Publication date: 1 April 1998

Teresa Warwicker

The focus of the paper is on the relationship between General Practitioners (GPs) and central government. This relationship dates from the introduction of national health…

Abstract

The focus of the paper is on the relationship between General Practitioners (GPs) and central government. This relationship dates from the introduction of national health insurance in the UK. From the outset it had an impact on GPs’ medical role, their professional status and income. The structure created in 1911 meant that GPs operated as franchisees and, notwithstanding Labour’s policy objective of creating a salaried service, this role continued, effectively unchanged, after the creation of the National Health Service (NHS) in 1948. General Practice was also the poor relation in contrast to hospital medicine, a feature intensified by the priorities of the NHS. These forces meant that GPs had a dual role: that of clinician and gatekeeper to specialist hospital services, a role in which they exercised substantial clinical freedom: and running a small business, a feature which was exaggerated by the absence of grant aid to improve premises prior to the Family Doctor Charter of 1965. This structural relationship has been progressively transformed by changes in the 1980s and 1990s. On the one hand the emphasis on cost control has seen central government attempting to combine a financial with a clinical gatekeeping role. The crucial change in this respect is the creation of GP fundholding which, in turn, could be seen to have implications for the subordinate status of GPs within the medical profession. However, this has been combined with trends to greater measures of control over GPs. Of central importance in this respect were the changes introduced by the 1990 GP contract. The contract involved an attempt to substantially reduce clinical autonomy by building in much more detailed contractual duties with respect for example, to health promotion activities. This was combined with the use of financial incentives to reach, for example, immunization targets. Control over clinical autonomy has also involved constraints over prescribing and the shift from Family Practitioner Committees to Family Health Service Authorities. The rationale for this shift is the move from an administrative to a managerial body, acting as the agent of central government in enforcing the contract and imposing financial norms. GPs are thus to be made managerially accountable. The paper analyses the place of general practitioners in central government’s approach to health strategy and examines the tensions generated by the combination of conferring new powers on GPs and increasing controls over them. These tensions are related to current disputes over out‐of‐hours working and attempts by GPs to redefine a “core of service” approach to their job. The ambiguities of reliance on professionals combined with the desire to exert greater controls is traced in the recent policy statement by the Secretary of State Primary Care: The Future (1996). The paper thus aims to contribute to the critical discussion of the impact of central government managerialist initiative on key professional groups in the welfare state.

Details

International Journal of Public Sector Management, vol. 11 no. 2/3
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 16 September 2011

Martin Power and Mary Jo Lavelle

In response to the challenge of the ageing of societies and concerns over recruitment and quality of service delivery, many nations have introduced new educational and…

125

Abstract

Purpose

In response to the challenge of the ageing of societies and concerns over recruitment and quality of service delivery, many nations have introduced new educational and training pathways, as well as national standards that set a minimum qualification level for residential care staff. In Ireland, national standards were introduced in July 2009 and, against this backdrop this study aimed to explore the level of qualification held or being pursued by non‐nursing care staff.

Design/methodology/approach

An email/postal survey was conducted.

Findings

This survey revealed that while vocational qualifications were most common, more than 50 per cent of care staff neither held nor were pursuing the minimum qualification set by the standards.

Research limitations/implications

While the introduction of standards may address this situation, the workforce appears currently ill‐prepared for increasing professionalisation. Moreover, given Ireland's poor economic circumstances, training or supports are likely to be limited, with the burden of training liable to fall on staff, undermining morale and increasing already tense industrial relations. Limitations of this study include variations in the roles of non‐nursing care staff, with many staff classified as “multi‐task” staff that perform a range of duties from personal care through to more general domestic duties and, in the context of a mixed economy of provision, the abundance of responses from the public sector relative to the private sector.

Originality/value

Nonetheless, this study provides a timely snapshot and a reference point for further research around the impact of standards on quality of care or workforce professionalisation and it will be of particular interest to policymakers, regulators, employers and care staff.

Details

Quality in Ageing and Older Adults, vol. 12 no. 3
Type: Research Article
ISSN: 1471-7794

Keywords

Abstract

Details

Integrated Care: Reflections on Change in Health Services
Type: Book
ISBN: 978-1-80117-978-2

Article
Publication date: 3 June 2014

Stephen Gethin-Jones

The purpose of this paper is to discuss whether the use of outcome-focused homecare improves the subjective well-being of the familial carers of older people with…

Abstract

Purpose

The purpose of this paper is to discuss whether the use of outcome-focused homecare improves the subjective well-being of the familial carers of older people with dementia. It also discusses familial carers’ perception of whether this intervention has improved the well-being of their relative.

Design/methodology/approach

This qualitative study followed the familial carers of 20 service users suffering from dementia over a six-month period. Semi-structured interviews were undertaken at three intervals during the six months. The carers were asked to assess their subjective well-being at the start, middle and end of the study.

Findings

The key findings were that all 20 familial carers expressed an improvement in their subjective well-being and that of their older family member, who appeared more settled as a result of this model of care.

Practical implications

The need to consider the use of outcome-focused care as an intervention strategy for older people living alone in the community. The need to provide supportive environments for the carers of older people with dementia to limit their sense of isolation. The prioritising of outcome-focused care in the most complex and chaotic cases.

Originality/value

This study provides an insight into the effectiveness of outcome-focused homecare with older people experiencing dementia as perceived by their familial carers. Previously, research has established that outcome-focused care increased the subjective well-being of non-dementia sufferers. This study dovetails neatly with this in demonstrating the same effect on dementia sufferers as perceived by their familial carers. Additionally, this study also demonstrated that this model of outcome-focused care also improved the subjective well-being of the familial carers themselves. These finding will help practitioners consider the use of this model of homecare as a potential alternative or a delaying strategy to residential care.

Details

Working with Older People, vol. 18 no. 2
Type: Research Article
ISSN: 1366-3666

Keywords

Content available
Article
Publication date: 6 May 2014

Rachel Perkins and Julie Repper

477

Abstract

Details

Mental Health and Social Inclusion, vol. 18 no. 2
Type: Research Article
ISSN: 2042-8308

Open Access
Article
Publication date: 1 June 2008

Caroline Brandt

This study investigated undergraduate preparation of English as a Second Language (ESL) students through English for Academic Purposes courses, in relation to recipient…

Abstract

This study investigated undergraduate preparation of English as a Second Language (ESL) students through English for Academic Purposes courses, in relation to recipient subject lecturers’ expectations. Qualitative data were gathered from 36 faculty teaching ESL undergraduates in nine countries. A two-phase approach included seeking discursive responses to questionnaires from faculty and information about curricula. Outcomes highlighted difficulties with material selection for EAP tutors. Tutors chose between ‘general interest’ or ‘discipline-specific’ material, but reported that the former could lead to oversimplification or discipline irrelevance, while the latter usually requires some specialized subject knowledge which may be beyond tutors’ remit. Addressing this, it is suggested that articles about EAP-related topics can form the subject matter of EAP courses with significant benefits. In particular, they can simultaneously provide students with models of academic writing, while the content reinforces skills needed for successful study.

Details

Learning and Teaching in Higher Education: Gulf Perspectives, vol. 5 no. 1
Type: Research Article
ISSN: 2077-5504

Article
Publication date: 1 February 2003

Patricia Sloper, Lisa Jones, Suzanne Triggs, Jane Howarth and Katy Barton

The authors describe the rationale for key worker services for disabled children, factors to consider in developing such services, the role of key workers, how a key…

Abstract

The authors describe the rationale for key worker services for disabled children, factors to consider in developing such services, the role of key workers, how a key worker service is operating in one authority and the impact it has had for families who received it.

Details

Journal of Integrated Care, vol. 11 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 January 1946

In these times—aptly described as the age of dehydration—few food products appear to have aroused as much technical interest as has dried egg. Upon this point we have the…

Abstract

In these times—aptly described as the age of dehydration—few food products appear to have aroused as much technical interest as has dried egg. Upon this point we have the criterion of the galaxy of papers and communications in the various trade and scientific journals. Admittedly, much of the interest is doubtless due to the painfully rare appearance of the goods in the form delivered by the hen. However, there is little doubt that some of the developments in our knowledge and usage of a convenient form of an otherwise highly perishable commodity may have wide repercussions in food‐preparation in the future, both in industry and in the household. It would appear that the attaining and maintaining of hygienic conditions in the dehydrating plants has received the attention it warrants. Naturally, unless reasonable care in the storage or usage of the finished product is exercised, conditions will occur under which rapid contamination with and multiplication of bacteria will occur. The intention of the Dried Egg (Control of Use) Order, 1945 (S.R. & O. No. 627), which forbids the use of dried egg in certain foods and in materials sold in the wet state, is to provide against such conditions. Of the desirable properties which a dehydrated product should possess, ease of reconstitution is one of the most important. In the bakery and allied trades the difficulty, or, more correctly, the variability, of solubility of various deliveries of dried egg has occasioned some complaint. It is interesting to note that, with a view to assisting wetting, and hence reconstitution, addition of surface‐active agents, either to the egg pulp before dehydration, or to the dried product, has been the subject of several patents. As regards keeping properties, dried egg offers no exception to the general rule that the rate of deterioration on storage decreases progressively with reduction in the moisture content. It is reported that a product containing as little as 2 per cent. of moisture is being manufactured in U.S.A. Apparently, the only satisfactory packing for such a highly‐dehydrated product is a sealed metal container. The deterioration of dried egg powder, with the production of the peculiar and characteristic off‐flavour, has been shown to be connected with a small amount of glucose originally present. This decreases during storage, and the development of unpalatability may be correlated with the amount of glucose remaining. At the same time, the solubility of the powder decreases, rendering reconstitution more difficult, and the whipping or beating properties, so vital in the making of cakes, become impaired. Initial removal of the glucose, such as De‐controlled fermentation, markedly improves the stability of the product; re‐addition of glucose to an egg pulp from which the natural carbohydrate has been removed yields on dehydration a powder showing the same effects of deterioration as ordinary dried egg. Addition of reducing monosaecharoses other than glucose has a similar effect. Recently‐published reports of work carried out at the Cambridge Low Temperature Research Station provide strong evidence that the reaction mechanism resulting in the loss in solubility of dried egg powder is a two‐stage process. In the first stage, which does not in itself result in a decrease in solubility, the reducing group of the glucose molecule condenses with the free amino groups of the protein components; a further reaction then occurs which causes the protein to become insoluble. It had been previously discovered that addition to the egg pulp before drying of a simple amino‐acid such as glycine or alanine retarded the loss of solubility, although other forms of deterioration, such as the darkening of the colour of the powder, were not inhibited. Presumably, the glucose reacts preferentially with the added amino‐acid, instead of attacking the egg‐proteins. Another method of overcoming the loss of solubility is by the addition of substantial amounts of sucrose (or lactose) to the egg pulp before drying. How the protective action operates does not appear to be known, and it is peculiar that lactose, itself a reducing sugar, does not cause loss in solubility in the same manner as glucose. The “sugar‐dried egg” obtained on dehydration is readily soluble, and, since it possesses all, or nearly all, of the aerating properties of fresh egg, is claimed to be as good as frozen egg, or even shell egg, for cake‐making. Allocations of sugar‐dried egg are now being made to the bakery trade, and, should no difficulty be encountered in large‐scale production, it is to be presumed that in due course its use will become much more general. In the form now being supplied, sugar‐dried egg has an egg solids to sugar ratio of 2 to 1, thus allowing existing trade recipes to be rebalanced without recourse to awkward calculations. When reconstituted, 3 pounds of liquid egg contain approximately 5 ounces of sugar; this high sugar content of course restricts the use of this product to food preparations of a sweet nature. The mixture aerates rapidly, and, since it possesses a good oven spring, underbeating rather than full development of the batter gives the most satisfactory result. Additionally, the use of sugar‐dried egg lowers the amount of baking powder required; in some mixes baking powder may be omitted altogether. Sponges and similar goods of superior texture, flavour and keeping qualities may thus be made. Obviously, developments in other forms of dried egg and allied products are to be expected. Thus the previously‐mentioned protective action of lactose suggests the preparation of dehydrated mixtures of egg and milk or milk products, and in fact interesting experiments have been carried out involving the use of whey powder as a protective agent.

Details

British Food Journal, vol. 48 no. 1
Type: Research Article
ISSN: 0007-070X

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