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1 – 10 of over 5000Rachel Mills, Rajan Nathan, Paul Soper, Felix Michelet, Alex G. Stewart and Sujeet Jaydeokar
The purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the…
Abstract
Purpose
The purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the presence or absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping the overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. The authors examined the relationship between an individual’s level of intellectual disability and the presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.
Design/methodology/approach
A cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.
Findings
There was a high prevalence of mental health comorbidity, even higher for autistic adults. However, a relatively small percentage of the study population was receiving psychological interventions. The most frequent non-pharmacological intervention was a positive behaviour support plan, irrespective of comorbid mental illnesses.
Research limitations/implications
Not having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions, particularly for those with moderate to severe intellectual disability and for those with associated autism.
Originality/value
This large sample study examined the relationship between intellectual disability level and the presence of autism with accessing psychological interventions.
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Martha L.P. MacLeod, Neil Hanlon, Trish Reay, David Snadden and Cathy Ulrich
Despite many calls to strengthen connections between health systems and communities as a way to improve primary healthcare, little is known about how new collaborations can…
Abstract
Purpose
Despite many calls to strengthen connections between health systems and communities as a way to improve primary healthcare, little is known about how new collaborations can effectively alter service provision. The purpose of this paper is to explore how a health authority, municipal leaders and physicians worked together in the process of transforming primary healthcare.
Design/methodology/approach
A longitudinal qualitative case study was conducted to explore the processes of change at the regional level and within seven communities across Northern British Columbia (BC), Canada. Over three years, 239 interviews were conducted with physicians, municipal leaders, health authority clinicians and leaders and other health and social service providers. Interviews and contextual documents were analyzed and interpreted to articulate how ongoing transformation has occurred.
Findings
Four overall strategies with nine approaches were apparent. The strategies were partnering for innovation, keeping the focus on people in communities, taking advantage of opportunities for change and encouraging experimentation while managing risk. The strategies have bumped the existing system out of the status quo and are achieving transformation. Key components have been a commitment to a clear end-in-view, a focus on patients, families, and communities, and acting together over time.
Originality/value
This study illuminates how partnering for primary healthcare transformation is messy and complicated but can create a foundation for whole system change.
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Jasmin Mikl, David M. Herold, Marek Ćwiklicki and Sebastian Kummer
Digital freight forwarder (DFF) start-ups and their associated business models have gained increasing attention within both academia and industry. However, there is a lack of…
Abstract
Purpose
Digital freight forwarder (DFF) start-ups and their associated business models have gained increasing attention within both academia and industry. However, there is a lack of empirical research investigating the differences between DFFs and traditional freight forwarders (TFF) and the impact of digital start-ups on incumbents' companies. In response, this study aims to examine the key business model characteristics that determine DFFs and TFFs and propose a framework illustrating the extent to which digital logistics start-ups influence incumbent logistics companies.
Design/methodology/approach
Based on the primary data gathered from eight interviews with experts from start-ups' and incumbents' logistics companies, as well as secondary data, the authors identify the main factors of DFFs start-ups that have an impact on TFFs and analyze the similarities and differences in regard to the business model components' value proposition, value creation, value delivery and value capture.
Findings
The results show that differences between DFFs and TFFs appear in all four business models' components: value proposition, value creation, value delivery and value capture. In particular, the authors identify three main factors that need to be considered when assessing the impact of DFFs on TFFs: (1) the company size, (2) the market cultivation strategy and (3) the transport mode.
Originality/value
This is one of the first studies to specifically examine the key business model differences between DFFs and TFFs and to propose a conceptual framework for understanding the impact of digital logistics start-ups on incumbent companies.
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Steve Gillard, Rhiannon Foster, Sarah Gibson, Lucy Goldsmith, Jacqueline Marks and Sarah White
Peer support is increasingly being introduced into mainstream mental health services internationally. The distinctiveness of peer support, compared to other mental health support…
Abstract
Purpose
Peer support is increasingly being introduced into mainstream mental health services internationally. The distinctiveness of peer support, compared to other mental health support, has been linked to values underpinning peer support. Evidence suggests that there are challenges to maintaining those values in the context of highly standardised organisational environments. The purpose of this paper is to describe a “principles-based” approach to developing and evaluating a new peer worker role in mental health services.
Design/methodology/approach
A set of peer support values was generated through systematic review of research about one-to-one peer support, and a second set produced by a UK National Expert Panel of people sharing, leading or researching peer support from a lived experience perspective. Value sets were integrated by the research team – including researchers working from a lived experience perspective – to produce a principles framework for developing and evaluating new peer worker roles.
Findings
Five principles referred in detail to: relationships based on shared lived experience; reciprocity and mutuality; validating experiential knowledge; leadership, choice and control; discovering strengths and making connections. Supporting the diversity of lived experience that people bring to peer support applied across principles.
Research limitations/implications
The principles framework underpinned development of a handbook for a new peer worker role, and informed a fidelity index designed to measure the extent to which peer support values are maintained in practice. Given the diversity of peer support, the authors caution against prescriptive frameworks that might “codify” peer support and note that lived experience should be central to shaping and leading evaluation of peer support.
Originality/value
This paper adds to the literature on peer support in mental health by describing a systematic approach to understanding how principles and values underpin peer worker roles in the context of mental health services. This paper informs an innovative, principles-based approach to developing a handbook and fidelity index for a randomised controlled trial. Lived experiences of mental distress brought to the research by members of the research team and the expert advisors shaped the way this research was undertaken.
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