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1 – 10 of 98Kirstin Abraham, Huw Thomas and Alyson Bryden
The dermatology service on the islands of Orkney, with a population of approximately 22,500, was taken over by National Health Service (NHS) Tayside in August 2018. This paper…
Abstract
Purpose
The dermatology service on the islands of Orkney, with a population of approximately 22,500, was taken over by National Health Service (NHS) Tayside in August 2018. This paper aims to provide an overview of the planning and review of a highly efficient and effective dermatology service for a rural island population.
Design/methodology/approach
The service includes visiting dermatology consultants, enhanced electronic referral vetting, skin surgery services, a General Practice (GP) with extended role (GPwER) in dermatology, specialist virtual clinics, urgent advice for inpatients at the local district general hospital and remote systemic therapy monitoring. A new phototherapy service has been set up in an island GP practice.
Findings
Local GPs and consultant dermatologists find the enhanced vetting service useable, efficient and educational. Between August 2018 and November 2022, there have been 1,749 referrals. Of these referrals, 60% were seen in clinic or a GPwER surgery, with 40% managed remotely by providing advice back to the referring GP. The number of consultations performed by the GPwER has grown over the past 3 years, and in the last year, it accounted for more than 50% of patient appointments. The waiting time has been significantly reduced using this model.
Originality/value
This remote service uses an integrated approach of teledermatology (TD) whilst offering continual in-person services using local capabilities including a GPwER and island general surgeons. New treatment facilities are provided to the island population. Continual educational feedback to the primary care referrer is provided, and it enhances relationships that greatly aid the high-quality dermatology service provided.
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Since COVID-19, many services have burgeoned within the UK, but what about sexual minorities? Since the last review, there are appropriate therapies, but there is often inadequate…
Abstract
Purpose
Since COVID-19, many services have burgeoned within the UK, but what about sexual minorities? Since the last review, there are appropriate therapies, but there is often inadequate research. The purpose of this mixed-method review synthesis looking into the efficacy of psychological therapies for sexual minorities. Seven studies were found in total.
Design/methodology/approach
A mixed-method review synthesis, three studies looking into the efficacy of psychological therapies for sexual minorities and four studies addressing the experiences of sexual minorities partaking in psychological therapies were identified.
Findings
These included three quantitative and four qualitative studies. The minority stress hypothesis is used to formulate problems, but challenges remain to confidentiality and privacy in this context. Therapists still operate within the heteronormative framework, discounting intersectionality in therapy conversations.
Research limitations/implications
Most studies have had low retention rates since 2021. It shows that minority stress needs to be accounted for at the ethics committee and research delivery levels.
Practical implications
Applying a heteronormative framework to sexual minorities is not working. An alternative progress world view is needed.
Social implications
Health-care clinicians strive for equitable care. Unfortunately, using an equitable health service scale adapted from Levesque et al. (2013), the rating is 3 out of 6. More work is needed to improve services.
Originality/value
Some services are reporting much improvement post-pandemic. Sadly, this is not the case for sexual minorities. Individual and systemic barriers remain.
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Jackson Lord and Rachel Sabin-Farrell
The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM…
Abstract
Purpose
The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.
Design/methodology/approach
Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.
Findings
The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.
Originality/value
This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.
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Erfan Shakibaei Bonakdeh, Amrik Sohal, Koorosh Rajabkhah, Daniel Prajogo, Angela Melder, Dinh Quy Nguyen, Gordon Bingham and Erica Tong
Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the…
Abstract
Purpose
Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.
Design/methodology/approach
A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.
Findings
Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.
Practical implications
This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.
Originality/value
To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.
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Anti-racism has been practiced in various ways, with varying degrees of effectiveness. This chapter engages with the body of scholarship that focuses on approaches aimed at…
Abstract
Anti-racism has been practiced in various ways, with varying degrees of effectiveness. This chapter engages with the body of scholarship that focuses on approaches aimed at promoting anti-racist actions, policies and social change. It discusses some of the main anti-racism strategies that have been deployed across different countries and examines anti-racism practices in interpersonal, intergroup and community settings. These approaches encompass civil rights campaigns, legislative and policy interventions, affirmative action, diversity and inclusion training, prejudice reduction, intergroup contact, organisational development and holistic anti-racism approaches. Some anti-racism practices and policies, such as awareness campaigns, social marketing and diversity training, also extend to digital platforms, with social media and multimedia networks deployed to broaden the reach and impact of anti-racist endeavours. This chapter specifically engages with local anti-racism movements and draws principles for broader implementation of anti-racism policy and practice. It concludes with a brief discussion of the effectiveness of contemporary anti-racism approaches.
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Gabriella Karakas and Daniel R. du Plooy
Despite the substantial body of international research exploring the effects of forced migration on mental health and the obstacles faced by refugee cohorts in accessing mental…
Abstract
Purpose
Despite the substantial body of international research exploring the effects of forced migration on mental health and the obstacles faced by refugee cohorts in accessing mental health services, there is a lack of in-depth studies specifically focusing on Bosnian refugees in Australia – one of the largest ethnic groups of displaced peoples. This qualitative investigation seeks to convey the experiences of mental health services by five Bosnian refugees in Melbourne, highlighting perceived pathways and barriers to service utilisation. This study aims to address two primary research questions: firstly, what characterises the experiences of Bosnian refugees in Australia when accessing mental health services? Secondly, what are the main barriers encountered by this population when seeking mental health services?
Design/methodology/approach
This study used qualitative inquiry and in-depth interviews to investigate the experiences of Bosnian refugees with mental health services in Australia. Data was collected through face-to-face interviews with five Melbourne-based Bosnian refugees who had previously accessed mental health services. Participants were recruited from community groups or associations using purposive sampling. Thematic analysis was used.
Findings
Key themes were revealed, such as the crucial role of social and community services, preferences for individual vs group therapy, potential re-traumatisation from therapeutic engagement, distrust of government-run mental health services and concerns regarding psychopharmaceutical prescription practices. Addressing barriers to mental health service access necessitates a multifaceted approach, including flexible social and community service support, an increased number of co-ethnic professionals and a recognition of cultural variations for effective service provision. Implementing these strategies can enhance help-seeking behaviours, provide culturally appropriate mental health services and improve the experiences of Bosnian refugees in Australia.
Originality/value
To the best of the authors’ knowledge, this study is the first to qualitatively explore how Bosnian refugees in Melbourne perceived the adequacy and availability of mental health services upon arrival to Australia. They are a large and potentially vulnerable community, due to experiences of war trauma and dislocation from country of origin. A lack of understanding regarding how this cohort engage with mental health services can lead to persistent inequities and ineffective service provision. This study identifies unique experiences and perspectives of Bosnian refugee participants, including distrust of government-run mental health services, and concerns regarding psychopharmaceutical prescription practices. This research is expected to contribute positively to the discourse on mental health service provision for Bosnian refugees and wider refugee communities in Australia.
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Katie Russell, Nima Moghaddam, Anna Tickle, Gina Campion, Christine Cobley, Stephanie Page and Paul Langthorne
By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care…
Abstract
Purpose
By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.
Design/methodology/approach
TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.
Findings
There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.
Practical implications
Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.
Originality/value
To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.
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Anna Sokolova, Polina Lobanova and Ilya Kuzminov
The purpose of the paper is to present an integrated methodology for identifying trends in a particular subject area based on a combination of advanced text mining and expert…
Abstract
Purpose
The purpose of the paper is to present an integrated methodology for identifying trends in a particular subject area based on a combination of advanced text mining and expert methods. The authors aim to test it in an area of clinical psychology and psychotherapy in 2010–2019.
Design/methodology/approach
The authors demonstrate the way of applying text-mining and the Word2Vec model to identify hot topics (HT) and emerging trends (ET) in clinical psychology and psychotherapy. The analysis of 11.3 million scientific publications in the Microsoft Academic Graph database revealed the most rapidly growing clinical psychology and psychotherapy terms – those with the largest increase in the number of publications reflecting real or potential trends.
Findings
The proposed approach allows one to identify HT and ET for the six thematic clusters related to mental disorders, symptoms, pharmacology, psychotherapy, treatment techniques and important psychological skills.
Practical implications
The developed methodology allows one to see the broad picture of the most dynamic research areas in the field of clinical psychology and psychotherapy in 2010–2019. For clinicians, who are often overwhelmed by practical work, this map of the current research can help identify the areas worthy of further attention to improve the effectiveness of their clinical work. This methodology might be applied for the identification of trends in any other subject area by taking into account its specificity.
Originality/value
The paper demonstrates the value of the advanced text-mining approach for understanding trends in a subject area. To the best of the authors’ knowledge, for the first time, text-mining and the Word2Vec model have been applied to identifying trends in the field of clinical psychology and psychotherapy.
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Salvatore Cincimino, Salvatore Gnoffo, Fabio La Rosa and Sergio Paternostro
Scholarly interest in the business effects of organised crime (OC) has recently increased. This study aims to conduct a systematic literature review (SLR) on the conditions under…
Abstract
Purpose
Scholarly interest in the business effects of organised crime (OC) has recently increased. This study aims to conduct a systematic literature review (SLR) on the conditions under which OC could pose a threat to or take control of firms within a particular context.
Design/methodology/approach
We use narrative synthesis and thematic analysis, with a sample of 46 theoretical and empirical studies published over the past 30 years on the relationship between OC and firms within the disciplines of Business, Management and Accounting (BMA).
Findings
SLR and thematic analysis show that scholarly interest has focused on four key domains: OC as a firm, the impact of OC on firms, firms’ efforts to counter OC’s influence and governmental interventions. Using medical metaphors, we also develop a diagram depicting the interplay between OC and firms within the BMA literature.
Originality/value
This study contributes to the literature shaping an agenda to steer future research towards these four key themes. The effectiveness of anti-OC tools and measures depends on a thorough understanding of local norms, behaviours and business practices. In addition to measurement and methodological challenges, several grey areas remain, including the distinction between criminal enterprises and legitimate businesses. Ambiguities also surround the circumstances under which the OC preys upon firms or employs them to establish dominance over a territory.
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Latifa Sebti and Brent C. Elder
In this article, we highlight ways in which disability critical race theory (DisCrit) (Annamma et al., 2013), inclusive education and community-based participatory research (CBPR…
Abstract
Purpose
In this article, we highlight ways in which disability critical race theory (DisCrit) (Annamma et al., 2013), inclusive education and community-based participatory research (CBPR) can be used within professional development schools (PDS) to provide students with disabilities with more access to inclusive classrooms. At a grade 4–6 elementary school, we developed a model of a critical PDS to promote inclusive education and facilitate the transition of students of color with disabilities from self-contained to inclusive classrooms. We conducted semi-structured interviews and used action plan meetings with school administrators, teachers, professionals and students with disabilities and their parents to assess the impact of our critical PDS model. Findings suggest this model had a positive impact on administrators’ and teachers’ critical consciousness, ideological and instructional practices, students of color with disabilities’ social, academic and personal outcomes, as well as a schoolwide culture of inclusion and social justice. This study can inform tailored professional development efforts to improve educators’ inclusive practices.
Design/methodology/approach
We conducted semi-structured interviews and used action plan meetings with school administrators, teachers, professionals and students with disabilities and their parents to assess the impact of our critical PDS model.
Findings
The findings of this study suggest this model had a positive impact on administrators’ and teachers’ critical consciousness, ideological and instructional practices, students of color with disabilities’ social, academic and personal outcomes, as well as a schoolwide culture of inclusion and social justice.
Practical implications
This study can inform tailored professional development efforts aiming to improve educators’ inclusive practices.
Originality/value
We developed a model of a critical PDS to promote inclusive education and facilitate the transition of students of color with disabilities from self-contained to inclusive classrooms.
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