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The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.

This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.

Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.

The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.

It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.

Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.

The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.

It is well known that culture is a catalyst for change, helping economies respond to societal problems and demands and that culture is where people turn to in moments of crisis. In this case study around designing and implementing evaluation methodologies/frameworks for Coventry UK City of Culture 2021, it is suggested that in English public policy and within publicly invested arts there is a maturation of thinking around recognising/measuring the public value of culture including its social value. The purpose of this paper is to chart the recent policy of justifying cultural expenditure with social value claims and highlight challenges for evaluating activity within Coventry UK CoC 2021 as a change in wider policy is taking place.

This paper provides creative insights into the design and implementation of the evaluation methodologies/frameworks for Coventry UK City of Culture 2021. The authors of this paper as the collective team undertaking the evaluation of Coventry's year as UK City of Culture 2021 bring first-hand experiences of challenges faced and the need for a cultural mega-event to evidence its value.

The case study aims to address the concepts of measuring value within cultural events and argues that a paradigm shift is occurring in methods and concepts for evidencing the aforementioned value.

The case study within this paper focuses on the build-up period to the UK City of Culture 2021 year and the thinking and logic behind the creation of the evaluation/measurement framework and therefore does not include findings from the actual cultural year.

It is acknowledged that there are papers examining measuring and evidencing the “value” of cultural mega-events, the authors bring real-life first-hand experience of the concepts being utilised by them on the ground in the delivery and evaluation design of Coventry, UK City of Culture 2021.

Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions.

We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs.

This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India.

Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries.

This study aims to explore the experiences of living through the COVID-19 pandemic for people who faced homelessness and dealt with mental health and/or substance use challenges.

This qualitative study was comprised of 26 1:1 interviews (16 men and 10 women), conducted between February and May 2021 with people who experienced homelessness in North East England during the COVID-19 pandemic. An inductive reflexive thematic analysis was undertaken, with input from individuals with lived experience who were involved throughout the study.

Four themes were developed. The first theme, lack of support and exacerbation of mental health and substance use difficulties, highlighted how the lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people’s mental health and substance use. The second theme, uncertainty and fear during the pandemic, explored how the “surreal” experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. The third theme, isolation and impacts on social networks, discussed how isolation and changes to relationships also played a role in mental health and substance use. Finally, opportunity for reflection and self-improvement for mental health and substance use, explored how some people used the isolated time to re-evaluate their recovery journey and focus on self-improvement.

The experiences shared within this study have important implications for planning the future delivery and commissioning of health and social care services for people facing homelessness, such as sharing information accessibly through clear, consistent and simple language.

As one of the few papers to involve people with lived experience as part of the research, the findings reflect the unique narratives of this population with a focus on improving services.

This paper aims to discuss the utility of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for children with intellectual disabilities (ID) who have experienced trauma.

Relevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide support for the use of EMDR as a treatment for trauma in children with ID.

There is a growing body of evidence which demonstrates that EMDR therapy is successful for the treatment of trauma in adults and children. However, for children with ID, the research is limited despite those with ID being more likely than non-disabled peers to experience trauma such as abuse or neglect.

EMDR can only be facilitated by trained mental health nurses, psychiatrists, psychologists (clinical, forensic, counselling or educational) or occupational therapists or social workers with additional training. Finally, general practitioners who are experienced in psychotherapy or psychological trauma and have accreditation. Therefore, this highlights that there may be a lack of trained staff to facilitate this intervention and that those who are generally working with the client closely and long term such as learning disability nurses are not able to conduct this intervention.

This paper presents an account of NICE guidance and evidence of the efficacy of EMDR as a treatment for adults, children and those with ID.

It is over 20 years since the publication of the Wanless Report, “Securing our Future Health: Taking a Long-Term View”. The Wanless Report argued that the National Health Service (NHS) would survive in its current form only if the population became “fully engaged” with it.

In this discussion paper, the authors explored what “fully engaged” meant to Wanless, what it might mean now (allowing for the impact of the anti-vaxxer movement) and what policymakers could do to enhance public engagement.

Although the Wanless Report neatly fitted into other long-term thinking about the NHS, it was unique in that it built economic models to predict the costs and impact of different patterns of NHS performance. Wanless predicted that people’s poor levels of health would put considerable pressure on the NHS. This pressure could swamp efforts to meet healthcare targets and improve health outcomes, despite its sizeable investment of money. Wanless set out three possible scenarios for public engagement with the NHS: solid progress, slow uptake and fully engaged.

The authors pose questions for policymakers and practitioners. Would a reboot of the Wanless approach be worth the effort for policymakers? If yes, how would it differ from the original? The NHS faces the whole of society; could it be the vehicle for engaging the anti-vaxxer public with the truthfulness of medical science, and will it be this, that is, Wanless' enduring legacy?

The exploration of the Wanless Report is complicated (at least for the time being) by the rise of the anti-vaxxer movement’s resistance to health promotion and mistrust of part of the NHS.

The purpose of this study was to develop a scale that can be used to assess inequality at work based on gender, age and ethnicity that is grounded in Acker’s (2006) inequality regimes.

The authors used three representative samples (total N = 1,806) of Swedish teachers, nurses and social workers to develop and validate the scale. The validation process included the assessment of content validity, confirmatory factor analysis for factorial validity, internal consistency and associations with theoretically warranted outcomes and related constructs to assess criterion-related validity and convergent validity.

The authors found evidence supporting the content, factorial, criterion-related and convergent validity of the InEquality in organisations Scale (InE-S). Furthermore, the scale demonstrated high internal consistency.

The newly developed scale InE-S may be used to further the understanding of how inequality at work influences employees. This study makes a contribution to the current literature by providing a scale that, for the first time, can test Acker’s hypotheses using quantitative methods to demonstrate the consequences of inequality at work.

This paper contributes to this special issue on the ethics and aesthetics of adaptive reuse with a reflection on the specific case of the reuse of those sites and buildings that can be regarded as “difficult”, “uncomfortable”, or “neglected” heritage (MacDonald, 2009; Logan and Keir, 2009; Pendlebury et al., 2018; Lanz, 2021). By doing so it is the author's intention to add to the most recent research-driven and theory-oriented strand of the contemporary architectural debate on adaptive reuse (Lanz and Pendlebury, 2022). They also intend to encourage increased research engagement within such a debate, both across disciplines and with methods and approaches that may be able to bring in greater critical consideration of the more-than-architectural aspects involved in adaptive reuse practices.

Building equally on a comprehensive literature review on the subject and extensive field work, the paper works through one paradigmatic example – the San Girolamo mental asylum in Volterra, Italy – and combines on-site observation, field notes, qualitative interviews and archival research with theory-driven reflections to discuss the ramifications of adaptive reuse processes in place-based memory and heritage practices.

The case of the former mental asylum San Girolamo in Volterra, today abandoned and decaying on the landscape, is discussed via the metaphor of the building as palimpsest to explore the significance of this built heritage in both its materiality and meanings. The San Girolamo asylum demonstrates the value, complexity and potential of this heritage site, and other alike, to act as a powerful place which connects the past and present that might serve as a platform to promote productive discourses about contemporary sensible topics, ethics of care and human rights. Drawing on these observations, the paper concludes by expanding on how the case of the San Girolamo former asylum both showcases and advocates the need for developing more creative, explorative, trans-disciplinary and collaborative approaches and methodologies to the study and implementation of adaptive reuse projects for these site “beyond intervention”.

This paper draws on and contributes to the more recent research-driven and theory-oriented corpus of studies focussing on adaptive reuse.

Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation and Development (OECD) countries on public health security capacity and health service satisfaction.

Multiple linear regression analyses were employed for variables related to the level of health security capacity and satisfaction with the healthcare system while controlling for all socio-demographic variables from the European Social Survey, including over 44,000 respondents from 25 OECD countries. The Health Systems in Transition series of countries were used for assessing the decentralization level.

The result of multiple linear regression analyses showed that the level of decentralization in health systems was significantly associated with higher health security capacity (ß-coefficient 3.722, 95% confidence interval (CI) [3.536 3.908]; p=<0.001) and health service satisfaction (ß-coefficient 1.463, 95% CI [1.389 1.536]; p=<0.001) in the study. Countries with a higher level of decentralization in health policy tasks and areas were significantly likely to have higher health services satisfaction, whereas this satisfaction had a significant negative relation with the lower level of decentralization status of secondary/tertiary care services in OECD countries (ß-coefficient −5.250, 95% CI [−5.757–4.743]; p = 0.001).

This study contributes to a better understanding of the extent to which decentralization of health services affects public health safety capacity and satisfaction with health services, whereas the level of decentralization in OECD countries varies considerably. Overall, the findings highlight the importance of public health security and satisfaction with health care delivery in assessing the effects of decentralization in health services.