'If We Don't Get Back to Where We Were Before': Working in the Restructured Non-Profit Social Services
In: The British journal of social work, Band 40, Heft 3, S. 928-945
ISSN: 1468-263X
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In: The British journal of social work, Band 40, Heft 3, S. 928-945
ISSN: 1468-263X
In: Social work: a journal of the National Association of Social Workers, Band 53, Heft 2, S. 123-131
ISSN: 1545-6846
In: The British journal of social work, Band 32, Heft 2, S. 185-199
ISSN: 1468-263X
In: Business history, Band 7, Heft 1, S. 68-68
ISSN: 1743-7938
In: The economic history review, Band 23, Heft 3, S. 601
ISSN: 1468-0289
In: Business history, Band 8, Heft 2, S. 159-160
ISSN: 1743-7938
In: Economica, Band 55, Heft 217, S. 138
In: The economic history review, Band 23, Heft 3, S. 616
ISSN: 1468-0289
BACKGROUND: Both the government and the pharmaceutical industry are interested in increasing the use of over-the-counter (OTC) medicines. The reaction on the part of general practitioners is more circumspect. AIM: To investigate whether fundholding or dispensing status and patient exemption from, or prepayment of prescription charges influence the behaviour of general practitioners with respect to prescribing preparations otherwise available OTC. METHOD: Regression analysis of data for all 105 Lincolnshire practices for the fiscal year 1993-94, using the number of items prescribed by the practice that were also available OTC as the outcome variable. Comparison of Audit Commission Thematic Analysis of Prescribing (ACTAP) data for fundholders' and non-fundholders' OTC prescribing in the same year. RESULTS: The prescription of medicines otherwise available OTC is less likely when the practice is fundholding and more likely when the practice has dispensing status. Prescription of such medicines also increases as the proportion of patients exempt from, or having prepaid prescription charges increases.
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In: Economica, Band 37, Heft 148, S. 424
BACKGROUND: The national evaluation of general practitioner (GP) commissioning pilots was commissioned by the Department of Health in 1997 as part of its Policy Research Programme. It was conducted by the Health Services Management Centre at the University of Birmingham. AIM: To monitor the development of the 40 national pilot sites, identify the factors that inhibited or facilitated progress, and consider the implications for the implementation and development of primary care groups (PCGs). METHOD: Semi-structured face-to-face interviews with GPs, health authority (HA) managers, and pilot managers from each of the 40 pilot sites (141 interviews in total) and focus group discussions with nurses, social services officers, and community health council officers in the 40 sites. RESULTS: Stakeholders reported the key achievements of the pilots during their first six months as being improved collaboration between GPs, the establishment of organisational arrangements, and work towards managing the group prescribing budget. Obstacles for the groups included changes to government policy regarding primary care, the workload involved for clinical staff, the pilots' relationship with the local HA, and problems with information management and technology (IM&T). A more detailed analysis of the pilots' management arrangements, prescribing work, IM&T support, and stakeholder involvement points to a set of lessons for emerging PCGs. CONCLUSIONS: In their early stages of development, PCGs are likely to focus on issues of structure and process. Prescribing will be an area receiving particular attention, prefiguring some of the challenges of clinical governance in primary care. IM&T will prove to be more problematic than first assumed. The involvement of a wider range of stakeholders will be addressed by primary care groups, particularly in relation to GPs and nurses.
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Context. The intermediate-mass pre-main sequence Herbig Ae/Be stars are key to understanding the differences in formation mechanisms between low-and high-mass stars. The study of the general properties of these objects is hampered by the lack of a well-defined, homogeneous sample, and because few and mostly serendipitously discovered sources are known. Aims. Our goal is to identify new Herbig Ae/Be candidates to create a homogeneous and well defined catalogue of these objects. Methods. We have applied machine learning techniques to 4 150 983 sources with data from Gaia DR2, 2MASS, WISE, and IPHAS or VPHAS+. Several observables were chosen to identify new Herbig Ae/Be candidates based on our current knowledge of this class, which is characterised by infrared excesses, photometric variabilities, and Hα emission lines. Classical techniques are not efficient for identifying new Herbig Ae/Be stars mainly because of their similarity with classical Be stars, with which they share many characteristics. By focusing on disentangling these two types of objects, our algorithm has also identified new classical Be stars. Results. We have obtained a large catalogue of 8470 new pre-main sequence candidates and another catalogue of 693 new classical Be candidates with a completeness of 78.8ℓ ±ℓ 1.4% and 85.5ℓ ±ℓ 1.2%, respectively. Of the catalogue of pre-main sequence candidates, at least 1361 sources are potentially new Herbig Ae/Be candidates according to their position in the Hertzsprung-Russell diagram. In this study we present the methodology used, evaluate the quality of the catalogues, and perform an analysis of their flaws and biases. For this assessment, we make use of observables that have not been accounted for by the algorithm and hence are selection-independent, such as coordinates and parallax based distances. The catalogue of new Herbig Ae/Be stars that we present here increases the number of known objects of the class by an order of magnitude. ; With funding from the Spanish government through the "María de Maeztu Unit of Excellence" accreditation (MDM-2017-0737)
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Open Access Journal; Published online: 19 Nov 2019 ; Our understanding of food security in sub-Saharan Africa (SSA) has been hampered by limitations in the temporal and spatial representativeness of data. Food balance sheets provide scalable estimates of per capita food availability, but fail to represent food access, stability and their causal linkages. In contrast, rural household surveys represent detailed conditions for one or multiple points in time, but are influenced by survey timing and are often limited in geographical coverage. This study draws on a large sample of rural land-holding households in SSA (n = 6,353) to identify household level food access deficiencies and to understand the associations with rural livelihoods and food sourcing behavior throughout the year. Food access deficiencies were identified using food security of access and diet diversity indicators. Dietary diversity and channel of access (farm or purchased) were enumerated for the "flush" and "lean" periods and food security of access was enumerated for the lean period only - making the results of this study independent of survey timing. As many as 39% of households were classified as severely food insecure (in terms of food access) and as many as 49% of households were likely to be deficient in micronutrients in the lean period. Vulnerability to food insecurity and micronutrient deficiencies differed by household composition, agricultural livelihood characteristics and agro-ecological zone. Dairy, fruit and vitamin A-rich produce were predominantly accessed through the farm channel. Households with a livestock component to their farm had a lower prevalence of severe food insecurity and higher diet diversity scores. These findings have implications for the development of nutrition-sensitive and nutrition-specific interventions. Interventions need to be tailored to agro-ecological zone, household composition, scale of operation and production mix. Increasing income will not necessarily result in improved diet diversity or healthy dietary choices. Interventions focused on income generation should monitor and promote crop and livestock production diversity and provide nutrition education. ; United States Agency for International Development ; Swedish International Development Cooperation Agency ; European Union ; Bill & Melinda Gates Foundation ; International Fund for Agricultural Development ; Department for International Development, United Kingdom ; Peer Review
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Background: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.
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