Suchergebnisse

One of the many achievements of Kate Brown's remarkable new book is to relocate the Chernobyl disaster and its official medicine internationally, but Manual for Survival also certainly illuminates the particularities of Soviet and post-Soviet medicine. The Soviet Union had a penchant for secret medicine with regard to radiation. Brown's readers learn early of Angelina Gus΄kova, who was the first expert in Moscow to be called by the accident-stricken staff at the reactor, had treated more patients with radiation sickness than anyone else in the world, and had written the Soviet manual on the subject. Yet she did this having been forbidden to ask any patient directly about their exposure.

BACKGROUND: The popularity of social prescribing has grown in recent years following a series of high-profile recommendations in scientific reviews, political reports, and media coverage. Social prescribing has the potential to address multiple health and social problems, but few studies have examined how it works. AIM: To explore the ways by which social prescribing may be beneficial to individuals undertaking socially prescribed activity (SPA). DESIGN AND SETTING: A qualitative interview study involving people attending a range of SPA. METHOD: Participants were purposively recruited from a multi-activity social prescribing provider. Data were collected using semi-structured face-to-face interviews. Analysis used a thematic approach, in which emerging themes were contextualised with interview transcripts and findings from existing literature. RESULTS: The study identified five themes, which together formed a journey of engagement and participation. While not always present for any one individual, the themes occurred in a consistent order: receiving professional support for social problems; engaging with others through participation in SPA; learning different ways to relate to other people and developing new skills; changing perceptions by realising personal assets and becoming open to the possibility of new futures; and developing a positive outlook on the present while moving forwards in pursuit of future goals and better health. CONCLUSION: SPA appears to benefit individuals by a process that begins with personalised professional help to address social problems and moves through engagement with activities and others, to the recognition of personal and social assets and opportunities.

Like Canada, Wales, UK is a bilingual nation: the Welsh language is an important part of its national identity and legislative framework. This has implications for the delivery of public sector services, particularly in the context of health and social care, where responding to the language needs of service users is fundamental to quality health care provision. Nevertheless, despite the strengthening policy commitment for a whole-system approach towards enhancing Welsh language services, there is a paucity of evidence to guide best practice in organizational planning in health care settings. This commentary outlines the context and significance of bilingual health care provision in Wales and the implications for building and embedding the evidence base. It calls for further work to translate our knowledge and understanding of language-appropriate practice to provide more effective and sensitive health care services; and to close the implementation gap between evidence and practice. Given the relevance of this challenge for health care providers in Canada who plan and deliver services for French-language minorities, this approach has resonance across our research communities. Thus, in our common pursuit to establish integrated knowledge translation research for language-appropriate health care systems, this commentary offers a focus for reflection, discussion and collaborative action.

Abstract. Background: The relationship between self-harm and suicide is contested. Self-harm is simultaneously understood to be largely nonsuicidal but to increase risk of future suicide. Little is known about how self-harm is conceptualized by general practitioners (GPs) and particularly how they assess the suicide risk of patients who have self-harmed. Aims: The study aimed to explore how GPs respond to patients who had self-harmed. In this paper we analyze GPs' accounts of the relationship between self-harm, suicide, and suicide risk assessment. Method: Thirty semi-structured interviews were held with GPs working in different areas of Scotland. Verbatim transcripts were analyzed thematically. Results: GPs provided diverse accounts of the relationship between self-harm and suicide. Some maintained that self-harm and suicide were distinct and that risk assessment was a matter of asking the right questions. Others suggested a complex inter-relationship between self-harm and suicide; for these GPs, assessment was seen as more subjective. In part, these differences appeared to reflect the socioeconomic contexts in which the GPs worked. Conclusion: There are different conceptualizations of the relationship between self-harm, suicide, and the assessment of suicide risk among GPs. These need to be taken into account when planning training and service development.

Background: In healthcare, bridging the research-to-practice gap is a top priority. Knowledge mobilisation scholars suggest that this gap can be closed through collaboration between knowledge users and producers. The concept of boundary objects – shared things and ideas that enable communication – has gained popularity across various collaborative work practices, but their potential within knowledge mobilisation in health care is understudied. An ongoing challenge for designers of boundary objects is how to create objects that are valued and shared both in principle and in practice.
Aims and objectives: This paper reports on a study of boundary objects used during knowledge mobilisation through NHS-university partnerships called Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The distinction is investigated between boundary objects-in-theory and boundary objects-in-use, considering whether the latter possess specific characteristics which make them more effective during knowledge mobilisation.
Methods: A qualitative case study of three CLAHRCs was conducted. Twenty-one people employed as 'boundary spanners' were interviewed to explore whether boundary objects played a role in knowledge mobilisation.
Findings: The most effective boundary objects-in-use were co-produced through a process of bricolage. These possessed high levels of meaningfulness and resonance, and reconciled multiple user perspectives. Together these properties contributed to the overall authenticity of boundary objects-in-use.
Discussion and conclusion: This paper helps to explain why designated boundary objects frequently fail in practice, and why there is a need to focus on understanding boundary objects based on symbolic, rather than structural, dimensions.

MSS1 and MSS2 were supported by grants from the Chief Scientist Office of the Scottish Government (references CZG/2/412 and CZH/4/945). We are grateful to the general practitioners and patients who participated in these studies. ; Peer reviewed ; Postprint

As the use of realist approaches gains momentum, there is a growing interest in how systems approaches can complement realist thinking. In this article, we discuss how the epistemology of Soft Systems Methodology is compatible with realist approaches. Both Soft Systems Methodology and realist approaches emphasize the necessity to engage stakeholders; through models, the description of contingencies and exploring the intricacies of how complex programmes really work. We outline the key elements of realist approaches and Soft Systems Methodology, and report on two novel case studies. Drawing on our own experiences, we make the case that, used in conjunction with a realist approach, Soft Systems Methodology can provide a useful tool to a) map programme complexity, and b) develop and refine stakeholders programme theories, thus increasing the transparency, reliability, validity and accuracy of the theory building and refining process in realist approaches. We highlight Soft Systems Methodology as a novel companion to realist approaches and detail the first case studies of its use.