Understanding health system resilience in responding to COVID-19 pandemic: experiences and lessons from an evolving context of federalization in Nepal

From Springer Nature via Jisc Publications RouterHistory: received 2023-05-11, registration 2024-02-19, accepted 2024-02-19, epub 2024-04-04, online 2024-04-04, collection 2024-12Acknowledgements: The authors would like to acknowledge all stakeholders who participated in this study and shared their valuable experiences.Publication status: PublishedMaria Paolo Bertone - ORCID: 0000-0001-8890-583X https://orcid.org/0000-0001-8890-583XSophie Witter - ORCID: 0000-0002-7656-6188 https://orcid.org/0000-0002-7656-6188This record replaces https://eresearch.qmu.ac.uk/handle/20.500.12289/13690 for the AAM, which was deposited on 2024-03-05.Introduction: The COVID-19 pandemic has tested the resilience capacities of health systems worldwide and highlighted the need to understand the concept, pathways, and elements of resilience in different country contexts. In this study, we assessed the health system response to COVID-19 in Nepal and examined the processes of policy formulation, communication, and implementation at the three tiers of government, including the dynamic interactions between tiers. Nepal was experiencing the early stages of federalization reform when COVID-19 pandemic hit the country, and clarity in roles and capacity to implement functions were the prevailing challenges, especially among the subnational governments. Methods: We adopted a cross-sectional exploratory design, using mixed methods. We conducted a desk-based review of all policy documents introduced in response to COVID-19 from January to December 2020, and collected qualitative data through 22 key informant interviews at three tiers of government, during January-March 2021. Two municipalities were purposively selected for data collection in Lumbini province. Our analysis is based on a resilience framework that has been developed by our research project, ReBUILD for Resilience, which helps to understand pathways to health system resilience through absorption, adaptation and transformation. Results: In the newly established federal structure, the existing emergency response structure and plans were utilized, which were yet to be tested in the decentralized system. The federal government effectively led the policy formulation process, but with minimal engagement of sub-national governments. Local governments could not demonstrate resilience capacities due to the novelty of the federal system and their consequent lack of experience, confusion on roles, insufficient management capacity and governance structures at local level, which was further aggravated by the limited availability of human, technical and financial resources. Conclusions: The study findings emphasize the importance of strong and flexible governance structures and strengthened capacity of subnational governments to effectively manage pandemics. The study elaborates on the key areas and pathways that contribute to the resilience capacities of health systems from the experience of Nepal. We draw out lessons that can be applied to other fragile and shock-prone settings.pubpu

Bridging the divides: a case study of collective action across Scottish university business schools to support small business

Claire Seaman - ORCID: 0000-0003-4818-5051 https://orcid.org/0000-0003-4818-5051Item is restricted in this repository for 36 months from the date of publication.AM replace with VoR 2024-07-31.Support for small business is widely acknowledged as a complex issue of interrelated economic resilience and sustainability. Despite an established literature on the mechanisms through which university business schools support business, few studies have focused on relations between business schools in matters of such national importance. Our qualitative case study contributes to this limited stock of empirical knowledge by following a consortium of 16 university business schools and associated public bodies in Scotland, as they develop a national business support programme. A Networks of Practice (NofP) lens allows us to identify three processual components crucial in developing relations between entrepreneurial universities: acknowledging drivers, establishing relationships, and building a vision-based reference. These three components reveal tensions and challenges as a network of common interest forms. Fresh theoretical insights are offered on the nature of the entrepreneurial university and role of vision to bridge a fragmented higher education environment.This study was funded and supported by the Scottish Funding Council. No specific grant number is applicable.pubpu

Leaving or Staying “Home” in a Time of Rupture: International Students’ Experiences of Loneliness and Social Isolation during COVID-19

Olivia Sagan - ORCID: 0000-0001-6128-8499 https://orcid.org/0000-0001-6128-8499Mhairi Scally-Robertson - ORCID: https://orcid.org/0000-0002-3740-5285AM replaced with VoR 2024-01-15.During COVID-19, international students were faced with the decision of remaining in their country of study or returning to their home countries, with little knowledge of when they would next be able to return or leave. Both choices left the students vulnerable to feelings of loneliness and social isolation. This paper examines how international students at a Scottish university experienced and navigated leaving or staying “home” and how loneliness and social isolation characterised these experiences. We further contextualise these experiences through Holbraad et al.’s (2019) prism of “rupture”. The data were generated between February-July 2021 through semi-structured focus groups and qualitative questionnaire comments and were analysed through Thematic Analysis. We discuss three themes: 1) Liminal Friends and Strangers, 2) Sense of Home and Family, and 3) Staying or Leaving the Country. The study contributes to the expanding body of research on experiences of loneliness and social isolation amongst international students.pubpu

A Pig's Progress An arts-based research project exploring animation as a way to process setting up an art therapy service in an NHS Community Mental Health Team

This piece of arts-based research (ABR) uses animation to communicate the trials, tribulations and rewards of establishing an art therapy service as a trainee in an NHS Community Mental Health Team (CMHT). Although there are few resources on the topic, I propose that animation is useful to the art therapy profession and experiment with the art form by creating an animated response artwork. In the accompanying text, the research is grounded in existing literature exploring the therapeutic potential of animation, the difficulties that may arise when setting up a service and thoughts around response art by art therapists. As ABR, this project seeks to bridge the space between medicine and art. Animating does require time and some technical ability, but the findings suggest that it helped me to process my work, look after myself and make an accessible form of research. Additionally, there were many parallels to be found between the processes of animating and building an art therapy service. Subsequently, I recommend that other art therapists try animation themselves and share more about their experiences of setting up services. Animation is an empowering process that gives directorial power to its creator, so I also suggest that animating could be used by future clients to promote a sense of agency

An analysis of prescribing data in attention-deficit hyperactivity disorder for adolescents and adults in Scotland

AAM replaced with VoR 2024-08-08.Background Medication, combined with environmental and psychosocial support, can mitigate adverse outcomes in attention-deficit hyperactivity disorder (ADHD). There is a need for research into regional and national prescription volumes and patterns, especially among adults. Aims This study analysed prescribing patterns for medications commonly used to treat ADHD in adolescents and adults. Method Data was extracted from the NHS Scotland Prescribing Information System on prescriptions for 7806 adolescents (aged 10–19 years) and 4998 adults (aged 20–59 years) in 2019. This included medications listed under Section 4.4 of the British National Formulary. We explored 2019 prescription patterns across different regions and estimated ADHD prevalence levels. Additionally, we assessed changes in dispensed prescriptions, defined daily dose and costs, compared with figures from 2010. Results Between 2010 and 2019, prescriptions for ADHD medications increased (dispensed prescriptions +233.2%, defined daily dose +234.9%, cost +216.6%). Despite these increases, analysis indicated that in 2019, considering a 5% estimated ADHD prevalence among adolescents, 73% were not prescribed medication, increasing to 81% at a 7% estimated prevalence. Similarly, among adults with a 2% estimated prevalence, 91% were not prescribed medication, rising to 96% at a 4% estimated prevalence. Regional disparities were evident, with 41–96% of adolescents and 85–100% of adults, based on ADHD prevalence estimates, not receiving a prescription, depending on area. Conclusions Although prescription rates for ADHD medication have increased over time, the data do not indicate excessive use of medication. Instead, they suggest that for some groups there is a lower use of medication compared with expected prevalence figures, especially among adults.10pubpub

Community music therapy with refugee children in transit camps on the Greek island of Chios: ‘Like one family, together’

Giorgos Tsiris - ORCID: 0000-0001-9421-412X https://orcid.org/0000-0001-9421-412XItem is not available in this repository.This chapter is based on a five-year practice-led exploration of group music therapy with refugee children on the Greek island of Chios. Although an increasing number of music therapists work with refugees, practice is only sparsely documented, and there are rare accounts of work within transit camps to date. This chapter seeks to contribute to this gap. Extending beyond trauma-specific considerations, we outline the development of a community-oriented approach to music therapy in relation to the everyday refugee experience within formal and informal transit camps. The narratives and insights emerging from this exploration are explored alongside the principles of Psychological First Aid (PFA). We reflect on the role of music therapy in relation to refugee children's experience of crisis and adversity. Future directions that are transferable to other similar contexts of practice are discussed.https://www.taylorfrancis.com/chapters/edit/10.4324/9781003265610-3/community-music-therapy-refugee-children-transit-camps-greek-island-chios-mitsi-akoyunoglou-giorgos-tsiris?context=ubx&refId=14738761-b628-47e5-bb4b-e821729c9664https://doi.org/10.4324/9781003265610pubpu

How to measure lineup fairness: Concurrent and predictive validity of lineup-fairness measures

This item is embargoed in this repository until 2025-02-01.Jamal Mansour - ORCID: 0000-0001-7162-8493 https://orcid.org/0000-0001-7162-8493The current study examined the concurrent and predictive validity of four families of lineupfairness measures—mock-witness measures, perceptual ratings, face-similarity algorithms, and resultant assessments (assessments based on eyewitness participants’ responses)—with 40 mock crime/lineup sets. A correlation analysis demonstrated weak or non-significant correlations between the mock-witness measures and the algorithms, but the perceptual ratings correlated significantly with both the mock-witness measures and the algorithms. These findings may reflect different task characteristics—pairwise similarity ratings of two faces versus overall similarity ratings for multiple faces—and suggest how to use algorithms in future eyewitness research. The resultant assessments did not correlate with the other families, but a multilevel analysis showed that only the resultant assessments—which are based on actual eyewitness choices—predicted eyewitness performance reliably. Lineup fairness, as measured using actual eyewitnesses, differs from lineup fairness as measured using the three other approaches.https://doi.org/10.1080/1068316X.2024.2307358aheadofprintaheadofprin

Editorial: Exploring the links between social connections, care and integration

Marcia Vera Espinoza - ORCID: 0000-0001-6238-7683 https://orcid.org/0000-0001-6238-7683Arek Dakessian - ORCID: 0000-0001-7792-6862 https://orcid.org/0000-0001-7792-6862https://doi.org/10.3389/fhumd.2024.15018976pubpu

Novel palm shortening substitute using a combination of rapeseed oil, linseed meal and beta-glucan

Corrigendum to “Novel palm shortening substitute using a combination of rapeseed oil, linseed meal and beta-glucan” [Food Chemistry, 457 (2024), 140134](S0308814624017849)(10.1016/j.foodchem.2024.140134) available at: https://doi.org/10.1016/j.foodchem.2024.140273. The authors regret to inform that they omitted to include in the manuscript that Julien Lonchamp and Catriona Liddle are co-inventors on the patent PCT/GB2023/051783 (Palm-based shortening substitute). The authors would like to apologise for any inconvenience caused. © 2024 The Author(s)This study investigated the potential of a novel sustainable ingredient composed of rapeseed oil, linseed meal and beta-glucan (PALM-ALT) to mimic palm shortening functionality in cake. The combined functional properties of linseed meal and beta-glucan led to stable semi-solid emulsion-gels (20–31 μm oil droplet size, 105–115 Pa.s viscosity and 60–65 Pa yield stress). PALM-ALT contained 25 and 88% less total and saturated fat than palm shortening, whilst PALM-ALT cakes contained 26 and 75% less total and saturated fat than the palm-based control. PALM-ALT cakes matched the flavour profile of the palm-based control, while rapeseed oil cakes tasted more sour and less sweet than the control (p < 0.05). PALM-ALT cakes proved less hard and more cohesive than the control (p < 0.05), with 100% of the consumer panel preferring PALM-ALT formulations. This study demonstrated the unique potential of PALM-ALT as healthier, sustainable and competitive alternative to palm shortening.https://doi.org/10.1016/j.foodchem.2024.140134457pubpu

CSP2023: 471 Advanced Practice Physiotherapists (APPs) in General Practice: A Service Evaluation

From Elsevier via Jisc Publications RouterHistory: epub 2024-06-18, issued 2024-06-30Article version: AMPublication status: PublishedItem is not available in this repository.Judith Lane - ORCID: 0000-0003-0413-8421 https://orcid.org/0000-0003-0413-8421pubpu