The experiences of patients and carers in the daily management of care at the end of life

Background Home is the preferred location for most people with an advanced disease and at the end of life. A variety of care professionals work in community settings to provide support to this population. Patients and their spouses, who also care for them (spouse-carers), are rarely accompanied by these sources of support at all times, and have to manage independently between their contact with care professionals. Aim To explore how patients and spouse-carers manage their involvement with care professionals in the community setting. Method Interpretive phenomenology informs the design of the research, whereby 16 interviews were conducted with the patients and spouse-carers. Interviews were recorded and transcribed verbatim. Data were analysed using phenomenological techniques including template analysis. Findings Patients and spouse-carers were interdependent and both parties played a role in co-ordinating care and managing relationships with professional care providers. The patients and spouse-carers actively made choices about how to manage their situation, and develop and modify managing strategies based on their experiences. Conclusions When daily management is effective and care professionals acknowledge the dyadic nature of the patient and spouse-carer relationship, people have confidence in living with advanced disease

Service User Involvement in Training for the Therapeutic Management of Violence and Aggression

Involving service users in mental health education and training has increased considerably over the last few years, especially in the initial pre-registration training of mental health professionals (social workers, nurses, psychologists). There is a growing understanding of the important contribution that service users can make to developing the mental health practitioners of the future. Involving service users in the education of future mental health practitioners is seen as important in providing students with the opportunity for developing greater awareness and understanding through the unique insights of people’s lived experience of mental health conditions, and of their contact with mental health services. This paper describes the involvement of service user trainers in the development and delivery of a short training course in physical restraint for mental health professionals. It considers the impact of including service users who themselves have experience being restrained in acute mental health settings, from the perspective of course participants, tutors and the service user trainers themselves

Developing an Intervention Toolbox for the Common Health Problems in the Workplace

Development of the Health ↔ Work Toolbox is described. The toolbox aims to reduce the workplace impact of common health problems (musculoskeletal, mental health, and stress complaints) by focusing on tackling work-relevant symptoms. Based on biopsychosocial principles this toolbox supplements current approaches by occupying the zone between primary prevention and healthcare. It provides a set of evidence-informed principles and processes (knowledge + tools) for tackling work-relevant common health problems. The toolbox comprises a proactive element aimed at empowering line managers to create good jobs, and a ‘just in time’ responsive element for supporting individuals struggling with a work-relevant health problem. The key intention is helping people with common health problems to maintain work participation. The extensive conceptual and practical development process, including a comprehensive evidence review, produced a functional prototype toolbox that is evidence based and flexible in its use. End-user feedback was mostly positive. Moving the prototype to a fully-fledged internet resource requires specialist design expertise. The Health ↔ Work Toolbox appears to have potential to contribute to the goal of augmenting existing primary prevention strategies and healthcare delivery by providing a more comprehensive workplace approach to constraining sickness absence

ERP implementation methodologies and frameworks: a literature review

Enterprise Resource Planning (ERP) implementation is a complex and vibrant process, one that involves a combination of technological and organizational interactions. Often an ERP implementation project is the single largest IT project that an organization has ever launched and requires a mutual fit of system and organization. Also the concept of an ERP implementation supporting business processes across many different departments is not a generic, rigid and uniform concept and depends on variety of factors. As a result, the issues addressing the ERP implementation process have been one of the major concerns in industry. Therefore ERP implementation receives attention from practitioners and scholars and both, business as well as academic literature is abundant and not always very conclusive or coherent. However, research on ERP systems so far has been mainly focused on diffusion, use and impact issues. Less attention has been given to the methods used during the configuration and the implementation of ERP systems, even though they are commonly used in practice, they still remain largely unexplored and undocumented in Information Systems research. So, the academic relevance of this research is the contribution to the existing body of scientific knowledge. An annotated brief literature review is done in order to evaluate the current state of the existing academic literature. The purpose is to present a systematic overview of relevant ERP implementation methodologies and frameworks as a desire for achieving a better taxonomy of ERP implementation methodologies. This paper is useful to researchers who are interested in ERP implementation methodologies and frameworks. Results will serve as an input for a classification of the existing ERP implementation methodologies and frameworks. Also, this paper aims also at the professional ERP community involved in the process of ERP implementation by promoting a better understanding of ERP implementation methodologies and frameworks, its variety and history

Evercare/United Health Group briefing paper

The paper examines some of the issues raised by the recent involvement of Evercare, part of the US company, United Health Group, in a Department of Health (England) pilot initiative on the use of a case management approach to keep frail, older people out of hospital

Police Knowledge Exchange: Full Report 2018

[Executive Summary] This report was commissioned to explore the enablers and barriers to sharing within and between police forces and between police forces and partners, including the public. This was completed from an interdisciplinary review of international literature covering sharing, knowledge exchange, learning and organisational learning. The literature broke down into four main factors; who, why, what and how. An introduction to the literature is presented with ‘Who’ is sharing which considers both personal identity and different institutional issues. The ‘Why’ literature covers issues of cultural and community motivators and barriers. The ‘What’ segment reviews concepts of data, information and knowledge and related legislative issues. Finally, the ‘how’ section spans face to face sharing approaches to technologies that produce both enablers and barriers. A series of 42 in-depth interviews and focus groups were completed and combined with 47 survey responses . The aim of the interviews, focus groups and survey was to show perceptions and beliefs around knowledge sharing from a small sample across policing in order to complement the findings from the literature review. The survey was adapted from a standardised questionnaire (Biggs, 1987). The Biggs questionnaire focused on what motivated students to learn and how they approached their learning. Our adapted survey looked at what motivated police to share, and how they approached sharing. The responses showed a trend, across the police, towards a motivation for sharing to develop a deeper understanding of issues. However, the approaches and the strategies they used to share with others, which were primarily driven by achieving and surface approaches (to get promoted and get the job done). According to Biggs (1987) this could leave them discontented as they never progress to a deeper understanding of issues. Scaffolding sharing within the police through processes that are clearly defined, effective and valued could help to overcome these issues. Within the interviews and focus group findings a similar structured approach to sharing was adopted. Within the ‘who’ section some key aspects around personal relationships, reciprocity and reputation were identified. The ‘why’ the police share was one of the largest discussion points. Not only was there a deep motivation to solve key policing issues there was an approach of reciprocity. Police sharing was deeply motivated to support ‘good practice’ in the prevention and detection of crime. However, a sharing barrier was identified in the parity of value given to different types of knowledge for example between professional judgement and research evidence knowledge. Sharing was achieved when there were reciprocal benefits, in particular with personal networks or face to face sharing which was noted as ‘safe’. Again, this was inhibited by misunderstandings around the ‘risks’ of sharing, frequently attributed to data protection legislation; producing cautious reactions and as an avoidance tactic to save time and effort sharing. However, a divide was noted between technical users and those who avoided any online systems for sharing; often due to poorly designed systems and a lack of confidence in how to use systems. The police culture was identified as being risk-adverse, and competitive due to multiple factors, a lack of supported time to share, Her Majesty’s Inspectorate of Constabulary (HMIC) reviews and promotion criteria. The result was perceived to be a poor cultural ability to learn from mistakes and a likelihood to repeat errors. A set of strategic recommendations are given and include the use of a sharing authorised professional practice for HMIC reviews, sharing networks and training. A further set of operational recommendations are given such as; sharing impact cases for evidence based practice, data sharing officers and evaluating mechanisms for sharing. This full report is supported by the Police Knowledge Exchange Summary Report 2018 which gives an overview of the findings and recommendations

How will the Internet of Things enable Augmented Personalized Health?

Internet-of-Things (IoT) is profoundly redefining the way we create, consume, and share information. Health aficionados and citizens are increasingly using IoT technologies to track their sleep, food intake, activity, vital body signals, and other physiological observations. This is complemented by IoT systems that continuously collect health-related data from the environment and inside the living quarters. Together, these have created an opportunity for a new generation of healthcare solutions. However, interpreting data to understand an individual's health is challenging. It is usually necessary to look at that individual's clinical record and behavioral information, as well as social and environmental information affecting that individual. Interpreting how well a patient is doing also requires looking at his adherence to respective health objectives, application of relevant clinical knowledge and the desired outcomes. We resort to the vision of Augmented Personalized Healthcare (APH) to exploit the extensive variety of relevant data and medical knowledge using Artificial Intelligence (AI) techniques to extend and enhance human health to presents various stages of augmented health management strategies: self-monitoring, self-appraisal, self-management, intervention, and disease progress tracking and prediction. kHealth technology, a specific incarnation of APH, and its application to Asthma and other diseases are used to provide illustrations and discuss alternatives for technology-assisted health management. Several prominent efforts involving IoT and patient-generated health data (PGHD) with respect converting multimodal data into actionable information (big data to smart data) are also identified. Roles of three components in an evidence-based semantic perception approach- Contextualization, Abstraction, and Personalization are discussed

Are HIV smartphone apps and online interventions fit for purpose?

Sexual health is an under-explored area of Human-Computer Interaction (HCI), particularly sexually transmitted infections such as HIV. Due to the stigma associated with these infections, people are often motivated to seek information online. With the rise of smartphone and web apps, there is enormous potential for technology to provide easily accessible information and resources. However, using online information raises important concerns about the trustworthiness of these resources and whether they are fit for purpose. We conducted a review of smartphone and web apps to investigate the landscape of currently available online apps and whether they meet the diverse needs of people seeking information on HIV online. Our functionality review revealed that existing technology interventions have a one-size-fits-all approach and do not support the breadth and complexity of HIV-related support needs. We argue that technology-based interventions need to signpost their offering and provide tailored support for different stages of HIV, including prevention, testing, diagnosis and management