Delivering public services in the mixed economy of welfare : perspectives from the voluntary and community sector in rural England

The voluntary and community sector in England is playing an increasingly important role in the delivery of public services to older adults and in doing so they rely on unpaid volunteers. In this article, we draw on the findings of a recent qualitative study of the impact on the voluntary and community sector of delivering ‘low-level’ public services that promote independent living and wellbeing in old age. The fieldwork focused on services that help older adults aged 70+ living in remote rural communities across three English regions. Those charged with service delivery, which is increasingly the voluntary and community sector, face particular challenges, such as uncertain funding regimes and reliance on volunteer labour

Factors predictive of successful retention in care among HIV-infected men in a universal test-and-treat setting in Uganda and Kenya: A mixed methods analysis.

BackgroundPrevious research indicates clinical outcomes among HIV-infected men in sub-Saharan Africa are sub-optimal. The SEARCH test and treat trial (NCT01864603) intervention included antiretroviral care delivery designed to address known barriers to HIV-care among men by decreasing clinic visit frequency and providing flexible, patient-centered care with retention support. We sought to understand facilitators and barriers to retention in care in this universal treatment setting through quantitative and qualitative data analysis.MethodsWe used a convergent mixed methods study design to evaluate retention in HIV care among adults (age > = 15) during the first year of the SEARCH (NCT01864603) test and treat trial. Cox proportional hazards regression was used to evaluate predictors of retention in care. Longitudinal qualitative data from n = 190 in-depth interviews with HIV-positive individuals and health care providers were analyzed to identify facilitators and barriers to HIV care engagement.ResultsThere were 1,863 men and 3,820 women who linked to care following baseline testing. Retention in care was 89.7% (95% CI 87.0-91.8%) among men and 89.0% (86.8-90.9%) among women at one year. In both men and women older age was associated with higher rates of retention in care at one year. Additionally, among men higher CD4+ at ART initiation and decreased time between testing and ART initiation was associated with higher rates of retention. Maintaining physical health, a patient-centered treatment environment, supportive partnerships, few negative consequences to disclosure, and the ability to seek care in facilities outside of their community of residence were found to promote retention in care.ConclusionsFeatures of the ART delivery system in the SEARCH intervention and social and structural advantages emerged as facilitators to retention in HIV care among men. Messaging around the health benefits of early ART start, decreasing logistical barriers to HIV care, support of flexible treatment environments, and accelerated linkage to care, are important to men's success in ART treatment programs. Men already benefit from increased social support following disclosure of their HIV-status. Future efforts to shift gender norms towards greater equity are a potential strategy to support high levels of engagement in care for both men and women

MOSAIC roadmap for mobile collaborative work related to health and wellbeing.

The objective of the MOSAIC project is to accelerate innovation in Mobile Worker Support Environments. For that purpose MOSAIC develops visions and illustrative scenarios for future collaborative workspaces involving mobile and location-aware working. Analysis of the scenarios is input to the process of road mapping with the purpose of developing strategies for R&D leading to deployment of innovative mobile work technologies and applications across different domains. One of the application domains where MOSAIC is active is health and wellbeing. This paper builds on another paper submitted to this same conference, which presents and discusses health care and wellbeing specific scenarios. The aim is to present an early form of a roadmap for validation

Promoting social inclusion? The impact of village services on the lives of older people living in rural England

Drawing on data from a qualitative study, this paper explores the impact of ‘village services’ on the lives of people aged 70 or more years living in rural England. Throughout the paper, the phrase ‘village services’ refers to six community-based services and activities provided to help meet the needs of older rural residents, namely lunch clubs, welfare rights information and advice services, befriending schemes and community warden support, in rural areas in three regions of England. It is argued that, in various ways, village services promote social inclusion by enhancing older rural residents' access to the resources, rights, goods and services that encourage social interaction and meaningful participation in community life. It is clear, however, that the overwhelming majority of users of village services are female, that older men are often reluctant to engage with the services on offer, and that the providers of village services need to find new and innovative ways of engaging with older men in rural areas. It is concluded that restricted revenue and capital resources means that the expansion of village services so that they may better meet the requirements of older rural men is unlikely

Organising migrant workers in construction: experience from the North East of England

This report represents the conclusion of the first stage of the Northern TUC’s programme of activity designed to raise awareness amongst trade unions and elsewhere about the growing phenomenon of migrant labour. The free movement of individuals within the European Union is a cornerstone of the European social model. However, workers who are able to exercise their right to mobility should do so without fear and exploitation. Trade unions exist to protect and safeguard the rights of workers whatever their background and wherever their countr

Mobile Mental Health Crisis Intervention in the Western Health Region of Newfoundland and Labrador

The impetus for this research is Recommendation #15 of the 2003 Luther Inquiry into the deaths of Norman Reid and Darryl Power: “IT IS FURTHER RECOMMENDED that the Regional Health Boards establish mobile health units to respond to mentally ill persons in crisis where no criminal offence is alleged. Each unit would be developed locally and based on local needs.” Our stakeholder partners in the Western Regional Health Authority asked us to identify a range of mobile crisis intervention service models, some of which may be better suited to lower-density, rural populations and some of which may be better suited to higher-density areas like Corner Brook. Our partners expressed a particular interest in models that can be implemented with minimal additional human resources, but that involve local, face-to-face contact rather than telephone, electronic, or clinic-based models of service delivery. The term “crisis intervention” generally refers to any immediate, short-term therapeutic interventions or assistance provided to an individual or group of individuals who are in acute psychological distress or crisis. The term encompasses a number of after-the-fact interventions – such as rape counseling and critical incident stress debriefing – that would not be relevant to the kinds of situations described in the Luther Report. Given the project parameters specified by our partners at Western Health, we formulated a research question and a literature search strategy that would enable us to focus specifically on forms of crisis intervention that are designed to manage potentially dangerous mental health crises on-site rather than to mediate their impacts after the fact. Our research question is as follows: “What models of mobile– i.e., face-to-face – crisis intervention have proven effective in managing potentially violent mental health crises occurring outside the hospital setting?

Technology to support young people 16 to 18 years of age who are not in employment, education or training (NEET): a local authority landscape review - final report

Becta landscape review: Technologies used by local authorities to support young people who are not in education, employment or trainin