404 research outputs found
When Tony met Bobby
In June 1999, Wal-Mart intervened spectacularly in an agreed merger between Asda and Kingfisher by paying £6.7bn to takeover Asda outright. Reactions ranged dramatically; this was the death-knell of British retailing or the redemption of British consumers. Whatever the view, Wal-Mart buying a major retailer such as Asda, and in such a significant European market, was a landmark in the globalisation of retailing. One issue around this takeover attracted considerable speculation at the time and has been the focus of discussion specifically and generally. Some months previous to the takeover, a meeting apparently took place in Downing Street between the Prime Minister and Wal-Mart. The very fact this meeting occurred, and at that time, is intriguing. Secrecy surrounding the meeting increased speculation over the contents of any discussion. It was raised in Parliament and during investigations on retailing by the Select Committee on the Environment, Transport and Regional Affairs. Over time however the meeting has faded from public attention and consideration. Yet, it still remains potentially significant. The introduction from January 2005 of the Freedom of Information Act potentially opened a window on this previously ‘secret’ meeting. This commentary concerns the meeting itself and the use of the Freedom of Information Act to obtain information about it. It raises questions about lobbying, secrecy and retail change
What Does It Take? California County Funding Requests for Recovery-Oriented Full Service Partnerships Under the Mental Health Services Act
The need to move mental health systems toward more recovery-oriented treatment modes is well established. Progress has been made to define needed changes but evidence is lacking about the resources required to implement them. The Mental Health Services Act (MHSA) in California was designed to implement more recovery-oriented treatment modes. We use data from county funding requests and annual updates to examine how counties budgeted for recovery-oriented programs targeted to different age groups under MHSA. Findings indicate that initial per-client budgeting for Full Services Partnerships under MHSA was maintained in future cycles and counties budgeted less per client for children. With this analysis, we begin to benchmark resource allocation for programs that are intended to be recovery-oriented, which should be evaluated against appropriate outcome measures in the future to determine the degree of recovery-orientation
Service users' perceptions of the effective ingredients in supported employment
Background: The UK government is advocating the use of supported employment to help people on incapacity benefits back to work, with an emphasis on Individual Placement and Support (IPS) models. However there is little UK-based evidence on the key ingredients of effective support.
Aim: To ascertain service users' views of what they found helpful about supported employment.
Method: Interviews were carried out with 182 people with severe and enduring mental health problems who were actively engaged with one of the six supported employment agencies included in the study.
Results: Three themes emerged: emotional support, practical assistance and a client-centred approach.
Conclusion: The findings highlight the importance of the quality of support, particularly through interpersonal dynamics, which go beyond the organizational features emphasized in the IPS model
Parties in chains: do ethnic party bans in Africa promote peace?
Since the sweeping (re)introduction of multiparty systems in the early 1990s, almost all sub-Saharan countries have introduced legal provisions to ban ethnic or other identity-based particularistic parties. Altogether, 12 countries have actually banned political parties on these grounds. In theoretical terms, such bans can exclude particularism from politics but - contrary to public discourse - also run the risk of forcing groups to resort to violent means or of becoming an object of conflict themselves. Empirically speaking, hardly any general patterns in the effects of bans can be detected. A closer look at 12 politically relevant bans in six countries reveals an initially stabilizing impact in one case (Rwanda in 1994). A ban on a religious party in Kenya in 1993 triggered violent conflict. In cases such as Equatorial Guinea (1994) and Rwanda (2001, 2003), this regulatory measure, allegedly designed to promote peace, seems to be part of the 'menu of manipulation' and is abused to suppress the opposition
Violent Conflicts and Civil Strife in West Africa:Causes, Challenges and Prospects
The advent of intra-state conflicts or ‘new wars’ in
West Africa has brought many of its economies to the brink of collapse, creating humanitarian
casualties and concerns. For decades, countries such as Liberia, Sierra Leone, Côte d’Ivoire and
Guinea- Bissau were crippled by conflicts and civil strife in which violence and incessant
killings were prevalent. While violent conflicts are declining in the sub-region, recent
insurgencies in the Sahel region affecting the West African countries of Mali, Niger and
Mauritania and low intensity conflicts surging within notably stable countries such as Ghana,
Nigeria and Senegal sends alarming signals of the possible re-surfacing of internal and regional
violent conflicts. These conflicts are often hinged on several factors including poverty, human
rights violations, bad governance and corruption, ethnic marginalization and small arms
proliferation. Although many actors including the ECOWAS, civil society and international
community have been making efforts, conflicts continue to persist in the sub-region and their
resolution is often protracted. This paper posits that the poor understanding of the fundamental
causes of West Africa’s violent conflicts and civil strife would likely cause the sub-region to
continue experiencing and suffering the brunt of these violent wars
Establishing an implementation network: lessons learned from community-based participatory research
<p>Abstract</p> <p>Background</p> <p>Implementation of evidence-based mental health assessment and intervention in community public health practice is a high priority for multiple stakeholders. Academic-community partnerships can assist in the implementation of efficacious treatments in community settings; yet, little is known about the processes by which these collaborations are developed. In this paper, we discuss our application of community-based participatory research (CBPR) approach to implementation, and we present six lessons we have learned from the establishment of an academic-community partnership.</p> <p>Methods</p> <p>With older adults with psychosis as a focus, we have developed a partnership between a university research center and a public mental health service system based on CBPR. The long-term goal of the partnership is to collaboratively establish an evidence-based implementation network that is sustainable within the public mental healthcare system.</p> <p>Results</p> <p>In building a sustainable partnership, we found that the following lessons were instrumental: changing attitudes; sharing staff; expecting obstacles and formalizing solutions; monitoring and evaluating; adapting and adjusting; and taking advantage of emerging opportunities. Some of these lessons were previously known principles that were modified as the result of the CBPR process, while some lessons derived directly from the interactive process of forming the partnership.</p> <p>Conclusion</p> <p>The process of forming of academic-public partnerships is challenging and time consuming, yet crucial for the development and implementation of state-of-the-art approaches to assessment and interventions to improve the functioning and quality of life for persons with serious mental illnesses. These partnerships provide necessary organizational support to facilitate the implementation of clinical research findings in community practice benefiting consumers, researchers, and providers.</p
Physician attitude toward depression care interventions: Implications for implementation of quality improvement initiatives
<p>Abstract</p> <p>Background</p> <p>Few individuals with depression treated in the primary care setting receive care consistent with clinical treatment guidelines. Interventions based on the chronic care model (CCM) have been promoted to address barriers and improve the quality of care. A current understanding of barriers to depression care and an awareness of whether physicians believe interventions effectively address those barriers is needed to enhance the success of future implementation.</p> <p>Methods</p> <p>We conducted semi-structured interviews with 23 primary care physicians across the US regarding their experience treating patients with depression, barriers to care, and commonly promoted CCM-based interventions. Themes were identified from interview transcripts using a grounded theory approach.</p> <p>Results</p> <p>Six barriers emerged from the interviews: difficulty diagnosing depression, patient resistance, fragmented mental health system, insurance coverage, lack of expertise, and competing demands and other responsibilities as a primary care provider. A number of interventions were seen as helpful in addressing these barriers – including care managers, mental health integration, and education – while others received mixed reviews. Mental health consultation models received the least endorsement. Two systems-related barriers, the fragmented mental health system and insurance coverage limitations, appeared incompletely addressed by the interventions.</p> <p>Conclusion</p> <p>CCM-based interventions, which include care managers, mental health integration, and patient education, are most likely to be implemented successfully because they effectively address several important barriers to care and are endorsed by physicians. Practices considering the adoption of interventions that received less support should educate physicians about the benefit of the interventions and attend to physician concerns prior to implementation. A focus on interventions that address systems-related barriers is needed to overcome all barriers to care.</p
Innovations in mental health services implementation: a report on state-level data from the U.S. Evidence-Based Practices Project
BACKGROUND: The Evidence-Based Practice (EBP) Project has been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment) in state public mental health systems in the United States since 2001. To date, Project findings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project. METHODS: Content analysis and Greenhalgh et al's (2004) definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002 – Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation. RESULTS: One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1) state infrastructure building and commitment, 2) stakeholder relationship building and communications, 3) financing, 4) continuous quality management, and 5) service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation. CONCLUSION: Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a) empirically test the effects of tools and methods used to implement EBPs, and b) establish a stronger evidence-base from which to plan, implement and sustain such efforts. This paper offers a classification scheme and list of innovative implementation activities and strategies. The classification scheme offers potential value for future studies that seek to assess the effects of various implementation processes, and helps establish widely accepted standards and criteria that can be used to assess the value of innovative activities and strategies
The state of the evidence base for psychodynamic psychotherapy for children and adolescents
This article reviews outcomes of psychodynamic psychotherapy (PP) for children and adolescents reported in articles identified by a comprehensive review of the literature on treatment evaluations of psychological and medical interventions for mental disorders in pediatric populations. The review identified 48 reports based on 33 studies. While there is evidence of substantial clinical gains associated with PP, in almost all the studies, when contrasted with family-based interventions, PP fares no better and appears to produce outcomes with some delay relative to family-based therapies. Further rigorous evaluations are needed, but evidence to date suggests that the context in which PP is delivered should be extended from the traditional context of individual therapy and parents should be included in the treatment of children
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