Recruitment and Mental Health

[Excerpt] Large numbers of people in the UK have mild to moderate and severe mental health conditions. Mental ill health is common and can affect anyone of any age, gender, ethnicity or social group. Three in ten employees will experience mental health problems during a year. The most prevalent mental health problems for people of working age are: anxiety, depression, phobic anxiety disorders and obsessive compulsive disorders. Depression will rank second only to heart disease as the leading cause of disability worldwide by the year 2020. The majority of people with mental health problems are willing and able to work. Despite this, an estimated one million people are out of work. While businesses are beginning to get better at employing individuals with a history of mental ill health, there remain significant barriers for both individuals and employers. This report describes what employers and government could do differently that would make it easier to recruit people with mental health problems

Evaluation of the impact of National Breast Cancer Foundation-funded research

© Copyright 2014. The Medical Journal of Australia - reproduced with permission.Objective: To evaluate the impact of the National Breast Cancer Foundation’s (NBCF’s) research investment. Design and participants: Surveys based on the Payback Framework were sent to chief investigators involved in research funded by the NBCF during 1995–2012; a bibliometric analysis of NBCF-funded publications in 2006–2010 was conducted; and a purposive, stratified sample of case studies was obtained. Main outcome measures: Research impact on knowledge production, the research system, informing policy, product development and broader health and economic benefits. Results: Of 242 surveys sent, 153 (63%) were returned. The average impact of journals in which NBCF publications appeared was double that of world publications. Seventy surveys (46%) reported career progression, and 185 higher degrees were obtained or expected, including 121 PhDs. One hundred and one grants (66%) produced tools that built capacity across the research system, and research teams leveraged an additional $1.40 in funding for every dollar invested. Fifteen applied grants and one basic grant impacted on policy. Ten basic and four applied grants led to the development of drugs, prognostic tools or diagnostic technologies. Twenty applied and two basic grants led to changes in practice and behaviour of health care staff, consumers and the public, with further impacts anticipated. Case studies provided illustrations of high impact. Conclusions: NBCF’s strategy of investing in a mixed portfolio of research areas and mechanisms encouraged a broad range of impacts across all Payback categories. The impacts from basic research tended to focus on knowledge production and drug development; while applied research generated greater impacts within the other Payback categories. The funding of shared infrastructure stimulated impact across the research system

How people with chronic illnesses view their care in general practice: a qualitative study

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.Objectives: To explore the perceptions of patients with chronic conditions about the nature and quality of their care in general practice. Design: Qualitative study using focus group methods conducted 1 June to 30 November 2002. Participants and setting: 76 consumers in 12 focus groups in New South Wales and South Australia. Main outcome measures: Recurring issues and themes on care received in general practice. Results: Three groups of priorities emerged. One centred on the quality of doctors, including technical competence, interpersonal skills, time for the patient in the consultation and continuity of care. A second concerned the role of patients and consumer organisations, with patients wanting (i) recognition of their knowledge about their condition and self-management, and (ii) for GPs to develop closer links with consumer organisations and inform patients about them. The third focused on the practice team and the importance of practice nurses and receptionists. Conclusion: GPs should consider the amount of time they spend with chronically ill patients, and their interpersonal skills and understanding of patients’ needs. They need to be better informed about the benefits of patient self-management and consumer organisations, and to incorporate them into their care. They also need to review how their practice nurses and receptionists can maximise the care of patients.Fernando A Infante, Judith G Proudfoot, Gawaine Powell Davies, Tanya K Bubner, Chris H Holton, Justin J Beilby and Mark F Harri

Final Report: The Practice and Impact of Shared Decision-Making

Several recent developments are likely to address those factors seen as contributing to shared decision-making’s mixed results: the lack of a nationally recognized certification process; insufficient funds to adequately invest in the training and infrastructure to support shared decision-making; and adequate methods for monitoring its effectiveness

Primary Care Staff's Views and Experiences Related to Routinely Advising Patients about Physical Activity. A Questionnaire Survey

Background: United Kingdom public health policy has recently re-emphasised the role of primary health care professionals in tackling increasing levels of physical inactivity within the general population. However, little is known about the impact that this has had in practice. This study explores Scottish primary care staff's knowledge, attitudes and experiences associated with advising patients about physical activity during routine consultations. Methods: A cross-sectional questionnaire survey of general practitioners (or family physicians), practice nurses and health visitors based in four health regions was conducted during 2004. The main outcome measures included: i) health professionals' knowledge of the current physical activity recommendations; (ii) practice related to routine physical activity advising; and (iii) associated attitudes. Results: Questionnaires were returned by 757 primary care staff (response rate 54%). Confidence and enthusiasm for giving advice was generally high, but knowledge of current physical activity recommendations was low. In general, respondents indicated that they routinely discuss and advise patients about physical activity regardless of the presenting condition. Health visitors and practice nurses were more likely than general practitioners to offer routine advice. Lack of time and resources were more likely to be reported as barriers to routine advising by general practitioners than other professional groups. However, health visitors and practice nurses were also more likely than general practitioners to believe that patients would follow their physical activity advice giving. Conclusion: If primary health care staff are to be fully motivated and effective in encouraging and supporting the general population to become more physically active, policymakers and health professionals need to engage in efforts to: (1) improve knowledge of current physical activity recommendations and population trends amongst frontline primary care staff; and (2) consider the development of tools to support individual assessment and advice giving to suit individual circumstances. Despite the fact that this study found that system barriers to routine advising were less of a problem than other previous research has indicated, this issue still remains a challenge

Improving mental and neurological health research in Latin America: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Research evidence is essential to inform policies, interventions and programs, and yet research activities in mental and neurological (MN) health have been largely neglected, particularly in low- and middle-income countries. Many challenges have been identified in the production and utilization of research evidence in Latin American countries, and more work is needed to overcome this disadvantageous situation. This study aims to address the situation by identifying initiatives that could improve MN health research activities and implementation of their results in the Latin American region.</p> <p>Methods</p> <p>Thirty-four MN health actors from 13 Latin American countries were interviewed as part of an initiative by the Global Forum for Health Research and the World Health Organization to explore the status of MN health research in low- and middle-income countries in Africa, Asia and Latin-America.</p> <p>Results</p> <p>A variety of recommendations to increase MN health research activities and implementation of their results emerged in the interviews. These included increasing skilled human resources in MN health interventions and research, fostering greater participation of stakeholders in the generation of research topics and projects, and engendering the interest of national and international institutions in important MN health issues and research methodologies. In the view of most participants, government agencies should strive to have research results inform the decision-making process in which they are involved. Thus these agencies would play a key role in facilitating and funding research. Participants also pointed to the importance of academic recognition and financial rewards in attracting professionals to primary and translational research in MN health. In addition, they suggested that institutions should create intramural resources to provide researchers with technical support in designing, carrying out and disseminating research, including resources to improve scientific writing skills.</p> <p>Conclusion</p> <p>Fulfillment of these recommendations would increase research production in MN health in Latin American countries. This, in turn, will raise the profile of these health problems, and consequently will underscore the need of continued high-quality and relevant research, thus fostering a virtuous cycle in the decision-making process to improve MN health care.</p

Replacing Myths With Facts: Sex-Selective Abortion Laws In The United States

Sex selection is the practice of attempting to control the sex of one’s offspring in order to achieve a desired sex. One method of sex selection is sex-selective abortion. Laws banning sex-selective abortion are proliferating in the United States. Eight states have enacted laws prohibiting sexselective abortion. Twenty-one states and the federal government have considered such laws since 2009. Those laws prohibit the performance of an abortion if sought based on the sex of the fetus and provide for both criminal and civil penalties in most cases. A great deal of misinformation exists regarding sex selection in the United States. We have identified six inaccuracies commonly associated with sex-selective abortion and laws prohibiting it. They appear, among other places, in statements made by legislators, testimony submitted to legislatures, and reports issued by legislative committees that have considered or adopted laws banning sexselective abortion. We present each piece of inaccurate information as a “myth.” This Report draws on legal research, empirical analysis of U.S. birth data, field-work, and an extensive review of scholarly publications in social sciences, law and other disciplines to replace these myths with facts. Legislators and proponents of sex-selective abortion bans have consistently referred to the existence of male-biased sex ratios and the practice of sex selection in other parts of the world. Discussions have focused on the problem of “missing women” in China and India in particular. However, China and India are not the only countries with male-biased sex ratios. On the contrary, the two countries with the highest sex ratios at birth are Liechtenstein and Armenia (see discussion of Myth #2 below). Both have higher sex ratios at birth than China and India. Legislators and major news outlets have stated that the United States is one of the few countries that does not prohibit abortion for sex selection purposes. However, the eight states in the United States that currently ban sex-selective abortion are among a small minority of places in the world where it is banned. Only four other countries explicitly prohibit sex-selective abortion: China, Kosovo, Nepal and Vietnam (see discussion of Myth #3 below). Instead, many countries that are concerned about sex selection prohibit the use of technology to sex select prior to implantation of the embryo in the uterus. The main empirical support for the view that Asian Americans are obtaining sex-selective abortions based on son preference in the United States is from a study by economists Douglas Almond and Lena Edlund published in 2008. That study, using United States census data from 2000, found that when foreign-born Chinese, Indians and Koreans have two girls, the sex ratios at the third birth in those families is skewed towards boys. However, in analyzing more recent data from the 2007 to 2011 American Community Survey (ACS), we found that the sex ratios at birth of foreign-born Chinese, Indians and Koreans are not male-biased when all their births are taken into account. In fact, foreign-born Chinese, Indians and Koreans have proportionally more girls than white Americans (see discussion of Myth #5 below). Proponents of sex-selective abortion bans claim they are needed to “prohibit discrimination against the unborn on the basis of sex” and to stop the practice of sex selection among Asian Americans in the United States. As noted, sex-selective abortion is only one among several methods available to select the sex of one’s offspring. None of the laws enacted or proposed in the United States prohibit methods other than abortion, such as sperm sorting or preimplantation genetic diagnosis (see discussion of Myth #1 below). Instead, the laws focus solely on abortion. Moreover, sex-selective abortion bans have not been shown to impact sex ratios in the United States. On the contrary, our study shows that laws in Illinois and Pennsylvania—adopted in 1984 and 1989, respectively—are not associated with changes in sex ratios at birth in those states (see discussion of Myth #4 below). Sex-selective abortion laws are part of the legislative campaign of groups opposed to reproductive rights. The laws are generally proposed by legislators who are anti-abortion. Our analysis found that over 90% of Republican representatives in the six states that enacted bans in the last four years voted for the laws. In contrast, less than 10% of Democrats voted for the bans in four of the six states. In the two states where sex-selective abortion bans achieved meaningful support from Democrats— Oklahoma and South Dakota—laws that restrict access to abortion consistently receive bipartisan support (see discussion of Myth #6 below)

Consumer involvement in Quality Use of Medicines (QUM) projects – lessons from Australia

BACKGROUND: It is essential that knowledge gained through health services research is collated and made available for evaluation, for policy purposes and to enable collaboration between people working in similar areas (capacity building). The Australian Quality Use of Medicine (QUM) on-line, web-based project database, known as the QUMmap, was designed to meet these needs for a specific sub-section of health services research related to improving the use of medicines. Australia's National Strategy for Quality Use of Medicines identifies the primacy of consumers as a major principle for quality use of medicines, and aims to support consumer led research. The aim of this study was to determine how consumers as a group have been represented in QUM projects in Australia. A secondary aim was to investigate how the projects with consumer involvement fit into Australia's QUM policy framework. METHOD: Using the web-based QUMmap, all projects which claimed consumer involvement were identified and stratified into four categories, projects undertaken by; (a) consumers for consumers, (b) health professionals for consumers, (c) health professionals for health professionals, and (d) other. Projects in the first two categories were then classified according to the policy 'building blocks' considered necessary to achieve QUM. RESULTS: Of the 143 'consumer' projects identified, the majority stated to be 'for consumers' were either actually by health professionals for health professionals (c) or by health professionals for consumers (b) (47% and 40% respectively). Only 12 projects (9%) were directly undertaken by consumers or consumer groups for consumers (a). The majority of the health professionals for consumers (b) projects were directed at the provision of services and interventions, but were not focusing on the education, training or skill development of consumers. CONCLUSION: Health services research relating to QUM is active in Australia and the projects are collated and searchable on the web-based interactive QUMmap. Healthcare professionals appear to be dominating nominally 'consumer focussed' research, with less than half of these projects actively involving the consumers or directly benefiting consumers. The QUMmap provides a valuable tool for policy analysis and for provision of future directions through identification of QUM initiatives