A qualitative study of primary care clinicians' views of treating childhood obesity

Background: The prevalence of childhood obesity is rising and the UK Government have stated a commitment to addressing obesity in general. One method has been to include indicators relating to obesity within the GP pay-for-performance Quality and Outcomes Framework (QOF) contract. This study aimed to explore general practitioners' and practice nurses' views in relation to their role in treating childhood obesity. Methods: We interviewed eighteen practitioners (twelve GPs and six nurses) who worked in general practices contracting with Rotherham Primary Care Trust. Interviews were face to face and semi structured. The transcribed data were analysed using framework analysis. Results: GPs and practice nurses felt that their role was to raise the issue of a child's weight, but that ultimately obesity was a social and family problem. Time constraint, lack of training and lack of resources were identified as important barriers to addressing childhood obesity. There was concern that the clinician-patient relationship could be adversely affected by discussing what was often seen as a sensitive topic. GPs and practice nurses felt ill-equipped to tackle childhood obesity given the lack of evidence for effective interventions, and were sceptical that providing diet and exercise advice would have any impact upon a child's weight. Conclusion: GPs and practice nurses felt that their role in obesity management was centred upon raising the issue of a child's weight, and providing basic diet and exercise advice. Clinicians may find it difficult to make a significant impact on childhood obesity while the evidence base for effective management remains poor. Until the lack of effective interventions is addressed, implementing additional targets (for example through the QOF) may not be effective

Corporate Social Responsibility and Sustainability Challenges for a Bancassurance Company

This contribution originates from the ideas and discussions during the third edition of the Montepaschi Vita Forum on “The Paradigms of Value. Towards a Good Governance in Financial and Insurance Services: the challenge of ethics, transparency and trust”, which took place in Rome, 15 October 2004 and was organized by the MPS insurance pole in partnership with The Geneva Association and Ania. The Forum series are prompted by the awareness of the critical role and nature of the “paradigms of value” topic in the present competitive context of financial services. Value-creation mechanisms are key elements of financial and insurance services, both in the interests of shareholders and, in broader terms, of all stakeholders. The theme of the third Montepaschi Vita Forum was encouraged by the current uncertainty of the financial scenario, in which the rule-based system and the reliability and accountability of several interlocutors is being questioned. The basic assumption is that good corporate governance and corporate social responsibility (CSR) are gradually advancing from a “philanthropic” variant of corporate capitalism to strategic approaches for regaining the trust of clients and society in general. Their role as risk (and also social) managers means that insurers have to work out different models and mechanisms for good corporate governance and CSR in view of a new state of play among the various stakeholders involved. The narrow borderline between legally binding requirements and self-regulatory initiatives has to be borne in mind when addressing topics such as good governance and CSR. A cultural change is involved, transforming a “regulatory compliance” approach into a “regulatory plus” approach. This article focuses on the challenges that MPV, as an insurance company belonging to a banking group with a well-defined CSR strategy, faces in identifying and implementing coherent CSR initiatives and measures. The Geneva Papers (2005) 30, 485–497. doi:10.1057/palgrave.gpp.2510040

Food debris index

These findings may offer care givers the possibility of quantifying the accumulation of food in their patients\u2019 mouth in order to be able to evaluate the positive effects of an educational programme directed at nursing staff