An evaluation of staff engagement programmes in four National Health Service Acute Trusts

Purpose – The purpose of this paper is to report the findings from an evaluation project conducted to investigate the impact of two staff engagement programmes introduced to four National Health Service (NHS) hospital Trusts in England. It seeks to examine this development in the context of current policy initiatives aimed at increasing the level of staff involvement in decision-making, and the related literature. \ud \ud Design/methodology/approach – A mixed-methods approach incorporating document analysis, interviews, a survey and appreciative inquiry, informed by the principles of impact evaluation design, was used. \ud \ud Findings – The main finding to emerge was that leadership was crucial if widespread staff engagement was to be achieved. Indeed, in some of the trusts the staff engagement programmes were seen as mechanisms for developing leadership capability. The programmes had greater impact when they were “championed” by the Chief Executive. Effective communication throughout the organisations was reported to be a prerequisite for staff engagement. Problems were identified at the level of middle management where the lack of confidence in engaging with staff was a barrier to implementation. \ud \ud Practical implications – The nature of the particular organisational context is crucial to the success of efforts to increase levels of staff engagement. The measures that were found to work in the trusts would need to be adapted and applied to best meet the needs of other organisations. \ud \ud Originality/value – Many health care organisations in England will need to harness the efforts of their workforce if they are to meet the significant challenges of dealing with financial restraint and increasing patient demand. This paper provides some insights on how this can be done

Decision-making and ante-natal screening for sickle cell and thalassaemia disorders : To what extent do faith and religious identity mediate choice?

When making decisions about prenatal diagnosis, couples not only draw on their understanding of the condition but also broader aspects of their cultural identity. This article looks at how faith and religion mediate attitudes towards screening, prenatal diagnosis and termination of pregnancy for sickle cell and thalassaemia disorders. The article specifically reports on a qualitative study, which used focus groups from a variety of faith communities (Muslim, Sikh, Hindu and Christian), at risk of haemoglobin disorders, living in England. Our findings suggest that the decision about whether or not to have diagnostic testing generally related to attitudes towards the termination of pregnancy. The consequences of the condition were as important as religious beliefs to most people. More generally, faith beliefs emerged as negotiable and contingent: realized within a broader moral framework. Religion was felt not to be prescriptive and reproductive decisions were seen as personal. When making decisions, people utilize faith within a broader context of individual, family and social relationships

Stroke Survivors Who Score below Threshold on Standard Depression Measures May Still Have Negative Cognitions of Concern

Background and Purpose— There has been an increase in screening for depression in the physically ill. We explored whether important negative cognitions may be missed by conventional approaches to screening for depression in 2 independently conducted stroke studies with similar methods. Methods— The Auckland Regional Community Stroke (ARCOS) study was a prospective, population-based stroke incidence study conducted in Auckland, New Zealand, for 12 months in 2002 to 2003. The Stroke Outcomes Study was a prospective, hospital cohort study conducted in Leeds and Bradford, United Kingdom, for 33 months in 2002 to 2005. Symptoms of abnormal mood were assessed at 6 months in ARCOS with a single simple question, “Do you often feel sad and depressed?” and the 28-item General Health Questionnaire administered as part of a structured interview and in the Stroke Outcomes Study with the 28-item General Health Questionnaire and a single question about depressed mood taken from the Present State Examination. Results— Mood data were available at 6 months from 770 ARCOS and 492 Stroke Outcomes Study participants. A significant proportion (up to 28%) of people who did not meet study criteria for depression reported important negative cognitions such as hopelessness, worthlessness, or suicidality. People who were older, dependent in activities of daily living, or not partnered were more likely to report negative cognitions. Conclusions— Important negative cognitions, including suicidal thoughts, may be missed when people are screened for depression after stroke. Screening alone is not an adequate substitute for a sensitive exploration of the psychological impact of stroke on the survivor

Localism in Thailand: a study of globalisation and its discontents

Recent work has suggested that the discontent over perceived negative impacts arising from liberalisation and globalisation needs to be more carefully considered. The critiques emanating from non-governmental organisations and social movements are considered to be amongst the most significant. This paper examines one example of such criticism – localism – that emerged during the economic crisis in Thailand. This example of localism is found to be an example of populist reaction to the changes and inequalities generated by capitalist industrialisation. The paper assesses this critique, its political strength and its potential to provide an alternative economic model for Thailand. While providing a useful moral argument regarding the impact of neoliberal globalisation, populist localism is unable to develop a sound alternative model

STABILITY Study: A multicentre RCT comparing ACL reconstruction with and without lateral extra-articular tenodesis for individuals at high risk of graft failure

Seventy patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) were randomly assigned to receive ACLR alone or ACLR plus a lateral extra-articular tenodesis (LET). Our primary outcome was Limb Symmetry Index (LSI) calculated using a series of four hop tests at six months postoperative. Secondary outcomes measures included pain, subjective function and isokinetic strength testing. We found no statistically significant difference between the two groups in LSI calculations. We found statistically significant differences favouring the ACLR alone group in quadriceps average power and peak torque symmetry measurements at six-months postoperative when we adjusted for baseline measurements. No other statistically significant differences were found. This thesis presents the six-month preliminary results of a larger continuing study and at this time no definitive conclusions can be made

Student outcomes and learning environments at the tertiary level in New Zealand: the develpment of an assessment framework

This thesis reports the findings of a case study into the outcomes and learning environments of students studying for a Diploma of Technology at a New Zealand Tertiary Education Institution. The primary focus of the study was to develop an assessment framework that would facilitate simultaneous assessment of the local Institute achievement-based Diploma of Technology and the competency-based assessment of a National Diploma that the local diploma subsumed. From this primary focus on assessment, the study provided the opportunity to undertake a grounded theory study of literature that impacted on the learning environment, supported the necessity to rationalise the student learning outcomes from both an academic and work skill perspective, and presented a suitable situation in which to take a fresh look at the method of grading and marking students’ assessment material.The grounded theory study grew out of the need to condense the vast amount of literature that was gathered in the process of searching for background material to use in the building of a foundation on which to construct a dual assessment model. Although no literature was found that specifically dealt with the simultaneous dual assessment, a large amount of material was found that related to various aspects of the learning environment. Through the process of a grounded theory study, this material was condensed into categories of data that in turn were used to develop a theoretical model of an ‘ideal’ learning environment. Into this model was also added the results of a questionnaire based research study into the perceived need for diploma graduates to have a range of employability skills. This study involved a range of employers who considered themselves likely to employ a diploma graduate. Because the learning outcomes for the two diplomas covered essentially the same material yet the actual wording of the outcomes were substantially quite different, there was a need to rationalise the sets of learning outcomes for each diploma. This process led to a common set of outcomes that in turn were used as a focus for students’ learning and assessment.Once these common outcomes had been identified, a rubric based marking/scoring system was developed so that both students and teacher could quickly grade students’ assessment material and then convert that grade into a mark. The use of the grade facilitated the assessment of achievement against a unit standard and the resultant marks satisfied the need for an achievement mark. The results and findings from the various studies were then translated into a working model that was used for two courses over one semester. Various other research methodologies were then used in order to provide some evaluation of the working model.The thesis does present some of the difficulties facing tertiary teachers in an environment that is becoming more and more of a production line business rather than a service to provide learning opportunities for students. However it also presents solid evidence that teachers can take measures to prove themselves through study and initiative and provide those focussed learning environments where students can attain the outcomes necessary for a successful career in tomorrow’s world

Evaluation of the performance and feasability of the fluorescein diacetate (FTA) vital staining method for follow up of Tuberculosis (TB) treatment

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