An overview of the research evidence on ethnicity and communication in healthcare

• The aim of the present study was to identify and review the available research evidence on 'ethnicity and communication' in areas relevant to ensuring effective provision of mainstream services (e.g. via interpreter, advocacy and translation services); provision of services targeted on communication (e.g. speech and language therapy, counselling, psychotherapy); consensual/ participatory activities (e.g. consent to interventions), and; procedures for managing and planning for linguistic diversity

Weaving the realities and responsibilities: Crossing culture and concepts of healing within co-existing mental health and addictive disorders.

Within ‘Mainstream’ western and Kaupapa Māori services, competing priorities often mean that cultural and clinical services are not implemented in unison. Without this ‘unison’, treatment of Māori with co-existing mental health and addictive disorders may be ineffective. This paper reflects the journey of a small social service agency ‘Pai Ake Solutions Limited’ (PASL) in integrating western clinical approaches within tikanga Māori values. Pai Ake Solutions Limited (PASL) provides a range of group and individual services to whānau who are affected by mental illness and co-existing substance use problems. The initial development of the service was based on the whakaaro of providing ‘pai ake’ (better) services for whānau in the greater Waikato. These services were initially founded on the strong values of founders Mihaka Hohua and the late Ritchie Re Cribb, which were influenced by the practices and experiences of Ngati Kahangungu, Ngati Haua, and Waikato-Maniopoto. From an initial non-clinical service provision contract, PASL began receiving referrals from individuals and whānau whose needs were not being met by mainstream service providers. Encouraging outcomes and an internal agency review of clientele utilising the service, identified that those accessing PASL services were experiencing socially and clinically significant mental and physical health, addiction and psychosocial problems

Evaluation of Services Our Way

An evaluation of Services Our Way, a NSW Government service model designed to build the capacity of Aboriginal people to have greater access to mainstream and disability services and encourage self-directed support. Overview Services Our Way is a NSW Government service model designed to build the capacity of Aboriginal people to have greater access to mainstream and disability services and encourage self-directed support. The Social Policy Research Centre was commissioned to evaluate the Services Our Way pilot in Nowra, New South Wales, and did so through interviews with families and service providers. Services Our Way had positive impacts on Aboriginal people with disability and their families. The program helped Aboriginal people access a range of services, meeting immediate priorities of the families. The program was successful in engaging with the Aboriginal community using a culturally appropriate approach – an approach which could be shared with other staff and services to improve the appropriateness of service delivery more broadly. Through the program, families were able to access support and services to participate in social, economic and cultural activities, that helped strengthen and support community and social relationships. The evaluation could not determine the degree to which families transitioned to mainstream services – the research found that families had urgent needs to be met prior to transitioning to other services. The Services Our Way program in Nowra was a pilot, which developed from the initial concept in response to local needs. The evaluation identifies a range of issues in providing person centred approaches to Aboriginal people with disability and their families and communities which should influence the future directions under the National Disability Insurance Scheme (NDIS).&nbsp

Improving services for pupils with social, emotional and behavioural difficulties : responding to the challenges

This paper considers some of the major challenges facing key stakeholders, including teachers, professionals working in support services, parents and pupils, as they strive to improve services for children with social, emotional and behavioural difficulties (SEBD). For each of these challenges (working with families, low educational attainments, including pupils with SEBD in mainstream schools, transition from school to college or employment, early intervention and prevention) we review research evidence, mainly from the UK and USA, and discuss possible solutions. A key theme in the paper, discussed in the concluding section, is that governments, local authorities and schools, should use the research evidence to develop carefully planned and evidence based interventions that will lead to sustained improvements being made in the education of vulnerable young people.peer-reviewe

Bringing genetics into primary care: findings from a national evaluation of pilots in England

Objectives: Developments in genetic knowledge and clinical applications are seen as rendering traditional modes of organizing genetics provision increasingly inappropriate. In common with a number of developed world countries the UK has sought to increase the role of primary care in delivering such services. However, efforts to reconfigure service delivery face multiple challenges associated with divergent policy objectives, organizational boundaries and professional cultures. This paper presents findings from an evaluation of an English initiative to integrate genetics into 'mainstream' clinical provision in the National Health Service. Methods: Qualitative research in 11 case-study sites focusing on attempts by pilots funded by the initiative to embed knowledge and provision within primary care illustrating barriers faced and the ways in which these were surmounted. Results: Lack of intrinsic interest in clinical genetics among primary care staff was compounded by national targets that focused their attention elsewhere and by service structures that rendered genetics a peripheral concern demanding minimal engagement. Established divisions between the commissioning of mainstream and specialist services, along with the pressures of shorter-term targets, impeded ongoing funding. Conclusions: More wide-ranging policy and organizational support is required if the aim of entrenching genetics knowledge and practice across the Health Service is to be realized

Reluctant Bedfellows or Model Marriage? Postmodern Thinking Applied to Mainstream Public Sector Health Services Research Settings

An important mobilisation of postmodernism is as a way of thinking that pays particular attention to the play of differences in human thought and experience. Informed by the Derridean theory of deconstruction, the current discussion critically examines an original piece of health services research undertaken by the author, which aimed to derive propositions about how health service researchers disseminated research information to those in daily practice in the United Kingdom (UK) National Health Service (NHS). The objective is to provide an analytical review of those tacit and oftentimes suppressed, marginalized or hidden, forms of knowledge that may be conveniently overlooked or glossed over in mainstream health services research, which is largely produced by university-based researchers who remain subject to traditional academic pressures. Following a review of the theory and practice of deconstruction, Boje and Dennehy’s (1994) specific seven-point ‘deconstruction methodology’, based on drawing empirical data through bipolar opposite themes, is deployed before concluding with a consideration of the implications of a postmodern analysis of mainstream healthcare practice, policy and organisation settings, which have a central role to play in delivering service improvement in the new financial environment.

Building Community Assets: A Guide to Credit Union Partnerships

The purpose of this guide is to help community organizations enable their members to join a mainstream credit union and begin building modest assets. Many credit unions offer financial products and services tailored to the needs of low-income people, but mainstream credit unions have not historically reached this population. Partnering with community organizations expands a credit union's membership while giving community organizations the tools to help their members build assets

Banking unbanked immigrants through remittances

High service fees for sending money abroad can be a financial strain for low and moderate-income immigrants. George Samuels explores how some mainstream financial institutions are offering competitive pricing for the service and, as a result, are banking a new set of customers.Emigrant remittances ; Banks and banking - Customer services ; Banks and banking - Massachusetts ; Community development - Massachusetts

A Prioritised Traffic Embedding Mechanism enabling a Public Safety Virtual Operator

Public Protection and Distaster Relief (PPDR) services can benefit greatly from the availability of mobile broadband communications in disaster and emergency scenarios. While undoubtedly offering full control and reliability, dedicated networks for PPDR have resulted in high operating costs and a lack of innovation in comparison to the commercial domain. Driven by the many benefits of broadband communications, PPDR operators are increasingly interested in adopting mainstream commercial technologies such as Long Term Evolution (LTE) in favour of expensive, dedicated narrow-band networks. In addition, the emergence of virtualization for wireless networks offers a new model for sharing infrastructure between several operators in a flexible and customizable manner. In this context, we propose a virtual Public Safety (PS) operator that relies on shared infrastructure of commercial LTE networks to deliver services to its users. We compare several methods of allocating spectrum resources between virtual operators at peak times and examine how this influences differing traffic services. We show that it is possible to provide services to the PS users reliably during both normal and emergency operation, and examine the impact on the commercial operators.Comment: Accepted in VTC Fall 2015, 5 page