27 resultados para ACCESS TO HEALTHCARE SERVICES

em Aston University Research Archive


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Health disparities between groups remain even after accounting for established causes such as structural and economic factors. The present research tested, for the first time, whether multiple social categorization processes can explain enhanced support for immigrant health (measured by respondents’ behavioral intention to support immigrants’ vaccination against A H1N1 disease by cutting regional public funds). Moreover, the mediating role of individualization and the moderating role of social identity complexity were tested. Findings showed that multiple versus single categorization of immigrants lead to support their right to health and confirmed the moderated mediation hypothesis. The potential in developing this sort of social cognitive intervention to address health disparities is discussed.

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Objectives - In line with a national policy to move care ‘closer to home’, a specialist children's hospital in the National Health Service in England introduced consultant-led ‘satellite’ clinics to two community settings for general paediatric outpatient services. Objectives were to reduce non-attendance at appointments by providing care in more accessible locations and to create new physical clinic capacity. This study evaluated these satellite clinics to inform further development and identify lessons for stakeholders. Methods - Impact of the satellite clinics was assessed by comparing community versus hospital-based clinics across the following measures: (1) non-attendance rates and associated factors (including patient characteristics and travel distance) using a logistic regression model; (2) percentage of appointments booked within local catchment area; (3) contribution to total clinic capacity; (4) time allocated to clinics and appointments; and (5) clinic efficiency, defined as the ratio of income to staff-related costs. Results - Satellite clinics did not increase attendance beyond their contribution to shorter travel distance, which was associated with higher attendance. Children living in the most-deprived areas were 1.8 times more likely to miss appointments compared with those from least-deprived areas. The satellite clinics’ contribution to activity in catchment areas and to total capacity was small. However, one of the two satellite clinics was efficient compared with most hospital-based clinics. Conclusions - Outpatient clinics were relocated in pragmatically chosen community settings using a ‘drag and drop’ service model. Such clinics have potential to improve access to specialist paediatric healthcare, but do not provide a panacea. Work is required to improve attendance as part of wider efforts to support vulnerable families. Satellite clinics highlight how improved management could contribute to better use of existing capacity.

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This study explores differences between men and women entrepreneurs and social entrepreneurs. It explores the barriers and discriminatory effects that hinder women’s entrepreneurship, including access to finance in the European Union. The study includes four case studies covering the situation in the Czech Republic, Italy, Sweden, and the United Kingdom.

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Purpose - The purpose of the paper is to develop an integrated quality management model, which identifies problems, suggests solutions, develops a framework for implementation and helps evaluate performance of health care services dynamically. Design/methodology/approach - This paper uses logical framework analysis (LFA), a matrix approach to project planning for managing quality. This has been applied to three acute healthcare services (Operating room utilization, Accident and emergency, and Intensive care) in order to demonstrate its effectiveness. Findings - The paper finds that LFA is an effective method of quality management of hospital-based healthcare services. Research limitations/implications - This paper shows LFA application in three service processes in one hospital. However, ideally this is required to be tested in several hospitals and other services as well. Practical implications - In the paper the proposed model can be practised in hospital-based healthcare services for improving performance. Originality/value - The paper shows that quality improvement in healthcare services is a complex and multi-dimensional task. Although various quality management tools are routinely deployed for identifying quality issues in health care delivery and corrective measures are taken for superior performance, there is an absence of an integrated approach, which can identify and analyze issues, provide solutions to resolve those issues, develop a project management framework (planning, monitoring, and evaluating) to implement those solutions in order to improve process performance. This study introduces an integrated and uniform quality management tool. It integrates operations with organizational strategies. © Emerald Group Publishing Limited.

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Although the various tools and techniques of quality management are routinely deployed in order to improve healthcare quality, an integrated approach is lacking, which combines the customer focus to identify quality issues, analytical techniques for prioritising improvement measures and a project management approach to plan, implement and evaluate the improvement projects. This study develops an innovative framework using Quality Function Deployment (QFD) and a logical framework in order to address this issue, and demonstrates its effectiveness using a case study on the intensive care unit of a hospital.

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DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

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Background: The prevalence of hearing loss is considerably higher in individuals in residential care than in people within the community-dwelling population, and yet hearing aids and hearing services are relatively underused. Care staff have a key role in supporting access to services. Objectives: This study identifies staff perspectives on hearing loss and their views about potential hearing service improvements. Study design: A four-stage mixed methods study was used, made up of qualitative interviews, observation, a survey and a stakeholder involvement meeting. Results: The qualitative stages indicated that staff were concerned about their levels of interaction with residents. Staff considered maximizing communication as part of their professional role. The quantitative survey indicated that these views were widely held by staff, and the stakeholder stage identified the need for social support and dedicated staff training opportunities. Conclusion: Care home staff regard communication as a shared issue. Future interventions could enhance access to hearing services and provide care home staff with training in hearing loss and hearing aid management. © 2013 Informa Healthcare.

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A recent, comprehensive database is used to investigate the link between inward foreign direct investment (FDI) and innovation activity in China. The results of the analysis suggest that private and collectively owned firms with foreign capital participation and those with good access to domestic bank loans innovate more than other firms do. Among enterprises not owned by the state, inward FDI at the sectoral level is positively associated with domestic innovative activity only among firms that engage in their own research and development or that have good access to domestic finance. At the sector level the effect of inward FDI into technology transfer is distinguished from the effect on domestic credit opportunities. FDI affecting credit is of little significance for state-owned enterprises and is independent of their access to finance. In contrast, better access to credit is an important channel through which FDI affects the innovation of domestic private and collectively owned enterprises.

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To readers of the popular press, the words ‘positive psychology’ may conjure up images of happiness gurus and people having their feet massaged, their heads resting peacefully on pink, fluffy clouds. But in this article, our aim is to demonstrate how the new science of positive psychology speaks powerfully to - and has much to contribute to - the development of leadership and the practices and processes of organisations, whether in the public or private sectors. Much of our work is concerned with the applications of this new field, and particularly with building strengths-based organisations. A key pillar of this work is around enabling strengths-based leadership, and provides our focus for this article.

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Since the mid-1990s, automatic citizenship for children born in the Republic has been a source of growing debate against a backdrop of increasing immigration and the peace process. In June 2004, the debate culminated in a referendum, opening the way to a constitutional amendment that attaches residence qualifications to the hitherto unfettered entitlement to citizenship available through ius soli. Arguments for the amendment were couched in terms of a threat posed by Third World women having babies in Ireland to obtain residence, and a putative obligation to the EU to harmonise citizenship laws. This article explores how pregnant foreign women’s bodies became a site of perplexity about the borders of the twenty-first century Irish nation. It is therefore suggested that neither the ‘racial state’ theories nor feminist theories of the nation-state account fully for this. On closer inspection, the seemingly sui generis case of the Irish referendum is therefore fruitful in that it demands further reflection in terms of bridging gaps in the existing theory.

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Aims: To explore newly diagnosed Type 2 diabetes patients' views about Scottish diabetes services at a time when these services are undergoing a major reorganization. To provide recommendations to maximize opportunities brought by the devolvement of services from secondary to primary healthcare settings. Methods: Qualitative panel study with 40 patients newly diagnosed with Type 2 diabetes, recruited from hospital clinics and general practices in Lothian, Scotland. Patients were interviewed three times over 1 year. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results: Patients were generally satisfied with diabetes services irrespective of the types of care received. Most wanted their future care/review to be based in general practice for reasons of convenience and accessibility, although they dis-liked it when appointments were scheduled for different days. Many said they lacked the knowledge/confidence to know how to manage their diabetes in particular situations, and needed access to healthcare professionals who could answer their questions promptly. Patients expressed a need for primary care professionals who had diabetes expertise, but who had more time and were more accessible than general practitioners. Patients who had encountered practice lead nurses for diabetes spoke particularly positively of these professionals. Conclusions: Nurses with diabetes training are particularly well placed to provide information and support to patients in primary care. Ideally, practices should run 'one-stop' diabetes clinics to provide structured care, with easily accessible dietetics, podiatry and retinopathy screening. Newly diagnosed patients may benefit from being made more aware of specific services provided by charitable organizations such as Diabetes UK. © 2005 Diabetes UK.

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Universities are encouraged to widen access to a broad range of applicants, including mature students taking Access qualifications. Admissions tutors can find it difficult to compare and choose between Access and A-level applications, and Access applicants for popular courses may be disadvantaged relative to students with good A-levels. In this evaluative case study a foundation year designed to avoid Access selection problems and widen participation in psychology, biology, optometry and pharmacy is reviewed. Progression and success rates are compared to national averages for Access courses and issues in Foundation Year management considered. The Foundation Year is rejected as unsatisfactory and it is concluded that widening participation for mature students can be achieved through Access courses. Difficulties in achieving this for high-demand courses in leading universities are discussed.

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Editorial: The contributions to this special issue of the International Journal of Technology Management are all based on selected papers presented at the European Conference on Management of Technology held at Aston University, Birmingham, UK in June 1995. This conference was held on behalf of the International Association for Management of Technology (IAMOT) and was the first of the association’s major conferences to be held outside North America. The overall theme of the conference was ‘Technological Innovation and Global Challenges’. Altogether more than 130 papers were presented within four sub-themes and twenty seven topic sessions. This special issue draws on papers within five difference topic sessions: ‘Small firm linkages’; ‘The global company’; ‘New technology based firms’; ‘Financing innovation’; ‘Technology and development’. Together they cover a wide range of issues around the common question of accessing resources for innovation in small and medium sized enterprises. They present a global perspective on this important subject with authors from The Netherlands, Canada, USA, Ireland, France, Finland, Brazil and UK. A wide range of subjects are covered including the move away from public support for innovation, the role of alliances and networks, linkages to larger enterprises and the social implications associated with small enterprise innovation in developing countries.

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This paper aims to investigate the linkage between the use of external advice and access to finance for small and medium-sized enterprises (SMEs) in the UK, with particular consideration of differences in personal characteristics: gender, ethnicity and education. The approach adopted for the research is a telephone survey conducted by the Barclays small business research team in late 2005 on behalf of the authors. These data are quantitative in nature and involve a large sample of 400 SMEs with specific questions analysed by gender, ethnicity and education level. The approach adopted is robust and empirically sound and is a long established research methodology. We find that there appears to be a correlation between the provision of external advice and the ability to raise bank finance. Furthermore, there are clear gender, ethnic and educational differentials in the use of particular sources of advice, for example: Gender • men and women are equally likely to use accountants as sources of advice. • men are more likely to use family and friends and solicitors. • women, however, are around twice as likely to access external advice from Business Link and Enterprise Agencies. Ethnicity • family and friends is predominant amongst Asians or black respondents and the other ethnic group, which is also slightly true of accountants and solicitors. • ethnic minority respondents were considerably less likely to use Business Link/ Enterprise Agencies. Education • graduates are most likely to use solicitors and accountants, whilst they are very low users of advice from family and friends and Business Links/Enterprise Agencies. • O level and A level educated respondents predominate in family and friends and Business Link/ Enterprise Agencies.

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This paper draws upon four case studies to examine characteristics, entrepreneurial motivations and access to finance of black and minority ethnic (BME) graduates in the UK. We find that BME graduates starting a business are motivated by a desire to “do better”, and rely heavily on personal savings and family sources for start-up capital. In addition: • There is no conclusive evidence that suggests in this study that BME graduates entered entrepreneurship because of unemployment; with the exception of a few, all had jobs prior to entering self employment. • “Glass ceilings” were often cited by participants of the case studies as a kind of barrier, but there was reluctance to specify exactly what that meant. • Also, lack of satisfaction from working for others is considered to be a strong motivator for entering self-employment but other reasons, to be one’s own boss and the prospect of higher earnings, are also strong motivators. There is, therefore, a need for support agencies and universities to recognise the distinctive nature of BME graduate enterprise in order to provide effective solutions for different groups. This might include a) work experience, b) advice on an adequate capital structure at start up, c) adequate funding and training, and d) appropriate training for all graduates in basic business education.