Encouraging majority support for immigrant access to health services:multiple categorization and social identity complexity as antecedents of health equality

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.

Transfer of patients from health care centres to special care services:analysis of travel distances in Nordic countries

Objectives: This paper highlights the importance of analysing patient transportation in Nordic circumpolar areas. The research questions we asked are as follows: How many Finnish patients have been transferred to special care intra-country and inter-country in 2009? Does it make any difference to health care policymakers if patients are transferred inter-country? Study design: We analysed the differences in distances from health care centres to special care services within Finland, Sweden and Norway and considered the health care policy implica tions. Methods: An analysis of the time required to drive between service providers using the "Google distance meter" (http://maps.google.com/); conducting interviews with key Finnish stakeholders; and undertaking a quantitative analyses of referral data from the Lapland Hospital District. Results: Finnish patients are generally not transferred for health care services across national borders even if the distances are shorter. Conclusion: Finnish patients have limited access to health care services in circumpolar are as across the Nordic countries for 2 reasons. First, health professionals in Norway and Sweden do not speak Finnish, which presents a language problem. Second, The Social Insurance Institution of Finland does not cover the expenditures of travel or the costs of medicine. In addition, it seems that in circumpolar areas the density of Finnish service providers is greater than Swedish ones, causing many Swedish citizens to transfer to Finnish health care providers every year. However, future research is needed to determine the precise reasons for this.

Introducing consultant outpatient clinics to community settings to improve access to paediatrics:an observational impact study

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.

Foreign direct investment, access to finance, and innovation activity in Chinese enterprises

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.

Managing people and performance:An evidence based framework applied to health service organizations

People and their performance are key to an organization's effectiveness. This review describes an evidence-based framework of the links between some key organizational influences and staff performance, health and well-being. This preliminary framework integrates management and psychological approaches, with the aim of assisting future explanation, prediction and organizational change. Health care is taken as the focus of this review, as there are concerns internationally about health care effectiveness. The framework considers empirical evidence for links between the following organizational levels: 1. Context (organizational culture and inter-group relations; resources, including staffing; physical environment) 2. People management (HRM practices and strategies; job design, workload and teamwork; employee involvement and control over work; leadership and support) 3. Psychological consequences for employees (health and stress; satisfaction and commitment; knowledge, skills and motivation) 4. Employee behaviour (absenteeism and turnover; task and contextual performance; errors and near misses) 5. Organizational performance; patient care. This review contributes to an evidence base for policies and practices of people management and performance management. Its usefulness will depend on future empirical research, using appropriate research designs, sufficient study power and measures that are reliable and valid.

Babies, bodies and entitlement: gendered aspects of access to citizenship in the Republic of Ireland

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.

Widening access to Higher Education:an evaluative case study of a foundation year alternative to access

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.

Access to technological and financial resources for SME innovation

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.

How SME owners’ characteristics influences external advice and access to finance

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.

Access to medical information and the role of english language in an Algerian selected community : media and modes of exchange among the paediatricians

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Substances hazardous to health:the nature of the expertise associated with competent risk assessment

This research investigated expertise in hazardous substance risk assessment (HSRA). Competent pro-active risk assessment is needed to prevent occupational ill-health caused by hazardous substance exposure occurring in the future. In recent years there has been a strong demand for HSRA expertise and a shortage of expert practitioners. The discipline of Occupational Hygiene was identified as the key repository of knowledge and skills for HSRA and one objective of this research was to develop a method to elicit this expertise from experienced occupational hygienists. In the study of generic expertise, many methods of knowledge elicitation (KE) have been investigated, since this has been relevant to the development of 'expert systems' (thinking computers). Here, knowledge needed to be elicited from human experts, and this stage was often a bottleneck in system development, since experts could not explain the basis of their expertise. At an intermediate stage, information collected was used to structure a basic model of hazardous substance risk assessment activity (HSRA Model B) and this formed the basis of tape transcript analysis in the main study with derivation of a 'classification' and a 'performance matrix'. The study aimed to elicit the expertise of occupational hygienists and compare their performance with other health and safety professionals (occupational health physicians, occupational health nurses, health and safety practitioners and trainee health and safety inspectors), as evaluated using the matrix. As a group, the hygienists performed best in the exercise, and this group were particularly good at process elicitation and at recommending specific control measures, although the other groups also performed well in selected aspects of the matrix and the work provided useful findings and insights. From the research, two models of HSRA have been derived, an HSRA aid, together with a novel videotape KE technique and interesting research findings. The implications of this are discussed with respect to future training of HS professionals and wider application of the videotape KE method.

Black and minority ethnic graduate entrepreneurs: motivations, characteristics and access to finance

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.

Access to start up finance for ethnic minority graduate entrepreneurs in the West Midlands: a gendered perspective

This aim of this paper, from a study funded by the National Council for Graduate Entrepreneurship (NCGE), is to explore access to finance for ethnic minority graduate entrepreneurs (EMGEs) with a particular focus on comparisons between different ethnic groups, and men and women. The authors interviewed selected individuals based upon a review of literature on finance for ethnic minority enterprise. A number of key results from the survey, in that EMGEs: • use external finance significantly (more so than non graduates) and encounter barriers in accessing finance at start-up, in particular those belonging to poor families. • rely excessively on personal savings and family finance, at the start-up and long after the start-up stage, that has implications for the optimal capital structure. • start up businesses that are, on average, larger than non-graduate enterprises and have the potential to reduce economic inactivity amongst the ethnic population. • have, in contrast to general graduate start-ups, a high level of unemployment, take a longer period of time to enter employment and there is a higher level of dissatisfaction with career progression. These findings raise the question whether the right financial advice is taken and whether this behaviour constrains EMGEs' expansion.

Infraslow (<0.1 Hz) oscillations in thalamic relay nuclei basic mechanisms and significance to health and disease states

In the absence of external stimuli, the mammalian brain continues to display a rich variety of spontaneous activity. Such activity is often highly stereotypical, is invariably rhythmic, and can occur with periodicities ranging from a few milliseconds to several minutes. Recently, there has been a particular resurgence of interest in fluctuations in brain activity occurring at <0.1 Hz, commonly referred to as very slow or infraslow oscillations (ISOs). Whilst this is primarily due to the emergence of functional magnetic resonance imaging (fMRI) as a technique which has revolutionized the study of human brain dynamics, it is also a consequence of the application of full band electroencephalography (fbEEG). Despite these technical advances, the precise mechanisms which lead to ISOs in the brain remain unclear. In a host of animal studies, one brain region that consistently shows oscillations at <0.1 Hz is the thalamus. Importantly, similar oscillations can also be observed in slices of isolated thalamic relay nuclei maintained in vitro. Here, we discuss the nature and mechanisms of these oscillations, paying particular attention to a potential role for astrocytes in their genesis. We also highlight the relationship between this activity and ongoing local network oscillations in the alpha (a; ~8-13 Hz) band, drawing clear parallels with observations made in vivo. Last, we consider the relevance of these thalamic ISOs to the pathological activity that occurs in certain types of epilepsy.