Evaluation of the quality and promotion of open learning materials

In the UK, Open Learning has been used in industrial training for at least the last decade. Trainers and Open Learning practitioners have been concerned about the quality of the products and services being delivered. The argument put forward in this thesis is that there is ambiguity amongst industrialists over the meanings of `Open Learning' and `Quality in Open Learning'. For clarity, a new definition of Open Learning is proposed which challenges the traditional learner-centred approach favoured by educationalists. It introduces the concept that there are benefits afforded to the trainer/employer/teacher as well as to the learner. This enables a focussed view of what quality in Open Learning really means. Having discussed these issues, a new quantitative method of evaluating Open Learning is proposed. This is based upon an assessment of the degree of compliance with which products meet Parts 1 & 2 of the Open Learning Code of Practice. The vehicle for these research studies has been a commercial contract commissioned by the Training Agency for the Engineering Industry Training Board (EITB) to examine the quality of Open Learning products supplied to the engineering industry. A major part of this research has been the application of the evaluation technique to a range of 67 Open Learning products (in eight subject areas). The findings were that good quality products can be found right across the price range - so can average and poor quality ones. The study also shows quite convincingly that there are good quality products to be found at less than 50. Finally the majority (24 out of 34) of the good quality products were text based.

An evaluation of the effectiveness of intervention strategies for the promotion of health and safety performance in small firms

Recognition of the contribution of small firms to the UK economy has grown considerably since 1995 when this research first began. The poor record of small firms in managing health and safety effectively has caused concern, and efforts made to improve knowledge and awareness of the target group through various initiatives have had some success. This research thesis attempts to identify the range of intervention routes and methods available to reach the target group, and to consider ways of evaluating the outcome of such efforts. Various interventions were tested with small firms, including a Workshop; use of Questionnaires; short postal Reply Slip survey; leading to a closer evaluation of a specific industry- the Licensed Trade. Attitudes and beliefs of the sample were identified, and observations carried out to consider actions taken by workers and others in the workplace. These empirical research findings were used to develop the theme of Primary and Secondary interventions intended to change behaviours, and to confirm assumptions about what small firms currently do to manage health and safety risks. Guidance for small firms was developed as a Secondary intervention tool to support Primary interventions, such as inspection or insurance provision.

Logics, thresholds, strategic power, and the promotion of liberalisation by governments: a case study from British Higher Education

Liberalisation has become an increasingly important policy trend, both in the private and public sectors of advanced industrial economies. This article eschews deterministic accounts of liberalisation by considering why government attempts to institute competition may be successful in some cases and not others. It considers the relative strength of explanations focusing on the institutional context, and on the volume and power of sectoral actors supporting liberalisation. These approaches are applied to two attempts to liberalise, one successful and one unsuccessful, within one sector in one nation – higher education in Britain. Each explanation is seen to have some explanatory power, but none is sufficient to explain why competition was generalised in the one case and not the other. The article counsels the need for scholars of liberalisation to be open to multiple explanations which may require the marshalling of multiple sources and types of evidence.

Estimating the efficiency of healthcare facilities providing HIV/AIDS treatment in Zambia:a data envelopment approach

Zambia and many other countries in Sub-Saharan Africa face a key challenge of sustaining high levels of coverage of AIDS treatment under prospects of dwindling global resources for HIV/AIDS treatment. Policy debate in HIV/AIDS is increasingly paying more focus to efficiency in the use of available resources. In this chapter, we apply Data Envelopment Analysis (DEA) to estimate short term technical efficiency of 34 HIV/AIDS treatment facilities in Zambia. The data consists of input variables such as human resources, medical equipment, building space, drugs, medical supplies, and other materials used in providing HIV/AIDS treatment. Two main outputs namely, numbers of ART-years (Anti-Retroviral Therapy-years) and pre-ART-years are included in the model. Results show the mean technical efficiency score to be 83%, with great variability in efficiency scores across the facilities. Scale inefficiency is also shown to be significant. About half of the facilities were on the efficiency frontier. We also construct bootstrap confidence intervals around the efficiency scores.

The promotion of children's health and wellbeing:the contributions of England's charity sector

Background. Sports and arts based services for children have positive impacts on their mental and physical health. The charity sector provides such services, often set up in response to local communities expressing a need. The present study maps resilience promoting services provided by children's charities in England. Specifically, the prominence of sports and arts activities, and types of mental health provisions including telephone help-lines, are investigated. Findings. The study was a cross-sectional web-based survey of chief executives, senior mangers, directors and chairs of charities providing services for children under the age of 16. The aims, objectives and activities of participating children's charities and those providing mental health services were described overall. In total 167 chief executives, senior managers, directors and chairs of charities in England agreed to complete the survey. From our sample of charities, arts activities were the most frequently provided services (58/167, 35%), followed by counselling (55/167, 33%) and sports activities (36/167, 22%). Only 13% (22/167) of charities expected their work to contribute to the health legacy of the 2012 London Olympics. Telephone help lines were provided by 16% of the charities that promote mental health. Conclusions. Counselling and arts activities were relatively common. Sports activities were limited despite the evidence base that sport and physical activity are effective interventions for well-being and health gain. Few of the charities we surveyed expected a health legacy from the 2012 London Olympics. © 2010 Bhui et al; licensee BioMed Central Ltd.

The knowledge-based perspective of risk management in healthcare organisations

The aim of this research is to investigate how risk management in a healthcare organisation can be supported by knowledge management. The subject of research is the development and management of existing logs called "risk registers", through specific risk management processes employed in a N.H.S. (Foundation) Trust in England, in the U.K. Existing literature on organisational risk management stresses the importance of knowledge for the effective implementation of risk management programmes, claiming that knowledge used to perceive risk is biased by the beliefs of individuals and groups involved in risk management and therefore is considered incomplete. Further, literature on organisational knowledge management presents several definitions and categorisations of knowledge and approaches for knowledge manipulation in the organisational context as a whole. However, there is no specific approach regarding "how to deal" with knowledge in the course of organisational risk management. The research is based on a single case study, on a N.H.S. (Foundation) Trust, is influenced by principles of interpretivism and the frame of mind of Soft Systems Methodology (S.S.M.) to investigate the management of risk registers, from the viewpoint of people involved in the situation. Data revealed that knowledge about risks and about the existing risk management policy and procedures is situated in several locations in the Trust and is neither consolidated nor present where and when required. This study proposes a framework that identifies required knowledge for each of the risk management processes and outlines methods for conversion of this knowledge, based on the SECI knowledge conversion model, and activities to facilitate knowledge conversion so that knowledge is effectively used for the development of risk registers and the monitoring of risks throughout the whole Trust under study. This study has theoretical impact in the management science literature as it addresses the issue of incomplete knowledge raised in the risk management literature using concepts of the knowledge management literature, such as the knowledge conversion model. In essence, the combination of required risk and risk management related knowledge with the required type of communication for risk management creates the proposed methods for the support of each risk management process for the risk registers. Further, the indication of the importance of knowledge in risk management and the presentation of a framework that consolidates knowledge required for the risk management processes and proposes way(s) for the communication of this knowledge within a healthcare organisation have practical impact in the management of healthcare organisations.

The impact of a father's presence during newborn resuscitation:a qualitative interview study with healthcare professionals

Objective: To explore healthcare professionals’ experiences around the time of newborn resuscitation in the delivery room, when the baby’s father was present. Design: A qualitative descriptive, retrospective design using the critical incident approach. Tape-recorded semistructured interviews were undertaken with healthcare professionals involved in newborn resuscitation. Participants recalled resuscitation events when the baby’s father was present. They described what happened and how those present, including the father, responded. They also reflected upon the impact of the resuscitation and the father’s presence on themselves. Participant responses were analysed using thematic analysis. Setting: A large teaching hospital in the UK. Participants: Purposive sampling was utilised. It was anticipated that 35–40 participants would be recruited. Forty-nine potential participants were invited to take part. The final sample consisted of 37 participants including midwives, obstetricians, anaesthetists, neonatal nurse practitioners, neonatal nurses and paediatricians. Results: Four themes were identified: ‘whose role?’ ‘saying and doing’ ‘teamwork’ and ‘impact on me’. While no-one was delegated to support the father during the resuscitation, midwives and anaesthetists most commonly took on this role. Participants felt the midwife was the most appropriate person to support fathers. All healthcare professional groups said they often did not know what to say to fathers during prolonged resuscitation. Teamwork was felt to be of benefit to all concerned, including the father. Some paediatricians described their discomfort when fathers came to the resuscitaire. None of the participants had received education and training specifically on supporting fathers during newborn resuscitation. Conclusions: This is the first known study to specifically explore the experiences of healthcare professionals of the father’s presence during newborn resuscitation. The findings suggest the need for more focused training about supporting fathers. There is also scope for service providers to consider ways in which fathers can be supported more readily during newborn resuscitation.

Expanding the evidence within evidence-based healthcare:thinking about the context, acceptability and feasibility of interventions

Evidence-based medicine is crucial to contemporary healthcare. It is dependent on systematic review methodology modelled on an arguably inadequate hierarchy of evidence. There has been a significant increase in medical and health research using qualitative and mixed method designs. The perspective taken in this article is that we need to broaden our evidence base if we are to fully take account of issues of context, acceptability and feasibility in the development and implementation of healthcare interventions. One way of doing this is to use a range of methods that better fit the different aspects of intervention development and implementation. Methods for the systematic review of evidence, other than randomised-controlled trials, are available and there is a readiness to incorporate these other types of evidence into good-practice guidance, but we need a clear methodology to translate these advances in research into the world of policy.