Working at the nexus between public health policy, practice and research : dynamics of knowledge sharing in the Netherlands

Background
Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.
This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing.
Method
An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories.
Results
Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives.
Conclusion
We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks.

Who is responsible for the public's health? The role of the alcohol industry in the WHO global strategy to reduce the harmful use of alcohol

In this editorial the Editors of Addiction join over 500 public health leaders and 27 organizations in their endorsement of the ‘Statement of Concern’ addressed to the Director General of the World Health Organization. The Editors support the Statement’s contention that the global alcohol industry should have no role in the formulation of public health policies.

Nurses' experiences of ethical preparedness for public health emergencies and healthcare disasters: a systematic review of qualitative evidence

Little is known about nurses' direct experiences of ethical preparedness for dealing with catastrophic public health emergencies and healthcare disasters or the ethical quandaries that may arise during such events. A systematic literature review was undertaken to explore and synthesize qualitative research literature reporting nurses' direct experiences of being prepared for and managing the ethical challenges posed by catastrophic public health emergencies and healthcare disasters. Twenty-six research studies were retrieved for detailed examination and assessed by two independent reviewers for methodological validity prior to inclusion in the review. Of these, 12 studies published between 1973 and 2011 were deemed to meet the inclusion criteria and were critically appraised. The review confirmed there is a significant gap in the literature on nurses' experiences of ethical preparedness for managing public health emergencies and healthcare disasters, and the ethical quandaries they encounter during such events. This finding highlights the need for ethical considerations in emergency planning, preparedness, and response by nurses to be given more focused attention in the interests of better informing the ethical basis of emergency disaster management.

Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study

BACKGROUND: People who experience traumatic events have an increased risk of developing a range of mental disorders. Appropriate early support from a member of the public, whether a friend, family member, co-worker or volunteer, may help to prevent the onset of a mental disorder or may minimise its severity. However, few people have the knowledge and skills required to assist. Simple guidelines may help members of the public to offer appropriate support when it is needed.

METHODS: Guidelines were developed using the Delphi method to reach consensus in a panel of experts. Experts recruited to the panels included 37 professionals writing, planning or working clinically in the trauma area, and 17 consumer or carer advocates who had been affected by traumatic events. As input for the panels to consider, statements about how to assist someone who has experienced a traumatic event were sourced through a systematic search of both professional and lay literature. These statements were used to develop separate questionnaires about possible ways to assist adults and to assist children, and panel members answered either one questionnaire or both, depending on experience and expertise. The guidelines were written using the items most consistently endorsed by the panels across the three Delphi rounds.

RESULTS: There were 180 items relating to helping adults, of which 65 were accepted, and 155 items relating to helping children, of which 71 were accepted. These statements were used to develop the two sets of guidelines appended to this paper.

CONCLUSIONS: There are a number of actions which may be useful for members of the public when they encounter someone who has experienced a traumatic event, and it is possible that these actions may help prevent the development of some mental health problems in the future. Positive social support, a strong theme in these guidelines, has some evidence for effectiveness in developing mental health problems in people who have experienced traumatic events, but the degree to which it helps has not yet been adequately demonstrated. An evaluation of the effectiveness of these guidelines would be useful in determining their value. These guidelines may be useful to organisations who wish to develop or revise curricula of mental health first aid and trauma intervention training programs and policies. They may also be useful for members of the public who want immediate information about how to assist someone who has experienced a potentially traumatic event.