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Search Results: 1 - 10 of 3405 matches for " Claire Goodman "
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Sustaining innovation in the health care workforce: A case study of community nurse consultant posts in England
Vari M Drennan, Claire Goodman
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-200
Abstract: A mixed method case study evaluation was undertaken over three years, using interviews, observations, documentary analysis and questionnaires. The final element of data collection was obtained three years later. Data was anonymised, analysed using a framework method and then integrated using a narrative synthesis.Ten nurse consultant posts were created over a period of two years (2002-2004). Within two years only five posts remained and within five years (2009) only two part time posts, with the original appointees, remained. When the nurse consultants left their posts, these were not replaced. In exploring the interaction between the innovation (the nurse consultant posts), the adoptees (the senior staff in the organisation) and the context (the immediate service colleagues, the service organisation and commissioners as well as the broader NHS policy context) three key factors were identified as influential in the demise of the posts. These were: a) the extent to which there was support for individual nurses rather than the post, b) the extent to which there was an unambiguous and uncontested clinical service requirement for a nurse consultant and c) the extent to which finances for the post were judged as being used to best effect in a service setting.This case study example demonstrates how tantalisingly close the nurse consultant initiative came to achieving a clinical career pathway for nurses in community services but more work was required to normalise clinician and managers' beliefs in the relevance and need for the role. Those looking to embed these types of nursing workforce innovations should pay due regard to these issues.Recruiting, retaining and meeting increasing demand for experienced, qualified nurses is an issue of concern not just for individual organisations but for government agencies throughout the world [1,2]. Human resource analysts offer a wide range of solutions from the economic e.g. attractive pay and benefits, to the wider social advanta
Integrated working between primary health care services and care homes for older people: challenges from the approach study
Sue Davies,Claire Goodman,Frances Bunn,Angela Dickinson
International Journal of Integrated Care , 2010,
Pretense Theory and the Imported Background  [PDF]
Jeffrey Goodman
Open Journal of Philosophy (OJPP) , 2011, DOI: 10.4236/ojpp.2011.11004
Abstract: Kendall Walton’s pretense theory, like its rivals, says that what’s true in a fiction F depends in part on the importation of background propositions into F. The aim of this paper is to present, explain, and defend a brief yet straightforward argument–one which exploits the specific mechanism by which the pretense theory says propositions are imported into fictions–for the falsity of the pretense theory.
The Social Ecology of Cervical Cancer: The Challenges to Pap Smear Screening  [PDF]
Annekathryn Goodman
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.412A1004

Cervical cancer is a preventable disease. The risk factors for the development of cervical cancer include both biologic factors and social factors. In the United States, the leading risk factor for the development of cervical cancer is not having a Pap smear for five years prior to the diagnosis of cancer. In low and middle income countries, cervical cancer incidence and mortality are directly related to the lack of both screening programs and cancer treatment facilities. This paper examines the social ecology of cervical cancer. The literature is reviewed on social and cultural barriers to access to health care and its effect of cervical cancer rates and outcomes.

The Development of the Qatar Healthcare System: A Review of the Literature  [PDF]
Annekathryn Goodman
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.63023
Background: Qatar, one of the smallest and wealthiest countries in the world, is a newly emerging healthcare system. Medical leadership in Qatar has had to create an infrastructure for medical care over the past twenty years. The purpose of this paper is to review the challenges and achievements of the newly emerging Qatar healthcare system. Methods: PubMed was searched using MESH terms: Qatar, healthcare, medical development, medical insurance and medical history. Websites of the World Bank, CIA fact book, Qatar Ministry of Health, Hamad Medical Corporation, Organization for Economic Co-operation and Development and the US State department were searched for information about Qatar’s healthcare system and its history. Results: Qatar is a rapidly growing, multicultural country with over 80 nationalities represented. Qatar has developed a healthcare system with universal coverage. Up until 2014, the government has subsidized all care. There are plans to develop a medical insurance system. Conclusions: Qatar has experienced the rapid development of a healthcare system over the past twenty years. The government has centrally controlled growth and development. An examination of the unique challenges to building a Qatari healthcare system will be useful in considering how to develop medical infrastructure in other countries.
Navigating Turbulent Religious Diversity in Global Health  [PDF]
Annekathryn Goodman
Open Journal of Social Sciences (JSS) , 2018, DOI: 10.4236/jss.2018.610005
Abstract: Physicians who work internationally and in culturally diverse settings will on occasion be challenged by political upheavals, riots, or other disturbances. Medical professionals who work in global health need to be aware of the tensions and challenges that people of different religions experience. This editorial reviews the philosophy of several theological leaders who grappled with issues of social justices and the importance of respectful communication and understanding across religious differences. Physicians must have training and develop expertise in global health diplomacy to function on three levels: individual, national, and international.
Psychosocial Factors That Shape Patient and Carer Experiences of Dementia Diagnosis and Treatment: A Systematic Review of Qualitative Studies
Frances Bunn ,Claire Goodman,Katie Sworn,Greta Rait,Carol Brayne,Louise Robinson,Elaine McNeilly,Steve Iliffe
PLOS Medicine , 2012, DOI: 10.1371/journal.pmed.1001331
Abstract: Background Early diagnosis and intervention for people with dementia is increasingly considered a priority, but practitioners are concerned with the effects of earlier diagnosis and interventions on patients and caregivers. This systematic review evaluates the qualitative evidence about how people accommodate and adapt to the diagnosis of dementia and its immediate consequences, to guide practice. Methods and Findings We systematically reviewed qualitative studies exploring experiences of community-dwelling individuals with dementia, and their carers, around diagnosis and the transition to becoming a person with dementia. We searched PubMed, PsychINFO, Embase, CINAHL, and the British Nursing Index (all searched in May 2010 with no date restrictions; PubMed search updated in February 2012), checked reference lists, and undertook citation searches in PubMed and Google Scholar (ongoing to September 2011). We used thematic synthesis to identify key themes, commonalities, barriers to earlier diagnosis, and support identified as helpful. We identified 126 papers reporting 102 studies including a total of 3,095 participants. Three overarching themes emerged from our analysis: (1) pathways through diagnosis, including its impact on identity, roles, and relationships; (2) resolving conflicts to accommodate a diagnosis, including the acceptability of support, focusing on the present or the future, and the use or avoidance of knowledge; and (3) strategies and support to minimise the impact of dementia. Consistent barriers to diagnosis include stigma, normalisation of symptoms, and lack of knowledge. Studies report a lack of specialist support particularly post-diagnosis. Conclusions There is an extensive body of qualitative literature on the experiences of community-dwelling individuals with dementia on receiving and adapting to a diagnosis of dementia. We present a thematic analysis that could be useful to professionals working with people with dementia. We suggest that research emphasis should shift towards the development and evaluation of interventions, particularly those providing support after diagnosis. Please see later in the article for the Editors' Summary.
Models of inter professional working for older people living at home: a survey and review of the local strategies of english health and social care statutory organisations
Claire Goodman, Vari Drennan, Fiona Scheibl, Dhrushita Shah, Jill Manthorpe, Heather Gage, Steve Iliffe
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-337
Abstract: An online survey of health and social care managers across England directly involved in providing services to older people, and a review of local strategies for older people services produced by primary care organisations and local government adult services organisations in England.The online survey achieved a 31% response rate and search strategies identified 50 local strategies that addressed IPW for older people living at home across health and social care organisations. IPW definitions varied, but there was an internal consistency of language informed by budgeting and organisation specific definitions of IPW.Community Services for Older People, Intermediate Care and Re-enablement (rehabilitation) Teams were the services most frequently identified as involving IPW. Other IPW services identified were problem or disease specific and reflected issues highlighted in local strategies. There was limited agreement about what interventions or strategies supported the process of IPW. Older people and their carers were not reported to be involved in the evaluation of the services they received and it was unclear how organisations and managers judged the effectiveness of IPW, particularly for services that had an open-ended commitment to the care of older people.Health and social care organisations and their managers recognise the value and importance of IPW. There is a theoretical literature on what supports IPW and what it can achieve. The need for precision may not be so necessary for the terms used to describe IPW. However, there is a need for shared identification of both user/patient outcomes that arise from IPW and greater understanding of what kind of model of IPW achieves what kind of outcomes for older people living at homeThe challenge faced by health and social care services in the developed world is to create integrated systems that address frailty [1-3]. Models of long-term chronic disease management for frail older people emphasize the need for multi-professi
Sedative load of medications prescribed for older people with dementia in care homes
Carole Parsons, Jane Haydock, Elspeth Mathie, Natasha Baron, Ina Machen, Elizabeth Stevenson, Sarah Amador, Claire Goodman
BMC Geriatrics , 2011, DOI: 10.1186/1471-2318-11-56
Abstract: Medication data were collected at baseline and at two further time-points for eligible residents of six care homes participating in the EVIDEM-End Of Life (EOL) study for whom medication administration records were available. Regular medications were classified using the Anatomical Therapeutic Chemical classification system and individual sedative loads were calculated using a previously published model.At baseline, medication administration records were reviewed for 115 residents; medication records were reviewed for 112 and 105 residents at time-points 2 and 3 respectively. Approximately one-third of residents were not taking any medications with sedative properties at each time-point, while a significant proportion of residents had a low sedative load score of 1 or 2 (54.8%, 59.0% and 57.1% at baseline and time-points 2 and 3 respectively). More than 10% of residents had a high sedative load score (≥ 3) at baseline (12.2%), and this increased to 14.3% at time-points 2 and 3. Approximately two-thirds of residents (66.9%) regularly used one or more psychotropic medication(s). Antidepressants, predominantly selective serotonin re-uptake inhibitors (SSRIs), were most frequently used, while antipsychotics, hypnotics and anxiolytics were less routinely administered. The prevalence of antipsychotic use among residents was 19.0%, lower than has been previously reported for nursing home residents. Throughout the duration of the study, administration of medications recognised as having prominent sedative adverse effects and/or containing sedative components outweighed the regular use of primary sedatives.Sedative load scores were similar throughout the study period for residents with dementia in each of the care homes. Scores were lower than previously reported in studies conducted in long-term care wards which have on-site clinical support. Nevertheless, strategies to optimise drug therapy for care home residents with dementia which rely on clinicians external to the care
A systematic review of integrated working between care homes and health care services
Sue L Davies, Claire Goodman, Frances Bunn, Christina Victor, Angela Dickinson, Steve Iliffe, Heather Gage, Wendy Martin, Katherine Froggatt
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-320
Abstract: A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis.Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in duration.Despite evidence about what inhibits and facilitates integrated working there was limited evidence about what the outcomes of different approaches to integrated care between health service and care homes might be. The majority of studies only achieved integrated working at the patient level of care and the focus on health service defined problems and outcome measures did not incorporate the priorities of residents or acknowledge the skills of care home staff. There is a need for more research to understand how integrated working is achieved and to test the effect of different approaches on cost, staff satisfaction and resident outcomes.In the UK care homes are the major provider of long term and intermediate care for older people [1-3]. There are 18, 255 care homes providing 459, 448
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