17390 research outputs found
Sort by
Investigating the influence of accountability, power dynamics and political influences among NGO major stakeholders: Namibian perspective
No full textThe study shows how stakeholders’ decision-making is played out transparency, and accountability, and offers insights into power dynamics and relationships within NGO governance. It also addresses the regulatory landscape's impact on accountability structures and the significant influence of international and local donors, particularly in public health initiatives. Integrating corporate governance principles derived from King IV codes and sustainability reporting guidelines (GRI), the paper highlights an advanced framework to enhance accountability aligned with NGO global standards for strengthening NGO governance practices in Namibia. This study finds that the asymmetric power relations as a positive tool for empowerment which gives beneficiaries a voice to state their needs and helping them to insist their rights as beneficiaries
An exploration of kinship carers' experience and stories
Get PDFContext: Kinship care for children in care has increased in the past years in many countries across the world. Formal kinship care arrangements have been favoured by children social services over unrelated foster care due to the positive child outcomes. However, research has found that kinship carers have been ‘invisible’ to social care services, facing significant difficulties. This review critiques and synthesises the existing literature exploring formal kinship carers’ experiences and perceived challenges.
Methodology: Ovid Full Text Journals, Wiley Online Library, MedLine, PsycArticles, PsycInfo, Scopus, Web of Science and Google Scolar were searched for relevant studies. Eleven eligible papers, comprising five qualitative, three quantitative descriptive, and three mixed methods studies were included in the review. The MMAT appraisal tool was used to assess their quality. Findings were then synthesised using a narrative approach, and themes were derived from the data.
Results: Eight studies explored kinship carers’ experiences and three studies investigated outcomes of depression and distress. Themes were identified from the studies:‘transition to a restricted lifestyle’, ‘sense of increased responsivity towards troubled kinship children’, ‘deterioration of physical and mental wellbeing’, ‘managing complex family dynamics’, ‘experiences of microaggression and unfair treatment from services’, and ‘social isolation and sense of rejection’.
Implications: Recommendations are made that a package of support should be offered to all kinship carers by social care. Clinical psychologists should support this group at individual and systemic levels, by providing individual therapy, working closely with social care staff, and impacting policies. Future directions of research are also discussed
Critical incidents: prevention and post-vention
Get PDFIt is important to gain better understanding of suicide-related training, given its potentials in contributing to national aims of reducing suicide mortality. This paper aims to critically appraise existing literature to examine the effectiveness of suicide-related training offered to healthcare workers in pre-qualification training (HCWs-PT). A systematic literature search was conducted across four electronic databases, MEDLINE, PsycArticles, PsycInfo, and
PTSDpubs, using four search criteria linked with Boolean AND. Fourteen papers meeting inclusion criteria for the review were identified. Study findings were grouped by themes, which is informed by training outcomes measured in studies, and examined: knowledge, skills, application of skills, self-efficacy, preparedness to cope following patient suicide, and
training experience. While no conclusion could be drawn due to the lack of homogeneity of papers, this review adds to an existing systematic review of suicide-related training delivered to nursing students, and preliminarily suggests that suicide-related training may support the development of competence for HCWs-PT across various disciplines. Methodological limitations of the current literature, and implications for practice and future research are
discussed
Experiences of intensive treatment settings for people with eating disorders
Get PDFEating disorders (EDs) are complex mental health difficulties that impact the individual, their supporters and society. Increasing numbers are being admitted into intensive treatment (i.e., inpatient, day-patient or acute medical settings). The lived experience perspective of what helps and hinders ED recovery during intensive treatment is an emerging area of interest. This review explored clients’ perspectives of what helps and hinders ED recovery during intensive treatment. A systematic literature search and quality appraisal yielded 30 published studies for inclusion. Thematic synthesis generated six themes; collaborative care; intensive environment; negotiating identity; focus on mind and body; specialist support; and support from others. This review identified that a person-centred, biopsychosocial approach is necessary throughout treatment, with support from a sufficiently resourced and adequately trained multidisciplinary team. Improving physical health remains fundamental, though psychological support is also essential to understand what causes and maintains the ED and facilitate a shift away from an ED-dominant identity. Carers and peers who instil hope and offer empathy and validation are valuable sources of support. Future research should explore what works best for whom and why, evaluating patient- and carer-focused psychological interventions and dietetic support, and should explore how to mitigate against potential harm during intensive treatment
Self-disclosure and disordered eating in inflammatory bowl disease (IBD)
Get PDFIntroduction: As Inflammatory Bowel Disease (IBD) is an invisible illness, individuals must make decisions around self-disclosure. Existing reviews have identified stigma as a barrier to disclosing IBD, however, other factors potentially affecting disclosure decisions have not been reviewed. The current review sought to synthesise qualitative papers exploring the experiences of disclosure, and identify facilitators and barriers to disclosure, within IBD. Methods: A systematic review across five databases was completed. In total 1487 papers were identified, with 34 (comprising 1004 participants) being included in analysis. Following critical appraisal, a thematic meta-synthesis was completed. This review was registered with The International Prospective Register of Systematic Reviews (PROSPERO; registration ID CRD42023481441). Results: A total of five main themes were identified: It’s an invisible, stigmatized illness; Reluctance to disclose; A need to disclose; Balancing the need to disclose and the reluctance to disclose; and Varied consequences to disclosure. Conclusions: This review synthesised the varying experiences of disclosures for individuals with IBD and highlighted the complexity of disclosure decisions, with these decisions being influenced by personal beliefs, social contexts, and previous experiences. In support of previous reviews, individuals identified the role of stigma in preventing self-disclosures. Potential clinical implications, the impact for public health services, and the need for future research is discussed
Teachers’ use of questions and the science – religion encounter: Basil Bernstein and the impossibility of the unthinkable
No full textThis article examines the teaching of creation in a year six and a year three Religious Education (RE) class in schools in the south of England with a focus on the type and role of teacher questioning in relation to classroom discussions. The nature of knowledge, curriculum content and the relationship between RE and other subjects is currently under scrutiny and there is an ongoing debate about the negative effects of presenting science and religion as epistemically siloed. This paper presents an analysis of the way two teachers in two primary schools used questions to frame the relationship between science and religion where the aim was to minimise the polarisation of religion and science. Using Bernstein’s idea of the pedagogic device and the related notions of frame, classification and the unthinkable the analysis suggests that teachers employed both visible and invisible pedagogies that limited the diversity of ideas that were considered legitimate in discussions, and which therefore influenced the nature of pupil questions and responses. We suggest that despite attempts by both teachers to diminish the strong boundaries between different types of knowledge their use of questions serves to reinforce them
An international survey of the diagnosis and management of Ménière's disease amongst otolaryngology consultants
Get PDFMénière's Disease (MD) is a disease that may be difficult to diagnose and manage. Our UK survey showed variability in the practice of UK Otolaryngology consultants. We hence surveyed Otolaryngology consultants internationally, to assess their confidence levels in diagnosing MD, their use of the AAO-HNS guidelines and current diagnostic and treatment modalities. An online questionnaire was distributed internationally over four weeks. The questionnaire asked respondents to anonymously rank their confidence in diagnosing MD, identify the minimum investigations required to make a diagnosis, describe their use of the AAO-HNS criteria, share their preferred treatment modalities for acute attacks, and state their 1st and 2nd-line preventative treatment options. A total of 173 responses were collected with 77% of respondents reporting high levels of confidence in diagnosing MD. Most respondents stated the minimum tests required were "History, Otoscopy, Clinical Vestibular testing, and Pure Tone Audiometry" although some chose as few as 1 test. Regarding the use of the AAO-HNS criteria, responses ranged from "always" (20.2%) to "never" (22.5%). Cinnarizine was the first-line treatment for acute attacks followed by betahistine. Betahistine (30.1%) and dietary restrictions (28.3%) were recommended almost equally as first-line preventative measures. The most popular second-line measure was intratympanic steroids injection (30.1%). Our survey revealed disparities in the diagnosis of MD and its management, like the results of our previously conducted UK survey. This suggests the need for an international consensus regarding the diagnosis and subsequent management strategies for this disease
Data security and governance in multi-cloud computing environment
Get PDFThe adoption and integration of a multi-cloud computing environment for data transmission and storage is a crucial step for organizations, offering optimization, redundancy, and increased accessibility. However, this transition has also brought about significant security challenges, vulnerabilities, and attack vectors. These include inefficient resource management across diverse cloud providers, interoperability issues, identity and access management concerns, unauthorized access, data governance, and operational optimization. These challenges have led to various types of attacks, such as supply chain attacks, data breaches, DoS, APTs, and cross-cloud attacks. This paper delves into the growing complexities of securing multi-cloud environments, specifically focusing on governance and security implications. It also evaluates the effectiveness of multi-cloud management tools, such as Azure Arc and Google Anthos, in addressing these challenges. The contribution of this paper is threefold. First, we thoroughly investigate the various multi-cloud data storage mechanisms, vulnerabilities, and attacks. Secondly, we compare three prominent multi-cloud management tools, Azure Arc, Google Anthos, and AWS Elastic Kubernetes Service (EKS), regarding their ability to secure resources across diverse cloud providers. Finally, we conduct an attack on the multi-cloud platform to detect vulnerabilities and operational inefficiencies and propose security mechanisms to enhance security. Our results demonstrate how data security and governance can be effectively implemented to secure multi-cloud operation environments and how inefficiencies can be detected and addressed to ensure data security
Provision and accessibility to primary care services for immigrants experiencing homelessness in England: a sequential exploratory mixed method study
Get PDFBackground
Immigrant communities, like refugees, asylum seekers, and irregular immigrants, encounter unique health challenges, contributing to their suboptimal well-being. Accessing primary care services (PCS) is particularly challenging and exacerbated by homelessness. Research on homeless immigrants' access to PCS in the UK is a notable knowledge gap.
Aim
To investigate the perspectives and experiences of immigrants facing homelessness, along with stakeholders who provide and facilitate access to PCS. The research also identified priority strategies for enhancing access to PCS.
Methods
A sequential exploratory mixed-methods research design with two phases was used. The qualitative phase, guided by the Levesque framework of healthcare access and an intersectionality lens, preceded the quantitative phase (Delphi surveys). In-depth, semi-structured interviews were conducted with 30 homeless immigrants and 30 stakeholders. Data were organized in Nvivo 12 software and thematic analysis was conducted. The quantitative phase utilized a two-round Delphi approach to identify priority strategies for improving access to PCS. The top ten strategies were determined through participant rankings using a 5-point Likert scale. Twelve stakeholders participated in the Delphi surveys. Data analysis was conducted using STATA-15 software.
Findings
Dominant themes included low health literacy, language barriers, cultural norms, mistrust, fear of deportation, healthcare-related costs, long waiting times, partner violence, digital exclusion, inadequate culturally sensitive healthcare, competing priorities, and discrimination. The impact of the COVID-19 pandemic and accommodation instability were also identified. Alternative health-seeking approaches like self-medication and the use of emergency services were common. The three most prioritized strategies from the Delphi surveys were fighting discrimination and prejudice, improving mental health services, and empowering homeless immigrants on their rights to healthcare.
Conclusion
This study highlighted significant inequalities in access to PCS among homeless immigrants in the UK. This stresses the need to address systemic inequalities and their drivers in this sub-population. The top strategies identified may offer initial solutions to address healthcare inequalities. This study expands the understanding of immigrant experiences in accessing PCS by including a focus on homelessness