687 research outputs found
[Oldbury Farm, Berrima, New South Wales, November 2000] [picture] /
No full textTitle devised by cataloguer based on information supplied by vendor.; Part of Historic Australian homesteads and gardens, 1994-2000 collection.; Condition: good. 'Oldbury Farm stands at the foot of Mount Ginnenbullen near Berrima and was built in 1828 for James Atkinson, author of the 1826 book Account of the State of Agriculture & Grazing in New South Wales. ... Photographed November 2000 [Berrima, N.S.W.]'--Trisha Dixon
Primary Health Care: Theory and Practice
No full textGeneral practitioners and other primary care professionals have a leading role in contemporary health care, which Trisha Greenhalgh explores in this highly praised new text. She provides perceptive and engaging insights into primary health care, focussing on: • its intellectual roots • its impact on the individual, the family and the community • the role of the multidisciplinary team • contemporary topics such as homelessness, ethnic health and electronic records. Concise summaries, highlighted boxes, extensive referencing and a dedicated section on effective learning make this essential reading for postgraduate students, tutors and researchers in primary care. From the foreword by Julian Tudor Hart "Trish Greenhalgh, in her frequent columns in the British Medical Journal...more than any other medical journalist spoke to her fellow GPs in the language of experience, but never without linking this to our expanding knowledge from the whole of human science. When I compare the outlines of primary care so lucidly presented in this wonderful book, obviously derived from rich experience of real teaching and learning, with the grand guignol theatre of London medical schools when I was a student 1947-52, the advance is stunning." "Trish Greenhalgh is one of the international stars of general practice and a very clever thinker. This new book is a wonderful resource for primary health care and general practice. Every general practice registrar should read this book and so should every general practice teacher and primary care researcher." Professor Michael Kidd, Head of the Department of General Practice, University of Sydney and Immediate Past President of The Royal Australian College of General Practitioners "This important new book by one of primary care's most accomplished authors sets out clearly the academic basis for further developments in primary health care. Health systems will only function effectively if they recognise the importance of high quality primary care so I strongly recommend this book to students, teachers, researchers, practitioners and policy makers." Professor Martin Marshall, Deputy Chief Medical Officer, Department of Health, UK. © 2007 Trisha Greenhalgh
Editorial Note: The book review as "performance"
No full textThe growth of the Internet presents challenges to knowledge transfer; such knowledge is formed contextually and dialogically, a negotiated discursive construct that is created between people. The editorial makes a case for book reviews and review essays which are auto-ethnographic, "performative" and critical. The shift to a more dialogic exploration of emergent knowledge through the book review as social discourse is discussed. The essence of qualitative research itself is explored as the bedrock of book reviews. Reviews are considered as polyvocal attempts at interfacing with cultural/relational/linguistic accounts of the real. A narrative approach to reporting on reviewed books is encouraged, permitting authors to reveal themselves in the relationships presented through their writing. A case is made that a phenomenological approach to writing reviews would be more interested in the person who writes than in the act of writing itself.
It is through the creative representations of the reviewed book that reviewers can fashion their own individual Gestalt or worldview woven from the writing under review. The report itself mediates between researcher/writer and reviewer/reader. Such an approach opens up opportunities to write book reviews "performatively". Finally, reviewers are encouraged to create both a dialogue with the author under consideration as well as with their reader
Small Data and Big Data in the Waves of the Pandemic Building the Boat as we Sailed it
No full textThe pandemic hit the research world like a cannonball. ‘Normal’ ways of working and methodological approaches became impossible overnight, but the world desperately needed high-quality research to inform urgent policy decisions. This presentation will describe how one research team mobilised to undertake hypothesis-generating qualitative research (“small data”) to inform a major prospective study of acute COVID symptoms in over 10,000 patients (“big data”). The standard research timelines were upended and governance processes suspended. Nevertheless, some degree of rigour was achieved. In this keynote from the 2021 Research Methods e-Festival, Professor Trisha Greenhalgh reflects on lessons learned from high-stakes research at the interface between health and social care at this time of crisis
Narrative based medicine: narrative based medicine in an evidence based world
No full textSummary points: Even "evidence based" clinicians uphold the importance of clinical expertise and judgment. Clinical method is an interpretive act which draws on narrative skills to integrate the overlapping stories told by patients, clinicians, and test results. The art of selecting the most appropriate medical maxim for a particular clinical decision is acquired largely through the accumulation of "case expertise" (the stories or "illness scripts" of patients and clinical anecdotes).The dissonance we experience when trying to apply research findings to the clinical encounter often occurs when we abandon the narrative interpretive paradigm and try to get by on "evidence" alone
Quantifying the risk of type 2 diabetes in East London using the QDScore: a cross-sectional analysis
No full textBackground: risk scores calculated from electronic patient records can be used to predict the risk of adults developing diabetes in the future.Aim: to use a risk-prediction model on GPs’ electronic health records in three inner-city boroughs, and to map the risk of diabetes by locality for commissioners, to guide possible interventions for targeting groups at high risk.Design and setting: cross-sectional analysis of electronic general practice records from three deprived and ethnically diverse inner-city boroughs in London.Method: a cross-sectional analysis of 519 288 electronic primary care records was performed for all people without diabetes aged 25–79 years. A validated risk score, the QDScore, was used to predict 10-year risk of developing type 2 diabetes. Descriptive statistics were generated, including subanalysis by deprivation and ethnicity. The proportion of people at high risk (?20% risk) per general practice was geospatially mapped.Results: data were obtained from 135 out of 145 general practices (91.3%); 1 in 10 people in this population were at high risk (?20%) of developing type 2 diabetes within 10 years. Of those with known cardiovascular disease or hypertension, approximately 50% were at high risk. Male sex, increasing age, South Asian ethnicity, deprivation, obesity, and other comorbidities increased the risk. Geospatial mapping revealed hotspots of high risk.Conclusion: individual risk scores calculated from electronic records can be aggregated to produce population risk profiles to inform commissioning and public health planning. Specific localities were identified (the ‘East London diabetes belt’), where preventive efforts should be targeted. This method could be used for other diseases and risk states, to inform targeted commissioning and preventive researc
Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study
No full textObjective To explore ethnic stereotypes of UK medical students in the context of academic underachievement of medical students from ethnic minorities.Design Qualitative study using semistructured one to one interviews and focus groups.Setting A London medical school.Participants 27 year 3 medical students and 25 clinical teachers, purposively sampled for ethnicity and sex.Methods Data were analysed using the theory of stereotype threat ( a psychological phenomenon thought to negatively affect the performance of people from ethnic minorities in educational contexts) and the constant comparative method.Results Participants believed the student- teacher relationship was vital for clinical learning. Teachers had strong perceptions about "good" clinical students ( interactive, keen, respectful), and some described being aggressive towards students whom they perceived as quiet, unmotivated, and unwilling. Students had equally strong perceptions about "good" clinical teachers ( encouraging, interested, interactive, non- aggressive). Students and teachers had concordant and well developed perceptions of the "typical" Asian clinical medical student who was considered over- reliant on books, poor at communicating with patients, too quiet during clinical teaching sessions, and unmotivated owing to being pushed into studying medicine by ambitious parents. Stereotypes of the "typical" white student were less well developed: autonomous, confident, and outgoing team player. Direct discrimination was not reported.Conclusions Asian clinical medical students may be more likely than white students to be perceived stereotypically and negatively, which may reduce their learning by jeopardising their relationships with teachers. The existence of a negative stereotype about their group also raises the possibility that underperformance of medical students from ethnic minorities may be partly due to stereotype threat. It is recommended that clinical teachers be given opportunities and training to encourage them to get to know their students as individuals and thus foster positive educational relationships with them
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