bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the quality of primary care through tailored interventions and customizable software linked to electronic medical records
Authors: Treweek S. , Flottorp S. , Oxman A.
Published: April 2009

The principal information system used in Norwegian primary healthcare - the electronic medical record (EMR) - is a rich but underused source of data for quality improvement purposes.

This paper describes two systems that aim to make better use of the EMR. First, ‘Best Possible Practice’ provides general practitioners with online support for the treatment of urinary tract infections and sore throats, tailored to the patient via the EMR. The second system, ‘QTools’, will allow health professionals, researchers and others to create a wide range of quality improvement tools.

Studies with both systems are under way. Early results from ‘Best Possible Practice’ provide information on antibiotic use, use of laboratory tests and use of telephone consultations. These data will be used to assess the ability of the system to change the behaviour of health professionals. ‘QTools’ is under development but several elements of the system are in place, primarily a flexible data extraction tool.

EMR systems offer many possibilities for quality improvement systems tailored to individual patients. Although working in this area is a challenge, such systems have the potential to chart and change practice at the local, regional and national levels.
Knowledge management in evidence-based healthcare: issues raised when specialist information services search for the evidence
Authors: Fennessy G.
Published: April 2009

Knowledge management is in many ways a new paradigm in healthcare. This paper discusses how knowledge-management problems arising in evidence-based practice can be explored using ‘soft systems methodology’ and action research. An information centre working exclusively in evidence-based practice is used as a case study to explore how work teams and systems can be better utilized to provide clinical effectiveness information for busy healthcare practitioners.
An evaluation of a basic life support CD-ROM
Authors: Moule P. , Gilchrist M.
Published: April 2009

The faculty has developed a basic life support (BLS) CD-ROM as part of a staff development project across the UK’s south west region’s universities. The introduction of the BLS CD-ROM to the faculty represents a paradigm shift, from the former method of delivering an acetate-based BLS lecture to groups of students across the professional disciplines. It is the intention that all students and staff requiring BLS instruction, should access the CD-ROM to gain and test essential theoretical knowledge, and have an opportunity to observe best practice through video demonstrations. The production of the BLS CD-ROM meets many of the current National Health Service and Higher Education agendas, with the potential for learning to take place in clinical environments and for developing key transferable skills. The tool can also be used to achieve the requirements for multi-professional education.

This presentation introduces the evaluative testing by questionnaire of the beta version of the CD-ROM, using a convenient sample of 26 Diploma nursing students, adult branch. The results identify changes needed before implementation of the CD-ROM as a learning tool across all pre- and post-qualified professional groups.

The students particularly valued the opportunity to learn at their own pace, and the use of critical thinking scenarios, which enhanced their learning. A small number of technical and presentational errors were identified for correction. Students also made suggestions for other improvements and further developments of multimedia learning materials.

While this enthusiastic appraisal is acknowledged, the current paucity of research demands that the faculty continues to evaluate the use of the CD-ROM when fully implemented. This research will be used to inform further developments of multi-media learning materials.
Telecare in practice: a telecare initiative focusing on carers of older people based on Action
Authors: Emery D.
Published: April 2009

There is a continual need to support and assist carers who play a central role in providing informal care for a relative. This approach to care provision must have a strong foundation based on liaison between the family carers, professional carers and the older or disabled person who is the focus of care. Services that enable effective communication using videoconferencing, interactive communication, tailored Web based programs and other specific resources configured for the needs of the individual can help carers carry out their role effectively. The initiative described in this paper uses a combination of telematic focused interventions to meet the needs of carers and provides an in-depth overview of the ACTION telecare project.

The ACTION (Assisting Carers using Telematic Interventions to meet Older persons’ Needs) project was set up and funded because of the need to develop supportive methods for carers and older people. The initiative was designed to improve autonomy and maintain independence and quality of life for people in their own homes and therefore reduce the need for institutional care. This has an economic as well as a social dimension. The project has demonstrated that with the involvement of users at all levels it can fulfil this need. The role of the ACTION project was to develop a cost-effective telecare system for the provision of education, information and support and has been demonstrated with successful results.
Evaluation of the use of videoconferences for healthcare planning
Authors: Grundén K.
Published: April 2009

The use of Computer Supported Co-operative Work (CSCW) systems in general involves complex informal communication between multiple users at different geographical locations. An evaluation strategy for such systems has to be complex and focus especially on their organizational and social aspects. The MOA-E model is used for the evaluation of the use of videoconferences in healthcare planning. The case study has a multi-method approach and uses participatory observation, interviews and a questionnaire. If the patients are not well enough then face-to-face meetings are found more appropriate than video-conferences for healthcare planning. The case study may be seen as a ‘critical case’ for the use of videoconferences with elderly people. The MOA-E model has contributed to a comprehensive understanding of the case study.
A model-based framework for assessing the value of ICT-driven healthcare delivery
Authors: Cramp D. G. , Carson E. R.
Published: April 2009

New developments in information and communications technologies are increasingly being proposed as technological enhancements to healthcare delivery. However, if the full potential of such technological advances is to be realized from a clinical perspective, it is vital that proper methodology is in place to facilitate the assessment and evaluation of such proposed solutions in order to maximize the benefit which technology can offer. In this paper it is proposed that a model-based framework should provide the underpinning evaluative methodology. Candidate models are proposed. The applicability of this modelling approach is considered in the context of a recently developed prototype service for the telematic delivery of home and satellite haemodialyis in the management of end-stage renal disease.
Using electronic medical records to evaluate healthcare interventions
Authors: Treweek S. , Flottorp S.
Published: April 2009

Successive Norwegian governments have introduced a number of health reforms that aim to make better use of resources while improving patient care. One of the most recent reforms, the Regular General Practitioner (GP) Scheme, will introduce a general practitioner patient list system across Norway.

The government plans an evaluation of this reform. One project within the evaluation will develop a system for the collection of ‘activity data’ within primary healthcare. The intention is that these data will give an overview of what is happening within the primary healthcare sector and facilitate planning of services. Routine data stored in GPs’ electronic medical record systems (EMRSs) will be the major source of this activity data. Indeed, collection of these activity data may become a permanent feature of primary healthcare monitoring in Norway.

This paper presents one method for obtaining these data and gives examples of the sort of data that are available in the EMRS. Finally, the paper discusses some of the problems that may be encountered when using EMRS data for evaluations of healthcare interventions. The greatest challenges in this field are unlikely to be technical or organisational, but human. In other words, what is the best way to encourage GPs to collect high quality data
Contexts for collaboration in healthcare education
Authors: Alpay L. L. , Littleton K. S.
Published: April 2009

In recent years, the drive towards cost-effectiveness and efficiency, coupled with radical changes in healthcare education, have resulted in an increased need for collaboration, both at the interpersonal and institutional levels. Such collaborations were once regarded primarily as pragmatic ventures. Increasingly, however, there are reports of these collaborations yielding tangible benefits, both in terms of curriculum innovation and reconceptualization of the educational process.

This paper draws upon some recent examples from the literature to examine the nature of collaborative partnerships in healthcare education. In particular, it discusses the development of collaborative practices and identifies diverse contexts (such as the sharing of resources and the integration of computer technologies in the curriculum) in which these practices evolve. This paper brings to the front changes that are triggered by collaborative initiatives, and highlights lessons learned for successful collaborations.
WAP-based personalized healthcare systems
Authors: Koutkias V. G. , Meletiadis S. L. , Maglaveras N.
Published: April 2009

In this paper a prototype system for personalized healthcare delivery is presented. The system involves monitoring and education services, designed specifically for people suffering from chronic diseases such as diabetes mellitus. Adaptation to every patient’s special requirements was kept in mind, in order to achieve personalization of the service provided. The technological platform adopted for implementing the service is the Wireless Application Protocol (WAP™), an emerging technology between the two most dynamically evolving communication mediums, the Internet and wireless communication networks. The fundamental idea behind this innovative system lies in the fact that by delivering customized to the special patients’ needs healthcare systems, a more flexible and efficient way of dealing with some kind of diseases may be provided. More precisely, adopting monitoring facilities by following a condition report process in a regular time base, healthcare delivery may become more prosperous. In the long term, clinical patterns useful for better diagnosis results may be extracted, by applying data-mining techniques on the data collected by the service. Thus, embodying such types of system in the demanding healthcare delivery domain can promise continuity of care, advanced quality of services, increased patient satisfaction and a more effective approach to disease management.
System issues for telemedicine systems
Authors: Fitch C. J. , Briggs J. S. , Beresford R. A.
Published: April 2009

This paper extends the discussion introduced at SHIMR 2000 regarding principal issues that influence the technical aspects of systems. It sets out how some of these issues, or ‘ilities’, apply to telemedicine systems used to support home monitoring.

Although most of us know broadly what is meant by the various terms used to described provision of care at a distance, this paper also introduces a taxonomy of the various telemedicine systems which is used to assess the degree to which these ilities apply to the different telemedicine implementations. The reason for this is that not all ilities apply in equal measure to all telemedicine solutions.

The paper looks at the degree to which the ilities apply to systems used to support home monitoring. In the same manner as the previous paper [1], it aims to aid understanding by proposing the questions that need to be asked and answered and so aid the design and development of successful telemedicine solutions.
Healthcare information standards: comparison of the approaches
Authors: Spyrou S. S. , Bamidis P. , Chouvarda I. , Gogou G. , Tryfon S. M. , Maglaveras N.
Published: April 2009

Electronic transfer of healthcare record information between heterogeneous systems raises the need for healthcare information standards. Such standards improve the level of quality that healthcare organizations offer and also control the expenditure on healthcare services provided by these organizations. There are a large number of healthcare related applications that effectively support specific needs but are isolated or incompatible. There is an urgent need to integrate those applications or to interoperate between them, ensuring security concepts. The cost is another crucial aspect that should be considered in the integration of already implemented systems and the design of new systems. This paper aims to give a description of the current developed standards that can be used to provide interoperability in healthcare information systems and to make a short comparison between these standards, including the following: HL7, HL7’s CCOW, CEN/TC251 Healthcare Information System Architecture Standard. This paper also discusses a solution that is being developed in the Citizen Health System (CHS) project to achieve integration of data using a healthcare informatics standard. A test scenario to make some of the project’s modules visually interoperate is also implemented.
Qualitative health research via the Internet: practical and methodological issues
Authors: Murray C. D. , Sixsmith J.
Published: April 2009

Electronic mail (email) has become a ubiquitous form of global communication. Much of this discourse concerns the experience of health and illness. As it is stored and accessible via the Internet, it is then available for qualitative analysis by health researchers. In particular, researchers can employ document analysis methods using Internet communication such as email posts and archives. This paper outlines ways in which such research could proceed, including locating potential research sites and collecting and analysing data. In addition, the advantages and disadvantages of using documentary analysis of Internet communication in qualitative health research are explored.
Acceptability of medical digital libraries
Authors: Adams A. , Blandford A.
Published: April 2009

Evidenced-based medicine has increased the importance of quick accessibility to reputable, upto-date information. Web-accessible digital libraries (DLs) on the wards can address the demand for such information. The use and acceptability of these resources has, however, been lower than expected due to a poor understanding of the context of use. To appreciate the social and organizational impacts of ward-accessible DLs for clinicians, results of a study within a large London-based hospital are presented. In-depth interviews and focus groups with 73 clinicians (from pre-registration nurses to surgeons) were conducted, and the data analysed using the grounded theory method. It was found that clinical social structures interact with inadequate training provision (for senior clinicians), technical support and DL usability to produce a knowledge gap between junior and senior staff, resulting in information – and technology – hoarding behaviours. Findings also detail the perceived effectiveness of traditional and digital libraries and the impact of clinician status on information control and access. One important conclusion is that increased DL usability and adequate support and training for senior clinicians would increase perceptions of DLs as support for, rather than replacement of, their clinical expertise.
Why are we waiting? How poor information systems increase hospital queues
Authors: Lederman Reeva
Published: April 2009

In this paper, we examine the data delivery process in the neurology department of a large public hospital and consider whether information systems failure contributes to queuing in hospitals. This is a particularly important issue given the pressures worldwide on governments to provide funding to reduce hospital queues. What we find in this research is that, where data are lost or delayed in a system, queues for service increase. In systems where data are distributed manually or in a semi-automated fashion, a search for lost data can extend beyond one week. This can cause service queues to increase disproportionately to the time spent searching for the data and have a dramatic impact on all stakeholders in the hospital system.
The standard generalized markup language for electronic patient records
Authors: Roberts A.
Published: April 2009

A pilot study at the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK, examined the use of the Standard Generalized Markup Language (SGML) for electronic patient records. Seven hundred patients had their text records encoded in SGML and 14 of these patients had legacy, laboratory and other data included. Records were incorporated in a commercial SGML database to demonstrate in-context searching. A commercial SGML browser allowed rapid access to clinical events in large records.

A study of comparative file sizes between formats was performed. The acceptability of electronic records was assessed with clinicians. Specifications for the system are discussed and the relationship with traditional technologies explained. SGML represents a suitable format for the manipulation and publication of electronic patient records.
Digital patient assistants: privacy vs cost in compulsory health insurance
Authors: Bleumer G. , Schunter M.
Published: April 2009

Many countries have a compulsory health insurance system. Compulsory health insurers charge income-related fees as opposed to private health insurers who charge risk-related fees. Compulsory health insurance is based on solidarity among policy holders and can give them more privacy than any private health insurer can. As an example, the present paper considers the German health insurance system, and discusses how the charging and clearing of medical services can be implemented so as to support both the legitimate privacy interests of patients and physicians and the health insurer’s interest to control the overall cost. A cryptographic solution is presented that is based on digital patient assistants, that is, personal palmtop computers, organizers or personal digital assistants (PDAs). Patients are, therefore, able to manage their own health insurance certificates, referrals and prescriptions. Although still too expensive for large-scale introduction, digital patient assistants have a number of significant advantages over any chip-card or paper-based system: (1) significantly more efficient and reliable data communication between the various health-care providers involved in treatment; (2) real patient privacy through direct and off-line communication between digital patient assistants and physicians’ practices; and (3) a huge potential to develop telemedicine in a privacy oriented way. Finally, one possible implementation is presented in more detail. The paper also shows how compulsory health insurers can use this solution to control their overall costs.
From security to trust
Authors: Carter M.
Published: April 2009

The use of information technology for information management in healthcare is fundamentally about facilitating the holding of much more comprehensive data on people throughout the health system. More comprehensive health information obviously creates the potential for greatly improved health-care. At the same time, however, it raises concerns about the amount of information about individuals flowing through the system. This information has the potential not only to benefit the community but also to be used in ways which are discriminatory or otherwise harmful. This paper argues that if the potential of information technology to benefit information management in health-care is to be realized, there must be a shift in the culture of the health sector, to one which has a far greater emphasis on consumer privacy than is presently evident.
Protecting the identity of doctors in drug prescription analysis
Authors: Matyás° V.
Published: April 2009

This paper describes work undertaken to assure the privacy of doctors in a system that enables some other parties to analyse prescription information at a reasonably detailed level. The task was to determine what ‘reasonably’ should mean. The paper outlines the risks to the privacy of doctors, which were identified during fieldwork and data analysis. The measures chosen to safeguard the identity of doctors when they do not explicitly give consent for it to be known are then described. Although the paper concentrates on technical measures, some relevant organizational and contractual issues are also mentioned.
Nursing information for electronic clinical exchange (NIECE)
Authors: Ballard E.
Published: April 2009

The value of clinical nursing information is not just within professional care delivery, but as a source for educational and professional development for practitioners. At the core of this argument is the informative connection nurses make through discussion, questioning and reflecting together. Nurses contribute to the production of much healthcare information; there is a danger, however, of their own expert information and knowledge being subsumed.

There are ways to move forward: through facilitating the capture of nursing’s ‘professional’ information, organizing a nurses’ system, and establishing a nursing information electronic clinical exchange. This ‘living’ encyclopaedia would revalue knowledge and experience and support professional information development for the benefit of healthcare delivery.

The issue for nurses becoming involved in electronic information exchange is the need for support from their healthcare organizations to facilitate professional networking. A nurses’ information system needs to be ‘open’, though managed within a ‘closed’ organizational environment. Informal networking does not serve the purpose of exchanging ‘professional’ information at the workface. This demands new approaches.

Worldwide healthcare professions are examining ways in which communication can be more effective and the electronic networking of a nurses’ information system is right for this age in healthcare.
Using administrative data for primary care research: the City and East London General Practice Database Project
Authors: Naish J. , Moser K. , Sturdy P. , Carter Y. H.
Published: April 2009

The City and East London General Practice Database Project was launched in 1992 to provide a framework for describing and understanding the nature of general practice in east London using routinely available administrative data from all practices in the area. It has provided an opportunity to use information on practices for research, health planning and policy, and for educational purposes. The project differs from others because it allows description in detail, clarity and depth in three distinct ways. Firstly, by covering all practices, and not just a select group, it is possible to investigate intra-health authority variability. Secondly, it has taken into account social and demographic characteristics of the practice populations, so making it possible to examine practice outputs in relation to population deprivation. Thirdly, in time, analyses using a combination of patient outcomes, morbidity information and longitudinal data become possible, making it an even more powerful information base for commissioning.
Developing and implementing a clinical patient information system: a mental health perspective
Authors: Sheridan A. J. , Corcoran M.
Published: April 2009

The Hospitaller Order of St John of God is involved in providing health, educational and social services to people with mental health problems and learning difficulties in the Republic of Ireland. As part of its development plan the Order is engaging in the development of a comprehensive Mental Health Information System encompassing both community and hospital-based services. This system is being developed by local practitioners with the assistance of an external facilitator.

The Order is also extensively involved in developing legal and ethical protocols to ensure the system meets all requirements of data protection legislation both nationally and at European levels.

Within the overall system, the nursing component is the first part to have been operationalized and some initial evaluation of its efficacy has been conducted. The purpose of this paper is to present the work of the nursing department at St John of God Hospital, Dublin, in the development, implementation and initial evaluation of a computerized patient information system.
Informal communications networking among health professionals: a study of gp-uk
Authors: Thomas R. E. , James S. D.
Published: April 2009

The use of electronic mail (email) has increased greatly over the last few years, not only in the wider world but also within the medical community, particularly in the general practitioner (GP) sector. Email discussion lists have proliferated, and this study looks at one month’s postings from such a list (gp-uk) through author and content analyses, and assesses its value as considered by members of the discussion list. A general overview shows that, although classified as an academic list, the use is more of a ‘buddy’ support network given over to general chat and humour, as well as providing almost instant worldwide opinion and information on practice. Given the professional background of the membership, a surprising finding is the fact that clinical discussion does not figure as the highest valued aspect of the discussion list: that position is taken by its humorous aspects. The overwhelming benefit offered through the use of gp-uk is the access to like-minded professionals worldwide who have taken to the advantages of computer networking technology and computer-mediated communication (CMC).
Testing headings for communicating the personal health record: comparison from the recipients’ perspective
Authors: Bowns I. R. , Newton P. , Long S. , Walters S. , Rector A. , Conway J. V.
Published: April 2009

In the spring of 1998, 16 general practitioners and 16 community psychiatric nurses participated in a study to test a draft set of headings for communicating clinical summaries. Eight anonymized psychiatric discharge summaries were used to assess the impact of the presentational format on the time taken by professionals to read the summaries and to answer a series of standard questions about each of them. Respondents also completed a questionnaire on their opinions of the headings. There was considerable variation between individuals in the times taken to read the summaries and answer the questions, but no evidence that any of the formats was associated with decreased reading time or with improvement in retrieving information. Most respondents preferred information structured using the headings rather than the original semi-structured discharge summaries, and information on paper rather than on computer screen.

Respondents were guardedly supportive of the particular draft headings presented. A weak preference was expressed for locally defined headings, with some recognition of advantages in widely agreed headings. There was a view that there were too many headings, and there was overlap between specific heading pairs (for example, ‘aim’ and ‘goal’). Concerns were expressed about specific headings, particularly the ‘softer’ headings, such as ‘informing’ and ‘communicating’.
The Leicestershire fracture index
Authors: Brown T. P. , Kirby D. , McGrother C. M. , Donaldson M. K. , Harper W. M.
Published: April 2009

The aim of the Leicestershire Fracture Index is to bring together data from routine sources: inpatient, outpatient and A&E, into a single patient-centred database and in so doing promote the use of outpatient systems. The index should then be able to provide accurate information on incidence and outcomes and hence be a reliable foundation for audit, a basis for estimating needs and activities and a sampling frame for research. The development is particularly timely in view of the increased sophistication of contract specification with a move from simple speciality totals to detailed service provision and the introduction of effectiveness and outcome measures for outpatient services.
Have the completeness and accuracy of computer medical records in general practice improved in the last five years? The report of a two-practice pilot study
Authors: Thiru K. , de Lusignan S. , Hague N.
Published: April 2009

Through its involvement in primary care groups (PCGs) general practice is destined to play a major role in the commissioning of UK National Health Service (NHS) services. If this objective is to be achieved then data will be required at PCG level from electronic patient records (EPRs). The aim of this study was to examine the completeness and accuracy of GP computer records over the last five years in two computerized practices. The objectives were: to establish whether data recording has improved; to discover whether cross-platform data extraction using MIQUEST (Morbidity Information Query Export Syntax) has advantages over the different in-system search tools provided in the EMIS and Meditel systems in our pilot practices; and to suggest how the potential of GP databases to be sources of valid data might be realized.

We have demonstrated that high standards of data quality can be achieved in general practice and that there are benefits in using the cross-platform data extraction tool MIQUEST. While being vigilant of coding practices that may introduce systematic errors, data extractors should focus on data validation. We surmise that there are both human and technical barriers to achieving high quality data recording that need further research.
Microfinance and the commercial banking system
Authors: Knight Tonya , Hossain Farhad , Rees Christopher J.
Published: April 2009

By adopting microfinance as a core component in their development aid programmes, non-governmental organizations (NGOs) and other development groups aim to reduce poverty and also, raise the status of women and disadvantaged communities. Nevertheless, despite its enormous success in tackling poverty, the applicability of microfinance in formal banks remains a major challenge for developing countries where most of the world's poor reside without access to banking facilities. The authors of this article posit that central banks and the banking sector, in general, can promote good and inclusive financial governance in developing countries by adopting microfinance practice and by integrating pro-poor policies into their banking systems. Focusing on the case of Barbados, the article examines the importance of microfinance for commercial banks. It is argued that the integration of microcredit into the banking and credit schemes of commercial banks and microfinance institutions is a key to promoting good governance.
Market-led ‘agrarian reform’ in Brazil
Authors: Sauer Sérgio
Published: April 2009

This article surveys the process of implementing the World Bank's market-led ‘agrarian reform’ model in Brazil and analyzes some of its consequences and effects. It places the model in a recent political context (the Cardoso administration, 1995–2002), explaining the opposition and criticism of land struggle movements and rural organizations. It questions the political and ideological arguments related to the model's persistence, particularly with regard to the decision to maintain the programme on the part of Luis Inácio Lula da Silva's administration after 2003.
Knowledge, Truth and Reflexivity
Authors: Taylor Carolyn , White Susan
Published: April 2009

• Summary: The authors argue that social work is as much a practical-moral activity as it is a technical-rational one. In order to pursue these themes, they explore the place of realist knowledge in social work and their alternative position on the complexities and ambiguities of practice.

• Findings: Social work has long been troubled by the adequacy of its claims to professional status and about its possession of appropriate levels of knowledge and expertise. The dominant responses to this have been managerialist and procedural, or rational and technical, as represented in the evidence-based practice movement. This article acknowledges the contribution of such approaches, but argues that they are unrealistic in that they fail to recognize the practical-moral dimensions of social work and the role of emotion and normative judgement in assessment and intervention.

• Applications: The problem of judgement is an essential area for exploration. The range of rationalities upon which social workers depend in making their judgements requires rigorous analysis and debate within the profession. This article opens up a discursive space in which to rethink our understanding of knowledge making in social work.
Female Juvenile Offenders Incarcerated as Adults
Authors: Pomeroy Elizabeth C. , Green Diane L. , Kiam Risa
Published: April 2009

• Summary: A pilot study was conducted which examined the development and implementation of a psychoeducational group intervention for young female offenders incarcerated in adult jail. The purpose of the group intervention was to reduce levels of depression, anxiety and trauma symptoms among the female juveniles. T-test analyses were utilized to examine differences between pre-tests and post-tests on the three outcome variables.

• Findings: Findings indicated that the group intervention may be effective in alleviating depression and trauma symptoms among young female offenders. No significant differences between pre-test and post-test were found for anxiety.

• Applications: Due to large caseloads and lack of mental health professionals in the jails and prisons in the United States, young offenders receive little or no mental health treatment when they are incarcerated in the adult jail system. The group intervention described in the current study holds promise for providing a cost-effective and efficient technique for delivering mental health services to this young population of offenders incarcerated in adult jail. If we are concerned about curbing the rising tide of violence among juveniles, we must develop innovative rehabilitation programs to meet the needs of this population of inmates in our jail and prison systems.
An International Social Work Perspective on Drug Misuse Problems and Solutions
Authors: Keene Jan
Published: April 2009

Summary: This article examines the problems facing social workers working with drug misusers throughout all modern societies and considers possible social work perspectives and solutions. It examines the limitations for social workers of internationally accepted medical and disease models of drug use and considers the implications of moving from medical to social work perspectives. To do this it clarifies the three main treatment models and reviews literature on their basic assumptions and effectiveness. It then examines the range of social and psychological problems associated with different types of drug misuse from a social work perspective and analyses the implications for social work practice.

Findings: The article concludes that whilst the relationship between social work and drug treatment is influenced by the dominant treatment philosophy in any one country, social work models can be an effective alternative to, or addition to, treatment models as a whole.

Applications: The limitations of treatment models for social work practice and the applications of social work models to drug problems are examined.
Social Work in Health Care
Authors: Auslander Gail
Published: April 2009

Summary: Social work in health care has been established for more than 100 years and has developed into a major sector of the profession in countries around the world. This article reports on a Delphi exercise aimed at exploring the achievements of social work in health care in a variety of countries, as judged by a team of expert practitioners and academics.

Findings: Twenty key accomplishments were identified. Two of them received particularly high ratings: achieving recognition and legitimacy, and effecting a change in the models of illness and health. Three others - knowledge development, direct interventions with patients and development of culturally appropriate interventions - also received high marks.

Applications: The findings are quite consistent with the social work literature, indicating the benefits to be gained from international cooperation and collaboration.
The Role of Science in Social Work
Authors: Reid William J.
Published: April 2009

• Summary: The age-old debate about the role of science in social work has intensified with the growth of scientific activities and the emergence of philosophically-based criticisms of prevailing scientific paradigms. Issues have included: constructionist challenges to the role of research in validating social work knowledge; divisions over whether there is enough credible scientific knowledge to make a difference in practice; disputes over whether such knowledge can be adequately disseminated and properly utilized; and controversies about the utility of applying research methods (e.g. single-case evaluations) in practice.

• Findings: Scientific methods are likely to provide superior knowledge, because they have evolved to become humankind’s most powerful form of enquiry. Enough research-based knowledge does exist to make a difference in practice, and there are means to enable its dissemination and utilization. Moreover, a number of these methods can be productively used in practice.

• Applications: Practice based on research knowledge and strengthened by selective use of research methods should become a growing force in social work. Emphasis on methodological pluralism in research, and the development of common standards for the appraisal of knowledge, may further rapprochement among different factions in the debate over the role of science in social work.
Interrogating Person-centred Dementia Care in Social Work and Social Care Practice
Authors: Parker Jonathan
Published: April 2009

• Summary: Traditional approaches to the understanding and organization of dementia care, often drawn from medical perspectives, are examined. Alternative understandings based around the conception of ‘personhood’ are critically considered. Some of the philosophical challenges and practical difficulties raised by this debate are explored in the context of care management in the UK.

• Findings: The concept of personhood presents a challenge to traditional thought and has been influential in promoting the ‘new culture’ of dementia care within health and social service settings. It is crucial in contemporary social and health care to retain a clear sense of the person with whom we are working at any point in time. Medical, sociological and psychological approaches to dementia should not be seen as mutually exclusive.

• Applications: A shift in culture and thinking does not deny the importance of medical advance but adds a holistic and human element that brings back the person with dementia to centre stage. While the diseases underlying the personal and mental deterioration are important, it is equally important to consider how the disease and its characteristics are interpreted by the person with dementia, their carers, professionals and wider society.
Researching Field Practice in Social Work Education
Authors: Noble Carolyn
Published: April 2009

• Summary: This article reports on a research project with final year social work students on placement from a University in Sydney which, as part of developing a more critically reflective pedagogy, asked students to write narratives about placement experiences. The richness of these narratives makes them useful for developing a critically reflective process for application in practice teaching, in both Australia and the UK, where critical reflection is increasingly being incorporated in the field placement curriculum.

• Findings: The use of narratives is found to represent a way of knowing and thinking that is particularly suited to identifying the issues which students on placement have to confront.

• Applications: Used in the context of a critically reflective framework, student-centred narratives provide practice-based teachers with an opportunity to develop critically reflective processes as part of curriculum scholarship; overcoming, rather than reinforcing, the potential division between theory and practice strands.
Public Law Protection of Vulnerable Adults
Authors: Williams John
Published: April 2009

• Summary: This article examines the need for a new public law designed to protect vulnerable adults who are being abused. It considers the impact of the Human Rights Act 1998 on the debate on the need for a new law, and considers developments in the USA and proposals for reform in Scotland. Social workers are frequently in the position of having to deal with the abuse of adults, without a clear legal framework that empowers them to act to protect the person being abused.

• Findings: The article concludes that there is a need for some form of public law designed to protect vulnerable adults. Existing law, which is mainly judge-made, is inappropriate and lacks the required predictability and procedural safeguards. The article argues that the European Convention on Human Rights imposes a duty on states to protect vulnerable adults; however, in devising such a law, regard must be had to the right under the convention to a private life. Any new law must carefully balance these two (often competing) rights. Further difficulties may arise when seeking to define ‘vulnerable adult’ and to identify the precise moment of intervention. The term ‘vulnerable adult’ should include in its definition not only people who lack capacity, but others who are extremely vulnerable and at grave risk.

• Applications: Existing provisions do not provide adequate protection for abused vulnerable adults. The governments in Wales and England need to learn from the US experience and also look at the Scottish Law Commission’s proposals. The current soft-law approach is no longer adequate; new legislation is urgently needed. Social workers should consider their professional response to the current situation.
‘This is your home now!’: conceptualizing location and dislocation in a dementia unit
Authors: Reed-Danahay Deborah
Published: April 2009

In this chapter, I discuss ethnographic work in a residential unit for Alzheimer’s patients located in the southeastern part of the United States. The borders of home and work in this nursing home are analyzed in order to unpack meanings of ‘home’ for residents. Postmodern discussions of location and dislocation for contemporary identities have relevance for an analysis of this setting. The concepts of non-place ( non-lieu) from the work of Marc Augé and of location ( lieu) from the work of Pierre Bourdieu are employed in the analysis. In this unit, well-to-do white residents are cared for by working-class black women. Intersections of race and class, as well as gender and age, form an important context for social relationships within this space. The case of one resident who daily asked for her car so that she could go home is used to illustrate the social and spatial arrangements in this setting and the ‘location’ of both patients and staff.
In the flesh or online? Exploring qualitative research methodologies
Authors: Seymour Wendy S.
Published: April 2009

This article discusses the use of computer-mediated research techniques in a research project which investigates how people with disabilities engage with and use computer technologies. Identifying the rationale, process and experiences involved in the decision to engage in electronic research in this particular research topic will illuminate some limitations in traditional methods of qualitative data collection more generally. In responding to the opportunities presented by the information age, electronic research methods will substantially enhance the development of a more participatory research process. While incorporative research is imperative to the disability research agenda, the issue is no less critical to other aspects of the research enterprise.
The art(fulness) of open-ended interviewing: some considerations on analysing interviews
Authors: Rapley Timothy John
Published: April 2009

Considerable analytic attention has focused on interviewees’ talk as ‘accounts’, or ‘versions’, rather than as direct reports of attitudes or perceptions. However, despite recognition of the ‘co-construction of accounts’, little analytic attention has been given to the interviewer as central in the production of the talk. With this attention, we are left with an analysis of some decontextualized-features-of-talk (or discourse/identities/narrative/repertoires/rhetoric). By contrast, this article argues that interviews are inherently social encounters, dependent on the local interactional contingencies in which the speakers draw from, and co-construct, broader social norms. Through a close reading of one published paper and extracts from an interview, I document how interviewees and interviewers work to construct themselves as certain types-of-people in relation to the topic of the interview and reflexively the interview itself. I then show how a prescription from some interview methods texts document an ideal about interview practices. The analysis of the interview extracts shows this ideal-in-practice (cf. Hester and Francis, 1994). I argue that whatever ideals are practised, no single practice will gain ‘better data’ than the other practices. The ‘data’ obtained are highly dependent on and emerge from the specific local interactional context which is produced in and through the talk (and concomitant identity work) of the interviewee and interviewer. An awareness of this local context of data production is central to analysing interview data whatever analytic stance is taken when analysing the data.
Researching groups of lives: a collective biographical perspective on the Protestant ethic debate
Authors: Jones Diana K.
Published: April 2009

In this article I discuss the efficacy of biography, in particular prosopography, or collective biography, as a methodological tool for analysing and interpreting socio-historical phenomena. Max Weber’s proposition regarding perceived sociological factors that have significantly influenced the development of modern vocationalism, provides the focus. The discussion takes account of existing sociological literature on biography, in particular reference is made to the work of Bulst, Erben, Denzin and Ferrarotti. Weber’s hypothesis - Protestant asceticism as the foundation of modern vocational civilization and the use or lack of use of biographical data, is first reviewed. Collective biography as a methodological tool for addressing particular socio-historic problems, is then considered. This is mainly within the context of Lawrence Stone’s exegesis. In recent years it is in the work of Stone that the approach has been most systematically theorized upon. This is followed by reference to my own application of the method - the research group, the construction of case studies, and the dangers and limitations of using biographical evidence. Selected examples are included. Finally, I briefly reflect on the possibility of using prosopography for the purposes of juxtaposing and comparing the lives of one distinctive socio-economic group with another.