The INCENTIVE protocol: an evaluation of the organisation and delivery of NHS dental healthcare to patients--innovation in the commissioning of primary dental care service delivery and organisation in the UK

Introduction In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards ‘blended contracts’ that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England. Methods and analysis The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life

No longer hungry in hospital : improving the hospital mealtime experience for older people through Action Research

‘The definitive version is available at www.blackwell-synergy.com.’ Copyright Blackwell Publishing DOI: 10.1111/j.1365-2702.2007.02063.xAims and objectives.  This study aimed to improve the mealtime experience of older people in a hospital setting through helping staff to make changes to their clinical practice and the ward environment. Background.  Poor nutritional care has been a persistent and seemingly intractable problem for many years. Methods.  We used an action research design for the study, drawing on techniques from practice development to support the action phase of the work, including action learning, role modelling good practice and reflection. The ward context was explored at the beginning and end of the study using focus groups, interviews, observation and benchmarking. Results.  Ward staff made a number of changes to their nursing practice. The most significant was that all staff became engaged with, prioritized and were involved in the mealtime, ensuring that there was sufficient time and expertise available to assist patients with eating. Conclusions.  This study demonstrates that it is possible to change nursing practice at mealtimes and that this change leads to improvements in patients’ experience through ensuring they receive the help they need. Relevance to clinical practice.  Although hospital mealtimes are frequently viewed as problematic, we have shown that nurses can be enabled to make changes to their practice that have a positive impact on both the mealtime experience and wider patient care.Peer reviewe

IIS UPDATE

An overview of the Institute of Ismaili Studies’ key academic initiatives in 2008, including major publications, leadership updates, and a feature on Muslim devotional spaces.https://ecommons.aku.edu/arch_research_publications_secondary-sources/1015/thumbnail.jp

Investigating child participation in the everyday talk of a teacher and children in a preparatory year

In early years research, policy and education, a democratic perspective that positions children as participants and citizens is increasingly emphasized. These ideas take seriously listening to children’s opinions and respecting children’s influence over their everyday affairs. While much political and social investment has been paid to the inclusion of participatory approaches little has been reported on the practical achievement of such an approach in the day to day of early childhood education within school settings. This paper investigates talk and interaction in the everyday activities of a teacher and children in an Australian preparatory class (for children age 4-6 years) to see how ideas of child participation are experienced. We use an interactional analytic approach to demonstrate how participatory methods are employed in practical ways to manage routine interactions. Analysis shows that whilst the teacher seeks the children’s opinion and involves them in decision-making, child participation is at times constrained by the context and institutional categories of “teacher” and “student” that are jointly produced in their talk. The paper highlights tensions that arise for teachers as they balance a pedagogical intent of “teaching” and the associated institutional expectations, with efforts to engage children in decision-making. Recommendations include adopting a variety of conversational styles when engaging with children; consideration of temporal concerns and the need to acknowledge the culture of the school

Dementia-friendly communities: challenges and strategies for achieving stakeholder involvement.

Dementia-friendly communities (DFCs) are a UK policy initiative that aims to enable people with dementia to feel supported and included within their local community. Current approaches to DFC creation rely on stakeholder involvement, often requiring volunteer assistance. There is though a lack of evidence that examines the reality of achieving this. This paper critically assesses the challenges and strategies for achieving stakeholder involvement in DFCs. The evidence base is drawn from an inter-agency project funded by the National Health Service in the South of England where seven DFCs were developed by steering group partners and four part-time project workers (PWs). Data from the independent evaluation undertaken in the first year (2013-2014) of the project were analysed: 14 semi-structured interviews and a focus group examined PWs' experiences; while progress and key milestones are determined from monthly progress forms, good news stories, locality steering group minutes and press releases. Analysis was undertaken using a directed content analysis method, whereby data content for each locality was matched to the analytical framework that was drawn from Alzheimer's Society guidance. Challenges to achieving stakeholder involvement were identified as: establishing networks and including people representative of the local community; involving people affected by dementia; and gaining commitment from organisations. Strategies for achieving stakeholder involvement were recognised as: a sustainable approach; spreading the word; and sharing of ideas. By highlighting these challenges and the approaches that have been used within communities to overcome them, these findings form the foundation for the creation of DFC initiatives that will become embedded within communities. Stakeholder involvement is unpredictable and changeable; therefore, reliance on this approach questions the long-term sustainability of DFCs, and must be considered in future policies designed to enhance quality of life for people affected by dementia

California farmworkers housing assistance plan, 1977

Pursuant to its duties under Health and Safety Code Section 41125, the Commission of Housing and Community Development hereby refers the California Statewide Housing Plan, 1977 (which includes the Farmworker Housing Assistance Plan, reproduced in a separate volume) to the Legislature for review, revision, and adoption. The Plan was prepared by the Department of Housing and Community Development, in conjunction with the Business and Transportation Agency. The Department and the Commission of Housing and Community Development jointly held extensive public hearings on drafts of the Plan. Private industry, local government, and other state agencies provided substantial and valuable input into the preparation of the Plan. The Commission commends the staff of the Department of Housing and Community Development for its diligent efforts to involve as many individuals and organizations as possible in the preparation of the Plan. These efforts not only made the Plan a better document, but also tended to assure that the Plan should have the widest possible public support and acceptance. The Legislature has directed our Commission to send to it our comments on the Plan. Because the Plan has many aspects to it, and because each Commissioner\u27s view of our state\u27s housing problems differs somewhat, some Commissioners wish to comment separately · on the Plan. Those comments are attached

California farmworkers housing assistance plan, 1977

Pursuant to its duties under Health and Safety Code Section 41125, the Commission of Housing and Community Development hereby refers the California Statewide Housing Plan, 1977 (which includes the Farmworker Housing Assistance Plan, reproduced in a separate volume) to the Legislature for review, revision, and adoption. The Plan was prepared by the Department of Housing and Community Development, in conjunction with the Business and Transportation Agency. The Department and the Commission of Housing and Community Development jointly held extensive public hearings on drafts of the Plan. Private industry, local government, and other state agencies provided substantial and valuable input into the preparation of the Plan. The Commission commends the staff of the Department of Housing and Community Development for its diligent efforts to involve as many individuals and organizations as possible in the preparation of the Plan. These efforts not only made the Plan a better document, but also tended to assure that the Plan should have the widest possible public support and acceptance. The Legislature has directed our Commission to send to it our comments on the Plan. Because the Plan has many aspects to it, and because each Commissioner\u27s view of our state\u27s housing problems differs somewhat, some Commissioners wish to comment separately · on the Plan. Those comments are attached

Life is sexually transmitted: Live with it

This article explores issues of sexual health relevant to client care that is, could, or should be offered by nurses in general practice. Sexual health is often the most important element of a person’s holistic health and well-being to be overlooked during consultations. Sadly, some professional carers consider it is not their job, is too embarrassing, morally ‘problematic’ or outside their area of expertise. Sexual health is part of life: not to address it means that health professionals fail to fully address all aspects of their clients’ holistic health and well-being. The result is selective or reduced—not holistic—care. This article will point to ways for practice nurses to remedy this situation

Australian Government Disability Services Census: 2002

[Excerpt] The 2002 Australian Government Disability Services Census recorded information about 64,639 consumers who received assistance from Australian Government disability employment services between 1 July 2001 and 30 June 2002. These are referred to as ‘All Consumers’ and Tables and Figures referring to all consumers have the suffix ‘FY’ (financial year)