Textual accounts, ruling action: the intersection of knowledge and power in the routine conduct of community nursing work

Introduction to<i>Visual Arts Research</i>Special Issue, Body Cam: The Visual Regimes of Policing

This essay describes institutional ethnography as a method of inquiry pioneered by Dorothy E. Smith, and introduces a collection of papers which make distinctive contributions to the development of this novel form of investigation. Institutional ethnography is presented as a research strategy which emerges from Smith's wide-ranging explorations of the problematic of the everyday world. Smith's conception of the everyday world as problematic involves a critical departure from the concepts and procedures of more conventional sociologies. She argues for an alternative sociology which begins with the standpoint of the actor in everyday life, rather than from within a professional sociological discourse aligned with the society's ruling institutions. The familiar sociologies of everyday life do not suffice for this purpose, since they deal with local settings and social worlds, but stop short of examining how these are knitted into broader forms of social organization. In contrast, institutional ethnography examines how the scenes of everyday life are shaped by forms of social organization which cannot be fully grasped from within those scenes. The principal tasks of institutional ethnography include describing the coordination of activities in the everyday world, discovering how ideological accounts define those activities in relation to institutional imperatives, and examining the broader social relations in which local sites of activity are embedded. The four papers which follow demonstrate that specific contributions to institutional ethnography can be made in relation to a wide array of topics, methods, and interests.

This research entitled: The Role of Indonesian National Police at Public Relations division about Cyber Public Relations giving the public information services online. This research is motivated by the rise of the phenomenon of public services through cyber activity or online. As similar with other state institutions, the Indonesian National Police also has an obligation to provide public information services, as mandated in the Act Public Information. Uniquely humas.porli.go.id website is managed by the Police Public Relations Division, involving 380 operators and 32 operators at the police station at the police station. It definitely requires good coordination, and this is part of the task of Police Public Relations Division to synergize it. Therefore, researchers are interested in finding out more about how the role of cyber public relations implemented by Police Public Relations Division. Theories and concepts used in this research is the concept of public relations, cyber public relations, public services and public information. This research is a qualitative descriptive study. The results showed that the role of Police Public Relations Division in conducting cyber public relations activity is more dominant on the role as a tecnicion communication and facilitator communication. However the role of expert preciber communication and solving process facilitator remains, although not so dominant. The application of the concept of public relations is a form of cyber police commitment in providing the best service to the community, as well as support for the implementation of the Law on Public Information. The quality of services through the medium of Police Public Relations humas.polri.go.id website still needs to be improved, considering there are still things to be improved, such as improving the quality of human resources manager of the website, optimize the look of the website, complete the menus in the website, improve protections system. Keyword: Cyber Public Relations

The impact of public versus private health care services in the treatment of diffuse large B-cell lymphoma in Brazil: An analysis from the bra-DLBCL multicenter, retrospective real-world registry

This study examined the relationship of age and gender with risk of arrest among adolescents and young adults who were intensive adolescent users of public mental health services. Data were obtained from the Massachusetts Department of Mental Health (DMH) and juvenile and criminal courts. Participants were youths receiving DMH adolescent case management services sometime in 1994-1996 who were born between 1976 and 1979 (781 males and 738 females). They were cross-matched to document arrests between age seven and 25. The study examined age at first arrest, age-specific risk, and the relationship between arrest history and arrest risk by gender and age. Most males (69%) and almost half the females (46%) were arrested by age 25. First arrest was most common before age 18. As in the general population, males' arrest patterns were more concerning than those of females, although patterns were of concern in both groups. Most female arrestees had multiple arrests, many as adults. No gender differences were observed for several factors, including risk of first arrest over age 18. Risk was far greater for those arrested in the previous year than for those never arrested. Findings justify concerns of public mental health systems regarding justice system involvement of adolescent clients. Risk of first arrest was significant from early adolescence through age 24, indicating a need for arrest prevention into young adulthood. The heightened arrest risk at all ages among those who were recently arrested demarcates a population in need of immediate intervention.

Under the condition of market economy, market competition has shown unprecedented pressure on agricultural producers with family as a production unit. Agricultural producers are at a relatively weak position. Agricultural production having the characteristics of small scale can hardly adapt to market competition effectively and agricultural production is facing a huge market risk. Therefore, farmers urgently need a wide range of public services. In March, 2007, the Ministry of Finance and Huazhong Normal University investigated a total of 1000 residents in 35 sample villages, belonging to 33 towns of Ningxia Hui Autonomous Region, China. Status of the supply of public services in rural areas is introduced from three aspects, which are backward service of public education, low level of public health service, and slow development of public cultural service. It is pointed out that the supply of rural public service is in serious shortage, and can hardly meet the practical needs of rural residents, rural development and agricultural production. Problems in rural public service are analyzed from the insufficient ability of government public service, the single supply subject of rural public service, and the lack of effective evaluation mechanism during the supply of public services. Finally, countermeasures for improving the supply of rural public service are put forward, such as strengthening the public service functions of governments at all levels, constructing a supply mechanism with diversified subjects, and establishing a farmer participation mechanism for rural public service supply, so that rural residents can enjoy the essential public services, develop rural economy, improve the living standards of rural residents, establish a sound social security system, ensure the smooth implementation of new countryside construction, and realize the coordinated socio-economic development between rural and urban areas.

Can dissatisfaction with existing policies lead to the co‐production of public goods and services? If so, under what conditions could such dissatisfaction lead to the co‐production of public goods and services? We posit that when (1) citizens are dissatisfied with the policy as designed, (2) third‐sector organisations are formed, and (3) politicians and street‐level managers are engaged, the co‐production of public goods and services will take place. Analysing the Israeli religion‐based restrictions on public transportation on the Jewish Sabbath (Saturday), this study argues that the intentional lack of public transport on Saturdays is overall met with discontent within the population and, in turn, leads third‐sector organisations and local authorities to combine forces to find solutions on the local level. We have employed various mixed methods tools (e.g. a public opinion survey, existing statistics, in‐depth interviews, and textual analysis) in order to test the Israeli case as an illustrative, crucial case study.Points for practitioners Limited public services impose burdens on disadvantaged groups, who are often those with fewer resources, causing societal dissatisfaction with policy and its implementation. Co‐production is facilitated when dissatisfied citizens encourage third‐sector organisations, politicians, and street‐level managers to engage. Local co‐production efforts are expected to cease when governments decide to supply the lacking services.

Overall enhancement of the public health system ranks a key task and goal for the ongoing health reform.This paper described the public health development in Shenzhen amid the ongoing health reform.Shenzhen has achieved the following objectives as required in the reform:better public service by public health institutions,availability of major and primary public health services as required by the state and city,overall elevation of public health service capabilities,and significant drop of disease morbidity and mortality.Challenges ahead include room of improvement in public health service network,incentive mechanism of public health service providers,and that of public health service delivery capability. Key words: Health care; System reform; Public health; Health service

Background Mexico has implemented policies seeking to reduce barriers to care for migrants in transit; however, it is estimated that only 3% of migrants use public health services when needed. The main purpose of this study was to identify the barriers to access public health services faced by migrants in transit through Mexico. Methods Under the human security perspective, in 2018, a qualitative study was carried out in Mexican communities with high migrant mobility. 34 semi-structured interviews were conducted with migrants in transit, and personnel from public health services and migrant shelters (NGOs). Values and meanings related to risks, health problems, barriers to care, experiences of health services utilization, and opinions on facilitating elements to diminish these barriers were identified. Results Migrants in transit through Mexico face risks that affect all dimensions of human security. Perceived anti-migratory and discriminative attitudes during the journey were constantly mentioned in the interviews. Barriers to care were found in the four stages of health care access, classified according to the Tanahashi framework, with the majority related to accessibility and acceptability. The following facilitating elements were also identified: political willingness of local government, knowledge and talent management of health personnel, and strategies implemented for adapting local health care services to migrants. Conclusions Social and political conditions in Mexico disrupt any effort to reduce social risks and barriers to care for migrants in transit. Non-governmental actors are key players for facilitating interactions between migrants and local governmental health care institutions. However, the general anti-migratory context negatively affects access to health care and influence the perspectives of migrants, NGOs, and health personnel. Key messages The predominant perceived barriers to care are in counterpoint to local governmental pro-migrant rights perspectives. NGOs are key actors to promote access to public health care services.

A decade after health sector reform, public health services in rural Cambodia remain under-utilised for multiple reasons related to financial, structural and personnel factors. Ineffectiveness of rural public health services has led to a significant increase in private providers, often the same people who staff public facilities. Public health clinics are often portrayed as low quality, with long waiting times and unexpected costs; in contrast, private clinics are seen to provide more convenient health care. Several strategies, including contract management and health equity funds, have been introduced to improve public sector performance and encourage utilization; these efforts are ongoing. However, the feasibility of these strategies remains in question, particularly in terms of cost-effectiveness and sustainability. In this article the strategies of and barriers met by health workers who remain in rural areas and deliver public health services are elucidated. Ethnographic research conducted in 2008 with health providers involved in treating tuberculosis patients in Kampong Speu Province, Cambodia is drawn on. Participants were recruited from the provincial health department, provincial hospital and four health centres. Data collection involved in-depth interviews, participation in meetings and workshops aimed at health workers, and observation of daily activities at the health facilities. Data were transcribed verbatim, imported into NVivo software (www.qsrinternational.com) for management, and analysed using a grounded theory approach. Primary healthcare service delivery in rural Cambodia was reliant on the retention of mid-level of health staff, primarily midwives and nurses. Its performance was influenced by institutional characteristics relating to the structure of the health system. Personal factors were impacted on by these structural issues and affected the performance of health staff. Institutional factors worked against the provision of high-quality public health services, and included the fragmentation of service delivery and structure, limited capacity and shortage of high-qualified health staff, competition with the private sector, and shortage of medical supplies. These factors all de-motivated health staff, and undermined their performance in public service positions. Personal factors were paramount for staff retention. These included: optimism and appreciation of work responsibilities and position, the personal ability to cope with financial barriers, and institutional benefits such as opportunities for professional development, job security, financial opportunities (via performance-based allowances), and status in society. Individual financial coping strategies were the dominant factor underlying retention, but alone were often de-motivating: clients were diverted from the public services, which led to distrust, and thus undermined the capacity of public system. There was significant interaction between institutional and personal factors, which impacted on the effectiveness of health staff retention in rural areas. Health workers tended to remain in their government positions for prolonged periods of time because they experienced personal rewards. At the same time, however, their job performance in the public health services were hindered by challenges related to the institutional factors. The interaction between institutional factors and personal factors was crucial for effectiveness of health staff retention in rural Cambodia. Efforts aimed at ensuring quality of care and encouraging health staff retention should attempt to remove the institutional barriers that discourage the use of rural public health services.

BackgroundIn Vietnam and many developing countries, private healthcare is increasingly being leveraged by governments to complement public services and increase health service access and utilisation. Extensive understanding of patterns of utilisation of private over public health services, and the rationale for such consumer decisions, is important to ensure and promote safe, affordable and patient-centred care in the two sectors. Few studies within the Southeast Asian Region have explored how private and public providers interact (via social networks, marketing, and direct contact) with consumers to affect their service choices. This study investigates providers’ views on social factors associated with the use of private over public health services in Vietnam.MethodA thematic analysis was undertaken of 30 semi-structured interviews with experienced health system stakeholders from the Vietnam national assembly, government ministries, private health associations, health economic association, as well as public and private hospitals and clinics.ResultsMultiple social factors were found to influence the choice of private over public services, including word-of-mouth, the patient-doctor relationship and relationships between healthcare providers, healthcare staff attitudes and behaviour, and marketing. While private providers maximise their use of these social factors, most public providers seem to ignore or show only limited interest in using marketing and other forms of social interaction to improve services to meet patients’ needs, especially those needs beyond strictly medical intervention. However, private providers faced their own particular challenges related to over-advertisement, over-servicing, excessive focus on patients’ demands rather than medical needs, as well as the significant technical requirements for quality and safety.ConclusionsThis study has important implications for policy and practice in Vietnam. First, public providers must embrace social interaction with consumers as an effective strategy to improve their service quality. Second, appropriate regulations of private providers are required to protect patients from unnecessary treatments, costs and potential harm. Finally, the insights from this study have direct relevance to many developing countries facing a similar challenge of appropriately managing the growth of the private health sector.

Background: The public health services project of the South-eastern Europe health network has undertaken an evaluation of public health services in its nine member countries. The purpose of the evaluation of public health services provision in the South-eastern European (SEE) countries is to understand where these countries now stand in public health, the institutional, organisational, legislative and service delivery developments that are taking place and to identify strengths and weaknesses in their public health systems and services in order to inform decision making about investment and future reform. Methods: The evaluation was orientated around “essential public health operations” that are deemed to form the core of public health activities and services and to be indispensable to the delivery of modern public health services in any country. The evaluation analysed these activities and services within the structure of the health system functions of stewardship, resource generation, financing and service delivery, as developed by WHO. Results: The results demonstrate a mixed picture of strengths and weaknesses within the context of significant social, economic and political challenges in the region. Among the many visible and significant strengths in public health services in the region are well developed networks of public health institutes with well defined surveillance systems, highly experienced and well educated public health professionals as well as many positive examples of service delivery. But there are also many concerns and challenges, not the least of which is political focus, direction and support for modern public health services, as well as funding. Collaboration and partnership among sectors is weak and information and communication systems are inadequate and not sufficiently integrated. Conclusions: Having emphasized the main weak and challengeable points in the Public Health systems and services in the SEE countries, the evaluation is also a first step to defining a way forward in the SEE countries to ensure that the turmoil of ‘transition’ is only a prelude to the comprehensive modernisation of public health services.

The Japanese government launched a project to facilitate collaboration between public health services and occupational health services with the aim of promoting overall health and wellbeing. However, collaboration at the practitioner level, including professionals who develop health support activities, has not yet been achieved. This study was conducted to clarify the actual state of collaboration between public health services and occupational health nurses as well as the factors related to their experiences with such collaboration. It also aimed to gather suggestions for promoting collaboration between occupational health nurses and public health and occupational health services. A self-administered questionnaire-based survey was conducted in 2017, targeting 2,574 occupational health nurses belonging to the Japan Society for Occupational Health. Survey items included basic attributes, recognition of the need for collaboration and the reasons behind it, whether or not they had collaboration experience, and self-study and learning experiences. Of the 756 nurses surveyed, 34.0% had experience collaborating with public health services and 80.8% felt such collaboration was necessary. Experience of collaboration was related to the number of years of experience as an occupational health nurse, experience reading guidelines and participating in workshops and study groups organized by public health services, opportunities to receive guidance, and recognition of the need for collaboration. Because only a few respondents had experience collaborating with public health services and some did not even recognize the need for such collaboration, it was deduced that occupational nurses might have few opportunities to collaborate with public health services and may find it difficult to recognize the need for such collaboration. This finding suggests that occupational nurses may be able to promote collaboration with public health services by reinforcing learning from life events. A mechanism should be created to obtain information on public health services. Furthermore, opportunities can be provided for those with experience in collaboration to communicate with those with no experience through specific examples of such teamwork.

Interpretable analysis of public library service outcomes based on ensemble learning models: Data study from China (2007–2021)

COVID-19 is a Public Health Emergency of International Concern (PHEIC). Direct economic loss is expected to be much more than that of SARS outbreak in 2003. The risk factors of COVID-19 epidemic at the early stage included the misjudgment of the epidemic, delay in reporting this emerging infectious disease, nosocomial infection-caused transmission of the virus into local communities, and weak public health interventions. The infection rate (or the incidence) reflects the prophylactic effect in population. Case fatality reflects the therapeutic effect of clinical intervention. There were sufficient medical resources at the national top levels accumulated in Wuhan. Furthermore, medical professionals and sufficient medical supplies from other provinces have been assigned to join in the fighting against the epidemic in Wuhan. However, the case fatality in Wuhan has been kept the highest in China, indicating that clinical treatment for this virus-caused emerging infectious disease, whose pathogenesis remains to be elucidated, with limited effect in controlling this epidemic. The unusual, extremely costly public health interventions including the temporarily city quarantine and transportation ban issued by the central government are crucial in controlling this epidemic. The control of epidemic indicates the importance of public health measures but also reflected its insufficient capacity in China. Recently, profit-seeking mechanism run in Chinese health service system disorganized the balance of clinical service and public health service patterns in China, promoting the vicious circle of "attaching importance to clinical treatment and despising disease prophylaxis" , damaging the infrastructure of public health capacity, thus contributing to the formation of the inevitability in various fortuities of public health emergency. To strength the capacity of our medical service system to respond to public health emergency efficiently, two key issues should be considered. First, public health service, which should be fixed as the health section of the governments' public services by the law, must be greatly improved to meet the increasing health needs of the publics. Second, the vicious circle of profit-seeking-caused "attaching importance to clinical treatment and despising disease prophylaxis" should be immediately broken to optimize the national health service system in China by increasing the investment in public health service.