Delivering a primary care-based social prescribing initiative: a qualitative study of the benefits and challenges.

BACKGROUND: Social prescribing is a collaborative approach to improve inter-sectoral working between primary health care and community organisations. The Links Worker Programme (LWP) is a social prescribing initiative in areas of high deprivation in Glasgow, Scotland, that is designed to mitigate the negative impacts of the social determinants of health. AIM: To investigate issues relevant to implementing a social prescribing programme to improve inter-sectoral working to achieve public health goals. DESIGN AND SETTING: Qualitative interview study with community organisation representatives and community links practitioners (CLPs) in LWP areas. METHOD: Audiorecordings of semi-structured interviews with 30 community organisation representatives and six CLPs were transcribed verbatim and analysed thematically. RESULTS: Participants identified some benefits of collaborative working, particularly the CLPs' ability to act as a case manager for patients, and their position in GP practices, which operated as a bridge between organisations. However, benefits were seen to flow from new relationships between individuals in community organisations and CLPs, rather than more generally with the practice as a whole. Challenges to the LWP were related to capacity and funding for community organisations in the context of austerity. The capacity of CLPs was also an issue given that their role involved time-consuming, intensive case management. CONCLUSION: Although the LWP appears to be a fruitful approach to collaborative case management, integration initiatives such as social prescribing cannot be seen as 'magic bullets'. In the context of economic austerity, such approaches may not achieve their potential unless funding is available for community organisations to continue to provide services and make and maintain their links with primary care.

The adaptive pattern of the auditory N1 peak revealed by standardized low-resolution brain electromagnetic tomography.

The N1 peak in the late auditory evoked potential (LAEP) decreases in amplitude following stimulus repetition, displaying an adaptive pattern. The present study explored the functional neural substrates that may underlie the N1 adaptive pattern using standardized Low Resolution Electromagnetic Tomography (sLORETA). Fourteen young normal hearing (NH) listeners participated in the study. Tone bursts (80 dB SPL) were binaurally presented via insert earphones in trains of 10; the inter-stimulus interval was 0.7s and the inter-train interval was 15s. Current source density analysis was performed for the N1 evoked by the 1st, 2nd and 10th stimuli (S(1), S(2) and S(10)) at 3 different timeframes that corresponded to the latency ranges of the N1 waveform subcomponents (70-100, 100-130 and 130-160 ms). The data showed that S(1) activated broad regions in different cortical lobes and the activation was much smaller for S(2) and S(10). Response differences in the LAEP waveform and sLORETA were observed between S(1) and S(2), but not between the S(2) and S(10). The sLORETA comparison map between S(1) and S(2) responses showed that the activation was located in the parietal lobe for the 70-100 ms timeframe, the frontal and limbic lobes for the 100-130 ms timeframe, and the frontal lobe for the 130-160 ms timeframe. These sLORETA comparison results suggest a parieto-frontal network that might help to sensitize the brain to novel stimuli by filtering out repetitive and irrelevant stimuli. This study demonstrates that sLORETA may be useful for identifying generators of scalp-recorded event related potentials and for examining the physiological features of these generators. This technique could be especially useful for cortical source localization in individuals who cannot be examined with functional magnetic resonance imaging or magnetoencephalography (e.g., cochlear implant users).