Communities as 'renewable energy' for healthcare services? a multimethods study into the form, scale and role of voluntary support for community hospitals in England.

OBJECTIVE: To examine the forms, scale and role of community and voluntary support for community hospitals in England. DESIGN: A multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups. SETTING: Community hospitals in England and their surrounding communities. PARTICIPANTS: Charity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents). RESULTS: Communities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers. CONCLUSIONS: Communities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or 'renewable'.

Motivating the adoption of new community-minded behaviors: An empirical test in Nigeria.

Social scientists have long sought to explain why people donate resources for the good of a community. Less attention has been paid to the difficult task of motivating the first adopters of these important behaviors. In a field experiment in Nigeria, we tested two campaigns that encouraged people to try reporting corruption by text message. Psychological theories about how to shift perceived norms and how to reduce barriers to action drove the design of each campaign. The first, a film featuring actors reporting corruption, and the second, a mass text message reducing the effort required to report, caused a total of 1181 people in 106 communities to text, including 241 people who sent concrete corruption reports. Psychological theories of social norms and behavior change can illuminate the early stages of the evolution of cooperation and collective action, when adoption is still relatively rare.

Ethical, legal and professional issues arising from social media coverage by UK Helicopter Emergency Medical Services.

OBJECTIVE: Social media (SoMe) are gaining increasing acceptance among, and use by, healthcare service deliverers and workers. UK Helicopter Emergency Medical Services (HEMS) use SoMe to deliver service information and to fundraise, among other purposes. This article examines UK HEMS use of SoMe between January and February 2014 to determine the extent of adoption and to highlight trends in use. METHODS: The database of the Association of Air Ambulances, crosschecked with UK Emergency Aviation, was used to identify flying, charitable UK HEMS. This search identified 28 UK HEMS, of which 24 services met the criteria for selection for review. Using information harvested from the public domain, we then systematically documented SoMe use by the services. RESULTS: SoMe use by UK HEMS is extensive but not uniform. All selected UK HEMS maintained websites with blogs, as well as Facebook, Twitter, Wikipedia and JustGiving profiles, with the majority of services using Ebay for Charity, LinkedIn and YouTube. Some HEMS also held a presence on Pinterest, Google+, Instagram and Flickr, with a minority of services maintaining their own Rich Site Summary (RSS) feed. CONCLUSIONS: The SoMe adopted, while varied, allowed for increased, and different forms of, information delivery by HEMS to the public, often in real time. Such use, though, risks breaching patient confidentiality and data protection requirements, especially when information is viewed cumulatively across platforms. There is an urgent need for the continued development of guidance in this unique setting to protect patients while UK HEMS promote and fundraise for their charitable activities.

The ethics of charity dental clinics.

The Ben Massell Dental Clinic is part of the Jewish Family & Career Services in Atlanta, Georgia, which provides a wide range of health and social services on a sliding-fee basis. A fixed location, comprehensive service, and a clinic with full regular hours is an obvious benefit to patients. This structure also provides advantages to dentists who wish to donate their professional expertise without disrupting their offices and without the need to create a new logistic and management structure. Such a regular clinic also provides continuity of care in a charity setting.

Nursing and philanthropy: both about giving and joy.

There is a surprising intersection between nursing and charitable giving, and it is not about the money. Some nurses I know would find that statement to be a bit off-kilter. Maybe a few of them would find it even a bit off-putting. But there is, indeed, a strong case to be made that the two are of the same cloth.

Developing an ethical framework for short-term international dental and medical activities.

The popularity of volunteering to provide charity health care in third-world countries has increased dramatically in recent years. While there are advantages to both those being helped and to volunteers, there are also ethical issues that need to be addressed. A framework for analyzing the ethical impact of such service is presented which continues 27 principles that should be addressed.

A student's perspective on the ethics of international charity dental care.

A senior dental student describes the deep sense of personal satisfaction from participating in a weeklong charity dental care trips to the Dominican Republic. Care, primarily consisting of extractions, was provided to individuals living in conditions that encourage dental disease at the same time the availability of oral healthcare services are essentially nonexistent.

Sustainability and the principle of respect for community as a means of enhancing healthcare equality.

Global short-term dental or medical volunteerism has grown significantly in recent years. Dental and medical schools, their faculty, and students, are becoming increasingly interested in the experience of providing care to individuals in low-resource communities around the world. A laudable goal of such care is to provide care to individuals in low-resource communities and to work to achieve equity in health for all people. These goals are consistent with the American Dental Association's ethical principles of justice, beneficence, and nonmaleficence. This paper will discuss ethical guidelines for conducting these volunteer experiences with an emphasis placed on sustainability--the provision of ongoing collaborative care, between the institution overseeing the experience and the local community, after the visiting group has departed. The ultimate goal, global health care equity, requires transforming these shortterm efforts into long-term sustainable solutions. This goal is based on an ethical principle entitled respect for communities. This ethic can be likened to a community-wide application of the ethic of respect for autonomy as routinely applied to individuals such as patients. A tripartite model is proposed as a means for transforming short-term efforts into long-term sustainable solutions.

When psychiatric diagnosis becomes an overworked tool.

A psychiatric diagnosis today is asked to serve many functions-clinical, research, medicolegal, delimiting insurance coverage, service planning, defining eligibility for state benefits (eg, for unemployment or disability), as well as providing rallying points for pressure groups and charities. These contexts require different notions of diagnosis to tackle the particular problem such a designation is meant to solve. In a number of instances, a 'status' definition (ie, a diagnostic label or category) is employed to tackle what is more appropriately seen as requiring a 'functional' approach (ie, how well the person is able to meet the demands of a test of performance requiring certain capabilities, aptitudes or skills). In these instances, a diagnosis may play only a subsidiary role. Some examples are discussed: the criteria for involuntary treatment; the determination of criminal responsibility; and, assessing entitlements to state benefits. I suggest that the distinction between 'status' versus 'function' has not been given sufficient weight in discussions of diagnosis. It is in the functional domain that some of the problematic relationships between clinical psychiatry and the social institutions with which it rubs shoulders are played out. A status, signified by a diagnosis, has often been encumbered with demands for which it is poorly equipped. It is a reductive way of solving problems of management, allocation or disposal for which a functional approach should be given greater weight.

The Akhonya Dental Project: a new charity aiming to provide oral health education and preventative care in Kenya.

Kenya is a country plagued by HIV and lacking in adequate healthcare resources, and despite dental caries remaining the most common disease in the world, there is estimated to be only one dentist per 100,000 population in Kenya. Evidence suggests that many Kenyans are unaware of the causes of dental disease and half of the population are unaware of measures that can be taken to prevent dental disease. Oral health education is a clearly vital for improving the health of the Kenyan population. The Akhonya Dental Project is a new charity which aims to provide oral health education, prevention and treatment for AIDS orphans in rural Kenya. This article describes the ethos of the charity and long-term aim to increase oral health awareness in the region.

[From service of charity to profit center? An ethical critique of commodification of medicine]. / Vom karitativen Dienst am Menschen zum Profitcenter? Zu den ethischen Grenzen der Marktorientierung in der Medizin.

This paper wants to reflect the actual transformations of modern medicine. The implementation of the market into medicine is only possible by presupposing at least three implications: (a) the patient as consumer, (b) medical care as commodity, (c) competitiveness as criteria for good medicine. All three implications seem to be inadequate if the core identity of medicine is considered. If medicine is regarded as a human service for suffering people, it becomes clear that what medicine has to offer must be more than mere commodity. It is suggested to see medicine as a social institution which is linked to the obligation of the whole society to give medicine the possibility and the economic independence in order to remain an institution of charity which assures help for every man in need and which cannot be reduced to a mere enterprise.