Online technologies have facilitated the development of Virtual Communities of Practice (virtual CoPs) to support health professionals collaborate online to share knowledge, improve performance and support the spread of innovation and best practices. Research, however, shows that many virtual CoPs do not achieve their expected potential because online interaction among healthcare professionals is generally low. Focusing on health visitors, who are UK qualified midwives or nurses who have undertaken additional qualifications as specialist public health workers in the community, the paper examines the factors that influence online interaction among health visitors collaborating to share knowledge and experience in a virtual CoP. The paper makes suggestions for how to improve online interaction among health professionals in virtual CoPs by increasing the size of membership in order to take advantage of both posting and viewing contributions, facilitating moderation to improve networking among geographically dispersed members groups and improving the topic relevance in order to stimulate contributions.
An emerging body of work on farmers markets and other traditional retail markets has recently come into focus among scholars concerned with the study of contemporary retailing and consumption practices. Marketplaces in Euro‐American contexts are currently promoted as essential elements of urban renaissance, promoting local food movements, tourism and economic regeneration and encouraging face‐to‐face interactions among increasingly diverse ethnic groups in towns and cities. At the same time, the study of marketplaces which has long been of interest to scholars working in the global south is primarily portrayed through a lens of developmentalism as archaic and embroiled in a narrative about the poverty of traders and urban informality, thus limiting the latter's contributions to the critical retailing and consumption literature. This paper explores the case of marketplaces in Lagos, Nigeria, to comments on the challenges and possibilities for making meaningful comparative research that connect marketplaces across the global north–south divide.
The older population is particularly susceptible to malnutrition, which currently affects 1.3 million people aged 65+ in the United Kingdom. Malnutrition is an outcome of food insecurity and despite demographic changes that have led to a rise in numbers of older people, we know very little about how older people become vulnerable to food insecurity. The aim of this study was therefore to explore older people's everyday food practices in order to expose the strengths and challenges within local and national food systems, and better understand how food insecurity might arise in later life. This empirical study operationalised practice theory using a multi-method ethnographic approach with 25 households aged 60–94 years, comprising interviews, observation, visual methods and food logs. A model of vulnerability developed by Schröder-Butterfill and Marianti framed data collection and analysis. Analysis revealed the assets and adaptations older households used to protect themselves from threats to food security. Factors ranging from changes to physical and mental health, and structural factors such as supermarket design, moved households towards food insecurity. Smaller everyday ‘trivia’, e.g. lack of seating and accessible toilets in supermarkets, accumulated to shift people towards vulnerability. Vulnerability is structured by the habitus but is a fluid, relational, temporal and socially constructed state, and people moved towards and away from vulnerability. We have developed a model that accommodates this fluidity, incorporates the concept of ‘cumulative trivia’ and suggests how the ‘aggregation of marginal gains’ could counter-balance and address trivial threats. This model demonstrates to policy makers and those working in public health how vulnerability to food insecurity operates and where interventions could be applied to support households to achieve food security and avoid becoming malnourished.
At the heart of health visiting practice has been the emphasis on ensuring that healthcare services transferred to and commissioned by local authorities, deliver successfully on the Healthy Child programme. And while part of that focus has been on increasing numbers in the health visiting workforce, there has also been a renewed strategy in health policy to enhance continued professional development (CPD) of the workforce through innovative tools that will transform, improve and deliver services in response to the six high impact areas. This paper describes the use and evaluation of such a tool that was developed in the form of an Online Community of Practice to enhance and support practitioners to share issues, resolve recurring problems and collaborate to share best practices and robust evidence around the six high impact areas. The posts of 250 health visitors who shared, managed and co-produced knowledge online over a 2-year period were explored using realist evaluation techniques. Results showed that the success of online CoPs as interventions to improve and transform healthcare practice around the six high impact areas is promising. Participating in online discussion saved time and strengthened and improved support from peers that would otherwise be unavailable to geographically distributed practitioners. The advantage of a secure virtual environment allowed health visitors to discuss key issues arising from everyday practice as a coherent professional group, which in turn produced peer reviewed knowledge that prioritised clients' needs in relation to local community needs.
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