Perceptions of high involvement work practices, person-organization fit and burnout: a time lagged study of health care employees

Previous research demonstrates that high-involvement work practices (HIWPs) may be associated with burnout (emotional exhaustion and depersonalization); however, to date, the process through which HIWPs influence burnout is not clear. This article examined the impact of HIWPs on long-term burnout (emotional exhaustion and depersonalization) by considering the mediating role of person-organization fit (P-O fit) in this relationship. The study used a time-lagged design and was conducted in a Canadian general hospital among health care personnel. Findings from structural equation modeling (N = 185) revealed that perceived HIWPs were positively associated with P-O fit. There was no direct effect of HIWPs on burnout; rather, P-O fit fully mediated the relationship between employee perceptions of HIWPs and burnout. This study fills a void in the HR and burnout literature by demonstrating the role that P-O fit has in explaining how HIWPs alleviate emotional exhaustion and depersonalization. © 2016 Wiley Periodicals, Inc.

An analysis of Child Care Policy and Practice in Barnardo’s Macedon and Sharonmore residential homes in Northern Ireland during the period 1952 – 1990, the period under investigation by the Inquiry.

Report to examine the nature and extent of any abuse in Barnardo’s Macedon and Sharonmore residential homes in Northern Ireland and to determine whether that abuse was caused or facilitated by failings on the part of Barnardo’s, and whether they were systemic in nature. Abuse and systemic failings as defined in the document published by the Inquiry in June 2013 “Definition of Abuse and Systemic Failings”.

Music therapy for end-of-life care: an updated systematic review

Background: Music therapy during palliative and end-of-life care is well established and positive benefits for patients have been reported.
Aim: Assess the effectiveness of music therapy versus standard care alone or standard care in combination with other therapies for improving psychological, physiological and social outcomes among adult patients in any palliative care setting.
Data sources: In order to update an existing Cochrane systematic review, we searched MEDLINE, CINAHL, EMBASE, PsycINFO, CENTRAL, ClinicalTrials.gov register, and Current Controlled Trials register to identify randomised or quasi-randomised controlled trails published between 2009 and April 2015. Nine electronic music therapy journals were searched from 2009 until April 2015, along with reference lists and contact was made with key experts in music therapy. Only studies published in English were eligible for inclusion. Two reviewers independently screened titles, abstracts, assessed relevant studies for eligibility, extracted data and judged risk of bias for included studies. Disagreements were resolved through discussion with a third reviewer. Data were synthesised in Revman using the random effects model. Heterogeneity was assessed using l2.
Results: Three studies were included in the review. Findings suggest music therapy may be effective for helping to reduce pain in palliative care patients (standard mean deviation (SMD) = -0.42, 95% CI -0.68 to -0.17, P = 0.001).
Conclusions: Available evidence did not support the use of music therapy to improve overall quality-of-life in palliative care. While this review suggests music therapy may be effective for reducing pain, this is based on studies with a high risk of bias. Further high quality research is required.

Healthcare Staff Experience of Providing End-of-Life Care to Children: A Mixed Method Review

Background: Staff who provide end-of-life care to children not only have to deal with their own sense of loss, but also that of bereaved families. There is a dearth of knowledge on how they cope with these challenges.
Aim: The aim of this review is to explore the experiences of health care professionals who provide end-of-life care to children in order to inform the development of interventions to support them, thereby improving the quality of paediatric care for both children and their families.
Data sources: Searches included CINAHL, MEDLINE, Web of Science, EMBASE, PsychINFO, and The Cochrane Library in June 2015, with no date restrictions. Additional literature was uncovered from searching reference lists of relevant studies, along with contacting experts in the field of paediatric palliative care.
Design: This was a systematic mixed studies review. Study selection, appraisal and data extraction were conducted by two independent researchers. Integrative thematic analysis was used to synthesise the data.
Results: The 16 qualitative, six quantitative, and eight mixed-method studies identified included healthcare professionals in a range of settings. Key themes identified rewards and challenges of providing end-of-life care to children, the impact on staff’s personal and professional lives, coping strategies, and key approaches to help support staff in their role.
Conclusions: Education focusing on the unique challenges of providing end-of-life care to children and the importance of self-care, along with timely multidisciplinary debriefing are key strategies for improving healthcare staffs’ experiences, and as such the quality of care they provide.

Why Putin has pulled Russia out of Syria

By formally quitting during a ceasefire he himself masterminded – and on the back of significant military gains – Putin can leave with his head held high. Having proven his critics wrong and demonstrated the capability of Russia’s military (and its new weapons – a splendid advert to any buyers of Russian arms), Putin can now concentrate on the diplomatic aspect of the peace process, something at which Moscow usually excels.

Measuring healthcare integration: Operationalization of a framework for a systems evaluation of palliative care structures, processes, and outcomes

BACKGROUND: Healthcare integration is a priority in many countries, yet there remains little direction on how to systematically evaluate this construct to inform further development. The examination of community-based palliative care networks provides an ideal opportunity for the advancement of integration measures, in consideration of how fundamental provider cohesion is to effective care at end of life.

AIM: This article presents a variable-oriented analysis from a theory-based case study of a palliative care network to help bridge the knowledge gap in integration measurement.

DESIGN: Data from a mixed-methods case study were mapped to a conceptual framework for evaluating integrated palliative care and a visual array depicting the extent of key factors in the represented palliative care network was formulated.

SETTING/PARTICIPANTS: The study included data from 21 palliative care network administrators, 86 healthcare professionals, and 111 family caregivers, all from an established palliative care network in Ontario, Canada.

RESULTS: The framework used to guide this research proved useful in assessing qualities of integration and functioning in the palliative care network. The resulting visual array of elements illustrates that while this network performed relatively well at the multiple levels considered, room for improvement exists, particularly in terms of interventions that could facilitate the sharing of information.

CONCLUSION: This study, along with the other evaluative examples mentioned, represents important initial attempts at empirically and comprehensively examining network-integrated palliative care and healthcare integration in general.

‘Harmonising the precaution out of the precautionary principle? The need for maintaining flexibility and an interpretative role’

The precautionary principle has the potential to act as a valuable tool in food law. It operates in areas of scientific uncertainty, calling for protective measures where there are potential threats to human health (or the environment). However, the manner of the principle’s incorporation and implementation within legislation are key to its effectiveness and general legitimacy. Specific considerations include the role and nature of risk assessments, assessors, sources of evidence, divergent opinions, risk communication, other legitimate factors and the weighting of interests. However, more fundamentally, the crystallisation of approaches and removal of all flexibility would undermine the principle’s central tenets. Firstly, principles crucially play a guiding and interpretative role. Secondly, reflexive modernisation and continuing scientific uncertainty call for the precautionary principle’s continued application – precautionary measures do not end the precautionary principle’s relevance. This can be partially achieved through the legislation so as to facilitate later precautionary measures, e.g. through temporary authorisations, derogations and safeguard clauses. However, crucially, it requires that the legislation also be interpreted in light of the precautionary principle. This paper investigates the logic behind the Court of Justice of the EU’s judgments and the circumstances that enable or deter the Court in taking, or permitting, stronger precautionary approaches. Although apparently inconsistent, a number of contextual factors including the legislative provisions and actors involved influence the judgments substantially. The analysis provides insight into improving the principle’s incorporation to facilitate its continued application and maintenance of flexibility, whilst bearing in mind the general desirability of objectivity and legal certainty.