Managerial leadership for research use in nursing and allied health care professions : a narrative synthesis protocol

BACKGROUND: Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours.Methods/design: Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. DISCUSSION: With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership that supports and enables research use by health care practitioners, and how to develop leadership for the purpose of enhancing research use in clinical practice.

User perspectives on the Swedish Maternal Health Care Register

Background: Established in 1999, the Swedish Maternal Health Care Register (MHCR) collects data on pregnancy, birth, and the postpartum period for most pregnant women in Sweden. Antenatal care (ANC) midwives manually enter data into the Web-application that is designed for MHCR. The aim of this study was to investigate midwives? experiences, opinions and use of the MHCR. Method: A national, cross-sectional, questionnaire survey, addressing all Swedish midwives working in ANC, was conducted January to March 2012. The questionnaire included demographic data, preformed statements with six response options ranging from zero to five (0 = totally disagree and 5 = totally agree), and opportunities to add information or further clarification in the form of free text comments. Parametric and non-parametric methods and logistic regression analyses were applied, and content analysis was used for free text comments. Results: The estimated response rate was 53.1%. Most participants were positive towards the Web-application and the included variables in the MHCR. Midwives exclusively engaged in patient-related work tasks perceived the register as burdensome (70.3%) and 44.2% questioned the benefit of the register. The corresponding figures for midwives also engaged in administrative supervision were 37.8% and 18.5%, respectively. Direct electronic transfer of data from the medical records to the MHCR was emphasised as significant future improvement. In addition, the midwives suggested that new variables of interest should be included in the MHCR ? e.g., infertility, outcomes of previous pregnancy and birth, and complications of the index pregnancy. Conclusions: In general, the MHCR was valued positively, although perceived as burdensome. Direct electronic transfer of data from the medical records to the MHCR is a prioritized issue to facilitate the working situation for midwives. Finally, the data suggest that the MHCR is an underused source for operational planning and quality assessment in local ANC centres.

Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Marketing Social Change: A Comparative Historical and Methodological Analysis of Anti-Smoking Endeavors

Even though assessing social marketing endeavors proves to be challenging, evaluators can learn from previous campaigns and identify which facets of social marketing events, programs and campaigns need to be improved. Additionally, by analyzing social movements and evaluating how they connect to social marketing, we can gain a clearer view on ways to ameliorate the field of social marketing. As social marketing becomes increasingly sophisticated and similar to commercial marketing, there is hope that social marketing can yield higher rates of success in the future. Friend and Levy (2002) claimed that it was nearly impossible to compare social marketing endeavors using quantitative criteria and advocate the use of qualitative methods. However, if social marketing scholars developed a more systematic paradigm to assess events, programs and campaigns employing a combination of both quantitative and qualitative methods, then it would be easier to establish which social marketing efforts generated more success than others. When there are too many confounding variables, conclusions cannot always be drawn and evaluations may not be viewed as legitimate. As a result, critics become skeptical of social marketing’s value and both the importance and credibility of social marketing decline. With the establishment of proper criteria and evaluation methods, social marketing can progress and initiate more social change.

Franquias sociais: minimizando riscos no investimento social

o interesse pela responsabilidade social nos últimos anos, quer como conceito ou prática, vem crescendo à medida que os problemas sociais eclodem e aumentam as expectativas de contribuição das organizações como uma parceria qualificada. Nesse contexto, o segmento empresarial vem se deparando com pressões advindas de movimentos de defesa do consumidor, campanhas de combate à miséria e a fome, além de outros que surgem com o recrudescimento de temas de minorias excluídas da vida social. Diante deste quadro as empresas estão incorporando a responsabilidade social aos objetivos de seus negócios como um fator de diferenciação no mercado e para promover benefícios sociais de grande relevância. Este estudo enfoca a responsabilidade social empresarial e a alternativa de utilização de metodologia semelhante a das franquias comerciais, as franquias sociais, para a prática das ações sociais nas empresas cearenses. A abordagem da investigação é predominantemente qualitativa e parte de uma revisão bibliográfica sobre a temática em foco, procurando compreender suas interações e incorporações nas práticas empresariais. A pesquisa considerou o universo de 32 empresas que concorreram ao "Premio Delmiro Gouvêa" , edição 2003, das maiores e melhores empresas do Estado do Ceará. A amostra corresponde a 22 dessas organizações onde as informações foram disponibilizadas. Os resultados encontrados produzem evidências que a metodologia das Franquias Sociais tem uma percepção positiva por parte do empresariado e novos estudos, sobre a temática, devem ser conduzidos com o intuito da construção de um referencial teórico mais abrangente que o ora disponível.

Fisioterapia no sistema único de saúde : estudo etnográfico de representações e práticas em saúde em Porto Alegre

Este trabalho aborda as representações e práticas dos fisioterapeutas inseridos no Sistema Único de Saúde. Com o intuito de desvendar o modo de pensar e agir, além do nível de inserção que alcançou a fisioterapia dentro do Sistema Único de Saúde, busquei compreender a lógica orientadora de suas ações terapêuticas bem como sua adequação às diretrizes desse Sistema. Para tal, utilizei uma abordagem antropológica de cunho qualitativo com o privilégio da observação participante e entrevistas semi-estruturadas realizadas em dois serviços de saúde de Porto Alegre: um hospital e um ambulatório de nível secundário. A revisão histórica da profissão ajudou na contextualização e, deste modo, entender por que os fisioterapeutas estão centrados na abordagem física das pessoas. Esse modo de tratar as pessoas é ensinado aos profissionais no processo de formação e reforçado na prática profissional dirigida à reabilitação, tendo o manuseio do paciente um valor importante para o fisioterapeuta. Por sua vez, este tipo de trabalho manual associado a um papel feminino do cuidado são fatores de demérito frente as outras profissões da saúde. Isto reforça a posição hierárquica inferior que o profissional possui dentro do Sistema Único de Saúde, que em alguns momentos é confundido como um especialista da medicina física. Desse modo, este trabalho contribuiu para repensarmos as concepções de saúde que são ensinadas na academia, o que vem a ser o “fazer fisioterapêutico”, bem como, a integralidade das ações terapêuticas dentro do Sistema Único de Saúde.

The impact of content marketing on attitudes and purchase intentions of online shoppers : the case videos & tutorials and user-generated content

This thesis was written as part of a Double-Degree Masters program in Management, with focus in Marketing. Aligned with the nature of the degree, this study aims to be a useful tool for managers and marketers, which conduct business online. This thesis is a study of Content Marketing in the content of online commercial product pages. Its aim is to understand how to use content marketing to drive conversion, by understanding consumer attitudes and purchase intention towards content. A in-depth study of existing theories and exploratory primary research was developed in other to attain these objectives. Business-to-consumer electronic commerce (B2C e-commerce) has provided consumers and online retailers with a more effective medium to perform online transactions through commercial websites. Although consumers have realized that the benefits of online shopping; such as time saving, minimizing effort, convenience, broader selection, and wider access to information, they are still greatly unwilling to shop online. Consumers shop essentially for two motives, to meet experiential (fun) or goal-oriented (efficiency) needs (Wolfinbarger & Gilly, 2001). The information provided by content marketing seeks to focus on consumers need for information and entertainment, instead of focusing on the brand. Thus, it is expected that the type of content format will have different effects on the attitudes and purchase intention on the online shopper, depending on the online shopping purpose. Concretely, a goal-oriented shopper should find user generated content (UGC) to be more valuable content formats, since they decrease the amount of search effort. While on the other hand, videos & tutorials (VT) might be perceived as more valuable for a consumer looking to spend time and being entertained through online shopping. The exploratory research was characterized by a survey experiment with online consumers. Participants were exposed to stimuli of content marketing tested according to their attitudes and purchase intention. The focus was to understand the impact of two different content marketing tactics—User-generated content and Videos & Tutorials—on attitudes and purchase intentions and how they interact with content complexity. The results indicate that content marketing in commercial product pages is relevant in driving consumer attitudes and purchase intentions. Consumers are not motivated by a specific content marketing tactic, unless that content has a certain level of complexity. In that case, Ur-Generated Content becomes a relevant tactic in product pages, however VT is not.

Effects of elevated calcium on motor and exploratory activities of rats

The effects of serum and brain calcium concentration on rat behavior were tested by maintaining animals on either distilled water (N = 60) or water containing 1% calcium gluconate (N = 60) for 3 days. Animals that were maintained on high calcium drinking water presented increased serum calcium levels (control = 10.12 ± 0.46 vs calcium treated = 11.62 ± 0.51 µg/dl). Increase of brain calcium levels was not statistically significant. In the behavioral experiments each rat was used for only one test. Rats that were maintained on high calcium drinking water showed increased open-field behavior of ambulation (20.68%) and rearing (64.57%). on the hole-board, calcium-supplemented animals showed increased head-dip (67%) and head-dipping (126%), suggesting increased ambulatory and exploratory behavior. The time of social interaction was normal in animals maintained on drinking water containing added calcium. Rats supplemented with calcium and submitted to elevated plus-maze tests showed a normal status of anxiety and elevated locomotor activity. We conclude that elevated levels of calcium enhance motor and exploratory behavior of rats without inducing other behavioral alterations. These data suggest the need for a more detailed analysis of several current proposals for the use of calcium therapy in humans, for example in altered blood pressure states, bone mineral metabolism disorders in the elderly, hypocalcemic states, and athletic activities.

Children's Perspectives on their Economic Activity as a Pathway to Resilience

When viewed in the context of children's physical, social, and economic ecologies, children's work has both contextually specific benefits and consequences. This paper examines children's experiences of their economic activity using a theory of resilience as a contextually and culturally embedded phenomenon [British Journal of Social Work, 38 (2008) 218]. Though there is evidence that child labour is a potential threat to children's well-being, some forms of children's work may function as potential sources of health-enhancing resources associated with resilience, resulting in positive psychosocial development. Working children can find through their working experiences positive sources of efficacy and cohesion, strong identity, feelings of well-being, positive relationships, and access to material and social capital. (C) 2009 The Author(s). Journal compilation (C) 2009 National Children's Bureau and Blackwell Publishing Limited.

Understanding the effects of isolation on seed and pollen flow, spatial genetic structure and effective population size of the dioecious tropical tree species Myracrodruon urundeuva

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)