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Using codesign to support the implementation of a midwifery unit in Europe
Get PDFBackground
Midwifery units (MUs) have demonstrated to be a safe and cost-effective model of maternity care. Several European countries do not offer this model yet but are working towards its implementation to improve perinatal outcomes, service users’ and midwives’ satisfaction while making effective use of healthcare resources. Few research projects have focused on the implementation aspect. This study observed and supported the process for implementation of a new MU in Italy using participatory action research (PAR) and codesign.
Methods
A 4-stage project was conducted to codesign an implementation plan aimed at supporting the transition from the obstetrically led maternity unit to an integrated model with a MU. The study engaged maternity professionals, managers and service users via online focus groups and eSurveys.
Findings
Participants identified ten themes to focus the implementation work on: team vision, creation of a multidisciplinary advisory group, creation of a dedicated group of midwives, implementation of intrapartum guidelines for low-risk women, appropriate risk assessment, integration hospital-community, training, effective communication and information for service users and within the team, and reflective practice. Service users supported the initiatives proposed in the implementation plan and expressed openness towards the model of care and its implementation.
Conclusions
This was the first study using codesign and PAR including maternity team, managers and service users to support the implementation of a MU. This work showed value in a collaborative codesign approach. While this work is adapted to the Italian context, the process and findings could be useful in other international contexts
The code and the community nurse: preserving safety
Get PDFThe ‘preserving safety’ section of the Nursing and Midwifery Council's code is integral to the delivery of safe and effective care. Nurses working in community settings are often exposed to unique challenges linked to their environment and the nature of their caseloads. The author addresses some of the ways in which community nurses can optimise their own safety while safeguarding the public. This article also explores best practice when things go wrong from a duty of candour perspective
“We’re all in it together”: uniting a diverse range of professionals and people with lived experience within the development of a complex, theory-based paediatric speech and language therapy intervention
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It is increasingly commonplace to involve relevant professionals and people with lived experience within healthcare research. Although valuable case studies regarding such involvement exist, there is currently a paucity of case studies highlighting the professional and personal impacts of uniting a diverse group of professionals and people with lived experience within the development of new, theory-based interventions. The aim of this paper is to provide insight into the impacts of involving a diverse range of individuals, unified within a single steering group, within the development of a new, theory-based, paediatric speech and language therapy intervention (“Supporting Words and Sounds” - SWanS). By describing the involvement process in detail and providing our personal insights, we hope our recommendations will be of use to future healthcare researchers.
Main body
Our project steering group consists of two people with lived experience (an adult with Developmental Language Disorder-DLD, a parent of a child with DLD), three specialist NHS speech and language therapists (including one university lecturer with equality and diversity expertise), and two individuals working in the education sector (a specialist teacher and a bilingual educational support worker). Group members have been involved across the 4 phase intervention development process. Tools such as the PiiAF (Public involvement impact Assessment Framework) have guided our personal and professional reflections on our individual experiences of being in a diverse steering group responsible for developing a new and complex theory-based intervention.
Conclusion
We found that having a diverse range of people unified in a singular intervention development steering group had unexpected benefits. Learning from each other has enriched professional practice and developed individuals’ confidence in terms of playing an active role in research. Our structured reflection has implications for future intervention development research, by highlighting that the provision of a safe, supportive space and nurturing of shared values is key when involving a diverse range of parties. Such contexts promote sustained involvement and therefore have longer term implications for increasing the relevance of the research for those it is aiming to help
Local News as Propaganda: Precarization and Media Control in Qinghai News
Get PDFIn this paper we report on the challenges that Chinese local news outlets face in the absence of independent newspapers and radio stations, the underfunding and under-training of journalists, and the effective use of digital-only local news outlets for state propaganda. To this end, we carried out in-depth interviews with 20 staff members, including department heads, editors, and journalists from Qinghai News, the local news outlet in the Chinese province of Qinghai, to examine the daily routine of a local news organization dedicated to state media propaganda. Our results also show that journalists are cognizant of the overzealous grip of the central government on the press, but that low pay, dwindling professional opportunities, limited financial support for career progression, and management inaction are the main reasons for the high attrition rate in the Chinese local news industry. The paper concludes with an overview of the local news industry in China and the relative differences to the sector in Western industrialized countries
Re-imagining procedural justice in policing sexual violence: centring survivors
Get PDFProcedural justice is recognized as being of substantial value to policing and, increasingly, victim-survivors. However, little research has engaged with the meaning of procedural justice theory in sexual violence, and none have developed an understanding with and for survivors. We conducted consultations with 42 survivors via five diverse expert-by-experience panels in England. We propose the following new conceptualizations of the key principles of procedural justice: dignity and respect, equity and fairness, voice, safety and trustworthiness. These principles foreground a feminist, situated and intersectional approach, and emphasize the importance of recognition, equity and the unconditional humanity of survivors. This work offers a new understanding of procedural justice in the context of policing sexual violence, and in institutional responses to gender-based violence more broadly
Female entrepreneurs targeting women: Strategic redirection under scientific decision-making
Get PDFThis paper explores whether and to what extent a scientific approach to decision-making can be a useful tool for helping entrepreneurs overcome limitations in the commercial exploitation of their idea particularly when these limitations stem from their status as users of the product or service. Using data from a variety of sources, including three randomized control trials and LinkedIn data, and focusing on female entrepreneurs who develop a value proposition targeting female consumers as a case of user entrepreneurs, this paper shows that exposure to a training that encourages entrepreneurs to develop theoretical maps about their business proposition and validate them with evidence prompts more radical pivots on their initial ideas compared to entrepreneurs with a value proposition that does not target women explicitly. In turn, treated female entrepreneurs with a female-targeted value proposition who pivot radically show better performance in launching and sustaining their ventures compared to those who have not pivoted
Emotional false memories: the impact of response bias under speeded retrieval conditions
Get PDFEmotional false memory findings using the DRM paradigm have been marked by higher false alarms to negatively arousing compared to neutral critical lure items. Explanations for these findings have mainly focused on false memory-based accounts. However, here we address the question of whether a response bias for emotional stimuli can, at least in part, explain this phenomenon. Participants viewed both neutral and negative arousing DRM lists and completed a recognition test in speeded or self-paced conditions. Speeded test reduces the opportunity to adjust response bias. Analysis showed no significant difference in false recognition across critical lure types for the speeded condition, but false recognition was higher for negative compared to neutral critical lures in the self-paced condition. We argue that when retrieval does not allow for shifts in response criteria, false alarms to negative emotional critical lures appear more similar to neutral equivalents. The discussion explores memory-based and criterion-shift explanations for the enhanced emotional false memory finding
Addressing Workplace Sexual Harassment Through Organizational Policy Messaging
Get PDFThis online experiment (N = 894) of working professionals in Kenya, South Africa, and the UK explored the potential impacts of organizational messaging on implementing anti-sexual harassment policies. After reading a victim focused, penalty focused, or neutral message, participants were tested on the Likelihood to Sexually Harass (LSH), Likelihood to Report (LR), Sexual Harassment Myth Acceptance (SHMA), and Ambivalent Sexism Inventory scales. Results showed the victim- and penalty-focused messages were a negative predictor of hostile sexism but not the remaining measures. The control was a positive predictor of LSH and a negative predictor of LR, indicating any messaging was better than none. Men had higher levels of LSH, SHMA, and hostile sexism, and lower levels of LR. UK participants were a positive predictor of LSH but notably, had lower levels of SHMA and ambivalent sexism. South African participants had higher levels of LR. The results show the need for organizations to increase their messaging on anti-sexual harassment policies as part of a pluralistic approach, while understanding the influence of culture and gender norms across multiple country contexts
Exploring social, cultural and environmental factors that influence attitudes to exercise among people with Parkinson’s disease: a qualitative study
Get PDFExercise is recommended for people with Parkinson’s (PwP) but clinical exercise-based interventions are generally ineffective. Social, cultural and environmental factors can influence exercise behaviours, but these topics are under-researched. We interviewed 18 PwP using a narrative approach to identify factors influencing their exercise behaviours throughout their lives. Thematic analysis identified three themes: (1) Why I exercise, (2) What helps, and (3) Exercise with Parkinson’s. Participants had consistent core motivations to exercise: mood and well-being, body image, competition, and camaraderie. Having active partners, supportive work, and varied exercise options were among the important facilitators of long-term exercise. Participants believed strongly in the benefits of exercise for Parkinson’s, but experienced guilt about not exercising enough and frustration when symptoms made it harder to continue. This study illustrates how narrative interviews can reveal important social, cultural and environmental influences on exercise behaviour, offering potential to develop more individualised and effective exercise interventions
Nowcasting U.S. state-level CO2 emissions and energy consumption
Get PDFThis paper proposes panel nowcasting methods to obtain timely predictions of CO2 emissions and energy consumption growth across all U.S. states. This is crucial, not least because of the increasing role of sub-national carbon abatement policies but also due to the very delayed publication of the data. Since the state-level CO2 data are constructed from energy consumption data, we propose a new panel bridge equation method. We use a mixed frequency set-up where economic data are first used to predict energy consumption growth. This is then used to predict CO2 emissions growth while allowing for cross-sectional dependence across states using estimated factors. We evaluate the models’ performance using an out-of-sample forecasting study. We find that nowcasts improve when incorporating timely data like electricity consumption relative to a simple benchmark. These gains are sizeable in many states, even around two years before the data are eventually released. In predicting CO2 emissions growth, nowcast accuracy gains are also notable well before the data release, especially after the current year’s energy consumption data are used in making the prediction
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