Improving continence services for older people from the service-providers' perspective: a qualitative interview study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.Objective To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting 3 acute and 13 primary care National Health Service Trusts in England. Participants 16 continence service leads in England actively treating and managing older people with UI. Results In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.Funding was received from the New Dynamics of Ageing Programme, led by the Economic & Social Research Council, UK (grantnumber RES-353-25-0010)

Perceived cultural competence levels among challenge course facilitators

The purpose of this study was to provide a greater understanding of the perceived levels and the importance of cultural competence within the context of challenge course facilitation and professional practice. One hundred seventy-two challenge course facilitators, who are currently members of the Association for Challenge Course Technology (ACCT), completed online surveys regarding cultural competence in professional practice. The findings showed that challenge course facilitators, who work in diverse settings, felt that cultural competence is an important issue in their professional practice and in the challenge course industry. Overall, the perceived levels of facilitator cultural competence (awareness and knowledge) were fair to good while the perceived levels of cultural skills varied from limited to good. Cultural competence was rated and ranked as the lowest professional skill when compared to the four other professional skills (core, risk management, technical, and facilitation) in regards to proficiency and importance for professional practice. Facilitators commented that cultural diversity is an important issue in the industry as professionals and participants are not as diverse as the current U.S. demographics. Challenge course facilitators acknowledged that training and education in cultural competence would improve their professional practice and positively influence the industry. This research adds to our understanding of cultural competence in challenge course professional practice, the importance of cultural diversity in the industry, and the importance of cultural competence as a skill in professional practice

Shotguns vs Lasers: Identifying barriers and facilitators to scaling-up plant molecular farming for high-value health products.

Plant molecular farming (PMF) is a convenient and cost-effective way to produce high-value recombinant proteins that can be used in the production of a range of health products, from pharmaceutical therapeutics to cosmetic products. New plant breeding techniques (NPBTs) provide a means to enhance PMF systems more quickly and with greater precision than ever before. However, the feasibility, regulatory standing and social acceptability of both PMF and NPBTs are in question. This paper explores the perceptions of key stakeholders on two European Union (EU) Horizon 2020 programmes-Pharma-Factory and Newcotiana-towards the barriers and facilitators of PMF and NPBTs in Europe. One-on-one qualitative interviews were undertaken with N = 20 individuals involved in one or both of the two projects at 16 institutions in seven countries (Belgium, France, Germany, Italy, Israel, Spain and the UK). The findings indicate that the current EU regulatory environment and the perception of the public towards biotechnology are seen as the main barriers to scaling-up PMF and NPBTs. Competition from existing systems and the lack of plant-specific regulations likewise present challenges for PMF developing beyond its current niche. However, respondents felt that the communication of the benefits and purpose of NPBT PMF could provide a platform for improving the social acceptance of genetic modification. The importance of the media in this process was highlighted. This article also uses the multi-level perspective to explore the ways in which NPBTs are being legitimated by interested parties and the systemic factors that have shaped and are continuing to shape the development of PMF in Europe

Perceptions of Burden in Needs Assessment: An Exploration of Measurement Creation and Validation

Needs assessment is a valuable tool in the instructional designer and performance improvement practitioner toolbox. However, it is often avoided due to perceived burdens associated with the needs assessment process. The current research explores needs assessment participants’ perceptions of four proposed components of burden, including: 1) duties, obligations, and responsibilities; 2) cost; 3) needs assessment facilitator skills; and 4) needs assessment facilitator systemic sensitivities. The researcher also developed and tested a Perceived Burden for Needs Assessment Participants Survey (PBNAPS) as a potentially reliable and valid measure of this phenomena. The PBNAPS proved to be both internally consistent (a= 0.86) and applicable across organizational contexts, constituent types, and lengths of affiliation. The majority of participants reported low levels of perceived burden (M = 2.97, SD = 0.88), suggesting that perceived burden in needs assessment is not as high as anticipated. Finally, an exploratory factor analysis yielded 1) a four-component model accounting for 52.27% of the variation on the concept of perceived burden, and 2) several implications for practitioners and future iterations of the PBNAPS

The New Charrette: Stakeholder Perceptions Of An Alternate Approach

Landscape architects, many of whom practice the design principles of the New Urbanism, have become increasingly involved with the participatory planning process. A key principle of New Urbanism, the participatory planning process is incorporated in an attempt to ensure that any new development - or alteration of an existing development - meets the needs of the community for which the design is created. This study examines data gathered from a web-based survey addressing the alternate, stakeholderess charrette approach. It was distributed to participants of charrettes facilitated by the Mississippi Main Street Association and is an attempt to understand the perceptions of those actively involved in the process. The purpose of this study was to examine this alternate approach to charrette facilitation and identify trends associated within. The analysis of stakeholder perceptions may prove beneficial in identifying trends that threaten charrette efficiency while highlighting trends worthy of replication in future charrettes

Biopsychosocial factors that hinders and/or facilitate successful return to work: A review of literature and knowledge of translation

Two community practitioners collaborated with the University of Puget Sound Occupational Therapy program and submitted the following clinical question: “What bio/psycho/social factors have been identified to hinder and/or facilitate successful return to work in addition to traditional work hardening/conditioning intervention for adults?” A literature review discovered 47 articles ranging from systematic reviews, descriptive, qualitative, outcome, and experimental studies. Evidence was synthesized by two reviewers into a critically appraised topic (CAT). Numerous facilitating (job satisfaction, employment accommodation, social support, multidisciplinary approach) and hindering factors (social isolation, depression, pain, self-perceived disability) were identified affecting one’s ability to return to work after various diagnoses. Due to the lack of literature on interventions addressing the biopsychosocial factors specifically for vocational rehabilitation, another literature review was conducted for the knowledge translation portion of the project. This review resulted in 22 additional articles addressing effective interventions to alleviate pain and/or depression, used by various healthcare professions. The researchers provided a document with detailed flow charts to the community practitioners summarizing the findings. Satisfaction surveys were administered to both collaborators to assess their professional opinion about the potential use of these interventions in their settings. Further research should explore the effectiveness and applicability of the interventions identified in this study in vocational rehabilitation

Systematic review of transition models for young people with long-term conditions: A report for NHS Diabetes.

Aims For many young people with Type 1 diabetes, transition from paediatric to adult care can result in a marked deterioration in glycaemic control. A systematic review assessed the effectiveness of transition models, or components of models, for managing the transition process in young people with long-term conditions, including Type 1 diabetes. This involved identifying (i) the main barriers and facilitators in implementing a successful transition programme, and (ii) the key issues for young people with long-term conditions and professionals involved in the transition process. Methods The following databases were searched from inception to August 2012: MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, Social Services Abstracts, Academic Search Complete, Social Science Citation Index, Cochrane and Campbell Libraries. Selected studies included young people aged 11 to 25 diagnosed with long-term conditions who were in transition from paediatric to adult secondary health care services. Results 16 systematic reviews and 13 primary studies were included from 9992 records retrieved. No single transition model was uniquely effective. The most successful transitions centred around: young person-focused; age and developmentally appropriate content and delivery; self-management education; family participation; paediatric and adult collaboration; designated transition clinics; transition co-ordinator; young person’s portfolio; specific professionals training; multidisciplinary approach; structured process embedded in service delivery. There were no distinctive characteristics of condition-specific Type 1 diabetes services. Conclusion This important and timely review summarises the key factors that need to be considered for the development of transition programmes for young people with long-term conditions, including those with Type 1 diabetes

An empirical investigation of the channels that facilitate a total quality culture

It is generally agreed that the culture of an organisation is a function of its values, beliefs and behavioural practices and that the influence of culture on an organisation is powerful and pervasive. There is also broad agreement that total quality management (TQM ) is a management paradigm that propagates certain values, behaviour and working methods. Moreover, that the successful introduction and practice of a total quality management approach requires close attention to, and more often than not modification of, organisational culture. Yet, culture is somewhat intangible, and regardless of the precise cultural aspirations, in order to change or maintain the desired culture an organisation needs a set of facilitating channels. These are mechanisms or necessary conditions that influence, mould and help sustain a desirable cultural orientation. This paper examines the channels that facilitate the development of a total quality culture based on the findings of an investigation of an international sample of organisations widely regarded as leading exponents of TQM