Providing the family-nurse partnership programme through interpreters in England

This study looks at the delivery of the Family-Nurse Partnership (FNP) in England with interpreters. This home-visiting programme for vulnerable, young first-time mothers is known in the USA as the Nurse-Family Partnership (NFP). FNP is manualised with a number of fidelity targets and stretch objectives. This study covers the first two phases, pregnancy and infancy (up to 12 months). The programme relies on the development of a close nurse-client relationship. Interpreters can be a barrier for therapeutic work with vulnerable groups. The aims are to determine from quantitative and qualitative data whether the FNP programme can be delivered with fidelity in the presence of an interpreter and to explore issues concerned with the impact of interpreters on relationships. Statistical comparisons were made of delivery objectives over 2 years, from April 2007 to February 2009, in the 10 sites in England, spread across all nine Government Office Regions providing FNP. Forty-three clients had an interpreter at some point and 1261 did not. Qualitative interviews were conducted between April and May 2009 with 30 stakeholders (nurses, clients, interpreters). In relation to quantitative indicators, the percentage of planned content covered in visits was lower with interpreters (pregnancy 90% vs. 94%; infancy 88% vs. 93%) and both understanding and involvement of clients, as judged by nurses on 5-point scales, were lower (understanding, pregnancy 4.3 vs. 4.6, infancy 3.8 vs. 4.5; involvement, pregnancy 4.4 vs. 4.7, infancy 3.7 vs. 4.5). The interpreter was not thought by nurses to impede the development of a collaborative client-nurse relationship unless the interpreter and client became too close, but some nurses and clients reported that they would rather manage without an interpreter. Some stress was noted for nurses delivering the programme with an interpreter. More research is needed to determine the extent to which interpreters accurately convey the programme's strength-based approach

Rulemaking in the Shade: An Empirical Study of EPA’s Air Toxic Emissions

In this article, the authors trace the engagement and the influence of interest groups over the entire life cycle of a complete set of complex EPA rules that set emissions standards for the industrial release of air toxins. In particular they focus on three of the most worrisome phases of the administrative process where imbalances in interest group engagement and influence may be occurring. The thesis of this study is that imbalances in interest group engagement are occurring at critical albeit somewhat obscure stages of the rulemaking life cycle and that these imbalances are impacting the substance of the rulemaking project. This article proceeds in five parts. Part I explores three stages in the rulemaking life cycle that may be afflicted with imbalanced interest group engagement that in turn might distort the outcome of the rulemaking project. Part II describes the methods of the article, which examine the nature of interest group engagement and activity at these problem stages in a complete set of rules promulgated by the EPA governing the industrial emissions of air toxics. Part III describes the findings and Part IV collects information from disparate sources in detective like fashion to explain some of the surprises and new questions that emerge from this research. In the conclusion, the authors retell the store that emerges from their data and consider whether it suggests more pervasive problems in administrative law that will benefit from further study.The Kay Bailey Hutchison Center for Energy, Law, and Busines

Institutional Support to Academic Wellbeing during COVID-19 Disruptions and the Move to Emergency E-Learning: A time to Signal SOS

The COVID-19 restrictions in place for 2020 and 2021 were investigated in terms of the changing environment academics were forced into due to stay at home orders, where they entered into emergency e-learning, from home. The effects of emergency e-learning on academic’s workloads, job satisfaction and motivation, as well as overall wellbeing have yet to be investigated and reported. This identified gap in the literature enabled the generation of a research problem and research questions, on the challenges of emergency e-learning for academics in the higher education sector. Survey findings show institutions unprepared, academics untrained and under resourced and students disengaged with the online learning environment. The development of the SOS model is proposed as a recommendation that institutions need to Support their staff and students in the move to the Online environment, and to Supplement resources and training for academics delivering contact online that was designed for a face-to-face delivery

How TRUST is both the Driver and Inhibitor in Not-for-profit Sector Growth Strategies: The “Lived” Experience of Merger and Acquisition

This research is a case study based on the “lived experience” of two not-for-profit organisations wanting to create synergies and efficiencies in back office operations and to increase the offerings of services to existing clients by joining together as one business unit. This research has followed the different stages of the proposed merger or acquisition from the initial signing of the Memorandum of Agreement (MOA), to the strategic planning for the new entity including the potential organisational structure, board structure and executive team recruitment. The negotiations have varied from the rejection of a takeover, to the proposal of a merger, to the eventual decision for the larger organisation to “acquire” the smaller organisation. These decisions were deliberated at great length by both organisations, but the clear driver in all negotiations was TRUST. Trust that at all times the outcomes should benefit clients, trust that the new Board would be represented in equal parts by both of the organisations and trust that the new senior executive team of the single entity would utilise the efficiencies gained to sustain the organisation. But this trust also became an inhibitor at times, where trust was used as an excuse to not carry out all due diligence governance processes (DDGP). This lived experience has shown that Trust is indeed an important factor in any proposed merger or acquisition but will never replace DDGP. In fact DDGP enhanced trust, and enabled for more transparent decisions to be reached by both parties at the negotiation table. The not-for-profit sector can learn a great deal from this case study that shows the benefits of societal needs of their clients in aged care, disability and transport by a merger or acquisition. It should be used by other not-for-profit organisations to put into practice strategic merger and acquisition processes to create an organisation that is run efficiently and for the benefit of their clients, with a combination of trust and DDGP

The Influence of the 7 Habits of Highly Effective People During a Merger of a Fire Department and Emergency Medical Services in a Midwestern State : A Single Case Study from 2007 to 2013

Problem. Organizational mergers are difficult and often chaotic at best, fraught with unknowns that can derail the best of plans. In this study, two cultures, fire suppression and emergency medical services, were brought together in order to create a stronger fire department by consolidating resources and knowledge and to appease an ever-tightening municipal budget. How to save the best practices from each side and create a new culture was the conundrum the leadership team faced. The purpose of this study was to understand how Stephen Covey\u27s The 7 Habits of Highly Effective People influenced the change dynamics experienced during the merger of fire suppression and emergency medical services (EMS) in one American Midwestern fire department from 2007-2013. Method. This case study relied on interviews and the lived experiences of the members of two organizations, along with artifacts and the Standard Operating Guidelines that are the operational policy and procedure documents found in any fire department. The assessment rating by the Insurance Standards Office provided an overall independent, external validation source of their performance. Interviewees self-selected into the research process based on an open-invitation letter to all members of the department. Of the 106 members receiving the interview invitation, 23 members of varying rank in the department responded; the past and present mayors of River City also accepted. Open-ended questions were asked allowing participants to freely respond based on their vantage points during the merger process. Together, their stories and lived experiences chronicle the 10-year merger process while providing a unique look into the emotional and cultural atmosphere leadership faced when creating their merger strategy, a dilemma which significantly delayed the change process and impacted job performance. Interviewees were assigned an identity-protective pseudonym which provided a much needed sense of safeness in order to speak without fear of reprisal. Compilation of the information gleaned during the interviews began with transcribing the interviews, which were processed using the Dedoose qualitative software program. Documents and artifacts indigenous to the River City Fire Department were utilized to strengthen the foundation of the research. Results. Analysis revealed information and behaviors which corresponded to the research question: How did The 7 Habits of Highly Effective People influence the organizational change process during the merger of fire suppression and emergency medical response in one Midwestern fire department during the years of 2007-2013? Four specific areas of growth and improvement were clearly identified: (a) the prevailing passive-aggressive divisive spirit was replaced with a sense of department renewal and unification, (b) attitudes, language, and behavior changed, improving communication, (c) the overall structure was solidified to provide better services and, (d) Standard Operating Guidelines were updated to reflect the newly established practices. Conclusions. This fire department experienced many of the pitfalls and successes organizational theorists predict in such situations. However, while those theorists provide a change framework to model, many of them do not consider the emotional elements that will surface when human beings are involved. The emotions behind the passive-aggressive behavior in this study, which at times held this merger hostage, could have been assuaged had leadership anticipated problem areas of the merger and then sought the necessary support and training to work with the individuals involved. The result was a significant loss of time while everyone tried to figure out how to move forward together. Persistence and a pragmatic change process template found within the teachings of Covey\u27s The 7 Habits of Highly Effective People eventually set this organization on a less troublesome path to success. Organizational language and leadership practices changed to mirror their new collaborative paradigm. Additionally, a leadership mentoring program was developed so that future leaders would be trained to carry the new baton of leadership forward

Educating Students to Become Culturally Competent Physical Therapists: Issues of Teaching and Assessment

With the growing multicultural population within the United States, healthcare providers need to be prepared to care for and educate adult clients from various cultural backgrounds. The purpose of the study was to examine the teaching and assessment methods being used by faculty in the education of future physical therapists in teaching the construct of cultural competence, how these methods may vary according to the educational background of faculty in relation to the use of concepts specific to adult education that may lead to transformational learning, and faculty opinions about teaching and assessing this abstract construct. Survey methodology was used in the study. A questionnaire was distributed to faculty within physical therapy academic programs throughout the United States. Participants were separated into groups by educational background of clinical sciences versus education in order to assess for differences in teaching and assessment methodology, attitudes related to adult learning theory, and opinions related to personal understanding of cultural competence and the ability to teach and assess cultural competence in the educational environment. The results of the study offered an overall picture of academic activities in physical therapy education related to preparing future physical therapy practitioners to be culturally competent healthcare providers

The on-going search for perspective-taking IRAPs : exploring the potential of the natural language-IRAP

Under a Relational Frame Theory (RFT) framework, researchers have investigated the role of deictic relational responding (perspective-taking) in the analysis of self in relation to others, place, and time. The aim of the current research was to develop IRAPs that targeted deictic relational responding with regard to the mental states of self and others. This was pursued in a series of experiments that employed a novel version of the IRAP, known as the Natural Language-IRAP (NL-IRAP). The use of the NL-IRAP allowed for the presentation of relatively complex statements that required participants to infer the thoughts or beliefs of others on a trial-by-trial basis within the IRAP. Across a sequence of six experiments, a self-focused IRAP required participants to respond to both positive and negative statements about themselves, whereas an other-focused IRAP required participants to respond to similar statements about others. Experiments 1 and 2 investigated perspective-taking with regard to an unspecified other. Experiments 3-6 investigated perspective-taking with regard to a specified other, with the specified relationship between self and other manipulated across experiments. The results of Experiments 1 and 2 indicated that the other-focused IRAP produced overall bias scores that were significantly stronger than responding to the self-focused IRAP. It is interesting that nonsignificant differences were recorded across Experiments 3-6 when other was specified. The findings obtained across the six studies highlight potentially important limitations in the use of the NL-IRAP as a measure of perspective-taking