Long term care and the coronavirus pandemic: a new role for environmental design in a changing context

First paragraph: It took more than three decades of championing the principles of environmental design for dementia and developing the research evidence base on how the physical environment can support the independence and wellbeing of people with dementia to reach a point where cognitively supportive design should be the default requirement for new and existing long term residential care facilities. It has taken a fraction of that time for an emerging coronavirus to displace concern with residents’ lived experience in favour of strict transmission and infection control measures, forcing a return to more institutionalised and medicalised environments and care practices

The short form of the Workplace Affective Commitment Multidimensional Questionnaire (WACMQ-S): A bifactor-ESEM approach among healthcare professionals

Although it has long been recognized that employees' workplace affective commitment can be directed at a variety of foci, theory and research on this multifocal perspective remain underdeveloped, possibly due to the lack of a short, yet comprehensive measure. The purpose of the present study was to assess the psychometric properties of a newly developed short (24-item) version of the Workplace Affective Commitment Multidimensional Questionnaire (WACMQ-S), covering affective commitment directed at the organization, supervisor, coworkers, customers, tasks, profession, work, and career. Using two independent samples of English - (N = 676, including 648 females) and French - (N = 733, including 593 females) speaking healthcare professionals and the newly developed bifactor-ESEM framework, the present study supported the factor validity, composite reliability, test-retest reliability, linguistic invariance, and criterion-related validity (in relation to turnover intentions, in-role performance, and organizational citizenship behaviors) of the WACMQ-S ratings. The results also demonstrated the superiority of a bifactor-ESEM representation of WACMQ-S ratings, confirming the importance of taking into account employees' global levels of commitment to their work life. Finally, the results also proved to be fully generalizable to subsamples of hospital and community healthcare professionals, as well as of nurses and beneficiary attendants

Crop pests and predators exhibit inconsistent responses to surrounding landscape composition

The idea that noncrop habitat enhances pest control and represents a win–win opportunity to conserve biodiversity and bolster yields has emerged as an agroecological paradigm. However, while noncrop habitat in landscapes surrounding farms sometimes benefits pest predators, natural enemy responses remain heterogeneous across studies and effects on pests are inconclusive. The observed heterogeneity in species responses to noncrop habitat may be biological in origin or could result from variation in how habitat and biocontrol are measured. Here, we use a pest-control database encompassing 132 studies and 6,759 sites worldwide to model natural enemy and pest abundances, predation rates, and crop damage as a function of landscape composition. Our results showed that although landscape composition explained significant variation within studies, pest and enemy abundances, predation rates, crop damage, and yields each exhibited different responses across studies, sometimes increasing and sometimes decreasing in landscapes with more noncrop habitat but overall showing no consistent trend. Thus, models that used landscape-composition variables to predict pest-control dynamics demonstrated little potential to explain variation across studies, though prediction did improve when comparing studies with similar crop and landscape features. Overall, our work shows that surrounding noncrop habitat does not consistently improve pest management, meaning habitat conservation may bolster production in some systems and depress yields in others. Future efforts to develop tools that inform farmers when habitat conservation truly represents a win–win would benefit from increased understanding of how landscape effects are modulated by local farm management and the biology of pests and their enemies

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Condition-dependent adaptivity of organizational learning in Ontario's long-term care industry

grantor: University of TorontoOrganizations learn as a consequence of operating in their environments where they, intentionally or unintentionally, gather information and acquire knowledge. While organizational learning is generally considered adaptive, research suggests that the impact of learning on firms is far more complex. Recently, it has been suggested that the adaptivity of organizational learning is condition-dependent (Miner, Raghavan and Haunschild, 1997), complementing earlier views that some types of learning extend the survival of firms in certain situations (Dutton and Freedman, 1985; March, 1991; Levinthal, 1991). My review of current theory and recent research supports the idea of condition-dependence--that learning at the organization and population levels may be differentially advantageous to organizational survival. Specifically, organizational learning may be survival-enhancing, survival-imperiling, or exert no effects, depending upon the extent of environmental uncertainty confronting organizations. My research investigates the notion of condition-dependent adaptivity of organizational learning. The dependent variable I examine is the risk of organizational failure: survival-enhancing organizational learning serves to lower the risk of failure while harmful organizational learning increases the risk of failure. I test a series of hypotheses concerning the effects of organization-level, vicarious population-level, cross-population, and congenital population-level experience, and the moderating effects of regulation-induced uncertainty--regulatory dynamism--on the risk of organizational failure. I use event history analysis to test my hypotheses in the population of charitably-funded Homes for the Aged in the Province of Ontario over the entire 160 year history of the long-term care industry. Increasing regulatory dynamism significantly increases the risk of organizational failure. I find support for condition-dependent adaptivity: under conditions of increasing regulatory dynamism, only extremes of organization experience significantly reduce the risk of organizational failure. I observe a "stuck in the middle" phenomenon, where immunity to increasing regulatory dynamism enjoyed by charitable homes with very little, or a great deal, of experience is not enjoyed by homes with a moderate amount of experience. In addition to offering insights into some of the conditions under which certain types of experiential learning are survival-enhancing, my findings challenge some of the characteristics assigned organization- and population-level learning in extant organizational learning literature.Ph.D

Reimagining community relationships for organizational learning: a scoping review with implications for a learning health system

Abstract Background Communities represent a highly relevant source of knowledge with regard to not only healthcare performance but also sociocultural context, yet their role in learning health systems has not been studied. Situating the learning health system as an organization, this paper explores the phenomenon of organizational learning from or with communities (defined as one of ‘the people,’ such as a town, a specific patient group or another group directly receiving a healthcare service). Methods We conducted a scoping review to determine what is known about organizational learning from or with communities that the organization serves, and to contribute to a more comprehensive evidence base for building and operating learning health systems. In March 2019, we systematically searched six academic databases and grey literature, applying no date limits, for English language materials that described organizational learning in relation to knowledge transfer between an organization and a community. Numerous variables were charted in Excel and synthesized using frequencies and thematic analysis. We updated this search in August 2020. Results In total, 42 documents were included in our analysis. We found a disproportionate emphasis on learning explicit knowledge from community rather than on tacit knowledge or learning in equal partnership with community. Our review also revealed inconsistently defined concepts, tenuously linked with their theoretical and empirical foundations. Our findings provide insight to understand the organization-community learning relationship, including motives and power differentials; types of knowledge to be learned; structures and processes for learning; and transformative learning outcomes. Conclusions Our review makes a singular contribution to organizational learning literatures by drawing from diverse research disciplines such as health services, business and education to map what is known about learning from or with community. Broadly speaking, learning health systems literature would benefit from additional research and theory-building within a sociological paradigm so as to establish key concepts and associations to understand the nature of learning with community, as well as the practices that make it happen

Understanding middle managers’ influence in implementing patient safety culture

Abstract Background The past fifteen years have been marked by large-scale change efforts undertaken by healthcare organizations to improve patient safety and patient-centered care. Despite substantial investment of effort and resources, many of these large-scale or “radical change” initiatives, like those in other industries, have enjoyed limited success – with practice and behavioural changes neither fully adopted nor ultimately sustained – which has in large part been ascribed to inadequate implementation efforts. Culture change to “patient safety culture” (PSC) is among these radical change initiatives, where results to date have been mixed at best. Discussion This paper responds to calls for research that focus on explicating factors that affect efforts to implement radical change in healthcare contexts, and focuses on PSC as the radical change implementation. Specifically, this paper offers a novel conceptual model based on Organizational Learning Theory to explain the ability of middle managers in healthcare organizations to influence patient safety culture change. Summary We propose that middle managers can capitalize on their unique position between upper and lower levels in the organization and engage in ‘ambidextrous’ learning that is critical to implementing and sustaining radical change. This organizational learning perspective offers an innovative way of framing the mid-level managers’ role, through both explorative and exploitative activities, which further considers the necessary organizational context in which they operate