Access to aidable residual hearing in adult candidates for cochlear implantation in the UK

Guidance from the National Institute for Health and Care Excellence (NICE) permits candidates to receive a cochlear implant provided they only hear sounds louder than 90 dB HL at 2 and 4 kHz. In some patients, their level of residual hearing may be sufficient to warrant the use of a hearing aid in their non-implanted ear. A survey of unilaterally-implanted adults indicated that those implanted since the publication of NICE guidance were almost seven times more likely to use a hearing aid than those implanted prior to this. If contralateral hearing aid use provides additional benefits over implant use alone, it may be appropriate to consider the capacity to use residual hearing following implantation when determining candidacy

A Longitudinal Investigation of the Glass Ceiling in Nursing

Purpose: This paper presents a longitudinal, qualitative study exploring changes in the attributional constructions of sense-making in the perceptions and lived experiences of the glass-ceiling among a cohort of female mental health nurses in the National Health Service (NHS) who participated in a 12-month multi-faceted career and leadership development pilot programme compared to a matched control group. Design/methodology/approach: The authors interviewed 27 female mental health nurses in the UK who participated in a multi-faceted development programme specifically designed to support female nurses secure career advancement and 27 members of a matched control group who did not experience the programme. Participants engaged in semi-structured telephone interviews at three separate time points (six months apart) over a 12-month period. Findings: Programme participants differed in their attributional constructions of sense-making in relation to the glass-ceiling over time compared to the matched control group. e.g. triggering understandings and awakenings and re-evaluating the glass-ceiling above when promoted. Findings are used to theorise about the glass-ceiling as a concept that shifts and changes over time as a function of experience. Practical implications: Practical implications include important organisational outcomes in relation to fostering the career advancement and retention of talented female leaders at all career stages. Originality/value: The authors present the first known longitudinal, qualitative study to explore changes in attributional constructions of sense-making in perceptions and experiences of the glass-ceiling among female nurses over time compared to a matched control group

The potential of online coaching to develop female entrepreneurial self-efficacy

Purpose – The purpose of this study is to explore the potential of coaching to develop female entrepreneurship by overcoming potential barriers. It sought to understand how entrepreneurial self-efficacy can be applied to development relationships, through on-line coaching, examining changes in the four key elements of entrepreneurial self-efficacy enactive mastery, vicarious experiences, social persuasion and psychological arousal. The study examines the impact of coaching relationships on female entrepreneurial self-efficacy compared to a control group. The participant group was matched with coaches and undertook a structured six months’ coaching programme. Design/methodology/approach – This was a longitudinal study using a mixed methods approach. Questionnaires investigating entrepreneurial self-efficacy were collected at two time points for both the coaching and control group. After the first time point, the coaching group was supported through a six months coaching development programme. At the second time point, questionnaires were again completed by both groups and qualitative data gather via interviews with the coaching group. Findings – The findings from this study showed that coaching relationships had a positive impact on coachees’ entrepreneurial self-efficacy, compared to the control group in terms of enactive mastery, vicarious experience, social persuasion and psychological arousal. This suggests that coaching is a development intervention which can be used to enhance self-efficacy beliefs of female entrepreneurs, thereby increasing their chances of engaging in successful business creation and operation. Research limitations/implications – The group size was a problem, with four of the coaching group and ten of the control group dropping out. The coaching participants left the intervention due to personal reasons but no reason could be established for the control group participants leaving the study. The problem of ‘Type II’ was considered and in an attempt to overcome this problem, data were shown at below 10% (p <0.10). It would also have been useful to collect more qualitative data from the control group. Practical implications – An online coaching programme provided by women for women, which is tailored to the individual, can support female entrepreneurs through the difficult stages of start-up and development phases of business development. Creating more successful women owned businesses will not only provide financial benefits, but should help provide additional entrepreneurial networks for women, as well as more positive female role models. Exposure to positive role models has been found to have a direct effect on entrepreneurial self-efficacy. This circular affect should in theory keep on increasing, if female entrepreneurs have access to the tailored support provided by coaching programmes such as the one used here. Social implications – Considering the current global economic climate, it is increasingly important for women to be supported in small business ownership (Denis, 2012). Countries which actively promote women entering into business ownership will ultimately share the gains in terms of wider issues, i.e. improving education and health, and economic growth (Harding, 2007). If female entrepreneurship is to be encouraged and supported, provision needs to be designed and developed based on female entrepreneurs’ needs and requirements, rather than simply conforming to traditional business support models. Originality/value – This study contributes to learning and theoretical debates by providing an understanding of female entrepreneurs’ needs with regard to business support and how this can be related to and supported by coaching. It also adds to the literature on entrepreneurial self-efficacy, coaching and learning by providing empirical evidence to illustrate how coaching interventions, including the use of online methods, can have a positive impact on female entrepreneurial self-efficacy

The NIHR collaboration for leadership in applied health research and care (CLAHRC) for greater manchester: combining empirical, theoretical and experiential evidence to design and evaluate a large-scale implementation strategy

Background: In response to policy recommendations, nine National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were established in England in 2008, aiming to create closer working between the health service and higher education and narrow the gap between research and its implementation in practice. The Greater Manchester (GM) CLAHRC is a partnership between the University of Manchester and twenty National Health Service (NHS) trusts, with a five-year mission to improve healthcare and reduce health inequalities for people with cardiovascular conditions. This paper outlines the GM CLAHRC approach to designing and evaluating a large-scale, evidence- and theory-informed, context-sensitive implementation programme. Discussion: The paper makes a case for embedding evaluation within the design of the implementation strategy. Empirical, theoretical, and experiential evidence relating to implementation science and methods has been synthesised to formulate eight core principles of the GM CLAHRC implementation strategy, recognising the multi-faceted nature of evidence, the complexity of the implementation process, and the corresponding need to apply approaches that are situationally relevant, responsive, flexible, and collaborative. In turn, these core principles inform the selection of four interrelated building blocks upon which the GM CLAHRC approach to implementation is founded. These determine the organizational processes, structures, and roles utilised by specific GM CLAHRC implementation projects, as well as the approach to researching implementation, and comprise: the Promoting Action on Research Implementation in Health Services (PARIHS) framework; a modified version of the Model for Improvement; multiprofessional teams with designated roles to lead, facilitate, and support the implementation process; and embedded evaluation and learning. Summary: Designing and evaluating a large-scale implementation strategy that can cope with and respond to the local complexities of implementing research evidence into practice is itself complex and challenging. We present an argument for adopting an integrative, co-production approach to planning and evaluating the implementation of research into practice, drawing on an eclectic range of evidence sources.Gill Harvey, Louise Fitzgerald, Sandra Fielden, Anne McBride, Heather Waterman, David Bamford, Roman Kislo and Ruth Boade