2,483 research outputs found

    The Glass Funnel: A Tool to Analyse the Gender Regime of Healthcare Education and Work

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    The concepts glass escalator and glass ceiling have been widely used in studies of gender and organisations. In this paper we propose a novel metaphor to describe and analyse gender segregation and discrimination, that of aglass funnel. This concept does not relate to men and women as groups in the sense of fixed collective entities, but rather shows how taken-for-granted distinctions between men and women are reiterated and promote men in a way that downgrades women. However, as gender intersects with other power structures, both men and women can be propelled downwards through the funnelling motion made up of a market-oriented devaluation of the healthcare profession. Through an empirical investigation of the community of practice and gender regime of an upper secondary healthcare education programme in Sweden, we develop theglass funnelconcept, an analytical tool aiming to open up for intersectional analyses of healthcare education and work

    A bit of medical paternalism? A qualitative study on power relations between women and healthcare providers when deciding on mode of birth in five public maternity wards of Argentina

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    Abstract Background Whether women should be able to decide on mode of birth in healthcare settings has been a topic of debate in the last few decades. In the context of a marked increase in global caesarean section rates, a central dilemma is whether pregnant women should be able to request this procedure without medical indication. Since 2015, Law 25,929 of Humanised Birth is in place in Argentina. This study aims at understanding the power relations between healthcare providers, pregnant women, and labour companions regarding decision-making on mode of birth in this new legal context. To do so, central concepts of power theory are used. Methods This study uses a qualitative design. Twenty-six semi-structured interviews with healthcare providers were conducted in five maternity wards in different regions of Argentina. Participants were purposively selected using heterogeneity sampling and included obstetrician/gynaecologists (heads of department, specialists working in 24-h shifts, and residents) and midwives where available. Reflexive thematic analysis was used to inductively develop themes and categories. Results Three themes were developed: (1) Healthcare providers reconceptualize decision-making processes of mode of birth to make women’s voices matter; (2) Healthcare providers feel powerless against women’s request to choose mode of birth; (3) Healthcare providers struggle to redirect women’s decision regarding mode of birth. An overarching theme was built to explain the power relations between healthcare providers, women and labour companions: Healthcare providers’ loss of beneficial power in decision-making on mode of birth. Conclusions Our analysis highlights the complexity of the healthcare provider-woman interaction in a context in which women are, in practice, allowed to choose mode of birth. Even though healthcare providers claim to welcome women being an active part of the decision-making processes, they feel powerless when women make autonomous decisions regarding mode of birth. They perceive themselves to be losing beneficial power in the eyes of patients and consider fruitful communication on risks and benefits of each mode of birth to not always be possible. At the same time, providers perform an increasing number of CSs without medical indication when it is convenient for them, which suggests that paternalistic practices are still in place

    Dynamics of wilful ignorance in organizations

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    Contemporary society is obsessed with knowledge, leaving its less seductive counterpart, ignorance, in the shadows. However, as an expanding literature suggests, it is equally important to understand ignorance, and consider its varieties. This study specifies the nature of wilful ignorance in organizations. It does so by a) making a distinction between the will of an actor and the epistemic properties of ignorance, and showing how these two form a dynamic relation, b) linking wilful ignorance to its various drivers, and c) suggesting how our concept of wilful ignorance can be used in the study of organizations. Rather than reducing the phenomenon into a simple to know/to ignore dichotomy, we zoom in on its processual and dynamic nature. Moreover, we explore complexities and ambiguity inherently involved in all knowing and ignoring, as well as the role of agency to reduce harmful effects of wilful ignorance in organizations.peerReviewe

    Motivational determinants of physical activity in disadvantaged populations with (pre)diabetes: a cross-cultural comparison

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    Background Understanding motivational determinants of physical activity (PA) is essential to guide the implementation of PA at individual and population level. Knowledge about the cross-cultural generalizability of these determinants is lacking and they have mostly been studied as separate factors. This study compares a motivational process model across samples from diverse populations with, or at risk of diabetes. Methods Measurement invariance of barrier identified regulation, barrier self-efficacy and social support was assessed in a rural Ugandan sample (n = 712) and disadvantaged samples with high proportions of immigrants in urban South Africa (n = 566) and Sweden (n = 147). These motivational determinants were then compared through multigroup structural equation modeling. Results The studied motivational constructs showed scalar invariance. Latent mean levels of perceived social support and barrier self-efficacy were lower in South Africa and Sweden. Structural models (for different PA outcomes) were not consistent across settings except for the association between perceived social support and identified regulation. Identified regulation was only associated with vigorous PA in Uganda and with moderate PA in South Africa. The association between social support and PA outcomes ranged from weak to not significant and the association between self-efficacy and PA was not significant. Self-reported PA was highest in Uganda and lowest in Sweden. Self-reported vigorous PA was significantly related to lower hemoglobin A1c levels, while moderate PA was not. Conclusions Findings suggest that: 1) it is feasible to compare a motivational process model across diverse settings; 2) there is lower perceived social support and self-efficacy in the urban, migrant samples; 3) identified regulation is a more promising determinant of PA than self-efficacy or social support in these populations; 4) associations between motivational determinants and PA depend on the perceived type and/or intensity of PA; 5) perceived relatedness functions as a basic psychological need across diverse settings; and 6) people’s perception of the PA they perform depends on their perceived level of intensity of PA which would have major implications for health promotion

    Interaction-context schema : A proposed model to support interaction analysis in small and medium enterprises

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    Information Systems Interactions are a pivotal point in developing an understanding of a socio-technical system. From this perspective, Information Systems could be defined as the cooperation, coexistence and integration of a socio-technical approach with the social aspect. This research investigates how people communicate in a business and how this is likely to support knowledge sharing practices. Given this, the real-work practices that drive a business emphasise the interactions. This paper proposes an “Interaction-Context” schema, which factors in the interactions sparked by several stakeholders that occurs in different areas of interest of a business. Therefore, a multi-proposal expanded analysis of interactions which seek to attends diverse purposes in different contexts. The schema envisages three categories to classify the interaction. Similarly, there are three contexts which distinguish the orientation. Hence, the interplay between interactions, technology and ICT competencies, which support or develop a business, underpin the Proposed Model “Interaction-Context” schema

    Enchantment in Business Ethics Research

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    This article draws attention to the importance of enchantment in business ethics research. Starting from a Weberian understanding of disenchantment, as a force that arises through modernity and scientific rationality, we show how rationalist business ethics research has become disenchanted as a consequence of the normalisation of positivist, quantitative methods of inquiry. Such methods absent the relational and lively nature of business ethics research and detract from the ethical meaning that can be generated through research encounters. To address this issue, we draw on the work of political theorist and philosopher, Jane Bennett, using this to show how interpretive qualitative research creates possibilities for enchantment. We identify three opportunities for reenchanting business ethics research related to: (i) moments of novelty or disruption; (ii) deep, meaningful attachments to things studied; and (iii) possibilities for embodied, affective encounters. In conclusion, we suggest that business ethics research needs to recognise and reorient scholarship towards an appreciation of the ethical value of interpretive, qualitative research as a source of potential enchantment

    Employee Well-Being Under Corporate Psychopath Leaders

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    This chapter reports on twenty-one in-depth interviews in the UK and USA with corporateemployees who were currently working or had previously worked with a toxic leader in theform of a corporate psychopath. This is thus a chapter that is concerned with the impact onwell-being of working with a corporate psychopath. Corporate psychopathy was definedusing a measure of psychopathy involving proto-typical characteristics such as lying,cheating, egocentricity, emotional unresponsiveness and grandiosity. A contribution of thechapter is that it answers the call for research which links the destructive leadership literaturewith employee well-being. Research participants in both countries reported that their wellbeing was affected by psychopathic leadership, with reports of stress-related illnesses anddepression, including suicidal thoughts. The chapter concludes that corporate psychopaths, inboth the UK and USA, appear to have a similar protocol for achieving their objectives andachieve similar results. This protocol involves using loud, regular, public bullying combinedwith threats of violence to create a fearful, cowed and compliant workforce who can the moreeasily be manipulated and controlled by the abusive corporate psychopath. Researchparticipants in both the USA and UK suffered from severely reduced well-being because ofthis common experience

    Action leveraging evidence to reduce perinatal mortality and morbidity (ALERT): study protocol for a stepped-wedge cluster-randomised trial in Benin, Malawi, Tanzania and Uganda

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    Background: Insufficient reductions in maternal and neonatal deaths and stillbirths in the past decade are a deterrence to achieving the Sustainable Development Goal 3. The majority of deaths occur during the intrapartum and immediate postnatal period. Overcoming the knowledge-do-gap to ensure implementation of known evidence-based interventions during this period has the potential to avert at least 2.5 million deaths in mothers and their offspring annually. This paper describes a study protocol for implementing and evaluating a multi-faceted health care system intervention to strengthen the implementation of evidence-based interventions and responsive care during this crucial period. Methods: This is a cluster randomised stepped-wedge trial with a nested realist process evaluation across 16 hospitals in Benin, Malawi, Tanzania and Uganda. The ALERT intervention will include four main components: i) end-user participation through narratives of women, families and midwifery providers to ensure co-design of the intervention; ii) competency-based training; iii) quality improvement supported by data from a clinical perinatal eregistry and iv) empowerment and leadership mentoring of maternity unit leaders complemented by district based bi-annual coordination and accountability meetings. The trial’s primary outcome is in-facility perinatal (stillbirths and early neonatal) mortality, in which we expect a 25% reduction. A perinatal e-registry will be implemented to monitor the trial. Our nested realist process evaluation will help to understand what works, for whom, and under which conditions. We will apply a gender lens to explore constraints to the provision of evidence-based care by health workers providing maternity services. An economic evaluation will assess the scalability and costeffectiveness of ALERT intervention

    An Action Research Inquiry: facilitating early childhood studies undergraduate researcher development through Group Supervision

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    This paper reports an Action Research Inquiry that aimed to develop research supervision as a learning strategy, in order to facilitate early childhood undergraduates’ completion of a primary research project and dissertation in the final year of their degree programme. Researchers in this context are conceptualised as a community of practice where there is a common goal for undergraduates to become researchers. In this community, supervision accompanies students along their research project; it provides opportunities for learning for the supervisor and the student. Communities of Practice are spaces for social learning. The objectives of introducing supervision as a group social practice were to provide a space to develop researcher identity, apply research skills and make sense of the experience of research. Group Supervision represented a shift in teaching and learning practice. Action Research was applied as a research method. Such an approach placed emphasis on the participation and collaboration of lecturers in a strategy for changing practice. The research was conducted in a University in the United Kingdom. One cycle of action research was completed. Findings from the study suggest Group Supervision is valued and understood, by lecturers and students, as a social learning process