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External Barriers (external + barrier)
Selected AbstractsNurse-Midwives' Experiences with Planned Home Birth: Impact on Attitudes and PracticeBIRTH, Issue 4 2009Saraswathi Vedam RM, SciD(h.c.) ABSTRACT: Background: Health care providers' attitudes toward maternity care options influence the nature of informed decision-making discussions and patient choice. A woman's choice of birth site may be affected by her provider's opinion and practice site. The objectives of this study were to describe American nurse-midwives' attitudes toward, and experiences with, planned home birth, and to explore correlates and predictors of their attitudes toward planned home birth as measured by the Provider Attitudes towards Planned Home Birth (PAPHB) scale.Methods: A survey instrument, which incorporates the PAPHB and assesses demographic, education, practice, personal experience, and external barrier variables that may predict attitudes toward planned home birth practice, was completed by 1,893 nurse-midwives. Bivariate analysis identified associations between variables and attitudes. Linear regression modeling identified predictors of attitudes.Results: Variables that significantly predicted favorable attitudes to planned home birth were increased clinical and educational experiences with planned home birth (p < 0.001), increased exposure to planned home birth (p < 0.001), and younger age (p < 0.001). External barriers that significantly predicted less favorable attitudes included financial (p = 0.03) and time (p < 0.001) constraints, inability to access medical consultation (p < 0.001), and fear of peer censure (p < 0.001). Willingness to practice in the home was correlated with factors related to nurse-midwives' confidence in their management abilities and beliefs about planned home birth safety.Conclusions: The results suggest that nurse-midwives' choice of practice site and comfort with planned home birth are strongly influenced by the nature and amount of exposure to home birth during professional education or practice experiences, in addition to interprofessional, logistic, and environmental factors. Findings from this research may inform interdisciplinary education and collaborative practice in the area of planned home birth. [source] Compulsory continuing professional development: a questionnaire-based survey of the UK dietetic professionJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2009J. B. E. Sturrock Abstract Background:, Continuing professional development (CPD) for Health Professions Council (HPC) registrants became mandatory in July 2006. Some health professions have identified external barriers to CPD participation, and other research suggests that mandatory CPD can devalue learning. The present study aimed to investigate current CPD practices of UK dietitians and to identify their attitudes towards the new mandatory requirement. Methods:, UK Dietitians were asked to participate in an online questionnaire made available via an advert placed on the British Dietetic Association's website and in an electronic newsletter. Results:, Of 206 respondents, 98.1% kept a CPD portfolio. Those who had undertaken the ,ABC' placement model (23.7%) were more likely to keep their portfolio up to date (P = 0.006). Only 41.3% dietitians were confident that they would currently meet the minimum CPD requirement, whereas 77.2% believed they would comply by the first audit in 2010. Some 50.5% dietitians considered their CPD time commitment insufficient due to obstacles such as workload and time constraints. A total of 96.1% respondents acknowledged the importance of undertaking CPD, with the introduction of a mandatory system appearing to provide the motivation to engage in CPD. Conclusions:, UK dietitians are currently engaging in CPD. There is, however, concern regarding achievement of the compulsory requirement for the HPC 2010 audit. The findings show barriers exist to engaging in CPD activities and to maintaining a portfolio. These issues could be addressed with the introduction of protected time for CPD. [source] Improving the quality of processing gastric cancer specimens: The pathologist's perspective,JOURNAL OF SURGICAL ONCOLOGY, Issue 3 2010Alyson L. Mahar BSc Abstract Background and Objectives Research into surgeon and pathologist knowledge of guidelines for lymph node (LN) assessment in gastric cancer demonstrated a knowledge deficit. To understand factors affecting optimal assessment we surveyed pathologists to identify external barriers. Methods Pathologists were identified using two Ontario physician databases and surveyed online or by mail, with a 40% response rate. Results The majority (56%) of pathologists stated assessing an additional five LNs would not be a burden. Most (80%) pathologists disagreed with pay for performance for achieving quality standards. Qualitative analysis determined the majority of pathologists believed achieving quality standards was inherent to their profession and should not require incentives. Poor surgical specimen was identified as a barrier and underscores the importance of aiming quality improvement initiatives at the multidisciplinary team. Conclusion In addition to education, tailoring an intervention to address all barriers, including laboratory constraints may be an effective means of improving gastric cancer care. J. Surg. Oncol. 2010; 101:195,199. © 2010 Wiley-Liss, Inc. [source] The Role of Champions in the External Commercialization of Knowledge,THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 4 2009Ulrich Lichtenthaler Besides applying knowledge in their own products or services, firms may externally commercialize their knowledge assets (e.g., by means of outlicensing). The literature on champions, however, has focused on internal innovation. This gap in prior research is particularly remarkable as the potential for promoting external knowledge exploitation is high. Some pioneering firms realize great benefits, whereas most others experience major managerial difficulties. This paper tests five hypotheses regarding the emergence and impact of champions of external knowledge exploitation with data from 152 firms across industries. The results of the questionnaire-based study demonstrate the relevance of champions of external knowledge exploitation. Championing constitutes an essential success factor and has strongly contributed to the recent increase in external knowledge commercialization. These findings help to explain the discrepancies between the few successful and the majority of unsuccessful firms. Beyond existing insights, the emergence of champions is affected by external determinants in addition to internal determinants. There is an inverted U-shaped relationship between championing and the internal determinants, that is, organizational climate and active strategy. Moreover, there is a negative relationship between championing and market imperfection and an inverted U-shaped relationship between championing and competitive intensity, which both constitute external determinants of championing. In contrast to the traditional understanding, champions tend to emerge in supportive environments, in which internal and external barriers are relatively low. This surprising finding calls for rethinking the role and motivation of champions. [source] An empirical analysis of green supply chain management in the German automotive industryBUSINESS STRATEGY AND THE ENVIRONMENT, Issue 2 2010Jörn-Henrik Thun Abstract The purpose of this paper is the empirical investigation of the status quo of green supply chain management in the German automotive industry from a practitioner's point of view. Several aspects of green supply chain management, such as the point of time of implementation, the driving forces, the relevance of intended goals and their particular realization and the adoption of eco-programs with suppliers and customers as well as internal and external barriers are analyzed. Furthermore, the link to different performance criteria is tested by inductive statistics in order to show the potential of green supply chain management for competitiveness. For this study, managers from the automotive supply industry in Germany were asked about their estimations in this regard. The main conclusion is that managers express the need for green supply chain management on the one hand but also see corresponding problems in terms of required resources on the other hand. Furthermore, the analyses show that green supply chain management leads to higher performance in terms of several performance criteria. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment. [source] | ||||||||||