Maternity service reconfigurations for intrapartum and postnatal midwifery staffing shortages: modelling of low-risk births in England

INTRODUCTION

Choice of birth setting is important and it is valuable to know how reconfiguring available settings may affect midwifery staffing needs. COVID-19-related health system pressures have meant restriction of community births. We aimed to model the potential of service reconfigurations to offset midwifery staffing shortages.

METHODS

We adapted the Birthrate Plus method to develop a tool that models the effects on intrapartum and postnatal midwifery staffing requirements of changing service configurations for low-risk births. We tested our tool on two hypothetical model trusts with different baseline configurations of hospital and community low-risk birth services, representing those most common in England, and applied it to scenarios with midwifery staffing shortages of 15%, 25% and 35%. In scenarios with midwifery staffing shortages above 15%, we modelled restricting community births in line with professional guidance on COVID-19 service reconfiguration. For shortages of 15%, we modelled expanding community births per the target of the Maternity Transformation programme.

RESULTS

Expanding community births with 15% shortages required 0.0 and 0.1 whole-time equivalent more midwives in our respective trusts compared with baseline, representing 0% and 0.1% of overall staffing requirements net of shortages. Restricting home births with 25% shortages reduced midwifery staffing need by 0.1 midwives (-0.1% of staffing) and 0.3 midwives (-0.3%). Suspending community births with 35% shortages meant changes of -0.3 midwives (-0.3%) and -0.5 midwives (-0.5%) in the two trusts. Sensitivity analysis showed that our results were robust even under extreme assumptions.

CONCLUSION

Our model found that reconfiguring maternity services in response to shortages has a negligible effect on intrapartum and postnatal midwifery staffing needs. Given this, with lower degrees of shortage, managers can consider increasing community birth options where there is demand. In situations of severe shortage, reconfiguration cannot recoup the shortage and managers must decide how to modify service arrangements.

Moral distress among clinicians working in US safety net practices during the COVID-19 pandemic: a mixed methods study

OBJECTIVE

To explore the causes and levels of moral distress experienced by clinicians caring for the low-income patients of safety net practices in the USA during the COVID-19 pandemic.

DESIGN

Cross-sectional survey in late 2020, employing quantitative and qualitative analyses.

SETTING

Safety net practices in 20 US states.

PARTICIPANTS

2073 survey respondents (45.8% response rate) in primary care, dental and behavioural health disciplines working in safety net practices and participating in state and national education loan repayment programmes.

MEASURES

Ordinally scaled degree of moral distress experienced during the pandemic, and open-ended response descriptions of issues that caused most moral distress.

RESULTS

Weighted to reflect all surveyed clinicians, 28.4% reported no moral distress related to work during the pandemic, 44.8% reported 'mild' or 'uncomfortable' levels and 26.8% characterised their moral distress as 'distressing', 'intense' or 'worst possible'. The most frequently described types of morally distressing issues encountered were patients not being able to receive the best or needed care, and patients and staff risking infection in the office. Abuse of clinic staff, suffering of patients, suffering of staff and inequities for patients were also morally distressing, as were politics, inequities and injustices within the community. Clinicians who reported instances of inequities for patients and communities and the abuse of staff were more likely to report higher levels of moral distress.

CONCLUSIONS

During the pandemic's first 9 months, moral distress was common among these clinicians working in US safety net practices. But for only one-quarter was this significantly distressing. As reported for hospital-based clinicians during the pandemic, this study's clinicians in safety net practices were often morally distressed by being unable to provide optimal care to patients. New to the literature is clinicians' moral distress from witnessing inequities and other injustices for their patients and communities.

Meanings and senses of organisational silence by male nurses in the emergency department: an interpretative phenomenological study protocol

INTRODUCTION

The organisational silence of nursing teams has received increasing attention from managers. Chinese nurses have a relatively high score for organisational silence, and male nurses score higher than female nurses. Lack of professional empathy, high pressure in the work environment, and traditional Chinese cultural factors suggest that Chinese male nurses' experiences of and reasons for organisational silence are complex and unique. Taking male nurses in the emergency department as an example, this study explores the experience and meaning of male nurses' organisational silence and provides ideas for nursing managers to understand the silence of male nurses.

METHODS AND ANALYSIS

An interpretative phenomenological approach underpins the study design. In this study, the purposive sampling method will be used to select male nurses who meet the inclusion criteria with maximum differentiation as a strategy. Face-to-face semistructured interviews and Van Manen analysis methods will be used for data collection and analysis.

ETHICS AND DISSEMINATION

The study was approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (ethical approval ID: 2019-KL-036-01). Participants will provide informed consent, will be able to withdraw at any time and will have their contributions kept confidential. The findings of the study will be shared with relevant stakeholders and disseminated in conference presentations and journal publications.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trial Registry (ChiCTR2100047057).

Examining the discourse regarding the delivery of occupational infection prevention and control training to healthcare workers: a scoping review of pandemic plans of 23 countries

BACKGROUND

Over the years, countries reformed their pandemic plans but still healthcare systems were unprepared to handle the COVID-19 pandemic. Throughout the COVID-19 pandemic, healthcare workers (HCWs) raised issues around shortage of personal protective equipment (PPE), inadequate occupational infection prevention and control (IPC) training, lack of guidance regarding reuse/extended use of PPE and absence of HCWs.

OBJECTIVE

The objective of this scoping review was to compare national and transnational pandemic plans and COVID-19 guidelines for the inclusion of recommendations regarding pandemic-specific occupational IPC training for HCWs, as well as strategies for managing the surge in PPE needs and staffing.

INCLUSION CRITERIA

From each of the six WHO defined world regions, four countries with the highest burden of COVID-19 cases (as of mid-2020) were selected and attempted to locate the relevant pandemic plans and COVID-19 guidelines.

METHODS

Searches were undertaken of 1: National Guidelines Clearinghouse, 2: websites of international public healthcare agencies such as WHO, the European Centre for Disease Prevention and Control (ECDC) and, 3: in-country health departments/Ministry of Health/Department of Public Health, between June 2020 and July 2021. The data were summarised under six themes drawn from publicly available pandemic plans and COVID-19 (IPC) guidelines of WHO, ECDC and 23 countries.

RESULTS

The WHO, ECDC and 14 countries reported pandemic-specific IPC training; however, only four discussed training HCWs on correct PPE use; six countries listed strategies to manage the surge in demand of HCWs, while only five discussed managing the shortage of PPE. None of the COVID-19 guidelines recommended training HCWs for correct reuse or extended use of PPE and only one country's guideline outlined mandatory HCWs attendance and delivery of training in a regional language.

CONCLUSION

Pandemic plans should be revised to include guiding principles regarding the delivery of pandemic specific IPC training. There is also a need to provide guidance on when countries should consider reuse and extended use of PPE. This discourse should also be reflected in disease-specific pandemic guidelines, like COVID-19 (IPC) guidelines. The aim of this review is to assist international health agencies in generating evidence-based guideline updates.

Health workforce retention in low-income settings: an application of the Root Stem Model

The World Health Organization (WHO) recognizes a critical shortage of health workers as a growing global crisis. The shortage persists despite local and global efforts to recruit health workers ethically. Unequal migration of healthcare professionals, most often from low to high-resource countries, overwhelmingly defeats the objective of achieving Universal Health Coverage (UHC). If not addressed, especially given emerging global pandemics like COVID-19, the critical shortage of health workers could decimate vulnerable public health systems. This Viewpoint describes the Root-Stem Model, a six-stage process of strategic factors affecting work life that could help policymakers address the challenge of brain-drain among healthcare workers in low-income countries.

International prevalence of consultation with a naturopathic practitioner: a systematic review and meta-analysis

OBJECTIVES

Naturopathy is a traditional medicine system informed by codified philosophies and principles, and an emphasis on non-pharmacologic therapeutic interventions. While naturopathy is practised by approximately 75 000-100 000 000 naturopathic practitioners in at least 98 countries, little is known about the international prevalence of history of consultation with a naturopathic practitioner. This study reports a systematic review and meta-analysis of studies describing the global prevalence of history of consultation with a naturopathic practitioner by the general population.

SETTING

The included literature was identified through a systematic search of eight databases between September and October 2019, as well as the grey literature.

PARTICIPANTS

Studies were included if they reported the prevalence rate of consultations with a naturopathic practitioner by the general population.

INTERVENTIONS

Survey items needed to report consultations with a naturopathic practitioner as defined in the country where data was collected, and not combine naturopathic consultations with other health services or only report consulations for illness populations.

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary measures used for the analysis was consultations in the previous 12 months. Other prevalence timeframes were reported as secondary measures.

METHODS

Meta-analysis of prevalence data was conducted using random effects models based on individual countries and WHO world regions.

RESULTS

The literature search identified eight manuscripts summarising 14 studies reporting prevalence for inclusion in the review. All included studies had a low risk of bias. Meta-analysis of the included studies by world region found the 12-month prevalence of history of naturopathy consultations ranged from 1% in the Region of the Americas to 6% in the European and Western Pacific Regions.

CONCLUSIONS

There are up to sixfold differences in the prevalence of naturopathy consults over 12 months between and within world regions, which may be driven by a range of policy, legislative and social factors.

PROSPERO REGISTRATION NUMBER

CRD42020145529.

"Raising the curtain on the equality theatre": a study of recruitment to first healthcare job post-qualification in the UK National Health Service

BACKGROUND

UK equality law and National Health Service (NHS) policy requires racial equality in job appointments and career opportunities. However, recent national workforce race equality standard (WRES) data show that nearly all NHS organisations in the UK are failing to appoint ethnically diverse candidates with equivalent training and qualifications as their white counterparts. This is problematic because workforce diversity is associated with improved patient outcomes and other benefits for staff and organisations.

AIM

To better understand the reasons behind underrepresentation of ethnically diverse candidates in first NHS healthcare jobs post-qualification and to identify any structural or systemic barriers to employment for such groups.

METHODS

The study was informed by critical theory and the authors' interdisciplinary perspectives as educators and researchers in the healthcare professions. Data collected from semi-structured face-to-face interviews with 12 nurse and physiotherapy recruiting managers from two NHS trusts in London were analysed using a healthcare workforce equity and diversity conceptual lens we developed from the literature. Using this lens, we devised questions to examine six dimensions of equity and diversity in the interview data from recruiting managers.

RESULTS

Recruiting managers said they valued the benefits of an ethnically diverse workforce for patients and their unit/organisation. However, their adherence to organisational policies for recruitment and selection, which emphasise objectivity and standardisation, acted as constraints to recognising ethnicity as an important issue in recruitment and workforce diversity. Some recruiting managers sense that there are barriers for ethnically diverse candidates but lacked information about workforce diversity, systems for monitoring recruitment, or ways to engage with staff or candidates to talk about these issues. Without this information there was no apparent problem or reason to try alternative approaches.

CONCLUSION

These accounts from 12 recruiting managers give a 'backstage' view into the reasons behind ethnic inequalities in recruitment to first healthcare job in the UK NHS. Adherence to recruitment and selection policies, which aim to support equality through standardisation and anonymisation, appear to be limiting workforce diversity and creating barriers for ethnically diverse candidates to attain the jobs that they are trained and qualified for. The Healthcare Workforce Equity + Diversity Lens we have developed can help to 'raise the curtain on the equality theatre' and inform more inclusive approaches to recruitment such as contextualised recruitment or effective allyship between employers and universities.

The effect of hindrance stressors on the emotional exhaustion among front-line healthcare workers in the recuperation period during the COVID-19 epidemic in China: a prospective cross-sectional study

OBJECTIVES

This study aimed to examine the influence and conditioning process of hindrance stressors on the emotional exhaustion of the front-line healthcare workers during recuperation, examine the potential mediating process of rumination, and explore the moderating role of organisational and family factors.

SETTING

This cross-sectional study was conducted during 12-20 July 2020. Total 418 questionnaires were collected from front-line healthcare workers by random cluster sampling. Hierarchical regression was performed to analyse the mediating effect of affective rumination using SPSS25.0, while PROCESS was used to further investigate the moderating role of servant leadership and family support.

PARTICIPANTS

418 healthcare workers were investigated randomly from front-line medical teams. Inclusion criteria included worked as front-line health workers and participated in the fight against COVID-19 in Hubei; age ≥18 years; normal cognitive and comprehension abilities under physical and mental health; volunteer to participate in this study. Exclusion criteria included recently affected by major events other than COVID-19 or those with a history of neurasthenia and trauma.

RESULTS

Using descriptive analysis of average value and SD measured by a five-item scale (MBI-GS), we found that front-line healthcare workers' emotional exhaustion score (2.45±0.88) was at the medium level. Hindrance stressors, mediated by affective rumination, had a significant positive predictive effect on emotional exhaustion. Servant leadership negatively moderated the direct effect of hindrance stressors on emotional exhaustion (β=-0.106, p<0.01). Family support positively moderated the impact of hindrance stressors on emotional exhaustion (β=0.082, p<0.05).

CONCLUSIONS

During the recuperation period, after successfully controlling COVID-19 at the front line, the first-line healthcare workers should be screened through affective rumination evaluation to gain insight for targeted interventions. We find that servant leadership is beneficial in alleviating emotional exhaustion while family support worsens emotional exhaustion. We suggest that servant leadership should be further promoted in medical organisations, and family support should be applied correctly and cautiously.

Pandemic and the human factor

As the staffing crisis in the UK deepens, it is time for the policy-makers and professional bodies to rethink the approach to the most vital and yet most fragile component of the healthcare system-the human beings. The austerity measures, combined with pandemic and more recently the vision of a backlog with attached unrealistic expectations of tackling it, have brought the NHS and many other healthcare systems to the brink of a crisis. It is a human factors approach, which emphasises clinician's well-being as the core aspect of optimising performance that should become our goal. Delivery of healthcare under circumstances of physical, legal or moral threat cannot be optimal and is not sustainable. The pandemic served to highlight this quite clearly. Also, an injured, tired or burn-out healthcare professional cannot be expected to repair the system that has precipitated his or her condition. The approach to changing the culture of medicine may be multifaceted, but ultimately, we should rethink professionalism and the definition of duty of care putting emphasis on the well-being of those delivering the care as the way to assure best possible care.

Canadian healthcare capacity gaps for disease-modifying treatment in Huntington's disease: a survey of current practice and modelling of future needs

OBJECTIVES

Disease-modifying therapies in development for Huntington's disease (HD) may require specialised administration and additional resource capacity. We sought to understand current and future capacity for HD management in Canada considering the possible introduction of an intrathecal (IT) disease-modifying treatment (DMT).

DESIGN, SETTING AND PARTICIPANTS

Using a case study, mixed methods framework, online surveys followed by semistructured interviews were conducted in late 2020 and early 2021. Neurologists from Canadian HD (n=16) and community (n=11) centres and social workers (n=16) were invited to complete online surveys assessing current HD management and potential capacity to support administration of an IT DMT.

OUTCOME MEASURES

Survey responses, anticipated demand and assumed resource requirements were modelled to reveal capacity to treat (ie, % of eligible patients) by centre. Resource bottlenecks and incremental support required (full-time equivalent, FTE) were also determined.

RESULTS

Neurologists from 15/16 HD centres and 5/11 community centres, plus 16/16 social workers participated. HD centres manage 94% of patients with HD currently seeking care in Canada, however, only 20% of IT DMT-eligible patients are currently seen by neurologists. One-third of centres have no access to nursing support. The average national incremental nursing, room, neurologist and social worker support required to provide IT DMT to all eligible patients is 0.73, 0.36, 0.30 and 0.21 FTE per HD centre, respectively. At peak demand, current capacity would support the treatment of 6% of IT DMT-eligible patients. If frequency of administration is halved, capacity for IT-DMT administration only increases to 11%.

CONCLUSIONS

In Canada, there is little to no capacity to support the administration of an IT DMT for HD. Current inequitable and inadequate resourcing will require solutions that consider regional gaps and patient needs.

Returning to clinical work and doctors' personal, social and organisational needs: a systematic review

OBJECTIVE

This systematic review aims to synthesise existing evidence on doctors' personal, social and organisational needs when returning to clinical work after an absence.

DESIGN

Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

DATA SOURCES

AMED, BNI, CINAHL, EMBASE, EMCARE, HMIC, Medline, PsycINFO and PubMed were searched up to 4 June 2020. Non-database searches included references and citations of identified articles and pages 1-10 of Google and Google Scholar.

ELIGIBILITY CRITERIA

Included studies presented quantitative or qualitative data collected from doctors returning to work, with findings relating to personal, social or organisational needs.

DATA EXTRACTION AND SYNTHESIS

Data were extracted using a piloted template. Risk of bias assessment used the Medical Education Research Study Quality Instrument or Critical Appraisal Skills Programme Qualitative Checklist. Data were not suitable for meta-analyses and underwent narrative synthesis due to varied study designs and mixed methods.

RESULTS

Twenty-four included studies (14 quantitative, 10 qualitative) presented data from 92 692 doctors in the UK (n=13), US (n=4), Norway (n=3), Japan (n=2), Spain (n=1), Canada (n=1). All studies identified personal needs, categorised as work-life balance, emotional regulation, self-perception and identity, and engagement with return process. Seventeen studies highlighted social needs relating to professional culture, personal and professional relationships, and illness stigma. Organisational needs found in 22 studies were flexibility and job control, work design, Occupational Health services and organisational culture. Emerging resources and recommendations were highlighted. Variable quality and high risk of biases in data collection and analysis suggest cautious interpretation.

CONCLUSIONS

This review posits a foundational framework of returning doctors' needs, requiring further developed through methodologically robust studies that assess the impact of length and reason for absence, before developing and evaluating tailored interventions. Organisations, training programmes and professional bodies should refine support for returning doctors based on evidence.

The human side of humanitarian supply chains: a research agenda and systematization framework

Humanitarian operations are increasingly receiving attention due to the numerous recent disasters and crises caused by both natural and man-made events, from mass human exodus to pandemics such as COVID-19. The successful management of humanitarian supply chains requires the effective use of human resource practices, which in turn requires strong leadership in the so-called 'soft side' of management. This study aims to investigate the current status of research on the human aspects of humanitarian supply chains. Through a systematic and comprehensive literature review, encompassing an original codification and in-depth analysis of journal articles, this work provides a research agenda and a number of lessons concerning human resource management (HRM) in humanitarian operations. The main findings reveal that: (i) HRM impacts the ability of humanitarian organizations to adequately prevent, prepare for and respond to disasters; (ii) training programs for aid personnel are a vital aspect of humanitarian responsiveness; (iii) humanitarian operations require a workforce with a variety of soft and hard skills; (iv) lack of trained staff is one of the main challenges in this field; and (v) building relationships and strengthening networks can enlarge the human resource pool available. Therefore, the findings of this study and its proposed research agenda have implications for both theory and practice. In terms of theory, this work provides seven recommendations, representing opportunities for scholars to advance this body of knowledge. For humanitarian practitioners, this paper offers insightful lessons to guide them in the management of human resources in humanitarian operations.

Human resource management practices and organizational injury rates

INTRODUCTION

This study investigated the extent to which five human resource management (HRM) practices-systematic selection, extensive training, performance appraisal, high relative compensation, and empowerment-simultaneously predicted later organizational-level injury rates.

METHODS

Specifically, the association between these HRM practices (assessed via on-site audits by independent observers) with organizational injury rates collected by a national regulatory agency one and two years later were modeled.

RESULTS

Results from 49 single-site UK organizations indicated that, after controlling for industry-level risk, organization size, and the other four HRM practices, only empowerment predicted lower subsequent organizational-level injury rates. Practical Applications: Findings from the current study have important implications for the design of HRM systems and for organizational-level policies and practices associated with better employee safety.

Assessing organizational culture in public mental healthcare service organizations

PURPOSE

The purpose of this paper is to investigate aspects of organizational culture among the nursing staff of public mental health services organizations in Cyprus. Specifically, highlights are provided of possible differences on the attitudes of nurses regarding actual and desired aspects of organizational culture with respect to demographic characteristics such as gender, years of service and experience.

DESIGN/METHODOLOGY/APPROACH

A descriptive explanatory type survey study was conducted in all public mental health services organizations of Cyprus. Specifically, a questionnaire was given to a representative sample of the nursing population, and data were collected and analyzed. The survey questionnaire was based on the organizational culture profile (OCP) methodology. Statistical analysis was carried out using correlational analysis, t-tests and analysis of variance (ANOVA).

FINDINGS

Results showed that there are significant discrepancies between the actual organizational culture and what is desired by staff members of public mental health services organizations in Cyprus. Further, significant differences are identified between actual and desired organizational culture moderated by the type of work, which is determined by the workplace.

ORIGINALITY/VALUE

Even though, organizational culture is a major research topic little has been done in the context of public mental healthcare organizations. Further, for the case of Cyprus, it is the first time that such a study is carried out. The results presented in this paper may provide the foundation for measures to be taken for improving the existing operation of public mental healthcare organizations.

Innovative human resource management strategies during the COVID-19 pandemic: A systematic narrative review approach

BACKGROUND

The spread of COVID-19 creates disruption, uncertainty, complexity, and ambiguity in all organizations. People are the primary asset of any organization and help achieve their goals. Accordingly, to manage human resources sustainably, the organizational strategy review is an appropriate retort.

OBJECTIVE

The purpose of this comprehensive review study is to identify unknown challenges, strategies, and unusual decisions related to human resource management other than clinical organizations during the COVID-19 pandemic.

METHODS

The study applied a narrative review approach dissection based on organizations' human resource management strategies to combat the COVID-19 impacts. The review study conducted published literature research through the electronic databases at Web of Science, PubMed, Scopus, PsycINFO, and LISTA. The study extracted 1281 articles from the mentioned databases from November 2021 to the first quarter of 2021. This study reviewed selected papers, included 15 relevant articles, and removed duplicates according to inclusion and exclusion criteria. Finally, the study developed a conceptual framework of human resource management strategies based on the literature findings to fight against the COVID-19 pandemic.

RESULTS

The COVID-19 pandemic posed numerous adverse consequences, such as economic shock, global health crisis, change in social behaviors, and challenges at the organization level to continue business operations. Besides, the strategies included flexibility, strengthening internal efficiency, talent acquisition, and making innovative changes based on organizational assessment and needs for smooth business activities.

CONCLUSION

The appropriate human resource management strategies implementations would increase employees' mental well-being, satisfaction, productivity, motivation, and health safety at the workplace.

Workplace Injury and the Failing Academic Body: A Testimony of Pain

This article explores how meanings around risk, health/safety, and workers' bodies are constructed in an academic context. I do so through the study of a single academic in Australia who sustained a back injury at work. Through an analysis of in-depth interviews and documents, I attempt to show the embodied experience of an injured worker's struggle for care, recovery, and survival in the neoliberal academy. Writing from the nexus of workplace health and safety and critical management literatures, the raw testimony of this injured academic lays bare the violences that are enabled within a wider culture of self-discipline, individualism, and performativity in the university. The story presented in this article exposes how physiological and psychological injuries can be exacerbated through the very health and safety procedures that are designed to prevent and alleviate harm. Please note that this article contains references to suicide and suicidal ideation.

Identity and relationship frames in medical leadership communication

PURPOSE

A frame is an interpretive scheme of meanings that guide participants' interpretations of social interaction and their actions in social situations (Goffman, 1974). By identifying early-career physicians' identity and relationship frames, this study aims to produce information about socially constructed ways to interpret leadership communication in a medical context.

DESIGN/METHODOLOGY/APPROACH

The data consist of essays written by young physicians (n = 225) during their specialization training and workplace learning period. The analysis was conducted applying constructive grounded theory.

FINDINGS

Three identity and relationship frames were identified: the expertise frame, the collegial frame and the system frame. These frames arranged the meanings of being a physician in a leader-follower relationship differently.

ORIGINALITY/VALUE

The findings suggest that identity questions discussed recently in medical leadership studies can be partly answered with being aware of and understanding socially constructed and somewhat contradictory frames.

Job satisfaction of certified employees in viticulture: A qualitative study

BACKGROUND

The need for qualified employees in wineries leads to a gain in importance of human resource management in the wine industry. Knowledge on job satisfaction of employees in wineries and cooperatives as well as research in human resource management is rare.

OBJECTIVE

The aim of this qualitative study is to find aspects affecting job satisfaction of employees in Austrian and German wineries. These identified aspects were analysed with regard to the perceived satisfaction or dissatisfaction of the employees.

METHOD

Sixteen qualitative interviews were conducted in Austria and Germany with employed winemakers, production managers and vineyard managers.

RESULTS

Aspects of job satisfaction which were found in agricultural studies were validated for employees in wineries. In addition to these influencing factors of job satisfaction, interviewed workers mentioned other important aspects, such as equality issues, development of the company and attachment to the final product, which affect their job satisfaction.

CONCLUSIONS

The positive image of the product wine, the wine sector and the profession contributes to a high job satisfaction overall. The personal interest in wine is one of the major factors of job satisfaction. It reduces dissatisfaction with remuneration, monotonous work processes and long working hours. However, employees in wineries saw problems in reconciling family life and work. Furthermore, employees complained about physical strains leading to possible changes in job or position.

Maintaining High Professional Standards, morally, ethically and fairly: what doctors need to know right now

Facing an investigation into performance concerns can be one of the most traumatic events in a doctor's career, and badly handled investigations can lead to severe distress. Yet there is no systematic way for National Health Service (NHS) Trusts to record the frequency of investigations, and extremely little data on the long-term outcomes of such action for the doctors. The document-Maintaining High Professional Standards in the Modern NHS (a framework for the initial investigation of concerns about doctors and dentists in the NHS)-should protect doctors from facing unfair or mismanaged performance management procedures, which include conduct, capability and health. Equally, it provides NHS Trusts with a framework that must be adhered to when managing performance concerns regarding doctors. Yet, very few doctors have even heard of it or know about the provisions it contains for their protection, and the implementation of the framework appears to be very variable across NHS Trusts. By empowering all doctors with the knowledge of what performance management procedures exist and how best practice should be implemented, we aim to ensure that they are informed participants in any investigation should it occur.

Credit constraints and rural farmers' welfare in an agrarian economy

This study aims to determine the impact of credit constraints on wheat farmers' welfare. For this study, data on 575 wheat farmers were collected through a simple random sampling technique. The treatment-effect model was used to find the effect of credit constraints on the farmers' welfare. In addition, to control for the problem of endogeneity, ordinary least squares and logistic regressions were employed. Farmers' welfare was measured by as consumption. The results show that constrained farmers cultivate 2.8–4.1% more area of land than unconstrained farmers but that the spending and income per capita of credit-constrained farmers are 18.9 to 13.8% lower, respectivley, than those of unconstrained farmers. Moreover, the results indicate that the welfare and income of credit-constrained farmers are influenced by age, the interest rate, area of land, and family size. An increase in the area of land enhances wellbeing and returns for the constrained farmer, which is in contrast to the unconstrained farmer. The results show that credit constraints have a negative impact on farmers' welfare and income. Better welfare may only be achieved if credit is supplied to credit-constrained farmers. Furthermore, this study has potentially significant implications. First, the negative impact of the interest rate suggests that the State Bank of Pakistan should modify agricultural credit policies, particularly to design a flexible interest rate for farmers. Second, the central bank should amend the agricultural credit limits based on the current financial needs of the agricultural market when the rate of inflation is high and the impact of agricultural crises is long and drawn-out. Third, the government should launch an agricultural Islamic bank in the study area. This Islamic bank would support religious farmers who are constrained due to objections to interest, and it would relax the farmers’ credit constraints as well as help them to increase welfare and income.

Analysis of factors affecting project communications with a hybrid DEMATEL-ISM approach (A case study in Iran)

One of the main factors in the success of projects is communications management and proper and timely distribution of information among all internal and external project stakeholders. Despite of emphasizing on the importance of project communications in the literature, there are few studies identifying factors influencing project communications. This research aims to address this shortcoming by identifying and determining sequences and relationships factors affecting project communications and their clustering. The informed communication strategy allows managers to structure the information flow in a better and more controlled manner and to avoid the costs caused by lack of effective and timely communication. The present study is conducted to help clarify the views of the organization's managers and project managers on project communications, and to identify factors affecting it and how they effectively communicate to successfully accomplish the projects. First a number of factors influencing project communications are identified on the basis of previous studies and interviews with experts and project managers working in oil, gas and power plant construction megaprojects in Iran. Then, these factors are analyzed by using the combination of fuzzy DEMATEL and Interpretive Structural Modeling (ISM) techniques. The relationships and sequence between the indicators are determined so that it can be effective in project communications planning and project success through providing an insight for senior managers and project managers.

Intangible assets and organizational citizenship behavior: A conceptual model

Through reviewing extant literature, this conceptual paper is aimed to improve the understanding of the intervening mechanisms that influence the relationship between intangible assets (IAs) and organizational citizenship behavior (OCB) to improve the performance of contemporary knowledge-dependent organizations. The authors believe this to be the first attempt to bring four major components of IAs together and look at their relationship with OCB. This helps to create awareness of the necessity of matching key resources with appropriate behavior to improve organizations’ competitive advantages. The proposed model and propositions showed relationships between IAs and OCB mediated and moderated by work engagement and perceived organizational support, respectively. Moreover, this paper suggests the need for integrated multi-level studies to strengthen the links between critical resources and behaviors to put the learning organization on the right growth track. Future research is suggested on new conceptualizations of IAs, such as spiritual capital, as well as the relationship of IAs with other typologies of OCB.

Employee adjustment and well-being in the era of COVID-19: Implications for human resource management

Today's organizations have to remain alert and adaptive to unforeseen events, such as external crises, which create increased uncertainty among their workforce and pose immediate threats to the organizations' performance and viability. However, with the recent COVID-19 pandemic, organizations suddenly have to navigate the unprecedented and thereby find new solutions to challenges arising across many areas of their operations. In this article, we discusses some of these challenges, focusing on the implications COVID-19 has for human resource management (HRM) as organizations help their workforce cope with and adjust to their newly altered work environment. In addition, we propose several avenues for future research and advocate for an integrated research agenda for tackling the challenges discussed.

Responding and adapting to change: an allied health perspective

PURPOSE

The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change.

DESIGN/METHODOLOGY/APPROACH

A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process.

FINDINGS

The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice.

RESEARCH LIMITATIONS/IMPLICATIONS

This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health.

PRACTICAL IMPLICATIONS

SOCIAL IMPLICATIONS

This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes.

ORIGINALITY/VALUE

To the best of the authors' knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change.