Impact of support networks for breastfeeding: A multicentre study

Background

The rates of breastfeeding worldwide are slowly improving since 1996. Europe is still trailing behind the global breastfeeding incidence and prevalence rates. Thus, breastfeeding promotion, protection, prolongation and support have become an important challenge as breastfeeding sharply decreases in the first six months of life.

Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research

Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of this scoping review will be used to inform the development of a study aimed at assessing the health of and improving pathways to health services among LGBTQ populations in Nova Scotia, Canada.     

Competing Values Framework: A useful tool to define the predominant culture in a maternity setting in Australia

Objective

To identify the predominant culture of an organisation which could then assess readiness for change.

Linking Electronic Medical Records Use to Physicians’ Performance: A Contextual Analysis

Electronic Medical Records (EMR) studies have broadly tested EMR use and outcomes, producing mixed and inconclusive results. This study carefully considers the healthcare delivery context and examines relevant mediating variables. We consider key characteristics of: (i) interdependence in healthcare delivery processes, (ii) physician autonomy, and (iii) the trend of hospital employment of physicians, and draw on theoretical perspectives in coordination, shared values, and agency to explain how the use of EMR can improve physicians’ performance. In order to examine the effects of physician employment on work practices in the hospital, we collected 583 data points from 302 hospitals in 47 states in the USA to test two models: one for employed and another for nonemployed physicians. Results show that information sharing and shared values among healthcare delivery professionals fully mediate the relationship between EMR use and physicians’ performance. Next, physician employment determines which mediating variable constitutes the pathway from EMR use to physicians’ performance. Finally, we highlight the impact of shared values between the hospital and physicians in enhancing information sharing and physicians’ performance, extending studies of these behaviors among network partners in industrial settings. Overall, our study shows that EMR use should be complemented by processual (information sharing), social (shared values), and structural (physician employment) mechanisms to yield positive effects on physicians’ performance.     

Navigating health care: brokerage and access for undocumented Latino immigrants under the 2010 Affordable Care Act

ABSTRACT

Brokerage is a prominent mechanism that explains access for Latino immigrants to many American institutions. However, few studies examine the dual nature of brokerage in answering questions on access to health care for undocumented Latino immigrants. The growing importance of Federally Qualified Health Centers (FQHCs) and ethnic navigators connecting immigrants to health care under the 2010 Affordable Care Act calls attention to the duality of brokers and its role in access. The study draws from 44 in-depth interviews with providers, clinic directors, navigators, and immigrant patients and two years of fieldwork in FQHCs in California’s San Francisco Bay Area (2011–2013). Results show that brokers enable access through coaching and myth-busting but they also hinder it through scrutiny and bureaucratic filtering. The widespread dependence on brokerage, I argue, leads to ersatz brokerage, such as when providers navigate the health-care system for the undocumented without the appropriate linguistic resources or coordination. Furthermore, the study shows that the duality in brokerage generates misinformation, churning, and alienation. Understanding the relational processes that both include and exclude vulnerable populations from needed services enhances theories of immigrant integration and can help design more efficient policies and address inequalities related to documentation status.     

“I bled like you,brother, although I was a thousand miles away”: postwar Yiddish sources on the experiences of Polish Jews in Soviet exile during World War II

ABSTRACT

An estimated 230,000 Polish Jews escaped Nazi persecution during World War II by flight or deportation to the interior of the Soviet Union. This article examines early postwar Yiddish and Polish sources on their survival in Soviet exile such as poems, newspaper articles, and witness testimonies. Two sets of sources are analyzed in-depth, testimonies written by young people in Jewish Displaced Persons (DP) camps in occupied Germany and Yiddish poetry from Poland and the DP camps. The author argues that many former exiles were eager to write down their experiences. In doing so, they were aware of the complex nature of deportation and flight that characterized the experiences of Polish Jews in the Soviet Union. In their testimonies many young witnesses express their understanding that they too were “marked by the khurbn.” Whereas Yiddish poetry from the same period helps us understand how writers dealt with their own story of wartime survival outside the realm of German persecution. In their poetry they seek meaning in their own suffering and express their desire to establish a dialogue with other survivors.     

“Empowerment” as efficiency and participation: gender in responsible agricultural investment principles

Amidst global concern over the state of transnational large-scale agricultural investments, several efforts have been made to set global standards for “responsible agricultural investment.” While these efforts have received mixed reviews from the international community, very little attention has been paid to the gendered language of these principles. Through examining two separate sets of agricultural investment principles – one created by the United Nations Food and Agriculture Organization (FAO), the United Nations Conference on Trade and Development, the International Fund for Agricultural Development and the World Bank, and the other by the United Nations Committee on World Food Security – this article finds that, despite different processes and participants in the creation of these principles, they nonetheless share a language of “empowerment” targeted at women and marginalized groups. However, in contrast to early feminist discourses of empowerment, these principles instead perpetuate the notion that empowerment is to be found through efficiency, productivity and participation in land and labor markets. This article takes a critical look at this language of economic empowerment in each set of principles, and points to the dangers of equating efficiency, productivity and participation with feminist empowerment. By not acknowledging the broader gender dynamics of agricultural governance and markets, these discourses risk deepening existing inequalities rather than moving toward meaningful social change.     

Dialogic communication in the health care context: A case study of Kaiser Permanente's social media practices

This case study examines how one of the largest not-for-profit health care organizations in the US, Kaiser Permanente, uses social media to communicate with its stakeholders. Through content analysis and interviews, this study identifies the communication models reflected in a sample of social media posts and examines the organization's approach to using social media. The study finds evidence of both one-way and two-way communication models, as well as principles of dialogic communication. The implications of these findings are discussed.