Decoding the drivers and deterrents of physician-led innovation: a systematic qualitative review

Current debate about organic farming emphasizes on the sustainability of farming systems, rural livelihood, and food quality on the technical and economic factors influencing the conversion to organic farming. The paper aims at describing the psychosocial adoption factors associated with institutional and technical support systems set up for the promotion of organic farming, based on a case study in Benin. We carried out this study in Djidja District in South Benin. We conducted semi-structured interviews with two leaders and five agricultural advisers from the Benin Organisation for Promoting Organic Agriculture and structured interviews with 100 farmers selected randomly among 255 organic farmers, 50 non-adopters to record why they did not adopt organic farming, and 25 farmers who reverted to conventional farming to understand their rationales. We used descriptive statistics and correlation for quantitative data analysis and discourse analysis for qualitative data analysis. We found that important factors that affected the adoption of organic farming were their perceptions of the characteristics of the technology, the economic factors, the institutional support for socio-technical learning networks, and the credit gained by the nongovernmental organization promoting organic farming. Farmers' needs for technical competence, social relatedness, and farm income safety acted as psychosocial mediators between the technical and institutional supports and their motivation to convert to organic farming. Alongside their technical abilities, the capacity of agricultural advisers to cope with psychosocial factors associated with the institutional support systems appears to be crucial in motivating farmers to adopt innovation.

PurposeThe degree of remote working has increased in the health-care sector, but remote leadership in health-care contexts has not been systematically studied. Thus, the purpose of this review was to map existing literature and research themes of remote leadership in health care and identify potential research gaps to guide future studies.Design/methodology/approachA scoping review with narrative synthesis was conducted, covering all published literature addressing remote, virtual, online or distance leadership practices. The ABI/INFORM Collection, CINALH, PsycArticles, Scopus and Web of Science, MedNar, Open Grey and PQDT Open databases were searched electronically, and Finnish Journal of eHealth and eWelfare was searched manually.FindingsIn total 15 articles were included in the review. Most literature concerning remote leadership in health care has been published during the past three decades. The main themes discerned in this research stream are related to interactions, work environments, leadership in practice, use of technology and needs for more study of remote leadership and guidance for remote leaders.Research limitations/implicationsResearch on remote leadership in health care is limited, patchy and associated concepts vary substantially. More comprehensive research on the phenomenon is needed, with more systematic attention to, and coverage of, relevant populations, concepts, contexts and the identified themes.Originality/valueTo the best of the authors’ knowledge, this appears to be the first review to map research on remote leadership in health care and identify research gaps, which is important as its prevalence has rapidly increased.

Digital native media have gone through different stages since their emergence in the last decade of the twentieth century under the shadow of the evolution of the ‘network of networks’ and digital transformation. Despite the influence that legacy media have exerted on the models of many digital media, the efforts they have made to find their own way in the digital communication ecosystem have resulted in the introduction of new practices and strategies that have fuelled renewed debates on journalistic frontiers. The aim of this paper is to review the birth, evolution and current landscape of digital native media with special attention given to research in this field. This is an object of study with its own and differential characteristics in relation to legacy media, which attracts the focus of more and more digital communication researchers every day. To offer a current assessment of such research, a systematized review of articles published in scientific journals included in the Web of Science and Scopus databases was carried out. The results show that the conceptualization of digital native media, their mapping in media ecosystems and comparison with legacy media, the study of their typology and characteristics, research on their economic and organizational models, the analysis of their content, and their relationship with audiences are among the main objects of research. These media constitute a fundamental sector in the current media ecosystem, which will require multidisciplinary and interdisciplinary perspectives in their research to face the challenges of digital media, digital native media and digital journalism.

BackgroundThere are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards.MethodsTen databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework.ResultsOf the initial 2704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic.ConclusionsSeveral overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTOR tool is a useful starting point for individuals and organisations to record the impact of their research activity. Further work is needed to explore standardised methods of capturing research impact that address the full range of impacts identified in this systematic review and are specific to the context of clinical academics outside medicine.

Introduction: The innovations in healthcare management have been phenomenal over the last few years, and we highlight some of them here to combat with the challenges surrounding the cost, quality, and access dilemma. I hope to provide insight with this post illuminating the three pivotal components within the Health System and the roles they play on one another in navigating those gears.Methods: The authors identified numerous innovations in healthcare management that seek to balance cost, quality, and access. Such steps may involve the use of technology, including electronic health records and telemedicine, along with value-based care models and population health management strategies. This has been a key aspect of reformed policies, regulations and decision-making processes that have been put in place as a result of reform efforts to go towards cost-effective and efficient management of healthcare.Results: The authors found that various innovations have been introduced in healthcare management to address the challenges of balancing cost, quality, and access. These include implementing technological advancements, such as electronic health records and telemedicine, as well as adopting value-based care models and population health management strategies. Additionally, changes in healthcare policies and regulations have also played a significant role in promoting cost-effective and efficient healthcare management.Conclusions: The management innovations in healthcare have proven to be effective in enhancing the health outcomes and in solving the problems regarding cost, quality, and access. But healthcare leaders need to keep a close watch over and assess when and how they put these innovations to use, to make sure that they are put to good use and continue over the long haul. Additionally, it is through collaboration between different stakeholders - such as healthcare providers, policymakers, and patients - where we will find an equilibrium in cost, quality, and access in healthcare management. Healthcare systems can work towards high-quality, affordable, and safe care for everyone by integrating these novel approaches, measuring the outcomes over time, and repeat.

Objectives While school-based mindfulness programs (SBMP) have been shown to improve youth mental and behavioral health, their implementation in low-income schools remains poorly understood. This scoping review aimed to synthesize existing evidence on the barriers and facilitators to SBMP implementation in PreK-12, low-income schools in the United States, applying the Consolidated Framework for Implementation Research (CFIR) to map extracted evidence and identify actionable strategies for SBMP research and practice. Method The searches were conducted in PsycINFO, ERIC, PubMed, and Web of Science. Study characteristics were summarized and qualitative data on implementation barriers and facilitators were extracted and analyzed using the CFIR. Results Seven articles met the inclusion criteria and were included in the qualitative synthesis. A total of 53 implementation factors were mapped onto the CFIR, with 34 (64%) identified as facilitators and 19 (36%) as barriers. All studies discussed implementation factors related to the inner setting, such as classroom noise and peer pressure. Most (n = 5, 71%) identified factors related to innovation characteristics, individual characteristics, and the implementation process. Only two studies (n = 2, 29%) reported outer setting factors, such as collaboration with community organizations to support implementation. Conclusions Findings highlight the complexity of implementing SBMPs in low-income settings, emphasizing the need for researchers and schools to assess potential barriers and facilitators across different CFIR domains and to integrate these considerations into implementation planning for SBMPs. Implications for mindfulness research in low-income school settings are discussed. Preregistration This study was not preregistered.

There has been an increasing interest in the concept of hope within the field of brain injury rehabilitation. Existing reviews have nevertheless focused on stroke, leaving out the broad population of people with acquired brain injury (ABI). Furthermore a majority of the included studies in those reviews excluded the subgroup of people with communication difficulties, thus primarily giving voice to a select group of people with ABI. A qualitative systematic review was conducted with the purpose of systematically reviewing and thematically synthesise findings about hope as experienced by adults with ABI in a rehabilitation or recovery process. The search strategy included peer-reviewed qualitative studies published after 2000 in English or Scandinavian languages. Searches of EBSCO databases incorporating CINAHL, MEDLINE, and PsycINFO were conducted together with SocINDEX, Social Work Abstracts, Eric and Web of Science. Ten qualitative studies were included, and the Critical Appraisal Skills Program (CASP) was used for assessing the quality and relevance of the ten studies. Qualitative findings were synthesized using Thomas and Harden's methodology. Through a thematic synthesis eleven subthemes were identified relating to experiences of hope. These were grouped into four analytical themes: (1) hope a two folded phenomenon; (2) time and temporality; (3) progress, goals and visibility and (4) the alliance; a balancing act requiring good communication skills. This review has shown that even though hope has both a positive and negative side to it, it is necessary as a driving force for people with ABI in terms of supporting them to keep going and not give up. Rehabilitation professionals are advised to embrace the ambiguity of hope, customizing the support of hope to each person with ABI. Attention is needed on how to make progress visible for persons with ABI during their rehabilitation process just as rehabilitation professionals should acknowledge the alliance with the person with ABI as a core component of rehabilitation. This requires a focus on professionals' communication skills if hope promoting relationships between professionals and persons with ABI are to be achieved.

IntroductionPeople with dementia are more likely than people without dementia to be hospitalized and to experience in-hospital preventable adverse events, such as falls, skin injury, and infection, compared to other hospitalized groups. Negative attitudes towards people with dementia are common among acute healthcare workers and have been linked to a cascade of negative adverse events in this population. However, no qualitative systematic review has ever been conducted to synthesize the existing evidence in this area, which hampers the development of preventative measures.AimThis is a protocol for a qualitative systematic review aimed at exploring and synthesizing existing qualitative evidence regarding the attitudes of nursing staff towards the prevention of adverse events among hospitalized people with dementia.MethodsLiterature searches will be performed in PubMed, CINAHL, PsycINFO, Web of Science, Biblioteca Virtual de Salud, Scopus, The Cochrane Library, and Google Scholar. The references of eligible studies will be checked for eligibility. All primary qualitative or mixed-methods studies with a qualitative component published in peer-reviewed academic journals in English, Portuguese, or Spanish will be eligible. There will be no limitations to the date of publication. The selection process will be conducted independently by two researchers using the software Rayyan and then compared and discussed. Any disagreements regarding eligibility will be discussed among the entire research team and resolved via consensus. Methodological quality will be assessed using Cochrane’s guidance. A meta-aggregative approach will be employed to extract and synthesize the evidence using the software package QARI from the JBI. The confidence in the findings will be graded using ConQual.ImplicationsThis review will help identify and better understand specific attitudinal and psychosocial aspects that influence nursing care delivery for people with dementia in hospital settings. Such data can be used to generate novel explanatory models of nursing behaviors in dementia care, as well as capacity building and training to enhance hospital care for people with dementia globally.

Recent advances have highlighted the potential of artificial intelligence (AI) systems to assist clinicians with administrative and clinical tasks, but concerns regarding biases, lack of regulation, and potential technical issues pose significant challenges. The lack of a clear definition of AI, combined with limited focus on qualitative research exploring clinicians' perspectives, has limited the understanding of perspectives on AI in primary health care settings. This review aims to synthesize current qualitative research on the perspectives of clinicians on AI in primary care settings. A systematic search was conducted in MEDLINE (PubMed), Scopus, Web of Science, and CINAHL (EBSCOhost) databases for publications from inception to February 5, 2024. The search strategy was designed using the Sample, Phenomenon of Interest, Design, Evaluation, and Research type (SPIDER) framework. Studies were eligible if they were published in English, peer-reviewed, and provided qualitative analyses of clinician perspectives on AI in primary health care. Studies were excluded if they were gray literature, used questionnaires, surveys, or similar methods for data collection, or if the perspectives of clinicians were not distinguishable from those of nonclinicians. A qualitative systematic review and thematic synthesis were performed. The Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach was used to assess confidence in the findings. The CASP (Critical Appraisal Skills Program) checklist for qualitative research was used for risk-of-bias and quality appraisal. A total of 1492 records were identified, of which 13 studies from 6 countries were included, representing qualitative data from 238 primary care physicians, nurses, physiotherapists, and other health care professionals providing direct patient care. Eight descriptive themes were identified and synthesized into 3 analytical themes using thematic synthesis: (1) the human-machine relationship, describing clinicians' thoughts on AI assistance in administration and clinical work, interactions between clinicians, patients, and AI, and resistance and skepticism toward AI; (2) the technologically enhanced clinic, highlighting the effects of AI on the workplace, fear of errors, and desired features; and (3) the societal impact of AI, reflecting concerns about data privacy, medicolegal liability, and bias. GRADE-CERQual assessment rated confidence as high in 15 findings, moderate in 5 findings, and low in 1 finding. Clinicians view AI as a technology that can both enhance and complicate primary health care. While AI can provide substantial support, its integration into health care requires careful consideration of ethical implications, technical reliability, and the maintenance of human oversight. Interpretation is constrained by heterogeneity in qualitative methods and the diversity of AI technologies examined across studies. More in-depth qualitative research on the effects of AI on clinicians' careers and autonomy could prove helpful for the future development of AI systems.

This qualitative systematic review was conducted to summarize the policies for prevention of common gastrointestinal cancers worldwide. This study was conducted using PubMed, Web of Science, SCOPUS, and ProQuest databases. Two independent reviewers assessed included studies for methodological quality and extracted data by using standardized tools from Joanna Briggs Institute (JBI). Primary study findings were read and reread to identify the strategies or policies used in the studies for prevention of gastrointestinal cancers. The extracted findings were categorized on the basis of their similarity in meaning. These categories were then subjected to a meta-synthesis. The final synthesized findings were graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis. From the nine included studies in this review, 39 findings were extracted and based on their relevance in meaning were aggregated into 12 categories. Four synthesized findings were developed from these categories. We used World Health Organization report on 2000 for synthesizing the findings. The four synthesized findings were “service provision”, “resource generation”, “financing”, and “stewardship”. In order to reach a comprehensive evidence informed policy package for the prevention of gastrointestinal cancers, there should be a great communication among the interventions conducted directly on patients, health system infrastructures, and resources.

The article considers the modern transitional model of inter-agency partnership as a qualitatively new semantic state of person, state and society, in which the international security sector plays an important role. On the basis of the analysis, a new transient model of inter-agency partnership in the modern quantum world has been outlined that includes a set of original (natural, authentic, exclusive, etc.) phenomen, in which the quantum is the minimum unit of any physical object that has corpuscular-wave universe structure in the modern geopolitics of states. At the same time, the quantum world is a collection of original phenomen, investigated by a phenomenal approach. The author's vision regarding the innovative updating of the content of anti-corruption education on the European level is revealed. No less strategic direction of interdepartmental partnership is cyber justice - the introduction of new practices from both the developers of new technologies and users of such technologies, which collectively provide the quality of services provided by the courts. The conceptual model of quantum philosophy as an entropy matrix in interdepartmental partnership is highlighted. The investment policy of states in the quantum world is outlined. It has been argued that the state border guard is the key to success in the international legal field of interdepartmental partnership characterized by a qualitatively new semantic state of the individual, state and society, in which the international security sector plays an important role. It is alleged that security sector reform in the inter-agency partnership of the world contributes to the qualitative growth of the scientific and technological potential as a breakthrough in the future. Under current circumstances, anti-corruption education is an important criterion in the international security sector as an intellectual critical infrastructure of inter-agency partnership. It is proved that the innovative updating of the content of education at the European level today should be the aggregate fundamental matrix of interagency, providing the corresponding quality on the basis of prestige, competitiveness and perspective needs of the individual, state and society. The filling of interdepartmental partnership with specific content takes place depending on the specific goals and tasks that are solved by it.

We are excited to share the promise and innovation of Strengths-Based Nursing and Healthcare (SBNH) Leadership (SBNH-L). As a mindset, SBNH-L is more than a management philosophy. It is an intentional and purposeful value-driven approach that puts humans at the forefront and helps leaders honour, mobilize and cultivate the strengths that reside in individuals and teams. SBNH leaders focus on people, systems and solutions, cultivating relationships and being transformative in the service of others and the system at large. An SBNH leader is one who leans into change with an open mindset, who thinks about the ecosystems we are in and who acts to make a positive difference and address challenges across the healthcare sector as we emerge from the pandemic period. What we need right now is authentic leadership to foster positive change, influence work environments and support much-needed recovery and healing. In short, this issue of the Canadian Journal of Nursing Leadership has arrived at the right time. You will find articles that offer valuable exemplars of how SBNH-L has guided advancements in nursing administration and leadership, practice, teaching and research.

Objectives: To identify, critically appraise and synthesise the qualitative literature on the experiences of informal carers of people with long-term conditions during the COVID-19 pandemic. Design: A qualitative systematic literature review. Data Sources: Eight electronic databases were systematically searched (Medline, Embase, CINAHL, PubMed, PsychINFO, Web of Science, Nursing and Allied Health and ASSIA) along with Google Scholar and handsearching via secondary sources. Study selection: Eligible studies had to include the experiences of informal carers (adults who are 65 or older), use a qualitative methodology and had to be written in English. Data extraction and synthesis: Retrieved papers were quality assessed using the Critical Appraisal Skills Programme qualitative checklist and ranked for quality. Thematic analysis was used to synthesise the findings. Results: Fourteen studies were included, all from medical or nursing journals (n = 5 specifically gerontology). Four main themes were identified: (i) fear, (ii) uncertainty, (iii) burden and (iv) staying connected. Caregiving demands have increased for carers during the pandemic, as well as negative emotions such as fear and uncertainty. At the same time, less social support has been available, leading to concerns about carers’ wellbeing and ability to cope. Conclusion: Carers’ needs have been exacerbated by the COVID-19 pandemic. Greater practical and emotional support is needed for carers from both formal services and community sources that considers their changing needs and offers educational and emotional support for long-term wellbeing. Strengths and Limitations: (1) This is the first systematic review to explore in depth the experiences of informal carers caring for people with a range of long-term conditions and from an international context. (2) The review includes an analysis of the quality of the studies, as well as a study of their relative contributions. (3) Further research is needed to explore the physical, emotional and financial impact of the pandemic for bereaved carers which is not captured in this review due to the lack of empirical data available at the time of review.

Daily life with severe mental health (SMI) and cancer comorbidity entails multiple challenges. The study aims to explore everyday life experiences among individuals with SMI and cancer comorbidity from the perspectives of patients, significant others, and involved healthcare professionals. The study is registered in PROSPERO (CRD42021259604). A qualitative systematic review was conducted through searches in the databases MEDLINE, CINAHL, PsychInfo, and Web of Sciences (last search 14 February 2023). Inclusion criteria were empirical qualitative research studies investigating experiences of healthcare and everyday life among persons living with SMI and who were subsequently diagnosed with cancer from the perspective of the individuals themselves, their significant others, and healthcare professionals involved in their care. Exclusion criteria: Literature reviews, quantitative studies, intervention studies, quantitative parts of mix-methods studies, non-English languages, persons <18 years, dementia/learning disabilities, diagnosed with anxiety/depression as a consequence of cancer. Seven articles, published between January 2011 and February 2023, were included and analysed through a thematic analysis. The PRISMA 2020 checklist guided the study. The results were presented in four themes: 'Navigating between different worlds and logics', 'Decision-making capacity depending on the assessor', 'Cancer must give way to severe mental illness or vice versa', and 'Significant others as a safety net'. Research about the everyday lives of persons with SMI and cancer comorbidities from patients' and relatives' perspectives is lacking and thus called for.

IntroductionAs the Chinese immigrant population in European countries ages, it is important to gain a deeper understanding of Chinese immigrants’ ageing processes from a life course perspective by recognising the complex interactions between social, cultural, and institutional constructs and dynamics. This article aimed at exploring how older Chinese immigrants in Europe handle everyday lives in respect to ageing from the perspectives of older Chinese immigrants, their relatives, and health/social care professionals.MethodsThe study is registered in PROSPERO (CRD42023455411), and the PRISMA 2020 checklist guided the study. A qualitative systematic review was conducted through searches in the databases CINAHL, Embase, PsycINFO, Medline/PubMed, SocINDEX, Web of Science, and pearl search in Scopus (last search 3 September, 2023). Inclusion criteria were: (1) Studies about Chinese immigrants’ everyday lives, living, and ageing, or studies focusing on their use of health/social care services, (2) Perspectives of Chinese immigrants in Europe, their relatives, and related health/social care professionals, (3) Qualitative peer- reviewed studies published in English, and (4) publications from 2000–2023. The initial search retrieved 842 publications. Seventeen publications were included and analysed through a thematic analysis.ResultsThe results presented the included studies’ characteristics and four themes: Everyday life as an older adult mirrored the life lived, Work and working conditions as significant for ageing, Cultural complexes that shape social identities, Immigrants’ social position as significant for encounters with health and social care professionals.DiscussionOlder Chinese immigrants’ everyday lives related to ageing were not only dynamically influenced by social, interpersonal, and institutional factors accumulated in their life trajectories, but reflected the process of constructing social and cultural identity in their new homeland. Future policies should promote culturally responsive healthcare, social services, and employment support to address the unique ageing experiences of older Chinese immigrants.Systematic review registrationsThe systematic review has been registered on PROSPERO and the registration number is CRD42023455411.