BackgroundImplementing research findings into practice is a complex process that is not well understood. Facilitation has been described as a key component of getting research findings into practice. The literature on facilitation as a practice innovation is growing. This review aimed to identify facilitator roles and to describe characteristics of facilitation that may be associated with successful research use by healthcare professionals.MethodsWe searched 10 electronic databases up to December 2016 and used predefined criteria to select articles. We included conceptual papers and empirical studies that described facilitator roles, facilitation processes or interventions, and that focused on healthcare professionals and research use. We used content and thematic analysis to summarise data. Rogers’ five main attributes of an innovation guided our synthesis of facilitation characteristics.ResultsOf the 38 488 articles identified from our online and manual search, we included 195 predominantly research studies. We identified nine facilitator roles: opinion leaders, coaches, champions, research facilitators, clinical/practice facilitators, outreach facilitators, linking agents, knowledge brokers and external-internal facilitators. Fifteen facilitation characteristics were associated with research use, which we grouped into five categories using Rogers’ innovation attributes: relative advantage, compatibility, complexity, trialability and observability.ConclusionsWe found a diverse and broad literature on the concept of facilitation that can expand our current thinking about facilitation as an innovation and its potential to support an integrated, collaborative approach to improving healthcare delivery.
"How do you experience having a son who is undergoing the circumcision rite?" The study revealed cultural circumcision as a "sacred religious practice" with five themes, namely (a) readiness of Xhosa families to engage in the circumcision ritual, (b) the act of circumcision and preparation for manhood, (c) the importance of symbolic purity during the circumcision ritual, (d) celebrating acquired manhood, and (5) aspects of manhood and the rejection of clinical care. Secondary to this are health promotion recommendations made for individuals involved in this ritual.
Male circumcision is practiced in South Africa among the Xhosa people as a rite of passage from boyhood to manhood. The manhood status achieved after the ritual accords men power and authority in the community over women and uncircumcised men. Therefore, uninitiated men experience great pressures to get circumcised. We describe the experience of newly initiated Xhosa men in East London, South Africa. Interpretive phenomenology was used as the inquiry of choice. Data were collected through focus group discussions in which 14 men participated. The theme of marginalization of uninitiated Xhosa males emerged with two categories: (a) rejection, and (b) lack of respect. The participants revealed that uninitiated men are rejected by the community, their own families, friends, and women. We frame the discussion around the concept of stigma. Acknowledging that uninitiated males are stigmatized can help mitigate stigma, and in turn, the incidence of medical complications from botched circumcisions.
After the democratization of South Africa in 1994, the health-care system was reorganized in accordance with the primary health-care philosophy advocated by the World Health Organization. This was accompanied by a process of deinstitutionalization of mental health-care services, which has led families to become the main providers of care to individuals with mental illness. This study explores the experiences of informal family caregivers of persons with mental illness in a rural area in South Africa. Data were collected through eight individual semistructured interviews of informal caregivers who cared for relatives with mental illness and collect medications monthly at a community clinic in the Makhuduthamaga local municipality in Limpopo, South Africa. A qualitative research design was used, which was explorative, descriptive, and contextual. The data analysis revealed four major themes: (i) experiences of providing for physiological/physical needs; (ii) experiences of providing for emotional needs; (iii) experiences of providing for security needs; and (iv) experiences associated with the medical health-care programme. The study revealed that the experiences of family caregivers were conceptualized negatively, although the interview questions were intentionally neutral. This is believed to be due to the cultural explanatory models of mental illness prevalent in this region of South Africa. It is suggested that to increase compliance with medication, reduce relapse, and mitigate stigma associated mental illness, medical professionals need to incorporate aspects of cultural explanatory models into their explanations of the causes of illness.
We present a synthetic review and expert consultation that assesses the actual risks posed by arthropod pests in four major crops, identifies targets for integrated pest management (IPM) in terms of cultivated land needing pest control and gauges the implementation “readiness” of non-chemical alternatives. Our assessment focuses on the world’s primary target pests for neonicotinoid-based management: western corn rootworm (WCR, Diabrotica virgifera virgifera ) in maize; wireworms ( Agriotes spp.) in maize and winter wheat; bird cherry-oat aphid ( Rhopalosiphum padi ) in winter wheat; brown planthopper (BPH, Nilaparvata lugens ) in rice; cotton aphid ( Aphis gossypii ) and silver-leaf whitefly (SLW, Bemisia tabaci ) in cotton. First, we queried scientific literature databases and consulted experts from different countries in Europe, North America, and Asia about available IPM tools for each crop-pest system. Next, using an online survey, we quantitatively assessed the economic relevance of target pests by compiling country-level records of crop damage, yield impacts, extent of insecticide usage, and “readiness” status of various pest management alternatives (i.e., research, plot-scale validation, grower-uptake). Biological control received considerable scientific attention, while agronomic strategies (e.g., crop rotation), insurance schemes, decision support systems (DSS), and innovative pesticide application modes were listed as key alternatives. Our study identifies opportunities to advance applied research, IPM technology validation, and grower education to halt or drastically reduce our over-reliance on systemic insecticides globally. Electronic supplementary material The online version of this article (10.1007/s11356-020-09279-x) contains supplementary material, which is available to authorized users.
Aims: Low back pain (LBP), a common presenting problem in general practice in the United Arab Emirates (UAE), has received increasing attention in recent decades. We seek to investigate the prevalence of LBP and associated risk factors among people living in the typically hot, humid desert environment of the UAE. Methods: A cross‐sectional questionnaire survey was conducted. The setting was the Primary Health Care (PHC) Clinics in Al‐Ain, UAE. The subjects were a multistage stratified sample of 1304 UAE nationals, 15–70 years of age, who attended PHC clinics for any reason. All subjects were invited to participate. The questionnaire used in the survey is a modified version of the Roland‐Morris scale for evaluating low back pain. The questionnaires were administered during face‐to‐face interviews conducted in Arabic by qualified nurses. Results: Of the total 1304 subject, 1103 (84.5%) living in both urban and rural areas agreed to participate and responded to the study; 586 (53.1%) were men and 517 (46.9%) women. The mean ages and SD of the subjects were 34.9 ± 13.4 years for the men and 33.5 ± 11.8 years for the women. The prevalence of LBP in the present study was 64.6% (95% CI = 60.7–68.5). The results revealed that there were statistically significant differences between men and women with respect to LBP and body mass index (BMI) (P < 0.001), marital status (P < 0.001), occupational status (P < 0.001), housing condition (P < 0.001), and smoking habits (P < 0.001). Back pain had a greater influence on the lifestyle habits of the women than men. Stepwise multiple regression analysis showed that only BMI (OR = 2.54, 95% CI = 2.30–281; P < 0.001), prolonged standing (OR = 6.22, 95% CI = 4.01–9.67; P < 0.0001), weakness in leg (OR = 2.11, 95% CI = 1.16–3.85; P = 0.0142), lifting heavy weights (OR = 6.34, 95% CI = 4.09–9.84; P = 0.019) regular exercise (OR = 12.47, 95% CI = 7.50–20.71; P < 0.001) and smoking habits (OR = 1.61, 95% CI = 1.08–2.38; P < 0.05) had a significant effect on the presence of LBP in these patients. Conclusions: The study showed that the prevalence of back‐related disability was higher among women than men in the UAE. Also, low socio‐economic status and adverse lifestyle habits may constitute risk factors and predictors of LBP.
These novel findings indicate that besides the well-known facilitation of entry of HIV-1 by the interaction between virus-bound C3 fragments and CR2 present on the target cells, fixation of C1q to intact virions also results in an enhanced productive HIV-1 infection in the MT-4 cell cultures.
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