Improving Nursing Home Care through Feedback On PerfoRMance Data (INFORM): Protocol for a cluster-randomized trial

Background Audit and feedback is effective in improving the quality of care. However, methods and results of international studies are heterogeneous, and studies have been criticized for a lack of systematic use of theory. In TREC (Translating Research in Elder Care), a longitudinal health services research program, we collect comprehensive data from care providers and residents in Canadian nursing homes to improve quality of care and life of residents, and quality of worklife of caregivers. The study aims are to a) systematically feed back TREC research data to nursing home care units, and b) compare the effectiveness of three different theory-based feedback strategies in improving performance within care units. Methods INFORM (Improving Nursing Home Care through Feedback On PerfoRMance Data) is a 3.5-year pragmatic, three-arm, parallel, cluster-randomized trial. We will randomize 67 Western Canadian nursing homes with 203 care units to the three study arms, a standard feedback strategy and two assisted and goal-directed feedback strategies. Interventions will target care unit managerial teams. They are based on theory and evidence related to audit and feedback, goal setting, complex adaptive systems, and empirical work on feeding back research results. The primary outcome is the increased number of formal interactions (e.g., resident rounds or family conferences) involving care aides – non-registered caregivers providing up to 80% of direct care. Secondary outcomes are a) other modifiable features of care unit context (improved feedback, social capital, slack time) b) care aides’ quality of worklife (improved psychological empowerment, job satisfaction), c) more use of best practices, and d) resident outcomes based on the Resident Assessment Instrument – Minimum Data Set 2.0. Outcomes will be assessed at baseline, immediately after the 12-month intervention period, and 18 months post intervention. Discussion INFORM is the first study to systematically assess the effectiveness of different strategies to feed back research data to nursing home care units in order to improve their performance. Results of this study will enable development of a practical, sustainable, effective, and cost-effective feedback strategy for routine use by managers, policy makers and researchers. The results may also be generalizable to care settings other than nursing homes. Trial registration ClinicalTrials.gov Identifier: NCT02695836 . Date of registration: 24 February 201

N2O increasing faster than expected

International audienceNitrous oxide (N2O) is an important greenhouse gas produced by natural and human sources and is also the main contributor to the depletion of the stratospheric ozone layer1. With a long atmospheric lifetime of at least 100 years and a global warming potential about 265–298 times as high as that of CO2, N2O has the potential to cause both short-term and long-lasting environmental problems. Agriculture is the main source of anthropogenic N2O emissions, primarily through the application of synthetic nitrogen (N) fertilizers and manure on agricultural land1. As the global amount of fertilizer used is expected to increase considerably over the next few decades, it is essential to establish reliable inventories of N2O in order to define effective mitigation strategies. Writing in Nature Climate Change, Rona Thompson and colleagues2 present new global estimates of N2O emissions and show that this greenhouse gas has increased substantially since 2009, at a faster rate than expected. Their result questions one of the main methods currently used for the inventory of N2O emissions at the global scale

Ethnografische Ansätze in der Genossenschaftsforschung - Felder, Methoden und Erkenntnisinteressen

Der Beitrag widmet sich ethnografischen Ansätzen in der Genossenschaftsforschung und benachbarten Forschungsfeldern, die sich mit kooperativen Praktiken befassen. Neben den Grundzügen dieser Forschungsansätze stellen wir ethnografische Studien zu Genossenschaften und anderen kooperativen Wirtschafts- und Organisationsformen vor. Ziel ist es dabei, die vielfältigen Perspektiven ethnografischer Ansätze auf Genossenschaften und kooperative Praktiken zu systematisieren und zu diskutieren, welchen Beitrag ethnografische Ansätze zur aktuellen Genossenschaftsforschung leisten können