BACKGROUND:Clinical guidelines are intended to improve healthcare. However, even if guidelines are excellent, their implementation is not assured. In subfertility care, the European Society of Human Reproduction and Embryology (ESHRE) guidelines have been inventoried, and their methodological quality has been assessed. To improve the impact of the ESHRE guidelines and to improve European subfertility care, it is important to optimise the implementability of guidelines. We therefore investigated the implementation barriers of the ESHRE guideline with the best methodological quality and evaluated the used instrument for usability and feasibility.METHODS:We reviewed the ESHRE guideline for the diagnosis and treatment of endometriosis to assess its implementability. We used an electronic version of the guideline implementability appraisal (eGLIA) instrument. This eGLIA tool consists of 31 questions grouped into 10 dimensions. Seven items address the guideline as a whole, and 24 items assess the individual recommendations in the guideline. The eGLIA instrument identifies factors that influence the implementability of the guideline recommendations. These factors can be divided into facilitators that promote implementation and barriers that oppose implementation. A panel of 10 experts from three European countries appraised all 36 recommendations of the guideline. They discussed discrepancies in a teleconference and completed a questionnaire to evaluate the ease of use and overall utility of the eGLIA instrument.RESULTS:Two of the 36 guideline recommendations were straightforward to implement. Five recommendations were considered simply statements because they contained no actions. The remaining 29 recommendations were implementable with some adjustments. We found facilitators of the guideline implementability in the quality of decidability, presentation and formatting, apparent validity, and novelty or innovation of the recommendations. Vaguely defined actions, lack of facilities, immeasurable outcomes, and inflexibility within the recommendations formed barriers to implementation. The eGLIA instrument was generally useful and easy to use. However, assessment with the eGLIA instrument is very time-consuming.CONCLUSIONS:The ESHRE guideline for the diagnosis and treatment of endometriosis could be improved to facilitate its implementation in daily practice. The eGLIA instrument is a helpful tool for identifying obstacles to implementation of a guideline. However, we recommend a concise version of this instrument.

Background Clinical practice guidelines (CPG) are important tools for improving patient care. Patient and public involvement is recognised as an essential component of CPG development and implementation, The Guideline International Network Patient and Public Involvement Working Group (G-I-N PUBLIC) aims to support the development, implementation and evaluation of guideline-oriented patient and public involvement programmes (PPIPs).Objective To develop an international practice and research agenda on patient and public involvement in CPG.Method 56 CPG developers, researchers, and patient/public representatives from 14 different countries, were consulted in an international workshop. Recommendations were validated with G-I-N PUBLIC steering committee members.Results Many CPG organisations have set up PPIPs that use a range of participation, consultation and communication methods. Current PPIPs aim to improve the quality and responsiveness of CPGs to public expectations and needs, or to foster individual healthcare decisions. Some organisations use structured involvement methods, including providing training for patient and public representatives. A number of financial, organisational and sociopolitical barriers limit patient and public involvement. The paucity of process and impact evaluations limits our current understanding of the conditions under which patient and public involvement is most likely to be effective.Conclusion Greater international collaboration and research are needed to strengthen existing knowledge, development and evaluation of patient and public involvement in CPG.

The reaction of [Ru(eta(6)-p-cymene)Cl-2](2) with 2.0 mol equivalents of C(CH2SMe)(4), C(CH2SeMe)(4), 1,2,4,5-C6H2(CH2SMe)(4) or 1,2,4,5-C6H2(CH2SeMe)(4) (L-4) and [NH4][PF6] in ethanol solution forms the [RuCl(eta(6)-p-cymene){kappa(2)-L-4}][PF6] complexes. Similar Os(II) complexes are obtained starting with [Os(eta(6)-p-cymene) Cl-2](2). Treatment of [RuCl(eta(6)-p-cymene){kappa(2)-L-4}][PF6] with a further 0.5 mol equivalents of [Ru(eta(6)-pcymene) Cl-2](2) or reaction of [Ru(eta(6)-p-cymene) Cl-2](2) directly with 1.0 mol equivalent of L-4 forms the homobimetalllic [{RuCl(eta(6)-p-cymene)} 2{kappa(2) k'(2)-L-4}][PF6](2). Reaction of [OsCl(eta(6)-p-cymene)-{kappa(2)-C (CH2SeMe)(4)}][PF6] with [Ru(eta(6)-p-cymene) Cl-2](4) or [PtCl2(MeCN)(2)] affords the heterobimetallic [{OsCl(eta(6)p- cymene)}{RuCl(eta(6)-p-cymene)}{kappa(2) k'(2)-C(CH2SeMe)(4)}][PF6](2) and [{OsCl(eta(6)-p-cymene)}{PtCl2}{kappa(2)k'(2)-C (CH2SeMe)(4)}][PF6] respectively. The complexes have been characterised by multinuclear NMR and IR spectroscopy and X-ray crystallography. (C) 2010 Elsevier B. V. All rights reserved.

Otolaryngology–Head and Neck SurgeryVolume 143, Issue S1 p. 45-45 Articles S64– A new approach to advice for guideline developers Kay C. Currie MPH, Kay C. Currie MPH Presenter NHMRC's National Institute of Clinical Studies, Hampton, Victoria, AustraliaSearch for more papers by this authorGeraint R. Duggan, Geraint R. Duggan NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this authorHeather Buchan, Heather Buchan NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this authorEmma Tavender, Emma Tavender EPOC, Melbourne, Victoria, AustraliaSearch for more papers by this authorCatherine Marshall, Catherine Marshall Independent Guideline Advisor & Health Consultant, Waipukurau, New ZealandSearch for more papers by this authorTari Turner, Tari Turner National Trauma Research Institute, Melbourne, Victoria, AustraliaSearch for more papers by this authorMarie Misso, Marie Misso Australasian Cochrane Centre, Clayton, Victoria, AustraliaSearch for more papers by this authorTanyth de Gooyer, Tanyth de Gooyer NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this authorCatherine King, Catherine King NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this author Kay C. Currie MPH, Kay C. Currie MPH Presenter NHMRC's National Institute of Clinical Studies, Hampton, Victoria, AustraliaSearch for more papers by this authorGeraint R. Duggan, Geraint R. Duggan NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this authorHeather Buchan, Heather Buchan NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this authorEmma Tavender, Emma Tavender EPOC, Melbourne, Victoria, AustraliaSearch for more papers by this authorCatherine Marshall, Catherine Marshall Independent Guideline Advisor & Health Consultant, Waipukurau, New ZealandSearch for more papers by this authorTari Turner, Tari Turner National Trauma Research Institute, Melbourne, Victoria, AustraliaSearch for more papers by this authorMarie Misso, Marie Misso Australasian Cochrane Centre, Clayton, Victoria, AustraliaSearch for more papers by this authorTanyth de Gooyer, Tanyth de Gooyer NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this authorCatherine King, Catherine King NHMRC's National Institute of Clinical Studies, Melbourne, Victoria, AustraliaSearch for more papers by this author First published: 20 June 2017 https://doi.org/10.1016/j.otohns.2010.04.186Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume143, IssueS1July 2010Pages 45-45 RelatedInformation

PurposeWithin the emotional labor (EL) literature, the paper's aim is to test for additional scale distinctions in surface acting and deep acting, using a “difficult client” referent.Design/methodology/approachWorking with existing definitions and operationalizations across prior EL studies, an on‐line sample of 1,975 massage therapists and bodywork practitioners (M&Bs) was used to test the hypotheses. Hinkin's recommended three steps for scale development: item development, scale development and scale evaluation were applied. The M&B sample was randomly split to carry out exploratory factor analysis (EFA) and then confirmatory factor analysis (CFA). A smaller validation sample of 203 working adults was also tested using EFA.FindingsConvergent support was found for EFA between the M&B and validation samples, as well as between EFA and CFA for the M&B sample. Two types of surface acting could be distinguished, basic surface acting (BSA) and challenged surface acting (CSA), while three types of deep acting could be distinguished, basic deep acting (BDA), perspective taking deep acting (PTDA) and positive refocus deep acting (PRDA).Originality/valueThis paper studies a unique sample, massage and body therapists, and the “difficult client” stimulus has not been formally tested in prior EL scale work.

Previous literature lacks a theoretical conceptualisation of breast reconstruction and its impact on patients' and partners' sexual functioning. The aims of the present study were to identify factors that impact on the sexual relationship, to explore coping strategies used by patients and partners, and to highlight service needs. In total, 12 women who had undergone breast reconstructive surgery within the last three years and their partners (10 men) took part in the study. Grounded theory methodology was used to analyse the data and identify key categories for both patients and partners. Patients' key categories included anxiety and worry, influencing factors, self-image and sexual changes. All women experienced some degree of sexual change and sexual anxiety, and a minority reported a loss of sexual self. Partners' key categories included anxiety and stress, influencing factors and negotiating sexual changes. The majority of partners reported that initially, their priority was their partner's survival rather than sexual concerns; however the majority of men acknowledged some degree of sexual anxiety. The study highlighted the lack of information and discussion about sexual issues for both patients and partners, and the timing of such information if it were to be provided. It also stresses the need for services to include partners throughout the process.

The Guidelines International Network (G-1-N www.g-i-n.net) is a major new international initiative involving guideline-developing organisations from around the world. G-I-N seeks to improve the quality of health care by promoting systematic development of clinical practice guidelines and their application into practice. The Network now has over 45 international members, most of whom prepare evidence-based clinical practice guidelines, or actively promote the use of evidence in practice. One of the priorities of the organisation is to share evidence tables and adapt guidelines for local circumstances based on international evidence. In the longer term, guideline developers are planning to create 'living guidelines' that can be continuously updated and used by a number of different countries. A major consideration for guideline developers is how to communicate and work with information technology scientists to develop standards and protocols for the translation of these trans-national guidelines into electronic formats. To be effective, there must be formal internationally agreed standards that allow electronic guidelines to be shared and automatically updated. The Guidelines International Network will be taking a leading international role in working with designers and vendors of electronic decision support systems and tools to guarantee the integrity of guidelines when translated into electronic formats. This presentation by Catherine Marshall, Kitty Rosenbrand and Guenter Ollenschlaeger will: --explore current experiences from New Zealand, Germany and the Netherlands --identify issues from the perspective of guideline developers --make recommendations for establishing opportunities for software designers, vendors and informatics experts to collaborate with guideline developers to ensure that up to date evidence can be easily implemented and shared throughout the world.

AIMS:This study explores the use of evidence-based guidelines by New Zealand general practitioners, and describes strategies developed to overcome identified barriers in the New Zealand setting.METHODS:In-depth, semi-structured interviews with a purposeful sample of New Zealand guideline stakeholders including policy makers and general practitioners. Data were analysed using inductive thematic analysis. Feedback of emergent themes to the New Zealand Guidelines Group (NZGG) and further collaboration resulted in strategies to overcome barriers to use, some of which have now been implemented.RESULTS:At the time of the research (2000/2001), general practitioners reported that they did not regularly use guidelines to support decision-making regarding patient care. Reasons given included guidelines formats not being recognisable or user-friendly, lack of general practitioner involvement in prioritisation and development processes, influence of stakeholders, and recommendations not being accessible or relevant. Policy and other interviewed stakeholders reported general acceptance of guidelines, however there were minimal interfaces between the NZGG and these organisations.CONCLUSIONS:Effective implementation of guidelines requires more than guidelines endorsement by policy stakeholders and passive dissemination strategies, but rather an understanding of the issues facing general practitioners and their attitudes to guideline use.

Challenging the field of educational administration to take an activist and prosocial justice stance, this article introduces the special issue. Some professors and preparation programs are inadequately attuned to equity concerns. Standards and testing for administrator licensure touch only the surface of cultural diversity, equity, and democracy. Disproportionally small percentages of administrators are women and minorities. Still, with the high turnover of administrators and with the work of scholars in Leadership for Social Justice, the time for transforming the field is now.

New Directions for Institutional ResearchVolume 1991, Issue 72 p. 65-80 Article Integrating a qualitative and quantitative assessment of the quality of academic life: Political and logistical issues Catherine Marshall, Catherine Marshall Professor of educational leadership at the University of North Carolina, Chapel Hill.Search for more papers by this authorYvonna S. Lincoln, Yvonna S. Lincoln Professor of higher education at Texas A&M University, College Station.Search for more papers by this authorAnn E. Austin, Ann E. Austin Associate Professor in the Department of Educational Administration, Michigan State University, East Lansing.Search for more papers by this author Catherine Marshall, Catherine Marshall Professor of educational leadership at the University of North Carolina, Chapel Hill.Search for more papers by this authorYvonna S. Lincoln, Yvonna S. Lincoln Professor of higher education at Texas A&M University, College Station.Search for more papers by this authorAnn E. Austin, Ann E. Austin Associate Professor in the Department of Educational Administration, Michigan State University, East Lansing.Search for more papers by this author First published: Winter 1991 https://doi.org/10.1002/ir.37019917207Citations: 2 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume1991, Issue72Winter 1991Pages 65-80 RelatedInformation

Reference to values in education policy studies is commonplace, but close analysis is never done. This article provides behavioral definitions of four basic values—quality, equity, efficiency, choice—that render them amenable to quantitative analysis. The concept of culture is offered to explain policy behavior, specifically the meritocratic, egalitarian, and democratic cultures within our national culture. These value definitions are applied—via content analysis—to state education codes in Illinois and Wisconsin to demonstrate how policy choices are moved by different cultures. The results also demonstrate evidence for Elazar’s “political culture” concept. The conflict and complementarity inherent in these values are also discussed.

To identify the relative power and influence of various state education policy groups, data were collected by elite interviewing as part of a larger study by the authors. This article displays the variation among six states in the ranking of policy groups. The relative rankings show how the configurations of power differ among the states. Using the qualitative data, the article provides short analyses of the policy processes that explain these differences. History, recent political battles, and the action styles of policy actors are part of the context that explains the differences (e.g., showing how teachers’ associations may rank first in one state and twelfth in another). The research explores further the qualitative data to search for policy actors’ sense of the rules that must be followed to gain and maintain power in the cultural state policymaking. The article introduces the theory of assumptive worlds; the common action principles understood by all state policy actors and learned from their socialization in the culture of politics. It concludes by showing how assumptive worlds build cohesion, translate values, and are barometers of change.

This report examines the function of experience in the role of vice‐principal as preparation for the school principalship, proposing that a dysfunctional socialization outcome of this career entry pattern is the development of a role orientation that emphasizes managing rather than leading the school. The authors differentiate these two dimensions of the administrative role by suggesting that the managerial function emphasizes organizational stability and maintenance of the day‐to‐day operation, and that the leadership function emphasizes improvements in instructional and organizational arrangements facilitating teaching and learning. While a balance in functions is the preferred orientation implicit in theoretical as well as prescriptive models of the principalship, and principals themselves espouse the desirability of an instructional leadership emphasis, most empirical studies of the principalship indicate a substantial skewing of emphasis in the direction of managerial activities. The paper offers an empirically grounded theoretical explanation of this occurrence. Based on data from the studies of the enculturation process and the work activities of vice‐principals, and guided by socialization theory, the report discusses role‐learning implications of experience in the vice‐principalship role and concludes with seven propositions for further study.

Field research conducted by female researchers in policy settings requires special attention to access, entrée, reciprocity, and ethics. A researcher must manage information about informal coalitions or networks of influence and power, the posturing and manipulation in policy games, and the special norms and traditions in policy settings. The author proposes ways to manage role, entrée and access, data gathering, reciprocity, ethics, and reporting in policy settings, issues that must be managed differently at different stages in the research. The author also raises the issue of male‐female dynamics in field research, suggesting appropriate roles for female researchers in policy settings.

Anthropology & Education QuarterlyVolume 15, Issue 3 p. 194-201 Research Dilemmas in Administration and Policy Settings: An Introduction to the Special Issue CATHERINE MARSHALL, CATHERINE MARSHALL Guest Editor Catherine Marshall is Assistant Professor of Education, Graduate School of Education, University of Pennsylvania, Philadelphia, PA 19104.Search for more papers by this author CATHERINE MARSHALL, CATHERINE MARSHALL Guest Editor Catherine Marshall is Assistant Professor of Education, Graduate School of Education, University of Pennsylvania, Philadelphia, PA 19104.Search for more papers by this author First published: Fall 1984 https://doi.org/10.1525/aeq.1984.15.3.05x1567gCitations: 1 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References Cited Allison, Graham 1971 Essence of Decision: Explaining the Cuban Missile Crisis. Boston: Little, Brown and Company. Becker, Howard, Blanche Geer, Everett C. Hughes, and Anselm Strauss 1961 Boys in White: Student Culture in Medical School. University of Chicago Press. Berman, Paul, and Milbrey McLaughlin 1978 Federal Programs Supporting Educational Changes, Vol. VIII: Implementing and Sustaining Innovations. Santa Monica, CA: Rand Corporation. Clark, Burton R. 1960 The Open Door College: A Case Study. New York: McGraw Hill. D'Lamatur, Gary D. 1982 Utilizing a Review of the Literature in Ethnographic Educational Research Validation, Contamination and Modeling Functions. Paper presented at third annual University of Pennsylvania Ethnography in Education Research Forum. Freeman, Derek 1983 Margaret Mead and Samoa: The Making and Unmaking of an Anthropological Myth. 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