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AbstractA non‐conventional marketing strategy is used by the owners of a not‐for‐profit code of practice,Fairtrade. People buyFairtrade‐branded goods because of the social discourse around it – what friends, newspapers, teachers and others tell them about what it guarantees, what it achieves and what is its social acceptability – rather than because of the advertising. The social discourse is favourable toFairtrade but bears little relation to observable fact. Methods used by the brand owners and others to control and manipulate the social discourse are identified.

AbstractIn a recent issue of this journal, Tedeschi and Carlson presented far reaching conclusions on the impact of fair trade. They reject the conclusions of others on the grounds that they are based on incorrect assumptions. It is argued here that their own assumptions are false, seriously misrepresenting fair trade or Fairtrade. Their analysis is therefore incorrect, and their models must be rejected in their entirety. Copyright © 2013 John Wiley & Sons, Ltd.

Alastair Smith (2009) claims to refute a few criticisms of Fairtrade. It is shown that his empirical evidence consists of anecdotes with no statistical or other evidential value, and that his economics is wrong. Though Fairtrade is an agricultural marketing system, he appears not to be aware of the literature on agricultural marketing or co‐operatives. Accordingly he makes statements not in accord with the accepted theory or evidence. He assumes, for instance, backward‐sloping supply curves and that the prices offered by state marketing boards are not affected by markets. There are ethical trading alternatives which avoid all the criticisms of Fairtrade.

Learning Disability and other Intellectual Impairments is the first book of its kind to explore the similarities and parallels between the needs of people with various types of intellectual impairments as they encounter health services. It not only looks at the shared issues from a bio-psycho-social perspective, but also discusses the transferable skills that a practitioner can develop working across these groups. It identifies the key skills and knowledge that professionals need in order to work with intellectually impaired patients whether they are in the hospital or at home. Rather than just focusing on people with learning disabilities, this text attempts to break down barriers and look at some of the issues associated with care and treatment of people who have intellectual impairment for a variety of reasons, including acquired brain injury, dementia and long-term mental health issues where cognition has been affected. Learning Disability and other Intellectual Impairments is suitable for health care practitioners at all levels who work with people who have intellectual impairments in their work and who wish to further develop their skills and knowledge to care for this neglected client group.

Background: Releasing Time to Care: The Productive WardTM(RTC) is a method for conducting continuous quality improvement (QI). The Saskatchewan Ministry of Health mandated its implementation in Saskatchewan, Canada between 2008 and 2012. Subsequently, a research team was developed to evaluate its impact on the nursing unit environment. We sought to explore the influence of the unit¿s existing QI capacity on their ability to engage with RTC as a program for continuous QI. Methods: We conducted interviews with staff from 8 nursing units and asked them to speak about their experience doing RTC. Using qualitative content analysis, and guided by the Organizing for Quality framework, we describe the existing QI capacity and impact of RTC on the unit environment. Results: The results focus on 2 units chosen to highlight extreme variation in existing QI capacity. Unit B was characterized by a strong existing environment. RTC was implemented in an environment with a motivated manager and collaborative culture. Aided by the structural support provided by the organization, the QI capacity on this unit was strengthened through RTC. Staff recognized the potential of using the RTC processes to support QI work. Staff on unit E did not have the same experience with RTC. Like unit B, they had similar structural supports provided by their organization but they did not have the same existing cultural or political environment to facilitate the implementation of RTC. They did not have internal motivation and felt they were only doing RTC because they had to. Though they had some success with RTC activities, the staff did not have the same understanding of the methods that RTC could provide for continuous QI work. Conclusions: RTC has the potential to be a strong tool for engaging units to do QI. This occurs best when RTC is implemented in a supporting environment. One size does not fit all and administrative bodies must consider the unique context of each environment prior to implementing large-scale QI projects. Use of an established framework, like Organizing for Quality, could highlight the distinctive supports needed in particular care environments to increase the likelihood of successful engagement.

Abstract Background Releasing Time to Care: The Productive Ward™ (RTC) is a method for conducting continuous quality improvement (QI). The Saskatchewan Ministry of Health mandated its implementation in Saskatchewan, Canada between 2008 and 2012. Subsequently, a research team was developed to evaluate its impact on the nursing unit environment. We sought to explore the influence of the unit's existing QI capacity on their ability to engage with RTC as a program for continuous QI. Methods We conducted interviews with staff from 8 nursing units and asked them to speak about their experience doing RTC. Using qualitative content analysis, and guided by the Organizing for Quality framework, we describe the existing QI capacity and impact of RTC on the unit environment. Results The results focus on 2 units chosen to highlight extreme variation in existing QI capacity. Unit B was characterized by a strong existing environment. RTC was implemented in an environment with a motivated manager and collaborative culture. Aided by the structural support provided by the organization, the QI capacity on this unit was strengthened through RTC. Staff recognized the potential of using the RTC processes to support QI work. Staff on unit E did not have the same experience with RTC. Like unit B, they had similar structural supports provided by their organization but they did not have the same existing cultural or political environment to facilitate the implementation of RTC. They did not have internal motivation and felt they were only doing RTC because they had to. Though they had some success with RTC activities, the staff did not have the same understanding of the methods that RTC could provide for continuous QI work. Conclusions RTC has the potential to be a strong tool for engaging units to do QI. This occurs best when RTC is implemented in a supporting environment. One size does not fit all and administrative bodies must consider the unique context of each environment prior to implementing large-scale QI projects. Use of an established framework, like Organizing for Quality, could highlight the distinctive supports needed in particular care environments to increase the likelihood of successful engagement.

OBJECTIVES: To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. DESIGN: Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. SETTING: Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. PARTICIPANTS: Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. MAIN OUTCOME MEASURES: Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. RESULTS: Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80

No study has systematically examined how researchers address cross-cultural adaptation of burnout. We conducted an integrative review to examine how researchers had adapted the instruments to the different contexts. We reviewed the Content Validity Indexing scores for the Maslach Burnout Inventory-Human Services Survey from the 12-country comparative nursing workforce study, RN4CAST. In the integrative review, multiple issues related to translation were found in existing studies. In the cross-cultural instrument analysis, 7 out of 22 items on the instrument received an extremely low kappa score. Investigators may need to employ more rigorous cross-cultural adaptation methods when attempting to measure burnout. ; This research is funded by the European Union's Seventh Framework Programme FP7/2007-2013 under grantagreement n° 223468 (W. Sermeus, PI), the National Institute of Nursing Research, National Institutes of Health(P30NR05043 L. Aiken), and by the Spanish Agency Fondo de Investigación Sanitaria under grant agreementPI08/0599 (C. Fuentelsaz-Gallego, PI). ; Sí

BACKGROUND: Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. METHODS/DESIGN: A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences.This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce. DISCUSSION: RN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe. ; The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 223468. For more information on the RN4CAST project, please visit http://www.rn4cast.eu ; Sí