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Purpose: The prevalence of Congolese refugee women seeking asylum in the USA has recently garnered substantial attention. Many women have fled the Democratic Republic of Congo due to trauma and loss. Likewise, the resettlement process, particularly acculturative stress, may exacerbate mental health issues such as depression and anxiety. By recognizing the centrality of family within Congolese culture, this study aims to investigate cultural beliefs about family among Congolese refugee women in the USA, using acculturative theory as an interpretative lens. Design/methodology/approach: The authors' study centered on understanding the resettlement experiences of 20 Congolese refugee women living within an urban area of Midwest America after their arrival in America since 2011. Through using convenient sampling methods, the authors chose these particular activists as they could provide insight into their stories concerning their journey from Congo to settling down as refugees within Northeast America. During interviews, semi-structured questioning was used to gather responses from participants which were later analyzed through implementing a thematic interpretation process. Findings: Three themes emerged encapsulating cultural beliefs about family: supporting one another; the importance of togetherness; and disciplining our children. These findings provide culturally tailored resources to support Congolese refugee women and their families upon resettlement optimally. Research limitations/implications: The authors' work provides health equity researchers with an opportunity to better understand cultural beliefs among Congolese refugee women. Findings from this study provide an increased understanding of how to provide culturally specific tools to better aid Congolese refugee women and their families upon arrival. Practical implications: The authors' research offers insights for health equity researchers seeking to understand the cultural beliefs of Congolese refugee women. The findings contribute to an enhanced understanding of how to provide culturally specific resources better to support Congolese refugee women and their families upon arrival. Originality/value: The authors verify that, to the best of the authors' knowledge, the paper was written completely independently, and neither the entire work nor any of its parts have been previously published. The authors confirm that the paper has not been submitted to peer review, nor is in the process of peer reviewing, nor has been accepted for publishing in another journal. The authors confirm that the research in their work is original. [ABSTRACT FROM AUTHOR]

Purpose: Building on social exchange and leader-member exchange theories, this paper aims to propose a model of the impact of coronavirus-induced anxiety on health-care professionals' burnout and turnover intention through the mediation role of servant leadership. Design/methodology/approach: This model was examined by adopting partial least square-based structural equation modeling using data collected from 271 health professionals (doctors, nurses, midwives and analysts) from Turkey. Findings: The findings of the research illustrate that coronavirus-induced anxiety is positively associated with burnout and turnover intention. Furthermore, servant leadership mediates the relationship between coronavirus-induced anxiety, burnout and turnover intention. Yet, according to factor loadings, the mediating role of servant leadership is not strong (β : 0.035 and 0.053, respectively). Research limitations/implications: First, this study targeted the health-care professionals from Turkey. Therefore, this population may not be able to provide general information on the topic. Thus, this study suggests that the subject be addressed in other populations as well. Second, the data were self-reported by the participants. Although common method bias and social desirability bias were not an issue in this study, it should be known that the results are based on the subjective judgments of the participants. Third, this study was limited to investigating the mediating role of servant leadership only. Practical implications: This study gives much beneficial information to both administrators and organizations by mirroring highly stressed workers' inside throughout statistically results. Hence, it is assumed that the findings will help leaders to cope with several difficult situations, especially in crisis moments. As the chaotic circumstances occurred, achieving organizational goals became more and more difficult. To do this, some leaders play critical roles for members like servant leaders by contributing uniquely spiritual dimensions. Social implications: Struggling with the COVID-19 pandemic has aggravated the health-care professionals' existing mental health and has loaded more agitation on them. According to Mozes (2021), suicide cases among nurses have doubled the number of women in the general population. Thus, leaders should do something to lower those ratios. This study points out that servant leaders could break down those unwanted issues by decreasing burnout and turnover intention rates of health workers. Barbuto and Wheeler (2006) highlighted this situation by creating a dimension called "The Natural Desire to Serve Others." Originality/value: To the best of the authors' knowledge, to date, this study is the first to examine the mediating role of servant leadership in the effect of coronavirus-induced anxiety on burnout and turnover intention. Furthermore, this research reveals that servant leadership may play a role in avoiding burnout and turnover intention in the health sector. [ABSTRACT FROM AUTHOR]

Purpose: Population ageing is a demographic transition and burdens every country's health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab. Design/methodology/approach: This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above. Findings: This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population. Originality/value: This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences. [ABSTRACT FROM AUTHOR]

Purpose: The demand for long-term home care services has been increasing in Taiwan due to the significant growth of the older population. In order to understand the crucial roles that language and communication play in providing better long-term home care services in Taiwan, this study aims to adopt a gerontological sociolinguistic perspective to investigate how professional care workers communicate with older people in this context. Design/methodology/approach: Interviews were conducted with 58 long-term home care workers to identify their communication accommodation strategies for older people, considering their health conditions (dementia), personalities (grumpiness), living status (loneliness) and general principles of long-term home care communication. Findings: The study's findings provide practical insights for long-term home care workers to enhance their communication skills while interacting with older people. Research limitations/implications: The results could contribute to improving the quality of care services provided to older people and address their specific communication needs. Originality/value: To the best of the author's knowledge, this paper is the first attempt to identify contextually specific communication accommodations to older people in existing literature of gerontological sociolinguistics that addresses language, communication and older age. The salience of the findings in this study can be further enhanced if they were applied in the development of training programs for future Taiwanese long-term home care workers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the perceptions that older people in Argentina have about the use of cell phones and to analyze their influence on user behavior. At the same time, it was intended to analyze whether sociodemographic factors influence these perceptions. Design/methodology/approach: The authors conducted a study with a non-experimental, cross-sectional and cross-correlational design; a non-probabilistic sample of 138 intentionally selected older people was chosen. Findings: The frequency and years of cell phone use, as well as the applications used, are influenced by the perceptions that older people have about cell phone use. In addition, it was found that age, gender and socio-educational level determine the perceptions that older people have about cell phone use. Originality/value: This research has implications for interventions aimed at improving older people's functional health. Understanding the perceptions of older people in relation to technology will enable the enhancement of its utility to foster an autonomous lifestyle and social integration in old age. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report on research undertaken in an National Health Service (NHS) emergency department in the north of England, UK, to identify which patients, with which clinical conditions are returning to the emergency department with an unscheduled return visit (URV) within seven days. This paper analyses the data in relation to the newly introduced Integrated Care Boards (ICBs). The continued upward increase in demand for emergency care services requires a new type of "upstreamist", health system leader from the emergency department, who can report on URV data to influence the development of integrated care services to reduce further demand on the emergency department. Design/methodology/approach: Patients were identified through the emergency department symphony data base and included patients with at least one return visit to emergency department (ED) within seven days. A sample of 1,000 index visits between 1 January 2019–31 October 2019 was chosen by simple random sampling technique through Excel. Out of 1,000, only 761 entries had complete data in all variables. A statistical analysis was undertaken using Poisson regression using NCSS statistical software. A review of the literature on integrated health care and its relationship with health systems leadership was undertaken to conceptualise a new type of "upstreamist" system leadership to advance the integration of health care. Findings: Out of all 83 variables regressed with statistical analysis, only 12 variables were statistically significant on multi-variable regression. The most statistically important factor were patients presenting with gynaecological disorders, whose relative rate ratio (RR) for early-URV was 43% holding the other variables constant. Eye problems were also statistically highly significant (RR = 41%) however, clinically both accounted for just 1% and 2% of the URV, respectively. The URV data combined with "upstreamist" system leadership from the ED is required as a critical mechanism to identify gaps and inform a rationale for integrated care models to lessen further demand on emergency services in the ED. Research limitations/implications: At a time of significant pressure for emergency departments, there needs to be a move towards more collaborative health system leadership with support from statistical analyses of the URV rate, which will continue to provide critical information to influence the development of integrated health and care services. This study identifies areas for further research, particularly for mixed methods studies to ascertain why patients with specific complaints return to the emergency department and if alternative pathways could be developed. The success of the Esther model in Sweden gives hope that patient-centred service development could create meaningful integrated health and care services. Practical implications: This research was a large-scale quantitative study drawing upon data from one hospital in the UK to identify risk factors for URV. This quality metric can generate important data to inform the development of integrated health and care services. Further research is required to review URV data for the whole of the NHS and with the new Integrated Health and Care Boards, there is a new impetus to push for this metric to provide robust data to prioritise the need to develop integrated services where there are gaps. Originality/value: To the best of the authors' knowledge, this is the first large-scale study of its kind to generate whole hospital data on risk factors for URVs to the emergency department. The URV is an important global quality metric and will continue to generate important data on those patients with specific complaints who return back to the emergency department. This is a critical time for the NHS and at the same time an important opportunity to develop "Esther" patient-centred approaches in the design of integrated health and care services. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to critically examine the multinational oil companies' (MOCs) corporate social responsibility (CSR) initiatives in Nigeria. Its special focus is to investigate the impact of the global memorandum of understanding (GMoU) on improving female status by improving nutrition in the Niger Delta region of Nigeria. Design/methodology/approach: This paper adopts a survey research technique, aimed at gathering information from a representative sample of the population, as it is essentially cross-sectional, describing and interpreting the current situation. A total of 768 women respondents were sampled across the rural areas of the Niger Delta region. Findings: The results from the use of a combined propensity score matching and logit model indicate that GMoU model has made significant impact in the key areas of assessment – gender-sensitive nutrition education, food security at household level, reduction on food taboos and female access to education. Practical implications: This suggests that CSR interventions targeting to improve the nutrition status of girls and adolescents will help to ensure that female's status improves throughout the life circle in the region. Social implications: This implies that MOCs' investment in the nutrition of female is an important short-term barometer in assessing expected returns to improving household nutrition and overall human development capacity for sub-Saharan Africa. Originality/value: This research contributes to the inequality debate in the women's nutrition and inclusive growth literature from the CSR perspective. It concludes that business has an obligation to help in solving problems of public concern. [ABSTRACT FROM AUTHOR]

Purpose: Community support is an integral aspect of health and well-being for Indigenous peoples. The purpose of this paper is to demonstrate the valuable role of community support for Indigenous women specifically, who experience reproductive health disparities at alarming rates. This study helps fill an important gap in Indigenous scholarship by centering the resilience of women and Indigenous tribes and by using a framework that is consistent with Indigenous holistic views of health. Design/methodology/approach: The data for this paper was collected as part of a larger study exploring the reproductive health experiences of a state-recognized Gulf Coast tribe. A total of 31 semi-structured interviews were conducted with individuals who identify as women and as members of this tribe using qualitative descriptive methodology. This method is recommended for research with Indigenous communities. A community advisory board with representatives from this tribe provided feedback throughout the project. Findings: Themes expressed by participants included Community Closeness and Support; Community Support in Raising Children; Informal Adoption Common; and Community Values of Mutual Aid and Self-Sufficiency. The findings support current literature noting the value of generational and communal ties for Indigenous peoples. Implications of this research include the need to value and support community networks in programs serving tribes, in addition to meaningfully including Indigenous communities in developing interventions. Originality/value: This paper centers Indigenous women's resilience, approaches the health and well-being of Indigenous tribes holistically and helps to fill an important gap in literature describing informal adoption (outside the legal system) in state-recognized Indigenous communities. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to analyze how psychosocial support influences caring activities toward indigenous older adults. Design/methodology/approach: A descriptive study with the participation of 229 informal indigenous caregivers. The study considered both sociodemographic and medical variables. It used the mini-mental test to determine the cognitive level in the elderly. It applied the Yesavage and Zarit scales to establish depressive symptomatology and caregiver burden. Finally, the study used the MOS psychosocial support and Apgar screening questionnaires to assess the psychosocial dimension and the patient's family functional state, respectively. Findings: The study observed a low caregiver burden effect using the MOS questionnaire. This may be explained due to variability in the Zarit Scale Score product of other variables like years of care (−0.17 and −0.28), depressive symptoms (0.16 and 0.18), cognitive level (mini-mental) (−0.13 and −0.14) and comorbidity (0.26 and −0.27). The study obtained an incidence between (−0.02 and −0.12) when including all assessed dimensions into the model. The instrumental dimension in the social support questionnaire obtained the highest score. Originality/value: Protective factors prevail in the group of indigenous caregivers allowing this activity to not trigger overload. Yet, variables such as the female gender, some comorbidities and the presence of depressive symptoms could be potential variables for dysfunction in this occupational role. [ABSTRACT FROM AUTHOR]

Purpose: Social determinants of stressful events (SE) play an important role in justifying the cause of inequality in the experience of SE. The purpose of this study is to investigate the determinants that impact on inequality in the experience of SE. Design/methodology/approach: The statistical population of this study includes all residents of Tehran. The statistical sample was 5,895 people who were selected by multistage cluster method and were proportional to the population size. The research tool is a researcher-made questionnaire designed to measure SE in Tehran, which includes 11 psychological stressors. The Oaxaca–Blinder decomposing method was used to analyze data. Findings: In a total of 11 psychological SE, in 6 of those events, there was significant inequality in the experience of SE. Concentration Index (CI) of political SE is (CI = −0.27, 95% CI: −0.47, −0.07) and in favor of the rich (pro-rich). Education (OR = 1.60) in poor group and region development in poor and rich (respectively in all of the following) (OR = 0.42–0.73) are the main determinants of inequality in this stressor. CI of neighborhood underdevelopment SE is (CI = −0.47, 95% CI: 0.66, −0.28) and pro-rich. Education (OR = 1.26–1.27) and region development (OR = 1.18–2.24) are the main determinants of inequality in this stressor. CI of livelihood problems SE is (CI = −0.58, 95% CI: 0.68, −0.32) and pro-rich. Education (OR = 1.40) and health status (OR = 1.63) in poor group are the main determinants of inequality in this stressor. CI of future uncertainty SE is (CI = −0.12, 95% CI: 0.34, −0.08) and pro-rich. Gender (OR = 1.22) in poor group and region development (OR = 0.24–0.58) are the main determinants of inequality in this stressor. CI of education problems (CI = 0.19, 95% CI: 0.05, 0.32) and pro-poor. Age (OR = 0.32–0.34) and education (OR = 3.65–3.30) are the main determinants of inequality in this stressor. CI of housing problems is (CI = −0.29, 95% CI: −0.49, −0.08) and pro-rich. Education (OR = 1.31) and region development (OR = 1.64) in poor group are the main determinants of inequality in this stressor. Research limitations/implications: The first limitation is related to the level of data analysis, and the second limitation is the lack of comprehensive data on social determinants. Practical implications: Social determinants affecting the formation of inequality in the experience of SE. Some social determinants, such as the level of education and development of the region, play a more prominent role in justifying inequality in the experience of stress between rich and poor groups. Social implications: Inequality in the experience of SE is a serious threat to mental and social health. One of the ways to reduce the experience of psychological and social stress is to pay attention to social determinants that play a role in the formation of stress. Originality/value: This original paper was conducted by examining the effect of social determinants on the formation of inequality in the experience of stress, which draws the serious attention of policymakers. [ABSTRACT FROM AUTHOR]

Purpose: The need to reduce health expenditures raises the discussion on rationing possibilities and there is a growing interest in considering society's perspectives. The aim of this paper was to evaluate Portuguese citizens' opinion regarding the imposition of limits on National Health Service (NHS) spending. We also asked who decides how NHS money is spent, in order to obtain the respondents' views on public involvement. Design/methodology/approach: An online questionnaire was used to collect data. Descriptive and inferential statistics, factorial analysis and a logit model were applied. Findings: Our results showed that most of the respondents believe citizens have low participation on NHS' financial decisions, confirming the lack of public involvement. Health professionals are more likely to agree with limits on NHS spending, which could indicate potential inefficiencies. Practical implications: From a health policy perspective, we have concluded that different stakeholders should be involved before deciding how public spending limits should be implemented. Health professionals' perspectives should be considered, taking advantage of their experience. Originality/value: The main novelty of this paper is the evaluation of whether there should be limits on NHS spending, comparing health professionals and non-health professionals. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in South-West Nigeria and to assess the impact of a problem-solving skills and attributional retraining (PSSAR) intervention with this population. Design/methodology/approach: In total, 787 male students from two schools were screened for conduct disorder. All participants who met criteria for the disorder were allocated to either treatment (n = 55) or control (n = 47) groups. Outcome measures comprised the strengths and difficulties questionnaire (SDQ; teacher and student versions) and the teacher rating of students' aggressive behaviors. Findings: Of the sample, 13% were found to present with difficulties that met criteria for conduct disorder. The presence of these difficulties correlated with several demographic variables, including parental conflict and alcohol use. A statistically significant reduction in mean scores was observed for the treatment group in the student rating of the SDQ emotional subscale and total difficulties scores. Teacher ratings were less consistent in that conduct problems, prosocial behavior and total difficulties increased following the intervention, whereas peer problems and aggressive behavior were reported by teachers to reduce. No statistically significant change was found in the outcome measures for the control group. Practical implications: In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. Originality/value: In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. This study's findings offer some preliminary support for the PSSAR intervention for conduct disorder in this context and indicate areas for further research. [ABSTRACT FROM AUTHOR]

Purpose: The importance of effective public messages has been widely recognized during the coronavirus disease 2019 (COVID-19) pandemic. In particular, the role of news items and interpersonal conversations for the acceptance of public health measures has been highlighted. The authors propose a conceptual model based on the existing literature on how to measure the degree of persuasion of news narratives in the context of the COVID-19 pandemic. Design/methodology/approach: The authors adopted a whole population approach, where the unit of analysis was the population of the media news about the COVID-19 pandemic. The authors selected a sample to develop and test their conceptual model. The sample size was n = 248. The questionnaire was distributed online using a non-probability convenience sampling plan. The authors used a pre-post pseudo-experimental design. Respondents answered questions about their attitude toward the COVID-19 pandemic. After watching a narrative news report on the same subject, they then answered questions designed to measure changes in their attitude. A structural equation model, the Sobel test and a paired samples t-test were used to test hypotheses. Findings: The results showed that there is a significant relationship between narrative with transportation and empathy. There was also a positive and significant relationship between transportation and empathy with attitude and interpersonal talk. The relationship between transportation and self-referencing was also supported. Further, transportation and attitude mediated the relationships between narrative and interpersonal talk, self-referencing as well as empathy. A paired samples t-test revealed that attitudes were changed or reinforced before and after watching the narrative news report. Originality/value: This paper contributes to the body of knowledge by identifying the outcomes of narrative persuasion during public health crises such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify the difficulties and overload/burden experienced by family caregivers of older dependent people during the COVID-19 outbreak. Design/methodology/approach: A descriptive and cross-sectional study was conducted. This work was guided according to the Guideline strengthenin the reporting of observational studies in epidemiology (EQUATOR checklist). The study included 65 family caregivers of older people with physical or mental dependence. Caregivers were selected by convenience sampling through a national association of informal caregivers. Participants responded to an online questionnaire, which aimed to assess difficulties and burdens experienced during the pandemic. Ethical principles were followed throughout the research. Findings: The participants were mostly women, with an average age of 53 years, teleworking and cohabiting with the dependent elderly. Most caregivers reported that the pandemic has led to an increase in daily difficulties and associated burden. There was a statistically significant increase in hours devoted to care during the pandemic. Also, caregivers reported less time to take care of themselves and greater fatigue during this period. Research limitations/implications: This study had some limitations. For example, the small sample size. The sample was collected through an online version, and many caregivers did not have the digital skills needed to complete the questionnaires, and most of them were busy (divided between teleworking and household responsibilities). Another limitation was related to the perceived priority of caregivers because the majority of them considered this was a time-consuming study and saw no immediate benefits. Furthermore, they considered that this study has taken their time to manage all the provision of care to the elder relative and other activities related to their children who were also in quarantine. Finally, to date, there is no sufficient evidence to compare our results with other national and international studies. Further research is needed to allow the scalability of results and to apply the best available knowledge to mitigate the known and potential effects of this pandemic. Practical implications: This study highlighted that frontline caregivers suffered a negative impact on their physical and mental health, in addition to a significant economic burden during the pandemic outbreak. More research in this field is needed to plan, train and manage large-scale public health emergencies. Social implications: The COVID-19 pandemic imposed physical distancing, which profoundly affected the physical and mental health of community-dwelling older people and their family caregivers. Because of the confinement and closure of some social support institutions, family caregivers found themselves in a complex situation, having to reconcile care and teleworking. Therefore, it is important to identify the impact of the COVID-19 pandemic on the difficulties and burden of these caregivers to implement and develop social and health support measures. Originality/value: This paper addresses an increasingly important issue – the burden and difficulties of family caregivers, in the light of a new reality – the Covid-19 pandemic, which has brought new difficulties for this population. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to compare working conditions, experiences of discrimination and suspected cases of common mental disorders (CMDs) among Haitian and Brazilian migrant workers in the same production processes. Design/methodology/approach: This cross-sectional, exploratory study was conducted using a nonprobabilistic convenience sample of Brazilian and Haitian migrant workers aged over 18 years from the capital of the Brazilian Midwest, evaluated from October 2018 to May 2019. Individual and face-to-face interviews were conducted using a structured questionnaire consisting of three instruments: health and work (questions of the Health and Work Survey: Inquérito Saúde e Trabalho), the experience of discrimination score and the self-reporting questionnaire. Findings: In total, 165 workers were evaluated: 99 Haitians (58 from the service sector and 41 from the construction sector) and 66 Brazilians (37 from the service sector and 29 from the construction sector). Male workers of both nationalities were predominant. Deafening noise and dust or gas exposure were more prevalent among Brazilians than among Haitians. Chemical agents and radiation exposure have been reported more frequently among Haitians. Discrimination related to nationality or race was nine times more common among Haitians (10.1%) than among Brazilians (1.5%). Perceived discrimination at work was higher among Haitians (16.2%) than among Brazilians (3.0%). The prevalence of suspected CMDs among Haitians and Brazilians were 24.0% and 4.5%, respectively. Research limitations/implications: Despite the limitation regarding convenience sampling and the high number of Brazilians who refused to participate in the interviews, this paper brings contributions and recommendations. First, considering that comparisons in health outcomes between migrants and nonmigrant are challenging, this study sheds light on the knowledge of work-health relations between migrant populations and host populations. Practical implications: This study's results have attempted to show the importance of protecting health in the workplace as a right to be defended. In this regard, a matter of great concern is the recent loss of labor rights in Brazil and the Brazilian decision to leave the Migratory Pact, which aims to strengthen migrants' rights, contributing to sustainable development Social implications: Also, work is identified as a powerful determinant of health and a place that should protect and promote health. There is an urgent need to monitor and proceed with workers' health surveillance to grasp the impacts of work on migrant's health, develop health-work indicators and trigger plans and programs in health services. Originality/value: Haitians are at a disadvantage compared to Brazilians, mainly related to discrimination due to nationality and skin color. Experiences of discrimination and a higher prevalence of suspected cases of CMDs were observed among Haitian workers. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to characterize the type of support provided to victims of violence against women and domestic violence (VAWDV) during the first lockdown, assessing the training of professionals to use remote support (RS). Design/methodology/approach: This cross-sectional study involves a sample of 196 support professionals, mainly women (91.8%) and who integrate the Portuguese National Support Network for victims of domestic violence (NSNVDV) (Mean age = 36.49; SD = 10.52). Findings: Telephone emerges as the main RS communication media used in the lockdown (43.9%) and the emergency state periods (57.1%). Participants reported to have never used any social applications (41.8% vs 41.8%) or videoconference (46.4% vs 58.2%), in both periods assessed, i.e. lockdown and emergency state, respectively, and 82.7% assumed to have no training with RS to assist VAWDV victims. However, support professionals recognized several advantages in using RS such as dealing with isolation, reducing inhibition, fear and shame and in promoting the victims' empowerment. Research limitations/implications: Given the exploratory nature of this study, only descriptive analyzes were conducted. Originality/value: During the COVID-19 pandemic, little is known about effective RS given by professionals to victims of VAWDV in the Portuguese context. The paper aims to add knowledge to the studied field. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this action research was to explore, from a workforce and a patient/carer perspective, the skills and the capacity required to deliver integrated care and to inform future workforce development and planning in a new integrated care system in England. Design/methodology/approach: Semi-structured interviews and focus groups with primary, community, acute care, social care and voluntary care, frontline and managerial staff and with patients and carers receiving these services were undertaken. Data were explored using framework analysis. Findings: Analysis revealed three overarching themes: achieving teamwork and integration, managing demands on capacity and capability and delivering holistic and user-centred care. An organisational development (OD) process was developed as part of the action research process to facilitate the large-scale workforce changes taking place. Research limitations/implications: This study did not consider workforce development and planning challenges for nursing and care staff in residential, nursing care homes or domiciliary services. This part of the workforce is integral to the care pathways for many patients, and in line with the current emerging national focus on this sector, these groups require further examination. Further, data explore service users' and carers' perspectives on workforce skills. It proved challenging to recruit patient and carer respondents for the research due to the nature of their illnesses. Practical implications: Many of the required skills already existed within the workforce. The OD process facilitated collaborative learning to enhance skills; however, workforce planning across a whole system has challenges in relation to data gathering and management. Ensuring a focus on workforce development and planning is an important part of integrated care development. Social implications: This study has implications for social and voluntary sector organisations in respect of inter-agency working practices, as well as the identification of workforce development needs and potential for informing subsequent cross-sector workforce planning arrangements and communication. Originality/value: This paper helps to identify the issues and benefits of implementing person-centred, integrated teamworking and the implications for workforce planning and OD approaches. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to outline a knowledge translation (KT) case study undertaken as part of a multi-component research programme aimed at evaluating new parenting supports in the earliest years. The study aimed to: explore the influencing factors relating to research use in an early years context; and to use the findings, at least in part, to execute an integrated KT plan – to promote stakeholder engagement, greater research visibility and to enhance the understanding of findings emerging from the research programme. Design/methodology/approach: A mixed-methods study was embedded within a large-scale, longitudinal research programme. In the present study, a national survey (n = 162) was administered to stakeholders working with children and families throughout Ireland. A series of one-to-one interviews were also undertaken (n = 37) to amplify the survey findings. Also, one focus group was carried out with parents (n = 8) and one with members of the research team (n = 3). Several dissemination strategies were concurrently developed, executed and evaluated, based partly on survey and interview findings and guided by the knowledge translation planning template (Barwick, 2008; 2013; 2019). Findings: The main factors influencing the dissemination of evidence, as identified by the stakeholders – were: a lack of resources; an under-developed understanding of research use and dissemination; insufficient collaboration and communication; and conflicting stakeholder priorities. Despite these challenges, the research programme was found to benefit from a multi-component KT plan to achieve the outlined dissemination goals. Practical implications: The KT planning process allowed the research team to be more accountable, introspective and to work more efficiently. This helped increase the likelihood of more targeted and successful dissemination of the research findings, delivering a better return on research investment. Originality/value: This is the first study of its kind (to our knowledge) to provide important insights for stakeholders in Ireland and elsewhere about how to improve the dissemination process. Effective KT planning can ultimately help to bridge the research-policy-practice gap and enable the effective translation of high-quality evidence in the early years' sector to enhance outcomes for families in the shorter and longer-term. [ABSTRACT FROM AUTHOR]

Purpose: Health literacy (HL) is considered an important prerequisite for informed, self-determined health decisions. HL research among older migrants is scarce, but especially important, as older people face great challenges regarding management of chronic illnesses and, therefore, are in need of adequate healthcare. Therefore, this paper aims to report HL in the domain of healthcare (HL-HC) among older migrants in Germany stratified by different countries of origin. Design/methodology/approach: Data were collected by a quota sample in North Rhine-Westphalia, Germany. Computer-assisted personal face-to-face interviews were conducted in German, Russian and Turkish. For this analysis, a subsample of 192 first-generation migrants aged 65–80 years from Turkey, Poland, Greece or Italy was drawn from the main sample (n = 1,000). HL-HC was assessed using a sub-index of health literacy survey European questionnaire 47. Data analyses comprised descriptive statistics, bivariate and multivariate analyses. Findings: Overall, 68.6% of the older migrants have limited HL-HC, and mean HL-HC scores vary significantly among different countries of origin. There is great variation in reported difficulties for the single HL-HC tasks by migrant groups. In multiple regressions, country of origin, not German as main language, low functional HL and low social status are significantly associated with lower HL-HC. Practical implications: Interventions should be aimed at smaller target groups and should consider language issues and possible differences related to countries of origin into account. Both individual skills and system-related aspects need to be addressed. Originality/value: This paper presents first data on HL-HC among older migrants in Germany and its determinants, stratified by different countries of origin. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team works closely with local authority children's services to serve specific populations recognised as experiencing higher levels of mental health need, including children living in alternative care and with adoptive families. The evaluation sought to better understand the experience of this provision during the COVID-19 pandemic and concomitant increase in remote and digitally mediated care delivery. Design/methodology/approach: Analysis of the accounts of 38 parents, carers and professionals involved with the team gathered via telephone interviews and email and postal questionnaires. Findings: Similar views were expressed from participants involved with the team before and following the onset of the pandemic. Overall, satisfaction was high; however, changes in care appeared more challenging for those already involved with the team before the pandemic. Differences in experience between groups were also evident. Whereas foster carers' accounts were generally appreciative of the involvement of clinicians, particularly regarding clinician–patient relationships, amongst adoptive parents and members of children's birth families there were more mixed and negative impressions. Originality/value: Locally based service evaluations can help inform care pathway planning in specialist CAMHS provision as part of wider quality improvement initiatives. This is especially relevant considering the repercussions of the COVID-19 pandemic and as the longer-term acceptability of remote working practices is appraised. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to document the impact of participation in microfinance programs on domestic violence against women. Design/methodology/approach: This paper uses the survey data from 69 villages in Bangladesh and the instrumental variable approach to estimate the effect of participation in microcredit programs on domestic violence. Findings: The results show that women's participation in microcredit programs does not reduce domestic violence. However, this result is possible only when the authors do not distinguish between female borrowers who have control over credit and those who do not have control over credit. Classifying female borrowers into these two categories can significantly change the results. The authors report significantly lower physical violence against those female who have control over credit. In case of psychological violence, the authors report no significant impact of control over microcredit. Originality/value: The novelty of the paper lies in distinguishing between physical and psychological violence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to analyze factors associated with post-traumatic stress disorder (PTSD) among elderly who live in a post-earthquake area. Design/methodology/approach: This was a cross-sectional study involving 152 elder people who survived the disaster and were selected conveniently. The study was conducted in two worst-affected districts of Lombok Utara regency. PTSD was diagnosed using a modified version of the Clinician-Administered PTSD Scale version 5 (CAPS-5). The demographic data were assessed using a self-developed questionnaire consisting of 13 items. All data were analyzed by descriptive analysis, χ2 test and binary logistic regression with p<0.05. Findings: Out of the 152 elder people, 91 (59.9 percent) suffered PTSD. Intrusion symptoms were the most common symptoms experienced by the respondents (94.1 percent). The factors associated with the PTSD in the elderly after the earthquake were having chronic illnesses (OR=2.490; 95% CI=1.151–5.385), public health center utilization (OR=2.200; 95% CI=1.068–4.535) and occupational status before the disaster (OR=2.726; 95% CI=1.296–5.730). These findings highlight that individual factors and access to health care services remain an important aspect of stress identification among the elderly following the disaster event. Social implications: Elder people constitute a vulnerable group that is often forgotten and neglected during post-disaster recovery, though they have potentially higher psychosocial distress than younger age groups. This study was conducted to raise awareness about mental health problems suffered by the elderly. Originality/value: This is the first study to apply CAPS-5 to assess PTSD among Indonesian elderly people following a natural disaster. This paper also provides insights that can be used by governments and other relevant parties to address PTSD problems suffered by many elderly people in a post-disaster area. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) is a complex public health and social issue. Women with an intellectual disability (ID) are at greater risk of experiencing IPV. However, little is known about the IPV experiences of women with an ID and forensic care needs. The purpose of this paper is to explore the history of experienced and perpetrated IPV in women detained to secure specialist ID forensic service. Design/methodology/approach: Participants completed the Conflict Tactics Scale-2 (CTS-2, Straus et al., 1996). The CTS-2 measures experienced and perpetrated relationship tactics of common forms of IPV. Findings: Participants reported high levels of experiencing and perpetrating IPV across all relationship tactics measured by the CTS-2. Participants reported they engaged in similar levels of experiencing and perpetrating positive and negative relationship tactics. The only significant difference was "minor sexual coercive behavior" where participants were significantly more likely to experience than perpetrate this behaviour. Research limitations/implications: Further research exploring the risk factors that contribute to IPV is needed. Shortcomings in the current study are acknowledged. Practical implications: Women with an ID and forensic profiles may present with treatment needs as victims and perpetrators of IPV. Clinical activities of women in Forensic ID services should include possible IPV care needs. The importance of developing national guidance and interventions to prevent and manage IPV are discussed. Originality/value: This is the first paper, to the authors' knowledge, to explore experiences of IPV in women with an ID and forensic care needs. [ABSTRACT FROM AUTHOR]

Purpose: The reduction of the violence and child abuse requires the cooperation of national and international health-related organizations. The purpose of this paper is to investigate the role of NGOs in health and peace development through administrating supportive programs for child abuse and violence victims. Design/methodology/approach: The present research was a mixed method research, and the type of research was a descriptive-analytic study. To collect data, library and field methods were used. The research sample included 137 staff members of the NGOs supporting children in Tehran. Data analysis was performed using SPSS software. Findings: According to authorities and members of the NGOs supporting children, networking and affective factors played a significant role in the development of health and peace (P<0.01). This was feasible by controlling the factors affecting violence and child abuse. Practical implications: Given the fact that NGOs are contributing to the development and establishment of peace through effective participation and networking, trying to support the victims of child abuse and violence, the need for more attention from governments is recommended in order to support these organizations, especially legislative and financial support is needed to expand the activities of such organizations. Originality/value: This paper is original in its method, topic and findings. The first is mixed method research, which has studied the role of networking of NGOs for peace development through implementing support programs for victims of child abuse and violence. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to compare nurses' authentic leadership and perceptions of the safety climate and concepts association according to different areas of work and types of hospitals. Design/methodology/approach: A cross-sectional design was used to conduct this comparative study on 314 Jordanian nurses. The Authentic Leadership Questionnaire (ALQ) and the Safety Climate Survey (SCS) were used. Findings: Nurses in private hospitals were more educated. True leadership was mild. Unit nurses had higher ALQ and subscale mean scores. Armed forces hospitals had the highest ALQ subscales, while governmental hospitals had the lowest. The ALQ mean scores favored military hospitals. Governmental hospitals have a negative safety climate. Unit nurses had a higher SCS mean than ward nurses. Military, governmental and private hospitals are rated the safest. Nurses benefited from higher SCS scores in military hospitals. Nurses' ALQ and safety climate perceptions were moderately positive. Research limitations/implications: A larger, randomized and equal-sized sample is recommended in future studies to conclude different areas of work and hospitals. It is also recommended to report the confidence interval in further studies using different statistical methods, increasing confidence when interpreting statistical significance variables. Other mediating, moderating and predicting variables could be studied and compared across different areas of work and types of hospitals. Sample characteristics should be handled as confounding variables in the next planned study using various ways to control confounding variables such as randomization, restriction, matching, regression and statistical control. The authors plan to statistically control for the confounding variables by entering them into the regression model. Future studies could investigate safety culture; both safety culture and safety climate are formative and inclusive terms (Experts Insight, 2017). Practical implications: This paper fills in the gap in the literature and practice. Authentic leadership is associated with safety climate perceptions and varies across different areas of work and hospitals. Interventions are required to improve safety climate perceptions and promote authentic leadership in all settings and hospitals. Military hospitals ranked the highest in nurses' perceptions of authentic leadership and safety climate. Social implications: The current study's favorable association between authentic leadership and safety climate measurement would apply to many high-risk institutions, including public and private hospitals. It becomes necessary to include the impacts of authentic leadership on the safe climate within the nursing curriculum and continuing education courses. This may be put into action by executing a hands-on activity, followed by information and reflection conversations that highlight the link between authentic leadership and safety climate measurement. According to the findings of this study, authentic leadership appears to be a basic block in making a difference in nurses' views of safety climate. Originality/value: Authentic leadership style is a relatively new concept in the health-care sector, and its link to safety climate security still needs empirical evidence. It is still unclear how leadership resulted in more effective outcomes (Maziero et al., 2020). Few studies investigated both the concepts of authentic leadership and the nursing safety climate (Dirik and Intepeler, 2017; Lee et al., 2019a; Woo and Han, 2018). Aside from the scarcity of studies, no study has compared "working area," "department" or "hospital type" concepts. Few comparative studies have been conducted using concepts of interest. For example, authentic leadership was linked to empowerment and burnout (Laschinger et al., 2013) and nurses' satisfaction with safety climates (Vatani et al., 2021). No research has examined authentic leadership in Jordan's nursing and health-care context. Few studies focused on the safety climate other than authentic leadership (Abualrub et al., 2012) or the safety culture in Jordan rather than the safety climate (Khater et al., 2015). [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to identify the risk factors that affect depression in students who sought psychological consultation during lockdown period in the health department at a university in Colombia. Design/methodology/approach: The sample consisted of 33 students (12 men and 21 women) with a mean age of 21 ± 2.5 years during the COVID-19 lockdown in 2020. Convenience sampling was used. The beck depression inventory-II instrument and a sociodemographic questionnaire were used to determine levels of depression and associated risk factors. A Google Form was designed with the respective instruments and sent along with the informed consent by email. Findings: The results indicated that the population is characterized by presenting a level of mild (24.2%), moderate (15.2%) and severe (21.2%) depression. Concerning the levels of depression and risk factors, a significant difference was found with a history of violence (p-value = 0.000), mainly during childhood and adolescence, as well as objection to psychological therapy, belonging to a medium–high socioeconomic stratum, lack of family support and recent significant losses coupled with the lockdown because of the pandemic, which increased symptoms of depression and suicidal ideation. Research limitations/implications: This research was conducted using Google Forms, which meant that some questionnaires were incomplete. In addition, this study did not count with the full participation of patients who attended psychological consultation. Practical implications: Universities should generate programs for early detection of risk factors and prevention of depression in students, which could affect academic performance, school dropout, interpersonal relationships and trigger suicidal ideation. These results can also be applied to reducing family violence, which has increased since the pandemic, by improving students' family dynamics. Originality/value: Because of the scarce research on this topic in Latin America, this study contributes to mental health in this population. The university becomes a fundamental scenario in which the ability to help students develop an adequate expression of emotions, positive coping strategies and sense of life as protective factors against depression can be enhanced. [ABSTRACT FROM AUTHOR]

Purpose: "Psychosocial health" is a new term to comprehend the already established factors involved in mental health and psychological well-being. The term has not been specifically defined and explained within the framework of psychology. Design/methodology/approach: The study proposed and validated a new model of psychosocial health. Principal component analysis, exploratory factor analysis and confirmatory factor analysis were conducted by involving a total of 4,086 participants. Findings: Psychosocial health was interpreted as the "sexual, emotional, social, environmental, cognitive, religious, moral and spiritual satisfaction" of a person. The proposed model of psychosocial health was statistically validated. The additional findings revealed significantly higher levels of psychosocial health in women and significant inverse correlations between psychosocial health and age. Originality/value: The current paper provided a comprehensive picture of psychosocial health from a psychological perspective and presented a statistically reliable tool for measuring psychosocial health. [ABSTRACT FROM AUTHOR]

Purpose: One of the most affected groups during the COVID-19 pandemic was health-care providers due to the direct and continuous exposure to the virus and a lack of sufficient medical equipment. Palestinian health-care providers were exposed to several challenges related to their work environment as they worked in war-like conditions; therefore, this study aims to explore health-care providers' perceptions, perspectives, challenges and human rights-related concerns during the COVID-19 Pandemic in Palestine. Design/methodology/approach: The sample comprised 30 health-care providers 26–35 years, who were purposively selected from among health-care providers in two Palestinian cities, Nablus and Tulkarm, located in the north of the West Bank. Thematic content analysis was applied to transcripts of interviews with the practitioners to identify key themes. Findings: The thematic content analysis showed that the pandemic and quarantine negatively affect the mental health outcomes, daily routine and social relations of health-care providers. The main challenges related to human rights violations and faced by the health-care providers include a lack of sufficient infrastructure, lack of medical equipment's and protective gear, military occupation and a shortage of health-care providers in general, especially those who practice in speciality fields such as neurology, oncology, pediatric surgery and clinical psychology. Practical implications: Further investigations are recommended to test different variables related to health-care providers' work during the COVID-19 pandemic. This paper also recommends conducting studies targeting Palestinian health-care providers' training and supervision services to improve their skills and resiliency in dealing with future crises. Originality/value: The present work is the first to examine health-care providers' perceptions, perspectives, challenges and human rights concerns during the COVID-19 pandemic in Palestine. This novel sample resides in a political and social environment characterized by high environmental stressors due to decades of military and political violence (e.g. militarization, poverty, lack of employment opportunities, cultural pressures, human rights violations, etc.) [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to understand the profile of use of gerontechnology in Spanish older adults considering their age group (60–70; 71–80 and over 80 years) and to discern whether groups of subjects with similar characteristics can be established to ascertain which factors are behind the profile of frequent gerontechnology use. Design/methodology/approach: A quantitative study is presented to understand the profile of use of gerontechnology in Spanish older adults. The sample comprised 497 participants (aged between 60 and 94 years). Findings: The results show that, even though most participants consider technology to be useful in their daily lives, there is still a lack of knowledge on how to use it, especially among older subjects. This highlights the importance of promoting technological cocreation initiatives such as senior living labs. Research limitations/implications: Other researchers are encouraged to include the voices of older adults using gerontechnology in further studies. Practical implications: If we want to increase the acceptance of technology by older adults, we must first let them take part in the design of the technologies they will use. Social implications: This research provides promising data that should merit attention to contribute to the well-being and quality of life of older adults in a society where currently technology is a key part in every sphere of our daily life. Originality/value: The value of this research lies in the implications of "aging in place" studies today. [ABSTRACT FROM AUTHOR]

Purpose: In April 2020, it was announced that NHSX, a unit of the UK National Health Service (NHS) responsible for digital innovation, was developing a contact tracing app that would offer a digital solution to managing the COVID-19 pandemic. Despite the urgency with which the app was developed, a clear commitment was made to designing the technology in a way that enshrined key ethical principles, and an ethics advisory board (EAB) was established to provide timely advice, guidance and recommendations on associated ethical issues. Alongside this, there were extensive criticisms of how NHSX adhered to ethical principles in the handling of the app development-criticisms that require empirical exploration. This paper explores how ethics was incorporated into decision-making during governance processes associated with the development of app. Design/methodology/approach: Interviews were conducted with those involved in the app's development/governance, those with a consulting role associated with the app, or those who sat on the EAB. Findings: The EAB fulfilled an important role by introducing ethical considerations to app developers. Though at times, it was difficult to accommodate key ethics principles into governance processes, which sometimes suffered from little accountability. Originality/value: While several articles have provided overviews of ethical issues, or explored public perceptions towards contact tracing apps, to the best the authors, knowledge this is the first empirical piece analysing ethics governance issues via stakeholder interviews. [ABSTRACT FROM AUTHOR]

Purpose: Self-evaluated access and accessibility has been found to be associated with healthcare seeking and quality of life. Studies have shown that, however, a vast majority of individuals with disability living in poor countries have limited access to healthcare influenced by several barriers. The purpose of this paper is to compare the perception of general accessibility of health care services and its association with access barriers and other contextual factors between people with physical disabilities and counterparts without disability. Design/methodology/approach: This study is a cross sectional survey involving 213 individuals with physical disabilities and 213 counterparts without disability sampled using a multi-stage method. Data were collected using a structured questionnaire with sections on socioeconomic and living conditions, education, health, employment and access to health care. Data analysis involved using χ2 for proportions and T-test and multiple regressions (stepwise) method to determine significant factors that influence perception on accessibility. Findings: The study finds that people with disabilities fared worse in various socioeconomic factors such as education, employment, income and assets possession. People with disabilities also experience more dimensional barriers and reported poor health system accessibility. The difference in accessibility continued after adjusting for other variables, implying that there are more inherent factors that explain the perception of access for people with disabilities. Practical implications: Governments should ensure equitable access to health care delivery for people with disabilities through equitable health policies and services that are responsive to the needs of people with disabilities and promote the creation of enabling environment to enhance participation in health care delivery. Originality/value: The authors confirm that the paper has neither been submitted to peer review, nor is in the process of peer reviewing or accepted for publishing in another journal. The author(s) confirms that the research in this work is original, and that all the data given in the paper are real and authentic. If necessary, the paper can be recalled, and errors corrected. The undersigned authors transfer the copyright for this work to the International Journal of Health Governance. The authors are free of any personal or business association that could represent a conflict of interest regarding the paper submitted, and the authors have respected the research ethics principles. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report on a service evaluation of a competency-based dementia training programme for clinicians to establish its value in improving their knowledge and confidence of dementia care and to explore any resulting changes to practice. Design/methodology/approach: Mixed method quantitative and qualitative data, using rating scales and focus group discussions (FGDs), were collected. Wilcoxon signed-rank test was used to analyse changes in the responses to the rating scales of knowledge and confidence and thematic analysis of FGDs was undertaken to identify staff perceptions of the impact of training on their practice. Findings: In total, 162 qualified and clinical support staff undertook the training. A significant change in knowledge and confidence scores was found on all three scales. In general, feedback on the course was positive. Seven themes, demonstrating the relevance of the training to practice, emerged from the FGDs – experiential training awareness of diagnosis, approach, understanding, communication, risk, changed practice and going forward. Practical implications: Providing competency-based dementia training for large numbers of staff can have a positive effect on the care delivered to patients with dementia. Originality/value: Healthcare organisations have a responsibility to ensure their staff have the training to provide quality care for patients living with dementia. This paper suggests this can be achieved through a collaborative, multi-disciplinary approach involving co-production and best practice guidance. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to evaluate the Supported Discharge Service as a case study of integrated care. The paper will critically evaluate integrated care with regard to patient outcomes, patient satisfaction and cost and productivity.Design/methodology/approach A retrospective mixed methods case study design was adopted utilising patient satisfaction questionnaires, therapy outcome measure and a performance dashboard to measure improvements in patient satisfaction, patient outcomes and cost and productivity.Findings Measured improvements were observed in the integrated discharge process and analysis of the findings demonstrated a statistically significant improvement in patient outcomes, high levels of patient satisfaction and improved productivity subsequently leading to financial savings.Research limitations/implications Due to convenience sampling, the small sample size and a short time frame when analysing patient outcomes, the generalisability of results is limited. Despite this, with integrated care being polymorphous the findings can be utilised to develop theoretical principles to make assertions about integration (Wikfeldt, 1993).Originality/value This paper draws on the importance of integration as the principal driver of reform within the healthcare system. Even though on a small scale, the case study provides evidence to support the use of integration to improve patient outcomes, patient satisfaction and financial savings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case. Design/methodology/approach: The paper is based on the Reassure, Explain, Listen, Answer, Take Action and Express Appreciation (RELATE) model and the Four Habits models of Clinical Communication. Findings: The results of the study indicate that leadership conducted staff meetings with some of the components of the RELATE model. These include staff meetings, employee rounding and communication/notice boards. The results of the study also suggest that much as some parts of the Four Habits model was used in provider–patient communication, certain aspects of the model were absent. The study identified some communication challenges including poor dissemination, lack of unity among some health workers, poor attendance in meetings and, with respect to patients, language barrier, patients' reluctance to disclose their actual health problems to health providers, lack of privacy and lack of a friendly environment. Practical implications: Providers, especially physicians, should be given training on the local languages in areas where they perform their services. Health service providers should receive as part of their learning in-depth training on the Four Habits model of Clinical Communication, especially the Medical Officers. Originality/value: It is imperative to embrace evidence-based practices/models aimed at securing proper communication in all hospitals but most especially teaching hospitals. [ABSTRACT FROM AUTHOR]

Purpose: Nutrition education plays a significant role in inculcating lifelong healthy dietary behaviours among adolescents. The purpose of this paper is to understand the opinions of parents and teachers regarding nutrition education in private Indian secondary schools. Design/methodology/approach: A cross-sectional, self-administered, paper-based survey comprising both closed- and open-ended questions was completed by 32 teachers and 280 parents who were recruited from five private English-speaking secondary schools in Kolkata, India. Descriptive and cross-tabulation analyses were conducted to compare the responses of teachers and parents. Thematic data analysis informed by template analysis technique was performed to evaluate the qualitative data. Findings: While the curriculum was considered interesting and easy to understand, the gendered nature of the curriculum, excessive rote learning and lack of synchrony between the curriculum and school food services were highlighted as shortcomings of the existing curriculum. The need for the dissemination of food skills either through a compulsory food and nutrition curriculum or through extra-mural activities was expressed by most respondents. Both these ideas were indicative of strong support and motivation for modification in the current curriculum. Practical implications: These findings emphasise the support for a skills-focussed food and nutrition curriculum to inculcate experiential culinary skills and comprehensive nutrition knowledge in Indian adolescents, thus improving their nutritional and health profiles. Originality/value: This is the first cross-sectional survey to investigate the views of parents and teachers about the status of food and nutrition education in private Indian secondary schools. [ABSTRACT FROM AUTHOR]

Purpose: Health is one of the most basic human rights. The mental health of contemporary and future health services providers is of great significance. The purpose of this paper is to investigate the mental health of the faculty members and students of Kurdistan University of medical sciences Design/methodology/approach: This was an analytical-descriptive and cross-sectional study, which was conducted using the Census method on 249 faculty members and proportionately by using random sampling on 347 students in 2019. Data were collected using the 28-item General Health Questionnaire. Data analysis was done via SPSS 24 software by using statistical tests such as T-test and one-way ANOVA. Findings: The mean values (standard deviation) of the total score of mental health among students and faculty members were 27.43 (14.37) and 20.17 (11.37), respectively. In total, 57.2% of students and 31% of faculty members had symptoms of mental disorder. The highest mean score among faculty members and students was observed on the subscale of "social dysfunction." There was a significant relationship between the mental health of students and where they study and the mental health of faculty members and type of faculty member with the faculty in which they work (p < 0.05). Originality/value: The prevalence of mental disorders' symptoms among faculty members and students of Kurdistan University of medical sciences was high, and it must be considered by policymakers and managers of the health system to plan appropriate interventions. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe the delivery of a mainstreaming model within a public sector, mental health (National Health Service (NHS)) organisation. The model promotes the inclusivity of a spectrum of presentations from co-existing moderate anxiety and depression to severe mental disorder (psychosis) and problematic substance and alcohol use. Design/methodology/approach – This paper introduces the delivery of three collective approaches, termed the “three essential elements” to support a mainstreaming treatment model, facilitated by a “Dual Diagnosis Lead”. The model encompasses; a “direct access” referral pathway, joint collaboration with practitioners and the delivery of a “Dual Diagnosis” training programme. An independent evaluation was commissioned to explore eight mental health and substance misuse practitioners’ views and experiences in relation to the impact of the mainstreaming model. This paper also considers feedback from 230 course participants attending a one day “Dual Diagnosis” training programme. Findings – This paper suggests that practitioners may benefit from the implementation of the mainstreaming approach and the delivery of this approach could be moving “Dual Diagnosis” interventions closer to mainstream practice. Research limitations/implications – The limitations of the mainstreaming model are acknowledged in relation to the generalisation of practitioners’ views and reported experiences. Originality/value – This paper offers a description of the delivery of a mainstreaming model involving the “three essential elements”. The model provides a useful insight and demonstrates the possibilities which may be achieved when attempting to implement a mainstreaming treatment approach within mainstream mental health and drug and alcohol services. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore articulations of how individuals internalise official demands on handling COVID-19 and the function of social media in this process, and further to discuss this from a human rights' perspective. Design/methodology/approach: A thematic analysis of qualitative data from an international survey on COVID-19 and social media. The analysis was inspired by Berger and Luckmann's theory of reality as a social construction. Findings: Articulations expressed an instant internalisation and externalisation of the officially defined "new normal". However, negotiations of this "new normal" were articulated, whereby everyday life activities could proceed. Resistance to the "new normal" appeared, as routines and common sense understandings of everyday life were threatened. Health-care professionals were put in a paradoxical situation, living in accordance with the "new normal" outside work and legitimately deviating from it at work. The "new normal" calls for individuals' "oughtonomy" rather than autonomy. Social media were used to push individual's re-socialisation into the "new normal". The latter both promoted and challenged human rights as the individual's right to self-determination extends beyond the self as it risks threatening other people's right to life. Originality/value: With the means of a theoretically based thematic analysis inspired by Berger and Luckmann, the current study shows how articulations on COVID-19 and social media can both support and challenge human rights and reality as a facticity as dictated by dominant organisations and discourses in society. [ABSTRACT FROM AUTHOR]

Purpose – Child participation is increasingly a global phenomenon as stated by Article 12 of the United Nations Convention on Children's Rights. This supports the first principle, Democracy, of the Health Promoting School movement. The purpose of this paper is to facilitate a three-phase participatory research process (PRP) to document the views of children about participation in school. Design/methodology/approach – A total of 248 primary school pupils aged nine to 13 years participated: the first group of pupils answered two questions on individual coloured paper; the second group categorised these data separately, by question, assigning labels for each of the categories; and the third group used the categories to develop schema. The analysis was inductive. Findings – The most common categories for what made pupils feel a part of their school were school uniforms, sports, friends, teachers and their school/classroom environment. Increase in the number of school activities, encouraging friendship and equal participation were key indicators of how pupils would ensure that everybody felt a part of the school. The findings indicate that interpersonal relationships and belonging are in the opinion of children important for taking part in school life. Originality/value – The paper illustrates children's understanding of what taking part in school means to them. The PRP encouraged pupils to have control of the three-phase research process, and demonstrated the ability of children to work together in groups while having fun at the same time. [ABSTRACT FROM AUTHOR]

Purpose: The increasing prevalence of coronavirus disease (COVID-19) is a global crisis that leads to physical and psychological outcomes for health-care workers, so this study aims to investigate the mental health outcomes (including general health, generalized anxiety disorder and posttraumatic stress disorder) in health-care workers in Rafsanjan, Iran. Design/methodology/approach: By using convenience sampling, this cross-sectional study was conducted on 332 health-care workers working in public hospitals in southern Iran. Data collection lasted from March to April 2020. General Health Questionnaire (GHQ-28), Generalized Anxiety Disorder 7-item (GAD-7) and Impact of Event Scale were used to collect data. The data were then analyzed by using SPSS 25 and descriptive and inferential statistics (chi-square and multivariate logistic regression). Findings: In total 45.5% of the participants had psychological disorder according to GHQ. In addition, 25.3% of the participants had GAD and 31.6% had posttraumatic stress disorder (PTSD). The results using multivariate logistic regression showed that only income was significantly associated with psychological disorders (95% confidence interval for odds ratio: 1.32–6.45, P = 0.008). Practical implications: According to the results, the incidence of GAD and PTSD was high among health-care workers. Therefore, it is recommended that the psychological skills of health-care workers be strengthened through counseling and training programs. Originality/value: This paper provides a novel analysis of mental health in health-care workers in Iran. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to assess the magnitude of parent-adolescent communication on sexual and reproductive health (SRH) issues and its association with gender and premarital sexual practice among school adolescents of Woldia town. Design/methodology/approach: School-based cross-sectional study was conducted on 368 unmarried secondary and preparatory school adolescents (15–19 years) in Woldia town. Simple random sampling was employed to select study participants. Self-administered questionnaire was used. Data were entered by EPI-Data version 3.0.2 and analyzed by using SPSS version 20. Findings: In this study, 56.3% of school adolescents had parental communication on sexual and reproductive health issues. The result of this study showed that adolescents who had history of sexual intercourse where 64% less likely to communicate with parents on sexual and reproductive health issues (AOR: 0.36 95% CI: 0.20, 0.65), but there was no association between gender and sexual and reproductive health communication between adolescent and parent (AOR: 1.06, 95% CI: 0.64, 1.75). Originality/value: Parent-adolescent communication about sexual matters is one of the means that encourages adolescents to adopt responsible sexual behavior. Many children in Africa are uncomfortable to have a communication about sexual and reproductive health issues with their parents because the subject is a taboo topic in most homes. [ABSTRACT FROM AUTHOR]

Purpose: People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well understood. Furthermore, considerably less is known about the exposure to, and impact of, ACEs in detained adolescents with complex developmental disorder needs. This paper aims to explore the exposure to ACEs in an adolescent population detained in a secure specialist developmental disorder service. Design/methodology/approach: A retrospective file review was used to explore ACEs and placement histories within a specialist developmental disorder inpatient service. Data was collated for a convenience sample of 36 adolescents, 9 of whom were female, aged 13–20 years (M = 17.28 years). Findings: A total of 33 participants (91.7%) had experienced at least 1 ACE, with 58% experiencing 4 or more ACEs and 36% experiencing 6 or more ACEs. The most common ACEs reported were physical abuse (61.6%), parental separation (58.3%) and emotional abuse (55.6%). The majority of participants had also experienced high levels of disruption prior to admission, with an average of four placement breakdowns (range 1–13, standard deviation = 3.1). ACEs held a significant positive association with the total number of placement breakdowns and total number of mental health diagnoses. Practical implications: Adolescents detained in specialist developmental disorder secure care had, at the point of admission, experienced high levels of adversities and had been exposed to high levels of experienced and observed abuse. The level of exposure to adversity and ongoing disruptions in care suggests that Child and Adolescent Mental Health Services' developmental secure services should consider adopting dual treatment frameworks of developmental disorder and trauma-informed care. Originality/value: This study explored the early-life and placement experiences of a marginalised and understudied population. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the use of chewing tobacco by South East Asian men in Auckland and their difficulty in giving up the habit. Design/methodology/approach – Semi-structured interviews with ten men were conducted in a grounded theory case study design. Snowball sampling was used to identify and recruit participants from hard-to-find populations. Written consents were obtained. Findings – Each of the men attributed their initiation to chewing tobacco to the influence of friends and the society in which they lived. They all were aware that chewing tobacco could increase their risk for oral cancer and wanted to quit. New Zealand law prohibits the import and sale of oral forms of tobacco. However, the men in this study were still able to get chewing tobacco via friends and family bringing it into the country "for personal use". Research limitations/implications – This paper opens up a space for further research within the South East Asian communities, with the view to identifying and developing effective cessation methods. Originality/value – This paper is significant as there has been minimal research conducted on the pervasiveness of chewing tobacco in the South East Asian communities in New Zealand. [ABSTRACT FROM AUTHOR]

Purpose: Underreporting of new tuberculosis (TB) cases is one of the main problems in TB control, particularly in countries with high incidence and dominating role of a private sector in TB cases diagnosing. The purpose of this paper was to explore behavioral determinants of underreporting of new TB cases among private sector physicians in Iran. Design/methodology/approach: The authors conducted a population-based, cross-sectional study of physicians working in private clinics. The data collection tool was designed using the theory of planned behavior (TPB). The authors used structural equation models with maximum likelihood estimation to examine attitude toward the notification behavior. Findings: Of 519 physicians, 433 physicians completed the questionnaire. Attitude toward notification had the highest score (mean score = 87.65; sd = 6.79; range: 0–100). The effect of perceived behavioral controls on the notification behavior ((β^) = 0.13; CI: 0.01–0.25) was stronger than the total effect of attitude ((β^) = 0.06; CI: 0.00–0.12) and subjective norms ((β^) = 0.01; CI: −0.00–0.03) on the behavior. However, the attitude was the main predictor of intention and justified 46% of the intention variance. Intention had a significant effect on the behavior ((ß^) = 0.09; CI: 0.1–0.16). Practical implications: Considering stronger effect of perceived behavioral control on the behavior, interventions aiming at facilitating notification process would be more effective than those aiming at changing the attitude or enhancing intention among physicians. Originality/value: To the best of our knowledge, no other study previously explored determinants of underreporting from the behavioral and cognitive perspective. Specifically, the authors explored the role of the TPB constructs in predicting intention to notify new TB cases. [ABSTRACT FROM AUTHOR]

Purpose: In the present era of modernization, the social group members interact with each other with selfish and unselfish intents. However, the unselfish means and ends build a long term relationship among people. On the other hand, selfish ends bud out unethical means such as abuses, violence and fights. The situation becomes tough when the same becomes evident among the family relationship and as a consequence the elderly are being treated unfairly. Out of such cases, some are reported and the majority of them remain unreported, which eventually becomes the cause of concern for the social welfare agencies. Thus, this paper aims to examine the elder abuse (EA) tendency in metro, non-metro and religious cities. Design/methodology/approach: For this study, a mixed-method approach is used to develop survey instruments, validate findings using qualitative and quantitative data sources for better generalization of results. The present study explored and confirmed the related factors using exploratory factor analysis and confirmatory factor analysis for the establishment of a valid scale of EA. Further, the difference of perceptions among the elders for abuse across the metro, non-metro and religious cities was statistically checked using the ANOVA and post hoc techniques. Findings: The present study identified the traces of EA and created a comprehensive understanding of it. The present study manifests the prevailing practices of EA in society by discussing the demerits of dependency and modernization. Moreover, the present study assesses the pervasiveness and the repercussion of dependency and the impact of modernization on EA followed by a discussion on how the victim elders may handle the situation. In the present study, a scale is developed to identify EA because of the dependency of the elderly and the modernization of society. Originality/value: Some exclaiming thoughts such as the dependency of elders elevate the chances of EA on one side, while modernization of society hampers the social/family bonding leading to EA. The inconsistent development across the region has created modernization as a significant factor for EA. The level and depth of modernization across locations such as metro, non-metro and religious cities are the cause for varying degrees of EA. Based on the literature review, the present study has sensed the presence of EA in society at large by developing a scale for the aforesaid purpose. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the association between level of physical activity (PA) and perception of quality of life (QOL) and physical health in frail and non-frail older adults. Design/methodology/approach: Volunteer participants in this quantitative cross-sectional study were a convenience sample of 236 independent residents (120 frail, 116 non-frail) in an assisted living facility in Israel. Frailty was measured by Fried et al.'s phenotype; QOL and physical health were measured using the World Health Organization Quality of Life Instruments (WHOQOL-BREF) questionnaire. PA level was ascertained from attendance lists completed by exercise class instructors in each class during the eight-week study. Findings: Frail older adults who engaged in regular PA (at least 2.5 h/week) reported the same physical health as non-frail older individuals performing a similar level. Research limitations: Unsupervised PA performed independently was not taken into consideration; exercise class attendance may be a less reliable criterion of PA than collection of objective data, i.e. calories burned; participants were selected from an economically homogeneous population of a specific assisted living facility with easy access to a variety of PA. Practical implications: The level of PA performed by frail older adults impacts their perceived QOL and physical health. The logs were an incentive to attend PA classes. Originality/value: A minimum of 2.5 h a week of regular PA can be a protective factor that improves perceived QOL and physical health in frail older adults. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to understand landlords' attitudes toward applicants with histories of sex offenses and landlords' willingness to broaden eligibility criteria for tenancy. Design/methodology/approach: A convenience sample of 50 landlords in Connecticut were interviewed. The content of interviews was analyzed to examine how often a landlord would be open to renting to individuals on the sex offender registry and what conditions affect their decisions. Findings: In total, 44% of landlords would not rent to adults with histories of sex offenses under any circumstance, but 8% of landlords reported they would rent to such individuals and an additional 36% of landlords were open to it with a high threshold for other indicators of good tenancy such as stable housing history, good credit and timely rental payments. Practical implications: These findings not only illustrate the real-world challenges in finding housing for adults with histories of sex offenses but also highlight opportunities in working with landlords. Originality/value: There has been little examination of housing adults with sex offenders from the perspective of landlords, which is important to understand to address this difficult and sensitive issue. [ABSTRACT FROM AUTHOR]

Purpose: University academicians are struggling to engage in teaching, supervision, research and publication. The purpose of this paper is to determine how academicians cope with the various burdens of academia work stressors to overcome burnout. Design/methodology/approach: A cross-sectional study was conducted from January to July 2017. In total, 327 research university academicians were selected using a proportional stratified randomized sampling. Validated measures were used to collect data on perceived work stressors (teaching, research, interpersonal conflicts and career development), coping strategies (adaptive and maladaptive coping) and perceived burnout (emotional exhaustion (EE), depersonalization and personal accomplishment (PA)). The data were gathered via computer assisted self-interviewing (CASI). The research statistical model was tested by two-steps of assessment replicating covariance-based structural equation modeling (CB-SEM) with bootstrapping procedure to generalize the sample to the hypothesized model. Findings: Overall data fit the hypothesized model well (CMIN/df=1.788, GFI=0.833, CFI=0.921, TLI=0.916, RMSEA=0.047) with various degree of explanatory value for EE, depersonalization and PA were 60, 49 and 22 percent, respectively. Academicians were resilient against the burden of teaching. However, they did adopt coping mechanisms to overcome research challenges and interpersonal conflicts. The effects of research and interpersonal conflicts on tri-dimensional burnout mediated by maladaptive coping (f2 effect size=0.37) had a larger effect than interpersonal conflicts toward burnout mediated by adaptive coping (f2 effect size=0.02). Practical implications: Academicians adopt maladaptive coping for research and interpersonal conflicts to suppress burnout. An integrative approach at both organization and individual levels is crucial to enhance appropriate coping mechanism to curb with burnout among the academicians of a research university. Originality/value: This is the first study in Malaysia which uniquely estimate the effects of academician's work stressors toward burnout with introducing coping strategies as mediators toward work stressors and burnout relationship which has been analyzed via CB-SEM. [ABSTRACT FROM AUTHOR]

Purpose: Research indicates that the diagnostic label of Bipolar Disorder is being both over and under-used in mental health services. Disagreement between clinicians in how the diagnosis of Bipolar Disorder is perceived and how the label is used can make it difficult to establish and uphold consistent care. This may lead to the experience of negative emotions for service users and poor engagement with intervention. Therefore, the purpose of this paper is to explore whether clinicians do hold different perceptions of the diagnosis of Bipolar Disorder, with the view of providing insight into how this may impact service provision. Design/methodology/approach: Q-methodology was used to investigate the subjective viewpoints of 19 clinicians from mental health community teams supporting individuals with a diagnosis of Bipolar Disorder. The completed Q-sorts were subject to analysis using Q-methodology analysis software. Findings: Three main factors representing the viewpoints of participants were identified: seeing the person and their experience, promoting quality through standardised processes and understanding the function of diagnostic labels. All three factors agreed that more than one assessment appointment should be required before a diagnosis of Bipolar Disorder was given and that the focus should be on the difficulties experienced rather than the diagnostic label. Originality/value: These three viewpoints provide different perspectives of the diagnosis of Bipolar Disorder, which are likely to impact on service provision. Services may benefit from a better integration of the viewpoints, noting the important functions of each viewpoint and being guided by individuals' needs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to determine the prevalence of domestic violence against women and its related factors in Sanandaj, west of Iran. Design/methodology/approach: This is a cross-sectional study conducted in 2016. The sample consisted of 360 women who referred to two educational hospitals in Sanandaj. The data collection tool was a self-report questionnaire. A multivariate logistic regression was used to determine the risk factors of domestic violence against women. Findings: The prevalence of "any form of violence" in the past year was 71 percent (n=245). The prevalence of emotional, sexual and physical violence was 62.2 percent (n=225), 48.7 percent (n=168) and 49.9 percent (n=172), respectively. Multivariate logistic regressions revealed that the "any form of violence" has significant association with occupation of women, economic status of family and the status of sexual satisfaction of couples. Originality/value: The prevalence of domestic violence against women is high and alarming in Sanandaj, Iran. Given the relationship between experience of violence and sexual dissatisfaction, sexual education before and after marriage is recommended for couples. Also, the experience of exposure to violence in women can be included in health centers as screening programs. In this way, couples who have risk factors will receive the educational programs. [ABSTRACT FROM AUTHOR]