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Covid-19, the disease caused by severe acute respiratory syndrome coronavirus 2 is recognised as one of the most challenging global events of the twenty-first Century. The detrimental impact of the pandemic resulted in high rates of infection, morbidity, and mortality, with health-care workers firmly positioned on the frontline of this unparalleled international crisis. An emerging literature detailing the impact of COVID-19 on health-care practitioners identifies high levels of depression, anxiety, and distress. Accordingly, there are calls for the implementation of effective interventions to tackle the impending spectre of psychological morbidities and staff burnout. While it is important to explore new approaches, it is also valuable to examine how existing strategies, such as reflective practice, can be repurposed to specifically address practitioner well-being. This requires a reimagining of reflective practice and a reimagining of the reflective practice contexts in which reflective activity occurs. This paper presents The Reflective Practice Integrative Framework, which illustrates how reflective practice can be used to address the complex aims of supporting effective patient care, while also facilitating practitioner well-being. The Reflective Organisational Learning Framework is also presented which can be used to develop effective reflective practice environments through single, double, and/or triple loop learning. [ABSTRACT FROM AUTHOR]

In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020–2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19–20th August 2021). [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide discourse regarding awareness of institutional racism, from a non-Indigenous, Australian nursing student's perspective. The discussion has a focus on the presence of institutional racism in the Australian healthcare system, its impact on the health of First Nation Peoples and a commitment to ensuring culturally safe practice. It will be argued that institutional racism is pervasive in healthcare as a consequence of three factors: exclusion of First Nations Peoples from governance roles, inherent racism impacting on socio-cultural treatment bias, and institutional racism influencing key relationships in healthcare delivery. [ABSTRACT FROM AUTHOR]

Purpose: Children's perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation. Method: The present paper illustrates children's experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework. Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation. Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children's own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings. [ABSTRACT FROM AUTHOR]

This paper considers the ways that publicly funded developmental services for adults with developmental disabilities in southern Ontario are limited in how they support clients. This paper is informed by field research conducted in the summer of 2019, which was composed of semi-structured interviews, focus groups, and a policy review. Informed by parent advocates who are the main caregivers of their adult children labelled with intellectual and developmental disabilities, this paper claims that the administrative processes of the Ontario ministry that manages and funds adult disability services relate to broader exclusionary patterns among adults with developmental disabilities. I explore this claim by reviewing how common ableist assumptions of people with developmental disabilities are ingrained in the policies and administrative processes of these services. I contribute to ongoing discussions among Critical Disability Scholars of the ways that disability as a social category can be articulated outside of ableist assumptions. Informed by parent caregiver perspectives, this article outlines how the limitations of provincially funded disability services in Ontario, Canada cause significant challenge in the lives of those labelled with intellectual and developmental disabilities. One possible explanation for these limitations is that there is a disconnect between how the provincial government classifies who should receive immediate services and how many services, versus the actual need of those labelled with intellectual and developmental disabilities. The criteria for high supports, such as monthly funding, placement into a living facility, and the provincial assessment for determining a person's 'adaptive functioning' are rooted in problematic assumptions made of people labelled with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

Secondary prevention efforts, which target risk and protective factors associated with harmful sexual behaviour (HSB) and seek to intervene early in the trajectory of HSB, are underdeveloped in Australia. This study explored design considerations for an online early intervention service for children and young people worried about their sexual thoughts and behaviours. A trauma-informed child right's framework underpinned the study, which involved 10 individual interviews with international experts in HSB, and one group interview (n = 3) with Australian practitioners. Analysis was carried out using thematic analysis. Results reflect design considerations in relation to: theoretical approaches; practice frameworks; service delivery components; and helpseeking challenges. Key tensions emerging from the results are discussed, including the need to move beyond binary constructions of victims and perpetrators. PRACTICE IMPACT STATEMENT: This paper has significant potential to influence practice in the field of harmful sexual behaviour prevention and response. The paper sets out the components of an early intervention online service for children and young people worried about their sexual thoughts and behaviours. The online service could be built and trialed for impact and efficacy in supporting children and young people not to sexually harm. It would be the first service of its kind in Australia and fill a gap in the current service delivery landscape. [ABSTRACT FROM AUTHOR]

Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization’s Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the policy process, are highlighted. Policy should be evidence-informed and allowed for evidence-making; however, it is important to account for other factors within the given context in order for policy to be practical, authentic and actionable. Implications for Rehabilitation: The development of policy in the area of asssitive technology is important to provide an overarching vision and outline resourcing priorities. This paper identifies some of the key themes that should be addressed when developing or revising assistive technology policy. Each country should establish a National Assistive Technology policy and develop a theory of change for its implementation. [ABSTRACT FROM AUTHOR]

This paper describes the past, present, and future of medical education in Cambodia. Although doctor training began in 1902, the first medical school was not founded until 1946. Since the colonial era, the curriculum and teaching strategies have been strongly influenced by the French system, dominated by didactic lectures and the apprenticeship model. Three chronic issues have plagued medical education in the country following the Khmer Rouge regime: a shortage of doctors, poor-quality training, and lack of relevance to the current and future population needs. An increasing number of medical schools and yearly student enrollment have addressed the first issue. Today, the fundamental challenges have shifted from quantity to ensuring the quality and relevance of medical education. Competency-based medical education (CBME) has been adopted as a new curricular model to tackle the latter two issues. Active collaboration between government institutions, public universities, and development partners drives this curricular reform at the national and institutional levels. This paper further examines the challenges associated with medical education and proposes recommendations. [ABSTRACT FROM AUTHOR]

Like other health care practices, the increasing complexity in dentistry signals the need for a reconceptualisation of dentist professional learning. Professional dental bodies, at large, still privilege formal continuing professional development (CPD) provisions focusing on off-the-job activities despite growing evidence that much invaluable learning occurs through and at work. In exploring the two common dentist CPD approaches, this article critiques the narrow conceptions of learning inscribed in these frameworks, which are individualistic and acquisition oriented. Drawing on a vignette of dentists' professional practice at work, this paper argues for a shift in discussion from an emphasis on which CPD models work best to what counts as professional learning for dentists. To flesh out these arguments, the paper proposes using an innovative conceptual approach through the lens of 'complexity thinking' and the concept of 'co-present group'. Through this lens, the reframing of thinking brings out two key features of learning: Emergent learning cannot be specified in advance and much significant learning is typically beyond an individual's learning. Given the learning potentials of group practice and group learning, the paper concludes with suggestions to support dentists' lifelong learning at work. [ABSTRACT FROM AUTHOR]

Hearing voices is a highly stigmatised experience, despite being common across clinical and non-clinical populations. The stigma held by healthcare professions of the clinical populations they work with can have a detrimental impact on the recovery trajectory of people with mental illness, with early career professionals and students thought to have among the most negative attitudes. The current study examined the efficacy of an education intervention to reduce implicit and explicit stigma surrounding voice hearing in psychology students (N = 49). With the world turning to digital delivery methods in the face of COVID-19, the study also examined the impact of intervention delivery mode: comparing online with face-to-face delivery. Results indicated that the education intervention was associated with improvements to explicit – but not implicit – stigma towards voice hearing. Comparisons between education delivery type suggested online and face-to-face delivery methods found no difference in associated reductions to explicit stigma. These findings provide further support for the use of education interventions to reduce stigma surrounding voice hearing and support the online administration of such interventions to allow for more widespread education delivery to a broader audience. What is already known about this topic: Hearing voices is a common yet highly stigmatised experience. Stigma towards mental illness is common among by healthcare professionals, with early career professionals and students holding particularly negative attitudes. Education interventions can be effective in reducing stigma held towards mental illness in healthcare professionals. What this paper adds: This paper supports the use of an education intervention to reduce psychology students' explicit stigma towards voice hearing. It also provides support for education interventions to be delivered in both online and face-to-face formats. This may allow education interventions to be delivered to broader audiences in the future. [ABSTRACT FROM AUTHOR]

"Abortion Care is Health Care" by Barbara Baird provides a historical account of abortion services in Australia from the 1990s to the 2020s. The book argues that although abortion has been effectively pro-choice for decades, access to abortion services remains uneven and inequitable. Baird highlights that the majority of abortion services are provided by private clinics, resulting in limited access for marginalized and disadvantaged women. The book is meticulously researched and provides comprehensive information on providers, laws, regulations, and events in each Australian state and territory. However, it may be more suitable for scholars than a general audience. [Extracted from the article]

The COVID-19 pandemic created global disruption in health professions education and healthcare practice, necessitating an abrupt move to digital delivery. A longitudinal survey was conducted to track the evolution of global responses to the pandemic. During the initial stages, educational and health institutions were forced to adapt quickly without careful consideration of optimal pedagogy, practices, and effectiveness of implemented approaches. In this paper, we report the results of Phase 3 of the global survey that was distributed between November 2021 and February 2022 through InterprofessionalResearch.Global (IPR.Global). The Phase 3 qualitative survey received 27 responses, representing 25 institutions from 13 countries in 6 regions. Using inductive thematic analysis, the data analysis resulted in three emerging themes: Impact of the pandemic on the delivery of interprofessional education and collaborative practice (IPECP); Impact of the pandemic on the healthcare system (team, population/client health, clients); and Sustainability and innovation. This study highlights the evolving nature of health education and collaborative practices in response to the COVID-19 pandemic. IPECP educators need to be resilient and deal with the complexities of face-to-face and digital learning delivery. Preparing for emerging forms of teamwork is essential for new work contexts and optimal health services. [ABSTRACT FROM AUTHOR]

Theodor De Bry produced popular engravings of the Americas, Asia, and Africa for his published accounts of faraway places, constituting some of the earliest European ethnographic accounts. It has long been established that early ethnographic writing often portrays non-Europeans through a colonialist lens, adding fabricated feature such as cannibalism. At the same time, the early modern world was contending with new disease vectors and new treatments for those diseases. This paper reframes De Bry's images of the Timucua peoples of modern-day Florida and their medical practice, which had theatrical and othering features, to capture an Indigenous perspective of medical care. Prints and accompanying inscriptions of the Timucua are then compared to De Bry's satirical images of European medical care. De Bry's visual and textual depictions of the Timucua are intended to render the Timucua legible to his European audiences but based on early modern accounts of the Timucua and other known Indigenous medical practices, there are aspects of De Bry's representation that map to actual Timucua medical cultures. Although contemporary viewers must be aware that De Bry intervened in the accounts and some of it is fantastic, it is nevertheless worthwhile to recapture some of the actual historical conditions of the Timucua as represented in De Bry's work. [ABSTRACT FROM AUTHOR]

The rising incidence of trans youth throughout the world and the new policy of many European countries and 25 US states that psychotherapy should be the first therapeutic response to Gender Dysphoria have made a reexamination of a comprehensive psychiatric evaluation (CPE) urgently relevant. Two conflicting views of the purpose of the CPE exist based on etiologic beliefs and convictions about the best therapeutic approach. This paper provides one clinician's synthesis of the elements, processes, goals, values, benchmarks of CPE and its usual recommendation for psychotherapy. The CPE recommended herein provides cogent hypotheses about the origins of the intrapsychic creation of a trans identity that are to be strengthened, weakened, or supplanted by explanations that emerge from psychotherapy. It also strengthens familial bonds and clarifies the intention to improve the mental health, social function, and autonomy of the minor. The inescapable ethical tensions that surround trans minor health care are discussed. The recommended CPE does not prevent subsequent medical interventions. [ABSTRACT FROM AUTHOR]

Objectives: Persons with disabilities (PWD) often experience risks associated with HIV/AIDS including unmet needs and overlooked stigmatization. This could be attributed to certain misconceptions such as PWDs are asexual, and cannot enjoy sexual pleasure, among others. Therefore, this paper sought to investigate the extent of disability inclusion in recent National Strategic Plans (NSPs) for HIV/AIDS in West African countries. Methods: This study was a policy review of NSPs in 13 African countries. Relevant indicators in the UN Convention on the Rights of Persons with Disabilities and the UNAIDS International Guidelines on HIV and Human Rights were used. Six indicators (identification of people living with disability (PLWD) as a key population, the inclusion of principles related to PWD within the NSPs on HIV/AIDS, protecting the rights of PWD, recognition of PWD as a vulnerable population at higher risk of HIV and in need of special protection, providing HIV-related support services for PWD and monitoring and evaluating the impact of HIV on PWD). Results: Findings from this study revealed that only 30% of West African countries recognized disability as an issue of concern. Also, 38.5% of these countries recognize the vulnerability of people with disabilities to HIV. However, only a few (7.6%) provided support in the context of special needs, monitoring, and surveillance specifically for persons with disabilities. Conclusion: Most of the West African NSPs are outdated and due for renewal. Therefore, it is necessary to integrate the needs of persons with disabilities within the context of HIV/AIDS in the NSPs. More importantly, support and services should also be prioritized among the vulnerable groups to optimize inclusion. [ABSTRACT FROM AUTHOR]

This paper uses a drama-based method to illustrate the responses of healthcare and legal systems to women experiencing coercive control. This approach involved writing a play using the first-person narrative voice of a victim-survivor. We presented the play at the Stop Domestic Violence Conference (Gold Coast, Australia) in 2021. The central character, 'Kate', provided an embodied performance that enabled the conference participants to see, feel and understand experiences of coercive control from a personal perspective. We followed the trajectory of coercive control from the beginning of an intimate relationship to the time of separation. We showed how the process of coercive control escalates from love bombing, reproductive coercion, isolation, and technology-facilitated abuse until a point of police intervention. As Kate told her story, the conference audience witnessed the barriers and challenges faced by survivors of coercive control, and the emotional, financial, and psychological impacts that are intensified in geographically remote environments. They watched Kate navigate health and other systems meant to help women experiencing domestic and family violence, but that ultimately failed to deliver. Finally, the drama-based approach allowed us to present a feminist embodiment of coercive control and an innovative method for communicating inter-disciplinary research findings on domestic abuse. [ABSTRACT FROM AUTHOR]

Asexuals present at health services with unique needs, yet providers typically lack training to care for this population. This narrative review aims to inform providers on best methods of asexual care. Search terms included "asexuality" and "health." Abstracts were screened against inclusion criteria, yielding 987 articles. After full-text screening, 44 papers were included. Pathologization, microaggressions, lack of awareness, and institutional neglect pose challenges to asexuals seeking care. Providers can improve asexual care by affirming identity, taking asexual-specific approaches, educating themselves, challenging biases, and fighting for institutional-level changes. These findings may guide practitioners in developing asexual-competent practices. [ABSTRACT FROM AUTHOR]

In Southern European societies such as the Portuguese, family and civil society play a relevant role in welfare policies, acting as complementary or supplementary 'safety-nets' to the state. In times of crises, migrants' access to healthcare is not only questioned but put at risk. This paper unveils the specific roles played by Civil Society Organisations' (CSOs) in providing healthcare to migrants in the aftermath of TROIKA in Portugal. By categorising different types of CSOs based on their articulation with the State, and the health service delivery model adopted, we show how CSOs configure themselves differently ranging from 'service delivers' to migrants' 'advocates', adopting responses that vary between aid to co-production. [ABSTRACT FROM AUTHOR]

This paper considers matters of time in online mental health peer support. Significant evidence of the value of peer support exists, with new digital platforms emerging as part of the digitisation of mental health support. This paper draws from a project exploring the impact of digital platforms on peer support through interviews with users of a major UK-based online peer support platform. Drawing on Gilles Deleuze's concept of the 'living present', the paper highlights how notions of past, present and future operate as co-existing dimensions of the present. The analysis highlights how the immediacy of digital platforms elicits expectations of peer support being 'on tap', which creates challenges when support is not received synchronously. Unlike in-person support, digital platforms facilitate the archiving of support, which can (re)enter the present at any moment through asynchronous communication. Anticipations of the future feature as dimensions of the present in terms of feelings regarding when support may no longer be needed. The paper offers potential implications for social scientific understanding of digital peer support, which include valuable insight for mental health services designing and delivering digital peer support. [ABSTRACT FROM AUTHOR]

This paper problematizes the precision medicine approach embraced by the All of Us Research Program (US) and by Genomics England (UK) in terms of benefits distribution, by arguing that current "diversity and inclusion" efforts do not prevent exclusiveness, unless the framing and scope of the projects are revisited in public health terms. Grounded on document analysis and fieldwork interviews, this paper analyzes efforts to address potential patterns of exclusion upstream (from participating in precision medicine research) and downstream (from benefitting from precision medicine outputs). It argues that efforts for inclusion upstream are not corresponded downstream, and this unbalance jeopardizes the equitable capacities of the projects. It concludes that enhanced focus on socio-environmental determinants of health and aligned public health interventions as precision medicine outputs would be to the benefit of all and especially of those who are most at risk of (upstream as well as downstream) exclusion. [ABSTRACT FROM AUTHOR]

While innovation is known to catalyse solutions to global sustainable development challenges, lack of engagement from stakeholders during conceptualisation and development may influence the degree of success of implementation. This paper presents a complete and novel engagement methodology, developed from value led business modelling approaches, for working with multi-sector stakeholders. The methodology can be used to determine barriers and facilitators to clinical practice innovations or translational research, within a country-specific context. The approach has then been applied in the Cambodian prosthetics and orthotics sector to provide a practice-based exemplar application of the framework. This approach seeks to ensure the suitability and sustainability of clinical practice and research programmes being implemented within a complex ecosystem. A theoretical basis, drawn from academic and business innovation sectors, has been consolidated and adapted for practical application to design, direct, and inform initiatives in low resource settings. The methods presented provide a way to both develop and articulate the mission, vision, and goals of any proposed change, and to effectively communicate these with stakeholders in a way that engages the personal and professional values that exist in their ecosystem. It provides a structured process through which meaningful conversations can happen, and a basis for relationship management with key stakeholders; intrinsic to enable a sustained legacy from research and development. The engagement from stakeholders during conceptualisation and throughout development can determine the success, or not, of any implementation and scale of innovation. This paper presents a conceptual stakeholder-led engagement methodology, developed from value led business modelling approaches, for determining barriers and facilitators to translational global healthcare research in a country-specific context, in this case the Cambodian prosthetics and orthotics sector. Subsequent research and development work in this area needs to carefully manage and negotiate influencing factors identified through the application of the described methodology, to ensure initiatives (whether research or wider national development work) are sustainable and successful. [ABSTRACT FROM AUTHOR]

What role do texts play in LGBTQ (lesbian, gay, bisexual, transgender, and queer) parents’ experiences of disability service systems? In interviews with 15 LGBTQ parents of disabled children in Toronto, Canada, participants selected documents to be used as a focus for discussion. Parents considered how LGBTQ identity and other intersectional identities influenced their experiences of institutional texts including adoption certificates, intake forms, and assessments. Findings suggest that documentation practices can operate as forms of systemic gatekeeping. LGBTQ identity was sometimes very significant in parents’ accounts, and sometimes less central than other aspects of their families' identities and experiences. [ABSTRACT FROM PUBLISHER]

Perceptions and experiences of midwives regarding structural empowerment during practice in Saudi Arabia were explored using a qualitative, constructive, descriptive design. Data was gathered using individual semi-structured interviews with ten midwives employed in delivery rooms, and prenatal and postnatal units of governmental hospitals in Saudi Arabia's eastern province. Data was analyzed with assistance of NVivo software, Version 12. Five themes emerged from our study: the meaning of structural empowerment, ambiguous hospital policies, the insufficient numbers of midwives, midwife-physician dynamics, and continuing education and training. Structural empowerment of midwives in maternity units may be useful in improving midwifery services in Saudi Arabia and worldwide. ACCESSIBLE SUMMARY: What is the further research? Further studies on this topic should expand the current study's sample and include participants from more regions of Saudi Arabia. In addition, research on the psychological empowerment of midwives is needed. What is known on the subject? Midwives are educated to care for women during pregnancy, birth, and postnatal, and midwives must be empowered to fulfill this professional role. The evidence showed the importance of structural empowerment for midwives to perform their professional function and provide quality care for women during pregnancy, birth, and postnatal. What does this paper add to existing knowledge? In Saudi Arabia, there is little research evidence on how to explore the perceptions and experiences of structural empowerment among midwives. Our study provided valuable recommendations for identifying environmental practices, positive workplace characteristics, and promoting higher-quality midwifery in the workplace. What are the implications for practice? Midwife workplace empowerment is correlated with the quality of care, job satisfaction, staff effectiveness, and the positivity of the work environment. The results of this study suggest that every healthcare organization must work to bring about structural empowerment for midwives to facilitate successful practice. [ABSTRACT FROM AUTHOR]

This article uses the problems associated with citizenship verification in U.S. government health insurance programs to argue that paper needs to be analyzed as a media technology. To examine paper as a media technology is to ask, “How does paper work?” and “What are the rules and habits that enable paper to be used in paperwork?” To consider paper as a media technology, this article makes 2 arguments. First, it argues that there is a set of skills and knowledge associated with paper documents that need to be recognized as a distinct form of literacy. Second, this article argues that the relation between paper and identity is an argument about the materiality of information. In focusing on how paper facilitates the materialization of information, this case study illustrates how distinct practices of use create specific relationships between technology and information that give information a distinct functional presence. [ABSTRACT FROM PUBLISHER]

AbstractNurses are at the forefront of care in mental health services but their role is conflicted; they carry the most responsibility for care and also for restrictive practices. The harmful effects of restrictive practices for mental health patients are well documented, have attracted negative media attention, public concern, and criticism directed specifically at nursing staff. The need to reduce restrictive practices has been highlighted by patients, carer groups, legislators, policy makers, academics, and mental health service providers. Policies and best practice guidelines have resulted, but restrictive practices remain a global problem. This theory paper proposes that inertia is partly due to the absence of a coherent model that explains the initiation and maintenance of restrictive practice in inpatient mental health settings. The conceptual development and synthesis of the model and its practical implications are discussed. [ABSTRACT FROM AUTHOR]

There is a growing worldwide interest in educating nurses at an advanced level. Advanced practice nursing (APN) refers to an umbrella term for master-educated nurses working within expanded nursing practice. Previous APN research has primarily addressed comparative characteristics of education globally and several aspects related to practice after graduation. This study aimed to explore how higher education institutions position and legitimize APN as an education requisite for nurses, the health care system, and society. Program descriptions of relevant educational programs in the Norwegian context were analyzed using documentary reality construction. The findings point to how APNs are positioned to have a prominent contextual perspective, which are given precedence over direct patient care, legitimized through descriptions of societal problems and demands. This paper argues that APNs are positioned to hold individual responsibility to solve unmet societal demands. [ABSTRACT FROM AUTHOR]

It is not only the states of the European Union (EU) that are heterogeneous in many respects, but also the regions existing within them. In this paper, we make use of a conjoint experiment on a particular type of technocratic solidarity – joint procurement of medical countermeasures (JPMC) – to explore how old and new regional-level heterogeneities affect public support for such type of solidarity. To this end, we exploit an experimental dataset, covering five EU countries at different phases of the Covid-19 pandemic in spring 2020. Our experimental results show that a broad policy scope, allocation based on need and EU governance all raise support for JPMC. Moreover, economically weaker regions and areas more severely hit by the pandemic exhibit stronger public backing for JPMC. Turning to the link between regional heterogeneities and specific design features of JPMC, evidence suggests that wealthier regions display greater public backing for a broader scope of the policy. Thus, our results suggest that public preferences for technocratic solidarity are generally strong, but also depend to some extent on regional collective rationalism. [ABSTRACT FROM AUTHOR]

The transition to parenthood, or the addition of another child to the family system is a life altering event for both mothers and fathers that can affect both parents individually and their relationship. For some parents, this includes perinatal suicidal ideation. Despite the prevalence of perinatal mood disorders, there are no systemic models designed specifically for couples who are at risk for suicide. This paper reviews the literature on the prevalence of perinatal suicidal ideation and proposes an integrative treatment model using aspects of Collaborative Assessment of Suicidality (CAMS), Attachment based family therapy (ABFT), and Emotionally Focused Therapy (EFT). [ABSTRACT FROM AUTHOR]

The purpose of this paper is to describe non-participation during the outcome measurement step of the wheeled mobility service delivery process (WMSDP) based on the Functional Mobility Assessment (FMA)-Uniform Dataset (UDS) Registry. The WMSDP is a standard framework for the provision of wheeled mobility devices, and several factors influence the client's experience throughout the process. Patient-reported outcomes are one way to measure the client's experience as part of a quality improvement program. A retrospective descriptive study was conducted on the FMA-UDS Registry to measure the response rate during the outcome measurement step of the WMSDP and describe the reasons an individual did not complete the FMA-UDS. The FMA-UDS was examined at two time points: pre-delivery and post-delivery of the wheeled mobility device. As of September 2, 2021, 10,253 cases have been entered into the FMA-UDS Registry. 2,247 cases were no longer participating pre-delivery, and an additional 3,905 cases were no longer participating post-delivery. The most common reasons for non-participation in the FMA-UDS pre-delivery and post-delivery included: equipment not delivered; provider no longer participating in the FMA-UDS; funding issues; no new equipment; client opted out; loss in contact; deceased; returned equipment; and other. The type and frequency of non-participation in the outcome measurement step of the WMSDP is critical to understanding why individuals participate in outcome measures and provides insight into the barriers and facilitators for the implementation of quality improvement programs. The outcome measurement system provides a structured mechanism for consistent communication between the client and the professionals providing the service, thereby identifying issues earlier in the process and mitigating frustration throughout the wheeled mobility service delivery process. The role of a credentialed professional, specifically an Assistive Technology Professional, in the wheeled mobility service delivery process could emphasize the importance of the follow-up and outcome measurement steps, which may increase the consumers' participation rate and demonstrate the effectiveness of devices and services. Clients who no longer participate in the outcome measurement process do not have the sustained support of the interprofessional team, and possess an increased chance that they will not get their mobility needs met through the health care system. [ABSTRACT FROM AUTHOR]

Purpose: Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised. Methods: The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services. Conclusions: Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes. Aboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed. An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers. A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare. Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people. [ABSTRACT FROM AUTHOR]

This paper introduces a contemporary psychodynamic attachment approach for managing chronic illnesses with a focus on the role of impairments in mentalizing, attachment, and epistemic trust. This approach emphasizes the significance of relational dynamics in healthcare settings and may thus provide a complementary approach in health psychology which currently primarily targets individual and behavioral aspects of chronic illness by addressing the relational dynamics that are typically involved in chronic illness management. We review empirical evidence highlighting the roles of mentalizing, attachment, and epistemic trust in chronic illness. We propose an attachment and mentalizing-based healthcare paradigm that prioritizes relational dynamics that aligns with emerging health psychology trends, offering a holistic approach to patient care. Finally, we present some practical implications of this approach, underscoring the importance of psychologists working in health in fostering secure attachment, epistemic trust and mentalizing within patient-provider relationships. This involves tailoring patient interactions and psychoeducation to individual needs and narratives, enhancing treatment adherence and well-being. [ABSTRACT FROM AUTHOR]

Issue: For students in the preclinical years of medical school, it is easy to overlook the narrative component of medicine and become occupied with learning the vast sea of information about the human body. There are limited, if any, options to learn about historical figures in medicine and how they can inform our future in clinical medicine. Evidence: There is an apparent lack of education offered on pivotal figures in medicine across many institutions. The few instances that medical history has been incorporated into the curriculum are further discussed. Implications: In order to incorporate cultural competency in our delivery of care, it is important to consider the diversity of the population we will be serving and how we can prepare to help patients feel heard in their unique issues. In this paper, we propose learning about the true history of certain medical practices, rather than the "colonial" version often utilized in textbooks and lectures, as a means of diversifying students' perspectives of the origins of these practices as well as giving credit where it is due. The time period during which many of these medical practices were cultivated is referred to as the Islamic Golden Age, but scholars who made contributions belonged to many different faiths and cultural backgrounds. El-Zahrawi was a Muslim physician whose principal work, Kitab-at-Tasrif, contains topics on medicine, surgery, midwifery, pharmacology, therapeutics, diet, psychotherapy, and medical chemistry. He pioneered numerous techniques in surgery and invented surgical devices that are still used to this day. [ABSTRACT FROM AUTHOR]

Although HIV incidence and mortality rates have declined over the past 20 years, HIV health disparities continue to persist among patients living in urban communities. Barriers to proficient health outcomes for persons with HIV (PWH) in urban communities include lack of access to care, resulting from limited transportation or clinic availability. While healthcare systems in rural communities provide telemedicine (TM) services to PWH to eliminate transportation and accessibility barriers, few examples exist regarding TM use for PWH in urban communities. This project's goal was to increase the provision of healthcare services in an urban setting to PWH, using TM. As guided by "Integration of Healthcare Delivery Service" theories and key principles, we created an integration framework comprised of several simultaneous, overlapping activities to include: (1) capacity building (2) clinical standardization (3) community and patient engagement and (4) evaluation performance and measurements. This paper describes major activities involved with developing, implementing and evaluating a TM program for PWH. We discuss results, challenges, and lessons learned from integrating this program into our existing healthcare system. [ABSTRACT FROM AUTHOR]

This systematic review aims to identify and synthesize the available evidence on the receptivity toward, perceived advantages and challenges of remote service delivery among social work clients and practitioners during the context of COVID-19. Two electronic databases were searched from 2020 to 2022. Identified papers were screened against the established eligibility criteria, yielding 15 papers. Two additional papers were further identified through hand-search. As heterogeneity of studies was high, a narrative synthesis was performed to summarize the overall evidence. Our review provides evidence that remote service delivery holds the potential to increase access to services among selected client populations as well as promote a sense of empowerment for clients and opportunities for practice enhancement for practitioners. The findings from our study highlighted the need for innovative solutions and practical considerations for ongoing remote service, including the careful considerations of social work clients' and practitioners' suitability, the need for provision of training and ongoing support to optimize practitioners' well-being. As the delivery of services transition to face-to-face or remain remote, further research is needed to assess the promise of remote practice in optimizing overall service delivery, while maintaining client-reported satisfaction. [ABSTRACT FROM AUTHOR]

In the United Kingdom, people with non-white ethnicities are more likely to report being in worse health conditions and have poorer experiences of healthcare services than white counterparts. The voices of those of Black ethnicities are often merged in literature among other non-white ethnicities. This literature review aims to analyse studies that investigate Black participant experiences of primary care in the UK. We conducted a systematic literature review searching Medline, Web of Science, EMBASE, SCOPUS, Social Policy and Practice, CINAHL plus, Psych INFO and Global Health with specific search terms for appropriate studies. No publish date limit was applied. 40 papers (39 articles and 1 thesis) were deemed eligible for inclusion in the review. A number of major themes emerged. Patient expectations of healthcare and the health seeking behaviour impacted their interactions with health systems in the UK. Both language and finances emerged as barriers through which some Black participants interacted with primary care services. (Mis)trust of clinicians and the health system was a common theme that often negatively impacted views of UK primary care services. The social context of the primary care service and instances of a cultural disconnect also impacted views of primary care services. Some papers detail patients recognising differential treatment based on ethnicity. The review included the voices of primary care professionals where descriptions of Black patients were overwhelmingly negative. Views and experiences of Black groups may be radically different to other ethnic minorities and thus, should be teased out of broader umbrella terms like Black and Asian Minority Ethnic (BAME) and Black Minority Ethnic (BME). To address ethnicity-based health inequalities, culturally sensitive interventions that engage with the impacted community including co-designed interventions should be considered while acknowledging the implications of being racialised as Black in the UK. [ABSTRACT FROM AUTHOR]

In discussing therapeutic action as conceived within the British Independent School and the conceptual and technical difficulties involved in integrating dissociated states of mind, the author's linking of relational concepts of dissociated patterns of interaction with Winnicott's theory of potential space (for the purpose of transforming latent psychic capacities) presents a number of difficulties for this discussant which may reflect in part a culture different from the author's own but also profound differences of approach. Despite attempts to achieve common ground within psychoanalysis there are numerous variations of the discipline and areas of commonality are neither obvious nor clear. The paper under discussion left this discussant with a sense not having entered clinically into the unconscious world of the patient in a way that felt familiar. There is an emphasis on psychic change in the paper, but there is also an emphasis on the role of consciousness in relationships, which, though important, does not for this writer constitute the foundation of enduring psychological change. Overlaps and gaps in understanding are discussed which may reflect differing clinical trajectories or destinies as we undertake the analytic journey with our respective patients. [ABSTRACT FROM PUBLISHER]

The article discusses the commentary on Debra Rothschild's paper related to Dissociative Identity Disorder (DID) treatment. The author states the focus of Rothschild's paper on the relation of the concept of integration and the recognition of self-existence. Some elements of treatment used by Rothschild in his therapy to Sarah, a survivor of extreme trauma, are emphasized by the author on his discussion. A detailed discussion of the author's commentary is also presented.

The purpose of this paper is to describe the Caribbean HIV Evaluation Support demonstration program, a five-site HRSA-funded demonstration project that aimed to implement a peer support intervention to help HIV-positive Caribbeans living in the United States. This paper provides a framework of the demonstration including the rationale for the program, program requirements, and eligibility of participants. In addition, this paper describes each of the five programs including, Brookdale University Hospital and Medical Center, Brooklyn, NY; Lutheran Medical Center, Brooklyn, NY; Community Healthcare Network, New York, NY; University of Miami, Miami, FL; and Montefiore Medical Center, Bronx, NY. The background of each program description includes: setting, theoretical frameworks, peer training, client recruitment & staffing and content of the intervention. Finally, lessons learned including the utility and feasibility of the peer-support intervention program is identified at the closing. [ABSTRACT FROM AUTHOR]

Candidates' views of postgraduate medical examinations are seldom sought in a systematic way. There is little published evidence of candidates' views of the MRCGP examination, and its consequential validity, i.e. the effect of the assessment on learning or care for patients. A random sample of 100 registrars sitting the October 2003 multiple-choice paper (MCP) of the MRCGP exam were sent a questionnaire to seek their views about the validity of the paper. Most respondents found the questions difficult, in particular general medicine and medical specialties, but believed the paper assessed the application of their knowledge about common or important topics, relevant to general practice. However, more than half the candidates believed the paper contained inappropriate questions and were critical of some of the question formats. Pressure of time was a problem for many candidates, most of whom believed they needed a further 30 minutes to complete the paper. Preparation strategies were almost exclusively strategic, most often through help from fellow registrars rather than the trainer or vocational training scheme. Practising past papers was the most frequent desirable additional help. There are opportunities afforded by candidate feedback for the assessment governance system and the development of the paper, and qualitative feedback is of benefit in the evaluation of the quantitative data from the results of the assessment. [ABSTRACT FROM AUTHOR]

The impact of information and communication technology has been felt globally and the healthcare sector is not immune to the changes brought about by the introduction of new technologies. In contemporary clinical practice environments, information and communication technology skills are advantageous, not only to nurses, but also to the patients for whom they care. There is good evidence that these skills, appropriately utilised, can have a significant impact on patient outcomes. This scholarly paper presents the background to a project that explores graduate nurses' experiences of using information and communication technology in clinical contexts. A broad historical overview of the implementation of information and communication technology in higher education and healthcare in Australia is provided before discussing the extent to which the technology skills learnt at university are relevant or transferable to contemporary practice environments. The current levels and use of information and communication technology among new graduate nurses, the apparent dichotomy between technological versus humanised healthcare, and the need for national information and communication technology competency standards are discussed. [ABSTRACT FROM AUTHOR]

The way that the current conception of mutual enactment is understood, any analysis, in order to be ultimately successful must first go badly for some period of time. Any analysis that goes too smoothly is subject to the suspicion that some very difficult interactional material is being mutually unaddressed. In this context I see that Dr. Lauren Levine enacted the role of her abandoned patient (concordant countertransference) and as well, for a time, indeed, figuratively abandoned her patient (complementary countertransference). The author's central contribution in this paper is an illustration of how drawing on difficult and painful dimensions in one's own personal analysis, the analyst has the advantage of being able to withstand highly toxic material in both the transference and the countertransference. Dr. Levine is fortunate in having had a personal analysis that helped her integrate highly shameful aspects of her self, though it must be recognized that this is not always the case in all training analyses. [ABSTRACT FROM AUTHOR]

Although the public uses the media for sex advice, information and validation, much media coverage of sex contains inconsistent, outdated, or incorrect messages. There is little encouragement for those working in sex therapy, research, education or healthcare to engage with the media. The standard of media training and availability for these professions varies. Not all professionals work from an evidence-based perspective, and not all ‘experts’ in the media are recognised as such by their peers, resulting in inconsistent information being given to journalists by people not always qualified to speak about sex. Furthermore, a lack of training and understanding of sex and relationships results in misunderstanding or misreporting of stories by journalists, and perpetuating poor media coverage of sex. This paper outlines problems in media coverage, and highlights training opportunities and deficits for both sexologists and journalists. It advocates collaborative working, greater training in evidence-based sexology, and challenging problems in media training and sex coverage. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) is being built into the mainstream of professional education for all health and social care professions throughout the United Kingdom (UK) driven by the Labour Government elected in 1997, coincidentally the year that this Journal hosted the first All Together Better Health conference in London. The incoming government prioritized pre-qualifying IPE to be provided in partnership by universities and service agencies supported regionally by workforce development confederations, later absorbed into strategic health authorities (SHAs), and centrally by educational, professional and regulatory bodies. Ambitious agenda for pre-qualifying IPE set by government are being tempered by realistic assessment of current outcomes borne of experience and corroborated by evidence. This paper suggests some ways to ease constraints and improve outcomes, but emphasizes the need to generate continuing interprofessional learning opportunities that build on the basics. It argues that accumulating experience and evidence must be brought to bear in formulating criteria for the approval and review of IPE within regulatory systems for professional education. Can IPE be sustained within mainstream professional education once initial enthusiasm ebbs and earmarked funds run dry? That is the issue. [ABSTRACT FROM AUTHOR]

There are many ways that occupations are regulated, with the degree of regulation usually depending on the amount of harm to the public that lack of regulation could bring. Strict regulations, such as mandatory licensure, are established through state law and maintained by a state board. Less strict regulations, such as voluntary credentialing, may be requirements by employers or third-party payers. This white paper reviews the possible approaches ASET could take toward regulation of the practice of electroneurodiagnostic technology: maintain position of neutrality, advocate for no statutory regulation of END, advocate for statutory regulation of END, or advocate for voluntary credentialing. The routes taken by other allied health fields are outlined, with exploration of the advantages and disadvantages of each option, as well as what would be required of ASET in terms of time and other resources to achieve each option. The appendix is a summary of entry requirements of several healthcare professions. [ABSTRACT FROM AUTHOR]

This paper begins by providing a history of Japanese law pertaining to special education and its change towards a more inclusive education with the ratification of United Nations Conventions of the Rights of People with Disabilities. With the changes in laws, more children with constant medical care needs in Japan have the opportunity to attend mainstream schools. The recent court case, Kosuge v. Kanagawa prefecture and Kawasaki city, ruled against a child with medical care needs to attend mainstream school and made the judgment that a special needs school (tokubetsushien gakkō) is the appropriate placement for the child based on the child's disability type and degree of disability rather than needs and regardless of the wishes of the child's parents. This paper explores the case judgement and discusses where Japanese special education laws fall short similar to that of the US system based on Individuals with Disabilities Education Act. We suggest the need to keep inclusion as the basic human rights aligned with the Article 24 of the UNCRPD rather than focusing on the continuum of education principle in IDEA, and operationalise the law into practice to make integration of children with disabilities, including children with constant medical care needs, into mainstream education schools. [ABSTRACT FROM AUTHOR]

Fourier analysis is well known to provide complete information of the frequencies present in a signal. But in the process, time information is lost. Therefore, its time-frequency representation is required for depicting both time and frequency information simultaneously. Therefore in this paper, fractional wavelet transform (FrWT) is proposed to be used for the first time for extracting the features of various datasets in a standard ECG database by combining the advantages of both fractional domain techniques and wavelets as case-II. Afterwards, Probabilistic Principal Component Analysis (PPCA) is used for detecting R-peaks for diagnosing heart abnormalities in various morphologies of the ECG signal. The proposed technique has been evaluated on the basis of sensitivity (SEN), detection error rate (DER), and positive predictivity (PPR) (of the detected ECG beats) for MIT-BIH Arrhythmia database (M/B Ar DB). Even though both FrFT and FrWT techniques exhibit a high degree of robustness, but SEN of 99.99%, DER of 0.026%, & PPR of 99.99% obtained by latter in case-II are better than SEN of 99.97%, DER of 0.053%, & PPR of 99.98% obtained by the former in case-I for M/B Ar DB. In this paper, average time error (ATE) is also obtained for the considered datasets establishing the effectiveness of the proposed technique further. These encouraging results suggest that the proposed methodology will go a long way in assisting the cardiologists to detect temporal patterns in a wide variety of electrophysiological cases, which is important for improved management of healthcare system. [ABSTRACT FROM AUTHOR]

This paper focuses on the development and feasibility of a digitally-based educational intervention, titled Recognize & Resist (R&R), for writers of One Direction (1D) fanfiction on Wattpad.com. The goal of R&R is to reduce the prevalence of social norms that are supportive of sexual violence within 1D fanfiction. 1D fanfictions, or fictional romance stories written by fans of this British boy band, have hundreds of millions of views on Wattpad.com. Formative research has found that social norms supportive of sexual violence are prevalent in 1D fanfictions and that some authors have internalized these norms. R&R aims to motivate 1D fanfiction writers to highlight sexual consent and egalitarian gender roles in their writing. To evaluate the intervention’s feasibility, 15 1D fanfiction authors completed a survey and participated in an interview or focus group. Results demonstrate R&R’s feasibility, with high ratings of its acceptability and demand. Insights from the interviews and focus groups provide suggestions for revising R&R before rigorously evaluating its efficacy. Additionally, results demonstrate the utility of using popular culture as a vehicle for attitude-change regarding sensitive health issues. [ABSTRACT FROM AUTHOR]

Undiagnosed Autism Spectrum Disorder (ASD) may represent a diagnostic challenge in people who refer to specialized services for first-episode psychosis (FEP). Similarly, individuals with ASD can present newly-onset psychotic symptoms. The present review aimed to summarize the literature available on ASD and FEP to guide differential diagnosis between the two conditions and discuss the impact of ASD-FEP comorbidity on recovery. The PRISMA-ScR guidelines were followed. After conducting a comprehensive literature search, we screened 204 papers including participants with: (1) a comorbid diagnosis of FEP and ASD; (2) FEP and autistic traits; (3) separate groups of FEP and ASD. A total of 18 studies were discussed and confirmed the high prevalence of ASD or autistic traits in people referring to FEP services (up to 9% and 35% of FEP, respectively), which could negatively impact pathways to care, clinical presentation, and outcomes. Due to some similarities in ASD and FEP presentation (e.g., difficulties in social functioning), a differential diagnosis could be challenging. The features more suggestive of ASD rather than a primary FEP include illogical and concrete thinking, and a longstanding social interaction difficulty. Aberrant salience and suspiciousness can manifest in ASD, but are usually more transient, and stress-related than in FEP. Also, perceptual abnormalities are due to altered sensory processing rather than pathological hallucinations. The co-occurrence of ASD symptoms is associated with a reduced probability of clinical and functional recovery in FEP, a higher risk of suicidal behaviors, and higher unemployment rates. The kaleidoscopic manifestations of FEP require an adequate differential diagnosis that should include ASD. FEP services ought to be equipped for an adequate assessment and diagnostic formulation, which can result particularly challenging should symptoms of autism be present in adult patients. [ABSTRACT FROM AUTHOR]

Despite the numerous calls for integrating quality improvement and patient safety (QIPS) curricula into health professions education, there are limited examples of effective implementation for early learners. Typically, pre-clinical QIPS experiences involve lectures or lessons that are disconnected from the practice of medicine. Consequently, students often prioritize other content they consider more important. As a result, they may enter clinical settings without essential QIPS skills and struggle to incorporate these concepts into their early professional identity formation. In this paper, we present twelve tips aimed at assisting educators in developing QIPS education early in the curricula of health professions students. These tips address various key issues, including aligning incentives, providing longitudinal experiences, incorporating real-world care outcomes, optimizing learning environments, communicating successes, and continually enhancing education and care delivery processes. [ABSTRACT FROM AUTHOR]