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The study aimed to analyze the Journal of Hospital Librarianship (JHL) publications between 2001 and 2020 as indexed in Elsevier's Scopus database. The dataset was extracted on February 25, 2021 and 807 records were identified for data analysis. Various bibliometric indicators of the papers were assessed. There was an average of 1.32 citations per document. Sixty percent of the papers were single-authored, but the multi-author papers had a higher number of citations. The USA was identified as the country with the most contributions; Louisiana State University was the highest contributing institution, while Helen-Ann Brown Epstein was the most prolific author. [ABSTRACT FROM AUTHOR]

Authorship of academic papers is a currency that can bring career advantages in academia and other industries. How authorship should be decided is not always clear, particularly in co-produced research with non-academic collaborators, for which existing authorship guidelines are largely silent. In this paper, we critically reflect on what constitutes written authorship in the context of co-produced health research. We present examples from our own work to illustrate the argument we make, including publishing a co-authored paper with non-academic partners. We consider questions of what constitutes authorship and how it is mutually understood. We discuss some of the opportunities and limits to participation and how these might translate into academic authorship as a collaborative research output. Finally, we explore the potential of authorship guidelines as a resource for critical reflection on what we mean by co-produced work and how we recognise contributions to global health research. We suggest that authorship guidelines should be adapted to encourage attribution of co-produced research to include non-academic as well as academic collaborators, and we provide a draft guideline for how this might be done. [ABSTRACT FROM AUTHOR]

Coaching has become increasingly popular as a mechanism to support learning across the health professions education (HPE) continuum. While there is a growing body of literature in this area, there is minimal guidance related to the design and implementation of academic coaching in health professional courses. This paper seeks to contribute to this literature by presenting guidance for academic developers who are considering introducing academic coaching into a health professional course. The 12 tips are based on the authors' collective experiences of designing and implementing academic coaching in university medical courses in Australia and the UK. Although focused on medical education, this paper is intended to have applicability across the health professions, and potentially across university and postgraduate training contexts. Together, the tips offer a strategic and operational framework to guide the design and implementation of academic coaching initiatives in health professions education. [ABSTRACT FROM AUTHOR]

Construct: The competence of a trainee to perform a surgical procedure was assessed using an electronic tool.Background: “Going paperless” in healthcare has received significant attention over the past decades given the numerous potential benefits of converting to electronic health records. Not surprisingly, medical educators have also considered the potential benefits of electronic assessments for their trainees. What literature exists on the transition from paper-based to electronic-based assessments suggests a positive outcome. In contrast, work done examining the transition to and implementation of electronic health records has noted that hospitals who have implemented these systems have not gone paperless despite the benefits of doing so.Approach: This study sought to transition a paper-based assessment tool, the Ottawa Surgical Competency Operating Room Evaluation (which has strong evidence for validity) to an electronic version, in three surgical specialties (Orthopedic Surgery, Urology, General Surgery). However, as the project progressed, it became necessary to change the focus of the study to explore the issues of transitioning to a paperless assessment tool as we identified an extremely low participation rate.Results: Over the first 3 months 440 assessment cases were logged. However, only a small portion of these cases were assessed using the electronic tool (Orthopedic Surgery = 16%, Urology = 5%, General Surgery = 0%). Participants identified several barriers in using the electronic assessment tool such as increased time compared to the paper version and technological issues related to the log-in procedure.Conclusions: Essentially, users want the tool to be as convenient as paper. This is consistent with research on electronic health records implementation but different from previous work in medical education. Thus, we believe our study highlights an important finding. Transitioning from a paper-based assessment tool to an electronic one is not necessarily a neutral process. Consideration of potential barriers and finding solutions to these barriers will be necessary in order to realize the many benefits of electronic assessments. [ABSTRACT FROM PUBLISHER]

Institutional ethnography (IE), a term coined by sociologist Dorothy Smith, explores the nuances of institutions and their complex relationships in sociology. IE is an approach to studying and analysing social organization, and it provides a more holistic understanding of 'invisible' relationships that govern institutions and how those relationships interact with each other. Health sciences researchers in patient care, patient experience, and allied health professionals have recently become more interested in the use of this methodology and how to incorporate it into their research. However, in health professions education (HPE) there is little use of IE. We hypothesize this may be because of limited practical knowledge of this methodology. This paper serves as an introduction to the use of IE in HPE, describing the differences between IE and traditional ethnographies, recognizing the common pitfalls when utilising IE, and incorporating texts into IE. While ethnographies may be daunting to researchers less familiar with these approaches, the tips in this paper will provide an introduction and help educators and researchers successfully navigate the use of IE in health profession scholarship and education. [ABSTRACT FROM AUTHOR]

Aims: Academic medicine is a career route that historically struggles to recruit and retain suitable doctors. The aim of this paper is to review the evidence for interventions to encourage careers in academic medicine by way of a descriptive systematic review. Methods: Key databases were searched in February 2017. Studies that evaluated interventions to encourage careers in academic medicine and that used a pre-post analysis or included a comparison group were included. Interventions reporting only learner satisfaction were excluded. The review was specific to medical students and graduates. Results: Twenty-four studies were identified for inclusion within the review. The included studies identified interventions across five domains: postgraduate funding, postgraduate training, mentoring, undergraduate interventions, and institutional change. The papers varied in terms of strength of conclusion and method of analysis with broad, structured, well-funded programs having the most palpable results. Conclusions: The five domains identified offer a framework that can be used by institutions who wish to develop similar programs. It also offers a body of research on which an evidence base can be built. [ABSTRACT FROM AUTHOR]

Adolescent depression is a serious and debilitating disorder associated with lifelong negative outcomes, including heightened risk for recurrence into adulthood, psychiatric comorbidities, and suicide. Among evidence-based treatments for adolescents, psychotherapies for depression have the smallest effect sizes of all psychiatric conditions studied. Advancing care for depression in adolescents is complex due to the heterogeneity in etiology and co-occurring difficulties among youth presenting with depression symptoms. This and a companion paper (Lewandowski et al., 2022) draw on a recent multisite collaboration that focused on implementing depression treatment for adolescents within clinical and research contexts. Specifically, this paper will review our work adapting behavioral activation (BA) as a principle-based framework to improve effectiveness and efficiency of depression treatment used within clinical and research settings in academic medical centers. Piloted adaptations include the use of BA principles to address idiographic drivers of depression and in-session BA "exposures" to illustrate BA principles. Case vignettes illustrate these adaptations of BA to address adolescent depression in the context of co-occurring difficulties. [ABSTRACT FROM AUTHOR]

This paper describes the implementation of Behavioral Activation (BA) as the core psychotherapy treatment within a broader clinician-led effort to establish a care pathway for adolescent depression in an academic medical center that served public and private hospital systems. This quality improvement effort required a standardized yet flexible approach to psychotherapy to be used by clinicians with a range of experience and training backgrounds while serving diverse clinical populations in child psychiatry and pediatric clinics. This paper highlights implementation of BA in treating adolescent depression across these varying systems. In particular, the paper emphasizes the application of BA as a principle-driven, treatment that enables flexibility across settings while remaining rooted in scientific evidence. The paper also reviews lessons learned from this effort that may support efforts to implement BA in other clinical settings and systems. [ABSTRACT FROM AUTHOR]

While some academic health centers have organizational structures to support educational scholarship, such as Medical Education Research Units (MERU), many education scholars may lack access to such institutional resources to support their research agenda and professional growth. In 2014, as part of an externally funded education grant, three faculty educators established a unique education data management system Research & Evaluation Data for Educational Improvement (REDEI). Lacking an institutional MERU, they established an educational research community of practice (CoP) using REDEI as the research dataset. The senior faculty member's effort to facilitate the group is funded by the Dean's Office. The CoP meets every 2 weeks to generate research ideas, discuss analytic approach and strategy, review analyses designed to address or explore a research question, and plans for manuscript development. Our CoP has grown from 3 to 18 members representing faculty educators, administrators, and staff across many departments in the School of Medicine. As of 2021, the REDEI system contains performance data on 1,246 students across all years of undergraduate medical education. To date, we have published 11 peer-reviewed educational research manuscripts. Five learners have served as coauthors (three medical students and two residents), three of whom were first authors. Eleven additional papers are in process. This community of practice supports productivity, provides mentorship, overcomes barriers, and is flexible enough for people to join when they can or when an area of interest is actively under development. We are working on educational interdisciplinary research grant submission and creating collaborations with other institutions. Our focus remains on honing skills in grantsmanship, identification of impactful research questions, application of rigorous methods and instrumentation to address them, and refining process of budget development, timelines, and other planning strategies. [ABSTRACT FROM AUTHOR]

College students have been recognized as a risk group for substance use. Nevertheless, coherent risk factors for stimulant use remain to be elucidated. The objective of this paper is to identify risk factors associated with the recreational use of MDMA, cocaine, amphetamine and methamphetamine. An online questionnaire was distributed among colleges in Berlin. A sample of 12,914 college students participated, of which 9,382 met the inclusion criteria. Past-month prevalence was 7.0% for MDMA, 6.7% for amphetamine, 5.8% for cocaine and 0.1% for methamphetamine. Associated factors included male gender, "other" gender, homosexual and bisexual orientation, open relationship status or being single, engaging in sexual risk-taking behavior, having a psychiatric diagnosis, tobacco use, drinking alcohol and an increased number of (illicit) substances consumed in the past month and in life. Berlin college students showed a substantially higher prevalence of stimulant use compared to both the general population and college students in other cities. Certain parameters, e.g., polydrug use, were particularly high in this group. The results can be used in further development of prevention efforts. However, conclusions about causality are limited by the cross-sectional nature of this study, highlighting the necessity for longitudinal studies in this field. [ABSTRACT FROM AUTHOR]

Medical mistrust among the public was amplified during the COVID-19 pandemic due to racial and social inequities in infection rates and misinformation in the media. In Boston, two initiatives were launched by the Boston University Clinical Translational Science Institute (BU CTSI), Boston Medical Center (BMC), community health centers (CHCs), and community organizations to establish longitudinal and authentic partnerships with community-research boundary spanners who remained trusted sources of information. Each initiative addressed the immediate need for community-informed and partnered COVID research and provided a structure for longitudinal partnerships. In this paper, we describe the process of envisioning how these two initiatives could move from isolation toward collective impact. We also identify opportunities to improve community-engaged research practices within an academic health system. Our approach provides a structure that other organizations can use to align initiatives and move toward boundary-crossing partnerships which foster health equity. [ABSTRACT FROM AUTHOR]

In this paper, six social work scholars at varying career stages and institutions used collaborative autoethnography to identify (1) structural constraints and tensions to engage in participatory action research (PAR) in the academy, (2) the strategies we have used to navigate this work, and (3) suggestions for structural changes necessary to meaningfully value this work in the academy. Key structural constraints and tensions center around questioning the legitimacy of this work, time necessary to do this work, challenges funding this work, and inherent ableism in the academy. We share case examples of strategies PAR scholars have used to navigate or subvert academic expectations, including operationalizing values, rooting in movements, uplifting accessibility and knowledge; holding accountability to community, and articulating commitments. We end with recommendations for social work institutions and funders to meaningfully elevate, support, and fund PAR work in the academy. Specifically, we see the need for social work institutions to elevate PAR training and reward systems as legitimate knowledge, build support systems for conducting PAR in the academy, revise evaluation of scholars at milestones to value PAR; funders should also work to align funding opportunities and practices with participatory praxis. [ABSTRACT FROM AUTHOR]

This paper aims to examine the spatial attributes in the hospital ward environment and their impact on medical students' learning and experience of the clinical workplace. An ethnographic study was conducted in a Scottish teaching hospital, combining observations and interviews over a period of 10 months. Two teaching wards served as the field-sites where approximately 120 h of non-participant observations took place sequentially. In addition, 34 individual interviews were conducted with identified key informants that included medical students, junior doctors, postgraduate trainees, consultant supervisors, ward nurses and hospital pharmacist. A combination of Actor-network Theory (ANT) and Social cognitive theory (SCT) was applied to analyse data pertaining to spatial attributes and their relevance to clinical teaching and learning. Analysis of the observational and interview data led to generation of the following themes: spatial attributes in the clinical workplace can enable or constrain teaching and learning opportunities, inadequate spaces impact students' and junior doctors' sense of value, short clinical rotations influence a sense of ownership of doctors' spaces, and contested nature of space in the clinical environment. Several illustrations of the field-sites help to contextualise the themes and aid in understanding the participants' experiences and perceptions. Our findings suggest a complex entanglement of space with medical students learning and wellbeing in the clinical workplace. Provision of suitable spaces needs to be a core consideration to realise the full potential of work-based learning in medicine. [ABSTRACT FROM AUTHOR]

Chronic pain is a common feature of hypermobile Ehlers–Danlos Syndrome (hEDS), yet how patients assess and communicate their pain remains poorly understood. The objective of the present study was to explore the use of numeric pain assessment in individuals with hEDS, from a patient-centered perspective. Our analysis is based on in-depth qualitative interviews. The interviews were conducted over the phone. Our participants were patients living with hEDS (N = 35). Interviews were recorded, transcribed, and analyzed to identify factors related to their use of these pain assessment instruments. Three primary themes emerged from these data, namely, (1) confusion around the quantification of multidimensional pain, (2) the subjectivity of pain experience, and (3) a strategic use of assessments for practical purposes beyond the accurate representation of pain. These results demonstrate the need for caution in relying exclusively on numeric pain assessment instruments. We conclude with a brief proposal for a clinical communication strategy that may help to address the limitations of numeric pain assessment that were identified in our interviews. Chronic pain is a common feature of hypermobile Ehlers–Danlos Syndrome (hEDS), yet how patients assess and communicate their pain remains poorly understood. Clinicians should be aware that patients have difficulties with the Numeric Rating Scale (NRS) for at least three reasons: (1) confusion around the quantification of multidimensional pain, (2) the subjectivity of pain experience, and (3) a strategic use of assessments for practical purposes beyond the accurate representation of pain. Clinicians should use caution in relying exclusively on NRS instruments. Clinicians may benefit from using clinical communication strategies outlined in our paper, which may help to address the limitations of the NRS that were identified in our interviews. [ABSTRACT FROM AUTHOR]

Determination of smoking habits of medical students in Belgrade and the factors influencing cigarette use. A cross-sectional study was conducted among undergraduate medical students from all study years at the Faculty of Medicine, University of Belgrade, during the 2015–2016 academic session. A questionnaire, composed of four parts, was administered to all participants: 1. socio-demographic characteristics; 2. habits and lifestyle; 3. Fagerstrom Test for Nicotine Dependence; 4. the Rosenberg self-esteem scale. Logistic regression analysis was conducted to identify the factors significantly associated with cigarette smoking. A total of 2551 subjects, which constituted 81.8% of all undergraduate medical students, participated in the survey. The prevalence of current regular smokers among medical students was 21.7%. The results obtained using the Fagerstrom tolerance scale showed that 41.8% of the students had high nicotine dependence. According to the results of a multivariate analysis, the following were the independent determinants of being a smoker: being male, grade point average of <8/10, daily coffee consumption, self-reported excessive leisure time, self-reported pressure from parents, alcohol consumption, and smokers among parents. Understanding the factors influencing tobacco use is the first step in implementing prevention strategies and can be helpful in the cessation of smoking. What is already known about this topic Previous studies showed a strong association between smoking and alcohol consumption among undergraduate medical students. There is an association between tobacco use and academic performance. Higher-income families and the parents without higher education are significantly associated with students' smoking, but these associations were not independent. What this paper adds Independent predictive factors for smoking among undergraduate medical students are being male, having smokers among parents, daily coffee consumption, self-reported excessive leisure time, self-reported pressure from parents and consumption of alcohol. Family income does not influence smoking status of students directly, but students participated in this study from the higher-income families were more likely to have smokers among parents, which were found to be an independent predictive factor. Early psychologists' cessation smoking interventions can have implications for motivating students to quit smoking. [ABSTRACT FROM AUTHOR]

Personal Intelligent Agents (PIAs) like Siri and Alexa are becoming more popular among users. In this paper, we investigate the effect of humour and voice of personal intelligent agents, their impact on users' perceptions of intelligence and anthropomorphism, and the relationship of these perceptions with cognitive- and emotion-based trust. The results from an online experiment show that humour and voice significantly and positively influence users' perceptions of anthropomorphism. These perceptions positively impact users' emotion-based trust, which increases their intention to use the PIA. We also find that perceptions of intelligence shape users' cognitive-based trust in the PIA. Our model is novel because it examines two key design characteristics of PIAs and articulates their effects on user perceptions. The effect of human-like characteristics, specifically humour and voice, on perceptions of intelligence and anthropomorphism and the potential impact on users' cognitive- and emotion-based trust in PIAs have not been explored in an IS context. [ABSTRACT FROM AUTHOR]

In recent years, doctor-patient communication in the context of traditional Chinese medicine (TCM) has attracted increasing attention. Highly influenced by ancient Chinese philosophy, TCM is unique in its exemplification of Chinese wisdom, particularly with respect to how the idea of zhěngtǐguān (整体观) (lit. whole body concept), realized as "the idea of the whole" or simply "holism," is valued and realized in TCM consultations. Adopting an interactional analytical approach, our study aims to illustrate how TCM doctors and patients co-construct a medical consultation that can exemplify the idea of holism. Based on a spoken corpus of Mandarin Chinese totaling 443 minutes in length, this paper identifies instances of what can be labeled as the voice of TCM (VOTCM) in a typical TCM consultation that reflect the idea of holism and describes and analyzes the communicative routines that are specific to these TCM consultations. It is observed that the steps and strategies involved in the consultation not only illustrate the collaborative co-construction of holism but also point to the holistic aspect of TCM philosophy, particularly topics related to the different body parts and the lifeworld. The diagnostic explanations provided by doctors and the co-topical talks between doctors and patients at various stages of the consultation also play an important role in the co-construction and realization of holism. [ABSTRACT FROM AUTHOR]

Building fair, equitable, and beneficial partnerships between institutions collaborating in research in low- and middle-income countries (LMIC) and high-income countries (HIC) has become an integral part of research capacity building in global health in recent years. In this paper, we offer an example of an academic collaboration between the University of California Los Angeles, Center for Health Policy and Research (UCLA CHPR) and the University of Philippines, Manila, College of Public Health (UPM CPH) that sought to build an equitable partnership between research institutions. The partnership was built on a project to build capacity for research and produce data for policy action for the prevention and care of non-communicable diseases (NCDs) through primary healthcare in the Philippines. The specific objectives of the project were to: (1) locally adapt the Primary Care Assessment Tool for the Philippines and use the adapted tool to measure facility-level primary care delivery, (2) conduct focus group discussions (FGDs) to gather qualitative observations regarding primary care readiness and capacity, and (3) conduct a comprehensive population-based health survey among adults on NCDs and prior healthcare experience. We describe here the progression of the partnership between these institutions to carry out the project and the elements that helped build a stronger connection between the institutions, such as mutual goal setting, cultural bridging, collaborative teams, and capacity building. This example, which can be used as a model depicting new directionality and opportunities for LMIC-HIC academic partnerships, was written based on the review of shared project documents, including study protocols, and written and oral communications with the project team members, including the primary investigators. The innovation of this partnership includes: LMIC-initiated project need identification, LMIC-based funding allocation, a capacity-building role of the HIC institution, and the expansion of scope through jointly offered courses on global health. [ABSTRACT FROM AUTHOR]

Forty-five years ago, the first author of this paper surveyed the US medical schools to determine their offerings on EOL (End-of-Life) issues. The results showed limited exposure for medical school students to learn about dying and death, thus their "learning" was apparently on-the-job training. The EOL offerings were so limited that the American Association of Medical Colleges (AAMC), following the 1975 publication from the survey, contacted the first author to inquire about death and dying in the curricula of their medical schools. Apparently, it was so insignificant that the AAMC did not have such information. Palliative medicine, geriatric medicine, and hospice were then in the "birthing" process, a mere blur on the horizon. Today, as in 1975, it is likely that most medical students have personally had minimal experience with death and that for many entering students, other than on television, the cadaver is their first sight of a dead person. The objective of this research is a longitudinal study at five-year intervals since 1975 reporting on EOL education in US medical schools. The total number of medical schools has increased from 113 in 1975 to 150 in 2020. The current study surveyed medical schools electronically and via postal services with a response rate of 37%. Findings from the survey over time revealed significant inclusion of death and dying and palliative medicine as well as geriatrics and hospice. Gross anatomy has evolved from strictly hands-on to integrating 3D/virtual models, a change not without controversy. A noticeable difference in emphasis is obvious as care now plays a more significant role in medical training than previously, thus making modern medicine not only about cure, but more about care than was previously emphasized. Communication with dying patients and families, analgesics for chronic pain, and advance directives all are covered in over 90% of schools today. The current emphasis on EOL care, not just disease management, is increasing and puts more of a human face on modern medicine. [ABSTRACT FROM AUTHOR]

Dialogue on physician well-being was concerning even prior to onset of the COVID-19 pandemic, which introduced additional unprecedented strain on healthcare workers compounded by increased personal and family stress. This paper describes our process for a rapid needs assessment and creation of a pandemic resiliency and well-being support infrastructure for physicians and healthcare staff at an academic medical center. In March 2020, executive leadership from our health system and physician group created a Resiliency and Support Steering Committee (RSSC) for rapid development of a pandemic needs response for our healthcare providers. RSSC identified key priorities: psychological care, medical care, basic care, and communication. A brief pandemic-focused needs survey was designed and distributed to healthcare professionals and targeted efforts focused on initiatives prioritized by respondents. A shared drive database allowed initiatives and outcomes to be communicated in real time. A wellness webpage was rapidly built and disseminated. Psychological support initiatives included proactive and reactive support. Providers were offered rapid access scheduling for primary medical care. Vetted resources were shared for regional grab-and-go food, grocery delivery, laundry services, and childcare. Additional resources included personal protective equipment (PPE) supply chain information, PPE guideline updates and training and access to scrubs/scrub laundering. Our pandemic support will fold into ongoing wellness initiatives that will be tailored and intentionally communicated. Multimodal and intentional communication processes will continue with a focus on enhancing bidirectional platform functionality. Cultural awareness of the importance of mitigating distress and supporting well-being will be prioritized through partnership with frontline members and leadership. [ABSTRACT FROM AUTHOR]

The ability to be flexible and adapt quickly to changing circumstances is a crucial skill for librarians to develop in a world increasingly characterized by rapid change. It can take a crisis to learn how effective librarians have become in developing the needed adaptive behaviors, including a willingness to change workstyles, experiment with new technologies and readily move on from failed experiments. In this paper, librarians from the Preston Medical Library at the University of Tennessee Graduate School of Medicine, prompted by the crisis of COVID-19, present their response. Beginning with a description of how services were provided prior to the pandemic, librarians detail their response in several key areas and show how they implemented new approaches to teaching, collaboration, and mutual support, working together to handle patron issues and pursue scholarly activities. [ABSTRACT FROM AUTHOR]

This paper analyses the pedagogical pathways of a group of first-generation Iranian migrant doctors in the UK. It explores the complex system of class production and growing up as a classed subject in Iran, a process that ties young women’s educational aspirations to female independence on the one hand and to the modern feminine, heterosexual identity that sees women as part of the patriarchal family system on the other. By using Bourdieu’s concept of cultural capital and habitus [Bourdieu 1984.Distinction: A Social Critique of the Judgment of Taste. London: Routledge & Kegan Paul] and Foucault’s theory of surveillance [Foucault 1984. “The Means of Correct Training.” InThe Foucault Reader, edited by Paul Rabinow. London: Penguin Books, pp. 188-205], this paper analyses how migrant women’s trajectories of becoming highly educated are translated into their roles as mothers. Three major aspects of pedagogical trajectories are identified in the formation of classed selves: the first is the generational surveillance within families, particularly of girls by their mothers; the second is the normalisation of pathways and the importance of destined pathways that separate certain families, practices and choices in superior positions; the third is the moralising of educational choices, which distance being a doctor from classed consciousness, giving rise to an altruistic self as opposed to a selfish one. [ABSTRACT FROM AUTHOR]

Purpose:The construct validity, test–retest reliability, and measurement error of the Arm Function in Multiple Sclerosis Questionnaire (AMSQ) were examined. Additionally, the influence of administration-method on reliability and measurement error was investigated. Method:112 Dutch adult MS-patients from an academic- and a residential care-facility participated. Questionnaires were administered on paper, online or as interview, and patients performed several performance tests. Construct validity was assessed by testing pre-defined hypotheses. Reliability was assessed using Intraclass Correlation Coefficients (ICCs), Standard Error of Measurements (SEMs) and Smallest Detectable Changes (SDCs). Results:For construct validity (N = 105) 9 of 13 hypotheses were confirmed (69%). As expected, the AMSQ showed moderate to strong relationships with the instruments measuring similar constructs. The test–retest reliability coefficient was 0.96 (95% Confidence Interval 0.94–0.97); SEM was 6.3 (6.3% of scale range); SDC was 17.5 (on a sale from 0 to 100). Different administration-methods showed good reliability (ICC 0.88–0.94) and small standard errors (SEM 5.6–7.2). Conclusion:The AMSQ shows satisfying results for validity and excellent reliability; allowing for proper use in research. Due to a large SDC value, caution is needed when using the AMSQ in individual patient care. Further research should determine whether the SDC is smaller than the minimal important change.Implications for RehabilitationThe Arm Function in Multiple Sclerosis Questionnaire (AMSQ) measures activity limitations due to hand and arm functioning in patients with Multiple Sclerosis (MS).Results of this study confirm adequate validity and reliability of the AMSQ in patient with MS.The equivalence of scores from online, paper or interview administration is supported.A change score of ≥18 points on the scale of the AMSQ (on a scale 0–100) needs to occur to be certain a change beyond measurement error has occurred in an individual patient. [ABSTRACT FROM AUTHOR]

This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness. [ABSTRACT FROM AUTHOR]

This paper examines the emerging field of molecular oncology, in which targeted treatments are sought for patients who have exhausted standard cancer therapies. Drawing on an ethnographic study at a U.S. academic medical center, and building on recent theoretical work examining potentiality as a site where expectations, meaning and value are produced, I describe efforts to translate genetic information into extended life for patients. Clinicians, patients and families performed various types of largely-unrecognized labor that invested precision medicine with potential even when life-prolonging therapies remained elusive. Their future-making work was enabled and constrained by the structural conditions of U.S. health care. In this context potentiality was a generative force that was harnessed to the interests and inequities of a market-driven health system, raising important questions about who is able to participate in, contribute to, and benefit from emerging innovations and narratives of hope. [ABSTRACT FROM AUTHOR]

This paper investigates persistent elements of protracted phonological development (PPD) at ages 5;10 and 6;3 in a monolingual Greek girl's speech following earlier articulation intervention (3;6) and post-intervention assessment (4;3). The re-assessment data examined here, five months apart, were elicited using the Phonological Assessment for Greek (PAel). Results reveal interesting idiosyncratic patterns in the production of segmental sequences (VV, CC) in complex syllables and longer words, with a striking imbalance between singletons and sequences, which holds especially true for inconsistency in the acquisition of /ɾ/ across CV, CC, and C.C contexts. Phonological delay surfaces as chronological mismatches, idiosyncratic forms and, most notably, disparity between segmental and structural development. [ABSTRACT FROM AUTHOR]

Falling is one of the most common adverse events leading to patient injury. The purpose of this study (as part of a Ph.D. paper) was to investigate the effects of educational interventions on patients' self-efficacy and falls prevention knowledge. A sample of 176 participants were recruited at a university hospital in Iran. Each patient received an educational pamphlet on falls prevention. The questionnaire measured patient knowledge (scores ranged from 0 to 20) and falls prevention self-efficacy (scores ranged from 20 to 60) before and after the third day of the intervention. Overall, the mean knowledge score improved from 47.8% (9.57 ± 2.51) to 68.3 (13.68 ± 1.85), which was statistically significant (p < 0.001). For falls prevention self-efficacy, the pre-test mean was 41.0 ± 7.42 (range: 20–56; total: 60), but the post-test mean improved to 47.26 ± 9.12. 0.05. Our study suggests that the hospitalized patients have little knowledge of falls prevention and that educational interventions have improved their knowledge of falls prevention. Study participants were confident in implementing useful falls prophylaxis during hospitalization. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) degrees in Australian and British universities have come under attack from sceptics who argue that such courses teach only 'pseudoscience'. Moreover, CAM academics have themselves been publicly labelled 'quacks'. Comparatively little is known about this group of health professionals who span the two worlds of CAM practice and academia. How do they navigate between these domains, and how are their collective and individual professional identities constructed? Drawing on 47 semi-structured interviews, this paper explores the professional identities of academics working in three university-based CAM disciplines in Australia and the UK: osteopathy, chiropractic and Chinese medicine. By analysing these individuals' accounts, and building on prior research on health professions in the academy, the paper contributes to understanding how contests about professionalism and professional knowledge take place against the academic-practice divide. By focussing on a domain where knowledge claims are conspicuously contested, it highlights the salience of navigating 'epistemic stress' for both group and individual professional identity. [ABSTRACT FROM AUTHOR]

This paper analyzes patient-provider interaction (PPI). More precisely, it deals with the form-function relationship in questions used in counselor-patient interaction. The study is based on naturally occurring primary data collected at the Department of Pediatrics and the Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital (JNMCH), located in Aligarh Muslim University, India. The data are composed of audio-visual recordings of Hindi-Urdu interaction between 8 counselors and 27 patients. We identified compliance and condescension as the two unique functions the counselors seeks to accomplish and/or fulfill through the use of questions in their interaction with the patients. We also found four other functions – information seeking, recall, greeting, and diagnosis, which are sought by the counselors through their use of questions. The findings also suggest that these functions maintain and promote what can be termed as a counselor-centered interaction, and thus reflect asymmetrical power relationship between counselors and their patients. [ABSTRACT FROM AUTHOR]

Queuing networks (QNs) are widely used stochastic models for service systems include healthcare systems, transportation systems, and computer networks. While existing literature has extensively focused on modeling and optimizing resource allocation in QNs, very little research has been done on developing systematic statistical monitoring methods for QNs. This paper proposes cumulative sum (CUSUM) control charts that monitor the queuing information collected in real-time from the QN. We compare the proposed methods with existing statistical monitoring methods to demonstrate their ability to quickly detect a change in the service rate of one or more queues at the nodes in the QN. Simulation results show that the proposed CUSUM charts are more effective than existing statistical monitoring methods. The motivation for this research comes from the need to monitor the performance of a hospital emergency department (ED) with the goal of monitoring delays experienced by patients visiting the ED. A case study using the data from the ED of a large academic medical center shows that proposed methods are a promising tool for monitoring the timeliness of care provided to patients visiting the ED. [ABSTRACT FROM AUTHOR]

This paper presents findings of a study that explored the challenges and coping strategies of parents of children with mental disorders. In-depth interviews were conducted with 35 parents of children with mental disorders at the Psychiatric Unit of the Komfo Anokye Teaching Hospital in Kumasi. Data were analyzed using thematic content analysis. Findings indicated that financial constraints, inability to secure permanent employment, and stigma were the challenges of the parents. Having faith in God and accepting their children's condition were the coping strategies adopted by the parents. However, lack of effective support system makes coping difficult for the parents. [ABSTRACT FROM AUTHOR]

The role of technology in special education has increased over the last 20 years. Expedited by the introduction of Apple iPad and its implementation of touch-based input, the perception of technology has grown from a functional role for students with disabilities to a bridge in accessing general education curriculum. However, quality adoption of new technology within the classroom relies heavily on professional development of the special educator. This paper offers a discussion on the expansion of technology in special education, various attributes associated with quality educator training on technology, and the results of a five-year investigation on the formal training of special educators using iPad tablets. Results indicated longitudinal training focused on active learner experiences had a significant effect on the likelihood of special educator iPad tablet adoption and the resulting implementation in the classroom. Recommendations on educator professional training on iPad tablets follows results. [ABSTRACT FROM AUTHOR]

While Electronic Medical Records (EMRs) are an important mechanism used to document patient information and service provision, most interfaces prioritize collection of information required for medical billing purposes, rather than complexities of behavioral and social service needs. An emphasis on encounter data renders it challenging for social workers (SWs) to communicate statistically compelling explanations of contributions to team-based care and overall value to the health system. This paper reports outcomes of feasibility, acceptability, and appropriateness of integrating a validated psychosocial acuity metric into standardized social work (SW) documentation at a large, pediatric quaternary hospital in the northeastern United States. Approximately 20% (N = 42) of departmental SWs participated in an open pilot trial wherein participants were first trained in scale administration, utilized it for a circumscribed period following training, and evaluated implementation outcomes. Across five unique practice settings, results showed that the metric was feasible, acceptable and appropriate for use; 78% of participants were in favor of integrating it into the EMR interface as a required component of SW documentation. Assessing psychosocial acuity in every documented patient encounter facilitates intermittent review of psychosocial acuity at individual, setting, and programmatic levels and opportunities to evaluate how SW interventions address psychosocial acuity. [ABSTRACT FROM AUTHOR]

Feminist scholarship has considered how pedagogical identities and emotions are implicated in the gender politics of belonging and othering in higher education. This paper examines how gendered and embodied pedagogy is mobilised in Greek medical schools to construct notions of the ideal academic and assert women’s position women in Academic Medicine. I employ thematic analysis to illustrate that formations of pedagogy and academic professionalism are bound up with emotions and embodied practices of relating, connecting, creating learning communities and promoting virtuous academic citizenship. Women’s gendered accounts of pedagogy and their boundary practices of identification demonstrate agency, intentionality and operate as highly political actions of legitimacy and resistance within the patriarchal realm of Greek higher education. I argue that gendered discourses of pedagogy in Greek medical schools become resources for resisting neo-liberal notions of academic work, individualism and women’s exclusion in the highly prestigious discipline of academic medicine in Greece. [ABSTRACT FROM AUTHOR]

Whether being treated for COVID-19 related complications or otherwise, patients, families, and healthcare providers are all enduring various impacts of the COVID-19 pandemic. The inpatient Palliative Care Service at the University of California, Los Angeles, has observed prevailing themes of isolation, rapid decision making, and multifaceted distress during the COVID-19 pandemic. This paper discusses lessons learned and provides resources to mitigate these additional complexities to care being provided. [ABSTRACT FROM AUTHOR]

Given the role opioid overprescribing has played in the current overdose crisis, reducing the supply of prescription opioids available for misuse has gained widespread support. Prescription monitoring programs (PMPs) have been identified as a tool for achieving this goal, but little is known about how to promote PMP use to prescribers. This paper describes the process of developing a health communication campaign to support the adoption of the Texas PMP. After formative research, message development and concept testing, a range of campaign concepts and messages were tested and final recommendations determined. The messages and lessons learned have utility beyond Texas. [ABSTRACT FROM AUTHOR]

In this paper, we analyse how Italian-speaking children with cochlear implants produce subject and object questions introduced by who and which+NP. The aim of the study is to analyse whether a correlation exists between the accuracy of the responses of an elicitation task of wh-questions and clinical variables (i.e. age of hearing aid fitting; age of cochlear implantation; duration of hearing experience) in a group of children with cochlear implants, in order to provide new evidences in support of the efficacy of early intervention in Italian-speaking children with hearing loss. The experimental group was composed of 10 children fitted with a cochlear implant, who were diagnosed and promptly fitted with hearing aids within the first year of life. All these participants received a cochlear implant when hearing aids did not provide enough auditory input anymore. Indeed, while the hearing aids only amplify sounds, cochlear implants directly stimulate the auditory nerve providing better auditory perception. Results were compared with those of two control groups. The first group was composed of 10 children with normal hearing and comparable chronological age, while the second group was composed of 10 children with normal hearing matched on comparable hearing experience. Children were assessed with a test for the elicitation of subject and object who and which+NP questions. Results show that the two control groups performed better than the experimental group. Moreover, some correlations were found between the accuracy of the production of complex structures and the age of fitting of the hearing aids and the hearing experience. [ABSTRACT FROM AUTHOR]

The hold phase of the stop consonants is crucial for a successful production of the release and the acoustic burst. Concurrently, it is also associated with weak acoustic energy and minimal movement, so that conventional acoustic and kinematic approaches are not relevant to investigate motor control. This paper presents an innovative experimental method to study speech motor control during this phase, based on meticulous measurement of the time variation of the mechanical pressure exerted by the tongue against the palate and also characterizing tongue–palate interaction. The concept is based on using miniature transducers with enhanced response characteristics inserted in different locations of the complete denture of edentulous subjects without perturbing the articulation. The study was done with a French-speaking adult whose maxillary denture was duplicated and mounted with six strain gauge transducers. The experiment was done with denti-alveolar and velar stop consonants with two vowel contexts. The results illustrate the potential of such device to analyse speech motor control when contact constrains tongue movements. [ABSTRACT FROM AUTHOR]

Global demand for capacity building has increased interest for eLearning. As eLearning resources become more common, effective implementation is required to scale up utilization in Low- and Middle-Income Countries (LMICs). This paper describes the process of implementing a malnutrition eLearning course, effectiveness of course delivery models devised, factors affecting course completion, and cost comparison between the models and face-to-face training at healthcare and academic institutions in Ghana. Four delivery models: Mobile Training Centre (MTC), Online Delivery (OD), Institutional Computer Workstation (ICW) and Mixed Delivery (MD) – a combination of OD and ICW – were determined. Participants were enabled to access the course using one of the four models where contextually appropriate. Pre and post-assessments and questionnaires were administered to compare participants' course completion status and knowledge gain between delivery models. The effect of access to computer and Internet at home and relevance of course to job and academic progression on course completion were further investigated. Comparison of delivery model costs against face-to-face training was also undertaken. Of 7 academic and 9 healthcare institutions involving 915 people, 9 used MTC (34.8%), 3 OD (18.8%), 3 ICW (34.2%) and 1 MD (12.2%). Course completion was higher among institutions where the course was relevant to job or implemented as part of required curriculum activities. Knowledge gain was significant among most participants, but higher among those who found the course relevant to job or academic progression. The implementation costs per participant for training with MTC were £51.0, OD £2.2, ICW £1.2 and MD £1.1, compared with a face-to-face training estimate of £105.0 (1 GHS = 0.14 GBP). The malnutrition eLearning course makes global capacity building in malnutrition management achievable. Adopting contextually appropriate delivery models and ensuring training is relevant to job/academic progression can enhance eLearning effectiveness in LMICs. [ABSTRACT FROM AUTHOR]

Objectives. This study aims to compare the work stress and obsessive-compulsive symptoms of nurses and office workers and to determine the relationship between work stress and obsessive-compulsive symptoms. Methods. A total of 127 nurses and 127 office workers participated in the cross-sectional study and comparative study. Data were collected using the perceived work stress scale and the Maudsley obsessive-compulsive inventory. Results. Nurses had higher work stress scores (p = 0.003) in general than office workers. In particular, nurses with a low (p < 0.039) and average (p < 0.007) economic status, nurses who had been employed for 1–10 years (p < 0.001) and nurses working 40 h per week (p < 0.042) had higher work stress scores than office workers. There was no difference (p > 0.05) between obsessive-compulsive symptom scores. There was a positive significant relationship (p < 0.001) between work stress and obsessive-compulsive symptom scores of nurses and office workers. Work stress explains 6.1% of the obsessive-compulsive symptoms in nurses and 12.4% in office workers. Conclusion. The results of this study concluded that work stress of nurses is higher than that of office workers and work stress affects the obsessive-compulsive symptoms in both groups. [ABSTRACT FROM AUTHOR]

Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians use them and if OTAs themselves modify clinician prescribing practices. To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. Our analysis identified three main themes: (1) OTAs did not influence clinicians' decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians' decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs' purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. [ABSTRACT FROM AUTHOR]

Trainees may be interested in careers in aging but unfamiliar with career options, leading to a shortage in the geriatric workforce. In response to needs identified at a national geropsychology training conference, a multisite faculty group developed a six-session webinar series about careers in geropsychology, detailing career options in six unique settings. Each webinar session featured a moderated discussion with a panel of four professionals currently employed in the career of interest. The webinar was advertised to clinical and counseling psychology trainees with a potential interest in age-related careers, with evaluation of the series primarily including trainees from graduate programs, clinical internships, and postdoctoral fellowships. Participants rated their attitudes and beliefs about each career option at pre- and post-discussion. On average, each webinar session was attended by 48 individuals (SD = 12, range = 33–60). At baseline, attendees reported significantly more interest in careers in clinical practice compared to other careers, and interest in university settings increased from pre- to post-discussion. Across all six sessions, participants reported increased understanding of training experiences that would be helpful in pursuing that specific career. Findings point to the feasibility and utility of webinars for enhancing interest and confidence in pursuing careers in aging. [ABSTRACT FROM AUTHOR]

Non-communicable diseases (NCDs) are a global health burden that affects a broad scope of individuals worldwide. Pharmacists, as members of the multidisciplinary team, play a significant role in promoting public awareness towards potential risk factors for NCDs. This study aims to gauge the knowledge of NCDs risk factors among pharmacy students of a Malaysian public university. This paper also outlines perspectives of pharmacy students on the strategies to raise the awareness of NCDs risk factors. A descriptive cross-sectional study was conducted in the Faculty of Pharmacy, International Islamic University Malaysia. Self-administered questionnaires were pretested and validated before being distributed to pharmacy students across different years of study. The data indicated an average level of knowledge towards risk factors of NCDs among study participants with no significant differences in knowledge between male and female genders (p = 0.583). However, there is a significant difference in knowledge concerning the year of study (p < 0.001); as positive correlation can be seen between the level of education and the knowledge of NCDs risk factor. Most of the students (75%) were unaware of the planning by the Ministry of Health (MOH) to control NCDs. Reinforcement of NCDs-related education activities is imperative in order to increase the overall awareness concerning the risk factors of NCDs among future pharmacy practitioners. Further collaborations between educational institutions and the MOH were proposed to help raise awareness of NCDs risk factors among the younger population. [ABSTRACT FROM AUTHOR]

Undergraduate medical education has expanded substantially in recent years, through both establishing new programs and increasing student numbers in existing programs. This expansion has placed pressure on the capacity for training students in clinical placements, raising concerns about the risk of dilution of experience, and reducing work readiness. The concerns have been greatest in more traditional environments, where clinical placements in large academic medical centers are often the "gold standard". However, there are ways of exposing medical students to patient interactions and clinical supervisors in many other contexts. In this paper, we share our experiences and observations of expanding clinical placements for both existing and new medical programs in several international locations. While this is not necessarily an easy task, a wide range of opportunities can be accessed by asking the right questions of the right people, often with only relatively modest changes in resource allocation. [ABSTRACT FROM AUTHOR]

The article reports that hospital librarians are advised to provide new services to regular customers and hospital employees. It mentions that care providers seek degrees or certifications through distance programs. It mentions that the basic requirements for proctoring is a quiet place with a table for paper and increased human presence.

Background: Hookah tobacco use is an emerging public health problem. Purpose: The purpose of the present study is to examine recent hookah tobacco use among college students and potential correlates including other drugs and drug education. Methods: The paper version of the National College Health Assessment II was completed by 765 students enrolled at one urban university. Results: Findings indicated that 14.2% of students used hookah in the past 30 days. Significant differences were found based on recent alcohol, recent cigarette use, recent cigar use, recent smokeless tobacco use, and recent marijuana use. Students who received tobacco education were at increased odds for hookah use (χ2 = 5.592, df = 1, P =.018). The final regression model predicted recent hookah use (omnibus χ2 = 129.779, df = 6, P <.001) and accounted for 15.6% to 28.0% of the variance in recent hookah use. Discussion: Students using hookah were found to use other type of substances, which may warrant attention on college campuses. Translation to Health Education Practice: Study findings indicate that tobacco education programs may not adequately address hookah use. Health Education professionals may need to implement specific lessons on hookah as part of tobacco education programs. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars [ABSTRACT FROM AUTHOR]

The article presents the discussion on research on the professional and para-professional employee roles and qualifications of the Australian health library and information services workforce. Topics include discussing the role of library and information services staff not having library and information science (LIS) qualifications; and research identifying and describing complementary qualifications of Australian health library staff.

This paper reports on an action research study conducted in 2015 with five in-service English language teachers from an ELT undergraduate programme of a university in the central part of Mexico over a period of 9 weeks by means of two video recorded classroom observations and different spaces for professional dialogue (a focus group, one on one feedback discussions and personal interviews). Overall, the study revealed that teachers have the ability to be critically reflective about their teaching given the appropriate conditions which Reflective Practice (RP) necessitates such as opportunity, time, and assistance from others, often lacking in everyday teaching scenarios, traditional evaluative classroom observations and conventional teacher education programmes. Hence, by challenging the 'status quo' of classroom observations in this context, the RP processes carried out helped teachers understand and reconstruct their teaching knowledge especially in terms of students' responses to their instructional decisions and the impact this had on how their classes unfolded. It promoted an alternative way to fulfil the goal of teacher development, not through a 'transmission' model of education but through a process in which teachers learn and continue to develop their skill in dialogue within a professional community. [ABSTRACT FROM AUTHOR]

Purpose: In this paper, we present the major curricular reform in MD program of Tehran University of Medical Sciences, the oldest and the largest medical university in Iran, initiated about a decade ago. Materials and methods: Following a comprehensive program evaluation, many of the basic challenges of the traditional curriculum were revealed, namely, lack of pre-defined competencies for graduates, over-reliance on teacher-centered teaching methods, over-emphasis on knowledge base in student assessments, and focusing solely on biomedical aspects of patient care. In 2010, a vision statement for reform was created and approved by the University Council. The new curriculum was launched in 2011. Results: The changes included: revising the content of the courses, assimilating horizontal and vertical integration, emphasizing clinical skills, encouraging active involvement in patient management, providing more opportunity for supervised practice, integrating behavioral and psychosocial topics into the curriculum, incorporating interactive teaching methods, assessing students’ higher levels of cognition, and strengthening workplace assessments. To evaluate the changes, data were continuously collected and analyzed from the beginning. Conclusions: Changing the curriculum of an MD program is a laborious task which should be planned and undertaken carefully and cautiously. It is an endless, yet invaluable and satisfying endeavor toward better future. [ABSTRACT FROM AUTHOR]