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There is an urgent need to develop an international competency and capability framework to support standardization of education and roles in advanced practice physiotherapy (APP). This need arose due to the rapid growth of the APP model of care, implemented out of necessity in the absence of agreement as to the competencies and capabilities or formal education required for the roles. This study explores the views and perceptions of practitioners and key stakeholders on a draft competency and capability framework for advanced practice physiotherapists. The purpose of this study was to: 1) gather feedback from key stakeholders (advanced practice physiotherapists, researchers, and leaders) on a draft competency and capability framework and 2) use that feedback to revise and improve the draft framework. Qualitative study using a series of four multi-national online focus groups. Thematic analysis was conducted according to Braun and Clarke. Sixteen participants from the United Kingdom, Ireland, Canada, Australia, and New Zealand participated in the study. Five themes were generated after data analysis: clinical expert, experienced communicator, strong leader, collaborator, and knowledge creator). A modified competency and capability framework was developed based on feedback from the focus groups and input from subject matter experts (SMEs). This study provides a modified core competency and capability framework comprising 24 competencies grouped under six domains. This study is a step toward international standardization of advanced practice physiotherapy based on a commonly agreed framework for the education and training of advanced practice physiotherapists. [ABSTRACT FROM AUTHOR]

The dramatic growth in health expenditures is an important health policy concern worldwide. Therefore, understanding the factors that increase health expenditures provides policy makers with evidence for decision-making. We aim to examine long-term effects of carbon dioxide emission, urbanization rate and GDP per capita on health expenditures. This study investigates the effect of carbon dioxide emission, urban population, and GDP per capita on health expenditure for 21 OECD countries over the period 1992–2018. Panel ARDL Approach and Gengenbach, Urbain and Westerlund Panel Co-integration Test have been used in the article. Test results indicate the long-run relationship among health expenditure and carbon dioxide emission, urban population, and GDP per capita. Effect of carbon dioxide emission (CO2), urban population, and GDP per capita is significant and positive on health expenditure. Rapid economic growths of OECD countries recently and environmental pollution have increased health expenditures in the long term. [ABSTRACT FROM AUTHOR]

Homelessness is growing internationally, and resources to guide occupational therapy practice in this area are needed. To identify competencies needed for occupational therapists to support individuals during and following homelessness. We conducted a three-round Delphi study with occupational therapy practitioners and researchers with expertise in homelessness. Of 35 potential participants, n = 16 participated in Round I, n = 20 participated in Round II, and n = 18 participated in Round III. Participants included occupational therapists and researchers in Canada, United States, Brazil, UK, Ireland and New Zealand. Consensus was achieved on a total of 93 competencies in 10 categories after 15 were eliminated in Rounds II and III. The categories with the greatest number of competencies included occupational knowledge (n = 18), followed by psychosocial competencies (n = 16). This study represents the first to identify the competencies needed for occupational therapists working in the area of homelessness. Practitioners and educators are encouraged to view the identified competencies as a guide for the professional development of occupational therapists in this context. Stakeholders consulted for this study were able to communicate in English and situated in middle to high-income countries. As such, the competencies identified in this study only apply to these sociocultural contexts. [ABSTRACT FROM AUTHOR]

Objectives: To document medical educators' experience and initiatives in training international medical graduates (IMGs) to become general practitioners (GP). Design: Qualitative social-constructivist emergent design with descriptive and interpretive analyses. Setting: GP vocational training in Australia, Canada, Ireland, New Zealand, the Netherlands, and UK. Participants: Twenty-eight leaders of GP training. Intervention: Data collected from public documents, published literature and 27 semi-structured interviews. Main outcome measures: Tensions in training and innovations in response to these tensions. Results: Medical educators identified tension in teaching IMGs as it could be different to teaching domestic graduates in any or all aspects of a training program. They felt an ethical responsibility to support IMGs to provide quality health care in their adopted country but faced multiple challenges to achieve this. They described initiatives to address these throughout GP training. Conclusions: IMG's differing educational needs will benefit from flexible individualized adaptation of training programs. [ABSTRACT FROM AUTHOR]

Background: Aphasia services are currently faced by increasing evidence for therapy of greater intensity and comprehensiveness. Intensive Comprehensive Aphasia Programs (ICAPs) combine these elements in an evidence-based, time-limited group program. The incorporation of new service delivery models in routine clinical practice is, however, likely to pose challenges for both the service provider and administering clinicians. This program of research aims to identify these challenges from the perspective of aphasia clinicians from six countries and will seek to trial potential solutions. Continual advancements in global communication technologies suggest that solutions will be easily shared and accessed across multiple countries. Aims: To identify the perceived and experienced barriers and facilitators to the implementation of 1) intensive aphasia services, 2) comprehensive aphasia services, and 3) ICAPs, from aphasia clinicians across six countries. Methods and procedures: A qualitative enquiry approach included data from six focus groups (n = 34 participants) in Australia, New Zealand, Canada, United States of America (USA), United Kingdom (UK), and Ireland. A thematic analysis of focus group data was informed by the Theoretical Domains Framework (TDF). Outcomes and results: Five prominent theoretical domains from the TDF influenced the implementation of all three aphasia service types across participating countries: environmental context and resources, beliefs about consequences, social/professional role and identity, skills, and knowledge. Four overarching themes assisted the identification and explanation of the key barriers and facilitators: 1. Collaboration, joint initiatives and partnerships, 2. Advocacy, the promotion of aphasia services and evidence-based practice, 3. Innovation, the ability to problem solve challenges, and 4. Culture, the influence of underlying values. Conclusions: The results of this study will inform the development of a theoretically informed intervention to improve health services' adherence to aphasia best practice recommendations. [ABSTRACT FROM AUTHOR]

The Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP) is an online database of mental health and substance- abuse interventions that have undergone an independent review process to rate their quality of research and readiness for dissemination. Originally conceived as a U.S.-based national registry, NREPP has effectively become an international resource on evidence-based programs and practices, containing information on interventions from around the world and drawing an international audience. The objectives of this descriptive study were to determine how many interventions in the registry (1) have been implemented outside the United States, (2) have materials translated into one or more languages, (3) have received funding from a non-U.S. source, and (4) have been evaluated in studies conducted outside the United States. The growing interest in other countries for tools to assist in the identification and implementation of evidence-based programs suggests that NREPP will become increasingly relevant and useful to international mental health constituencies. [ABSTRACT FROM AUTHOR]

Studies of the Irish in New Zealand tend to focus predominantly on sectarian issues and respective ‘identities’. While class is explored to a lesser extent, it is mainly through the lens of occupational status. Overall, migrant poverty and criminality in that colonial setting has received the least attention from historians, because the socio-economic profile of the majority of Irish immigrants was generally of a higher status. This article traces a group of poor assisted immigrants that departed Cork at very short notice in 1874 and examines how some of them achieved notoriety in New Zealand. Using a combination of poor law records, shipping records, newspapers, government reports and criminal statistics, this article traces the fortunes of the single Irish workhouse girls. Irish Poor Law registers can be notoriously tricky to negotiate and present many problems for historians. Periodically Poor Law Guardians invested in assisted immigration schemes and to that end they surrendered groups of migrants. In so doing, the guardians bound individuals by a range of similarities—marital status, social class, fiscal means, age, abilities and gender to mention but a few—and such groups lend themselves to case-study analysis. As prophesised by those who argued against its foundation, the poor law network in Ireland both created and exacerbated many social problems. In many respects, when over-crowding occurred, it offered little by way of training and thus created a stasis for poverty. Building on recent case studies of ‘wild workhouse girls’ undertaken by Anna Clark on the South Dublin Union and Virginia Crossman on a Wexford Union, this research explores the concept of ‘modulation’ used by Patrick Fitzgerald and Brian Lambkin in the context of migration, whereby migrants were at the mercy of the host community to decide whether they can be accepted or rejected.1 This article traces and links the ‘institutionalised’ behavioural patterns of these poor, unskilled, single, young women with indefinite periods of ‘modulation’ in a negotiated space between rejection, vice, incarceration and an existence on the ‘outside’. [ABSTRACT FROM PUBLISHER]

This essay uses the concepts of 'distance' and 'proximity' to investigate and assess perceptions of community, nation and empire in inter-war New Zealand and Ulster (as well as Ireland and Northern Ireland) within a British imperial context, and explores the extent to which service of the empire (for example in the First World War) promoted both notions of imperial unity and local autonomy. It focuses on how these perceptions were articulated in the inter-war years during visits to Northern Ireland by three New Zealand premiers - Massey, Forbes and Coates - and to New Zealand by the Prime Minister of Northern Ireland, Lord Craigavon. It discusses the significant ways in which distance from their 'home base' and proximity to expatriate communities (in Craigavon's case) and Irish unionists and nationalists (in the case of the New Zealand premiers) inflected public statements during their visits. By examining these inter-war visits and investigating the rhetoric used and the cultural demonstrations associated with them, the factors of both distance and proximity can be used to evaluate similarities and difference across two parts of the empire. Thus, we can throw some light on the nature and dynamics of British imperial identity in the early twentieth century. [ABSTRACT FROM AUTHOR]