Search

The occupational therapy doctorate degree requires a capstone experience and project to be completed within a specific occupational therapy (OT)-related setting. The doctoral capstone experience and project can be difficult to complete in the highly specialized Neonatal Intensive Care Unit (NICU). This paper provides a sample outline of the doctoral capstone experience and project in the NICU. The NANT Core Competencies, written by the National Association of Neonatal Therapists Professional Collaborative, were utilized as a guideline to track student progress and ensure understanding of neonatal therapy topics. This paper follows one student's doctoral capstone experience and project in the NICU while mentored by an occupational therapist. Learning objectives related to utilizing the NANT Core Competencies, gaining clinical skills, and participating in program development were created. The site mentor trained, supported, and educated the student in the NICU while monitoring her progress during the fourteen weeks. Overall, the student successfully completed all objectives. This paper provides an example of the doctoral capstone experience and project in the NICU utilizing the NANT Core Competencies to support the mentor-student relationship and student learning with educational topics provided in the competencies guiding the capstone experience. With details including student progress, weekly mentor-student meetings, and roles/responsibilities of the student and mentor, this paper serves as a resource and guideline for OT faculty as well as potential mentors of occupational therapy doctorate students in the NICU setting. Additionally, this paper highlights the feasibility of the completion of the OT doctoral capstone in the NICU.

Early mobility in the Intensive Care Unit (ICU) can improve a multitude of patient outcomes, and occupational therapists (OTs) play a valuable role as part of the interprofessional team, with the ability to address activities of daily living, functional cognition, psychological and communication needs, and more. In 2022, the first iteration of an ICU interprofessional education simulation (Sim-IPE) yielded poor outcomes for OT students. This study aimed to modify existing pre-learning activities in the Sim-IPE's second iteration to improve OT students' perceptions and professional role awareness in interprofessional ICU care. Students from Doctor of OT, Bachelor of Science Nursing, Doctor of Physical Therapy (PT), and Associate Program Respiratory Therapy programs from one university participated in an ICU Early Mobility Sim-IPE with enhanced pre-learning activities and environmental modifications targeting OT student outcomes. Investigators employed a mixed methods approach, including pre/post quantitative analysis through the SPICE-R2 instrument and qualitative analysis of OT students' written reflections. Quantitatively, OT students (n = 12) demonstrated significant improvement in SPICE-R2 scores from pre- to post-Sim-IPE, as well as significant improvements when compared to OT student scores from the first iteration. Qualitatively, OT students reflected improved role awareness when compared to OT students from the first Sim-IPE, however, continue to struggle with role assertion and ambiguity, particularly with PT students. This study improved the OT students' Sim-IPE experience; specifically, role awareness and perceptions of interprofessional practice. Residual challenges in role assertion and ambiguity offer opportunities for future intervention and research.

Student translators at the College of Language Sciences take a Media and Political Translation course in which they translate the latest news stories, media and political texts and terminology. This study proposes a model for integrating Gaza-Israeli war terminology and texts in translation instruction to familiarize the students with terminology such as names of weapons (grenades, mortar, drones, missiles, Merkava, Cornet anti-armor, mortar shells), toponyms(Khan Younis, Maghazi, Sderot, Ashkelon), crossings (Rafah, Erez), Jihadist groups and brigades (Islamic Jihad, Golani), military actions (incursion, bombing, shelling, genocide, displacement) war metaphors (target bank, carpet bombing, scorched earth, fire belt, Philadelphia Axis, Hannibal's plan), (UNRWA, Gaza hospitals, starvation, humanitarian aid) and others. English and Arabic texts can be collected from mainstream media as RT, BBC, CNN, Al-Jazeera and Al-Ghad. A class blog can be created for posting translations, corrections, discussions, and feedback. The students can practice full, summary, and conceptual translation and avoid word-for-word translation. They can watch news stories about the Gaza-Israel war, write a summary translation of it and receive comments and feedback. Beginners can translate short news excerpts (few lines). Students make sure their translations are cohesive, make sense and are easy to read. Students should use Google Translate and artificial intelligence (AI) with caution and should read the same news story in both English and Arabic to get used to the terminology and their equivalents. The instructor serves as a facilitator. Further instructional guidelines and recommendations are given.

Limited research on diabetes education and support implementation in Appalachia, which is a critical knowledge gap considering barriers to care, and high prevalence rates. The aim was to understand what each facility is providing regarding diabetes education and services within West Virginia. This study reports cognitive interview qualitative findings from a multi-methods study. Individuals were recruited through an online search to identify clinics, organizations, and hospital staff that provided diabetes education in the state of West Virginia. Eligible participants were individuals who facilitated and managed diabetes education and support in counties of West Virginia. The interviews followed an 11-item interview guide, approved, and reviewed by a practicing Registered Dietitian and Certified Diabetes Care Education Specialist in West Virginia. All qualitative data from the interviews were hand-coded using grounded theory, by two researchers. 15 participating organizations from the state of West Virginia were included and described three phenomena: Diabetes Education Implementation (differences in: evaluation measures, modality, delivery format, topical areas); Barriers to Care (staffing, lack of training, evaluation, loss of research partnerships and funding); and Facilitators to Care (community-based involvement, interdisciplinary collaboration, capacity building (trainings). There are concerns with program drift and "risky" adaptations such as inconsistent evaluative measures, lack of training for program facilitators, variety of delivery formats, and content material. Findings recommend more alignment in program delivery to better implementation. Further studies should assess patient experiences with implemented diabetes education programs in West Virginia to further support the current research findings.

Children with developmental disabilities lack sufficient physical activity in their daily lives. The purpose of this study was to see if children with developmental disabilities who participated in stair-climbing exercises had better physical performance and health status than children with developmental disabilities who did not. This study adopted a pre-and-post-test experimental design, enrolling 30 subjects (experimental group, 15; control group, 15) with developmental disabilities aged 5-7 years from pediatric rehabilitation treatment departments of two regional teaching hospitals in Taiwan. The experimental group received stair-climbing exercises and physical therapy twice a week for eight consecutive weeks. The primary outcomes were health-related physical fitness assessment items, including body composition (body mass index: BMI), cardiorespiratory fitness (stair-climbing test), muscular fitness (knee-bend sit-ups), and flexibility (Chair Sit and Reach Test). The post-test measurements of BMI, cardiorespiratory fitness, sit-ups, and muscular flexibility of children in the experimental group were significantly better than the pre-test measurements. The stair-climbing exercise training results for cardiorespiratory fitness, muscular fitness, and muscular flexibility in the experimental group were significantly better than those in the control group. Stair-climbing exercise improves the physical fitness of children with developmental disabilities. The results of this study suggest that children with developmental disabilities should be encouraged to engage in this convenient and easy stair-climbing exercise to improve physical performance and health status.

Background: Competent clinical reasoning forms the foundation for effective and efficient clinical swallowing examination (CSE) and consequent dysphagia management decisions. While the nature of initial CSEs has been evaluated, it remains unclear how new information gathered by speech-language therapists (SLTs) throughout a patient's acute-care journey is integrated into their initial clinical reasoning and management processes and used to review and revise initial management recommendations. Aims: To understand how SLTs' clinical reasoning and decision-making regarding dysphagia assessment and management evolve as patients transition through acute hospital care from referral to discharge. Methods & Procedures: A longitudinal, qualitative approach was employed to gather information from two SLTs who managed six patients at a metropolitan acute-care hospital. A retrospective 'think-aloud' protocol was utilized to prompt SLTs regarding their clinical reasoning and decision-making processes during initial and subsequent CSEs and patient interactions. Three types of concept maps were created based on these interviews: a descriptive concept map, a reasoning map and a hypothesis map. All concept maps were evaluated regarding their overall structure, facts gathered, types of reasoning engaged in (inductive versus deductive), types of hypotheses generated, and the diagnosis and management recommendations made following initial CSE and during subsequent dysphagia management. Outcomes & Results: Initial CSEs involved a rich process of fact-gathering, that was predominantly led by inductive reasoning (hypothesis generation) and some application of deductive reasoning (hypothesis testing), with the primary aims of determining the presence of dysphagia and identifying the safest diet and fluid recommendations. During follow-up assessments, SLTs engaged in increasingly more deductive testing of initial hypotheses, including fact-gathering aimed at determining the tolerance of current diet and fluid recommendations or the suitability for diet and/or fluid upgrade and less inductive reasoning. Consistent with this aim, SLTs' hypotheses were focused primarily on airway protection and medical status during the follow-up phase. Overall, both initial and follow-up swallowing assessments were targeted primarily at identifying suitable management recommendations, and less so on identifying and formulating diagnoses. None of the patients presented with adverse respiratory and/or swallowing outcomes during admission and following discharge from speech pathology. Conclusions & Implications: Swallowing assessment and management across the acute-care journey was observed as a high-quality, patient-centred process characterized by iterative cycles of inductive and deductive reasoning. This approach appears to maximize efficiency without compromising the quality of care. The outcomes of this research encourage further investigation and translation to tertiary and post-professional education contexts as a clear understanding of the processes involved in reaching diagnoses and management recommendations can inform career-long refinement of clinical skills.

Background: Healthcare professionals (HCPs) have a responsibility to conduct assessments of decision-making capacity that comply with the Mental Capacity Act 2005 (MCA). Current best-practice guidance, such as the Mental Capacity Code of Practice and National Institute for Health and Care Excellence decision-making and mental capacity guidance, does not stipulate how to accomplish this in practice, for example, what questions should be asked, how options and information should be provided. In addition, HCPs struggle to assess the capacity of individuals with communication difficulties. Aims: This study was a service evaluation that aimed to objectively analyse, using Conversation Analysis (CA), how real-life capacity assessments were conducted in a hospital setting with patients with acquired brain injury (ABI)-related communication difficulties. A second aim was to establish the feasibility of using CA to advance knowledge of the conduct of capacity assessment. Methods & Procedures: Four naturally occurring capacity assessments were video-recorded. Recordings involved speech and language therapists, occupational therapists, neuropsychologists and patients with communication difficulties as a result of ABI. The methods and findings of CA were used to investigate the interactional behaviours of HCPs and patients during assessments of decision-making capacity. The analysis was informed by our knowledge of the MCA best practice guidance. Outcomes & Results: An overall structure of capacity assessment that enacted some of the best-practice MCA guidance was identified in one recording, consisting of six phases: (i) opening, (ii) preparation, (iii) option-listing, (iv) test, (v) decision, and (vi) close. The preparation phase consisted of two sub-components: information gathering and information giving. Variation from this structure was observed across the dataset, notably in the way in which options were (or were not) presented. Conclusions & Implications: CA is a feasible empirical method for exploring the structure and conduct of capacity assessments. CA identifies and provides ways of describing interactional behaviours that align with and diverge from best-practice MCA guidance. Future CA studies including a wider range of health and social care professionals and patients have the potential to inform evidence based training for HCPs who conduct assessments of decision-making capacity.

Children with chronic illnesses present unique health, psychosocial, and learning challenges. Due to the complexities surrounding their needs, these children and their families often encounter multilayered barriers when accessing educational services and health care management. Medical-family-school interprofessional interagency collaborations (IIC) are needed to facilitate information sharing across institutions, treatment alignment among care partners, and equitable and high-quality school-based service delivery. This article presents a novel hospital-based school consultative liaison service, the Educational Achievement Partnership Program (EAPP), which conducts IIC with the families, schools, hospitals, and community care partners of children with chronic illnesses. We explore disproportionalities in IIC services among low-income and racially/ethnically minoritized children and examine ways to increase IIC service access and utilization. Results demonstrate that systematic changes targeting in-person communication with families significantly increased minoritized and low-income children's EAPP participation. Despite this increase, differences occurred between minoritized and White children's utilization through all stages of EAPP service delivery. These results underscore the importance of ongoing IIC service evaluation to examine the effectiveness of implementation components. We discuss implications and highlight opportunities for similar medical-family-school IIC under a school psychologist-led medical liaison consultative approach. We conclude that IIC is best fostered through innovations in communication models, graduate training, practice, and research.

Autism spectrum disorder (ASD) is a neuropsychiatric condition that may be associated with negative health outcomes. This retrospective cohort study reveals the odds of hospitalization and mortality based on ASD for a population of insured patients with COVID-19. The odds of hospitalization and mortality for people with ASD were found to be greater than individuals without ASD when adjusted for sociodemographic characteristics. Hospitalization and mortality was associated with a dose-response increase to comorbidity counts (1 to 5+). Odds of mortality remained greater for those with ASD when adjusting for comorbid health conditions. ASD is a risk factor for COVID-19 mortality. Comorbid health conditions play a particular role in increasing the odds of COVID-19 related hospitalization and death for ASD patients.

Background: This study investigated differences in the clinical and demographic characteristics of individuals with intellectual disabilities delayed in assessment and treatment hospitals versus individuals who were not delayed. The study further investigated the clinical outcomes of the individuals whose discharge from the hospital was delayed. Method: This was a cohort study using secondary data collected from patient records. Variables included age, ethnicity, levels of deprivation, areas of origin, diagnoses, and the provision of a care and treatment review. A comparison was made between individuals who became delayed despite being clinically ready for discharge and those who were discharged on time. Findings: Individuals with severe intellectual disabilities were more likely to experience delayed discharge from hospital (p = 0.001). Similarly, people who were admitted to hospitals away from their home areas were also more likely to experience delayed discharge (p < 0.001). There were no significant differences between the delayed and nondelayed groups for other factors such as age, deprivation or ethnicity. Individuals who experienced a delay in discharge did not experience an increased rate of adverse incidents compared to the period of active treatment and clinical improvements were maintained during the period of delay. There were low rates of completion of care and treatment reviews before admission, although people who were delayed were more likely to have received a review during admission (78.8% vs. 27.1%). Conclusion: It is important for clinicians and service development leads to be aware that people who are admitted away from their home area and people with severe intellectual disabilities may be at higher risk of experiencing significantly delayed discharge from the hospital. More broadly, many people remained in hospital for a substantial length of time after being assessed as clinically ready for discharge. Due to the low rates of completion before admission, the expansion of community-based care and treatment reviews should also be explored. While people did not suffer increased rates of adverse incidents during their extended stay, their liberty was still restricted, hence there should be a focus on effective community provision. The current model of relying on the willingness of independent providers to support the care of complex individuals requires significant reform.

Children with cancer experience recurring hospitalizations and isolation during treatment, which affect their school attendance. This study explores experiences of children with cancer, their classmates, and teachers with using the telepresence robot as a learning mediator in the hybrid classroom during treatment periods. 31 children with cancer (aged 7-17 years), 30 teachers, and 118 classmates participated in interviews and 19 h of participant observations were undertaken in nine classrooms. The Agential Realism Theory and Situational Analysis framed the data analysis. There was a single overarching theme, "Telepresence robot didactic," and five sub-themes (Telepresence mediated learning, school-home collaboration, hybrid robot teaching, intra-actions in class, and inclusive spatiality). This study advocates the complexity of telepresence robot didactics, emphasizing that numerous human and other factors must intra-act and work simultaneously to achieve optimal learning conditions for children during cancer treatment. This includes considerations such as modality availability for the remote child; the teacher's understanding of telepresence robot didactic and hybrid learning; the classmate's ability to involve the remote child in groupwork; the child's own treatment protocol, the robot's functionalities, and spatiality in the class. Strategies for use and the systematic surveillance of telepresence robots are needed to ensure that children during cancer treatment do not lag in academic achievement. This study proposes that children with cancer can continue participating in class while hospitalized or isolated and consequently reduce social and academic setbacks.

Objective: This research was conducted to determine the relationships between psychological well-being, social support, and work-life balance and the mediating effect of psychological well-being on the relationship between social support and work-life balance. Methods: Data were collected from a convenience sample of 277 participants. Data analysis was done with regression and the Pearson correlation coefficient. Regression-based mediation analysis developed by Hayes (2013) was used to examine the mediation effect of psychological wellbeing. Results: Work-life balance is negatively related to social support (r=-0.51) and, positively related to psychological well-being (r=0.50). As a result of the mediation analysis based on regression to determine the mediating effects, it was concluded that psychological well-being had a mediating effect on the relationship between social support and work-life balance. The bootstrapp (10000) method was used to determine whether the mediation analysis was significant. Conclusions: These findings suggest that the inverse relationship between social support and work-life balance is at least partly explained by the level of psychological well-being.

This study examined hospitalizations in a large, all-payer, nationally representative sample of inpatient hospitalizations in the US and identified differences in rates of hospitalization for conditions by race and ethnicity in autistic adults. Conditions examined included mood disorders, epilepsy, schizophrenia, and ambulatory care sensitive conditions (ACSCs). Compared to white, non-Hispanic autistic adults, Black, Hispanic, Asian or Pacific Islander (API), and autistic adults of another race had lower prevalence of admission for a principal diagnosis of a mood disorder. Conversely, Black, Hispanic, API, and autistic adults of another race had higher odds of admission for epilepsy than white autistic adults. Black and Hispanic autistic adults were more likely to have schizophrenia as a principal diagnosis compared to white autistic adults, but only Black autistic adults had increased odds for admission for an ACSCs compared to white autistic adults. Differences in diagnosis prevalence among hospitalized autistic adults may suggest differential access to comprehensive outpatient care that could prevent such hospitalizations, while also pointing to concerns of differential validity of diagnostic tools and treatment approaches. Insurance policy and programs should prioritize optimizing outpatient care to ensure access to care and emphasize the need for equitable treatment.

Early childbearing is associated with high maternal stress and family violence. However, the long-term effects of rapid repeat pregnancy (RRP) in young motherhood on child outcomes remain largely unknown. This study examined the pathways between maternal RRP at young ages and child psychosocial problems and emergency room visits in later years. A total of 232 Chinese mother-child dyads provided baseline data in 2015 (Time 1; T1) and follow-up data 6 years later in 2021 (Time 2; T2). At T1, mothers completed questionnaires about child physical abuse frequency and family cohesion and reported their own stress levels. At T2, mothers were re-surveyed with the same questionnaires about child physical abuse frequency and family cohesion. Children's psychosocial problems were assessed through parent proxy-reports and records of emergency room visits were retrieved from hospital databases. After adjusting for demographic information, maternal history of RRP was associated with child physical abuse at T1 ([beta] = 0.15, p < 0.05) and in turn linked to child physical abuse recurrence ([beta] = 0.22, p < 0.01) and emergency room visits at T2 ([beta] = 0.22, p < 0.001). Improved family cohesion over time did not break the link between maternal RRP and child physical abuse recurrence. Poor family dynamics can lead to child physical abuse recurrence and worsen developmental outcomes in children, particularly when coupled with other risk factors such as maternal RRP at young ages. Early interventions to enhance support and reduce vulnerabilities are important for preventing child physical abuse in at-risk families.

Preparing novice physicians for an unknown clinical future in healthcare is challenging. This is especially true for emergency departments (EDs) where the framework of adaptive expertise has gained traction. When medical graduates start residency in the ED, they must be supported in becoming adaptive experts. However, little is known about how residents can be supported in developing this adaptive expertise. This was a cognitive ethnographic study conducted at two Danish EDs. The data comprised 80 h of observations of 27 residents treating 32 geriatric patients. The purpose of this cognitive ethnographic study was to describe contextual factors that mediate how residents engage in adaptive practices when treating geriatric patients in the ED. Results showed that all residents fluidly engaged in both adaptive and routine practices, but they were challenged when engaging in adaptive practices in the face of uncertainty. Uncertainty was often observed when residents' workflows were disrupted. Furthermore, results highlighted how residents construed professional identity and how this affected their ability to shift between routine and adaptive practices. Residents reported that they thought that they were expected to perform on par with their more experienced physician colleagues. This negatively impacted their ability to tolerate uncertainty and hindered the performance of adaptive practices. Thus, aligning clinical uncertainty with the premises of clinical work, is imperative for residents to develop adaptive expertise.

Introduction: Speech Language Therapy First Point of Contact Clinic (SLT-FPOCC) models can assist assessment of low-risk patient populations referred to ear, nose and throat (ENT) services. To further improve ENT waitlist management and compliance with best-practice care, consideration of other low-risk populations that could be safely managed through this service model is needed. The aims of this paper are to evaluate the clinical and service outcomes of completing vocal cord check (VCC) assessments for patients' pre and post thyroid/parathyroid surgery within an SLT-FPOCC model and examine consumer perceptions. Methods & Procedures: The service followed existing SLT-FPOCC procedures, with ENT triaging referrals, then SLT completing pre- and postoperative VCC assessment (interview, perceptual assessment, flexible nasendoscopy), with assessment data later reviewed by ENT to diagnose laryngeal pathology. Clinical and service outcomes were collected prospectively. Patients completed an anonymous post-service satisfaction survey. Results: Of the first 100 patients referred for preoperative VCCs, SLT assessment identified 42 with dysphonia and 30 reporting dysphagia, while ENT confirmed 9 with significant preoperative anatomical findings. Eighty-three underwent surgery, with 63 (95 nerves at surgical risk) returning for a postoperative VCC. Postoperative VCC identified three temporary neuropraxias (3.2%) and three unilateral vocal fold paresis (3.2%). Patients were highly satisfied with the service. All 163 pre-/postoperative VCCs were completed with no adverse events. Conclusion & Implications: The current data support SLT-FPOCC service expansion to include pre and post thyroid/parathyroid surgery VCC checks, with positive consumer perception. The model supports delivery of best practice management (i.e., pre- and postoperative VCC) for patients receiving surgery for thyroid/parathyroid dysfunction, and associated efficiencies for ENT services.

Cultural competence is a continuously developing process that requires transition-to-practice program training to enable new graduate nurses (NGNs) to transfer their knowledge and skills to clinical practice in a culturally sensitive manner. The development and implementation of residency programs, including a cultural competence curriculum, could support this transition. This study aimed to evaluate the preliminary effects of a hybrid learning module of cultural competence for NGNs. A quasi-experimental design was used in a 3,000-bed hospital in North Taiwan. We randomly allocated 37 NGNs to the experimental and control groups. The Cultural Competence Scale for Pre-Graduate Students to Licensed Professionals (CS-SP) was adopted to measure cultural competence before and after the intervention. We evaluated the correlations between learning time and cultural competence scores using a paired t-test, chi-square test, and Mann--Whitney test for statistical analysis. The curriculum for the learning application comprised three courses covering six topics. The experimental group scored significantly higher in awareness and skills after the intervention (p < 0.05), but there was no significant improvement in knowledge or self-efficacy. The control group showed no significant differences in any of the cultural competence subscale scores after intervention. The Mann-Whitney test showed that different learning times led to significant differences in the mean cultural competence scores (Z = 3.04, p < 0.05). Integrating cultural competency education into web-based NGNs' postgraduate year of nursing programs improved their cultural competence awareness and skills. The learning application can be adapted to target NGNs at different stages of the postgraduate year of nursing programs to maximize its benefits.

Background: Knowledge of specific health-related events encountered by students studying abroad and the availability and use of pre-travel healthcare for these students is lacking. Methods: Anonymous web-based questionnaires were sent to study abroad offices, student health centers, and undergraduate students after studying abroad at eight institutions of higher education in the United States and Ireland from 2018-2021. Analyses were descriptive; relative risks and 95% confidence intervals were calculated for health-related events. Results: One study abroad office required a pre-travel consultation. All student health centers had pre-travel counseling available. Among 686 students, there were 307 infectious and 1,588 non-infectious health-related issues; 12 students (2%) were hospitalized. Duration of travel and timing of a pre-travel consultation impacted the risk of health-related events. Certain mental health conditions were associated with increased risk of alcohol and drug use. Conclusion: Future studies should address the optimal timing and best practices to optimize health for students studying abroad.

Objective: The modern Australian diet is largely characterised by too few fruits and vegetables and too many discretionary foods. This is very different to how Indigenous Australians ate prior to colonisation. Native plants and seeds like bush tomatoes, warrigal greens, Kakadu plum and wattleseed are not common features of the contemporary Australian diet. We developed an initiative to incorporate native plants and seeds into a hospital inpatient menu to normalise their use and provide nutrition education to patients, staff and the community of the nutrition and sustainability benefits of native ingredients. Design: Between May and August 2022, the Chef's Special menu (for privately funded patients) featured Australian native ingredients in all dishes. The nutritional benefits of native foods were communicated to patients through a printed brochure delivered with the menu, to foodservices staff through in-service training, and to the broader community through social media. Setting: Urban hospital in Brisbane, Australia. Method: Data were collected on acceptability, engagement and reach of the education initiative. Results: The initiative was successfully delivered, with more than 8,000 patient brochures distributed, 45 staff attending training, and social media reaching approximately 10,000 people. The most frequently ordered main meal on the menu was grilled snapper (fish) with macadamia Asian herb salad and finger lime. Conclusion: The work highlighted how the patient menu in hospital can serve as a useful tool to communicate nutrition education to patients, staff and the broader community. In addition, we reflect on the many opportunities to continue to celebrate the nutritional benefits of Australian native foods in healthcare settings.

The pandemic brought a whole newfound collection of words into our everyday language, some of which had been terms that were infrequently used outside academic and medical settings. However, as familiar as this new pandemic vocabulary has become, there are still several terms that often get mixed in everyday conversations, media communications, and even in the medical field. Some of these terms are often mistaken, which may lead to issues in the understanding of important concepts. Science communication, as a facet of scientific literacy, intends to educate people in an easy-to-understand manner, and this communication is even more important in health care, when a literate patient's medical decisions depend frequently on this process. In this article, we explore the use and misuse of some of the most common terms utilized during the 2019 coronavirus disease (COVID-19) pandemic by nursing and medical students, i.e., future health care professionals, in the hospital environment. This single-center hospital-based cross-sectional study, performed throughout September 2022, included 30 medical and nursing students. All participants completed a self-administered 15-item anonymous questionnaire at a single time point. Nine multiple-choice questions evaluated knowledge, diagnosis, disease manifestations, and vaccines related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Six questions provided demographics and quality assessment information. The analysis of the answers indicated that for at least 75% of the population surveyed, COVID-19 literacy was better for terms related to technology and actions (3/5 questions answered correctly) than for terms related to the disease (1/4 questions answered correctly). The overall median score for questions 1 to 9 was 4.5 of 9 points in total. Based on the results, the language used in the questionnaire was considered easy to understand, with an easy to medium level of complexity, and the perceived time required to complete the questionnaire was less than 5 min. In conclusion, our results showed that efforts need to be made in continuous professional education to increase the knowledge in COVID-19 literacy in the health care environment for medical and nursing students. Larger studies are recommended to identify and to fulfill the challenges that COVID-19 brought to medical and nursing education.

Simulated learning programs are an important component of allied health education. Although the role of simulation clinical educators has been highlighted as critical for student learning within simulation, their perceptions of their role have not yet been investigated. This study aimed to explore the experiences of simulation clinical educators. Participants were ten simulation clinical educators who had supported speech-language pathology students' learning during a 5-day simulation program focussed on speech-language pathology practice with adult clients in acute hospital and rehabilitation settings. Educators participated in individual semi-structured interviews exploring their role and their perceptions of the simulation-based learning program. Data were analysed using inductive thematic analysis. Three inter-related themes emerged from participants' views. The major theme of Unique teaching and learning environment incorporated five subthemes: focus on teaching; safe learning environment; authenticity and engagement; structure and intensity of learning, and; feedback opportunities. Two additional themes were identified: Clinical educator role same but different, and Simulation bridges the gap between theory and practice. This study offers new insights into simulation clinical educators' perceptions of their role when supporting students within simulation and highlight the importance of harnessing the unique benefits of simulation as a teaching pedagogy to maximize its impacts on student learning and justify its costs.

Accreditation is typically a voluntary process that involves a thorough evaluation of an organization's policies, procedures, and practices. Much like a colonoscopy, the evaluation process probes deep and can be uncomfortable. With the discomfort, time, cost, and effort it takes to undergo evaluation for accreditation, the natural question is whether it is worth doing. In this paper, I will review the history of accreditation and the results of systematic literature reviews focused on the impact of accreditation. I will also discuss how accreditation may help provide quality control in behavior analysis and safeguard against service providers' behaviors being solely shaped by funding sources, such as insurance providers. Lastly, I will provide critical questions consumers can ask to assess accrediting bodies' transparency, objectivity, and fairness when they are seeking accreditation.

The present study aimed to explore the role of feedback in the medical workplace in the domain of radiology. Feedback is considered essential for learning, performance, and professional development, as it helps to build knowledge and skills, to correct errors, and to provide safe and autonomous patient care. Fifteen specialists were interviewed about what role feedback played in their own professional development. Moreover, we enquired about how they interact with residents and how they provide feedback in their daily work. Content analysis was used to categorise participants' answers. Results show that specialists see feedback as an omnipresent phenomenon at the workplace and perceive it as central to training. Feedback is usually provided face-to-face to reinforce and transfer knowledge, improve domain-specific knowledge, reduce mistakes, improve the outcome for the patient, change behaviour patterns, or increase social skills. Although feedback at the workplace was considered important for professional development, physicians stressed that there is often not enough time to discuss performance and possibilities for performance improvements. Forming tandems between less and more experienced physicians, so that learning becomes more embedded in medical practice and work activities might be a facilitating condition at the workplace.

Data is a powerful tool for the healthcare industry to use for managing, analyzing, and reporting on critical events in the field. The analysis of broad, salient data files aids healthcare businesses in uncovering hidden patterns, market trends, and customer preferences; these details may then be used to improve the quality and delivery of care to patients in an organization's community. In this case, students use simple data mining procedures to investigate issues a healthcare organization faces regarding regional and national population patterns, directions for facility and service expansion, and prospective staffing changes. The exercise highlights the use of data analysis as a planning tool for a mid-sized rural hospital with limited resources and may be used in an undergraduate or graduate level management information systems or healthcare information systems course to illustrate data analysis and visualization concepts, reporting, and data driven strategy development.

The adult population in the United States is more physically active and are living longer than prior generations. Due to the advancement in surgical techniques and the increased number of active people, there has been a rise in the number of hip and knee replacement surgeries. This rise in the number of surgeries is expected to continue. Post-surgical care is a critical component to a successful patient recovery. After surgery, patients experience limited mobility while the muscles around the impacted joints need time for inflammation to subside. Physicians and other medical providers are concerned with making sure that patients do not experience falls during this time as it may lead to more serious injuries. A sample dataset of patients who underwent elective hip or knee surgery from January 2014 to March 2020 has been provided to analyze other medical conditions that may contribute to the likelihood of a patient falling. The goal is to identify important factors that can assist in predicting the probability of a patient falling after surgery.

This study aims to emergency medical services(EMS) and their efficacy within the purview of Local Administrative Organizations (LAOs) in Thailand. As the responsibility for EMS has transitioned from public hospitals to LAOs, it has prompted inquiries into their efficiency. This research endeavors to scrutinize the determinants influencing the performance of EMS managed by LAOs. To accomplish this objective, we embraced a quantitative research approach. Data was obtained from 636 individuals who had availed emergency medical services, chosen through purposive sampling. Questionnaires were used to collect data, and the IOC index was employed to ensure data integrity. Descriptive statistics elucidated and assessed various variables. Multiple regression analysis was conducted with a statistical significance level of 0.01 to unearth the associations between administrative factors and the performance of EMS by LAOs. This research uncovers a positive, moderate-level correlation between administrative factors and the performance of EMS by LAOs. Specifically, factors such as community engagement, service preparedness, operational efficiency, budget allocation, resource availability, and staffing levels were identified as noteworthy predictors of EMS success by LAOs, explaining 60.8 percent of the variance. The outcomes of this study have practical implications for EMS management by local authorities, not only in Thailand but also in other regions grappling with analogous challenges. This research contributes to the ongoing endeavors to enhance pre-hospital care and emergency response, ultimately preserving lives and mitigating the repercussions of emergency illnesses and accidents on communities.

Thailand is now a medical center in Asia. There has been an increase in the number of foreign patients receiving medical services in Thailand. The employees in the healthcare industry, like the registered nurse, are the center of the relationship with that service. The vital learning promotion course for these registered nurses dealing with patients of various nationalities is cultural competence promotion. With the nature of the learning style of the registered nurse, they need more flexibility and respond to their learning nature. Ultimately, the enhancement of cultural competency learning still needs to be achieved. Therefore, this research study aimed to: 1) develop a self-directed learning program in the workplace to promote cultural competence for registered nurses in international hospitals and 2) study the effect of implementing a self-directed workplace learning program to promote cultural competency. The researcher adopted a Research and Development methodology divided into two phases. The first phase is to develop a self-directed workplace learning program to enhance cultural competency. The second phase is to study the effect of implementing a self-directed learning program. The findings revealed that: 1) a draft of a self-directed workplace learning program to enhance cultural competence consisting of concepts and principles, the primary goal of the program, the guideline for promoting cultural competence learning based on the idea of self-directed workplace learning, the learning program, the learning facilitators of the program, the learning spaces are locations or areas within an organization, the international hospital's networks and the learning resources include information sources from diverse places. Plus, 2) registered nurses had better levels of cultural competency learning in attitudes, knowledge, and skills than before participating in the program trial and had improved scores in all areas.

COVID-19, which affects the world, undoubtedly seems to have affected university students who receive applied education. Sports Science students continue their sports training within the mask and distance rules by switching to face-to-face teaching during the normalization period. This study aimed to reveal whether the physical activity levels of Sports Science students were affected by Coronavirus-19 phobia after switching to face-to-face training. 432 (female; 152, male; 280) university students from Sports Sciences attended the research. Data from the participants were collected using the Coronavirus-19 Phobia Scale and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The independent sample and Mann-Whitney U test, One-Way, and two-way ANOVA test (Post hoc Tukey) were used in the data analysis. According to the results, the 'psychological' sub-dimension scores of the participants, an increase in body mass index, not doing sports, reducing the vaccine dose, spending COVID-19 in the hospital, and wearing a mask in practical classes increase. In addition, those who wear masks in applied lessons have higher 'somatic,' 'social,' and 'economic' sub-dimension scores. Females' coronavirus-19 phobia, 'psychological' and 'economic' sub-dimensions, and total scale scores are higher than males. Consequently, with the increased physical activity levels of Sports Science students, coronavirus-19 decreases phobia scores.

Effective health service delivery hinges on the interface between professionals rendering health services to the sick and the injured. This paper examined the inter-professional collaboration and knowledge management practices among the clinical workforce in Federal Tertiary Hospitals in three Geopolitical Zones of Nigeria. The study employed a non-experimental survey design. 550 questionnaires were administered out of which 479 were completed for analysis comprising 204 Medical Doctors, 180 Nurses and 95 Health Information Management Officers, which resulted into 87% response rate. Findings from the study revealed that knowledge acquisition was the most practiced, closely followed by knowledge application. In addition, cooperation was the most practiced form of inter-professional collaboration, next to it is partnership. The study revealed a significant relationship between inter-professional collaboration and knowledge management practices. It shows that only cooperation significantly influenced knowledge management practices while knowledge capturing and knowledge dissemination significantly influenced inter-professional collaboration. The study concluded that Federal Tertiary Hospitals in Nigeria will perform better if they can sustain the culture of knowledge management practices and inter-professional collaboration.

Background: Individuals with Down syndrome are an at-risk population for severe COVID-19 outcomes, due to genetic predispositions and comorbidities. The current study focused on differences between persons with and without Down syndrome regarding age and severity of disease. Method: We used medical statistics to compare patients with and without Down syndrome who were admitted to Swiss hospitals (2020 and 2022) with a COVID-19 diagnosis. Differences in age, hospitalisation characteristics, mortality, and additional diagnoses were investigated. Results: Results revealed a lower median age and greater risk of intensive care unit admission and mortality among patients with Down syndrome. No differences were found in length of hospital stay. Conclusions: There is some evidence of increased vulnerability in people with Down syndrome compared to other patients, particularly in terms of mortality rates. However, compared to studies from other countries, the situation of people with Down syndrome does not appear to be particularly critical.

Purpose: This study aims to increase the understanding of the starting points and presuppositions of organizational learning (OL) processes in a hospital's surgical department based on the existing theory of OL and to make visible the practical possibilities of the theory in this context. Design/methodology/approach: The study was conducted as a case study. The data were collected from personnel of the hospital's surgical department and consisted of 26 thematic interviews. The data were analyzed using qualitative theory-driven content analysis. Findings: This study found different starting points for both employee-oriented and organization-oriented learning processes that could potentially progress to different levels of the organization: from individuals to a wider group or from a large group to an individual. The starting point of employee-oriented learning processes was depicted as everyday life problems or situations or was based on the person's interest. The starting points of organization-oriented learning processes were described as achieving or maintaining the organization's expected skill levels, pursuing continuous development or pursuing the organization's specific development needs. Different kinds of presuppositions were also located within the OL processes. Originality/value: This study produced new practice-based knowledge about the starting points of OL processes and their presuppositions. In health-care organizations, learning is especially important due to intensive and complex changes, and this study provides empirical evidence on how to enhance learning.

Purpose: This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19 pandemic and how the management learning is characterized. Design/methodology/approach: The paper is based on a qualitative case study carried out during the COVID-19 pandemic at two different public hospitals in Sweden. The study, conducted with semi-structured interviews, applies a combination of within-case analysis and cross-case comparison. The data were analyzed using thematic deductive analysis with the themes, i.e. sensemaking, decision-making and meaning-making. Findings: The COVID-19 pandemic was characterized by uncertainty and a need for continuous learning among the managers at the case hospitals. The learning process that arose was circular in nature, wherein trust played a crucial role in facilitating the flow of information and enabling the managers to get a good sense of the situation. This, in turn, allowed the managers to make decisions meaningful for the organization, which improved the trust for the managers. This circular process was iterated with higher frequency than usual and was a prerequisite for the managers' learning. The practical implications are that a combined management with hierarchical and distributed management that uses the normal decision routes seems to be the most successful management method in a prolonged crisis as a pandemic. Practical implications: The gained knowledge can benefit hospital organizations, be used in crisis education and to develop regional contingency plans for pandemics. Originality/value: This study has explored learning during the COVID-19 pandemic and found a circular process, "the management learning wheel," which supports management learning in prolonged crises.

Background: People with an intellectual disability have a higher risk of developing mental disorders compared to the general population. Available evidence suggests those with an intellectual disability receiving inpatient treatment in general psychiatric wards may have certain unique characteristics. Method: Data gathered from a retrospective review of records of adults with intellectual disability admitted to general psychiatry wards in a tertiary psychiatric hospital in Singapore were analysed. Results: Of 290 adults with intellectual disability, 62.8% were males. The median age was 38 years. The median length of stay was 12 days and over 80% had at least one previous admission. Nearly 80% had a mild intellectual disability and 64.5% had at least one psychiatric comorbidity, the majority having schizophrenia or psychotic disorder. Physical aggression was the most common primary reason for admission. Conclusions: The specific profile of patients identified in the study would be helpful in determining priority areas for the development of specialist psychiatric services for people with intellectual disability.

This study aimed to evaluate the frequency of sleep and eating problems in children with autism spectrum disorder (ASD), the factors associated with these problems, and the relationship with the risk of developing depression and anxiety in their parents. In the study, 156 children with ASD and their parents were included. The Brief Autism Mealtime Behavior Inventory (BAMBI), the Children's Sleep Habits Questionnaire (CSHQ), the Hospital Anxiety Depression Scale (HADS) were completed by the parents. The Childhood Autism Rating Scale (CARS) was administered by the researchers to evaluate the severity of ASD in children. The mean age of children was 8.08 ± 2.84, and 87.2% of the children were male. The mean score of CARS was 41.25 ± 6.16, the mean score of BAMBI was 45.67 ± 11.87, and the mean score of CSHQ was 51.67 ± 10.17. According to the CSHQ, 83.3% of the children had sleep problems. The response rate above the cut-off point in the HAD-A subscale was 59.6%, whereas it was 67.3% in the HAD-D subscale. There was a positive correlation between CARS and BAMBI, CSHQ, HAD-A, and HAD-D subscales. There was a positive correlation between BAMBI and CHSQ, HAD-A, and HAD-D subscales. There was a positive correlation between the CSHQ, HAD-A, and HAD-D subscales. There was a negative correlation between the age of the child with ASD, food refusal, and resistance to bedtime. As sleeping and eating problems affect a large portion of children diagnosed with ASD and their caregivers, large population-based studies evaluating both these problems must be designed and carried out to understand factors affecting the prevalence, development, and persistence of sleeping and eating problems and to determine interventions to reduce these issues.

Proper treatment of developmental disabilities requires health workers to have adequate knowledge of etiology and referral procedures. There is a dearth of research on knowledge of developmental disabilities among health workers in Ghana. The purpose of this study was to document knowledge about developmental disorders, causes, and referral procedures among health workers. Researchers used a successive free-listing method to interview 37 health workers. Developmental disabilities which present with physical symptoms were the most salient disorders identified among health workers, while learning disabilities and attention deficit disorder were largely overlooked. The most commonly listed developmental disabilities were cerebral palsy, Down syndrome, and autism spectrum disorder. Respondents had limited knowledge about the causes of and referral resources for developmental disabilities. Results show the need for continuing medical education, public awareness, and enhanced resources to support the identification and care of children with developmental disabilities in Ghana.

Professional trainers are responsible for teaching novice employees. However, the conventional approach to training professional trainers is generally a lecture-based mode, implying that they often lack the opportunity to learn to make use of practical cases encountered by novice employees, to explore problem-solving methods, to objectively evaluate the performance of novice employees, and to provide timely feedback. To deal with this problem, a ChatGPT-based Question-Exploration-Evaluation (QEE) training mode was proposed in this study. An experiment was conducted in a "teaching evaluation skills and feedback" training program for clinical teachers in a hospital to explore the effects of the ChatGPT-based QEE (ChatGPT-QEE) training mode on clinical teachers' learning achievement, critical thinking consciousness, and teaching evaluation skills and teaching feedback quality. It was found that the ChatGPT-QEE training approach was better than the conventional QEE training mode in terms of enhancing clinical teachers' learning achievement and critical thinking consciousness. Moreover, the ChatGPT-QEE group showed better teaching evaluation skills in the knowledge and description dimensions than the conventional QEE group, and the clinical teachers' teaching feedback quality in the aspects of skepticism and descriptiveness improved. Accordingly, several suggestions for future research are provided based on the findings of the present study.

Background: There is limited qualitative research focussed specifically on what it is like for children and young people with intellectual disabilities coming into hospital, with much of the evidence-base being about those with Autism Spectrum Condition or adults with intellectual disabilities. Aim: To share rich detail of the emotional and physical impact on children and young people with intellectual disabilities of attending hospital, from their own and their parent's perspective. Methods: Talking Mats interviews, sticker survey and photography with children and young people with intellectual disabilities, and in-depth interviews, hospital diaries and photography with their parents. Results and Conclusions: The multiple and compounding layers of complexity surrounding hospital care of children and young people with intellectual disabilities resulted in challenges associated with loss of familiarity and routine, undergoing procedures, managing sensory overload, managing pain and having a lack of safety awareness. An individualised approach to their care is needed.

The hospital setting may be especially difficult for pediatric patients on the autism spectrum and their families compared to those not on the spectrum. Child life specialists are healthcare professionals specifically trained to support parents and their children and help prepare them for hospital procedures. Because of this specialized skill set, these professionals likely have a wealth of expertise to share relevant to caring for autistic patients. This study aimed to understand 21 child life specialists' experiences working with patients on the spectrum. Our findings highlighted the following themes: Parents are the Experts, Proactive and Individualized Care, Disclosure, and Hospital-Wide Suggestions to Improve Patient Care. We discuss the practice implications of these findings on the healthcare experiences of pediatric patients on the spectrum.

This article explores the experiences of the use of the "Regional Health and Social Care Hospital Passport" ("Regional Hospital Passport") in Northern Ireland from the perspectives of adults with intellectual disabilities, family carers and health professionals. From semi-structured interviews three themes emerged: usefulness; facilitators; and barriers to the use of the "Regional Hospital Passport". There were clear benefits of the Hospital Passport when used across hospital services and clinical practice settings such as dental and General Practices. There was participant agreement that communication and the person-centred care experiences were enhanced. Findings suggest that providers of health and social care services need to take greater responsibility and accountability for ensuring "Regional Hospital Passports" are promoted and used across all settings. There is a requirement to develop the wider use and uptake of hospital passports to support adults with intellectual disabilities, with potential for use with other patient groups.

Infertile women often experience chronic stress that can harm their well-being. Our aim was to investigate the effect of mindfulness-based stress reduction programmes on tolerance of ambiguity, rumination, and metacognitive awareness in infertile women. The sample included all infertile women referred to the Valiasr Hospital Health Center in Iran in 2019 who were treated for infertility. A total of 52 women undergoing infertility treatment were selected by availability sampling and assigned to either the experimental (26) or the control group (26). Using multivariate analysis of covariance (MANOVA) we found that a mindfulness-based stress reduction programme helps to increase tolerance to ambiguity, rumination, and metacognitive awareness among infertile women.

Despite school psychologists working in non-school settings since 1896, no studies have investigated the practices that these professionals engage in outside the schools. The purpose of this study was to explore the practices of school psychologists in school and non-school settings, such as state agencies and hospitals. Additionally, the researchers sought to uncover why school psychologists chose non-school settings to work in over schools. Insight is provided as to whether the NASP (2020) Practice Model domains were being applied in non-school settings. Findings suggest that the practices of school psychologists in school and non-school settings were aligned with the domains of the NASP Practice Model. Implications for practice, training, and future research regarding school psychologists in non-school settings are discussed.

The article discusses the author's transformative journey, who transitioned from a traditional trainer to a passionate action learning coach through a series of personal and professional experiences. On top of that, the knowledge and experiences gained from action learning marked a pivotal moment, leading to a profound shift in the approach to coaching and people development. The article details three distinct cases in which the author applied action learning principles effectively: 1) Cultivating Core Values for a Public Hospital in Thailand, 2) Building a Team with Action Learning, and 3) Driving and Actualizing Results of a Leadership Development Program. Throughout these cases, the presence of a trained and certified action learning coach was highlighted as a critical factor. The coach's expertise in asking thought-provoking questions, encouraging learning from actions, and fostering a safe and effective learning environment played an essential role in the success of each initiative. The author concludes with key learnings, emphasizing the adaptability of action learning beyond traditional sessions, the importance of simplicity in its application, and the transformative power of skilled action learning coaches in driving meaningful change and development.

Background: Saudi Arabia has the second-highest prevalence of diabetes in the Middle East. Therefore, providing patients with high-quality materials is essential to help them understand their illness. The Patient Education Materials Assessment Tool (PEMAT) contrasts and evaluates materials regarding understandability and actionability. Purpose: This study aimed to evaluate materials for type 2 diabetes using a printed version of the PEMAT. Methods: This observational study was conducted in Riyadh from December 2022 to May 2023. Sixty-nine samples were collected from hospitals affiliated with the Ministry of Health and the government sector. Results: Materials evaluated in this study had an excellent understandability score of 78.9% and a low actionability score of 66.6%, with significant differences between the sources. Some of the materials (42%) achieved high quality regarding understandability and actionability. Discussion: Less than half of the materials were considered high quality. Approximately 99% of the materials made their purposes completely evident and logically presented the information, and approximately 97% identified at least one action. However, only 17.4% of the materials provided summaries and tangible tools. Translation to Health Education Practice: Health Educators should consider including summaries and tangible tools when developing patient education materials to make them more understandable and actionable.

Purpose: Multiple methods have been suggested for quantifying syntactic complexity in speech. We compared eight automated syntactic complexity metrics to determine which best captured verified syntactic differences between old and young adults. Method: We used natural speech samples produced in a picture description task by younger (n = 76, ages 18-22 years) and older (n = 36, ages 53-89 years) healthy participants, manually transcribed and segmented into sentences. We manually verified that older participants produced fewer complex structures. We developed a metric of syntactic complexity using automatically extracted syntactic structures as features in a multidimensional metric. We compared our metric to seven other metrics: Yngve score, Frazier score, Frazier-Roark score, developmental level, syntactic frequency, mean dependency distance, and sentence length. We examined the success of each metric in identifying the age group using logistic regression models. We repeated the analysis with automatic transcription and segmentation using an automatic speech recognition (ASR) system. Results: Our multidimensional metric was successful in predicting age group (area under the curve [AUC] = 0.87), and it performed better than the other metrics. High AUCs were also achieved by the Yngve score (0.84) and sentence length (0.84). However, in a fully automated pipeline with ASR, the performance of these two metrics dropped (to 0.73 and 0.46, respectively), while the performance of the multidimensional metric remained relatively high (0.81). Conclusions: Syntactic complexity in spontaneous speech can be quantified by directly assessing syntactic structures and considering them in a multivariable manner. It can be derived automatically, saving considerable time and effort compared to manually analyzing large-scale corpora, while maintaining high face validity and robustness.

Twelve qualitative case studies in German and Canadian hospitals and IT companies were used in this mixed-methods study analysing the labour market outcomes of immigrants. The reported case studies investigate the immigrants' recognition, integration process and the usability of foreign qualifications, skills and work experiences in the labour market. Furthermore, the strategies and rationales of employers and employees within the recruiting process are analysed. Here, the focus lies on the transferability and obstacles of cultural and social capital across country borders as well as the relevant framework conditions. This paper refers to Bourdieu's approach towards different types of capital as well as the rational choice theory. The results demonstrate that immigrants in both countries face more obstacles accessing the labour market within the health sector than within the IT sector. The context of the recruiting situation strongly affects the strategies and behaviour of the employers or the recruiters. Within these sector- and country-specific confines, individual factors determine the immigrants' labour market success. Furthermore, the sector and the country affect the relevance of each individual factor in the recruiting process.

Queer crip enrollment patterns describe the unique ways Two Spirit, lesbian, gay, bisexual, transgender, queer/questioning and disabled college students enter and persist in higher education. Elevating the voices of 10 queer, mad, mentally ill, neurodivergent and/or disabled (QMMIND) college students, this article highlights queer crip enrollment as a process that involves failing classes, withdrawing from institutions, (in)voluntary hospitalizations, and socioeconomic intersections. Queer crip enrollment patterns highlight institutional barriers limiting the success of QMMIND students. At the same time, QMMIND students dream of thriving and helping others thrive despite hostile campus environments. Using queer and crip theory, we engage in the process of dreaming about creating an accessible university. Specifically, we posit that structural changes in admissions, crisis response, and meeting students' basic needs will allow environments to support queer crip success.