Search

Copyright of Tidsskrift for Psykisk Helsearbeid is the property of H. Aschehoug & Co. (W. Nygaard) AS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Delays in seeking timely maternity care from health care professionals are crucial to address among the Rohingya population where many preventable pregnancy-related deaths occur within the camps when care is not sought. To address the challenges related to the referral of emergency and routine Sexual and Reproductive Health and Rights (SRHR) cases, United Nations Population Fund, through its partners, implemented a community-based referral transportation project called Referral hub. This paper presents the barriers and facilitators to the implementation of this referral transportation system from the perspectives of the beneficiaries and providers. Methods: The research adopted a sequential explanatory mixed-method design. The quantitative phase consisted of a survey among 100 women while the qualitative phase comprised of in-depth interviews with a total of 12 mothers who used the services and key informant interviews with 21 providers. Results: The barriers identified for referral hub are discordant understanding of emergency, strict gender norms and practices, distrust in providers, poor roads and mobile phone networks. The facilitators are partnership with the community, within and other organizations. Conclusion: The study observed that the referral hub has a high potential to increase the utilization of SRHR services. Despite the barriers, the facilitating factors show a scope of improvement for these services. [ABSTRACT FROM AUTHOR]

Child physical activity (PA) declines during summer reducing PA-related health benefits. Summer care programs (e.g., Boys & Girls Clubs) can promote active play while providing opportunities for friendships. Sport participation is a positive influence on PA and social development. Purpose: This article investigates the role of sport participation in PA attainment, perceived skill competency, and social connection at a summer care program. Methods: Children self-reported PA, sport participation, and the names of up to five peers whom they played with most at the program at the start (T1; n = 100; M age = 9.94 years; SD = 1.34; 47% male) and end (T2; n = 77; M age = 9.83 years; SD = 1.46; 51% male) of summer. Network autocorrelation models were used to determine if child sport participation was significantly associated with those they played with at the program. Results:Children who reported sport participation reported significantly more PA than those who did not at T1, but not T2. Child sport participation was significantly related to that of the peers they said they spent time with while at the program for T1 (β = 0.07, p <.01), but not T2 (β = 0.06, p =.10). Additionally, PA (β = 0.08, p <.01; β = 0.07, p =.01) and skill competency (β = 0.11, p =.02; β = 0.15, p <.01) were significantly associated with sport participation at both time points. While sports participation was a key factor in child friendships at the start of summer, the program allowed children, regardless of sport participation, to become friends outside of sports. Conclusions: These results suggest summer care programs promote PA through play and provide opportunities for children to facilitate friendships regardless of sport participation. [ABSTRACT FROM AUTHOR]

Bangladesh has the largest refugee camp in the world, which is home to 880,000 Rohingya refugees from Myanmar, who reside in 34 camps including Kutupalong camp (ReliefWeb [10]). " Displaced Rohingya Children at High Risk for Mental Health Problems: Findings from Refugee Camps Within Bangladesh." Reduced healthcare capacity, a high Case Fatality Ratio (CFR) due to COVID-19 (2.1%), lack of testing kits for COVID-19, and low vaccination rollout is exacerbating the mental health of the Rohingya (ReliefWeb [10]). [Extracted from the article]

Background: Scabies is a global health concern disproportionately affecting vulnerable populations such as refugees and asylum seekers. Greece is a main point of entry in Europe for refugees, but epidemiological data on scabies in this population are scarce. We aimed to describe the epidemiology of scabies, including trends over the study period. Methodology/Principal findings: Data were collected from June, 2016 to July, 2020, using the surveillance system of the Greek National Public Health Organization. Daily reports on scabies and other infectious diseases were submitted by staff at health centers for refugees/asylum seekers. Observed proportional morbidity for scabies was calculated using consultations for scabies as a proportion of total consultations. There were a total of 13118 scabies cases over the study period. Scabies was the third most frequently observed infectious disease in refugees/asylum seekers population after respiratory infections and gastroenteritis without blood in the stool. The scabies monthly observed proportional morbidity varied between 0.3% (August 2017) to 5.7% (January 2020). Several outbreaks were documented during the study period. The number of cases increased from October 2019 until the end of the study period, with a peak of 1663 cases in January 2020, related to an outbreak at one center. Spearman correlation test between the number of reported scabies cases and time confirmed an increasing trend (ρ = 0.67). Conclusions/Significance: Scabies is one of the most frequently reported infectious diseases by health care workers in refugee/asylum seekers centers in Greece. Observed proportional morbidity for scabies increased over time and there were several outbreaks. The current surveillance system with daily reports of the new cases effectively detects new cases in an early stage. Public health interventions, including mass drug administration, should be considered to reduce the burden of scabies in refugee/migrant populations. Author summary: Scabies is a skin disease caused by the ectoparasitic mite Sarcoptes scabiei var. hominis. Most people with scabies have a diffuse and pruritic rash, while the most complicated forms of the infection can lead to bacterial infections and sepsis. Scabies is a global health concern and in 2017, the World Health Organization (WHO) added it to the portfolio of conditions prioritized by WHO's Department of Control of Neglected Tropical Diseases. However, the prevalence of scabies among refugees residing in camps in Greece has not been thoroughly investigated. In this study, we wanted to obtain an overview of scabies epidemiology and identify trends over time. To do so, we analyzed data extracted from epidemiological reports submitted each week as part of the Greek National Public Health Organization. Our findings confirmed the high prevalence of scabies among refugees residing in the camps and identified a clear trend of significant increase over time. Public health interventions, like mass drug administration with ivermectin, could help restrain the dissemination of the disease and lower its burden among refugees. [ABSTRACT FROM AUTHOR]

Background: The psychosocial burden of having a chronic disease can be substantial for adolescents with childhood-onset systemic lupus erythematosus (cSLE). Current literature is scarce on interventions that can improve psychosocial outcomes for this population. Therapeutic recreation camps have been proposed as a beneficial experience for chronically ill pediatric populations. However, their effective components have not been well characterized in patients with cSLE. In this study, we sought to understand the various components of the camp experience for adolescents with cSLE from both the patient and parent perspective. Methods: We recruited patients with cSLE who had participated in one or more annual, weekend-long recreational lupus camp(s) near Dallas, Texas. Semi-structured in-depth telephone interviews were conducted from March-June 2020 with both the patients and parents. Questions focused on overall patient experience, psychosocial impact of camp participation, coping skills gained, and opportunities to prepare for the transition from pediatric to adult care. Interviews were coded and analyzed using inductive thematic analysis. Results: We interviewed 9 current and former campers (ages 16–24), including a current camp counselor, and 3 of their parents separately. Reported benefits included a positive impact on social support through peer bonding, opportunities to develop coping mechanisms through structured activities and peer/medical staff interactions, opportunities for education about the cSLE disease experience, improved adherence through peer modeling, overall increase in self-efficacy, and better parental insight into the patient experience. Participants also provided suggestions for expansion and improvement in program development to optimize educational opportunities for both campers and parents. In addition, they advocated for longitudinal social support and community building. Conclusions: In this qualitative study, in which cSLE patients and their parents reflected on their experiences with therapeutic recreation camps, we found several perceived benefits impacting the patient and parent experience. Participants expressed a desire for more educational opportunities that could contribute to their successful transition from pediatric to adult care. Further studies are needed to demonstrate the effects of therapeutic recreation camps on the psychosocial health of this population. [ABSTRACT FROM AUTHOR]

Background: Since 2011 Italy has faced an extraordinary increase in migrants arrivals, mainly from the Mediterranean route, one of the world's most dangerous journeys. The purpose of the present article is to provide a comprehensive picture of the migrants' health status in the "T. Fenoglio" centre, Settimo Torinese (Turin, Italy).Methods: A retrospective cross-sectional study was conducted using data collected from June 2016 to May 2018 on adult migrants (over 18 years old) from Africa, Middle East and South East Asia (Bangladesh, Cambodia, India, Nepal). Data was collected through the migrants' medical records. Descriptive statistics were performed on socio-demographic variables. The diagnosed diseases were anonymously registered and classified according to the International Classification of Primary Care (ICPC-2). Conditional Inference Trees were used to perform a descriptive analysis of the sample and to detect the covariates with the strongest association with the variables Disease on arrival, Disease after arrival, ICPC on arrival and ICPC after arrival.Results: Analyzed observations were 9 857. 81.8% were men, median age was 23 (Interquartile range: 20.0-27.4). 70.3% of the sample came from Sub-Saharan Africa. 2 365 individuals (24%) arrived at the centre with at least one disease. On arrival, skin (27.71%), respiratory (14.46%), digestive (14.73%) and generic diseases (20.88%) were the most frequent. During the stay respiratory diseases were the most common (25.70%). The highest probability of arriving with a disease occurred in 2018 and during the period September-November 2016, in particular for people from the Horn of Africa. During this period and also in the first half of 2017, skin diseases were the most reported. In seasons with lower prevalence of diseases on arrival the most common disease code was generic for both men and women (usually fever or trauma).Conclusions: This study provides information on the diverse diseases that affect the asylum seekers population. In our sample, the Horn of Africa was the most troubled area of arrival, with severe conditions frequently reported regarding skin diseases, in particular scabies. 2018 was the most critical year, especially for migrants from the Horn of Africa and Sub-Saharan Africa. During the stay at the camp, the prevalence of respiratory diseases increased. However, skin diseases remained the main issue for people from the Horn of Africa. Overall, the most reported diseases in the sample were dermatological, respiratory, digestive and generic diseases, both on arrival and during the stay. A better understanding of the health status of asylum seekers is an important factor to determine a more efficient reception and integration process and a better allocation of economic resources in the context of migrants' health care. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has acutely affected Rohingya refugees living in camps in Cox's Bazar, Bangladesh. Reported increases in sexual and gender-based violence (SGBV) were attributed in part to pandemic-related public health measures. In addition, the Government of Bangladesh's restrictions to prevent the spread of COVID-19 have impacted the provision of comprehensive care for survivors of sexual violence. This study sought to understand how the COVID-19 pandemic affected SGBV and the provision of services for Rohingya survivors in Bangladesh.Methods: Interviews were conducted with 13 professionals who provided or managed health care or related services for Rohingya refugees after the onset of the COVID-19 pandemic in March 2020.Results: At the outset of the COVID-19 pandemic, organizations observed an increase in the incidences of SGBV. However, health care workers noted that the overall number of survivors formally reporting or accessing services decreased. The pandemic produced multiple challenges that affected health workers' ability to provide essential care and services to Rohingya survivors, including access to the camps, initial designation of SGBV-related services as non-essential, communications and telehealth, difficulty maintaining confidentiality, and donor pressure. Some emerging best practices were also reported, including engaging Rohingya volunteers to continue services and adapting programming modalities and content to the COVID-19 context.Conclusions: Comprehensive SGBV services being deemed non-essential by the Government of Bangladesh was a key barrier to providing services to Rohingya survivors. Government restrictions adversely affected the ability of service providers to ensure that comprehensive SGBV care and services were available and accessible. The Government of Bangladesh has not been alone in struggling to balance the needs of displaced populations with the necessary precautions to prevent the spread of COVID-19 and its response can provide lessons to others overseeing the provision of services during epidemics and pandemics in other humanitarian settings. The designation of comprehensive services for survivors of SGBV as essential is vital and should be done early in establishing disease prevention and mitigation strategies. [ABSTRACT FROM AUTHOR]

Background: This study examines mental, neurological, and substance use (MNS) service usage within refugee camp primary health care facilities in low- and middle-income countries (LMICs) by analyzing surveillance data from the United Nations High Commissioner for Refugees Health Information System (HIS). Such information is crucial for efforts to strengthen MNS services in primary health care settings for refugees in LMICs.Methods: Data on 744,036 MNS visits were collected from 175 refugee camps across 24 countries between 2009 and 2018. The HIS documented primary health care visits for seven MNS categories: epilepsy/seizures, alcohol/substance use disorders, mental retardation/intellectual disability, psychotic disorders, severe emotional disorders, medically unexplained somatic complaints, and other psychological complaints. Combined data were stratified by 2-year period, country, sex, and age group. These data were then integrated with camp population data to generate MNS service utilization rates, calculated as MNS visits per 1000 persons per month.Results: MNS service utilization rates remained broadly consistent throughout the 10-year period, with rates across all camps hovering around 2-3 visits per 1000 persons per month. The largest proportion of MNS visits were attributable to epilepsy/seizures (44.4%) and psychotic disorders (21.8%). There were wide variations in MNS service utilization rates and few consistent patterns over time at the country level. Across the 10 years, females had higher MNS service utilization rates than males, and rates were lower among children under five compared to those five and older.Conclusions: Despite increased efforts to integrate MNS services into refugee primary health care settings over the past 10 years, there does not appear to be an increase in overall service utilization rates for MNS disorders within these settings. Healthcare service utilization rates are particularly low for common mental disorders such as depression, anxiety, post-traumatic stress disorder, and substance use. This may be related to different health-seeking behaviors for these disorders and because psychological services are often offered outside of formal health settings and consequently do not report to the HIS. Sustained and equitable investment to improve identification and holistic management of MNS disorders in refugee settings should remain a priority. [ABSTRACT FROM AUTHOR]

Background: Common mental disorders are frequently experienced by refugees. This study evaluates the impact of a brief, lay provider delivered group-based psychological intervention [Group Problem Management Plus (gPM+)] on the mental health of refugees in a camp, as well as on parenting behavior and children's mental health. Methods and findings: In this single-blind, parallel, randomized controlled trial, 410 adult Syrian refugees (300 females, 110 males) in Azraq Refugee Camp (Jordan) were identified through screening of psychological distress (≥16 on the Kessler Psychological Distress Scale) and impaired functioning (≥17 on the WHO Disability Assessment Schedule). Participants were randomly allocated to gPM+ or enhanced usual care (EUC) involving referral information for psychosocial services on a 1:1 ratio. Participants were aware of treatment allocation, but assessors were blinded to treatment condition. Primary outcomes were scores on the Hopkins Symptom Checklist-25 (HSCL; depression and anxiety scales) assessed at baseline, 6 weeks, and 3 months follow-up as the primary outcome time point. It was hypothesized that gPM+ would result in greater reductions of scores on the HSCL than EUC. Secondary outcomes were disability, posttraumatic stress, personally identified problems, prolonged grief, prodromal psychotic symptoms, parenting behavior, and children's mental health. Between October 15, 2019 and March 2, 2020, 624 refugees were screened for eligibility, 462 (74.0%) screened positive, of whom 204 were assigned to gPM+ and 206 to EUC. There were 168 (82.4%) participants in gPM+ and 189 (91.7%) in EUC assessed at follow-up. Intent-to-treat analyses indicated that at follow-up, participants in gPM+ showed greater reduction on HSCL depression scale than those receiving EUC (mean difference, 3.69 [95% CI 1.90 to 5.48], p =.001; effect size, 0.40). There was no difference between conditions in anxiety (mean difference −0.56, 95% CI −2.09 to 0.96; p =.47; effect size, −0.03). Relative to EUC, participants in gPM+ had greater reductions in severity of personally identified problems (mean difference 0.88, 95% CI 0.07 to 1.69; p =.03), and inconsistent disciplinary parenting (mean difference 1.54, 95% CI 1.03 to 2.05; p <.001). There were no significant differences between conditions for changes in PTSD, disability, grief, prodromal symptoms, or childhood mental health outcomes. Mediation analysis indicated the change in inconsistent disciplinary parenting was associated with reduced attentional (β = 0.11, SE.07; 95% CI.003 to.274) and internalizing (β = 0.08, SE.05; 95% CI.003 to 0.19) problems in children. No adverse events were attributable to the interventions or the trial. Major limitations included only one-quarter of participants being male, and measures of personally identified problems, grief, prodromal psychotic symptoms, inconsistent parenting behavior, and children's mental health have not been validated with Syrians. Conclusions: In camp-based Syrian refugees, a brief group behavioral intervention led to reduced depressive symptoms, personally identified problems, and disciplinary parenting compared to usual care, and this may have indirect benefits for refugees' children. The limited capacity of the intervention to reduce PTSD, disability, or children's psychological problems points to the need for development of more effective treatments for refugees in camp settings. Trial registration: Prospectively registered at Australian and New Zealand Clinical Trials Registry: ACTRN12619001386123. Richard A. Bryant and colleagues evaluate effects of a lay provider-delivered intervention on adult Syrian refugees' mental health, parenting behavior, and their children's mental health. Author summary: Why was this study done?: There are approximately 80 million refugees and forcibly displaced people today, and they are at greater risk for common mental disorders. Most countries hosting refugees lack the health resources to address these mental health problems. In response to this situation, the World Health Organization has developed a brief psychological intervention that can be delivered by trained lay workers that aims to reduce psychological distress following adversity. To our knowledge, this study was the first to test the effectiveness of the Group Problem Management Plus (gPM+) program in distressed refugees in a refugee camp. What did the researchers do and find?: This study screened adult Syrian refugees in a camp in in Jordan, and subsequently randomized 410 adult refugees who displayed distress and impaired functioning to either 5 individual sessions of gPM+ or enhanced usual care (EUC). Independent assessments indicated that 3 months following treatment, refugees who received gPM+ reported significantly less depression but not anxiety, with a moderate effect relative to EUC. gPM+ also led to greater reductions inconsistent disciplinary parenting, and this was associated with greater reductions in attentional and internalizing problems in refugees' children. What do these findings mean?: This study suggests that mental health nonspecialists can be briefly trained in gPM+, and they can deliver this intervention in a way that it can improve mental health of refugees. This brief intervention has the potential to scale up mental health services for refugees in settings that lack adequate health resources, and this may have downstream benefits for refugees' children. [ABSTRACT FROM AUTHOR]

Cervical cancer is preventable and also curable when detected early and treated adequately, yet it remains a leading cause of morbidity and mortality among women. In Bhutan, cervical cancer is the most common cancer among women. Bhutan was the first country among the low‐ and middle‐income economies to have instituted a national HPV vaccination program, in 2010, and has achieved >90% coverage. In 2019, Bhutan launched a cervical cancer elimination flagship program well ahead of WHO's launch of the global strategy for accelerated elimination of cervical cancer. Bhutan initiated vaccination of adolescent boys and adopted a gender‐neutral vaccination program beginning September 2020 through its well‐established network of primary healthcare centres. The flagship program aims to screen women aged 30–69 years with HPV testing using liquid‐based cytology (LBC) as triaging for screen positive women. For women aged 25–29 years, LBC will be continued as per American Society of Colposcopy and Cervical Pathology guidelines. Colposcopy and treatment will be performed in camps to decrease loss of follow up of screen positive women. This program is also expected to improve early diagnosis of cervical cancer and provide timely and adequate cancer treatment and palliative care services. This article reviews the progress made and the challenges facing the 2030 cervical cancer elimination targets in Bhutan. Bhutan initiated a nationwide immunization of adolescent girls in 2010 and of adolescent boys in 2020. This article reviews the progress and challenges in Bhutan's efforts of HPV and cervical cancer elimination. [ABSTRACT FROM AUTHOR]

Nearly 30% of all U.S. youth attend summer camp each year, making it one of the broadest reaching out‐of‐school‐time interventions in the country. Camp provides a space for seasonal employees, who are often emerging adults, to explore work values and identity, engage in mentoring and support opportunities, and stay connected to a community larger than themselves. However, research on camp experiences also suggests camp settings and expectations around emotional and physical care can cause counselors to experience burnout, compassion fatigue, and reduced job satisfaction. Using participatory culture‐specific consultation, the current study addressed a gap in the literature about systemic interventions to manage camp counselor mental health by designing, implementing, and evaluating a mental health consultation model at one of the largest YMCA summer camps in the country. Results suggest the intervention effectively addressed certain administrator and staff needs; results also suggest the model could be refined to more effectively respond to the particular contextual challenges of summer camps. Implications and recommendations for other summer camps are discussed. [ABSTRACT FROM AUTHOR]

Background and aims: India has a significant burden of hepatitis C virus (HCV) infection and has committed to achieving national elimination by 2030. This will require a substantial scale‐up in testing and treatment. The "HEAD‐Start Project Delhi" aimed to enhance HCV diagnosis and treatment pathways among the general population. Methods: A prospective study was conducted at 5 district hospitals (Arm 1: one‐stop shop), 15 polyclinics (Arm 2: referral for viral load (VL) testing and treatment) and 62 screening camps (Arm 3: referral for treatment). HCV prevalence, retention in the HCV care cascade, and turn‐around time were measured. Results: Between January and September 2019, 37 425 participants were screened for HCV. The median (IQR) age of participants was 35 (26‐48) years, with 50.4% male and 49.6% female. A significantly higher proportion of participants in Arm 1 (93.7%) and Arm 3 (90.3%) received a VL test compared with Arm 2 (52.5%, P <.001). Of those confirmed positive, treatment was initiated at significantly higher rates for participants in both Arms 1 (85.6%) and 2 (73.7%) compared to Arm 3 (41.8%, P <.001). Arm 1 was found to be a cost‐saving strategy compared to Arm 2, Arm 3, and no action. Conclusions: Delivery of all services at a single site (district hospitals) resulted in a higher yield of HCV seropositive cases and retention compared with sites where participants were referred elsewhere for VL testing and/or treatment. The highest level of retention in the care cascade was also associated with the shortest turn‐around times. [ABSTRACT FROM AUTHOR]

This narrative review of the public private mix (PPM) TB plan by comprehensively evaluated the performance of this initiative in case reporting, management, treatment outcome, affordability, and accessibility from the district health system data to the TB Control Programs. Comprehensive literature review was done from the peer-reviewed journals; reports including global and national TB control programs along with technical guidelines on PPM were reviewed. This paper focusses on PPM model in the TB case notification since its establishment in Pakistan based on the data reported by national TB control mechanisms by reviewing the involvement of and TB case contribution by private health care providers, active case finding through chest camps, TB case finding through enhanced case findings in large private hospitals, and case finding through lady health workers. PPM is a promising strategy for TB care and control and scaling up of PPM should include financial support in addition to material inputs. Moreover, improving program governance and training for the health care providers with the help of integrated collaborative mechanisms is warranted. There should be a standard reporting system for private practitioners for setting up standard guidelines for the Tuberculosis treatment. [ABSTRACT FROM AUTHOR]

Purpose: Obtaining meaningful clinical experiences with paediatric and perinatal (young families) populations is increasingly challenging for nursing programs. Care for this population has largely moved to outpatient and tertiary settings. Therefore, a current trend is to use non-traditional clinical settings. While summer camps offer rich learning experiences for nursing students, they are seldom used as clinical placements. Faculty at an Atlantic Canadian university sought a novel way to engage students in young families' learning by partnering with overnight summer camps, staffed by counsellors, camp administrators, and on-site nurses. Campers included those with lived experience of cancer, diabetes, physical and developmental challenges, and socioeconomic challenges. This study assesses how young families course outcomes were met by an innovative clinical experience within a Bachelor of Nursing program and describes the perceptions and experiences of those involved., Methods: Study participants included students (n = 4), camp directors (n = 3), a camp nurse (n = 1), and the clinical educator (n = 1). Data collection involved semi-structured interviews and a focus group. Interpretive description methodology was used to identify themes and patterns related to overarching research questions., Findings: Students met the outcomes and overall participant perceptions and experiences were positive. However, some participants shared constructive critiques for future consideration., Conclusions: Nursing students who completed a young families clinical placement at summer camps met course outcomes, and those involved reported both positive experiences and constructive critiques for future consideration., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Around a million FDMNs have settled in Cox's Bazar, the southeast coastal district of Bangladesh. The geographically proximate country of Rakhine state of Myanmar following armed conflict in this area in August 2017 and created a unique humanitarian crisis. It is important to know the current health status of FDMNs because, without this information, equal and equitable health service provision is not possible. So, we conducted this study to explore the common health problems of FDMNs residing in camps of Cox's Bazar, Bangladesh. Method: This descriptive observational study was conducted from January 2018 to July 2019 at Cox's Bazar Medical College Hospital, Cox's Bazar which first prioritized referred tertiary hospitals for FDMNs. Result: Among study FDMNs, Age ranges from 3 months to 97 years with a median age of 40 (25-60) years and male to female representatives were almost equal (51.6% male and 48.4% female). Majority of the male were farmers (engaged in agriculture, livestock and fish farming) and the females were house makers. One third of the primary respondents have formal education (i.e. religious education) in Myanmar. More than 30% of the participants reported having H/O recent death of family members in Myanmar with a median number of two members due to recent violence. 37% FDMNs were malnourished out of them 14.7% were severe. BCG scar marks were found in 70% and only 40.7% were vaccinated with other vaccines in under five children.75.4% FDMNs were dependent on unqualified village doctors" for treatment. The most common NCD among the FDMNs people were COPD, DM, and HTN with risk factor tobacco use and frequent betel nut chewing. Chronic liver disease with underlying hepatitis C or Hepatitis B infection, HIV and TB were more common. Nearly one third FDMNs were clinically anemic. 42.9% of the participants reported do not won and use LLN in Myanmar. 73.2% FDMNs have knowledge about ORS use in diarrhea. Predominant diseases among admitted primary respondents were CLD (15.7%) followed by COPD (13%), pregnancy complication and Injury (7.2%). Major causes of death in admitted FDMNs were COPD with its complication (25%) Cardiac disease (20%), CLD with Hepatic encephalopathy (15%), CNS infection and Septic shock (10%). Conclusion: This study identifies common health problems of the FDMN also called Rohingya refugees in Bangladesh. FDMNs in Bangladesh are under significant health risks and necessary to scale up targeted health care policy and improvement of local GOB and non-Government health care facilities for them. [ABSTRACT FROM AUTHOR]

Introduction: access to essential secondary and tertiary healthcare, including surgery and medical sub-specialties, is a challenge in low-and-middle income countries (LMICs), especially for displaced populations. Referrals from refugee camps are highly regulated and may pose barriers to accessing essential secondary healthcare in a timely manner. Refugee referral systems and the ways they interact with national systems are poorly understood. Such information is necessary for resource allocation and prioritization, optimizing patient outcomes, national-level planning, and investment in capacity-building. Methods: a retrospective review of referrals from Nyarugusu Refugee Camp in Tanzania to Kabanga Hospital between January 2016-May 2017 was conducted. Data was collected from logbooks on patient demographics, diagnosis, and reason for referral. Diagnoses and reasons for referral were further coded by organ system and specific referral codes, respectively. Results: there were 751 entries in the referral logbook between January 2016 and May 2017. Of these, 79 (10.5%) were excluded as they were caretakers or missing both diagnoses and reason for referral resulting in 672 (89.5%) total entries for analysis.The most common organ system of diagnosis was musculoskeletal (171, 25.5%) followed by head, ear, eye, nose and throat (n=164, 24.4%) and infectious disease (n=92, 13.7%). The most common reason for referral was imaging (n=250, 37.2%) followed by need for a specialist (n=214, 31.9%) and further management (n=116, 17.3%). X-ray comprised the majority of imaging referred (n=249, 99.6%). The most common specialties referred to were ophthalmology (n=104, 48.6%) followed by surgery (n=63, 29.4%), and otolaryngology (ENT) (n=17, 7.9%). Conclusion: given a large burden of referral for refugee patients and sharing of in and out-of-camp healthcare facilities with nationals, refugees should be included in national health care plans and have clear referral processes. Epidemiological data that include these intertwined referral patterns are necessary to promote efficient resource allocation, reduce unnecessary referrals, and prevent delays in care that could affect patient outcomes. International agencies, NGOs, and governments should conduct cost analyses to explore innovative capacity-building projects for secondary care in camp-based facilities. [ABSTRACT FROM AUTHOR]

Background: Telemedicine, a part of Medical Informatics used to consult patients from remote places either via videoconferencing or transferring data and resources via the Store and Forward method, makes the quality of healthcare in low-and middle-income countries more efficient, cost-effective, and accessible. The objectives of this study were to determine its effects on the health of refugees and its efficacy in terms of referrals and cost reduction for healthcare service providers among Bhutanese refugees in eastern Nepal. Methods: This was a cross-sectional study done retrospectively from the records of patient data of Bhutanese refugees from AMDA, Damak, and prospectively by asking the questionnaire to the healthcare providers of Beldangi PHC of AMDA, Damak. Results: The total percentage of patients that were seen via teleconsultation in the primary center was 58% male and 42% females, whereas from the secondary center, males were 43% and females constituted 57%. The referral rate from those primary centers and secondary centers were decreased to 31% and 39%, respectively, from 72% and 61% from previous records. The budget expenditure was also decreased to 13.65% from 29.41%. Conclusions: Telemedicine is beneficial in those types of refugee camps where there are chains of referring patients from primary health centers to tertiary care centers via secondary healthcare centers. As it not only decreased the referral rate but also save the budget expenditure, which are needed when referring those patients to other centers. [ABSTRACT FROM AUTHOR]

Background: Delivery of healthcare services needs to be rooted in frameworks supporting community engagement. Our organization delivers primary eyecare through two different models. These case studies quantitatively analyse the impact of community collaboration on the effectiveness of these models-camps and vision centres. Methods: Camp data from two rural blocks of north India comparing first year of operations in 2016 with that of 2017; April-September 2017 data from two underperforming vision centreswas compared to data from same period in 2018.Natural interventions in camps included visits of local leaders to surgical centre, health talks spreading awareness regarding eyecare plusour organization, and local partners helping counsel patients, while for vision centres,staff was trained to conduct regular health talks and meetings in nearby villages. For camps, before and after data on attendance, proportion of people over 50, proportion of people getting operated among those advised and acquisition cost were analysed,for vision centres referral from these centres wereanalysed. Results: Parameters for both models showed improvement inthe second year. Conclusion: Sustained presence in the community and collaboration with local stakeholders increases effectiveness of service delivery at primary level. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore mental health workers' perceptions and concerns about the psychosocial interventions provided to third-generation Palestinian refugee children. Our sample comprised 30 mental health practitioners aged 26–35 years, who were purposively selected at five Palestinian refugee camps in the West Bank of Palestine. Thematic content analysis was applied to transcripts of interviews with the practitioners, with a view to identifying key themes. It emerged that psychosocial service providers typically deliver consultation, group, and individual counselling, debriefing, and life skills training to children in Palestinian camps. The main challenges faced by the psychosocial service providers in the camps include a lack of qualified specialist staff, insufficient funding, the political conflict, and poor community awareness of psychosocial services, as well as low salaries and unemployment among psychosocial practitioners. The participants suggested that improving psychosocial services in the future will require investment in the sector, working alongside families and schools, establishing permanent psychosocial centres, and offering professional development opportunities to Palestinian psychosocial service providers. [ABSTRACT FROM AUTHOR]

Objectives: Community Health Workers are one way to address the shortage of ear and hearing care specialists in low‐resource settings. However, there are few reports evaluating training and service delivery by Community Health Workers. Design, setting and participants: We trained 13 Community Health Workers in primary ear and hearing care in Mukono District, Uganda. Community Health Workers attended a two‐day training workshop and received remote supervision thereafter during service delivery in the community. An ear camp was held at the local health centre every two months, where a local ENT specialist could assess referred cases. Main outcome measures: Clinical and diagnostic skills and decision‐making were assessed using an Objective Structured Clinical Examination, with scores recorded at baseline and six months. Service delivery was evaluated by analysing the following: (i) number of individuals evaluated; (ii) treatments delivered; (iii) cases referred for specialist opinion; (iv) proportion of appropriately referred cases; and (v) agreement between Community Health Worker and specialist diagnosis. Results: Observed Structured Clinical Examination scores were high and stable for six months. 312 individuals were screened in the community by the Community Health Workers, with 298 classified as having an abnormality. Care was delivered in the community to 167 of these, and the remaining 131 referred to the ear camp. Diagnostic agreement was 39%, but 98% of referrals were deemed "appropriate" by the ENT specialist. 27 individuals self‐presented to the ear camp without prior assessment by a Community Health Worker, and 97% of these were deemed appropriate. Conclusion: Trained Community Health Workers can play an important role in delivering ear and hearing services. Future work should look to explore this model in other contexts and/or compare it to other models of service delivery. [ABSTRACT FROM AUTHOR]

Background: In Somalia, maternal and child health service utilization is unacceptably low. Little is known about factors contributing to low maternal and child health service utilization in Somalia, especially in internally displaced people (IDP) settings. This study aimed to understand barriers to the use of maternal and child health-care services among IDPs in Mogadishu. Methods: A total of 17 in-depth interviews (IDIs), 7 focus group discussions (FGDs), and field observations were conducted on lactating/pregnant mothers, health-care providers, traditional birth attendants (TBA), and IDP camp leaders. The socio-ecological model (SEM) framework was employed for the categorization of barriers to healthcare utilization and further analysis was conducted to understand the major types and nature of barriers. Results: Using the SEM, the following major barriers that hinder maternal and child health service utilization were identified. Low socio-economic, lack of decision making power of women, TBA trust, poor knowledge and awareness on pregnancy danger signs, fear of going to unfamiliar areas were identified barriers at individual level. Traditional beliefs, male dominance in decision making, and lack of family support were also identified barriers at interpersonal level. Security and armed conflict barriers and formidable distance to health facility were identified barrier at the community level. Lack of privacy in the facility, transportation challenges, poor functional services, negative experiences, closure of the health facility in some hours, and lack of proper referral pathways were identified barriers at organizational or policy level. Conclusion: Overall, various factors across different levels of SEM were identified as barrier to the utilization of maternal and child health services. Hence, multi-component interventions that target these complex and multifaceted barriers are required to be implemented in order to improve maternal and child health services utilization among IDP in Mogadishu, Somalia. [ABSTRACT FROM AUTHOR]

Objective: To report the results of implementation of two-pronged system for strengthening of referral and receiving end of referral chain for people with Type-2 diabetes mellitus (T2DM) at a tertiary eye care hospital in Karachi. Methods: This observational, cross sectional study was conducted from the data collected in "Strengthening Pakistan's response to Diabetic Retinopathy" project. Peripheral referral was improved through community awareness camps (n=48), refreshing knowledge of primary healthcare professionals (PHCP) and conducting retinopathy screening camps (n=85) in the community. T2DM patients with best corrected visual acuity (BCVA) <6/18 or had retinopathy sign on screening were referred to tertiary center. The receiving end of the referral was improved by establishing "one window facility" at tertiary eye care center. Facility consisted of eight stations starting from registration, visual assessment, fundus photographs, consultation with ophthalmologist, anthropometry measurement, consultation with diabetologist to finally meeting with diabetes educator. At every station, patient's information was directly entered in HIMS software. Results: A total of 50,595 patients attended tertiary center over six years. Among all 34685 (68.5%) were new registration and 15910 (31.4%) were follow ups. During first year (2014-15) out of total registered individuals with DM, newly registered were 4414 (89.5%) and 518 (10.5%) were follow-ups. In the final year (2019-20) new cases registered reached to 62% (n= 7916) with 38% (n=4852) follow-ups. Patients referred by PHCP increased from 6.5% in 2014-15 to 43.7% in 2019-20. An increased uptake of all treatment modalities for retinopathy like laser (increased by 16.76%), intra-vitreal injections (by 14.72%) and vitrectomy (by 51.47%) were also observed. Conclusion: Implementation of two prong system resulted in improved service uptake, better referral system, enhanced follow-ups and increased intervention uptake. [ABSTRACT FROM AUTHOR]

Since the start of the Mediterranean refugee crisis in 2015, large numbers of migrants have been forced into the Italian accoglienza (reception) system, a muddled and ambiguous context describable as a camp. Based on our consultancy practice, we analyze the wide labeling of migrants – no matter their age, migratory journey, or family status – as ragazzi (boys/girls or kids), and what it reveals about the current Italian social imaginary: the effects of neoliberal emotional policies, the continuation of a colonialist mentality, the need for psychological defenses among staff, and the disempowerment of migrants in a camp-like institution. [ABSTRACT FROM AUTHOR]

Background: The Syrian conflict has produced one of the largest refugee crises in modern times. Lebanon has taken in more Syrian refugees per capita than any other nation. We aimed to study the burden of surgical disease and access to surgical care among Syrian refugees in Lebanon. Methods: This study was designed as a convenient cross-sectional cluster-based population survey of all refugee camps throughout the Bekaa region of Lebanon. We used a modified version of the Surgeons OverSeas Assessment of Surgical Need to identify surgical conditions and barriers to care access. The head of household of each informal tented settlement provided demographic information after which two household members were randomly chosen and administered the survey. Results: A total of 1,500 individuals from 750 households representing 21 camps were surveyed. Respondents had a mean age of 36.6 (15.0) years, 54.6% were female, and 59% were illiterate. Nearly 25% of respondents reported at least one surgical condition within the past year, most commonly involving the face, head, and neck region (32%) and extremities (22%). Less than 20% of patients with a surgical condition reported seeing any healthcare provider, > 75% due to financial hardship. Conclusions: The prevalence of surgical disease among Syrian refugees is very high with a fourth of refugees suffering from one or more surgical conditions over the past year. The surgical needs of this vulnerable population are largely unmet as financial reasons prevent patients from seeking care. Local and humanitarian efforts need to include increased access to surgical care. [ABSTRACT FROM AUTHOR]

Introduction: The humanitarian crisis in Iraq remains one of the largest and most unstable in the world. In 2014, over 2.5 million civilians were displaced in Iraq; between 2015 and 2017 more than 3 million people continued to be displaced. While health-related research concerning internally displaced persons (IDPs) population has been conducted in many settings, very few have looked at the quality of care delivered in primary health care centres (PHCC) inside camps. The objective of this operational research is to assess the quality of health care services at PHCC in operational IDP camps supported by local and international NGOs (humanitarian partners) as well as the Directorate of Health (DoH) in Iraq at baseline and after 6 months. Method: A framework based on five components was used to assess quality of care by assigning a quality-of-care index score. Using a longitudinal design; data were collected through observations of facilities and of patient consultations, as well as health worker and patient exit interviews, in static PHCC in operational IDP camps of Iraq during two different phases: in June (n = 55), and December 2018 (n = 47). These facilities supported more than 500,000 IDPs. Descriptive and statistical analyses were conducted, and the results compared. Result: For all camps (n = 47), the average overall quality of care index score increased between the two phases. No specific type of organisation consistently provided a better quality of care. The camp size was unrelated to the quality of care provided at the respective facility. The domain indicators "Client Care" and "Environment and Safety" mostly related to the variation in the general assessment of quality. Patient satisfaction was unrelated to any other domain score. Compared at 0 and after 6-months, the quality of care index score between the type of organisation and governorate showed that feedback positively impacted service delivery after the first assessment. Positive differences in scores also appeared, with notable improvements in Client care and Technical competence. Conclusion: Humanitarian partners and the DoH are able to provide quality care, independent of camp size or the number of camps managed, and their cooperation can lead to quick improvements. This research also shows that quality of care assessment in emergency settings can be carried out in formal IDP camps using non-emergency standards. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the information needs of addicts from the perspective of addicts. By identifying the experiences of the individuals involved in addiction and assessing the information they need, targeted educational interventions can be provided to meet their needs. Methods: Semi-structured interviews were conducted with 13 addicts in two addiction outpatient clinics. Data were analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. Findings: The information needs of the interviewees included recognizing types of addictive substances and the degree of dependence on them, awareness of the physical and psychological symptoms of addiction to various addictive substances, awareness of various pharmacological and non-pharmacological treatments, physical and psychological symptoms of quitting addiction, awareness of the length of treatment, knowledge about the dose and degree of dependence on drugs, recognizing the causes of failure in quitting addiction, awareness of governmental and non-governmental services, and awareness of the psychological measures and care services necessary after quitting addiction. Conclusion: The results of the study showed that the knowledge and awareness of addicted individuals in various fields of addiction is low and it is necessary to provide education based on the information needs of these individuals. This requires the cooperation and efforts of policy makers, the Ministry of Education, welfare managers, and specialists in camps and addiction treatment centers. Specialists in addiction treatment clinics can use the information needs of addicts determined in this study to enrich the education of addicts. [ABSTRACT FROM AUTHOR]

Background: Feedback on satisfaction regarding healthcare services is vital for continuous improvement of the service delivery process and outcome.Aims and Methods: The objective of this study was to assess the satisfaction of refugees with the medical and dental services in Zaatari camp, under 3 domains with 20 key indicators (human and physical health resources, interaction and reactivity, and administration) using a self-administered questionnaire.Results: Of the 500 participants, the satisfaction rate was 72.5%. Young participants and participants with a shorter stay in the camp showed higher overall satisfaction rates (P ≤ 0.01). Within the domains, 'interaction and reactivity' achieved the highest satisfaction score, whereas 'administration efficiency' was ranked the lowest. As for elements within the domains, the most acceptable were the sufficient number of staff and the working hours, availability of radiological services and proper care for children, reasonable waiting time and asking for medical history in every visit. Whereas difficulty to access healthcare services, difficulty to be referred to hospitals, lack of follow up and lack of dental services were the least acceptable.Conclusion: In conclusion, whereas refugees were generally satisfied with the provided services, this study indicates that there are areas for further service improvement. This study highlights a significant gaps in healthcare services which if not addressed have the potential to amplify oral/medical health problems. [ABSTRACT FROM AUTHOR]

The American Camp Association and Association of Camp Nursing collaborated for the creation of the Healthy Camps initiatives from 2006-2020. During that time, the initiative developed a holistic approach to a healthy camp framework by examining and addressing a range of challenges experienced by camp programs in the United States. Camper and staff mental, emotional, and social health (MESH) became an important focus, as camp professionals grew increasingly concerned with the behaviors and challenges exhibited by campers and staff during their programs. The purpose of this article is to share the extensive work and resources developed by the Healthy Camps initiatives to help camp professionals address the mental, emotional and social health needs of their campers and staff. [ABSTRACT FROM AUTHOR]

Objective: Describe the development and preliminary impact of CAMP Air, a web-based intervention for adolescents with uncontrolled asthma.Materials and Methods: CAMP Air was developed using an iterative process with input from stakeholders and incorporating usability testing results (n = 14 adolescents). To test CAMP Air's initial impact, 61 adolescents from two New York City public high schools (n = 37) and from clinics, community-based organizations, and third-party recruitment services (i.e., community sample; n = 24) were enrolled in a randomized pilot trial. Participants were randomized to CAMP Air (n = 30) or information-and-referral control intervention (n = 31). A point-person worked with school participants to complete CAMP Air.Results: CAMP Air participants were satisfied with the intervention and its value for supporting self-management, completing on average 6 of 7 modules. Relative to controls, CAMP Air participants demonstrated significantly improved asthma knowledge, asthma control, night wakening and school absences, and less risk for urgent care visits. Adolescents enrolled in schools completed more modules and had significantly fewer nights woken and school absences than community enrollees.Conclusion: CAMP Air improves asthma outcomes among adolescents with uncontrolled asthma.Practice Implications: A web-based intervention CAMP Air is a promising intervention. When a point-person works with adolescents, CAMP Air's access and impact are improved. [ABSTRACT FROM AUTHOR]

Refugees and displaced persons have been severely affected by the Covid-19 pandemic. Yet findings from this narrative review reveal that the health needs of refugees have been largely neglected within global healthcare responses. Such gaps include: (1) responding to the needs of refugees in camps and detention centers; (2) providing adequate public health information; (3) providing access to healthcare and mental health services; (4) and including refugees as decision-makers within health responses. More research is urgently needed to investigate why these gaps exists and to provide recommendations for improving the inclusiveness of healthcare policies during a pandemic. [ABSTRACT FROM AUTHOR]

The World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020.* Shortly thereafter, closures of 124,000 U.S. public and private schools affected at least 55.1 million students through the end of the 2019-20 school year.† During the summer of 2020, approximately 82% of 8,947 U.S. overnight camps did not operate.§ In Maine, only approximately 20% of 100 overnight camps opened.¶ An overnight camp in Georgia recently reported SARS-CoV-2, the virus that causes COVID-19, transmission among campers and staff members when nonpharmaceutical interventions (NPIs) were not strictly followed (1); however, NPIs have been successfully used to mitigate SARS-CoV-2 transmission among military basic trainees (2). During June-August 2020, four overnight camps in Maine implemented several NPIs to prevent and mitigate the transmission of SARS-CoV-2, including prearrival quarantine, pre- and postarrival testing and symptom screening, cohorting, use of face coverings, physical distancing, enhanced hygiene measures, cleaning and disinfecting, and maximal outdoor programming. During the camp sessions, testing and symptom screening enabled early and rapid identification and isolation of attendees with COVID-19. Among the 1,022 attendees (staff members and campers) from 41 states, one territory, and six international locations, 1,010 were tested before arrival; 12 attendees who had completed a period of isolation after receiving a diagnosis of COVID-19 2 months before arrival were not tested. Four (0.4%) asymptomatic attendees received positive SARS-CoV-2 test results before arrival; these persons delayed their arrival, completed 10 days of isolation at home, remained asymptomatic, and did not receive any further testing before arrival or for the duration of camp attendance. Approximately 1 week after camp arrival, all 1,006 attendees without a previous diagnosis of COVID-19 were tested, and three asymptomatic cases were identified. Following isolation of these persons and quarantine of their contacts, no secondary transmission of SARS-CoV-2 occurred. These findings can inform similar multilayered public health strategies to prevent and mitigate the introduction and transmission of SARS-CoV-2 among children, adolescents, and adults in congregate settings, such as overnight camps, residential schools, and colleges. [ABSTRACT FROM AUTHOR]

Background: An ever-growing and long surgical waiting list is a challenge within the NHS. Long waiting times can result in complications of the condition with more challenging operations and additional procedures. All of which implies reduced quality of life for patients and increased strain on NHS finances. On an average there are about 160 patients on the waiting list for groin hernia surgeries, with over a half of them waiting more than 30 weeks. Three patients every year breach the 52 weeks timeline, flagging a never event, with negative implications for the trust. Methods: The Hernia CAMP model was proposed to improve productivity and enhance patient experience. It helped create a pathway with experienced non-consultant surgeons, stepping up to free up consultants to attend to the pressing cancer and complex cases. This dedicated pathway, improved the patient experience and staff team-spirit too. Results: The Hernia CAMP resulted in a 40% improvement in efficiency. With better ratio per list/session, it makes care more cost-effective. It also improved the work environment amongst staff and rapport with patients. The patient-peer support and greater involvement meant better overall experience too. This supportive environment also has the potential for theme-based learning and training. Conclusions: The Hernia 'CAMP' is a transferable and adaptable model. It impacts not just long waiting lists, but also improves productivity with definite cost benefits, teambuilding, patient experience and creates a great opportunity to train too. [ABSTRACT FROM AUTHOR]

Every summer, millions of campers attend day camp, bringing with them a sense of adventure and a variety of healthcare needs. Within the day camp environment, the focus of nursing care may include care of healthy children, adult staff, and/or care of campers with specific healthcare needs. The camp nurse must practice autonomously outside a structured healthcare setting. This role can be challenging, even for the most experienced practitioner. The camp nurse needs the knowledge, skills set, and judgment to practice in such a potentially diverse and challenging setting. To prepare the nurse for this new role, one camp nurse educator describes a mentorship program for nurses new to day camp nursing. The mentor relationship consists of the following strategies: introductory meeting with the mentor, orientation to camp nurse practice, and support and guidance throughout the summer. Through this informal mentoring program, the camp nurse became prepared to provide competent care to campers in a fun-filled summer day camp environment. [ABSTRACT FROM AUTHOR]

Position statements and guidelines for the care of children with diabetes in a camp setting and reviews of nursing staff roles can be found in medical literature. In this article, the authors report some possible pitfalls in nurse safety practice that are not stressed in guidelines, and offer some practical suggestions based on their own experience in diabetes camps. They focus on the risk of blood-borne pathogen contamination through glucose meters and through reusable penlet finger-stick devices. They also emphasise the risk of blood regurgitation into insulin cartridges. [ABSTRACT FROM AUTHOR]

These nurses serve millions of youths all year round. [ABSTRACT FROM AUTHOR]

5 ESCRS Guidelines for prevention and treatment of endophthalmitis following cataract surgery: Data, dilemmas and conclusions, 2013. There are only a few reports of cluster endophthalmitis from India and there is no reliable national data on its incidence.[[1]] Prevention of endophthalmitis has been a long-unfulfilled utopian goal. A literature review and update on the incidence and microbiology spectrum of post-cataract surgery endophthalmitis over past two decades in India. [Extracted from the article]

With the passage of Bill C-4 and stronger professional governance, Canada's physicians will be doubly incentivized to reject cissexism and heterosexism, and to embrace a more inclusive approach to health care. Conversion therapy continues to occur in both regulated and unrelated settings in Canada, prompting federal, provincial and territorial, and municipal governments to have debated and enacted dozens of legislative bans over the past 6 years. [Extracted from the article]

Problem Incorporating mirrors into nursing is a relatively new field of research and practice. The focus of two studies was to explore (a) the meaning of women's mirror experiences following a mastectomy and (b) the experience of viewing self in the mirror for women who were terminally ill. The goal of the research was to establish a conceptual foundation for the development of nursing mirror interventions. Methods Open-ended questions and dialogical engagement in one-to-one audio-taped interviews were used in both studies. Ricoeur's hermeneutic phenomenology was used to analyze the findings. Findings Four concepts were uncovered in the experience of viewing self in the mirror: decision, seeing, understanding, and consent. Conclusion Exemplar composite case studies across the care continuum are provided as examples of the way in which mirrors may be utilized in nursing practice. [ABSTRACT FROM AUTHOR]

Oncology Nursing Society (ONS) members share a unique passion for the people they serve and frequently commit to projects that make a difference. Camp Raising Spirits, a weekend retreat for adults with cancer, has made a difference in southwestern Pennsylvania for hundreds of people with cancer and their caregivers for 24 consecutive years. This article will describe how an ONS chapter capitalized on the leadership attributes of partnership, creativity, and commitment to sustain an important community service program. [ABSTRACT FROM AUTHOR]