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Background: Considering the global shortage of nurses, leaders in the field must understand the strengths and weaknesses of various nursing specialties in order to retain professionals within the field. Occupational prestige reflects the perceived contribution of an occupation 'to society', and measures its desirability, benefit and values. Understanding how experienced nurses view the prestige of nursing specialties may help to explain why some specialties are more desirable than others. We conducted a cross-sectional study to examine the prestige of nursing specialties among nurses taking post-graduate in-training courses. Methods: The study questionnaire examined nurses' perceived prestige of nine nursing specialties, the perceived extent of autonomy and authority, the unique knowledge and clinical skills required for each specialty, and participants' demographic and professional characteristics. Results: A total of 101 nurses (90% females, mean age 35.4 ± 9.39 years) completed the questionnaire. Intensive care (4.67 ± 0.59) and neonatal intensive care (4.57 ± 0.74) were perceived as having the highest prestige, whereas physical activity consultation (2.67 ± 0.98) and sleep consultation (2.71 ± 0.92) were perceived as having the lowest prestige. These specialties were also perceived as requiring the most and least unique knowledge and clinical skills, respectively. In contrast, authority and autonomy were ranked highest in breastfeeding consultation (4.50 ± 0.81), followed by intensive care (4.10 ± 0.87), while congestive heart failure received the lowest score (3.48 ± 0.84). Principal component analysis showed that higher prestige is attributed to acute care specialties, while chronic care specialties or ones involving consultation have lower prestige. Conclusions: Nursing specialties with lower scores should be rebranded to encourage nurses to enter these fields. [ABSTRACT FROM AUTHOR]

During the Hu Jintao era, policy intellectuals participated in public debates, openly criticizing existing government policies. During the Xi Jinping era, despite regime efforts to tame intellectuals, some critical voices have retained influence over policymaking processes. What adaptation strategies have they utilized to circumvent the regime's control over public speech? This article points to two strategies. First, policy intellectuals formed shifting collaborations with both state and nonstate actors. Second, they utilized collaborations with state actors to enter consultative forums. The article finds that policy intellectuals not only formed Beijing-based alliances but also cultivated closer cooperation with local officials. By "going local" in this way, they bypassed Beijing's tightening political environment. This article focuses on two important policy intellectuals in the healthcare arena who have gone local. It also includes a comparison between these two policy intellectuals and seven of their prominent peers who did not go local, as well as with intellectuals from another policy arena: education. [ABSTRACT FROM AUTHOR]

Aim: To detect immune‐related adverse events (irAEs) early and treat them appropriately, our institute established an irAE‐focused multidisciplinary toxicity team in cooperation with various departments. This study aimed to evaluate a consultation system involving a team of hepatologists in terms of its utility for the management of severe immune checkpoint inhibitor (ICI)‐induced liver toxicity. Methods: To analyze the diagnosis and treatment of severe ICI‐induced liver toxicity (Grade 2 requiring corticosteroid therapy and Grade 3 or higher), we examined patients' clinical courses before and after the hepatologist consultation system was established (pre‐period, September 2014 to February 2019; post‐period, March 2019 to March 2023). Results: The median follow‐up period was 392 days. Of the 1247 patients with advanced malignancies treated with ICIs, 66 developed severe ICI‐induced liver toxicity (n = 22 and 44 in the pre‐ and post‐periods, respectively). In the pre‐period, hepatologist consultations were sought for 15/22 patients, whereas in the post‐period, 42/44 patients were referred to and treated by hepatologists. The time from the onset of liver toxicity to the consultation was significantly shorter in the post‐period than in the pre‐period (mean 1.9 vs. 6.5 days, respectively; p = 0.012). The number of patients with a biopsy‐confirmed diagnosis of ICI‐induced liver toxicity was significantly higher in the post‐period than in the pre‐period (n = 22 vs. n = 3, respectively; p = 0.006). Finally, there were no cases of immune‐related cholangitis in the pre‐period, compared to five cases in the post‐period. Conclusion: A hepatologist consultation system in an irAE‐focused multidisciplinary toxicity team is useful for managing severe ICI‐induced liver toxicity. [ABSTRACT FROM AUTHOR]

Given recent studies have begun to question the siloed nature of employee voice research this paper attempts to theorise the boundaries between Organisational Behavior (OB), Human Resource Management (HRM) and Industrial and Employment Relations (I/ER) voice. Researchers examine specific organisational contexts that may influence employees' voice behavior, with OB researchers paying particular attention to the micro contextual influences of leadership behavior and psychological safety climate on individual voice behavior; HR researchers emphasizing the meso role of HR practices that may facilitate employee voice; and I/ER researchers focusing more on how macro institutional supports such as unions and collective bargaining can protect employees and facilitate voice. The paper proposes a model of "contextual voice efficacy" as a bridge between these disparate literatures, and develops propositions as to how OB, HR and I/ER voice mechanisms can combine together in a single model. [ABSTRACT FROM AUTHOR]

Background Infectious diseases (ID) physicians are increasingly faced with the challenge of caring for patients with terminal illnesses or incurable infections. Methods This was a retrospective cohort of all patients with an ID consult within an academic health system from 1 January 2014 through 31 December 2023, including community, general, and transplant ID consult services. Results There were 60 820 inpatient ID consults (17 235 community, 29 999 general, and 13 586 transplant) involving 37 848 unique patients. The number of consults increased by 94% and the rate rose from 5.0 to 9.9 consults per 100 inpatients (P <.001). In total, 7.5% of patients receiving an ID consult died during admission and 1006 (2.6%) of patients were discharged to hospice. In-hospital mortality was 5.2% for community ID, 7.8% for general ID, and 10.7% for transplant ID patients (P <.001). Six-month mortality was 9% for all nonobstetric admissions versus 19% for community ID, 20.9% for general ID, and 22.3% for transplant ID. In total 2866 (7.6%) of all patients receiving ID consultation also received palliative care consultation during the same hospitalization. The index ID consult preceded any palliative consult in the majority (69.5%) of cases. A total of 16.3% of patients had a do-not-resuscitate order during the index hospitalization; 12.2% of all patients with a do-not-resuscitate order had this placed on the same day as the ID consult. Conclusions Patients receiving ID consultation were increasingly complex and more likely to die soon after consultation. These results provide a framework for ID clinicians to consider their role in end-of-life care. [ABSTRACT FROM AUTHOR]

One of the roles of school psychologists is consultation, an indirect service delivery method in which the consultant (i.e., the school psychologist) supports students' academic, behavioral, and social‐emotional functioning through collaborating with teachers and parents. Conjoint Behavioral Consultation (CBC), also known as Teachers and Parents as Partners (TAPP), is unique in that teachers and parents work together during the consultation process to improve elementary, middle, and high school students' functioning. This study evaluted the effects of CBC for children in early childhood when conducted via remote delivery. A nonconcurrent multiple baseline across participants design was used to evaluate the efficacy of CBC at improving outcomes for children in early childhood at home and school. Additionally, teacher and parent acceptability of CBC and CBC provided remotely were assessed. Participants included four parent‐teacher‐student triads. Results found CBC to improve difficulties for preschool children across settings. Additionally, CBC acceptability via remote delivery was high for both parents and teachers. Practitioner Points: Conjoint Behavioral Consultation was effective in improving preschool children's functioning.Parents and teachers reported CBC to be highly acceptable.CBC via remote delivery was rated as highly acceptable by parents and teachers. [ABSTRACT FROM AUTHOR]

Objective: The authors examined the initial implementation of the Indiana Adolescent Addiction Access (AAA) program, modeled on the widely disseminated Child Psychiatry Access Program framework. The AAA program developed a statewide consultation helpline to connect health care providers with adolescent addiction specialists. Methods: The AAA line was staffed by a coordinator, who fielded initial questions, and on-call clinical specialists (social workers, nurse practitioners, psychiatrists, and psychologists), who were paged to complete telephone consultations and provide care recommendations. When necessary, AAA providers offered urgent clinical assessments and initiated treatment. Descriptive analyses were performed for key variables over the first 21 months of AAA operations. Results: From July 2021 to March 2023, a total of 125 consultations were completed. Most callers were health care providers (71%) or parents (27%). Calls pertained to youths ages 10–18 years (mean±SD age=16.4±1.3; 62% of callers were male, 84% White, and 11% Black), with concerns around cannabis (63%), opioids (38%), and other substances. About 26% of calls related to an overdose, and 41% of cases were rated as severe. Recommendations included starting new medications (17%) or outpatient therapy (86%), and 17% of consultations resulted in urgent evaluations. Conclusions: The Indiana AAA program helps overcome key barriers to adolescent substance use treatment. Increasing the capacity to initiate medication for opioid use disorder and other treatment rapidly through consultation and direct care is a promising, scalable approach for preventing overdose deaths among youths. [ABSTRACT FROM AUTHOR]

Legislation produced under the EU Commission's Better Regulation Agenda sometimes fails to achieve the Treaty obligation to ensure a high level of health protection in all EU policies and activities. Public health advocates have raised the question of whether EU law can be employed to challenge this apparent breach of Treaty obligations at the proposal preparation stage, compelling the Commission to amend prospective EU legislation so that it better protects health. This article will demonstrate that unfortunately this is not possible due to the justiciability of both Article 168 TFEU and the Better Regulation Agenda. However, this awareness can help public health advocates to re-focus their efforts on strategies that will likely have a greater impact in swaying the direction of EU health policy. [ABSTRACT FROM AUTHOR]

Background: Substantial increases in UK consulting rates, mean consultation duration, and clinical workload were observed between 2007 and 2014. To the authors' knowledge, no analysis of more recent trends in clinical workload has been published to date. This study updates and builds on previous research, identifying underlying changes in population morbidity levels affecting demand for primary health care. Aim: To describe the changes in clinical workload in UK primary care since 2005. Design and setting: Retrospective cohort study using GP primary care electronic health records data from 824 UK general practices. Method: Over 500 million anonymised electronic health records were obtained from IQVIA Medical Research Data to examine consulting rates with GPs and practice nurses together with the duration of these consultations to determine total patient-level workload per person–year. Results: Age-standardised mean GP direct (face-to-face and telephone) consulting rates fell steadily by 2.0% a year from 2014 to 2019. Between 2005 and 2019 mean GP direct consulting rates fell by 5.8% overall whereas mean workload per person–year increased by 25.8%, owing in part to a 36.9% increase in mean consultation duration. Indirect GP workload almost tripled over the 15 years, contributing to a 48.3% increase in overall clinical workload per person–year. The proportion of the study population with ≥3 serious chronic conditions increased from 9.7% to 16.1%, accounting for over a third of total clinical workload in 2019. Conclusion: Findings show sustained increases in consulting rates, consultation duration, and clinical workload until 2014. From 2015, however, rising demand for health care and a larger administrative workload have led to capacity constraints as the system nears saturation. [ABSTRACT FROM AUTHOR]

Copyright of Archaeology in Oceania is the property of Wiley-Blackwell 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.)

Training in school-based consultation may encompass instruction on various consultation models, aims, and work with various partners. However, it is unclear how trainers currently structure coursework and the extent to which social justice is embedded in class. Therefore, we conducted a systematic replication of Hazel et al. (2010) analyses of consultation training syllabi. We analyzed 63 syllabi from 55 school psychology programs. We found many course instructors grounded training in problem-solving models. Trainers assigned at least one reading or assignment related to multicultural considerations or social justice, but social justice was rarely centered as a training goal. As compared to the Hazel et al. previous findings, we noted more syllabi incorporating topics on teleconsultation and self-reflection, which may be critical to advancing social justice in consultation. Limitations and implications of findings are discussed, including the need to more comprehensively incorporate social justice themes in all aspects of school consultation training. [ABSTRACT FROM AUTHOR]

Introduction: Many patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems. Methods: The sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant's permission, no note-taking was done during the interviews, which allowed for greater focus on the participants' conversation. The obtained data was analyzed using the content analysis. Results: A total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient's perceptions of general practitioner(GP) and dental practitioner's scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs. Conclusion: Most participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient's consult behaviors regarding dental problems. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy has been underdeveloped and often neglected in the global health workforce agenda, contrasting with the global rise of population needs for services. The World Federation of Occupational Therapists (WFOT) is utilizing a research-based, multi-step process for developing a Global Strategy for strengthening the occupational therapist workforce. A multi-pronged scoping review, situational analysis, and expert input process enabled the drafting of a provisional Global Strategy. Here, feedback on that draft from representatives of WFOT member organizations was obtained and analyzed as one key intermediate step toward shaping the in-developing Strategy's content and structure. Methods: Two-phased, mixed-methods consultation consisting of: (1) online survey with score ratings and comments on the utility of each strategy and (2) four in-person focus groups discussions on low-scoring items involving a total of 76 representatives of WFOT member organizations. The focus group discussions were analyzed using an inductive thematic analysis approach. Results: Strategies involving 'task shifting/task sharing' or the 'harmonization of workforce data-collection requirements' received the lowest scores in the initial survey and were thereby addressed in the focus groups discussions. The overarching theme of the focus groups was the need to: "clarify, specify, and contextualize the strategies", including: (1) "clarify the terminology and specify the application", for example, describe the meaning of task shifting, specify which tasks can (and cannot) be shifted and to whom, to address concerns regarding scope-of-practice, service demand, and safety; and (2) "outline the context of need and the context for the implementation" of the strategies, elucidating why the strategies are needed and how they can be feasibly implemented across the different jurisdictional contexts. Conclusion: Within a mixed-methods consultation, WFOT representatives identified challenging topics on the draft workforce strategies and suggested methods to improve the Global Strategy, its acceptability, and implementation. The terms 'task shifting/task sharing' raised the greatest discussion among the profession leaders, when the strategy was not sufficiently clarified, specified, or contextualized. [ABSTRACT FROM AUTHOR]

Early childhood educators often lack adequate preparation in the delivery of evidence-based practices. However, providing preservice teachers with ongoing implementation support during field-based training experiences may serve to occasion evidence-based practice delivery when they enter the field of early childhood education. Using a concurrent multiple baseline across participants design, this study examined the effectiveness of a multitiered consultation model to increase three early childhood preservice teachers' rates of behavior-specific praise in target and generalization settings. The results indicated all three preservice teachers' rates of behavior-specific praise increased across target and generalization settings, with evidence that praise rates maintained following removal of implementation supports. The results, limitations, and implications for research and practice are described. [ABSTRACT FROM AUTHOR]

Background. Although there is limited data about the role of infectious diseases and clinical microbiology (IDCM) consultations in the Emergency Department (ED), they have a key role in deciding on hospitalization and appropriate use of antibiotics. Objectives. To evaluate demographic and clinical characteristics of patients who visited the ED of our hospital and underwent an IDCM consultation. Materials and methods. In this cross-sectional study, we reviewed the medical records of adult patients who visited the ED of our hospital between May and August 2021 and needed IDCM consultation. The demographic data, the date and time of admission and consultation, the departments that were consulted before IDCM, laboratory results, diagnosis, and outcome were recorded. Results. Out of 42,116 ED visits, 1,007 (2.4%) IDCM consultations were requested. The median time between admission and IDCM consultation was 239 min (150.0-373.5). Before 56.9% of IDCM consultations, pre-consultations were requested from other departments, and the time interval was significantly longer. The median age of patients was 68 years (51-77 years). Infections were confirmed by the IDCM physician in 79.6% of the consultations. The most diagnosed infections were urinary tract infections (32.4%), skin-soft tissue infections (16.9%) and lower respiratory tract infections (10.3%), whereas 9.3% of the consultations resulted in hospitalization to the infection ward, 25.1% to other wards, and 5% to the intensive care unit (ICU). Conclusions. Two of 3 consultations resulted in hospitalization in other wards, and this shows that IDCM consultations are beneficial for managing patients with infectious diseases hospitalized in other departments. Communication between IDCM specialists and ED colleagues is important, especially in the management of elderly patients who require a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal 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: Food impaction can contribute to a variety of oral health problems. However, the prevalence of food impaction in the population and patient awareness of these issues are poorly reported on. Methods: A questionnaire about food impaction was designed and uploaded to an online platform (Sojump) which was then circulated among the study participants using various social media platforms. Participants were asked to anonymously respond to the questionnaire regarding the prevalence of food impaction, its influence on their quality of life, their consultation rates and their oral cleaning methods. The survey was conducted through an online survey portal. Statistical analyses were performed using SPSS and GraphPad. The Chi-Square test, Bonferroni test and the Kruskal–Wallis H test were used to measure categorical variables from the survey. Results: The results showed that the prevalence of food impaction in non-dental professional participants was 86.9%. Among these patients, 12,157 pairs/cases of proximal contacts were affected. The number of food impaction cases in posterior teeth was significantly higher than in anterior teeth. Approximately 81.9% of patients believed that food impaction could affect their lives. However, the consultation rate for these patients was only 17.7%. Conclusions: This study revealed that food impaction continued to have a high rate of incidence and a low rate of consultation, potentially due to a lack of awareness regarding its influence on oral health. To effectively prevent and address problems resulting from food impaction, both dentists and society need to enhance oral health knowledge in the population. [ABSTRACT FROM AUTHOR]

This "Best Practices in User Consultation" article is the result of a 2022 International Society for the Advancement of Cytometry (ISAC) membership survey that collected valuable insights from the shared research laboratory (SRL) community and of a group discussion at the CYTO 2022 workshop of the same name. One key takeaway is the importance of initiating a consultation at the outset of a flow cytometry project, particularly for trainees. This approach enables the improvement and standardization of every step, from planning experiments to interpreting data. This proactive approach effectively mitigates experimental bias and avoids superfluous trial and error, thereby conserving valuable time and resources. In addition to guidelines, the optimal approaches for user consultation specify communication channels, methods, and critical information, thereby establishing a structure for productive correspondence between SRL and users. This framework functions as an exemplar for establishing robust and autonomous collaborative relationships. User consultation adds value by providing researchers with the necessary information to conduct reproducible flow cytometry experiments that adhere to scientific rigor. By following the steps, instructions, and strategies outlined in these best practices, an SRL can readily tailor them to its own setting, establishing a personalized workflow and formalizing user consultation services. This article provides a pragmatic guide for improving the caliber and efficacy of flow cytometry research and aggregates the flow cytometry SRL community's collective knowledge regarding user consultation. [ABSTRACT FROM AUTHOR]

Bridging Mental Health and Education (BRIDGE) is an evidence-based model for embedding teacher consultation and coaching activities into school-based mental health clinicians' regular workflow. Here we describe the process of adapting BRIDGE in partnership with a large urban school district and a local managed care organization during a large-scale implementation effort. We also report the feasibility and perceived effectiveness of the adapted training and consultation model as reported by clinicians in one school year. Over 93% of trained clinicians (n = 75) initiated coaching sessions with assigned teachers. Eighty-five percent of coaching sessions were completed as scheduled (n = 505 of 592). After the completion of coaching visits, clinicians attended bi-weekly virtual group sessions for two months. Ninety percent of virtual group sessions were completed as scheduled. Clinicians indicated high levels of satisfaction and high likelihood of using BRIDGE in future. Additionally, clinicians' self-reported knowledge of BRIDGE practices and their comfort with training others in these evidence-based classroom practices improved from pre- to post- training and coaching. Expert coaches indicated that clinicians' knowledge of BRIDGE strategies, commitment to BRIDGE consultation, and likelihood of continuing to use BRIDGE strategies were high. These findings suggest that the adapted BRIDGE model is feasible and was perceived to be effective. We share lessons learned related to community-partnered, school intervention adaptation and implementation. [ABSTRACT FROM AUTHOR]

Copyright of Gériatrie et Psychologie Neuropsychiatrie du Vieillissement is the property of John Libbey Eurotext Ltd. 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.)

Objective: To assess rates of traversing barriers to care to access optimal clinical outcomes in people with migraine internationally. Background: People in need of medical care for migraine should consult a health care professional knowledgeable in migraine management, obtain an accurate diagnosis, and receive an individualized treatment plan, which includes scientific society guideline-recommended treatments where appropriate. Methods: The Chronic Migraine Epidemiology and Outcomes-International (CaMEO-I) Study was a cross-sectional, web-based survey conducted from July 2021 through March 2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States (US). Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria for migraine and had Migraine Disability Assessment Scale (MIDAS) scores of ≥ 6 (i.e., mild, moderate, or severe disability) were deemed to need medical care and were included in this analysis. Minimally effective treatment required that participants were currently consulting a health care professional for headache (barrier 1), reported an accurate diagnosis (barrier 2), and reported use of minimally appropriate pharmacologic treatment (barrier 3; based on American Headache Society 2021 Consensus Statement recommendations). Proportions of respondents who successfully traversed each barrier were calculated, and chi-square tests were used to assess overall difference among countries. Results: Among 14,492 respondents with migraine, 8,330 had MIDAS scores of ≥ 6, were deemed in need of medical care, and were included in this analysis. Current headache consultation was reported by 35.1% (2926/8330) of respondents. Compared with the US, consultation rates and diagnosis rates were statistically significantly lower in all other countries except France where they were statistically significantly higher. Total appropriate treatment rates were also statistically significantly lower in all other countries compared with the US except France, which did not differ from the US. All 3 barriers were traversed by only 11.5% (955/8330) of respondents, with differences among countries (P < 0.001). Conclusions: Of people with migraine in need of medical care for migraine, less than 15% traverse all 3 barriers to care. Although rates of consultation, diagnosis, and treatment differed among countries, improvements are needed in all countries studied to reduce the global burden of migraine. Trial registration: NA. [ABSTRACT FROM AUTHOR]

Background: Mental illnesses are common among children and negatively impact wellbeing during childhood as well as later in life. However, many children with these conditions are not able to access needed mental health care. The Wisconsin Child Psychiatry Consultation Program (WI CPCP) was created to reduce gaps in access to care by providing primary care providers with referral resources, access to behavioral health consultations, and training on mental health topics. Objectives: The purpose of this study was 1) to assess the effectiveness of the WI CPCP in Milwaukee County, providing specific insights into provider's ability to care for child mental health, and 2) identify challenges Milwaukee PCPs faced in providing mental health care to child patients and contextualize these challenges in a conceptual framework of access to health care. Methods: A cross-sectional mixed-methods secondary data analysis was conducted using data collected from online baseline and nine-month follow-up surveys completed by providers participating in the program practicing in Milwaukee County from 2014 to 2022. Provider confidence and skill in providing mental health care was analyzed quantitatively using Two-sample Wilcoxon rank-sum (Mann–Whitney) tests (baseline vs. follow-up survey responses) and descriptive statistics (follow-up survey only). Provider challenges to providing mental health care were analyzed qualitatively using a thematic analysis research approach. Results: Results from quantitative analyses showed that provider confidence and skill in treating childhood anxiety and depression improved from baseline to follow-up. Results from qualitative analyses were categorized by factors within and beyond the scope of WI CPCP. Within the scope of WI CPCP, providers reported a lack of knowledge of referral options and a lack of training in mental health care as well as a lack of knowledge in assessing and treating mental disorders. Still, many barriers to mental healthcare access persist that are beyond the scope of WI CPCP, such as long wait times and a lack of insurance coverage. Conclusions: This study supports the effectiveness of the program to improve access to care for children. However, there is a need for additional solutions such as better reimbursement for mental health professionals and expanded insurance coverage. [ABSTRACT FROM AUTHOR]

Background: Emergency medical services (EMS) are intended to provide people with immediate, effective, and safe access to the healthcare system. The effects of pandemics on emergency medical services (EMS) have not been studied sufficiently. The aim of this paper is to assess the frequency and structure of calls at an ambulance station in Kazakhstan during the period of 2019–2023. Methods: A retrospective analysis was conducted to estimate the incidence of emergency assistance cases from 2019 to 2023. Results: An analysis of the structure and number of ambulance calls before the pandemic, during the pandemic, and post-pandemic period did not reveal significant changes, except for calls in urgency category IV. Patients of urgency category IV handled by an ambulance decreased by 2 and 1.7 times in 2020 and 2021, respectively, which appears to be related to quarantine measures. In 2022 and 2023, category IV calls were 4.7 and 4.5 times higher than in 2019. Conclusions: This study's findings suggest no changes in the dynamics of ambulance calls, except urgency category IV calls. The number of category IV urgent calls decreased significantly during the COVID-19 pandemic and increased in the post-pandemic period. [ABSTRACT FROM AUTHOR]

Background: Managing diagnostic uncertainty is a major challenge in primary care due to factors such as the absence of definitive tests, variable symptom presentations and disease evolution. Maintaining patient trust during a period of investigative uncertainty, whilst minimising scope for diagnostic error is a challenge. Mismanagement can lead to diagnostic errors, treatment delays, and suboptimal patient outcomes. Objective: Our aim was to explore how UK primary care physicians (GPs) address and communicate diagnostic uncertainty in practice. Design: This qualitative study used video and audio-recordings. Verbatim transcripts were coded with a modified, validated tool to capture GPs' actions and communication in primary care consultations that included diagnostic uncertainty. The tool includes items relating to advice regarding new symptoms or symptom deterioration (sometimes called 'safety netting'). Video data was analysed to identify GP and patient body postures during and after the delivery of the management plan. Participants: All patient participants had a consultation with a GP, were over the age of 50 and had (1) at least one new presenting problem or (2) one persistent problem that was undiagnosed. Approach: Data collection occurred in GP-patient consultations during 2017–2018 across 7 practices in UK during 2017–2018. Key results: GPs used various management strategies to address diagnostic uncertainty, including (1) symptom monitoring without treatment, (2) prescribed treatment with symptom monitoring, and (3) addressing risks that could arise from administrative tasks. GPs did not make management plans for potential treatment side effects. Specificity of uncertainty management plans varied among GPs, with only some offering detailed actions and timescales. The transfer of responsibility for the management plan to patients was usually delivered rather than negotiated, with most patients confirming acceptance before concluding the discussion. Conclusions: We offer guidance to healthcare professionals, improving awareness of using and communicating management plans for diagnostic uncertainty. [ABSTRACT FROM AUTHOR]

The SARS‐CoV‐2 pandemic triggered an increased need in a method of delivering healthcare that simultaneously do not put patients at an increased risk of transmission. A remote consultation service (Telemed) for patients referred for dentoalveolar procedures was trialled. Objective: To investigate the outcome of the Telemeds and if treatment booked as a result of the Telemeds was successful, and could be made common practice. Materials and Methods: Data was collected from Telemeds between 04 August 2020 and 30 November 2020. Data collected included whether treatment was booked as a result of the Telemed, if the treatment was successfully completed at the resulting appointment (one‐stop treatment), if an additional face‐to‐face (F2F) consultation was required and any related reasons as to why this was the case. Results: After 499 Telemeds, 46.3% (N = 231) of patients required a F2F appointment being booked, 43.0% (N = 215) resulted in treatment being booked, 6.6% (N = 33) were discharged and 4% (N = 20) of patients did not answer when contact was attempted. Of the 215 patients who had a Telemed that led to booking of treatment, 110 had attended their follow up appointment and 95.4% (N = 105) successfully had their treatment carried out in one visit. Conclusion: Remote consultations are a feasible, successful and useful tool in assessing and booking dentoalveolar cases suitable for one‐stop treatment under local anaesthesia, as long as there is a specific and organized triage process, regardless of the number of teeth to be extracted or the patient's medical history. Patients requiring general anaesthesia, sedation or further radiographic imaging did not benefit from Telemeds as they needed to attend F2F anyway for pre‐operative assessment or to have their further imaging taken in the department. [ABSTRACT FROM AUTHOR]

Purpose: The increasing multi-drug resistance (MDR) is a serious threat to human health. The appropriate use of antibiotics can control the progression of MDR and clinical pharmacists play an important role in the rational use of antibiotics. There are many factors that influence the effectiveness of multi-drug resistant organisms (MDRO) infection consultations. The study aimed to establish a model to predict the outcome of consultation and explore ways to improve clinical pharmacy services. Patients and methods: Patients diagnosed with MDRO infection and consulted by clinical pharmacists were included. Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for MDRO infection consultation effectiveness, and then a nomogram was constructed and validated. Results: 198 patients were finally included. The number of underlying diseases (OR=1.720, 95% CI: 1.260– 2.348), whether surgery was performed prior to infection (OR=8.853, 95% CI: 2.668– 29.373), ALB level (OR=0.885, 95% CI: 0.805~0.974), pharmacist title (OR=3.463, 95% CI: 1.277~9.396) and whether the recommendation was taken up (OR=0.117, 95% CI: 0.030~0.462) were identified as independent influences on the effectiveness of the consultation. The nomogram prediction model was successfully constructed and the AUC of the training set and the verification set were 0.849 (95% CI: 0.780– 0.917) and 0.761 (95% CI: 0.616– 0.907) respectively. The calibration curves exhibited good overlap between the data predicted by the model and the actual data. Conclusion: A nomogram model was developed to predict the risk of consultation failure and was shown to be good accuracy and good prediction efficiency, which can provide proactive interventions to improve outcomes for potentially treatment ineffective patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Child & Adolescent Mental Health / Çocuk ve Gençlik Ruh Sagligi Dergisi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

The 'Child First' guiding principle for practice in the Youth Justice System of England and Wales has a growing international evidence-base and is fully embedded in policy/strategy, yet remains underdeveloped in consistent, coherent practice across local agencies and areas. This raises the potential for a policy–strategy practice implementation gap. Focus-group consultations (n = 11) with professional stakeholder groups (community, custody, strategy, inspectorate, and research) explored perceptions of the practice challenges to understanding, implementing and supporting Child First. Qualitative analysis identified child-centrism, professional relationships and cognisance as pivotal features of the effective realisation of Child First in practice. [ABSTRACT FROM AUTHOR]

Simple Summary: The success and the satisfaction of clinicians in practice relies heavily on how consultations, communication, and relationships are built with clients. Very knowledgeable and competent veterinarians might not be able to provide their services if the client declines their services based on misperceptions or lack of understanding, potentially resulting in lack of treatments of pets in need. The Calgary–Cambridge Guide for consultations and communication is an important tool taught in most veterinary colleges to help future clinicians improve their communication skills, ultimately benefiting the veterinary profession, clients, and the welfare of their pets. In this commentary we describe challenges in applying these guidelines in multilingual and multicultural scenarios such as Hong Kong. In these scenarios clinicians and clients often need an interpreter, adding complexity to the interaction and communication. Non-verbal communication, where body language plays an important role in showing expressions, empathy, and concerns is not effective or is altered if there is not even eye contact or a translator is not accurately interpreting all these emotions. This commentary analyses the challenges encountered by veterinarians during consultations in multicultural and multilingual centres. The Calgary–Cambridge Guide is a widely recognised framework for teaching communication skills to healthcare professionals that has become a cornerstone of communication training programs in medicine and other healthcare fields. In the context of veterinary medicine, its integration into communication training programs has become an asset improving communication, education, interaction, and quality of service, enhancing the veterinary–client–patient relationship (VCPR). In veterinary medicine, however, a more challenging consultation dynamic involves the veterinarian, the owner, and the animal. The addition of a veterinary assistant that acts as an interpreter or translator is common in Hong Kong where the native language (Cantonese) coexists with English when consultations are led by non-native language speakers. This addition converts this commonly dyadic model into a triadic communication model. The addition of an assistant interpreter influences the way consultations are conducted, how information is conveyed, and how interpersonal cues and empathy are delivered. In this report we depict challenges applying the Calgary–Cambridge Guide in multicultural and multilingual veterinary medical centres in Hong Kong and highlight the role of veterinary supporting staff in these scenarios, specifically veterinary assistant interpreters. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Arabian Sciences Heritage is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) 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: It is important to provide reliable information to people during a pandemic to prevent social fear. In this regard, the present study investigates the counseling needs of people who call the COVID-19 hotline in Yazd Province, Iran. Materials and Methods: In this qualitative study, the summative content analysis method was used. Due to possible changes in the counseling needs of the callers over time, the researchers first randomly checked 5% of all calls received each day. Data saturation was obtained by examining 5% of calls that were randomly selected. After reading the recorded interviews, the selected words were counted and entered into an Excel file. The keywords were then ranked. All keywords that seemed to have similar content were placed in related groups. Results: A total of 1023 audio files were analyzed. About 1279 analysis units were extracted and categorized into 17 sub-categories and 4 main categories. Among these, 80% of the obtained analyzed units were assigned to 8 subclasses, namely counseling needs regarding the symptoms of the disease (35.97%), patient care at home (9.38%), ways of disease transmission (7.27%), centers that provide services to patients (5.94%), fear of visiting medical centers (5.79%), reports of non-compliance with health protocols (5.55%), personal protective equipment (5.32%), disinfection of equipment and food (5.08%) were included. Conclusion: Establishing a hotline during an epidemic is an easy and quick method. One of the missing links in such systems is the existence of a monitoring team and a suitable content production team. It is necessary to hear the calls received simultaneously or daily by a scientific committee and provide feedback to the respondents to identify the counseling needs of the community members. [ABSTRACT FROM AUTHOR]

Background: Consultation with primary healthcare professionals may provide an opportunity to identify patients at higher suicide risk. Aim: To explore primary care consultation patterns in the 5 years before suicide to identify suicide high-risk groups and common reasons for consulting. Design and setting: This was a case–control study using electronic health records from England, 2001 to 2019. Method: An analysis was undertaken of 14 515 patients aged ≥15 years who died by suicide and up to 40 matched live controls per person who died by suicide (n = 580 159), (N = 594 674). Results: Frequent consultations (>1 per month in the final year) were associated with increased suicide risk (age- and sex -adjusted odds ratio [OR] 5.88, 95% confidence interval [CI] = 5.47 to 6.32). The associated rise in suicide risk was seen across all sociodemographic groups as well as in those with and without psychiatric comorbidities. However, specific groups were more influenced by the effect of high-frequency consultation (>1 per month in the final year) demonstrating higher suicide risk compared with their counterparts who consulted once: females (adjusted OR 9.50, 95% CI = 7.82 to 11.54), patients aged 15–<45 years (adjusted OR 8.08, 95% CI = 7.29 to 8.96), patients experiencing less socioeconomic deprivation (adjusted OR 6.56, 95% CI = 5.77 to 7.46), and those with psychiatric conditions (adjusted OR 4.57, 95% CI = 4.12 to 5.06). Medication review, depression, and pain were the most common reasons for which patients who died by suicide consulted in the year before death. Conclusion: Escalating or more than monthly consultations are associated with increased suicide risk regardless of patients' sociodemographic characteristics and regardless of the presence (or absence) of known psychiatric illnesses. [ABSTRACT FROM AUTHOR]

Background: Telemedicine improves access to specialized medical expertise, as required for paroxysmal disorders. The Epilepsy Network Hessen Evaluation (ENHE) is a pilot cross-sectoral teleconsultation network connecting primary neurologists and pediatricians with epilepsy centers in Hessen, a federal German state. Methods: We prospectively and longitudinally evaluated telehealthcare in the ENHE. Participating physicians rated each consultation for satisfaction and impact on further management. The survey was administered at each consultation and 3 months later. Results: We analyzed 129 consultations involving 114 adult and pediatric patients. Their mean age was 34 years (standard deviation: 26, range: 0.1–91 years), 48% were female, and 34% were children and adolescents. The most common consultation requests were co-evaluation of an electroencephalogram (electroencephalogram [EEG]; 76%) and therapeutic (33%) and differential diagnosis (24%) concerns. Physicians transmitted one paraclinical examination on average (range: 1–4), predominantly EEG (85%), followed by magnetic resonance imaging (17%) and written records (9%). Response rates were 72% for the initial and 67% for the follow-up survey. Across respondents, 99% (n = 92) were satisfied with the ENHE. Overall, 80% of the consultations contributed to the diagnosis, and 90% were considered helpful for treatment, influencing it in 71% of cases. Seizure frequency had decreased more often (96%) than increased (4%) at 3 months. The initial diagnosis was confirmed in 78% of patients. Discussion: In this pilot teleconsultation network for paroxysmal disorders, diagnostic and therapeutic advice was perceived as helpful. Clinical outcomes were largely positive, suggesting tele-epileptology is viable for paroxysmal (seizure) disorders. [ABSTRACT FROM AUTHOR]

Background: Telemedicineis use of remote based online technology to provide medical consultation to the patients by Physicians. The Covid-19 Pandemic has increased the use of virtual care since last two years. There is a need to analyze its effectiveness and usefulness among the Physician community so that we can get good benefits from it even in the future and address if any difficulties are being faced by them. Hence a study is done to assess the doctors’ perception about Telemedicine especially during the Covid-19 Pandemic at Basaveshwar teaching and general hospital attached to M R medical college in Kalaburagi City, Karnataka. Aim: 1.To assess the perception of telemedicine among Physicians. 2.To study the utilization of telemedicine during Covid-19 pandemic. Methods and material: Cross sectional study using Questionnaire based Google form survey answered by 100 doctors at Basaveshwar Teaching and General hospital attached to M R Medical College for a duration of 3 months from July to September 2021. Results: 58% responded that telemedicine gave desirable results in diagnosis and treatment. 100% agreed the flow increased during pandemic. 98% agreed that telemedicine is beneficial for their practice. Conclusion: There are benefits and drawbacks of telemedicine but in the present scenario benefits are substantial. Some patients and doctors still like physical examination and not all procedures can be performed online. In cases where patients can’t visit their doctors’ in-person as during pandemic and didn’t require a physical exam, telemedicine can be a good alternative. [ABSTRACT FROM AUTHOR]

Moral distress is a complex phenomenon whereby a person feels tension, constraint, or conflict with an action or circumstance because it goes against their individual or the perceived collective (e.g., community, organizational, or professional association's) moral stance. In pediatric healthcare settings, managing and mitigating feelings of moral distress can be particularly difficult to navigate through because of the intricate dynamics between the pediatric patient, parent and/or legal guardians, and clinicians. The proactive integration of an experienced pediatric palliative care (PPC) team can be an appropriate step toward reducing clinicians feeling overwhelmed by various case-specific and team management issues that contribute to the development of moral distress among healthcare professionals. Based on our experiences in a free-standing, quaternary pediatric hospital, the involvement of PPC can help reframe the approach to challenging situations, enhance communication, and provide guidance to the care team, patients, and families. Moreover, PPC teams can benefit other multidisciplinary team members through education on respecting the plurality of values of diverse families and patients and consideration of ethical implications during morally challenging situations. [ABSTRACT FROM AUTHOR]

Summary: Interviews and focus groups with patients, FLS clinicians, and GPs identified challenges relating to clinical and shared decision-making about bone health and osteoporosis medicines. Findings will inform the development of the multicomponent iFraP intervention to address identified training needs and barriers to implementation to facilitate SDM about osteoporosis medicines. Purpose: The iFraP (improving uptake of Fracture Prevention treatments) study aimed to develop a multicomponent intervention, including an osteoporosis decision support tool (DST), to support shared decision-making (SDM) about osteoporosis medicines. To inform iFraP intervention development, this qualitative study explored current practice in relation to communication about bone health and osteoporosis medicines, anticipated barriers to, and facilitators of, an osteoporosis DST, and perceived training needs. Methods: Patients attending an FLS consultation (n = 8), FLS clinicians (n = 9), and general practitioners (GPs; n = 7) were purposively sampled to participate in a focus group and/or telephone interview. Data were transcribed, inductively coded, and then mapped to the Theoretical Domains Framework (TDF) as a deductive framework to systematically identify possible barriers to, and facilitators of, implementing a DST. Results: Inductive codes were deductively mapped to 12 TDF domains. FLS clinicians were perceived to have specialist expertise (knowledge). However, clinicians described aspects of clinical decision-making and risk communication as difficult (cognitive skills). Patients reflected on decisional uncertainty about medicines (decision processes). Discussions about current practice and the proposed DST indicated opportunities to facilitate SDM, if identified training needs are met. Potential individual and system-level barriers to implementation were identified, such as differences in FLS configuration and a move to remote consulting (environmental context and resources). Conclusions: Understanding of current practice revealed unmet training needs, indicating that using a DST in isolation would be unlikely to produce a sustained shift to SDM. Findings will shape iFraP intervention development to address unmet needs. [ABSTRACT FROM AUTHOR]

Background: Including Aboriginal and Torres Strait Islander people and communities through consultation has been a key feature of policy implementation throughout the Australian Government's "Closing the Gap" (CTG) strategy. However, consultation often reinforces power imbalances between government and local community and can undervalue or marginalise Indigenous knowledge and leadership. Occupational therapy has a short history of examining colonial power structures within the profession, but there has been limited progress to decolonise consultation and practice. Methods: Drawing on decolonising research methodology and positioned at the interface of knowledge, comparative case studies were used to understand policy implementation in two regions. In Shepparton, Victoria, CTG policy was implemented predominately through an Aboriginal Community Controlled Health Organisation, and in Southern Adelaide, South Australia, CTG policy was implemented through mainstream state government and non‐government providers in the absence of a local Aboriginal‐controlled organisation. Findings were examined critically to identify implications for occupational therapy. Results: Our case studies showed that policy stakeholders perceived consultation to be tokenistic and partnerships were viewed differently by Aboriginal and non‐Indigenous participants. Participants identified the need to move beyond a rhetoric of "working with" Aboriginal and Torres Strait Islander people, to promote Aboriginal leadership and really listen to community so that policy can respond to local need. The findings of this research show that Aboriginal‐controlled services are best positioned to conduct and respond to community consultation. Conclusion: A decolonising approach to consultation would shift the status quo in policy implementation in ways that realign power away from colonial structures towards collaboration with Indigenous leadership and the promotion of Aboriginal‐controlled services. There are lessons for occupational therapy from this research on policy implementation on authentic, decolonised consultation as a key feature of policy implementation. Shifting power imbalances through prioritising Indigenous leadership and honouring what is shared can drive change in CTG policy implementation processes and outcomes. PLAIN LANGUAGE SUMMARY: Aboriginal and Torres Strait Islander people are often asked to give advice or share ideas on how health and education services are provided to community. We asked people in Southern Adelaide what this was like when the Closing the Gap strategy was first introduced in the region. People explained that Aboriginal leaders were not really listened to, and even when there are meant to be partnerships, it often does not work out as planned. There are lessons we can take from this for occupational therapy so that we stop making the same mistakes over and over. Health and education services need to really listen and respond appropriately, so that services are safer for Aboriginal and Torres Strait Islander people and communities. Aboriginal leadership must be valued and respected if we are to close the gaps in health and education. This is important for the future of occupational therapy. [ABSTRACT FROM AUTHOR]

The mental health vulnerability of children and young people in foster and adoptive families is well recognised, which has led to the development of dedicated posts and care pathways in mental health care provision. This article reports on learning resulting from local quality improvement work in a single child and adolescent mental health service team. This work was concerned with the 'front door' of access to care for these groups and specifically addresses initial consultations with adoptive parents and adoption professionals, reporting findings from an analysis of reports from consultations undertaken over a 13-month period between April 2021 and May 2022. The analysis highlights that support can be sought by these parents and professionals for diverse issues relating to mental health which is also indicative of a high level of need amongst children and young people involved with specialist mental health provision. The analysis also has wider implications for practice in demonstrating the benefits of attending to clinical data to contribute meaningfully to practice-based scholarship in this type of specialist setting. [ABSTRACT FROM AUTHOR]

Ophthalmologic emergencies (OE) in the pediatric age group are classified as traumatic or nontraumatic, potentially causing partial or total visual loss. These emergencies, which are significant contributors to acquired visual impairment or loss, hold a prominent position in emergency department visits globally. This retrospective study aimed to analyze the demographic, etiological, and clinical characteristics of patients aged 0–2 years who were brought to the Emergency Department (ED) with ophthalmologic emergencies and requested ophthalmologic consultation. Age (month), sex, complaint etiology, affected eye (right or left), diagnosis, examination findings, treatment, and clinical progression were analyzed. Of the patients, 26 who met the inclusion criteria were included in this study. The median age was 20 (14.75–24) months; 5 (19.2%) children were aged less than 1 year and 21 (80.8%) were aged more than 1 year. Three of the patients (11.5%) were refugees. When the cases were grouped as infective and noninfective eye emergencies, the diagnosis of conjunctivitis was statistically significant between refugee and nonrefugee children (p=0.032). Traumatic injuries were more common in children aged 13–24 months, which was statistically significant (p=0.029). Only a small proportion of children brought to emergency departments with ocular complaints actually have a genuine emergency necessitating consultation. Early pediatric patients, in particular, should undergo a more meticulous systemic examination. It is crucial to explore the presence of severe emergencies that could lead to vision loss, one of our most vital senses, in every patient. [ABSTRACT FROM AUTHOR]

Background Recent evidence suggests that the first consultation with a general practitioner (GP) for symptoms of depression may be more than just a vehicle for assessment and management planning (as current guidelines imply). Objectives To identify what patients find helpful, or otherwise, in their first consultation for low mood with a GP. Methods A cross-sectional questionnaire and interview study of patients with low mood who had recently consulted their GP, in the North of England. Patients were asked to complete a questionnaire regarding the consultation, and a Patient Health Questionnaire-9 (PHQ-9), within 2 weeks. They were also invited to take part in a face–face interview with a researcher. Both sources of data were subjected to qualitative thematic analysis. Results Thirty-seven questionnaires were returned; 5 interviews took place. The majority of participants felt better after consulting a GP for the first time for low mood. The factors most commonly cited as helpful were "being listened to" and "understanding or empathy from the GP." Others included "admitting the problem," "being reassured of normality," and "being provided with optimism or hope for change." The most commonly reported difficulty was the patients' struggle to express themselves. Patients often felt that GP follow-up was inadequate. Conclusions These results suggest that the therapeutic benefit of the GP consultation is under-recognized in current guidelines. The results of our study will provide crucial information as to how such consultations can be tailored to improve patient satisfaction. [ABSTRACT FROM AUTHOR]

Self-injurious, stereotyped, and aggressive/destructive behaviors exhibited by individuals with intellectual disabilities and autism spectrum disorders are called challenging behaviors (CBs). Severe CBs often require long-term treatment involving psychosocial approaches based on behavioral interventions and/or medication. A boy with severe CB enrolled in a special needs school, with diagnoses of autism and intellectual disability, was the client of the study. This case report describes the long-term outcomes of eight years of continuous school consultation. The student's severe CB improved with environmental adjustments in the classroom, unified teacher involvement, instruction of leisure and communication skills, and medication. Long-term research on changes in CBs through school consultation is limited, and this case report provides important insights into the development of effective educational programs and curricula for severe CBs in school-aged children. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

The University of Florida Health Precision Medicine Program plays a crucial role in delivering pharmacogenomics (PGx) result notes to providers who request PGx testing. Despite this, there is currently a lack of a formal assessment of provider needs and established best practice design principles to guide the ongoing development of PGx result notes. This study aims to enhance the content and format of the PGx consult note at UF Health by incorporating valuable feedback from healthcare providers. Through in-depth user sessions involving 11 participants, we evaluated the usability of our consult note template. While overall satisfaction with the content was noted, specific sections, including those addressing phenoconversion and the medication list, were identified for revision to enhance clarity based on insightful provider feedback. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Bioethics / Revue canadienne de bioéthique is the property of Ecole de Sante Publique de l'Universite de Montreal 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.)

Effective training of mental health professionals is crucial for bridging the gap between research and practice when delivering cognitive behavioural therapy (CBT) and motivational interviewing (MI) within community settings. However, previous research has provided inconclusive evidence regarding the impact of training efforts. The current study aimed to systematically search, review and synthesize the literature on CBT and MI training to assess its effect on practitioner behavioural outcomes. Following prospective registration, a literature search was conducted for studies where mental health practitioners were exposed to training in face‐to‐face CBT or MI, reporting on at least one quantitative practitioner behavioural outcome. A total of 116 studies were eligible for the systematic review, and 20 studies were included in four meta‐analyses. The systematic review highlights the need to establish psychometrically valid outcome measures for practitioner behaviour. Results of the meta‐analyses suggest that training has a greater effect on practitioner behaviour change compared to receiving no training or reading a treatment manual. Training combined with consultation/supervision was found to be more effective than training alone, and no differences were found between face‐to‐face and online training. Results should be interpreted with caution due to methodological limitations in the primary studies, large heterogeneity, and small samples in the meta‐analyses. Future directions are discussed. [ABSTRACT FROM AUTHOR]

Background Patients with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and dementia are underrepresented in specialist palliative home care (SPHC). However, the complexity of their conditions requires collaboration between general practitioners (GPs) and SPHC teams and timely integration into SPHC to effectively meet their needs. Objective To facilitate joint palliative care planning and the timely transfer of patients with advanced chronic non-malignant conditions to SPHC. Methods A two-arm, unblinded, cluster-randomised controlled trial. 49 GP practices in northern Germany were randomised using web-based block randomisation. We included patients with advanced CHF, COPD and/or dementia. The KOPAL intervention consisted of a SPHC nurse–patient consultation followed by an interprofessional telephone case conference between SPHC team and GP. The primary outcome was the number of hospital admissions 48 weeks after baseline. Secondary analyses examined the effects on health-related quality of life and self-rated health status, as measured by the EuroQol 5D scale. Results A total of 172 patients were included in the analyses. 80.4% of GP practices had worked with SHPC before, most of them exclusively for cancer patients. At baseline, patients reported a mean EQ-VAS of 48.4, a mean quality of life index (EQ-5D-5L) of 0.63 and an average of 0.80 hospital admissions in the previous year. The intervention did not significantly reduce hospital admissions (incidence rate ratio = 0.79, 95%CI: [0.49, 1.26], P  = 0.31) or the number of days spent in hospital (incidence rate ratio = 0.65, 95%CI: [0.28, 1.49], P  = 0.29). There was also no significant effect on quality of life (∆ = −0.02, 95%CI: [−0.09, 0.05], P  = 0.53) or self-rated health (∆ = −2.48, 95%CI: [−9.95, 4.99], P  = 0.51). Conclusions The study did not show the hypothesised effect on hospitalisations and health-related quality of life. Future research should focus on refining this approach, with particular emphasis on optimising the timing of case conferences and implementing discussed changes to treatment plans, to improve collaboration between GPs and SPHC teams. [ABSTRACT FROM AUTHOR]

[Background] The growing role of information technology in the activities of legal practitioners, lawyers, notaries, and judicial authorities highlights the importance of addressing the problem. Additionally, the lack of comprehensive studies in modern legal literature regarding the essence of digital paid assistance in the field of legal activity underscores the need for research in this area. [Purpose] The study's purpose is to address the growing significance of information technology in various legal professions, including legal practitioners, lawyers, notaries, representatives of judicial authority, and law enforcement agencies. [Methodology/Approach/Design] The following research methods are the main ones in this scientific work: systemic-legal, formal-legal, comparatively legal, as well as historical, logical, and dialectical methods. Due to these methods, it became possible to determine the essence of digital paid services in the field of legal activity, to reveal their features, as well as identify their problems and develop ways to improve such services. [Findings] During the course of this study, several significant results were obtained. Firstly, the concept of digital paid legal services was elucidated, and the main types of such services were identified, along with their distinctive characteristics. Furthermore, the study highlighted both the positive and negative aspects of providing these services, emphasizing their significance in the development of legal science and the legal profession as a whole. [Originality/Value] The study is significant as it addresses the need for an effective legal framework to regulate digital services in the field of legal activity in Kazakhstan. It highlights the lack of comprehensive legislation and the slow integration of digital technologies into the legal sector. By exploring the challenges and providing recommendations, the study aims to facilitate the adoption of innovative technologies and improve the quality of legal services in the country. [ABSTRACT FROM AUTHOR]

In New Zealand the last few years have seen a re-emergence of interest in processes that build on the theory of deliberative democracy. Commentary on this trend, which typically positions deliberative democracy as a novel development in New Zealand politics, ignores several decades of public agencies' democratic experimentation. In this article we describe three of the 15 identified processes displaying the critical elements of deliberative democracy: the Capital Power citizens' jury (1996); Toi te Taiao: the Bioethics Council's public deliberation on pre-birth testing (2007-08), and the citizens' advisory panel on the Newtown-Berhampore cycleway (2014). We analyse the reasons for their ostensible failure and identify lessons that current policymakers interested in deliberative democracy should draw from these historical cases. [ABSTRACT FROM AUTHOR]

Copyright of Raumforschung und Raumordnung is the property of Oekom Verlag GmbH 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.)

How does inclusion in social policy programs strengthen individuals' support for redistribution, and lead to spillovers in support for future social policy programs? We study a unique dataset of 1,300 Moscow residents to estimate the effect of participating in a government-sponsored redevelopment program on preferences for redistributive social policy. Our design exploits features of the program designed to foster institutional trust by engaging citizens in the policy design process. We report a positive effect: individuals in buildings slated for redevelopment are more likely to agree that the government should reduce income differences between rich and poor, provide for the unemployed, and provide public housing. Our findings suggest that increased trust in the government is a channel through which program participation affects redistribution preferences, show how programs can be used strategically to promote a redistributive agenda, and suggest a pathway for the co-persistence of redistribution preferences and redistributive state policies. [ABSTRACT FROM AUTHOR]