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Background. Between 2015 and 2020, 1,578 care homes in the UK closed, displacing nearly 50,000 older and disabled people with very significant care and support needs. It is widely thought that relocation can have a significant impact on the health and well-being of older people. Yet, evidence is limited due to sensitivity and logistical difficulties with data collection. This study aimed to review the published literature in order to (i) identify evidence on the costs, consequences, and wider impacts of care home closures, for older people, family members, care home staff, and local authorities and (ii) understand the causes of and processes surrounding the closure of residential care homes in the UK. Methods. Eight electronic databases (Medline, Embase, Web of Science, Scopus, ASSIA, HMIC, AgeInfo, and SPP) were searched from 1st January 2000 to 9th February 2023; Google and Google Scholar were searched for guidance/policy documents from the grey literature. Data on the objectives, methods, and main results were extracted, and the findings were narratively reported. Results. Eighteen records, comprising guidance documents and academic publications (quantitative, qualitative, and mixed-method approaches), met the inclusion criteria. We found a lack of good quality evidence on costs of closure and no consideration of outcomes for staff. Studies reporting on outcomes for residents suggest there may not be any long-term adverse effects on their health, in contrast to often-expressed views that care home closures result in harm. Conclusion. Future research should consider the stress and anxiety experienced by staff and families as relevant outcomes and show caution with respect to the use of proxy reporting of resident health outcomes. Given that a sizable portion of the costs associated with care home closure falls on local authorities, an evidence-based approach to closures that includes an assessment of cost-effectiveness will help to improve future outcomes and guide the most efficient use of limited public resources. [ABSTRACT FROM AUTHOR]

Domestic abuse is a worldwide public health and social issue which impacts the health and wellbeing of those experiencing abuse and their families. People living with a life-limiting illness are at increased risk of domestic abuse because they are often frail, isolated, and dependent on others. Little is known about domestic abuse and the coexistence of life-limiting illness and existing support for those experiencing or at risk of abuse. A scoping review was conducted to identify factors that shape and characterise experiences of adults with a life-limiting illness affected by domestic abuse and the health and social care practitioners and other organisations that support them. The Joanna Briggs Institute (JBI) methodology and checklist for Preferred Reporting Items for Systematic Reviews and Meta Analyses-Extension for Scoping Reviews (PRISMA-ScR) were applied. Five databases were systematically searched from 2000 to 2021: MEDLINE; CINAHL; PsycINFO; Social Sciences Citation Index (Web of Science); and ProQuest Dissertations and Global. Twenty-one papers met the inclusion criteria. Most studies were conducted in North America, with female participants living with cancer, and conducted in health and community settings. There were no studies involving third sector organisations. A range of abusive behaviours was reported resulting in missed medical appointments, delays in screening leading to late diagnosis, and palliative rather than curable treatment. Abuse also impacted on the physical, emotional, and psychological wellbeing of the person experiencing the abuse, which increased stress levels and could have a detrimental effect on their health. Identifying domestic abuse within the context of life-limiting illness was reported to be challenging for health and social care professionals, as was responding to and managing a disclosure. Further research is needed to address existing knowledge in order to inform policy and practice to identify and manage domestic abuse where it coexists with life-limiting illness. [ABSTRACT FROM AUTHOR]

Contemporary healthcare for those experiencing mental illness requires healthcare practitioners (HCPs) to effectively incorporate the prescription of exercise in their treatment, in accordance with clinical guidelines. However, there has been a lack of effective implementation of such recommendations. The purpose of this review was to identify barriers to exercise prescription in the treatment of people diagnosed with mental illness as perceived by HCPs. APA PsycINFO, CINAHL, MEDLINE, and PubMed electronic databases were searched for relevant articles published in the period from January 2005 to September 2023. A total of 18 papers were included for thematic synthesis. Four key themes were identified across the qualitative (8), quantitative (6), and mixed method (4) papers, including a lack of knowledge and confidence of HCPs in prescribing exercise; role and responsibility; HCPs' misconceptions of client barriers; and systemic issues impacting exercise prescription practices. A lack of knowledge or confidence was the most common barrier. Some HCPs indicated a desire to develop their skills in exercise prescription, while others indicated a preference for an exercise professional to take responsibility for this aspect of treatment. Systemic barriers were spread across a range of issues, with lack of time, excessive workload, and difficulties accessing qualified staff most commonly cited. This review provides further insight into the barriers to exercise prescription faced by HCPs and makes recommendations regarding how to address these barriers in order to better implement clinical guidelines and thus improve the quality of treatment provided to people diagnosed with a mental illness. [ABSTRACT FROM AUTHOR]

Migration to South Africa is motivated by the pursuit of employment, safety, and improved living conditions. However, immigrants encounter significant challenges, such as restricted access to essential services, which were exacerbated by the COVID-19 pandemic. This paper investigates the impact of the COVID-19 pandemic on Malawian immigrants in South Africa, addressing the lack of attention given to this immigrant population by highlighting their vulnerabilities. Using a qualitative exploratory and descriptive approach, in-depth interviews were conducted with 24 Malawi immigrants who were over 18 years old and had established residency in South Africa before the onset of the COVID-19 pandemic. Five key stakeholders were also interviewed for additional perspectives and to ensure triangulation and improve data reliability. The interviews were transcribed verbatim and analyzed using thematic analysis strategies and coding with Nvivo12 software. The study highlighted the exacerbated struggles of Malawian immigrants in South Africa amid the COVID-19 pandemic, uncovering systemic discrimination in healthcare, marked by longer wait times and reluctance from health workers to treat undocumented immigrants. The study also revealed a dire security situation, with immigrants living in high-crime areas and feeling particularly targeted due to their foreign status, a situation worsened by the pandemic's economic effects. Additionally, the economic downturn induced by COVID-19 significantly impacted employment opportunities, with many immigrants facing prolonged unemployment and job losses, especially in sectors where they traditionally found work. The detailed accounts of participants highlight not only the multifaceted challenges imposed by the pandemic but also the critical need for inclusive policies and support systems that ensure healthcare access, safety, and economic resilience for immigrants, particularly during global health emergencies. Future research should focus on effective interventions for socioeconomic integration and well-being, particularly for immigrants from other African countries. [ABSTRACT FROM AUTHOR]

The last three census data highlighted that UK Bangladeshi communities have the worst health outcomes. This includes a higher risk of type two diabetes and heart diseases; both are risk factors for developing vascular dementia. However, little is known about Bangladeshi community members' understandings of dementia, including cultural myths. This paper focuses on the cultural myths, superstitions, and stigma surrounding dementia in an English Bangladeshi community from the direct experiences of people living with dementia, their caregivers, and the views of dementia service providers/stakeholders. This qualitative research was undertaken with three distinct participant groups using semistructured interviews (n = 25), who were recruited from community settings. The first and second participant groups explored the experiences of people with dementia (n = 10) and their family caregivers (n = 10). The third group examined stakeholders'/service providers' views (n = 5). Interviews were recorded digitally and transcribed verbatim. Findings were reached using an interpretive approach, emphasising the sense people make in their own lives and experiences and how they frame and understand dementia. The study revealed that participants with dementia and their caregivers have "alternative" knowledge about dementia and do not necessarily understand dementia in a Westernised scientific/biomedical context. Misconceptions about dementia and belief in various myths and superstitions can lead people to go to spiritual healers or practice traditional remedies rather than to their GPs, delaying their dementia diagnosis. This paper concludes that there is a lack of awareness among the Bangladeshi participants and a need for targeted awareness about dementia to help dispel cultural myths and combat the stigma surrounding dementia within the Bangladeshi community. [ABSTRACT FROM AUTHOR]

Background. China will inevitably enter a medium, severe, or deep aging society in the future, and the number of elderly people living alone is also increasing. Mental health is a major issue for older people living alone. With the deepening of aging, social participation has become an important way to promote mental health and improve the quality of life of the elderly. Methods. This study uses data from Chinese Longitudinal Health Longevity Survey (CLHLS). Based on the CLHLS data of 2018, this paper uses multiple ordered logistic models to measure the mental health level of elderly people living alone through two dimensions of depression and anxiety and carries out a heterogeneity analysis on the mental health level of elderly people living alone. Results. The analysis of 2477 elderly people living alone shows that the increase of social participation in simple communication can reduce the degree of depression and anxiety of elderly people living alone, and the decrease of social participation in self-recreation can reduce the degree of depression and anxiety of elderly people living alone. In addition, the heterogeneity analysis found that the heterogeneity of social participation was more significant among the elderly living alone with different genders, ages, places of residence, and self-care abilities. Limitations. This study has some limitations, and CES-D-10 is a screening tool and cannot fully determine the presence of depression in high-rise older adults living alone. Conclusions. In the future, primary healthcare-targeted interventions can be provided according to the different degrees of depression and anxiety of elderly people living alone. [ABSTRACT FROM AUTHOR]

Safeguarding for healthcare involves working together to protect adults, children, and young people at risk of harm. Despite global research and national guidance outlining health professionals' roles in this regard, there is limited knowledge about the type of strategies used to mobilise safeguarding research to practitioners in England. Our critical interpretive synthesis (CIS) sought to explore how safeguarding knowledge is mobilised to enable practitioners to use research effectively. This synthesis aimed to bridge the theory-practice gap in mobilising safeguarding knowledge to practitioners. Knowledge mobilisation (KMb) is an emerging discipline concerned with moving knowledge across communities to catalyse change. This review aimed to build understanding about how safeguarding knowledge is mobilised for healthcare in England and to synthesise the type of approaches undertaken to protect adults and children from harms, including abuse. A critical interpretive synthesis was undertaken using KMb theory and computer-assisted modelling technologies for secondary thematic analysis of complex literature of relevance, including qualitative research, reviews, and reports. Few papers informed how safeguarding knowledge is mobilised for healthcare in England. Learning from experience dominated the literature in three ways: (i) crisis response, (ii) practice engagement, and (iii) influencing actions (for "best" practice). Embedding safeguarding knowledge and skills in healthcare settings usually followed a crisis response. Learning from experience showed movement between practice engagement and influencing actions for adult and/or child protection. KMb might be useful in supporting the implementation of evidence-based safeguarding for practice. CIS identified a gap in how safeguarding research is mobilised to practitioners for healthcare. KMb theory provided an analytical bridge to computer-assisted modelling of factors associated with moving learning from experience to learning in practice. Future research could build on hybrid synthesising of safeguarding functions and impacts for healthcare, to enable practitioners to protect adults and children from multiple harms, including violence and abuse. [ABSTRACT FROM AUTHOR]

People with dementia and their care partners report a lack of support, treatment, and information, fragmented services, and a lack of inclusion in decisions about their care. Care planning may address these issues; however, there is scarce literature on the process or benefits of care planning for people with dementia. This review describes the literature on care planning for community-dwelling people with dementia and their care partners. A systematic scoping methodology was followed to identify the research questions, identify relevant documents, select relevant documents, chart the data, and collate, summarise, and report the results. 31 full-text documents published between 2010 and May 2020 were identified and reviewed. Seven were guidelines, seven were expert opinion pieces, 11 were intervention studies, and six were descriptive studies. The topics and process of care planning varied depending on the service context (e.g., memory clinic, home care, and primary care). Care planning was presented as a component of case management in 15 papers. Six of the 11 intervention studies reported positive outcomes, one showed no improvement, and one did not evaluate outcomes for people with dementia or their care partners. Of the six with positive outcomes, four evaluated care planning in the context of care management. There is limited evidence that care planning alone improves outcomes for people with dementia and their care partners. It is unclear whether it may have benefits when combined with care management. [ABSTRACT FROM AUTHOR]

Purpose. This study aims to elucidate the gender gaps in the strategies for maintaining the social participation and interaction of older adults with people in a local community. Methods. The subjects were 130 older adults aged 65 years or older and independently living in their homes in Saitama, Saitama Prefecture, Japan. The authors conducted an anonymous questionnaire survey on paper and performed multiple regression analysis for men and women separately using the Lubben Social Network Scale-6 (LSNS-6) as the dependent variable. Results. Among the independent variables used for the analysis, those that significantly influenced LSNS-6 in men were social activities related to the daily life satisfaction of the elderly (SARDS). The independent variables that significantly influenced LSNS-6 in women were SARDS, sense of coherence-13 (SOC-13), and the number of family members living with the subjects. Discussion. Health promotion is not associated with interaction with people in men compared with women. [ABSTRACT FROM AUTHOR]

Health services research is important in improving health systems' and providers' efficiency and effectiveness. This may require health services to intervene at an individual and community level to address people's complex social issues. An important issue is social connections, which have been identified as a social determinant of health and can help buffer stressful life events. Social support networks can be visualized using eco-maps, a tool that originated in child welfare practices and has been adopted widely by clinicians and researchers. This paper aims to understand where and how eco-maps have been used in health services research. To answer the research questions, this scoping review used the Joanna Briggs Institute guidelines for scoping reviews. In total, 70 studies were included in the scoping review. The authors found that social support denoted in an eco-map does not guarantee the provision of support; however, the dialogue needed to create an eco-map could facilitate conversations about care expectations, identification of vulnerable points or risk factors, and actions to improve family and individual functioning. A significant gap remains in the knowledge and use of eco-maps in identifying population service and resource gaps and how to bridge the knowledge-to-action chasm better. Further exploration is needed to examine how to optimize the application of eco-mapping in the health services context, including generating guidelines, templates, or instructions for implementation. Therefore, addressing this gap is vital for ensuring eco-mapping informs future service design and policy changes. [ABSTRACT FROM AUTHOR]

There has been an increasing acknowledgement in the UK of the importance of recognising frailty as a condition that leaves older people vulnerable to dramatic, sudden changes in health triggered by seemingly small events. In policy, the approach to managing frailty is often an emphasis on staying well with limited consideration to frailty as an end-of-life phase. Meanwhile, discharge from hospital continues to be complex. Overstretched acute hospitals are juxtaposed with community and social services that struggle to keep up with the demand of those being discharged and the labelling of older people as "bed blockers" at the centre of delayed discharges. This paper reports a study underpinned by constructivist grounded theory methodology, with the aim of exploring the experiences and perceptions of stakeholders. Semistructured interviews were conducted with 57 participants including patients, their informal carer(s), community hospital staff, community health professionals, and care home managers. The core category of "the drive to discharge conveyor belt" was derived from data analysis. A significant finding of this study was that of the carer, their burden, and their intrinsic role in facilitating discharge, filling in gaps in services, coordinating services, and enabling the patient to stay at home, with little consideration of their choices or autonomy. The "drive to discharge" impacts older people, their informal carers, and health professional. This study suggests how they may be supported, through an ethical lens. [ABSTRACT FROM AUTHOR]

Reducing health inequities for migrants is a huge challenge shared globally. Based on big data of China Migrants Dynamic Survey in 2017, this paper applied Ordered Logit models and Logit models to examine the effect of health education on the health of migrants. Propensity score matching and instrumental variable were also employed to solve the endogenous problem. This paper found a significant health promotion effect of health education on the health of migrants, which remained significant after a series of robustness check. Further analysis showed that consultative health education is more effective than nonconsultative health education. Meanwhile, the positive association between health education and migrants' health behavior was identified which provided empirical evidence for knowledge, attitude, and practices theory. Heterogeneity analyses supported that health education has a stronger effect on migrants who were female, elderly, highly educated, and did not have chronic diseases than on those who were male, younger, less educated, and had chronic diseases. This paper demonstrates that health education is an important health promotion factor for migrants empirically and that the government should take actions to provide sufficient and targeted health education for migrants to promote their health. [ABSTRACT FROM AUTHOR]

This paper examines the healthcare provisions for migrants in Qatar. Migration and health are intricately entwined in the GCC states, with ramifications for both migrants and their host countries in the Gulf. The GCC states are home to nearly 30 million non-national residents or migrants, constituting the largest concentration of temporary migrants in the world. The provision of healthcare services to such a large migrant population presents a tremendous challenge for most Gulf states. It is worth pointing out that migration to the GCC states is inherently transient in nature, which further compounds the healthcare challenge. This paper explores how the GCC states respond to the rising demand for migrant healthcare by focusing on healthcare infrastructure and healthcare provisions for migrants in Qatar. The study reveals that Qatar has invested heavily in the expansion of healthcare infrastructure in tandem with its growing migrant population. Qatar offers healthcare services to the increasing migrant population through the Hamad health card, which allows its holders to access public healthcare services. This study suggests that there is a need for more expansion of public healthcare facilities to meet the expanding healthcare needs in coming years. [ABSTRACT FROM AUTHOR]

The abuse of animals is evident in different contexts. This article takes two discrete bodies of literature: threats and actual harm to animals in the context of domestic abuse and sex offending in the context of animal abuse. The reviews focus on the implications for risk assessment and risk management and explore the following questions: What is the international evidence base for threats or violence towards animals, with a specific focus on risk assessment, in the context of domestic abuse? What is the international evidence base for threats or violence towards animals, with a specific focus on risk assessment, in the context of sex offending? What similarities and differences are evident in the approaches in the two bodies of literature? A scoping review methodology was applied to the two bodies of animal abuse literature. The domestic abuse literature elicited 27 studies for full inclusion, while the sex-offending literature examined 15 papers. A broad analysis of the literature was taken to understand the implications for risk assessment and risk management. In the context of risk assessment, the literature indicates that threats or harm towards animals, including the sex abuse of animals, has the potential to be used in four ways: (1) animal abuse as an indicator of domestic abuse; (2) childhood animal abuse as a signal of other problems within a household; (3) animal abuse as an indicator of more severe domestic abuse; and (4) the inclusion of pet abuse as a unique form of domestic abuse. The comparison of the literature on animal abuse and animal sex abuse highlighted not only different approaches theoretically and methodologically but also important similarities. Both literature highlighted gaps in risk assessment, risk management, and the lack of identification and training in this neglected area of the service system prevention and response. [ABSTRACT FROM AUTHOR]

Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

Objective. The health benefits of medical care services for older adults have been well known. This study aims to identify trajectories of medical care accessibility and their impacts on Chinese older adults' psychological well-being to enrich findings on health outcomes of medical care accessibility. Methods. This study included 2660 participants aged 65 years and older from the 2005–2018 Chinese Longitudinal Healthy Longevity Survey, and this paper used the latent class growth model to analyze the heterogeneous trajectories of medical care accessibility among Chinese older adults. Ordinary least squares (OLS) regression was also used to explore whether the trajectories of medical care accessibility impact the psychological well-being of Chinese older adults and its heterogeneity among different subgroups of older adults. Results. Three distinct trajectories of medical care accessibility "maintaining high accessibility" (n = 2230, 84.1%), "medium to high accessibility" (n = 222, 8.10%), and "high to low accessibility" (n = 208, 7.80%) were identified, respectively. Regression results show that older adults maintaining high accessibility to medical care reported well psychological well-being. This result was particularly evident among older adults in urban and eastern areas. Discussion. Our findings highlight the importance of maintaining high accessibility to medical care and reducing inequalities in the accessibility to medical care for increasing psychological well-being of Chinese older adults. [ABSTRACT FROM AUTHOR]

Social participation is positively related to mental health recovery and wellbeing, yet people with mental health problems are often socially isolated. This article investigates how social participation was incorporated into an Australian-integrated program that aimed to improve the wellbeing of people with chronic mental health needs. The data are from a longitudinal evaluation of the integrated program, including data linkage (5533 participants) and interviews (111). The paper uses concepts from the network perspective of social capital (bonding, bridging, linking, horizontal, and vertical) as lenses to re-examine the evaluation's findings about the consumers' social participation in life areas (social, leisure, and productive) facilitated by the program. This social capital perspective offers a lens to examine the breadth and intensity of participation experienced by the consumers taking part in the support program. The article adds to the literature about how service providers can improve social participation and therefore consumers' opportunities for recovery and wellbeing. The analyses found that the support increased people's social interaction and their capacity in the community. Their social interaction was mostly with other people in the service. Often their interactions in the community were only transactional. Few consumers participated in activities in productive life areas, and few of the activities promoted vertical social capital in social networks outside the service. The implications are that service providers need greater attention on facilitating a variety of social participation activities that can extend mental health consumers' horizontal and vertical social capital and so further contribute to their current and future recovery and wellbeing. [ABSTRACT FROM AUTHOR]

Loneliness is considered to be a global public health challenge, impacting a range of physical and mental health conditions. Social prescribing, whereby service users are signposted into community-based activities and social groups by a community link worker, has been suggested as one mechanism to reduce service users' loneliness and social isolation. This paper reflects on service users' experiences of accessing a national social prescribing scheme. Drawing on qualitative findings from interviews with service users who were receiving support through a social prescribing programme between October 2017 and December 2018 (n = 26, with n = 12 interviewed a second time), we reflect on their experiences of the programme. We consider some of the complexities of providing short-term support with a focus on signposting people into local activities, when many service users prefer the companionship of their link worker. Furthermore, we highlight some of the difficulties in ending short-term support. Crucially, we highlight the importance of considering the intersection of the social determinants of health. We suggest that social prescribing schemes may exacerbate inequalities if consideration is not given to the ways in which people are (dis)advantaged in accessing the social capital necessary for their initial and continued involvement. [ABSTRACT FROM AUTHOR]

Most long-term care systems (social care) for older people rely on some means testing, copayment system, private insurance, or other non-governmental funding to supplement state provision. In England, an estimated quarter of homecare delivery is funded privately. For many older people, the absence of state funding for their care is only part of the problem: they are also expected to search for care in a market characterised by complexity, plurality, and imperfect information. Surprisingly, there are few services available to support private funders to navigate the system. This paper examines willingness to pay for care navigation and seeks to classify heterogeneity of preferences for navigation support. A discrete choice experiment (DCE) survey was completed by 182 participants across England in 2020-21. The results of the random parameter logit model used to analyse preferences showed that people valued information about care options (quality, information, and finances), but they also wanted help to "think things through," as processing information could be challenging. Generally, participants valued what the navigation service provided, more than how the services were organised and delivered. The study also used latent class analysis to identify four groups with similar preferences, with almost half of participants (48%) expressing high willingness to pay for a comprehensive navigation service. The other three classes represented those with preferences focused on a narrower set of attributes: fast access to information (20%), affordable help to "think things through" (18%), and information provided by their local council (14%). The study demonstrates the potential demand and likely take-up of navigation support if made available to people who pay privately for care. Future research needs to examine the barriers to market development for social care navigation services. [ABSTRACT FROM AUTHOR]

This paper aims to establish strategies of coping with COVID-19 pandemic adopted by the clients of social assistance from the perspective of social workers. The qualitative research among Polish social workers and family assistants was conducted from September to November 2021. Based on 30 in-depth interviews with social work professionals, groups of social assistance clients' behaviours were identified and classified into the theoretical models of reactions to social change by Merton and Giddens. The following types of behaviour have been selected and categorized into four groups of reactions when dealing with social workers in a pandemic situation: coolheaded calculation, defiance, confusion, and adaptation. At the same time, reactions to the situation of social change were categorized into one of the strategies of active or passive behaviour: innovation, contestation, retreat, and acceptance. In addition, we discussed the impact of clients' coping strategies on social workers and established three attitudes of the surveyed social workers: adapting to the pandemic situation and customer behaviour, assuming the role of an emotional buffer and informant, and expecting support from superiors and coworkers. Knowing the behaviour of social assistance clients in a challenging situation makes it possible to adopt tailor-made measures. [ABSTRACT FROM AUTHOR]

Vulnerable communities (including people from refugee, Indigenous, culturally and linguistically diverse, and low socioeconomic backgrounds) represent the most at-risk populations facing inequities and negative health, economic, and social outcomes. The recent COVID-19 pandemic both highlighted and fuelled these disparities. Community gardening has emerged as a community-based solution to address these inequities, yet the research literature has largely considered outcomes for the general population rather than those with the most need. This paper represents the first systematic review to summarise the evidence on the broad impact of community gardening on outcomes for vulnerable populations. A systematic search of 13 databases (PubMed, Medline, Scopus, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, Academic Search Complete, Education Source, Education Resources Information Center, Psychology and Behavioral Science Collection, SocINDEX, and Allied Health and Complementary Medicine Database) for English language articles from 1985 to 2022 was conducted. There were 33 studies identified where females were substantially overrepresented in the studies compared to males, and the main criteria for vulnerability included low socioeconomic-status and culturally diverse populations. Findings revealed that community gardening provides a wide range of benefits for vulnerable populations, with social connection, health, education, and nutrition being the more commonly cited. A relative emphasis on benefits of social connections, education, and nutrition is apparent for vulnerable populations in comparison to reviews considering the general population. The quality of studies was evaluated as moderate with little information provided about program characteristics. These shortcomings reduce the understanding of what characteristics are most likely to result in improvements and limit the capacity of practitioners to translate research into policy and practice for vulnerable communities. [ABSTRACT FROM AUTHOR]

Objectives. To review the prevalence of loneliness (during/after COVID-19) in older people. Design. Scoping review using Medline and PsycInfo for worldwide prevalence estimates (white published literature search) and Google for prevalence data inside the Euregio Meuse-Rhine (grey literature). Setting. Worldwide prevalence estimates and a focus on the Euregio Meuse-Rhine. Participants. Papers published between 2016 and 2022 and a mean age of minimum of 65 years. Measurements. Prevalence estimates for older people. Results. The white literature search yielded 37 articles. Before the onset of the COVID-19 pandemic, loneliness estimates were the highest in Nigeria (46%) and the lowest in Australia (5%) (mean prevalence was 25.6%). Loneliness was reported to be higher in specific populations, for example, people living in specific communities such as senior housing communities or with impairments, than in the general population, with a mean prevalence estimate of 47.8%. During COVID-19, the prevalence of loneliness was higher than that before the pandemic: we observed a mean prevalence of 39.4%, in comparison to 25.6 before COVID-19. The grey literature search showed that, compared to Belgium and the Netherlands (13.5% and 36.5%, respectively), loneliness estimates were the lowest in Germany, with a mean prevalence of 7.7%. Conclusion. Large international differences in the prevalence of loneliness were observed between countries and populations studied. Several hypotheses could explain such differences, including sociocultural or historical-political characteristics. Without surprise, the pandemic and associated measures were linked to a higher level of loneliness. Furthermore, recommendations for addressing loneliness, including interventions, are discussed. [ABSTRACT FROM AUTHOR]

COVID-19 vaccination is particularly challenging among populations who have experienced discrimination in healthcare settings. This paper presents qualitative findings from in-depth interviews about COVID-19 vaccination conducted in Australia between October 2020 and November 2021. Data from four different studies are presented; each population has unique experiences of discrimination within the healthcare system: Aboriginal people; people who inject drugs (PWID); people living with HIV (PLHIV); and gay and bisexual men (GBM). Analyses were guided by the behavioural and social determinants model that forms the basis of the World Health Organization's "data for action: achieving high uptake of COVID-19 vaccines" interim guidance. All populations viewed vaccination as necessary for community protection, although narratives of community care were most common among Aboriginal people. Concerns about vaccine safety were expressed by all participant groups, although participants living with HIV and GBM were more trusting of vaccines possibly because of their ongoing and usually positive past experiences with biomedical technologies for HIV management and sexual health. Aboriginal participants reported distrust of mainstream government and participants who inject drugs expressed a more generalised suspicion about COVID-19 and its origins. Practical problems related to transport, booking appointments for vaccination and so forth, were more common among participants living with HIV and GBM, possibly because these specific interviews were conducted throughout 2021 when vaccines were more available, whereas data for the other populations were collected before the vaccine rollout. Findings show that vaccine willingness is shaped by past experiences of discrimination in healthcare setting, but different histories of discrimination can differently impact vaccine willingness. Promotional messaging and delivery must take account of these important differences so to not treat these populations homogenously. [ABSTRACT FROM AUTHOR]

Background. Despite the growing prevalence of Parkinson's disease (PD) and the need to plan for future health service provision, little is known in the Irish context about PD patients' experiences of service access/use. Methods. A cross-sectional survey, with multiple formats, i.e., online, pen-and-paper, and telephone. Data were collected from May 2020 to July 2021 using a multipronged recruitment strategy. The survey was completed by people with PD alone or with the support of a carer/support person. Results. A total of 1402 responses were included. Over half (53%) were male. Approx. 10% were diagnosed with young-onset PD. A minority (6%) reported attending only their GP to manage their PD, with the rest attending a generic or specialist outpatient clinic. Almost 1-in-5 reported it took more than 12 months to obtain the diagnosis. Most were diagnosed by neurologists (84%), followed by GPs (8%) and geriatricians (7%); 1% indicated "other." Of those diagnosed privately, 37% of these patients subsequently switched to the public system for ongoing management. The majority (97%) reported currently taking PD medications, but just 52% believed these were working effectively. Access to the range of health and social care professionals, including PD nurse specialists and clinical therapies is universally poor. Conclusions. A number of significant gaps in PD care are discussed, which require urgent attention. A reconfigured model of PD care is necessary to accommodate the growing need for specialist, integrated care at the population level. Specifically, more PD nurse specialists are needed within the public health system. [ABSTRACT FROM AUTHOR]

A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues" and "lack of cultural awareness," "not feeling supported by their manager," "not having role models or mentors," and "inflexible human resource policies" predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. [ABSTRACT FROM AUTHOR]

Active citizen participation in research is important to generate societal impact of outcomes. Even so, many times, the community input in these processes is limited or non-existent, and co-creation processes are often not documented. This paper describes a structured and systematised protocol to co-create a nature-based social prescribing intervention addressed to face loneliness in urban deprived neighbourhoods. As a result, a nature-based social prescription menu was co-developed with stakeholders from health, social prescription, nature, associative, and research sectors. The menu consists of open spaces and nature activities and will be offered to the participants of a randomised controlled trial to test actions for social prescribing in natural spaces. [ABSTRACT FROM AUTHOR]

Research has historically focussed on participants who are relatively easy to access; those who have resources (time and literacy) to respond to surveys, who can travel, and are socially connected. Failure to meaningfully engage with intended participants and achieve representativeness in participation risks diminishing the applicability and impact of research findings to local contexts. Motivated by goals of social justice and health equity, this scoping review sought to identify strategies to effectively engage and integrate the "authentic voice" of populations that are described as vulnerable or precarious and therefore perceived as "hard-to-reach." A system tic search strategy identified 34 eligible papers. Articles underwent (i) a title and abstract screening by two reviewers, followed by (ii) a full text review of eligible articles by one author. Free-form research problem mind-mapping was applied to facilitate analysis and generate creative associations between ideas. Thematic and content analysis was then applied to generate themes and subthemes. Four high-level themes emerged: key players, trust and rapport, navigating structural precarity, and moving beyond "participation." We identified that substantial shifts in researcher mindsets are required to reframe perceptions of vulnerability and move towards strengths-based approaches. Efforts need to be directed towards establishing deep trust and rapport through early engagement and social reciprocity. Systemic barriers to research participation and partnership must be addressed to overcome issues of structural precarity. We urge researchers and practitioners to embrace "scholar activism" and to actively dismantle the precarity that limits active "participation" and to build deliberate strategies to create forums where the "authentic" voice can be amplified. [ABSTRACT FROM AUTHOR]

Social enterprises, which are businesses with social objectives, have been championed by the UK government as an opportunity to deliver more innovative, socially oriented, and commercially sustainable public services. However, very little is known about them, especially in a social care context. This paper therefore aims to answer the following three questions: (1) What are care social enterprises?, (2) What are their distinctive qualities?, and (3) How can they contribute to the adult social care sector? It presents evidence from a "mapping" of care social enterprises in three English local authorities, and from interviews with 35 stakeholders from across the social care and social enterprise sectors. Drawing on an institutional logics framework, we explore the influence of different norms, goals, and practices on care social enterprises and the extent to which they are aligned with those of the public, private, and not-for-profit sectors. We found that their unique combination of business and social logics, along with an entrepreneurial mindset, may make them more flexible, innovative, and able to diversify their income than public and not-for-profit care organisations. They were also considered more trustworthy than private care services. However, their competing social and business logics can create internal tensions and bring uncertainty about what organisational model they are. These tensions can make it challenging for us to define what a care social enterprise is and in turn for social enterprises to promote themselves and attract funding. [ABSTRACT FROM AUTHOR]

The aim of the current systematic review and meta-analysis was to examine the prevalence and incidence of somatoform symptoms and disorders (also referred to as medically unexplained symptoms, psychosomatic symptoms, functional syndromes, somatization disorder, or somatic symptom disorder) in childhood and adolescence. The PRISMA guidelines were followed, and the review was registered prior to initiation (PROSPERO CRD42022339735). Fitting search terms were entered in Web of Science, Scopus, and PubMed in June, 2022. Included were articles, reports, book chapters, and conference papers that reported on the prevalence or incidence rates of somatoform symptoms and disorder in under-18-year-olds with empirical primary data; these needed to be published in English or German. Publications were excluded if they focused on abuse, trauma, serious illness, or hypochondria, as well as if they had a qualitative or experimental (intervention) study design. To be included in the meta-analysis, studies needed to report values suitable to calculate a pooled prevalence or incidence rate. After the full-text screening, 33 articles remained, of which 29 were used for the meta-analysis. The quality evaluation criteria proposed by Loney and colleagues (1998) were utilized for quality assessment. The pooled global prevalence rate was 31.0% for somatoform symptoms and 3.3% for somatoform disorders, yet heterogeneity remained high. The noteworthy prevalence rates have important implications for healthcare professionals, as well as school nurses and counselors. [ABSTRACT FROM AUTHOR]

In order to supplement and improve the landscape evaluation system of traditional villages and play a positive guiding role in the specific protection and development of village landscape, this paper proposes the ecological landscape environment evaluation of traditional villages in Guanzhong from the perspective of rural revitalization. First of all, the relevant national and provincial evaluation standards are deeply studied, and the comprehensive evaluation system of the traditional village landscape in the Guanzhong region is constructed by using expert scoring and an analytic hierarchy process, which includes 6 criteria and 25 indicators. Three typical villages of different types and different development stages, namely, village A, village B, and Village C, were selected for landscape investigation and comprehensive evaluation. The results show that the weight of village location and landscape pattern is the largest, that is, the most important. The second is architectural landscape, with a weight of 0.236, accounting for a high proportion. Then, it is the natural landscape and street landscape, with a weight of 0.1-0.2. Finally, it is the intangible cultural landscape and landscape style protection, with a weight of less than 0.1. The alpha value of the comprehensive evaluation questionnaire of the village A is 0.984. The alpha value of the comprehensive evaluation questionnaire of village B is 0.941. The alpha value of the comprehensive evaluation questionnaire for the landscape of village C is 0.986, which is greater than 0.8. Conclusion. This study makes a comprehensive evaluation of the landscape of typical traditional villages. [ABSTRACT FROM AUTHOR]

The sustainable development of smart community is the key to China's grassroots governance and also the general trend of China's urban modernization. In the supervision of the smart community, the optimization of the behavior of the regulatory subject cannot be separated. Previous studies have focused more on how subjects participate in supervision and less on the behavior of stakeholders in the game. This paper analyzes the game behavior of regulatory participants in the process of sustainable development of smart community and studies the optimization strategy of regulatory behavior according to the game behavior logic among participants. The results show the following. (i) Government behavior plays a leading role in supervision. (ii) When the government invests resources in the screening of third-party evaluation agencies and service purchase and mainly adopts policy punishment methods for stakeholders with rent-seeking behavior, the probability of regulatory participation stakeholders' positive behavior is the greatest. (iii) The improvements should be made from the aspects of information network construction, the refinement of reward and punishment measures, and the improvement of evaluation party access rules. This not only helps to enhance the good supervision situation of the supervision enthusiasm of the participants but also can realize the self-discipline operation of the smart community and enhance the responsibility consciousness of the evaluation institutions. [ABSTRACT FROM AUTHOR]

This paper reports findings from a national, qualitative study in England that investigated if young adult carers services are facilitating young people's transitions to adulthood, including considering a future beyond caring. Semi-structured, online interviews were conducted in 2022 with a purposive sample of managers or lead workers of eleven young adult carers services in England. We discuss the consideration given in assessments to young people's caring preferences and the availability of support to facilitate them to relinquish their role, if they so wished. The majority of young adult carers services gave young people the opportunity to express their views on this issue. Although the Care Act 2014 aimed to provide choice over caring in adulthood to young adult carers, this was not matched by the necessary service provision to facilitate their preferences. A new national carers strategy is urgently required to ensure that young people, particularly women, have a credible choice over their future lives. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between the prevalence of the urgent and emergency care vanguard (UEC) at the local authority level and their delayed transfers of care (DTOC) rates in England. We created a novel measure of exposure to UEC vanguards based on the residence of patients who used UEC partner hospitals, and we group it by the level of exposure (high, medium, low, none). We use this measure to estimate the effect of UEC vanguards on DTOC rates and then on DTOC rates by sector and a range of reasons associated with the delay. The analysis was run at the local authority level (LA) using quarterly data from NHS England for 150 English LAs from the years 2012–2017. We find a statistically significant UEC exposure effect of around 0.3% reduction in total DTOC to a 1% increase of UEC exposure (equivalent to 775 DTOC days per local authority per quarter in high UEC exposure areas), a result robust to various specification checks. Nonacute sector DTOC was found to be more responsive to UEC vanguards in comparison to acute sector DTOC (0.4% and 0.3% reductions, respectively, to every 1% of UEC exposure). DTOC due to social care was particularly responsive to UEC exposure (0.7% reduction to 1% exposure). DTOC reasons associated with the highest impact of UEC exposure were as follows: awaiting a care package at own home, waiting for further NHS nonacute care, and completion of assessment (reductions of 0.5%, 0.3%, and 0.3% to 1% exposure, respectively). All three reasons were originally associated with the largest number of DTOC days. These findings further advocate for UEC vanguards having been successful at alleviating the pressure on hospitals related to DTOC. [ABSTRACT FROM AUTHOR]

Consumer-directed care (CDC) is a policy solution for quality deficiencies in aged care where seniors accessing care services are empowered with full choice and flexibility over their service packages. Various programs have been developed using this policy approach around the world, and implementation has invoked a mixture of responses. While consumer organisations welcome a policy direction providing additional choice, there is a concern that this policy complicates the decision-making process, leading people to rely on "rules of thumb" (heuristics) that may not reflect their best interests. Behavioural science provides a lens for looking at heuristics and biases that may occur during complex decision making, particularly as people age. Objective. To explore the presence and influence of heuristics and biases on the decision-making processes of older people receiving home care services under a CDC model. Method. Qualitative systematic review involving systematic searching of PubMed, MEDLINE via Ovid, Embase via Elsevier, CINAHL via Ebsco, PsycINFO via Ovid, Web of Science, Scopus, and EconLit, from inception until 14th April 2022 was undertaken. Identified articles were deduplicated, screened, and extracted for information relevant to the research question using PRISMA guidelines. Data extraction considered descriptive data and metadata including study type, participants, overall objectives, chosen methodologies, and their relationship to the research question. The variety of study types prompted a thematic synthesis to achieve greater comprehension of the existing knowledge base. Results. Descriptive categories were analysed to reveal five themes relevant to the presence and influence of heuristics and biases in decisions made by older people when allocating home care resources. Principally, CDC is implemented to afford autonomy but is complicated by the decision-making environment. Choice and decision making are both specific to the individual, and the processes employed for decision making vary over the life-course. Decision quality can be improved through the identification and mitigation of complicating factors. More research is needed to understand how modifications can assist decision making and improve health outcomes. [ABSTRACT FROM AUTHOR]

Health systems are poorly equipped to respond to complex health and social needs, which span sectors and diagnoses. This study puts forward a framework for complex care policy. The framework was developed using critical interpretive synthesis, a method for developing theory on the basis of a transparent search and critical analysis of a heterogenous body of the literature. Seventy-three results were included from a systematic search. We suggested that complex needs can be understood as a pattern of unmet needs occurring at the intersection of fragmented health systems and services, multimorbidity, and social marginalization. We proposed a multilevel framework to inform complex care policy design that accounts for each of these issues and their intersections at the individual, service, and system level. We further identified five principles that have relevance at all levels of complex care. Our framework centres clients and their relationships with providers and suggests how services and systems can support client-level interactions. Conceptualizing complex care policy as a multilevel intervention offers a tool for understanding unexpected effects. Further work is needed to test and refine this framework and to contextualize it for particular populations and settings. [ABSTRACT FROM AUTHOR]

Men's sheds are a community-based organisation that allows a space for a community of men to interact and engage with one another with hands-on activities. As such, men's sheds form an appropriate setting to deliver health and wellbeing initiatives. This review aims to understand the role of Australian men's sheds with respect to the health and wellbeing of their male participants. This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) following a three-step process of planning, conducting, and reporting the review. All three authors reviewed all the eligible articles. There was significant methodological heterogeneity between the sources identified (n = 11). A narrative synthesis identified three key themes: health promotion, wellbeing, and socialisation; intergenerational mentoring; and Aboriginal and Torres Strait Islander men's health. Men's sheds serve as ideal locations for the delivery of initiatives that can positively impact on the health and wellbeing of their male participants. Furthermore, research is needed to explore the implementation and evaluation of these health and wellbeing initiatives for men in their respective communities. [ABSTRACT FROM AUTHOR]

Internationally, community healthcare is provided by personal health budgets or personalised schemes as part of a consumer-directed care emphasis. Although the introduction of a personalised scheme in Australia has improved the lives of many, people with psychosocial disability (PSD) and their families have experienced many challenges with service integration. Six focus groups with 17 National Disability Insurance Scheme (NDIS) support workers were conducted between June and November 2022. Participants were asked semistructured questions about their engagement with emergency department (ED) clinicians when presenting with a person with PSD and NDIS plan. They were also asked how they contribute to service integration to improve communication practices between the two services. A qualitative, descriptive thematic analysis approach was used. Results indicate there is a need for improved service integration pathways between the ED and NDIS services. The thematic analyses identified five main themes: the ED is harmful and not safe, but nowhere else to go; make the ED safe; further training for ED staff; improving communication across services; and alternatives to the ED. This study reports NDIS support worker's experience when supporting a person they are caring for in the ED. NDIS support workers have an understanding of the needs of the people they care for;their wisdom can contribute greatly to ED clinical responses in crisis care. Recommendations are offered to assist with service integration between the two systems. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic significantly endangers the development of at-risk young adults across various life domains, with potential enduring consequences. Despite prior reporting on the pandemic's adverse effects on these individuals, there is a lack of the empirical literature regarding their resilience. Building upon the stress process model (Pearlin, 1978), we explored the challenges of 20 at-risk young adults (aged 18–25 years) and the strategies and resources they employed to cope with these challenges during this period. Thematic analysis revealed that these young adults struggled with worsened family relationships, loneliness, mental health issues, and setbacks in their quest for independence and autonomy. However, resources and character strengths that facilitated coping strategies during this period also emerged, specifically the motivation to become a role model within their family, personal abilities, and the use of formal and informal support. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Recently, baby healthcare monitoring systems have emerged as a key research area. However, numerous research studies have been conducted on babies and their state of either awakening or sleeping. But there is a lack of comprehensive and systematic review in this area of research. The existing research considers mostly the children's monitoring vital health parameters, in turn, giving relaxation to the parents in caring of their babies. Still, the fundamental practical issues related to daily life are missing. As a result, the safety of babies against suffocation and falling hazards for employed parents or mothers involved in the workforce has been overlooked. Only a few studies exist that cover the age range of 0 months to 4 years, with further focus on the age range of 6 months to 4 years. In response to these gaps in previous research and existing technologies, this review work proposes a vision for a baby safety system that utilizes various sensors and technologies like machine learning and image processing to ensure a safer environment for babies. [ABSTRACT FROM AUTHOR]

Children with disabilities in out-of-home care (OOHC) are an overrepresented group in Australia, yet little is known about their circumstances, needs, and experiences within OOHC. Utilising a systematic scoping review methodology, we explored the state of knowledge about the experiences of children and young people with a disability in out-of-home care in Australia. Findings in this review speak to the unmet needs and challanges that children with disabilities face in child welfare systems and how systemic failures can lead to institutional pipelines of further maltreatment, adversity, and marginalisation. The review discusses the key themes in the literature, including (i) compounding trauma and placement failures, (ii) concerns of safety, stability, and neglect, (iii) limited control and choice, and (iv) disability and multisystem involvement. [ABSTRACT FROM AUTHOR]

Moving into a nursing home is a significant transition for older people which can be emotional and stressful. The literature on the decision to move and subsequent residential stress focuses on the time after admission; however, there is less understanding of older people's management of the process. To fully understand and possibly reduce negative consequences and health-related risks, the aim of this article is to explore how older people manage the transition from home to nursing home. The study is based on 21 longitudinal interviews with seven older people during the process of moving. Following Dorothy Smith's theory of work, the analysis finds three types of work—practical, relational, and emotional—that older people engage in during the transition process. The results highlight the importance of considering the entire transition process, not only experiences before or after, if we are to reduce the negative, stress-related consequences of relocations of this kind. The findings have practical implications for professionals in health and social care and point to the need to develop practical, relational, and emotional support for older people throughout the transition process. [ABSTRACT FROM AUTHOR]

Rationale. Recent studies have highlighted organizational issues, work stressors, and moral distress as prevalent problems among staff working within care services for older people, but factors influencing regulatory compliance in care services for older people are currently uncharted. Aims and Objectives. The aim of this exploratory study was to investigate how organizational factors, the clinical characteristics of the clients, and perceived organizational factors are associated with staff regulation noncompliance within home care services and service housing facilities. Methods. A self-report survey was sent to practical and registered nurses working in home care services and service housing in Finland in October 2021. The sample consisted of 352 home care and 555 service housing staff members. Separate models were calculated for home care services and service housing facilities. The data were analyzed using logistic regression models. CROSS reporting guidelines were followed. Results. The results show that in service housing facilities, higher numbers of disruptions, lower team autonomy, and working for a private employer increased the odds of regulation noncompliance. In home care services, higher numbers of visits during a day, higher numbers of disruptions, and lower team autonomy increased the odds of regulation noncompliance, while attending to clients requiring less resources decreased the odds of regulation noncompliance. Perceived lack of time and resources were influential factors in both contexts. Conclusion. Allocating more time to attend to tasks, ensuring adequate staffing, as well as supporting team autonomy, may increase regulation compliance within care services for older people. [ABSTRACT FROM AUTHOR]

Despite efforts to acknowledge diversity among unpaid caregivers, Canadian research, advocacy, practice, and policy tend to be based in and to reproduce dominant social and institutional expectations and assumptions about who provides unpaid support and why, and what this support looks like. The objective of thtudinal, qualitative research study. In that study, qualitative case study interviews were conducted with twelve home care clients, their identified family or friend caregiver, home care aide, case coordinator, and agency supervisor (129 interviews in total). Case study profiles compiled over time generated deeper information about the availability and capacity of informal sources of support for these clients, which prompted abductive analysis in relation to dominant assumptions typically made about caregivers in research, policy, and practice. Specifically, only one case (participant) had a caregiver whose profile closely matched dominant conceptualizations. In the remaining eleven cases, we found situations wherein: (a) caregivers grappled with physical or mental health challenges limiting their participation in care (sometimes meaning the client is themselves a caregiver, or the caregiver is also receiving home care services); (b) caregivers facing burnout sought to delimit their participation in care; (c) caregivers' participation was limited by older adults' reluctance to accept their help; (d) caregivers were largely unavailable, unreliable, or peripheral; or (e) client's unpaid support networks were diffuse without a clearly central or identifiable "caregiver." Findings are used to nuance and problematize widely held assumptions about caregivers, particularly their availability and capacity. Discussion highlights the need for research, policy, and programs related to unpaid caregiving to better reflect the lived realities of this support for older adults and often overlooked sources of diversity in caregiver circumstances and roles. [ABSTRACT FROM AUTHOR]

Providing formal care and support in the home has many benefits. Applying a human rights-based approach places the person and their human rights at the centre of all that a health and social care service does. There is a paucity of evidence on how to apply a human rights-based approach in practice when providing homecare. Increasing knowledge and understanding of human rights will empower health and social care practitioners to protect and promote human rights in formal homecare. The aim of this narrative review was to identify and describe human rights-based approaches in homecare, in order to promote awareness and understanding of a human rights-based approach. Five bibliographic databases were searched. Primary research studies pertaining to the delivery of formal homecare that included a human rights-based approach were eligible for inclusion. Sixteen articles were identified for inclusion. Quality appraisal and data extraction were conducted on included studies. A deductive framework analysis was used and concepts of a human rights-based approach that emerged from the literature as relevant to homecare were as follows: dignity and respect, autonomy, equality, participation, and communication. We found that homecare planning and delivery requires the integration of human rights, using approaches, such as person-centred care, partnerships in decision-making, supporting independence, and acknowledging a person's beliefs and cultures, in everyday practice. Findings from this review can support and enable service providers to apply human rights in everyday practice, ultimately for the benefit of people using homecare services. [ABSTRACT FROM AUTHOR]

Community engagement (CE) has long been endorsed by policy makers and health practitioners. However, uncertainties remain about the workings and outcomes of CE. This study aims to provide in-depth insights into them. In a multiple case study, we investigated three participatory health promotion projects for families in vulnerable situations in the Netherlands. We adopted a realist approach combined with a theory of change (ToC) model. We then analysed the qualitative data for context–mechanism–outcome (CMO) configurations to refine this ToC. Results show that CE can strengthen social networks, empower families, and increase perceived health. However, specific contexts in combination with CE project approaches may or may not trigger positive responses. Participants may feel that they matter when asked to actively contribute to a project, which in turn can enhance their self-confidence. In another context, we found that families were overwhelmed by the responsibilities given to them in the project, leading to feelings of stress and withdrawal from the project. We present a list of CMO configurations and refine the ToC accordingly. Our main conclusion is that flexibility is key when CE is implemented in health promotion. Also, our findings question physical health outcomes as a realistic ambition for CE projects with groups in vulnerable situations. [ABSTRACT FROM AUTHOR]

Dementia is recognised as one of the major global health and social care challenges of present times. When the onset of dementia occurs in midlife, there is an increased possibility that there are children and young adults involved who are dependent on the parent concerned. The aim of the study was to describe health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. A qualitative descriptive approach was carried out with individual interviews of health and social care professionals, using a semistructured interview guide. Thirteen participants in rural and urban areas in Sweden were interviewed. The overarching theme, advocating a forgotten group with three categories were identified. They combine and reflect health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. Health and social care professionals who encountered children and young adults with a parent with dementia described how they were not sufficiently trained in supporting this group and identified a general shortage of available appropriate support services. The children and young adults were also described as a forgotten and overlooked group in need of affirmation and support in a more systematic way. [ABSTRACT FROM AUTHOR]

Pediatric palliative care (PPC) programs are essential in encompassing not only the affected children but also their family system and the healthcare and educational professionals involved. Despite the field's significance, there is a notable scarcity in current literature, which underscores the pressing need for further research into the attributes of PPC programs that effectively enhance the quality of life (QoL) for pediatric patients. This study particularly emphasizes the pivotal role of schools as key community resources within this framework, highlighting the crucial aspect of educational integration in PPC. Through a systematic review of relevant literature and applying stringent inclusion and exclusion criteria, we identified pertinent studies across various databases. Of these, 30 articles met our criteria and were subject to a thorough qualitative analysis. Our findings indicate that while PPC programs may vary in their methodologies, they consistently share certain core elements that significantly boost the QoL for pediatric patients. These include a holistic approach that addresses the physical, emotional, psychosocial, and spiritual facets of care; encourages the active involvement of the patient in decision-making processes; and ensures timely access to PPC services. Importantly, our analysis identified the critical role of educational settings in enhancing QoL, shedding light on the vital need for educational inclusion and the integration of schools into the broader spectrum of PPC services. The distinct individual perceptions of QoL and the varied international practices in PPC underscore the imperative to tailor successful strategies to specific local contexts, thereby fostering the global well-being of pediatric palliative care patients. [ABSTRACT FROM AUTHOR]

There has been growing interest in exploring factors that influence the success or otherwise of welfare policies in democratic countries, such as the interrelationships between the proposed policy and the context it will be introduced into, such as the sociodemographic characteristics of the population and the population's previous experience with welfare policies. However, there has been little exploration of factors that could influence general population support for long-term care for older people. The aim of this study was to investigate the general population's attitudes for determinants of high-quality aged care and different mechanisms for funding and any impact of individual characteristics on these. A representative sample of the Australian general population aged 18 years and over (N = 10,315, 52% female, 22% aged 65 years and over) drawn via quota sampling participated in the survey online. Participants were asked to rate the importance of a list of 10 determinants of quality care and their support for four models of funding, both using a five-point Likert scale. We identified consistently high expectations for long-term care services across the general population, especially among older people, females, those with a family member in care, and those living in rural or regional areas. In terms of how governments practically fund a high-quality long-term care system, we also identified broad support among the general population for both payment of a co-contribution towards the cost of care by older people using services and increased government funding for the system. Over 40% of participants said they would be willing to pay additional tax to improve access and quality of aged care services. While often neglected by governments in the past who assumed voter apathy on the topic, by comparison, our findings indicate that there is currently a strong appetite among the general population for improvements to the quality of care provided and that they are willing to consider changes to the funding model. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the well-being of older adults has been highlighted as a significant public health concern. In this study, we investigated the role of psychological resilience in mediating the relationship between positive self-perceptions of aging (SPA) and the subjective well-being (SWB) of community-dwelling older adults in Taiwan during the pandemic. We collected data through face-to-face interviews conducted from October 2021 to February 2022, involving 1,095 participants aged 50 years or above residing in a southern city in Taiwan. More than half of the study participants were female, aged 65 or older, and had less than a high school education. More than two thirds were married and/or living with partners. More than a third had two or more noncommunicable diseases. We calculated scores for SWB, positive SPA, and psychological resilience and examined correlations among the outcome and predictor variables. Our findings indicated that higher positive SPA was significantly associated with better SWB among community-dwelling older adults in Taiwan and that this association was mediated by psychological resilience. Specifically, after controlling for covariates, structural equation modeling (SEM) analysis revealed a significant main effect of positive SPA on SWB (b = 0.412, β = 0187, and p < 0.001), while bootstrap mediation analysis showed a statistically significant indirect mediating effect from positive SPA on SWB via psychological resilience (0.597, 95% bootstrap CIs = [0.445, 0.749], and p < 0.001). These findings highlight the potential importance of cultivating positive self-perceptions of aging and implementing resilience-centered interventions to promote well-being among Chinese older adults in the community. [ABSTRACT FROM AUTHOR]

Background. There is a high prevalence of homeless people with psychotic disorders and supported housing is often required. However, there is little evidence about supported housing services, especially in low-middle income countries. This rapid review synthesizes evidence about the experiences of users and providers of community-based accommodation services for people living with serious mental illness internationally to understand priorities for policy and practice. Methods. PubMed, PsycINFO, Google Scholar, and reference lists were searched to identify 1344 studies. The inclusion criteria specified qualitative studies about users' and/or providers' views of the accommodation services for adults aged 18+ years with serious mental illness. Title, abstract, and full-text screening were conducted in duplicate, and quality appraisal was conducted using the standard for reporting qualitative research tool. Data extraction was conducted using both Excel and Word documents, and we used thematic analysis to report findings. Results. Only 43 studies were identified for inclusion. Service users' and providers' experiences of accommodation services from high income countries and low-middle income countries were similar. Both the service providers and users appreciated housing, and service providers mentioned it was not a sufficient step towards independent living. Shortage of resources in low-middle income countries made it challenging for some service providers to provide care because they had to choose between buying medicine or food. While service users needed greater availability of service providers, providers were at risk of burnout. Although some service providers were trained to respond to stigmatizing events, some users continued to experience stigma from their family members, society, and service providers. Conclusions. People living with serious mental illness and service providers value the housing provision but globally their experience of this provision is relatively poor compared to mainstream society, suggesting people living with serious mental illness remain disadvantaged. Further research should explore low-cost housing options that will provide quality person-centered care for people living with serious mental illness. [ABSTRACT FROM AUTHOR]