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Healthcare professionals' advice on lifestyle behaviours is a key factor in improving a nation's health. Although allied health professionals have been well placed to provide such advice as part of patient care, little is known about the characteristics of allied health practitioners who discuss lifestyle topics with patients. This paper focused upon an overlooked avenue for lifestyle advice regarding an allied health profession – osteopathy. A workforce survey including questions about four lifestyle topics (including diet/nutrition, smoking/drugs/alcohol, physical activity/fitness, and stress management) was distributed to a nationally representative sample of Australian registered osteopaths in 2016. Separate multivariate logistic regression and Poisson regression models were developed to determine the most important predictors of the discussion of lifestyle factors. Amongst the 992 participating osteopaths, 89%, 49%, 38%, and 18% often discussed physical activity/fitness, stress management, diet/nutrition, and smoking/drugs/alcohol with their patients, respectively. Approximately 30% of participating osteopaths discussed at least three lifestyle topics with patients. Varied predictors were identified for discussing each lifestyle topic. Osteopaths who often discuss diet/nutrition in patient management plans were more likely to often discuss smoking/drugs/alcohol (OR = 14.13), physical activity/fitness (OR = 2.71), and/or stress management (OR = 1.69). In conclusion, lifestyle factors are often discussed with patients as part of osteopathy treatments in the Australian healthcare context. Osteopaths are well positioned to initiate discussions regarding patient lifestyles, and such discussions may be an effective contribution to health promotion. [ABSTRACT FROM AUTHOR]

The purpose of this study was to carry out an ethnobotanical and ethnopharmacological investigation on wild edible plants and their value to households in the Tach Gayint district of South Gondar Zone of northwestern Ethiopia. A total of 175 informants (56 women and 119 males) were interviewed for ethnobotanical data, and 25 of them were key informants. Data collection techniques included semistructured interviews, guided field walks, and focus group discussions. Quantitative analytical tools were employed for ethnobotanical methods including preference ranking and direct matrix ranking techniques to analyse the data. 36 species of wild edible plants have been identified in the study area. Of these plant species, shrubs account for 15 (42%), followed by herbs 13 (36%) and trees 8 (22%). Regarding the edible parts, fruits account for 19 (53%) followed by young shoots, leaves, and flowers, 4 (11%) for each. These plant species are eaten raw (86%) or cooked (14%) and most are collected by younger people for herding cattle. According to the preference ranking analysis, the fruit of Opuntia ficus-indica is the most preferred plant species because its sweet taste. Although Cordia africana, the most commonly used multipurpose wild edible plant species, is mostly exploited due to human activity, activities such as the production of charcoal, the gathering of firewood, the construction of homes, and the use of agricultural tools all played a significant role in the plant's eventual extinction. In the study area, agricultural expansion was the main cause of putting wild edible plants in danger. It is best to cultivate and manage edible plants in a backyard garden and to perform more research on popular edible plant species. [ABSTRACT FROM AUTHOR]

The study sought to explore user and community responses to service delivery gaps in emergency obstetric care provision in rural Ghana. A qualitative design was employed to draw evidence from observations, interviews and focus group discussion among healthcare providers, clients and community members. Data processing and analysis followed a thematic approach. Findings reveal community interference in obstetric care delivery processes, reliance on unskilled providers, recourse to local oxytocin use, non‐compliance to prescribed treatment and mistrust in healthcare providers as user and community coping mechanisms to perceived poor quality obstetric care. These behaviours have serious consequences on the life chances of pregnant and parturient women. The need to adapt to a more responsive and affordable maternal healthcare delivery system is essential for uptake of services in rural areas. Also, standardised guidelines to regulate health worker behaviour is critical to instil trust in the healthcare system. [ABSTRACT FROM AUTHOR]

Objective: In Switzerland, palliative sedation consists of using sedatives to relieve terminally ill patients. It is divided into several steps, with one of them consisting of informing patients and relatives about the procedure. In the current recommendations, there is a lack of orientation about how and when this discussion should take place. Hence, we aim to explore perceptions and experiences of palliative care professionals regarding these questions. Methods: Qualitative semi‐structured interviews with five physicians and five nurses working in specialised palliative care were conducted. They were then analysed with thematic analysis. Results: Results showed a uniformity around definition, goals and indications of palliative sedation. However, there was a lack of consistency regarding the process of delivering this information to patients and relatives. Finally, some participants strongly opposed the idea of systematically informing patients in specialised palliative care, while others were more divided on this question. Conclusion: Despite a common understanding of the concept of palliative sedation, there is no standard practice when informing patients on palliative sedation among palliative care professionals. Therefore, this study demonstrates the need for further guidelines on this question and calls for a better understanding and knowledge of palliative sedation among health professionals outside palliative care. [ABSTRACT FROM AUTHOR]

Sub‐Saharan Africa carries the highest burden of HIV, with approximately 70% of all people living with HIV (PLWH) globally living in this region. The provision of antiretroviral treatment (ART) significantly affects already overburdened health systems, which need to accommodate large volumes of ART patients while facing a shortage of professional health workers, infrastructure challenges and medical resources. Finding alternative ways to provide routine services to PLWH has become significantly more urgent. Multi‐month dispensing (MMD) of ART aims to improve access to treatment for PLWH, while also improving the efficiency of the health system. This study explores the experienced benefits and challenges of community‐based MMD in order to make recommendations for future implementation efforts. Twenty focus group discussions were conducted with members of community ART refill groups (CARGs) who received 3‐monthly or 6‐monthy MMD. Individual interviews were also conducted with health providers. All interviews and focus group discussions took place between April and June 2019 conducted by research nurses in English, Shona or Ndebele. Multiple benefits of community‐based MMD were reported, including decreased congestion in health facilities, improved service delivery, decline in staff burnout and increased time availability for CARG members due to less time spent at clinics, improved ART adherence and social support experienced amongst members of CARGs. Identified challenges included the possibility of being exposed to HIV‐related stigma when belonging to a CARG, and low levels of medical supplies and ART stock at clinics. Recommendations were made by CARG members and health care workers on how CARGs could be improved and sustained in the future. Results from this study show that the implementation of community‐based MMD holds multiple benefits at an individual and health facility level. Future recommendations include evaluating the feasibility of MMD among other vulnerable populations. [ABSTRACT FROM AUTHOR]

Services have improved due to public involvement in the planning, development, and implementation of health services. A wide range of public involvement methods, based on highly diversified methodological approaches and conceptualisations, have been developed. However, the extensive growth of new and different involvement methods lacks consistency and promotes uncertainty about which methods to apply when, how, and why. Aiming to identify, chart and summarise public involvement methods in the planning, development and implementation of community health services, we conducted a systematic search in April 2021. Seven databases were searched: CINAHL, Cochrane, Embase, PsycINFO, PubMed, ProQuest and Scopus. The systematic facet search corresponded with the PCC framework: Patient (P), Concept (C) and Context (C). A descriptive synthesis and a thematic analysis of included studies were conducted. Thirty‐nine studies met the inclusion criteria. Two main categories of public involvement methods were identified: multiple methods approaches and single method approaches involving a variety of involvement activities. The characteristics of the two categories of methods were coded in accordance with methodological approach, activity and facilitation technique. The majority of the studies' methodological approach was either participatory or community‐based. A variety of techniques to facilitate group discussions, sharing of ideas, and group processes were used. The results provide an overview of the characteristics of different public involvement methods, which may inform agencies and practitioners in choosing appropriate methods to qualify the public involvement in planning, developing, and implementing community health services. Further research is needed on how to manage public involvement in the implementation of community health services. In addition, rigorous evaluation studies of the impact of public involvement methods are needed. [ABSTRACT FROM AUTHOR]

Teletherapy services are being increasingly provided by allied health professionals to address major inequities of access. While clinical outcomes and stakeholder satisfaction are crucial for paediatric teletherapy's continued viability, processes for increasing parent/caregiver satisfaction, and for modifying aspects of caregiver engagement to improve outcomes, are under‐researched. Studies of in‐person therapy have shown that engagement, satisfaction and outcomes are influenced by the development of therapeutic alliance. This study investigates influences on parents' engagement with a teletherapy program and their therapeutic alliance with the therapist. Using a qualitative approach, data were analysed from semi‐structured telephone interviews with six parents in rural New South Wales, whose children had completed paediatric teletherapy programs provided by a psychologist, speech pathologist or occupational therapist. Parents described factors that affected aspects of their engagement and alliance. Thematic analysis with constant comparison was used to determine the themes of the interviews, which were (a) initial engagement, (b) collaboration and (c) rapport. The themes demonstrate that parents were evaluating the efforts the therapists were making in (a) communicating, (b) truly partnering with them, both being elements of collaboration and (c) building rapport with them and the child. A conceptual model, Parent And Caregiver Evaluation Cycle In Teletherapy (PACECIT), is proposed by the researchers to explain how parents evaluated the therapist to judge the current state of a personal relationship and to judge the effectiveness of a collaborative relationship, both influencing the therapeutic alliance and motivation for engagement. The findings emphasise the importance of fulfilling parent/caregiver expectations for clear and frequent communication, and discussion of their ideas. Also important is the development of therapeutic alliance through utilising parents' observations of non‐verbal communication to maintain an effective rapport and enhance engagement. [ABSTRACT FROM AUTHOR]

Although sexuality is an important part of health and emotional well‐being throughout the entire life cycle, including during old age, little is known about how physicians discuss or approach the topic of sexuality during later life. The present study examined the perspectives of two groups of physicians toward discussing sexuality with older patients: 17 physicians who did not have any training in human sexuality and 21 physicians who were certified as sex therapists. The interviews underwent thematic content analysis to identify and code major themes and patterns. Qualitative analysis of the interviews yielded three main themes: (a) discourse between physicians and older adults regarding sexuality, (b) diagnosing sexual dysfunction among older adults, and (c) treating sexual dysfunction among older adults. Physicians who were not trained in sex therapy did not regularly ask their older patients about sexual functioning and/or problems with sex, tended to diagnose sexual problems from a medical perspective, and offered medication as the main treatment for sexual problems. Physicians trained as sex therapists felt more comfortable discussing sex‐related issues with their older patients and diagnosed sexual problems from a medical, social, dyadic and psychological perspective. Although they offered their older patients a greater variety of medication‐oriented interventions than those without training in sexuality, they did not rush into such interventions and instead emphasised the importance of the psychological and relational aspects of sex. The present study highlights the importance of human sexuality training for physicians and points out the effects of such training on the discourse, diagnosis and treatment of sexual concerns in later life. [ABSTRACT FROM AUTHOR]