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Purpose: To meet the needs of people with mild stroke, multidisciplinary, person-centred, cross-sectoral rehabilitation is internationally recommended. However, there seem to be gaps in the rehabilitation process. The aim of this study was to investigate how occupational therapists and physiotherapists experience working in cross-sectoral rehabilitation for people with mild stroke. Materials and methods: Data were generated through interviews with occupational therapists and physiotherapists working in four different Danish rehabilitation settings. Four group interviews and two individual interviews with a total of 19 participants were conducted. Ricoeur's theory of interpretation was used to interpret and discuss the data. Results: Four themes were identified: the risk of overlooking symptoms: better safe than sorry; varying degrees of involvement of people with mild stroke; spontaneous involvement of relatives; and contextual challenges for coherence in the rehabilitation process. Conclusion: The therapists experienced challenges in coordinating rehabilitation across sectors due to the timing of the needs assessment and contextual challenges. They used a preventive strategy of sending a plan or referral for later re-assessment. The therapists involved people with mild stroke to varying degrees. They involved relatives spontaneously. For successful rehabilitation, ongoing assessment, recognition of collaboration factors and relative involvement are essential. IMPLICATIONS FOR REHABILITATION: It is crucial to continuously evaluate needs and establish goals throughout the entirety of the rehabilitation process. Recognizing that the capacity and resources of people with mild strokes to collaborate with professionals are contextually, relationally, and individually determined is important. Involvement of relatives should be strengthened on many levels from the institutional level to the personal level. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic continues to spread throughout the world causing serious morbidity and mortality. Health care professionals (HCP) are on the front line in the face of this pandemic and are identified as priorities for COVID-19 vaccination. This study aimed to estimate the acceptability rate of the COVID-19 vaccination among HCP and to identify their predisposing factors. Methods: This was a cross-sectional study using an anonymous self-administered questionnaire including a randomized sample of HCP in Southern Tunisia, on March–April 2021. Results: Among 300 participants, the COVID-19 vaccine acceptability rate was 65.3%. Factors independently associated with vaccine acceptability were age groups <30 years [Adjusted Odds Ratio (AOR)=4.36; p = 0.002)], urbanity of residence (AOR = 3.44; p = 0.027), medical professional category (AOR = 2.69; p = 0.023) and caring for coronavirus infected patients (AOR = 2.32; p = 0.047). Belief that COVID-19 vaccination is important to work safely as a health care provider (AOR = 3.26; p = 0.013), should be available for all HCP (AOR = 17.98; p = 0.004) and has been quickly developed before it has been thoroughly vetted and tested for efficacy and safety (AOR = 5.88; p < 0.01) were independently associated with willingness to accept vaccine. Planning to get a COVID-19 vaccine for the next years and recommending it to the family were independent predictive factors of accepting COVID-19 vaccine ((AOR = 6.88; p < 0.001) and (AOR = 25.03; p < 0.001), respectively).Conclusion: The acceptance rate of vaccination against COVID-19 among Tunisian HCP is still low in South Tunisian hospitals. Socio-demographic, cultural and professional factors predisposing to the vaccination willingness were highlighted. Combating the vaccine hesitancy of HCP through enhancing sensibilization campaigns is essential to promote vaccination in general population. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo explore perspectives of ambulatory and non-ambulatory people with MS (PwMS) and health care professionals (HCPs) on falls and falls management to gain a deeper understanding of how a self-management programme can be designed to fit the needs of end users.Twelve PwMS and seven HCPs participated in three four-hour workshops based on Design Thinking. Collected data were field notes and digital post-it notes gathered at the workshops. Data were analyzed using qualitative content analysis with an inductive approach.Two main categories, “Managing the complexity of fall-risk behaviour” and “Embracing diversity to establish group engagement”, comprising a total of seven categories were constructed from the analysis. The first main category reflects the challenges PwMS face in managing fall risk in their daily lives, and the support needed to address these challenges. The second main category highlights how engaging in peer learning activities can fulfil individual needs and improve learning outcomes for PwMS.A self-management fall prevention programme that is relevant to PwMS regardless of ambulation level should include the development of self-tailored behavioural strategies to prevent falls along with interactive learning activities with other PwMS.A self-management fall prevention programme should be customized to individual fall prevention needs and circumstances in daily life.A self-management fall prevention programme conducted online can enable accessibility for ambulatory and non-ambulatory people with multiple sclerosis (PwMS).Peer learning in groups with other PwMS can facilitate the development of self-tailored fall prevention strategies and provide positive reinforcement to support behavioral change.A self-management fall prevention programme should be customized to individual fall prevention needs and circumstances in daily life.A self-management fall prevention programme conducted online can enable accessibility for ambulatory and non-ambulatory people with multiple sclerosis (PwMS).Peer learning in groups with other PwMS can facilitate the development of self-tailored fall prevention strategies and provide positive reinforcement to support behavioral change. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignSettingSubjectsResultsConclusion\nKEY POINTSThis study described the experiences and perceptions of how primary health care professionals (PHCPs) support patients with venous leg ulcers (VLUs) in self-care monitoring.A qualitative approach with reflexive thematic analysis was used, with 24 individual qualitative open interviews.Primary health care clinics and community health care in four southern regions in Sweden.Registered nurses, district nurses and nurse assistants who had experience of caring for patients with VLUs. In total, 24 interviews were conducted with PHCPs in Sweden.PHCPs have a vital role in promoting patient independence and responsibility, identifying needs and adapting care strategies, while also recognising unmet needs in patients with VLUs.PHCPs actively monitor patients’ self-care and establish caring relationships. They see a need for a structured primary health care work routine for ulcer management.PHCPs described encouraging patients by identifying needs, adapting care and promoting self-care monitoring using various skills and strategies.PHCPs described unmet needs and insufficient care practices for patients with VLUs.PHCPs pointed out the importance of establishing caring relationships in order to involve patients in their VLU treatment.PHCPs described encouraging patients by identifying needs, adapting care and promoting self-care monitoring using various skills and strategies.PHCPs described unmet needs and insufficient care practices for patients with VLUs.PHCPs pointed out the importance of establishing caring relationships in order to involve patients in their VLU treatment. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this scoping review is to compile and examine characteristics and impacts of live music interventions on the health and wellbeing of children, families, and health care professionals in paediatric hospital care. Methods: We searched four scientific databases for peer-reviewed publications of empirical studies of all study designs. The first author screened the publications, with spot-checks for eligibility by the second and third authors. Data extraction and quality assessment were made by the first author with support from the second and third. Additionally, the included studies were screened for quality appraisal. The analysis followed an inductive, interpretive approach for synthesis. Results: Quantitative features were screened and compiled, and qualitative inductive analyses of findings were elaborated into categories connected to research questions. The reported impacts were thematized through emergent features of importance and prerequisites beneficial for successful interventions. Recurrent outcomes present themes of positive affect, copingand reduced hospitalization. Emotional regulation, play and participation, age, session design, adaptivity, and familiarity present benefits, barriers, and facilitators for outcomes. Conclusions: Findings from collected empirical research display philosophy, practice, and relations as keys for characteristics, impacts, and implications of live music interventions in paediatric hospital care. The communicative aspects of music appear at the core of importance. [ABSTRACT FROM AUTHOR]

In data analyses, pairing participant responses is often thought to yield the purest results. However, ensuring all participants answer all questions can be challenging. Concerns exist that pooling all responses together may diminish the robustness of a statistical analysis, but the practical insights may still exist. Data from a live, in-person, continuing education series for health professionals was analysed. For each topic, identical questions were asked prior to the educational content (pre), immediately following the content (post), and on a rolling 4 to 6 week follow-up survey (follow-up). For each educational topic, responses were matched by participant for a paired analysis and aggregated for a pooled analysis. A paired analysis was done for matched responses on pre vs post and pre vs follow-up questions. A pooled analysis was done for the aggregate responses on pre vs post and pre vs follow-up questions. Responses from 55 questions were included in the analysis. In both the paired and pooled pre vs post analyses, all questions yielded a statistically significant improvement in correct responses. In the paired pre vs follow-up analysis, 59% (n = 33) of questions demonstrated a statistically significant improvement in correct responses, compared to 62% (n = 35) in the pooled pre vs follow-up analysis. Paired and pooled data yielded similar results at the immediate post-content and follow-up time periods. [ABSTRACT FROM AUTHOR]

Introduction: Fluoroquinolones (FQs) is a distinct class of antibiotics which are prescribed and used quite frequently worldwide, despite the box warnings (BW) issued by Food and Drug Administration (FDA). Literature has shown in spite of BWs related to FQs there is minimal impact on health care professionals (HCPs) prescribing habits, potentially attributing towards limited and insufficient awareness. In Pakistan, FQs are mostly prescribed antibiotics for microbial treatments, therefore the purpose of this study was to determine the level of knowledge about the safety profile, use, and BW of FQs among HCPs working in Pakistan. Methods: A cross-sectional study was undertaken among the HCPs of Khyber Pakhtunkhwa province of Pakistan from October 2022 to December 2022. A validated questionnaire was used to assess the knowledge of HCPs regarding FQs, its safety profile and BW. A random convenient sample technique was used while recruiting HCPs in this study. As the HCPs comprised physicians, dentists, pharmacist and nurses, all were approached in person and the study objective was fully elaborated and explained to them. The statistic test like: one-way ANOVA, independent-t test, multivariate logistic regression were used keeping the p-value < 0.05 as statistically significant. Results: A total of n = 250 HCPs were approached, of which n = 186 HCPs completed the questionnaire with a response rate of 74.4%. FQs prescribing pattern was only assessed among the prescribers, i.e., physicians and dentists (39/186). The mean knowledge score for indications was 5.29 ± 3.05, while for the adverse effects was 7.70 ± 2.61. The highest score for knowledge for indications and adverse effect score was achieved by physicians followed by dentist. The mean knowledge score for the BW was 3.46 ± 2.93 and among the HCPs for the BW of FQs, 20.4% of the HCPs had appropriate knowledge score (score ≥ 50%). The knowledge score was significantly higher in males (p = 0.039), dentists (p = 0.001), HCPs having master/specialization level of education (p = 0.003), HCPs working in government sector hospitals (p = 0.010) and secondary care hospitals (p = 0.001) while the multivariate logistic regression analysis showed that HCPs working in primary care hospital (OR: 6.2) and secondary care hospital (OR: 20.3) were associated with the tendency to achieve 50% or above knowledge score. Conclusion: Findings of this study reveals the unsatisfactory knowledge of HCPs regarding the safety profile, use, and BW of FQs putting patients at heightened risks of FQs associated AEs. Therefore, it is crucial to implement a national antimicrobial stewardship program, seminars and lectures aimed at continuously updating the knowledge of HCPs, regardless of their specialties, and effectively restrict the misuse of antimicrobial and disseminate FDA BWs in clinical practice. [ABSTRACT FROM AUTHOR]

To be regularly physically active is of major importance for the health of people with metabolic risk factors. Many of these persons are insufficiently active and in need of support. This study aimed to explore barriers and facilitators perceived by health care professionals' within Swedish primary care in their work to support persons with metabolic risk factors to increase their physical activity. A qualitative design with focus group discussions was used. The data were analysed using qualitative content analysis with a manifest, inductive approach. Primary health care in five Swedish healthcare regions. Nine physiotherapists, ten physicians and five nurses participated in six digital focus group discussions including two to six participants. Barriers and facilitators to supporting persons with metabolic risk factors to increase their physical activity were found within four generic categories, where the barriers and facilitators related to each generic category: 'Patient readiness for change', 'Supporting the process of change', 'The professional role', and 'The organisation of primary care'. The findings suggests that barriers and facilitators for supporting patients with metabolic risk factors can be found at several levels within primary care, from individual patient and the health care professionals to the organisational level. In the primary care setting, this should be highlighted when implementing support to increase physical activity in people with metabolic risk factors. Health care professionals within primary care are in a position to support people with metabolic risk factors to increase their physical activity. Barriers and facilitators to support the patients should be addressed at several levels within primary care. The study highlights factors on multiple levels such as professional responsibility, organisational prioritisation and resources, and the challenge to motivate behaviour change. [ABSTRACT FROM AUTHOR]

The main objective of this study was to explore how health care professionals experience adaptation of user-involvement for people with dementia receiving health and social care. A qualitative explorative design was used with eight focus groups as the method of data collection. A total of 49 health care professionals were included representing a variety of professions, municipal and specialized health services, and all health regions of Norway. The transcribed focus group interviews were analyzed using qualitative content analysis following six steps to identify categories and the overall theme. Six main categories were identified: 1) facilitation of self-determination, 2) challenges of reduced or lack of awareness, 3) family caregivers' concern and protection, 4) open communication, 5) establishing a trustworthy relationship, and 6) clarifying expectations. To maintain independent lives for people with dementia, health care professionals must facilitate and support shared decision-making using an open and trustworthy communication. To facilitate user-involvement, health care professionals need to develop and implement strategies that consider the perspectives of people with dementia and support the relationship between people with dementia and their informal caregivers. [ABSTRACT FROM AUTHOR]

The article considers several socioeconomic processes to analyze changes in the social services of federal subjects in the south of the Russian Far East and Baikal region following the reforms initiated by President Putin's 2012 May Decrees. According to the Romer–Lucas model, increasing knowledge and improving the quality of human capital are key conditions for the long-term development of territories; therefore, the state of health care and education is one of the most important factors in solving the geopolitical problems of eastern Russian. Research has shown that at least in the public sector the recent reform of the social services has failed to improve the individual wealth of workers or to increase the availability of education and health care services. This is equally true for the border regions, where the new measures caused institutional transformations, and for the Baikal region, which was "not covered" by these measures. The results of the study confirmed the thesis that in the regional policy of the East, it is important to emphasize the quality rather than quantity of investment—the extent to which it improves the basic conditions determining the citizens' quality of life. [ABSTRACT FROM AUTHOR]

The lack of validated instruments assessing vaccine hesitancy/confidence among health care professionals (HCPs) for themselves, and their patients led us to develop and validate the Pro-VC-Be instrument to measure vaccine confidence and other psychosocial determinants of HCPs' vaccination behavior among diverse HCPs in different countries. Cross-sectional survey in October-November 2020 among 1,249 GPs in France, 432 GPs in French-speaking parts of Belgium, and 1,055 nurses in Quebec (Canada), all participating in general population immunization. Exploratory and confirmatory factor analyses evaluated the instrument's construct validity. We used HCPs' self-reported vaccine recommendations to patients, general immunization activity, self-vaccination, and future COVID-19 vaccine acceptance to test criterion validity. The final results indicated a 6-factor structure with good fit: vaccine confidence (combining complacency, perceived vaccine risks, perceived benefit-risk balance, perceived collective responsibility), trust in authorities, perceived constraints, proactive efficacy (combining commitment to vaccination and self-efficacy), reluctant trust, and openness to patients. The instrument showed good convergent and criterion validity and adequate discriminant validity. This study found that the Pro-VC-Be is a valid instrument for measuring psychosocial determinants of HCPs' vaccination behaviors in different settings. Its validation is currently underway in Europe among various HCPs in different languages. [ABSTRACT FROM AUTHOR]

To estimate the cost of antiviral medication guidance and/or support from the perspective of healthcare professionals by administration route (oral or inhalant). An online survey (December 2020) was conducted among physicians, pharmacists, and certified care workers. Those aged 20–64 years working in workplaces with experience of prescribing (physicians) or dispensing (pharmacists) antivirals for influenza, or having care service recipients who took antivirals (certified care workers) since October 2018, were selected through screening questions. The time required for guidance and/or support for drug administration was asked, and its monetary value was calculated by applying the Japanese average wage. Respondents who had a fear of infection while providing guidance and/or support were asked about the monetary value of this fear; the cost of fear was estimated from their responses and the percentage who reported such a fear. Responses were collected from 1,000 physicians, 1,000 pharmacists, and 642 certified care workers. The cost of the time for guidance and/or support in the entire workplace was estimated as JPY 244 (USD 2.14, as of October 2021) for oral antivirals and JPY 289 for inhalants among physicians, JPY 260 and JPY 428 among pharmacists, and JPY 555 and JPY 557 among certified care workers. The cost of fear was estimated to be JPY 965 for oral and JPY 1,361 for inhalants among physicians, JPY 756 and JPY 2,711 among pharmacists, and JPY 2,419 and JPY 2,837 among certified care workers. Respondents might not be representative of Japanese society. The reliability of the results depends on whether the respondents accurately understood the questions and their truthfulness. Higher costs for guidance and/or support were suggested for inhalant antivirals in physicians and pharmacists compared to oral antivirals. For certified care workers, almost no difference in costs was suggested between administration routes. [ABSTRACT FROM AUTHOR]

This study aimed to explore child health care nurses' clinical experiences from encounters with mothers exposed to intimate partner violence (IPV), as little research has explored this topic. Nine child health care nurses from two Swedish regions were interviewed. The interviews were analysed using thematic analysis. The narratives depicted the nurses' strong commitment to, and professional relationship with, the exposed mothers. The experience of working as a nurse and having encountered IPV in clinical practice made the nurses more confident, which impacted their performance and attitude towards this topic. The ability to uphold the professional relationship was threatened by lack of support and interprofessional collaborations. The professional relationship was central to the encounters, yet could impose an emotional burden on the nurses. While the nurses wanted to improve their knowledge of the process around the mother and child, they were happy to pass the primary responsibility over to other professionals. The findings highlight the challenge in establishing sustainable support for nurses, and building a transparent collaboration process between the health care sector and the social services, serving the well-being and safety of the mother and child. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe patient experiences of received primary care for low back pain (LBP) according to the BetterBack Model of Care (MoC) with a focus on illness beliefs and self-management enablement. Methods: Individual interviews were conducted with 15 adults 4–14 months after receiving treatment according to the BetterBack MoC for LBP in primary care in Sweden. Data were analysed using content analysis. Results: When analysing the data, the following theme emerged; "Participant understanding of their treatment for low back pain and self-management strategies—a matter of support systems", comprising the following categories: "Knowledge translation", "Interaction and dialogue", "The health care professional support" and "Form organization". Participants experienced that they had better knowledge about their LBP and received tools to better manage their health condition. The participants expressed good communication with the treating physiotherapist and provided suggestions to further improve the treatment of LBP. Conclusions: Participants experienced that they had gained new knowledge about their health problems and after the treatment they had the tools to handle their back problems. This suggests that the BetterBack MoC may be used as a basis for a support system to provide valuable tools for self-management for patients with low back pain. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic induced a radical shift towards digitally enhanced learning and teaching (DELT). Success of this adaptation depended on how much DELT had been provided before. The Bavarian Virtual University (BVU) is a university network to fund, promote and support DELT. The Ludwig-Maximilians-University Munich as a part of this network implemented the DELT course "Shared decision making (SDM) - a part of evidence-based medicine" in 2015. Based on regular evaluations and due to the latest developments, a media-didactic and content-related adaptation will be conducted now. Clinical cases will be embedded in a framework structure of SDM. Videos, podcasts and literature of doctor–patient interaction will be provided. To enable different health care professions to have a positive learning experience, the course will be linguistically adapted. The interaction between students and teacher will be enhanced by a transparent distribution of tasks and an issue-specific chat forum. SDM is an interdisciplinary general concept. With regard to the academization of different health care professions, the demand for DELT will increase. However, medical competencies can't be taught fully online, since face-to-face patient interaction is mandatory. Communication skills can be practiced theoretically but have to be applied in reality. [ABSTRACT FROM AUTHOR]

Background: Pharmacovigilance is a science that plays a significant role in reducing ADRs and helps predict adverse reactions to drugs in community. To safely use drugs in treatment and prevention of disease, adverse drug reaction has been paid more attention.Objectives: To evaluate the future needs of existing systems, the paper investigated the current state of pharmacovigilance and the reporting of ADR in Chinese hospitals.Methods: This cross-sectional, questionnaire-based study involved 10,063 pharmacists, doctors, and nurses from primary, secondary, and tertiary hospitals in all 31 provinces of China. It was commissioned by the National Centre for ADR Monitoring of China and conducted in March 2020. Three areas were assessed: sociodemographic characteristics of participants, awareness of the pharmacovigilance system, and the current state of hospitals' reporting of ADRs. Chi-square tests were used to calculate P values.Results: Health care professionals had heard the term "pharmacovigilance" previously (89.40%) and knew the reporting object (68.47%), content (65.94%), and range (64.83%) of pharmacovigilance. Most hospitals dispatched responsible professionals (87.64%) and departments (86.25%) to monitor ADR reporting. A total of 58.66% of tertiary medical, 45.25% of secondary, and 38.90% of primary hospitals extracted ADRs from a hospital information system. Moreover, 53.09% of tertiary medical, 38.93% of secondary, and 23.89% of primary hospitals had established a prescription automatic screening system to warn about risks for ADRs. Health care professionals' reports (99.92%) and patient feedback (77.99%) were included in most hospitals' ADR reporting.Conclusions: Chinese health care professionals generally have good awareness of pharmacovigilance, and pharmacovigilance is relatively more advanced in China compared to other developing countries. [ABSTRACT FROM AUTHOR]

This research explored the experiences of three health professionals transitioning into academia as second-career academics (SCAs), with the aim of gaining insight into potential enablements and constraints for such career changers. The process of redefining identity from expert health professional to novice academic could occur through a three-stage process of transitioning. However, if SCAs experience an unsupportive or 'care-less' environment, such redefining may not occur. The paper attempts to illuminate the crucial role of educational developers in understanding and supporting SCAs when they 'start a new life' in academia. [ABSTRACT FROM AUTHOR]

Background: A lack of physical activity during hospitalization can lead to adverse outcomes like complications and loss of physical function. More insight into factors that influence physical activity during a hospital stay is needed to develop strategies to change the mobility culture in hospitals. Objective: To give an overview of factors that influence physical activity of patients by exploring the perspectives of both patients and health-care professionals regarding physical activity during hospital stay. Method: Semi-structured interviews with patients and health-care professionals were conducted at a university hospital in the Netherlands. Patients were interviewed about their daily activities during their hospital stay and the factors that were of influence. Health-care professionals were asked about their perceptions regarding their responsibilities in promoting physical activity during hospitalization. Results: In total eight patients and nine health-care professionals participated. Patients and health-care professionals stated that low physical activity levels were mostly caused by a poor physical status, patients' expectations to lie in bed during hospitalization, and the lack of knowledge on the importance of physical activity. Lack of time was the main barrier for health-care professionals to promote physical activity. Conclusion: Physical activity is not yet seen as a structural part of hospital care by both patients and health-care professionals, and does not have priority within current daily routines. To increase physical activity levels of hospitalized patients, more knowledge and tools should be available for both patients and health-care professionals. [ABSTRACT FROM AUTHOR]

Objective: People with allergic rhinitis (AR) often self-manage in the community pharmacy setting without consulting health care professionals and trivialize their comorbidities such as asthma. A mobile health application (mHealth app) with a self-monitoring and medication adherence system can assist with the appropriate self-management of AR and asthma. This study aimed to identify an app effective for the self-management of AR and/or asthma. Methods: MHealth apps retrieved from the Australian Apple App Store and Android Google Play Store were included in this study if they were developed for self-management of AR and/or asthma; in English language; free of charge for the full version; and accessible to users of the mHealth app. The mHealth app quality was evaluated on three domains using a two-stage process. In Stage 1, the apps were ranked along Domain 1 (Accessibility in both app stores). In Stage 2, the apps with Stage 1, maximum score were ranked along Domain 2 (alignment with theoretical principles of the self-management of AR and/or asthma) and Domain 3 (usability of the mHealth app using Mobile App Rating Scale instrument). Results: Of the 418 apps retrieved, 31 were evaluated in Stage 1 and 16 in Stage 2. The MASK-air achieved the highest mean rank and covered all self-management principles except the doctor's appointment reminder and scored a total MARS mean score of 0.91/1. Conclusions:MASK-air is ranked most highly across the assessment domains for the self-management of both AR and coexisting asthma. This mHealth app covers the majority of the self-management principles and is highly engaging. [ABSTRACT FROM AUTHOR]

Objectives: The current study aimed to explore healthcare professionals' (HCPs) perceptions towards the registration and reporting process of stillbirth and neonatal mortality and their causes. Another aim is to explore HCPs' perceived importance of registering stillbirths and neonatal deaths as well as the perceived challenges and suggestions of building a new surveillance and auditing system to report stillbirths and neonatal deaths in Jordan.Methods: A descriptive qualitative approach using an in-depth focus group discussion was used. A total of 16 focus groups were conducted in four major representative hospitals that cover different geographical areas in Jordan. An average of five healthcare providers (HCPs) was interviewed in each focus group with a total of 80 HCPs. All recorded focus group interviews were transcribed in a full verbatim, which was checked for accuracy by the project team. The whole content thematic analysis process was conducted in its original Arabic language to conserve credibility of the findings. Healthcare providers' perceptions were derived from the group discussions using a group-interview guide.Results: Overall, the majority of HCPs across all hospitals agreed that it is important to document neonatal deaths and stillbirths in the hospital records mainly for statistical purposes. HCPs usually document neonatal deaths but not stillbirths. The causes of stillbirths and neonatal deaths are inaccurately recorded and not usually completed by the attending physician. Surprisingly, only neonates who live more than 4 h after delivery are registered as neonatal deaths but any neonate who dies before 4 h after delivery is not registered or registered as stillbirth. The majority of HCPs said that they were not aware of having neonatal death review committee in their hospitals. Importantly, the majority of HCPs in the four hospitals were enthusiastic about the development of a new surveillance system to register neonatal deaths and stillbirths in Jordan. Several suggestions were conveyed by the HCPs to better build, develop, implement, and sustain the proposed surveillance system.Conclusions: Electronic health information system and centralized database for compiling audit, registering births and deaths, and assigning causes of deaths should be developed and implemented. Designing and implementing an electronic registry or surveillance system that adopts ICD-10 codes is expected not only improve the completeness and timeliness of registration but also results in accurate recording of the causes of deaths. [ABSTRACT FROM AUTHOR]

Health care professionals are paramount to the prevention and management of suicidal thoughts and behaviors. Confidence in caring for people at risk of suicidal thoughts and behaviors is influenced by knowledge of and attitudes towards suicide. This systematic review aimed to explore health care professionals' knowledge of and attitudes towards suicide, as well as, their confidence in caring for people at risk of suicidal thoughts and behaviors. A systematic search of 4 electronic databases over 10 years was conducted. Following retrieval of 1,723 abstracts, 46 primary research publications were included, involving both cross-sectional (n=27) and intervention study designs (n=19). Knowledge of, attitudes towards, and confidence in caring for people at risk of suicidal thoughts and behaviors were explored among primary health care professionals, specialists, and health care students. The influence of training and education, type of health care professional, country of practice, and prior experience with suicide were highlighted among included studies. Health care professionals' knowledge of, attitudes towards and confidence in caring for people at risk of suicide are complex, interrelated constructs that shape their behaviors and may impact patient outcomes. Suicide training and education is necessary within health care curricula and as part of health care professionals' continuing professional development. [ABSTRACT FROM AUTHOR]

Objective: People in Post-Traumatic Confusional State (PTCS) present with communication difficulties that are well described in literature. However, limited study has been conducted on the experiences of their communication partners. The current study aimed to understand the experience of rehabilitation staff of their communication with patients in PTCS prior to communication partner training (CPT). Methods: Staff on a subacute inpatient TBI rehabilitation unit were invited to complete a 10-item questionnaire. The questionnaire contained quantitative and open-ended text response formats, analyzed with descriptive statistics and content analysis, respectively. Results: 78 interdisciplinary staff members completed the questionnaire. The majority of staff found communication to be difficult and time-consuming with half not feeling comfortable communicating with patients in PTCS. Confidence in communication was not associated with length of clinical experience. The majority of staff reported utilizing strategies to support communication, largely focused on augmenting activities with supportive objects and ensuring patient's comprehension through modification of verbal language. Conclusions: Staff are aware of the need for creating a structured environment for patients in PTCS and less aware of communication-specific strategies aiming at helping patients' expression, which underlines the need to emphasize these strategies as part of CPT in this type of setting. [ABSTRACT FROM AUTHOR]

Health care professionals are paramount to the prevention and management of suicidal thoughts and behaviors. Confidence in caring for people at risk of suicidal thoughts and behaviors is influenced by knowledge of and attitudes towards suicide. This systematic review aimed to explore health care professionals' knowledge of and attitudes towards suicide, as well as, their confidence in caring for people at risk of suicidal thoughts and behaviors. A systematic search of 4 electronic databases over 10 years was conducted. Following retrieval of 1,723 abstracts, 46 primary research publications were included, involving both cross-sectional (n = 27) and intervention study designs (n = 19). Knowledge of, attitudes towards, and confidence in caring for people at risk of suicidal thoughts and behaviors were explored among primary health care professionals, specialists, and health care students. The influence of training and education, type of health care professional, country of practice, and prior experience with suicide were highlighted among included studies. Health care professionals' knowledge of, attitudes towards and confidence in caring for people at risk of suicide are complex, interrelated constructs that shape their behaviors and may impact patient outcomes. Suicide training and education is necessary within health care curricula and as part of health care professionals' continuing professional development. [ABSTRACT FROM AUTHOR]

Medical practitioners of all specialisms (e.g. RN, MD) are identified by their professional titles. Their function is determined by their regulators, and subject to voluntary employment contracts. Whilst they are expected to act in their patients' best interests, there are situations in which a physician – having human rights – can object to certain acts. This right of objetction arises from the recognition of the practitioner's own conscience rather than the end or purpose of the procedure being performed. Gamble and Pruski explore an act-centred morality, and therefore define acts as medical (and subject to compulsion) and non-medical (therefore voluntary). This analysis has merit when applied to health-systems as a whole, but fails to take into account the humanity of physicians and the specific interactions with patients in different contexts. As such, it serves as a way of compelling physicians to act against their conscience rather than protecting them. [ABSTRACT FROM AUTHOR]

Objectives: The economic crisis in Greece has triggered an extensive public debate about the use of generic drugs (generics). Despite their cost-saving potential, generic market penetration remains very low. This raises questions on awareness of, perception on and preference for generics by health-care professionals and patients. This is a descriptive study on the level of knowledge and attitudes towards generics of final year pharmacy school students in Greece. Methods: An electronic questionnaire was distributed to 173 senior pharmacy school students in three Universities in Greece. Responses were submitted electronically. Results: The majority of students knew that generics contain the same active ingredient as the originator products and are cheaper. Students were somehow concerned with safety and efficacy of generics. The majority of students agreed that pharmacists should probably recommend the use of generics, and indicated that prescribing and dispensing practices would largely depend on the profit margin. Despite more than half of the students expressing a positive attitude towards generics, they were inadequately educated on their features. Conclusion: It is critical to improve knowledge of and preference for generics amongst health-care professionals from early on if to build the trust required to increase generic market penetration and achieve measurable savings in pharmaceutical expenditure. [ABSTRACT FROM AUTHOR]

A key question has been underexplored in the literature on conscientious objection: if a physician is required to perform 'medical activities,' what is a medical activity? This paper explores the question by employing a teleological evaluation of medicine and examining the analogy of military conscripts, commonly cited in the conscientious objection debate. It argues that physicians (and other healthcare professionals) can only be expected to perform and support medical acts – acts directed towards their patients' health. That is, physicians cannot be forced to provide or support services that are not medical in nature, even if such activities support other socially desirable pursuits. This does not necessarily mean that medical professionals cannot or should not provide non-medical services, but only that they are under no obligation to provide them. [ABSTRACT FROM AUTHOR]

Introduction: The future healthcare workforce are expected to serve as role models given that their roles cover patient education concerning positive health behavior. In light of the changes in healthcare, towards patient centered care and positive health, the need to encourage students of health sciences to adopt the concept of positive health will be necessary. Aim: To explore the attitudes of lecturers and students of health to the new concept of Positive Health, using the 6 domains, in Dutch health education systems with different health care professionals. Methods: A cross-sectional study comparing the perception towards health in students and lecturers of the health department of an Applied University in the Netherlands with the data of patients and other stakeholders. Results: Students scored aspects of social participation, mental functioning and daily functioning as less important compared to patients. Lecturers scored the aspects of bodily functions and daily functioning less important compared to patients. Conclusion: These differences in scores should be addressed in educational programs of health professionals because all aspects of health are important to the patient's experienced health. [ABSTRACT FROM AUTHOR]

Older adults with low vision need interventions with their environment that will improve their ability to function safely. The purpose of this article is to discuss the results of a literature review that suggested ways to facilitate an improved environment for older adults with low vision. A second purpose is to discuss the findings of a survey of occupational therapists on their perception of the clinical utility of these items. The participants were 10 occupational therapy practitioners that were surveyed about their perceptions of 17 items used to adapt the environment with older adults who have low vision. [ABSTRACT FROM AUTHOR]

Keywords: Vaccine hesitancy; vaccine confidence; health care professionals; COVID-19 vaccine; pandemic EN Vaccine hesitancy vaccine confidence health care professionals COVID-19 vaccine pandemic 991 993 3 01/02/21 20201101 NES 201101 Vaccine hesitancy, defined as the refusal, delay, or acceptance with doubts about vaccine usefulness and safety [[1]], is recognized by the World Health Organization as one of the 10 most important health threats in the world today [[2]]. Trust is not uniform across all vaccines and may vary for different vaccine components (e.g., multiple antigens, adjuvants), for new vs. "old" vaccines, and according to past or present vaccine-associated controversies. Vaccine hesitancy, vaccine confidence, health care professionals, COVID-19 vaccine, pandemic. [Extracted from the article]

This article examines the accuracy and rhetoric of reports by human health care professionals concerning dog bite injuries published in the peer-reviewed medical literature, with respect to nonclinical issues, such as dog behavior. A qualitative content analysis examined 156 publications between 1966 and 2015 identified by terms such as “dog bite” or “dangerous dogs.” The analysis revealed misinformation about human-canine interactions, the significance of breed and breed characteristics, and the frequency of dog bite-related injuries. Misinformation included clear-cut factual errors, misinterpretations, omissions, emotionally loaded language, and exaggerations based on misunderstood or inaccurate statistics or reliance on the interpretation by third parties of other authors’ meaning. These errors clustered within one or more rhetorical devices including generalization, catastrophization, demonization, and negative differentiation. By constructing the issue as a social problem, these distortions and errors, and the rhetorical devices supporting them, mischaracterize dogs and overstate the actual risk of dog bites. [ABSTRACT FROM AUTHOR]

In large cities around the world, the effects of air pollution on human health present a growing problem. In this commentary, we assert that governments alone are not responsible for addressing such issues and health care professionals (HCPs) need to consider whether their duty of care should extend beyond normal clinical boundaries. When considering the ethics around the generation and effects of air pollution, especially in relation to justice and health care, actions taken by HCPs (e.g. in a country such as India) potentially extend beyond treating individual patients one-at-a-time for toxic effects of emissions and include advocating on behalf of others. While these problems are not unique to India, India is particularly badly affected by air pollution, and the situation there is made worse by large sectors of the population having limited access to health care, resulting in poor morbidity and mortality outcomes compared with other SE Asian countries. Using illustrative scenarios, we consider the effects of air pollution on present and future generations, recognising, however, that cause and effect are sometimes disconnected, with human behaviour in one place having far-reaching consequences in another place or at another time. Furthermore, the consequences of air pollution do not fall evenly across populations, and an injustice arises if economically challenged, vulnerable sectors of the population pay a price (in this case impaired health) for the actions of others. From a moral perspective, HCPs should be willing to look beyond their traditional role as ‘healers’ and advocate on behalf of others to help limit harms caused by this often invisible yet life-limiting and life-threatening form of pollution. This may require cultural change to existing models of health care, including the role of the HCP, to improve health security in India and elsewhere. [ABSTRACT FROM PUBLISHER]

The aim of the study was to determine the magnitude of HIV and AIDS-related stigma and discrimination (SAD) and its associated factors in healthcare settings. Primary data were collected from June to September 2014 from two referral hospitals located in north-west Ethiopia. The study used pre-test/post-test design with a non-equivalent control group using a quantitative approach. Healthcare professionals were divided into strata and then, using the stratified random sampling technique, the study participants were selected from each stratum. The median age of study respondents in the treatment group was 32.2 years with standard deviation (SD) of 7.74. The regressions of stigma for the pre-tests of the first hospital and second hospital participants’ knowledge about SAD-related issues and perceived risk of HIV infection were found to be significantly associated with stigma in the first hospital. In the first hospital, healthcare professionals who felt HIV risk of infection at different contact points with HIV-positive patients were more than 13 times more likely to present stigmatising attitudes towards the patients (OR = 13.46,p= 0.005). In the second hospital, only perceived risk of infection was significantly associated with stigma (p= 0.036). Interventions to lessen HIV and AIDS-related SAD in healthcare settings must focus on improving the knowledge, attitudes and practices of healthcare professionals as well as overcoming the institutional barriers existing in the healthcare settings through staff training and hospital strategy development. [ABSTRACT FROM AUTHOR]

Background Rehabilitation professionals must be astute at recognizing, assessing, and treating individuals with cognitive deficits. No research is available to examine cognitive rehabilitation practices applied to individuals with neurological conditions in Kuwait. Objectives: To identify the use of cognitive assessments, the availability of resources, and the barriers to cognitive rehabilitation practices in Kuwait. Methods Face-to-face interviews were conducted with health care professionals working with adult individuals with neurological conditions. These professionals included occupational therapists, speech-language pathologists, psychiatrists, and neurologists. Results The most commonly used cognitive based assessments are MMSE (41%), and MoCA and LOTCA (15.2%). The only clinical assessment used is the Line-Bisection Test (2.2%). The most used occupation-based assessments are FIM (6.5%), COPM (4.3%), the Interest Checklist (2.2%), and the Barthel Index (2.2%). Resources related to cognitive rehabilitation in Kuwait that are unavailable to practitioners include journal clubs (91%), special interest groups (89%), and continuing education programmes (82.6%). Barriers to cognitive rehabilitation practice included lack of sufficient funds for continuing education, lack of time, lack of standardized assessments, and lack of inter-professional teamwork. Conclusion Many adults in Kuwait live with cognitive impairment. There is a need to develop appropriate evidence-based cognitive rehabilitation clinical guidelines in Kuwait. [ABSTRACT FROM AUTHOR]

Peer support is an important component in the promotion of recovery for people with serious mental illness. The Veterans Health Administration (VHA) has implemented peer support services nationally. This study used a series of questions about the perceived acceptance of peer services at VA facilities and the Recovery Self-Assessment (RSA), a standard measure of recovery attitudes, to evaluate and compare responses of a convenience sample of peer support specialists (PSS) and local peer supervisors (LPS). The authors hypothesized that level of receptivity of program among PSS and LPS will be high and that the scores on the five RSA domains will be comparable. The level of perceived receptivity was quite high for PSS and LPS and it was strongly correlated with recovery attitudes. Moreover, PSS scored significantly higher than LPS, on the Receptivity measure and on several domains of the RSA. RSA scores in this study were slightly higher than, or similar to, those observed in other VHA and non-VHA samples. PSS rated their programs as more receptive to peer services and more recovery oriented than their supervisors. The results of this study provide evidence of the successful implementation of this program in VHA and demonstrates an efficient approach and a first step in the evaluation of peer support services. [ABSTRACT FROM PUBLISHER]

Health literacy has been redefined in recent years to move beyond an individual’s own communication skills to include the skills of persons working within health care organizations, including librarians. Provision of consumer health services and resources, while a long-standing practice in hospital libraries, has also been redefined. As definitions of health literacy have evolved, so too have hospital librarian services as they embrace their role within health literacy. Many hospital medical and consumer health librarians have developed programs, services, and collaborations to further health literacy awareness, education, and initiatives for consumers, health care professionals, and their parent organizations. [ABSTRACT FROM PUBLISHER]

Background and objectives: Adherence to daily asthma controller medication has been shown to be the most effective component of asthma self-management; however, patient's adherence to asthma medication remains poor. This study aimed to understand how patients' long-term asthma controller medication adherence may be improved and facilitated by comparing key asthma stakeholders' perspectives.Method: Six focus group interviews including 38 asthma stakeholders (n= 13 patients,n= 13 pulmonologist physicians, andn= 12 allied healthcare professionals) were conducted. Interviews were qualitatively analysed.Results: Although similar themes were brought up across different asthma stakeholders, the way in which they were framed differed across stakeholders. The most salient discussion revolved around the content and the moment in which asthma education should be approached to facilitate patients' adherence to asthma medication.Conclusion: Asthma medication adherence is a complex process and successful interventions aimed at its improvement would benefit from: (a) making an effort to understand patients' experiences and negotiate the treatment regimen, rather than imposing recommendations; (b) considering treatment as a shared responsibility involving the patient, the healthcare professional(s), and the patients' social networks; and, (c) taking into account different stakeholders' concerns, needs, perspectives, and knowledge. [ABSTRACT FROM PUBLISHER]

People with drug addictions have among the lowest rates of adherence to HIV medications (i.e. HAART) of any infected population, which is often explained through reference to the instability associated with problematic drug use and the ‘chaos’ that is assumed to characterize the lives of people with addictions. Many studies examine the links between addiction and adherence from the perspective of HIV-positive populations, but few explore how HIV care providers think about addictions, their impact on adherence, and how to incorporate the complex health needs of drug-using populations into comprehensive HIV care practices. Using qualitative data from a pilot study on adherence to HAART among people with drug addictions in Vancouver, British Columbia, this paper examines how eight HIV care providers (i.e. physicians, pharmacists, and community-based service providers) approach these interconnected issues. Our findings illustrate that while addictions often complicate adherence to HAART, this is not a universal reality, and the kinds of drugs used as well as the individual capacities of these patients also factor significantly in their adherence success. The organization of the HIV care environment, which is highly stratified and provides certain professionals with more resources and structural capabilities to deliver comprehensive care than others, also plays a large role in our participants’ abilities to address the health needs of their clients with addictions. We recommend that the current HIV care delivery system be adapted to ensure more integrated care and greater equity across the different groups of providers working in the field of HIV care. [ABSTRACT FROM PUBLISHER]

Purpose:Exploring healthcare professional experiences of Multimodal rehabilitation (MMR) in primary care. Methods:Fourteen healthcare professionals (11 women, 3 men) were individually interviewed about their work with MMR in primary care. Interviews covered experiences of assessing patients and work with patients in the programme. Transcribed interviews were analysed by qualitative content analysis. Results:The analysis resulted in four categories: select patients for success; a multilevel challenge; ethical dilemmas and considering what is a good result. MMR work was experienced as useful and efficient, but also challenging because of patient complexity. Preconceptions about who is a suitable patient for MMR influenced the selection of patients (e.g. gender, different culture). Interviewees were conflicted about not to being able to offer MMR to patients who were not going to return to work. They thought that there were more factors to evaluate MMR than by the proportion that return to work. Conclusions:Healthcare professionals perceive MMR as a helpful method for treating chronic pain patients. At the same time, they thought that only including patients who would return to work conflicted with their ethical views on equal healthcare for all patients. Preconceptions can influence selection for, and work with, MMR.Implications for rehabilitationMultimodal pain rehabilitation in primary healthcare is challenging because of the complexity of the patients.Healthcare professionals must deal with conflicting emotions in regard to different commitments from healthcare legislation and the goals of multimodal rehabilitation.Healthcare professionals should be aware that stereotypes regarding gender and immigrants can lead to bias when selecting patients for multimodal rehabilitation. [ABSTRACT FROM AUTHOR]

A study conducted on 98 Italian health professionals investigated the associations between mindfulness, organizational commitment, and burnout syndrome, controlling for the effect of potentially stressful events. Results showed that affective commitment and dispositional mindfulness were negatively associated with burnout. Dispositional mindfulness also moderated the relation between potentially stressful events and two burnout dimensions, emotional exhaustion and depersonalization. These findings suggest that affective commitment and dispositional mindfulness are important factors in protecting against the onset of burnout in healthcare professionals. Moreover, mindfulness seems to contain the adverse consequences of potentially stressful events. [ABSTRACT FROM AUTHOR]

In response to the growing attention to integrated health care and the cultural change movement in nursing homes, this study examines the lived experiences of nursing home social workers to better understand their role perceptions, job satisfaction, and relationship with other staff members. Hermeneutic phenomenology was used in order to understand the lived experience of being a nursing home social worker. Ten nursing home social workers were recruited from a southern state and individual interviews were conducted. From the interviews, four themes emerged: challenge, coping, mattering, and rewarding. Guided by identity negotiation theory and social identity theory, these findings are discussed. Also, implications for social work education, nursing home administration, and policy is discussed. [ABSTRACT FROM AUTHOR]

Many different professionals play a key role in maintaining welfare in a welfare society. These professionals engage in moral judgements when using (new) technologies. In doing so, they achieve that radical responsibility towards the other that Levinas describes as being at the very core of ethics. Also, professionals try to assess the possible consequences of the involvement of specific technologies and adjust their actions in order to ensure ethical responsibility. Thus, ethics is necessary in order to obtain and sustain one's professionalism. This presents care institutions with the challenge to design work processes and technology work in ways that include a sense of ‘the Other’ and make moral judgement an indispensable part of professional competence in technology. This article provides new understandings of the way ethics are involved in care institutions. Nurses’ moral judgements are sophisticated with regard to ethical perspectives. In hospitals, nurses combine Latour's notion of symmetry in human/technology relations with an ethics implying ethical priority to human beings over other beings. This combination of ethics is not only sophisticated; it is also paradoxical, as it puts together mutually contradictory ethics. Instead of causing moral confusion, this ethical paradox is employed to produce a particularly refined notion of care situations, allowing nurses’ care to include patients and technology alike. [ABSTRACT FROM AUTHOR]

Depression is a complex problem, commonly but not always successfully managed in primary care. We know relatively little about the system of primary care for depression particularly at the level of organisations. In this paper, we describe the use of mandalas as a visual data collection method within an in-depth programme of participatory action research undertaken in six primary care organisations in Victoria, Australia. We draw on mandala images, selected and discussed by 49 multidisciplinary primary health care professionals and demonstrate how they can be employed as an effective graphic elicitation method. We conclude that mandalas offer an innovative approach for qualitative data collection for two reasons. First, they can engage busy research participants in a reflective space. Second, using the mandalas as an elicitation method generates meaningful data: it provides new insights, reveals unrecognised aspects of practice, generates new learning, gives physical form to tacit processes and enables complex information to become accessible; all within short timeframes. [ABSTRACT FROM AUTHOR]

Communities in which professionals share and create knowledge potentially support their continued learning. To realise this potential more fully, members are required to reflect critically. For learning at work such behaviour has been described as critically reflective work behaviour, consisting of six aspects: challenging groupthink, critical opinion sharing, an openness about mistakes, asking for and giving feedback, experimentation and research utilisation. We studied whether and how these aspects can be distinguished in dialogues of seven different communities of veterinary professionals (critically reflective dialogues). Our exploration of the nature of critically reflective dialogues resulted in an analytical framework. Within each aspect four different modes of communication were identified: interactive, on an individual basis, non-reflective and restricted. We assume that professionals use learning opportunities most in the interactive mode of communication. The framework was employed to study the extent to which dialogues showed these modes of critically reflective dialogues. The results demonstrate that in these communities the modes of communication within aspects were largely non-interactive (i.e., individual, non-reflective). The developed framework discriminates between communities in terms of their critically reflective dialogues. Interventions to improve the effectiveness of learning communities should focus on enhancement of members addressing each other's reasons and reflections. [ABSTRACT FROM AUTHOR]

This study investigates current opinions about hospital advertising and compares them to the attitudes expressed 25 years ago. It replicates a survey done in 1985, using the same questionnaire and population to compare responses longitudinally. The study indicates some changes in the public's opinions of hospital advertising. Although the image of hospitals remains positive, most of the 2010 respondents’ opinions were rather mixed regarding whether it is proper for hospitals to advertise. The study also confirmed that the quality of service and reputation of hospitals remain more important to the public than price. [ABSTRACT FROM PUBLISHER]

Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to cognitive-behavioral and patient-centered therapy have been found to be of utmost significance when it comes to preventing and treating burnout. However, evidence is insufficient to support that stress management programs can help reducing job-related stress beyond the intervention period, and similarly mindfulness-based stress reduction interventions efficiently reduce psychological distress and negative vibes, and encourage empathy while significantly enhancing physicians' quality of life. On the other hand, a few small studies have suggested that Balint sessions can have a promising positive effect in preventing burnout; moreover exercises can reduce anxiety levels and exhaustion symptoms while improving the mental and physical well-being of healthcare workers. Occupational interventions in the work settings can also improve the emotional and work-induced exhaustion. Combining both individual and organizational interventions can have a good impact in reducing burnout scores among physicians; therefore, multidisciplinary actions that include changes in the work environmental factors along with stress management programs that teach people how to cope better with stressful events showed promising solutions to manage burnout. However, until now there have been no rigorous studies to prove this. More interventional research targeting medical students, residents, and practicing physicians are needed in order to improve psychological well-being, professional careers, as well as the quality of care provided to patients. [ABSTRACT FROM AUTHOR]

Cinema is mainly produced for entertainment of the masses. With newer technology making film clips more available, teachers are increasingly turning their attention to films in training health care students. Transgenderism is one such area in sexuality training that can be taught using films. Transgender individuals face various phase-of-life issues and other life crises that include coming out, family pressures, discrimination, sexual abuse, and end of life. Various curricula in mental health or sexuality training may lack training about transgender issues that are often sidelined, more focus being given to sexual dysfunctions and lesbian, gay, and bisexual issues. As mental health care professionals-in-the-making, trainees need to understand issues surrounding transgenderism in a manner to which they can easily relate. This is important especially considering the fact that they may deal with such clients in their practice. Films serve this purpose by portraying these issues in an understandable way and at the same time they also protect the confidentiality of the characters involved. This paper discusses how film clips can be used in training mental health care professionals about phase-of-life and other life-crises issues in transgender individuals. [ABSTRACT FROM PUBLISHER]

Three impaired health care provider groups (N = 84) (nurses, pharmacists, and providers with prescriptive authority) referred for a substance abuse evaluation at an outpatient-based program were compared on demographic and family factors, substance abuse patterns, and psychiatric symptomology as assessed by the Personality Assessment Inventory. Nurses had the highest rates of family history of addiction, problems with benzodiazepines, and psychiatric comorbidity. Overall, health care professionals endorsed opioids twice as often as alcohol as a preferred substance. Family history of addiction, sex, and psychiatric comorbidity emerged as salient factors among these health care professionals. Clinical implications are examined in light of the current findings. [ABSTRACT FROM AUTHOR]

"Are older clients underserved?" this question is increasingly considered an issue in health care and social work. In service provision to citizens with brain injuries the problem is rarely discussed, although the vast majority of persons with brain injury are older adults. The present study investigated the relation between age of citizens with brain injury and staff estimation of unsatisfied needs and relevance of service provision. Local community health care professionals and social workers evaluated service needs and relevance of care of 411 adults with brain injury in three Danish municipalities. Results indicate that professionals in service provision judge older citizens with brain injury as having fewer unsatisfied needs for service than younger citizens. They also rated the service provided to older citizens more relevant than the service to younger citizens. The age difference in need-evaluation is highly significant, and cannot be accounted for by confounding variables (e.g. cause of injury or time since injury). Only for younger citizens was the degree of care burden associated with staff appraisal of unsatisfied needs, which could be an indication of age-bias in staff evaluation of service provision. [ABSTRACT FROM AUTHOR]

This study examined whether gender influenced fall-related risk factors among community-dwelling adults of 50 years of age and older who lived in a rural county in eastern North Carolina. Over a 4-year period, a semistructured fall questionnaire was administered. Significant findings at the 0.05 level included (a) women fell more frequently than men in the 71–80-year-old group; (b) women notified other people about their falls more often than men; (c) women who lived alone fell more often than men living alone; and (d) women were more fearful of falling than men. New findings from this study included the percentage of participants who felt like they were going to fall again; comparison of gender to the location of fall; activities engaged in when the fall occurred; fall-related injuries; bathroom safety equipment; and activity restriction due to a fear of falling. [ABSTRACT FROM AUTHOR]

Advertising by physicians is a relatively recent phenomenon. The purposes of this study were to determine (a) consumers' attitudes toward advertising by physicians; (b) whether certain potential consumer demographic variables account for any significant difference in attitudes toward physicians who advertise; and (c) which media consumers feel are appropriate for physicians' advertising. The intent was to discover information that would be useful to physicians in planning promotional strategies and improving the quality of their advertising. The study seems to confirm the belief of many professionals that advertising and promotion clearly have a place in the future of health care services. [ABSTRACT FROM AUTHOR]