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Wellbeing has not been at the core of the practice of public archaeology in the UK. Instead it is a niche practice focusing on specific therapeutic needs. The idea of wellbeing as a policy objective at a more strategic level has, however, been gaining ground across the arts, cultural heritage and archaeological sectors. The three-month secondment at UCL that is the focus of this piece took place at the end of 2021 and evaluated participatory archaeology in order to understand the outcomes of archaeological activities involving volunteers at the National Trust. This fitted with the Trust archaeologists’ aspirations to integrate wellbeing evaluations into their participatory projects. While mental health is a core focus of wellbeing in the heritage agenda writ large, National Trust priorities determined that it was not the focus of this project. Rather, the aim was to help the Trust build an evidence base for reflective practice to inform future programmes and to support the development of a bespoke evaluation framework and strategy for participatory archaeology for its volunteers and visitors. Considerable work had already been undertaken by the Trust staff to inform them about wellbeing, public benefit, nature connection and evaluation, although consultation with their archaeologists and partners in the sector revealed organisational needs for strategic guidance on evaluating participation in archaeology.

AbstractDiabetes Mellitus (DM) is a chronic disease characterized by abnormally uncontrolled high blood glucose level. The Risk Assessment and Management Program (RAMP) in Hong Kong has been providing long-term face-to-face follow-up to DM patients in the government out-patient clinics since 2009. However, under the current outbreak of COVID-19, these face-to-face consultations were ceased over and over again to lower the risk of disease transmission. With the advancement in technology, the recent emergence of telecare has provided an alternative to replace the conventional consultations in the clinics. Its clinical effectiveness on DM patients has also been supported by numerous studies. Yet, there is only a paucity of literatures discussing the practicality of such implementation design in the real-world settings. This study aims at studying both the effectiveness and implementation outcomes of telecare in Hong Kong DM patients. It adopts a type 2 hybrid effectiveness-implementation design. It will be conducted in seven government out-patient clinics in Hong Kong. The subjects will be randomly assigned to an intervention group or a control group when they 1) are aged 18 or above, 2) have a confirmed diagnosis of diabetes, and 3) are having regular follow-up appointment in the clinic. Subjects in the intervention group will receive a 84-week Risk Assessment and Management Program (RAMP) in an alternate telecare and face-to-face consultations mode, while the control group will receive the same program but in usual face-to-face consultation mode. RE-AIM is employed as the implementation and effectiveness outcome evaluation framework. The primary outcome measure will be HbA1c. Data will be collected pre-intervention (T1), 42-week (T2), and 84-week (T3). The study will provide effectiveness-implementation assessment of telecare mode for DM patients in Hong Kong, as an alternative or in addition to conventional face-to-face consultations. It also aimed to provide insights for the future adoption in a broader health care setting.

Background: Prior to the COVID-19 pandemic, Canada had longer wait-times for specialist appointments compared to other Commonwealth countries. During the pandemic, many specialist services were postponed or suspended, impacting access. The purpose of this study was to explore family physicians’ perspectives on specialist care availability during the pandemic and implications for family physician workload and patient management. These experiences can inform future pandemic plans. Methods: Using semi-structured interviews, we explored family physicians’ experiences during COVID-19 across regions within four Canadian provinces (British Columbia, Ontario, Nova Scotia, Newfoundland and Labrador). Thematic and framework analyses were used to identify themes from the interviews. Results: We interviewed 68 family physicians between October 2020 and June 2021. Of these 68 participants, 27 discussed their interactions with specialists during the pandemic. We identified themes around access to, and collaboration with, specialists. At times, specialists were less available for patient care and family physician consultations, and communications were uncoordinated across the system. Family physicians took on additional work to address the lack of access and identified pandemic planning challenges. Participants offered recommendations for improving collaboration and access post-pandemic. Interpretation: The COVID-19 pandemic exacerbated existing challenges in the Canadian healthcare system pertaining to specialist access. Pandemic plans should reflect the importance of specialist consultations. Decision-makers should consider innovations to facilitate collaboration between family physicians and specialists.

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The national shortage of child psychiatrists has resulted in the necessity of primary care providers (PCPs) managing increased mental health concerns of youth. The Wisconsin Child Psychiatry Consultation Program (WI CPCP) is one of several programs throughout the United States which provide PCPs with education, consultation, and resource support related to pediatric mental health. To evaluate initial impact of the program, data from 190 pediatricians and family practitioners from the Wisconsin Health Information Organization (WHIO) were analyzed. Enrollment in the WI CPCP was associated with a significant increase in rates of mental health diagnoses within primary care visits. In addition, the number of providers who made any mental health diagnosis increased from 56% of PCPs pre-enrollment to over 99% post-enrollment. These data provide additional support for pediatric psychiatry consultation programs within primary care. [ABSTRACT FROM AUTHOR]

Participatory approaches, in which researchers work together with members of the autism community (e.g., autistic people, family members, caregivers, or other stakeholders) to design, conduct, and disseminate research, have become increasingly prominent within the field of autism research over the past decade. Despite growing academic and community interest in conducting participatory studies, stakeholder collaboration remains infrequent in autism research, at least partially due to systemic barriers. To help reduce barriers to engaging in participatory autism research, the International Society for Autism Research (INSAR) Autistic Researchers Committee has launched the INSAR Community Collaborator Request (ICCR; https://www.autism-insar.org/page/iccr), a platform on the INSAR website that allows autism researchers conducting participatory research to seek out stakeholder collaborators from the autism community (including both autistic people and their family members/caregivers, as relevant to a given research project). Interested stakeholders also have the opportunity to subscribe to ICCR posts, allowing them to be alerted of new opportunities for collaboration and potentially increasing their involvement in autism research. Overall, the ICCR provides a venue to connect autism researchers with potential community collaborators, reducing barriers to participatory autism research and increasing the frequency of successful community–academic partnerships within the field. We are hopeful that in the long term, such changes will lead to greater alignment between research outputs and the goals of the greater autism community, and consequently an increase in the overall quality and relevance of autism research. Lay Summary: The INSAR Community Collaborator Request (ICCR; https://www.autism-insar.org/page/iccr) is a new system created to connect autism researchers with autistic people or other stakeholders (e.g., family members of autistic people) who can help them design or conduct a research study—a process called participatory autism research. Using the ICCR, researchers can post a classified ad looking for a stakeholder collaborator, and interested stakeholders can respond to that ad by contacting the researcher about the position. By providing one place that autism researchers and stakeholders can go to seek out participatory research opportunities, we hope to make it easier for both groups to engage in collaborations that can benefit the entire autism community. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to measure the patient's perception of patient centeredness in their consultations for non-communicable diseases (NCDs). We also measured consultation length and patient enablement. Method: A cross-sectional study was conducted over 2 months at four primary care clinics at the St. Joseph cluster of the North Central Regional Health Authority (NCRHA) in Trinidad and Tobago. Interviewers timed the consultation and completed post-consultation questionnaires using the Patient Perception of Patient-Centeredness (PPPC) questionnaire and the Patient Enablement Index (PEI). The PPPC is a 14-item (each scored 1–4) Likert-scaled instrument. The total score is averaged and a PPPC score of 4 is the maximum. The PEI measures the ability of the patient to cope with life and their disease. The PEI consists of 6 questions scored 0–2, with a maximum score of 12. Results: There were 180 respondents (response rate = 82.5%). Participants were female (75.6%), aged over 65 years (50.6%), married (51.1%), Indo-Trinidadian (52.2%), and Christian (60.6%). Half achieved a primary school education, and 37.2% secondary. The consultation length ranged between 1.32 and 31.22 min. The average, median and mode of the consultation length were 8.5, 7.74 and 10 min, respectively. The average, median and mode of the measures of patient-centeredness were PPPC (3.67, 3.86 and 4) and PEI score (5.93, 6 and 6). The PPPC average was lower in patients with a stroke (p = 0.022), and higher among those with more than 2 consultation interruptions (p = 0.015) and those who knew the doctor very well (p = 0.015). The PEI score was lower in patients with heart disease (p = 0.022). The consultation length was longer in those with tertiary education (p = 0.044) and those with two consultation interruptions (p = 0.032). PPPC Average and PEI Score correlated well (ρ = 0.408, p < 0.001). The consultation length correlated with the PPPC Average (ρ = 0.168,p = 0.025). Conclusion: Primary Care consultations in this cluster of health centres in NCRHA in Trinidad were often patient centered. The consultation length, patient-centeredness, measured with the PPPC instrument, and patient enablement scores, measured with the PEI instrument, in consultations for NCDs in Trinidad compare favourably with international reports. [ABSTRACT FROM AUTHOR]

Abstract Behavior specific praise (BSP) is widely regarded as an evidence-based classroom management strategy, with decades of research supporting its use. However, relatively few studies have examined the effect of BSP as a targeted intervention strategy, particularly for traditionally underrepresented students. The present study evaluated the utility of BSP as an individual behavior management strategy for diverse students in the context of a high-need educational setting. Specifically, it examined the effects of BSP on teacher’s ratings of academically engaged and disruptive behavior in the classroom using Direct Behavior Ratings–Single Item Scales (DBR-SIS). A concurrent multiple baseline design was implemented with three racially/ethnically minoritized (REM) target students across one third and one fourth grade classroom. Results demonstrated that teachers’ estimated rates of BSP delivered to target students were successfully increased to a criterion level of six per hour following delivery of a multicomponent training package, with high levels of treatment integrity. All participating students demonstrated statistically significant improvements in behavior, although visual analysis suggested only one clear demonstration and one replication of effect. Social validity data revealed high levels of teacher acceptability and willingness to implement the BSP strategy, with mixed perceptions from students. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

In the UK, the Medicines and Healthcare products Regulatory Agency consulted on proposals "to improve and strengthen the UK clinical trials legislation to help us make the UK the best place to research and develop safe and innovative medicines". The purpose of the consultation was to help finalise the proposals and contribute to the drafting of secondary legislation. We discussed these proposals as members of the Trials Methodology Research Partnership Adaptive Designs Working Group, which is jointly funded by the Medical Research Council and the National Institute for Health and Care Research. Two topics arose frequently in the discussion: the emphasis on legislation, and the absence of questions on data sharing. It is our opinion that the proposals rely heavily on legislation to change practice. However, clinical trials are heterogeneous, and as a result some trials will struggle to comply with all of the proposed legislation. Furthermore, adaptive design clinical trials are even more heterogeneous than their non-adaptive counterparts, and face more challenges. Consequently, it is possible that increased legislation could have a greater negative impact on adaptive designs than non-adaptive designs. Overall, we are sceptical that the introduction of legislation will achieve the desired outcomes, with some exceptions. Meanwhile the topic of data sharing — making anonymised individual-level clinical trial data available to other investigators for further use — is entirely absent from the proposals and the consultation in general. However, as an aspect of the wider concept of open science and reproducible research, data sharing is an increasingly important aspect of clinical trials. The benefits of data sharing include faster innovation, improved surveillance of drug safety and effectiveness and decreasing participant exposure to unnecessary risk. There are already a number of UK-focused documents that discuss and encourage data sharing, for example, the Concordat on Open Research Data and the Medical Research Council's Data Sharing Policy. We strongly suggest that data sharing should be the norm rather than the exception, and hope that the forthcoming proposals on clinical trials invite discussion on this important topic. [ABSTRACT FROM AUTHOR]

Objective: To reveal the characteristics of patients in need of neurosurgery by examining neurosurgery consultations within the emergency department (ED) admissions of a tertiary academic hospital. Methods: This is a retrospective, single-centre observational study. Patients admitted to the ED between 01.01.2022 - 31.12.2022 and consulted to the neurosurgery department were identified through the hospital computer system and included in the study. The demographic information of the patients, mode of admission to the ED, the reasons for admission, the time of admission, the number of brain computed tomography (CT) scans, whether they underwent surgery or not, and the mortality results were recorded. Results: A total of 441 neurosurgery consultations were examined. Fall 35.6% (n=157) and traffic accident 16.6% (n=73) were the most common reasons for consultation. It was observed that 92.5% (n=408) of the patients had a brain CT scan, and 19.5% (n=86) had two or more brain CTs. It was determined that 12.7% (n=56) of the patients consulted to neurosurgery were operated on, and 4.1% (n=18) of the patients' hospital admissions resulted in death. Only 53.7% (n=237) of the patients who underwent neurosurgery consultation were discharged from the ED. It was determined that significantly more Neurosurgery consultations were requested during working hours (p = 0.013). Conclusions: Most consultation calls from the ED to neurosurgery are for trauma patients. Brain CT examination is frequently used in neurosurgical patient evaluation. As a result of the consultations, almost half of the patients are hospitalized. Emergency physicians can select patients who need neurosurgery well. [ABSTRACT FROM AUTHOR]

To understand the process by which evidence-based practices (EBPs) move from identification as effective through research establishing empirically validated effects, to being routinely adopted to bring about meaningful impact, we examined the selection/adaptation process within a well-established consultation model, COMPASS, applying two frameworks—the Evidence-Based Practice in Psychology (EBPP) Framework and the Consolidated Framework for Implementation Research (CFIR). The EBPP Framework proposes the equal importance of the EBP, student/family factors, and school/teacher factors in decision-making. CFIR highlights greater understanding of the iterative decision-making process and elucidates how an EBP moves through selection, adaptation, and use. Descriptive analysis of COMPASS intervention plans revealed that five EBPs were selected on average and specific EBPs were based on goal domain. Social goals used the widest variety of EBPs and demonstrated the greatest number of intercorrelations with other EBPs. Goal attainment outcomes were similar across goal domains. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of medication consultation and pharmaceutical care for the treatment of stroke-associated pneumonia ( SAP ) with integrated traditional Chinese and western medicine by the clinical pharmacists, and summarize the characteristics of medication of the disease, so as to promote the clinical rational drug use. METHODS: Retrospective survey method was used to analyze the anti-infective-related medication of 87 SAP patients who were consulted by clinical pharmacists of integrated traditional Chinese and western medicine in the department of neurology of the hospital from Oct. 2020 to Oct. 2022. RESULTS: After consultation, the clinical pharmacists adjusted the anti-infective treatment regimen for 65 patients, Tongfu Xiere treatment for 21 patients, phlegm drug regimen for 42 patients, and renal function improvement regimen for 24 patients. On the basis of adjusting the anti-infective treatment regimen, the consultation pharmacist suggested strengthening the elimination of sputum, improvement of constipation and improvement of renal function from the perspective of integrated traditional Chinese and western medicine. The clinicians adopted the suggestions, and the infection indicators of the patient ( body temperature, white blood cell count, neutrophil percentage and C-reactive protein) were improved compared with those before consultation, with statistically significant difference (P<0. 05). CONCLUSIONS: Clinical pharmacists provide clinical pharmaceutical services and carry out pharmaceutical care. In addition to suggesting the selection of appropriate antibiotics, clinical pharmacists also analyzed the medication from the perspective of integrated traditional Chinese and western medicine. Tongfu Xiere treatment, phlegm elimination treatment and reducing turbidity can assist the anti-infective treatment, strengthen the control of pulmonary infection, improve the efficacy, reduce the abuse of anti-infective drugs and improve the rational application level of anti-infective drugs. [ABSTRACT FROM AUTHOR]

Different countries have different histories, traditions, cultures, and practices of student voice and are currently at different stages of their student voice journeys. This paper investigates how student voice is coming to be used in relation to classroom practice in different school types and socio-economic settings in the Irish education system. Ireland is a country without a strong tradition or history of student voice and particularly in relation to teaching and learning matters and it is envisaged that this paper will be of strong interest to those in countries where student voice is not yet prominent, but there are also wider implications. This research shows that students are now being consulted in relation to classroom practice in a variety of ways but that even within single school systems consultations are very much connected to school context with voice being used to different extents in different schools in different settings. [ABSTRACT FROM AUTHOR]

Background Integrating behavioural health care into primary care practices may increase patients' access to behavioural health services and improve health outcomes. However, few studies have explored factors that influence integration processes. Objective We sought to better understand contextual factors that support or impede behavioural health integration in primary care practices. Methods We conducted 71 semi-structured interviews with providers, staff, and leaders from eight primary care practices in the United States with integrated behavioural health services, which were participating in a randomized control, pragmatic trial: Integrating Behavioural Health and Primary Care. Practices were selected for diversity on geographic location, size, ownership, and experience with integration. We conducted a thematic analysis of the qualitative data derived from the interviews. Results We identified four categories of contextual factors influencing behavioural health integration: leadership commitment to integration, financial considerations, workflow and communication systems, and providers' perspectives on integration and team-based healthcare. Supportive factors included leaders' commitment to integration, adequate staffing, customized communication and workflow systems, collaborative practice culture, and healthy working relationships amongst providers. Impediments included staffing issues and payment models that do not reimburse for activities required to support integrated care. Conclusion Interviewees described various benefits of integration, including providers feeling better equipped to address patients' needs due to collaboration between medical and behavioural providers and resulting interdisciplinary learning. Given concerns about provider burnout, this finding warrants further study. [ABSTRACT FROM AUTHOR]

This piece analyses the recent judgment from the Makhanda High Court in Sustaining the Wild Coast NPC v Minister of Mineral Resources and Energy setting aside the decision to grant Shell and Impact Africa an exploratory right. Shell and Impact Africa intended to conduct a seismic survey along South Africa's Wild Coast. Such a survey stood to have a substantial impact on the rights and interests of several local communities residing along the coastline. Because Shell, Impact Africa and the Director-General of the Department of Mineral Resources and Energy failed to consider these rights and interests, the court decided to overturn the decision granting the companies their exploratory right. To this end, the judgment provides a powerful vindication of the rights of local communities, illustrating what is possible when regulatory schemes are applied purposively and not as a mere box-ticking exercise. [ABSTRACT FROM AUTHOR]

The European Social Charter (both in initial as well as revised version), as one of the most important legal acts regulating the standards of labour law, contains a number of provisions that regulate the principles of social dialogue. The Charter imposes an obligation to encourage joint consultation between workers and employers; supporting the mechanisms of voluntary negotiations between employers or employers’ organizations and employees’ organizations in order to regulate employment conditions through collective labour agreements; supporting conciliation mechanisms and voluntary arbitration for settling collective disputes. The provisions of the Charter also regulate the right of employees to be informed and participate in consultations regarding the employer’s situation. The standards of social dialogue included in the European Social Charter constitute a comprehensive solution that can be a point of reference for the analysis of national solutions. They are also an indicator of changes that should be introduced to the national labour law system in order to create a strong basis for dialogue between social partners. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources. Design: Qualitative method using the Cultural Formulation Interview (CFI) from the DSM-5 as an interview guide. Analysis of participants’ experiences of acculturation through systematic text condensation. Participants: Eleven Swedish former members of ideological or religion-based cults. Setting: Swedish mainstream, secular society. Results: Former cult members experience an ‘in-between time’ in the period after leaving the cult and find themselves in a confusing, chaotic state. They describe having lived in an honor culture where acts of violence were normalized. In the cult, they felt disconnected from themselves, and post-cult they try to regain access to their own values and feelings as well as create new bonds with family members and friends outside the cult. They find it hard to talk about their cult background and find relief in communicating with other former cult members. In their post-cult life, they eventually start seeing the world in a brighter, more hopeful way than before. However, they are also at risk of re-experiencing cult-related traumatic events and of new traumatic experiences within the post-cult acculturation process, and of persistent psychological distress. Conclusion: Former cult members face a challenging acculturation process, having lost a functioning worldview upon leaving the cult but not yet gained another to take its place. While the in-between time is often transient, they may need support from the healthcare system, especially regarding mental health concerns, while establishing themselves into mainstream society. [ABSTRACT FROM AUTHOR]

The concept of consultation has an important place in Ottoman political thought and discourse. The concept, which is traditionally included in the meaning of advisory councils and consultation, gains a political new meaning, especially with the New Ottomans Society. Later, the meaning of the concept is sharpened by the Young Turks and finally extends to constitutionalism. In the current studies, New Ottoman and Young Turk thought are examined, but there is no historical examination of concepts specific to these societies’ interpretation of the concept of consultation. In our article, the development of the concept of consultation in New Ottoman and Young Turk thought is examined in order to eliminate this deficiency. The study is carried out in the context of Hürriyet newspapers for the New Ottomans, Meşveret newspapers for the Young Turks. In the end, it is concluded that the consultation was included in the political discourse by the New Ottomans and that its political character was made permanent by the Young Turks. [ABSTRACT FROM AUTHOR]

Aim: Correct early diagnosis and intervention for schizophrenia is associated with improved outcomes. This study sought to determine the potential value of specialized consultations for individuals thought to have a recent‐onset schizophrenia spectrum disorder who were not receiving specialized care. Methods: 121 consecutive one‐time consultations were performed in a clinic specializing in recent‐onset schizophrenia. Parents of 79 patients were questioned about the process and the value of the consultation. Results: Consultations were perceived by parents as both positive and helpful experiences. 85% of parents were somewhat or very happy with the consultation experience, and 86% found the consultation to be moderately or very helpful. A third of parents viewed the consultation as contributing to the long‐term improvement of the patient's condition. Conclusions: The findings demonstrate the potential value of consultations for individuals with possible schizophrenia spectrum disorders not receiving specialized treatment, and provide rationale for comprehensive studies investigating the widespread implementation of such consultations. [ABSTRACT FROM AUTHOR]

Depressive disorders are common in primary health care clinics both nationally and overseas. Every 10th patient who visits their GP has depressive complaints. Moreover, depression is a disease of social significance, which not only causes suffering for the patient, but also has economic and social consequences for the society. General practitioners (GPs), being the first contact of these patients with the domestic healthcare system, must possess the necessary knowledge, skills and attitudes to solve this type of problem. A serious evaluation of the possibility of prescribing therapy in the conditions of General Medical Practice (GMP) or referring the patient to a specialist is required. The purpose of the study was to evaluate and analyze the attitudes and behaviors of GPs during depressive episodes in the General Medical Practice. An anonymous individual survey among 300 GPs from eight regions of the country for the period July-December 2022, was conducted. Of all the respondents who had at least one patient with a depressive episode, 96.3% reported examining patients with more than one depressive episode. According to the respondents, the data on frequency, affected sex, seasonality and age of first occurrence match the data from the literature. Male GPs are more confident in prescribing primary therapy for patients with a depressive episode, but also more often than female GPs consider that they must necessarily consult their patients with a psychiatrist. 99.3% of GPs do not use validated questionnaires to detect a depressive episode. They think the main reason for this is the lack of time. The surveyed physicians recognize the complexity of the problem for the patient and society as well as their own vital roles in providing primary mental health services to their patients. [ABSTRACT FROM AUTHOR]

One of the consequences after infection with SARS-CоV-2 is a temporary or permanent damage to the heart. In other patients, as a severe post-Covid-19 symptom, high arterial pressure is manifested, while in cases of a known hypertension insufficient control of arterial pressure by the previous antihypertensive therapy was established. The aim of the present study was to demonstrate the impact of the infection with COVID-19 on the arterial pressure of the patients who survived it. Material and methods: 123 persons (female ‒ 75, and male ‒ 48, aged 22 to 79) who are awaiting a consultation with a cardiologist after having been infected with COVID-19, were examined in the Center for Cardiovascular Diseases OOD - Sofia, in the period February-December 2022. An epidemiological survey was used for this purpose. The results show that in 41.3% of the examined persons, the blood pressure increased during illness or a few weeks after the infection. Age has a statistically significant negative correlation (by Spearman) with elevated blood pressure (-0.855**), which suggests that younger people are more likely to experience increased blood pressure as a result of past infection. This is probably due to the fact that the older population already has existing arterial hypertension. The results also show that the previous vaccination does not impact either the increase in blood pressure or the infection with COVID-19. Our study showed that the infection by Covid-19 can be the cause of the increase in blood pressure. Therefore, any patient who has recovered from Covid-19, even if there are no complaints from the cardiovascular system and regardless of age, can be referred for a preventive consultation with a cardiologist. [ABSTRACT FROM AUTHOR]

The aim of this paper is to describe the use of a discrete, two session large group in an organizational conference setting (of the Faculty of Medical Psychotherapy), which gave insight into unconscious systemic dynamics that affect the organization. In line with a tradition of the use of experiential large group experiences in organizational settings, we illustrate how such a group can be used as a consultative process through bringing forward fresh insights with a compelling emotional intensity and in community building through sharing experiences at a time of stress in mental health services with feelings of increasing isolation. Such insights can aid the organization and its elected officials in leading and developing strategy, whilst community building can lead to collective responsibility-taking and development of collegial relationships which serve to reduce isolation. We clarify different possible functions of the experiential large group in organizational conference settings including consultation regarding systemic dynamics, community building and affective integration of learning. [ABSTRACT FROM AUTHOR]

Despite evidence for the importance of playtime for children, the use of the withdrawal of playtime is a sanction that is used throughout schools in the UK. In light of this, there have been recent arguments highlighting the need to explore alternatives to this sanction in order to protect opportunities for playtime. This exploratory action research study included an initial focus group and multiple psychological consultations with teachers in a single setting to collaboratively explore and review potential alternatives. Findings include teachers wanting to address behaviours that often result in the withdrawal of playtime, and strategies to address these were co-constructed and implemented. Other findings included contextual barriers to stopping the use of withdrawing playtime, such as curriculum constraints, as well as facilitative aspects to stopping the withdrawal of playtime. Further implications for EP and school practice and research, as well as limitations, are discussed. [ABSTRACT FROM AUTHOR]

The '2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines' are authored by a Task Force of experts in feline hospice and palliative care convened by the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care. They emphasize the specialized communication skills and ethical considerations that are associated with feline hospice and palliative care, with references to other feline practice guidelines for a more complete discussion of specific diseases, feline pain management best practices and cat friendly interactions. A comprehensive, multi-step hospice consultation allows for tailoring the approach to both the cat and the family involved in the care. The consultation includes establishing 'budgets of care', a concept that greatly influences what can be done for the individual cat. The Guidelines acknowledge that each cat and caregiver will be different in this regard; and establishing what is reasonable, practical and ethical for the individual cat and caregiver is important. A further concept of the 'care unit' is introduced, which is extrapolated from human hospice and palliative care, and encourages and empowers the caregiver to become a part of the cat's care every step of the way. Ethical considerations include a decision-making framework. The importance of comfort care is emphasized, and the latest information available about how to assess the quality of a cat's life is reviewed. Emotional health is as equally important as physical health. Hence, it is fundamental to recognize that compromised physical health, with pain and/or illness, impairs emotional health. A limited discussion on euthanasia is included, referring to the AAFP's End of Life Educational Toolkit for recommendations to help the caregiver and the veterinary professional ensure a peaceful passing and transition - one that reflects the best interests of the individual cat and caregiver. [ABSTRACT FROM AUTHOR]

Implementation of social and emotional learning (SEL) programs and practices is becoming increasingly prevalent in Pre-K through Grade 12 educational settings. Research provides robust evidence to support positive outcomes associated with SEL implementation; however, we also know that implementation can be impacted by a variety of different individual and organizational factors. Teacher beliefs can influence how teachers implement SEL programming and represent an important area of study. The purpose of this study was to explore evidence for the technical adequacy of the Teacher SEL Beliefs Scale by examining the internal structure, internal consistency, and relations between subscale scores and teacher self-reported implementation fidelity of the Second Step SEL program. Confirmatory factor analysis of 103 teachers' responses indicated that the three-factor solution found by prior authors, consisting of Comfort, Commitment, and Culture subscales, was also supported in the current sample. Moreover, ordinal logistic regression analyses suggested that the Comfort factor was significantly associated with how consistently teachers reported implementing the Second Step program. Implications for practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Neuropathology consultations are an essential part of medico-legal cause-of-death investigations. However, there are little data on the rates of neuropathological examinations in medico-legal autopsies. The present nationwide, retrospective, register-based study aimed to report and compare neuropathology consultation rates (i.e. the percentages of medico-legal autopsies with a neuropathology consultation) in five Finnish regions from 2016 to 2021. The dataset comprised 50 457 medico-legal autopsies with 1 274 neuropathology consultations. Overall, ~1 in 40 autopsies (2.5%) involved a neuropathology consultation. Consultation rates were lowest in the Southern Finland region (1.4%) and highest in the Southwestern Finland and Åland region (6.5%). Throughout the study period, the consultation rates of Southwestern Finland and Åland were 1.5 to 9.4 times those of other regions (P  < 0.001). In conclusion, this nationwide Finnish study identified substantial differences in neuropathology consultation rates between regions, which may indicate regional differences in conventions and policies. However, the "optimal" consultation rate remains unknown. Future studies are required to further understand the differences in autopsy practices within the Finnish context as well as in medico-legal institutions elsewhere. Key points There are little data on the rates of neuropathology consultations in medico-legal autopsies. This Finnish study characterized regional differences in neuropathology consultation rates between 2016 and 2021. Overall, 1 in 40 autopsies (2.5%) involved a neuropathology consultation. The consultation rates of Southwestern Finland and Åland were 1.5 to 9.4 times those of other regions. Our findings may reflect regional differences in conventions and policies. [ABSTRACT FROM AUTHOR]

To evaluate an academic institution's implementation of a gynecologic electronic consultation (eConsult) service, including the most common queries, turnaround time, need for conversion to in-person visits, and to demonstrate how eConsults can improve access and convenience for patients and providers. This is a descriptive and retrospective electronic chart review. We obtained data from the UCSF eConsult and Smart Referral program manager. The medical system provided institution-wide statistics. Three authors reviewed and categorized gynecologic eConsults for the last fiscal year. The senior author resolved conflicts in coding. The eConsult program manager provided billing information and provider reimbursement. A total of 548 eConsults were submitted to the gynecology service between July 2017 and June 2020 (4.5% of institutional eConsult volume). Ninety-five percent of the eConsults were completed by a senior specialist within our department. Abnormal pap smear management, abnormal uterine bleeding, and contraception questions were the most common queries. Over half (59.3%) of all inquiries were answered on the same day as they were received, with an average of 9% declined. Gynecology was the 10th largest eConsult provider at our institution in 2020. The present investigation describes one large university-based experience with eConsults in gynecology. Results demonstrate that eConsults permit appropriate, efficient triaging of time-sensitive conditions affecting patients especially in the time of the COVID-19 pandemic. eConsult services provide the potential to improve access, interdisciplinary communication, and patient and provider satisfaction.

Background Diabetes is one of the common diseases among inpatients in non-endocrinology department. Patients with diabetes require assistance from endocrinologists in their blood glucose management. Objective To investigate consultation of blood glucose management for inpatients with diabetes in non-endocrinology department and analyze the quality of consultation and the needs of patients. Methods The inpatients with diabetes in non-endocrinology department consulted by the endocrinologists in West China Hospital, Sichuan University from January 1, 2013 to May 23, 2019 were selected and reviewed. The consultation and medical record information was recorded and organized. The recommended medications for the patients were analyzed to determine the potential contraindications according to drug instructions. Results During the study period, we identified 145 428 inpatients with diabetes in non-endocrinology department, 24 499 of them had 31 369 consultations from endocrinologists (0.17 consultations/inpatients), and 20 486 of them had 24 343 consultations for blood glucose management (0.17 consultations/inpatients). The top three departments with the most blood glucose management consultations per patient were neurology (0.30 consultations/inpatients), respiratory medicine (0.25 consultations/inpatients), and cardiology (0.18 consultations/inpatients). There were 18 306 blood glucose management consultations (16 269 inpatients) with complete suggestions, and the most commonly recommended hypoglycemic regimen was the combination of insulin with a meal and basal insulin, accounting for 32.34% (5 921/18 306). Among the all consultations, 1.16% (212/18 306) patients' hypoglycemic regimens had drug contraindications. Conclusion A large number of inpatients with diabetes in non-endocrinology department need specialized blood glucose management. The overall quality of the consultation for blood glucose management is relatively high but far from meeting the management requirements.

Abstract Introduction Infectious diseases (ID) consultations have been demonstrated to improve patient outcomes in the treatment of severe infections. However, ID consultation is often unavailable to patients that live in rural communities. Little is known regarding the treatment of infections in rural hospitals with no coverage from an ID specialist. We characterized the outcomes of patients cared for in hospitals without coverage from an ID physician. Methods Patients aged 18 years or older admitted to eight community hospitals without access to ID consultation during a 6.5-month period were assessed. All patients had received at least three days of continuous antimicrobial therapy. The primary outcome was the need for transfer to a tertiary facility for ID services. The secondary outcome was the characterization of antimicrobials received. Antimicrobial courses were evaluated independently by two board-certified ID physicians. Results 3706 encounters were evaluated. Transfers for ID consultation occurred in 0.01% of patients. The ID physician would have made modifications in 68.5% of patients. Areas for improvement included treatment of chronic obstructive pulmonary disease exacerbations, broad-spectrum treatment of skin and soft tissue infection, long courses of azithromycin, and management of Staphylococcus aureus bacteremia, including choice and length of therapy, as well as obtaining echocardiography. Patients evaluated received 22,807 days of antimicrobial therapy. Conclusions Patients hospitalized in community hospitals are rarely transferred for ID consultation. Our work demonstrates a need for ID consultation in community hospitals, identifying opportunities to enhance patient care by modifying antimicrobial regimens to improve antimicrobial stewardship and avoid inappropriate antimicrobials. Efforts to expand the ID workforce to include coverage at rural hospitals will likely improve antibiotic utilization.

Background: Few patients with chronic nonmalignant pulmonary diseases receive specialist palliative care consultation, despite their high symptom burden in end of life. Objectives: To study palliative care decision making, survival, and hospital resource usage in patients with nonmalignant pulmonary diseases with or without a specialist palliative care consultation. Methods: A retrospective chart review of all patients with a chronic nonmalignant pulmonary disease and a palliative care decision (palliative goal of therapy), who were treated in Tampere University Hospital, Finland, between January 1, 2018 and December 31, 2020. Results: A total of 107 patients were included in the study, 62 (58%) had chronic obstructive pulmonary disease (COPD), and 43 (40%) interstitial lung disease (ILD). Median survival after palliative care decision was shorter in patients with ILD than in patients with COPD (59 vs. 213 days, p?=?0.004). Involvement of a palliative care specialist in the decision making was not associated with the survival. Patients with COPD who received palliative care consultation visited less often emergency room (73% vs. 100%, p?=?0.019) and spent fewer days in the hospital (7 vs. 18 days, p?=?0.007) during the last year of life. When a palliative care specialist attended the decision making, the presence and opinions of the patients were recorded more often, and the patients were more frequently referred to a palliative care pathway. Conclusions: Specialist palliative care consultation seems to enable better end-of-life care and supports shared decision making for patients with nonmalignant pulmonary diseases. Therefore, palliative care consultations should be utilized in nonmalignant pulmonary diseases preferably before the last days of life.

Ren Kawamura, Yukinori Harada, Masashi Yokose, Shogo Hanai, Yudai Suzuki, Taro Shimizu Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, JapanCorrespondence: Taro Shimizu, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, 880 Kitakobayashi, Shimotsuga, Mibu, Tochigi, 321-0293, Japan, Tel +8128286-1111, Email shimizutaro7@gmail.comPurpose: The general internal medicine (GIM) department can be an effective diagnostic coordinator for undiagnosed outpatients. We investigated the contribution of GIM consultations to the diagnosis of patients admitted to specialty departments in hospitals in Japan that have not yet adopted a hospitalist system.Patients and Methods: This single-center, retrospective observational study was conducted at a university hospital in Japan. GIM consultations from other departments on inpatients aged ≥ 20 years, from April 2016 to March 2021, were included. Data were extracted from electronic medical records, and consultation purposes were categorized into diagnosis, treatment, and diagnosis and treatment. The primary outcome was new diagnosis during hospitalization for patients with consultation purpose of diagnosis or diagnosis and treatment. The secondary outcomes were the purposes of consultation with the Diagnostic and Generalist Medicine department.Results: In total, 342 patients were included in the analysis. The purpose of the consultations was diagnosis for 253 patients (74%), treatment for 60 (17.5%), and diagnosis and treatment for 29 patients (8.5%). In 282 consultations for diagnosis and diagnosis and treatment, 179 new diagnoses were established for 162 patients (57.5%, 95% confidence interval [CI], 51.5– 63.3).Conclusion: The GIM department can function as a diagnostic consultant for inpatients with diagnostic problems admitted to other specialty departments in hospitals where hospitalist or other similar systems are not adopted.Keywords: diagnosis, diagnostic excellence, consultation, consultative medicine, hospital admission

Background: Adolescence is considered one of the most important periods in the life of any human being. In most cases, adolescents suffer from fear, anxiety, and stress during this period, and how to pass through this period considerably affects their mental and physical health. Objectives: This study was conducted to investigate the effect of life skills-based group counseling on stress in female adolescents in the city of Zanjan. Methods: The present study is a randomized controlled trial with parallel groups. Sixty four female adolescents under the coverage of health centers in the city of Zanjan in 2019 were initially divided into two intervention (n=32) and control groups (n=32) by blocked random sampling method. In the intervention group, eight sessions of life skills-based group counseling were conducted once a week for 90 minutes. Data were collected using Cohen’s Perceived Stress Scale (PSS) and were analyzed using the Mann-Whitney U and repeated measurements tests in SPSS 18 software. Results: The results indicated no significant difference between the two intervention (35.06 ± 9.56) and control (29.94±9.16) groups before the intervention (p=0.253). The mean stress score two months after the intervention was significantly lower in the intervention group (29.94 ± 7.59) than in the control group (37.17±9.16) (p

Diana Ygiyeva,1 Lyudmila Pivina,1 Assylzhan Messova,1 Zhanar Urazalina,1 Yuliya Semenova,1 Almas Dyussupov,1 Altay Dyussupov,1 Tatyana Belikhina,2 Marat Syzdykbayev,1 Gulnara Batenova,1 Ayaulym Akhmetova,1 Amber Adams3 1Department of Emergency Medicine, Semey Medical University, Semey, Abay Region, Kazakhstan; 2Nuclear Medicine Department, Center of Nuclear Medicine and Oncology, Semey, Abay Region, Kazakhstan; 3JoAnne Gay Dishman School of Nursing, Lamar University, Beaumont, TX, USACorrespondence: Assylzhan Messova; Lyudmila Pivina, Department of Emergency Medicine, Semey Medical University, Abay str. 103, Semey, Abay Region, Kazakhstan, Tel +7 777 2138307 ; +77055227300, Email assylzhan2006@mail.ru; semskluda@rambler.ruObjective: Consultation is an important and necessary aspect of patient care in the emergency department. We prospectively examined difficulties during the consultation process between paramedics and providers in emergency departments in Kazakhstan.Methods: The paramedics were interviewed using various platforms and face-to-face meetings. Questionnaires were administered to paramedics to gather feedback on the current consultation process. In our survey, 202 paramedics of ambulance from the cities of Semey, Pavlodar, and Ust-Kamenogorsk, located in the North and East of Kazakhstan took part.Results: Serious barriers to effective consultation were identified during consultations with cardiologists, pediatricians, and traumatologists. Weekends, as well as nighttime, are associated with more consultation difficulties. The most common problems for paramedics are non-attendance of the consultant, refusal of hospitalization by the consultant, and referral to other specialists and departments. More than 40% of the respondents noted the desire to share responsibility for the patient with medical consultants, which indicates uncertainty in their own knowledge due to the limited work experience of the majority of respondents.Conclusion: Barriers that arise during the consultation process of patients with emergency conditions can lead to unfavorable outcomes. Strategies to address these barriers are needed to improve the quality of patient care. This review aims to understand and evaluate the issues that arise during the consultation process.Keywords: emergency department, consultation, paramedics, prehospital medical care

New tools for non-specific primary prevention strategies covering somatic and mental health in occupational medicine are urgently needed. Heart rate variability (HRV) reflects the capacity of the body to adapt to environmental challenges and of the mind to regulate emotions. Hence, a 24 h-measurement of HRV offers a unique possibility to quantify the interaction between situation-specific emotional regulation within a specific psychosocial environment and physiological state, thereby increasing self-perception and inducing motivation to change behavior. The focus of the present study represents such a 24 h-measurement of HRV and its presentation as a comprehensive graph including protocol situations of the client. A special training program for occupational health physicians and questionnaires for clients were developed and administered. The article reports the first data of the study healthy leadership and work - body signals for managers and employees, an investigator-initiated, interventional, single-arm, open (non-blinded), multicenter, national trial with 168 participants. They reported a significantly improved perception of their bodily needs after the consultation (from Median = 7, interquartile range 5-8 to Median = 8, interquartile range 7-9; scale range from 1 to 10; p < 0.001, Wilcoxon rank test; effect size 0.49). The 16 occupational health physicians stated that the measurement of HRV was very well suited to enter into dialog with the managers and was feasible to show interactions between situations, thoughts, feelings, and bodily reactions. Taken together, we show that a 24 h-HRV-measurement can be a feasible and effective approach for holistic, psychosomatic primary prevention in occupational medicine. We discuss possible mechanisms for improving the individual health via the consultation, containing mindset and improved ANS activity.

Background: Consultation is an implementation strategy that improves delivery and clinical outcomes for Cognitive Processing Therapy (CPT), an evidence-based practice (EBP) for posttraumatic stress disorder (PTSD). However, little is known about the specific components of consultation that influence the fidelity of treatment delivery or clinical outcomes. Methods: The current study examined whether specific activities performed during CPT consultation meetings were associated with better fidelity to the CPT protocol among 60 newly trained therapists or improved clinical outcomes among 135 clients treated by these therapists. Consultation activities that fall under three broad categories (discussion of the application of CPT to individual cases, review/feedback on fidelity, and technical difficulties) were measured by consultant checklists for each consultation session. Treatment fidelity (adherence to the protocol and competence of delivery) was rated by trained observers for a random sample of therapists' CPT sessions following consultation. The self-reported PTSD Checklist-IV assessed PTSD symptom change. Results: Multilevel regression analyses indicated that higher therapist consultation attendance predicted a greater decrease in their clients' PTSD symptoms and that attendance was not associated with observer-rated treatment fidelity. Discussion of the application of specific CPT strategies was the only consultation activity that was significantly associated with greater improvement in PTSD symptoms. Lastly, no consultation activities were significantly associated with treatment fidelity. Conclusions: Our findings suggest that specific consultation strategies such as emphasizing the discussion of the application of specific CPT strategies to individual cases during consultation meetings may be effective in improving the clinical outcomes of CPT.

Under § 7 of the federal Endangered Species Act (ESA or the Act),'federal agencies must ensure that actions they authorize, fund, or carry out are" not likely to jeopardize the continued existence of any endangered species or threatened species or result in the destruction or adverse modification of habitat of such species." 2 For species with low and declining populations, applying this standard is legally and scientifically difficult. 3 The US Fish and Wildlife Service (FWS) faced this problem in its recent biological opinion (BiOp) analyzing impacts to threatened Delta smelt from water project operations in the California Delta. FWS concluded the" species' recent abundance trends strongly suggest it is in the midst of demographic collapse," and most recent surveys to locate smelt have failed to find them.'Nevertheless, FWS approved agency actions that will likely increase extinction risk for Delta smelt.

The purpose of this review was to analyze English language articles that addressed collaborative consulting in adapted physical education (APE). A systematic process was used to search the literature in six different databases. First, article quality was analyzed. Subsequently, thematic categorization of data was performed. Eleven articles published between 1995 and 2015 that satisfied the criteria for inclusion in the study were selected. The results were organized into seven thematic categories: the concept and definition of consultation, the role of the APE consultant, the planning and documentation of APE consulting, the stages of APE consulting, general physical education and APE teachers' perceptions regarding consulting, major challenges of APE consulting, and collaborative work training for physical education teachers. In conclusion, although research remains scarce, all of the selected articles reinforce the relevance of collaborative consulting for including students with disabilities in general physical education settings. Further investigation, particularly through empirical studies, must be encouraged. [ABSTRACT FROM AUTHOR]

Introduction: Despite policy recommendations worldwide, too often dementia remains outside the scope of primary health care. In the context of Portuguese primary health care services, our group previously explored the experiences of people with dementia, carers, general practitioners (GPs), and other professionals, together with their perspectives on barriers to dementia care. However, we know little about triadic consultations that involve a patient, their carer, and their GP. Objective: To explore dementia care in triadic consultations in general practice. Methods: Analysis of ten consultations with dementia triads across six Portuguese practices from different social contexts. Purposive sampling was used to recruit nine GPs, ten patients, and ten carers. Triadic consultations were digitally recorded, transcribed, and analysed. The analytical framework combined codes derived from the transcripts with codes from the available literature. Themes focused on the corollaries of dementia (e.g. need for information), and coordination of services. Results: Dementia-related content took up only 30% of consultations, despite their length (median 27 min). The GPs did not seem engaged in dementia management, their assessments lacked breadth and person-centredness, and interventions were limited. Carers facilitated GPs’ assessment of dementia consequences, but their needs were poorly assessed. Patients’ self-expression was limited by communication patterns within the triad. Conclusion: It is challenging for GPs to assess dementia among other conditions in a context of fragmented care. Strategies for improving family carers’ assessments are needed. The analysis of triadic consultations may provide potential process measures for assessing the quality of clinical practice and consultation training in general practice, but this requires further study.

The use of AI in the public sector is emerging around the world and its spread affects the core States functions: the administrative, the judiciary, and the legislative. Nevertheless, a comprehensive approach to AI in the life-cycle of rules - from the proposal of a new rule to its implementation, monitoring and review- is currently lacking in the rich panorama of studies from different disciplines. The analysis shows that AI has the power to play a crucial role in the life-cycle of rules, by performing time-consuming tasks, increasing access to knowledge base, and enhancing the ability of institutions to draft effective rules and to declutter the regulatory stock. However, it is not without risks, ranging from discrimination to challenges to democratic representation. In order to play a role in achieving law effectiveness while limiting the risks, a complementarity between human and AI should be reached both at the level of the AI architecture and ex post. Moreover, an incremental and experimental approach is suggested, as well as the elaboration of a general framework, to be tailored by each regulator to the specific features of its tasks, aimed at setting the rationale, the role, and adequate guardrails to AI in the life-cycle of rules. This agile approach would allow the AI revolution to display its benefits while preventing potential harms or side effects.

ObjectiveTo explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources.DesignQualitative method using the Cultural Formulation Interview (CFI) from the DSM-5 as an interview guide. Analysis of participants’ experiences of acculturation through systematic text condensation.ParticipantsEleven Swedish former members of ideological or religion-based cults.SettingSwedish mainstream, secular society.ResultsFormer cult members experience an ‘in-between time’ in the period after leaving the cult and find themselves in a confusing, chaotic state. They describe having lived in an honor culture where acts of violence were normalized. In the cult, they felt disconnected from themselves, and post-cult they try to regain access to their own values and feelings as well as create new bonds with family members and friends outside the cult. They find it hard to talk about their cult background and find relief in communicating with other former cult members. In their post-cult life, they eventually start seeing the world in a brighter, more hopeful way than before. However, they are also at risk of re-experiencing cult-related traumatic events and of new traumatic experiences within the post-cult acculturation process, and of persistent psychological distress.ConclusionFormer cult members face a challenging acculturation process, having lost a functioning worldview upon leaving the cult but not yet gained another to take its place. While the in-between time is often transient, they may need support from the healthcare system, especially regarding mental health concerns, while establishing themselves into mainstream society.

IntroductionIn recent years, there has been an increasing use of otoendoscopy in middle ear surgery. There is also increasing evidence of its usefulness as a diagnostic tool for clinicians. However, there is limited evidence on whether understanding their ear condition is of benefit to patients. This novel study sought to explore the perceptions, perspectives, and satisfaction of parents, children, and young people regarding the use of otoendoscope images in outpatient ENT consultations in relation to their understanding of ear symptoms, disease, and subsequent treatment. The framework for the study is child (and parent) health literacy and how visual images can play in scaffolding understanding, communication, and decision-making.MethodsThis qualitative descriptive exploratory study used semi-structured observation, a survey, short conversational interviews, and child activities.ResultsPurposive sampling of 16 children (aged 4–15 yrs, various diagnoses) and parents/carers attending an outpatient ENT clinic at a tertiary pediatric hospital. One overarching theme, “Grounding perceptions and deepening engagement,” and two sub-themes, “Strengthening understanding” and “Supporting decision-making,” were identified. The children and parents valued the opportunity to see the images and gain insight and knowledge of their child's pathology.DiscussionThe images appeared to promote child (and parent) health literacy and interaction between the child-parent-clinician and informed shared decision-making. This study suggests that the use of otoendoscopy in an out-patient setting and sharing of the images with parents, children, and young people have a largely positive impact on understanding, relationship building, and decision making in pediatric ENT consultations.

Aim: Functional bowel (constipation and faecal incontinence) and bladder (urinary incontinence and enuresis) problems in children are often treated by paediatricians yet should mostly be managed by general practitioners (GPs). To understand whether the necessary skills and knowledge are being built in general practice, this study aimed to establish the prevalence and associated skills of Australian general practice registrars managing children with functional bowel and bladder problems. Together as paediatricians and GPs, we use these data to determine how best to ensure high quality, equitable care for children. Methods: We drew on 16 rounds of data collection from the Registrar Clinical Encounters in Training (ReCEnT) multi‐site cohort study (2010–2017) of general practice registrars' in‐consultation experience. It included a measure of paediatric consultations in which a functional bowel or bladder problem was managed, as well as demographic information. Results: Out of 62 721 problems/diagnoses for paediatric patients (0–17 years), 844 (1.4%) were coded as functional bowel (n = 709; 1.13% (95% confidence interval, CI: 1.05–1.22)) and/or bladder (n = 135; 0.22% (95% CI: 0.18–0.25)) presentations. Registrars were more likely to prescribe medication for bowel problems (odds ratio (OR) = 2.22 (95% CI: 1.86–2.64)) than for all other problems, but less likely to prescribe medication (OR = 0.31 (95% CI: 0.18–0.52)) for night‐time wetting and more likely to make a specialist referral (OR = 1.99 (95% CI: 1.22–3.25)) compared to all other problems. Conclusions: Only a small proportion of children with functional bowel and bladder problems were seen by registrars despite high prevalence in the community and amenability to management in the general practice setting (i.e. generally low morbidity and low complexity) versus need for specialists. Registrars appeared to be managing functional bowel and bladder problems according to evidence‐based guidelines, but with relatively high levels of referral. Given the inequitable access to specialist care, paediatricians should support local general practice management of these problems. This might include (i) engaging with training programs to ensure appropriate education and (ii) liaising with individual registrars/practices to provide management advice for individual or example cases. [ABSTRACT FROM AUTHOR]