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ABSTRACT Aim Design Methods Results Conclusion Impact Reporting Method Patient or Public Contribution To explore the factors influencing the implementation of reasonable adjustments in hospitals for people with intellectual disability: using a realist lens.A qualitative study using a realist lens.Data collection involved one focus group interview and three semi‐structured interviews with healthcare professionals working in hospital or community settings in September 2023. Data were analysed using qualitative content analysis and findings were mapped to the Context and Implementation of Complex Interventions (CICI) framework across the dimension's context, implementation and setting.Healthcare professionals support the provision of reasonable adjustments in acute hospitals as a person‐centred approach to caring for people with intellectual disability. While reasonable adjustments are evident in practice, they are mostly individual‐level cases with little evidence of strategic system‐level implementation. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework. Context factors spanned the domains of epidemiological (e.g., ageing population), socio‐cultural (e.g., historical healthcare), political (e.g., lack of integrated care pathways) and ethical (e.g., provision of person‐centred care). Implementation factors spanned the domains of strategies (e.g., leadership strategies), agents (e.g., liaison and advocacy roles) and outcomes (e.g., individual‐level reasonable adjustments). The setting for the complex intervention was the acute hospital. System‐level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources.A radical change is needed where implementation of reasonable adjustments in acute hospitals are broadened beyond isolated individual‐level cases to system‐level healthcare. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting in complex interventions such as reasonable adjustments and sets foundation for further implementation research in this area.Reasonable adjustments at the system‐level within acute hospitals would promote person‐centred care and help address the inequities and health disparities experienced by people with intellectual disability. This research uses a realist lens to explore the factors influencing the implementation of reasonable adjustments in acute hospitals for people with intellectual disability. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework across the dimensions of context (domains epidemiological, socio‐cultural, political and ethical), implementation (domains strategies, agents and outcomes) and setting. System‐level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting of complex interventions such as reasonable adjustments and sets a foundation for further implementation research in this area.This research adhered to the Equator research reporting guideline: standards for reporting qualitative research.A parent of a child with intellectual disability was involved in the conduct of this research, specifically in the design, data collection and preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Perinatal mental health is a growing public health concern. Refugee and asylum-seeking women are particularly susceptible to experiencing perinatal mental illness and may encounter a range of challenges in accessing healthcare. This scoping review sought to identify the enablers of and barriers to healthcare access and healthcare provision for refugee and asylum-seeking women experiencing perinatal mental illness in the WHO European Region. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was applied. Nine databases and six grey literature sources were initially searched in April 2022, and an updated search was completed in July 2023. The search identified 16,130 records, and after the removal of duplicates and the screening process, 18 sources of evidence were included in this review. A data extraction table was used to extract significant information from each individual source of evidence, which was then mapped to the seven dimensions of the candidacy framework. Empirical (n = 14; 77.8%) and non-empirical (n = 4; 22.2%) sources of evidence were included. The literature originated from seven countries within the WHO European Region, including the United Kingdom (n = 9; 50%), Germany (n = 3; 16.7%), Denmark (n = 2; 11.2%), Norway (n = 1; 5.6%), Greece (n = 1; 5.6%), Sweden (n = 1; 5.6%), and Switzerland (n = 1; 5.6%). The results indicate that, although enablers and barriers were apparent throughout the seven dimensions of candidacy, barriers and impeding factors were more frequently reported. There was also a notable overall lack of reported enablers at the system level. Unaddressed language barriers and lack of attention to the diversity in culturally informed perceptions of perinatal mental illness were the main barriers at the individual level (micro-level) to identifying candidacy, navigating healthcare systems, and asserting the need for care. The lack of culturally appropriate alignment of healthcare services was the key organizational (meso-level) barrier identified. The wider structural and political contexts (macro-level factors), such as lack of funding for consultation time, focus on Western diagnostic and management criteria, and lack of services that adequately respond to the needs of refugee and asylum-seeking women, negatively influenced the operating conditions and wider production of candidacy. It can be concluded that there are multilevel and interconnected complexities influencing access to and provision of perinatal mental healthcare for refugee and asylum-seeking women. [ABSTRACT FROM AUTHOR]

Background: Insomnia is a well‐established, prospective risk factor for Alcohol Use Disorder. Thus, targeting sleep problems could serve as a novel and efficacious means of reducing problematic drinking. Here, we examined the potential utility of a well‐validated, interactive, easy to use, self‐paced digital cognitive behavioral therapy for insomnia program. In a randomized, single‐blind pilot study, we examined the impact of treatment with Sleep Healthy Using the Internet (SHUTi) on drinking and sleep outcomes in a sample of heavy drinkers with insomnia. Methods: Heavy drinking men (n = 28) and women (n = 42) with insomnia were randomly assigned to complete either the SHUTi program or a control patient education program. Subjective measures of sleep and alcohol use were administered at baseline, immediately following completion of the intervention, 3 months post‐intervention, and 6 months post‐intervention. Sleep outcomes were assessed using the Insomnia Severity Index and Pittsburgh Sleep Quality Index. Drinking outcomes were assessed using the 30‐Day Timeline Follow‐Back calendar. We used linear mixed effects models to compare groups on both insomnia and drinking outcomes. Results: Data from all 70 subjects (SHUTI: n = 40; control: n = 30) were analyzed. Linear mixed effects models showed that SHUTi significantly reduced insomnia symptoms (p = 0.01) and drinking outcomes (ps < 0.05) more than the control condition over time. Trend‐level effects on sleep quality (p = 0.06) were also observed. No adverse events were reported. Conclusions: Improving sleep may be an effective treatment intervention for reducing hazardous drinking in at‐risk individuals. Further, findings provide preliminary support for the implementation of an easily accessible health behavior intervention with significant public health impact in a high‐risk population. [ABSTRACT FROM AUTHOR]

Sociologists have developed compelling pedagogical strategies to focus the undergraduate gaze on problems of gender and sexuality. Nested within the social construction of gender norms, the sexualization of girls and women negatively impacts individual, interpersonal, and societal levels of social interaction. Nevertheless, this important issue remains under-explored in the sociology of teaching and learning. This article reports on a pedagogical module that utilizes a multimedia presentation to define and illustrate the sexualization of girls and women. Lesson impacts were assessed through an online survey. Results indicate a critical gap between the social importance of this topic and educational exposure. Students unanimously recommended this module be taught in introductory sociology courses and offered specific examples of individual and interpersonal impacts. Our findings suggest an ongoing need to address the sexualization of girls and women inside, and outside, of the classroom.

Background: People with intellectual disability experience poorer health and healthcare access issues. As a leading role in healthcare provision for people with intellectual disability nurses are key to supporting person‐centred care and health outcomes. However, little is known about specialist intellectual disability nursing and their contribution to care provision for people with intellectual disability. Methods: A systematic scoping review. Searches of seven academic databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO, Embase, Scopus and Web of Science were conducted to identify relevant literature. Literature addressing intellectual disability nursing or nursing care for people with intellectual disability in intellectual disability centres/units/care homes were reviewed and reported as per PRISMA‐ScR checklist and PRISMA flow diagram. Results: The published literature (n = 68) is extensive and describes the value and contribution of intellectual disability nursing across all domains of professional practice and supports a biopsychosocial‐educational approach to addressing the physical, mental and social needs of clients with intellectual disability across the care continuum of health management, health promotion and health education. Conclusions: Despite the importance of the review question and the large volume of publication evidence detailing wide‐ranging professional nursing roles and responsibilities, there remains limited literature on the assessment and intervention strategies employed by intellectual disability nurses that highlight their specialist knowledge and skill. Future research should focus on making the role of the nurse more visible and presenting their unique contributions to client care, service delivery, policy and ultimately to the art and science of nursing. [ABSTRACT FROM AUTHOR]

A study examined barriers to transition faced by 12 young adults with disabilities receiving Supplemental Security Income (SSI) and their families. Obstacles to transition planning that were associated with SSI included difficulties managing the receipt of SSI and unawareness of the supports available through the SSI system. (Contains references.) (Author/CR)

A study examined self-definition in 11 adolescents with and without disabilities. Variation depended on sense of self, vision of the future, and access and use of supports to cope with difficulties as they prepared to graduate. Students with disabilities were most likely to have low self-definition and experience high struggle. (Contains references.) (Author/CR)