Community Practice Research Articles

Prevention & management of snakebite envenomation: A qualitative study on perspectives & practices in Maharashtra & Odisha.

Background & objectives Snakebite envenoming (SBE) is a major public health concern, with India bearing the highest global burden of SBE-related deaths. SBE is concentrated in rural and tribal regions of India, where the knowledge, attitude and behaviour of the dwelling communities largely influence mortality and morbidity. Understanding these factors is crucial to designing effective SBE prevention and management strategies. The present study's objective was to document the perspectives of community members and practices in selected blocks of Maharashtra and Odisha States regarding SBE prevention, first aid and health-seeking behaviour. Methods Between March and April 2022, 28 focus group discussions (FGDs) were conducted. Study sites included Shahapur block in Thane district, Aheri block in Gadchiroli district of Maharashtra, and Khordha block in Khordha district, Kasipur block in Rayagada district of Odisha. Separate FGDs were held for males (n=14) and females (n=14), involving about 8-16 participants above 18 yr. All discussions were audio recorded, and a grounded theory approach was employed to identify key themes from the translated transcripts. Results The findings of this study revealed a variety of perspectives and practices determining the SBE burden at the study sites. The findings included insufficient knowledge about snake species and their nature of toxicity, use of non-scientific first aid techniques, inaccessible health care and reliance on traditional healers, non-utilization of prevention methods, varied cultural beliefs and practices, and differential treatments based on gender. The findings have been collated in two simplistic frameworks; barriers to effective prevention and barriers to effective management. Interpretation & conclusions SBE burden results from a complex interplay between socioeconomic, cultural, and demographic factors, necessitating a collaborative inter-sectoral effort for adequate control. Through crucial regional inputs and the barriers to prevention and management models, this study provides critical insights and priority intervention areas to strengthen India's upcoming National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) in all high-burden States.

Rural Social Work Practice in Turkey

Rural social work continues to grow in importance as a unique field of practice with unique opportunities and challenges. This qualitative research explores explore different aspects of rural social work in Turkey. To this end, the study explores social work practice in rural communities in depth, recognizing the distinctive contexts and characteristics that influence service delivery. In-depth interviews were conducted with rural social workers (n = 30) with significant knowledge and experience in addressing the social work needs of rural communities. Participants were selected through purposive sampling to ensure a broad representation of expertise and geographic diversity. Thematic analysis was used to identify recurring themes and patterns in the participants’ responses. The findings support previous studies that have argued that rural social work is a distinct field of practice. At the same time, the study shows that social work practices are shaped in an urban-centered manner, and local culture is ignored. The study concludes that rural social work should be integrated into graduate social work education, and even start during undergraduate education.

Unraveling the role of digital leadership in developing digital dynamic capabilities for the digital transformation of firms

PurposeWith the emergence of the digital era, the role of digital leaders in developing digital capabilities and driving their firms towards digital transformation has gained significant attention. Digital dynamic capabilities involve continuous engagement of leaders in sensing, seizing, and transforming activities needed to digitally transform their firms. However, little attention is given toward the role of digital leadership in developing digital dynamic capabilities. We seek to develop an understanding of the role of digital leadership in building digital dynamic capabilities for successful digital transformation.Design/methodology/approachWe conducted a systematic literature review and looked at relevant articles using Google Scholar, ScienceDirect, and Scopus databases with key search items being “digital leadership”, “dynamic capabilities”, “digital dynamic capabilities,”. We used AND, OR operators in between the key terms to search for the relevant articles.FindingsOur conceptual framework and propositions demonstrate the digital leader's role in building three core dynamic capabilities: digital sensing (technological trends, digital scouting, digital vision, future interpretation, and digital strategies), digital seizing (organizational agility and digital portfolio), and transforming (redesigning internal structures and ecosystem partnerships) for successful digital transformation.Originality/valueThis study pioneers an integrated framework that elucidates the role of digital leadership in fostering digital dynamic capabilities essential for successful digital transformation. While previous research has examined digital leadership and transformation in separate silos, our work bridges this gap by defining and dissecting three core capabilities—digital sensing, digital seizing, and transforming. By doing so, we offer both academic and practical communities a nuanced understanding of how digital leadership shapes dynamic capabilities. The study serves as a foundational roadmap for future research and offers actionable insights for organizations striving to navigate the complex landscape of digital transformation.

Developing and delivering a migraine disparities and diagnosis undergraduate medical educational program to underrepresented in medicine medical student members of the Student National Medical Association: A pilot project.

Migraine is underdiagnosed. On average, medical students have approximately 3 h of exposure to headache education throughout medical school training. Moreover, some medical students have racially-based biases in pain. There is a paucity of underrepresented in medicine (UIM) headache practitioners. UIM practitioners are more likely to practice in underserved communities and provider-patient ethnic concordance may help eliminate healthcare disparities. The Student National Medical Association (SNMA) is an organization committed to supporting current and future UIM medical students and addressing the needs of underserved communities. The goal of this project was to develop and deliver a brief Migraine Diagnosis and Disparities Undergraduate Medical Education Program (MD2UMEP) to increase awareness of migraine diagnosis and disparities in UIM medical students in the SNMA. For connecting/relationship-building with SNMA, the SNMA Region V website was reviewed. Calls were made to Wayne State University School of Medicine (WSUSOM) Office of Diversity, Equity, and Inclusion (ODEI) explaining the educational initiative with subsequent emails to the Director of WSUSOM's ODEI followed by a video-conference meeting (VCM). VCMs were conducted with two SNMA member leaders from WSUSOM. A local and regional presentation/delivery of the MD2UMEP was planned. Communication was maintained electronically. For development/delivery of the MD2UMEP, headache literature was reviewed for key concepts underpinning migraine diagnosis and migraine disparities with a focus on African Americans. Slides with talking points were developed with references. Pre- and posttest questions were drafted and made accessible via a QR code. The MD2UMEP was presented and students completed the questionnaires. Descriptive statistics were used to quantify responses. The MD2UMEP work began July 31, 2021, with program delivered in final form on October 1, 2022. A professional relationship was established with SNMA leadership. A MD2UMEP was developed then administered at the 2022 SNMA Region V Medical Education Conference. Headache medicine was introduced to UIM SNMA medical students. Anonymously, nine individuals responded to the MD2UMEP pretest questions. Eight individuals answered the posttest questions. At the program's conclusion, UIM student performance improved on seven of 10 test questions on migraine diagnosis and disparities and remained at 100% on one of 10 test questions. On two of the questions, the number correct remained the same (although percentage overall increased due to the smaller denominator). There was a higher proportion of correct responses on the posttest. There is great need for migraine diagnosis and disparities education among medical students. A new migraine diagnosis and disparities program was developed for medical students. SNMA members were receptive to the MD2UMEP and it strengthened their knowledge of migraine diagnosis and disparities. This program exposed UIM medical students to headache medicine.

From traditional to transactional: exploration of khat use in Ethiopia through an interpretative phenomenological analysis

Khat, a naturally growing stimulant, has seen a significant increase in both consumption and cultivation in eastern Ethiopia. This reliance on khat in the region comes despite its known physiological complications, with users unable to restrict khat use due to its pervasive impact on their livelihood. This qualitative study sought to understand the meaning that those in eastern Ethiopia attribute to khat and explore their firsthand experiences with the substance. In June and July of 2023, six unstructured interviews were conducted among residents of the Haramaya District in Ethiopia. To promote a holistic comprehension of the participants’ lived experiences, an interpretative phenomenological analysis approach was employed when collecting and analyzing the data. Participant responses were coded independently from one another by two different researchers identifying superordinate and corresponding subordinate themes. Among the participants, six superordinate themes were captured: economic backbone of the region, market disruption & fluctuation, pesticide use, societal relationships around khat, applications of khat, and access to healthcare. The participants’ responses indicated that the normalization of khat use, coupled with the downplaying of its addictive potential, has established a framework where khat consumption is not only allowed but, in some cases, even encouraged. The unique interplay between communal practice and individual preservation creates a cyclical effect of using khat to supplement energy to farm khat and then sell or stimulate further work on their farm. This study illuminates the transitionfrom what was once the traditional or spiritual use of khat, to a more practical use for ensuring economic livelihood.

Perceived Competencies and Training Needs of Public Health Nurses in the Philippines: Basis for the Development of NurseLEAD: A Leadership Course on Advanced Practice Nursing in Public Health.

Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs. A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data. A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken. Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.

A Clinical Construct: Research, Experimentation, and Education at the Johns Hopkins Hospital

Background: The Johns Hopkins Hospital, the first U.S. institution to integrate medical education with practice, has served as a critical case study in understanding the evolution of American medical institutions in response to advancements in medical science, education, and technology. However, the role of architecture and design in informing those institutional practices has not been sufficiently explored. Aim: This study examines the intricate interplay between architecture and medicine in the late nineteenth century through a historical analysis of the design, construction, and early operation of the Johns Hopkins Hospital in Baltimore, focusing on how this interdisciplinary relationship shaped both the hospital’s physical environment and institutional practices. Methods: This paper utilizes historical analysis to investigate the design, construction, and operations of the Johns Hopkins Hospital. By examining primary archival materials, it details how architectural strategies addressed scientific, technological, and educational advancements. Results: The investigation reveals that the hospital’s architecture not only facilitated medical research, experimentation, and education but also embodied a novel blend of scientific inquiry and architectural design. Conclusions: The Johns Hopkins Hospital exemplifies the transformative potential of integrating architectural design with medical science. This case study underscores the enduring significance of interdisciplinary collaboration, offering insights into contemporary practices and the future of hospital design and medical education and practice in academic communities.

Анархическая этничность

The chapter “Anarchist Ethnicity” makes an attempt to consider the concept of ethnicity as part of the modern politics of values. The topic of ethnicity, which arose as a scientific response to a politically discredited racial theory, nevertheless, as the author shows, does not leave the political space. Both primordialist and constructivist concepts of ethnicity retain the priority of ethnic identity (separation of oneself from another, and in political form, attitude towards the enemy) in relation to that archaic (pre-political) community, which can also be extracted from the very idea of ​​ethnos. The author proposes to consider ethnicity not as a tool for dividing communities, but as one of the forces of bringing together the weak, different, and incapable of political solidarity and mobilization. This reveals a unique ethics of ethnicity, which the author calls “ethical mythology,” since here the action of myth and ethics are inseparable. Using the example of the polemics of Derrida and Lévi-Strauss regarding preliterate societies, it is shown that the myth in which a community manifests itself in opposition to various forms of imposed political community (be it a people, a nation or an ethnic group) is a variant of arche-writing in the form in which it described in the concept of deconstruction. In fact, ethnicity contains signs of resistance to the “common meaning” and “political will”, peculiar traces of ritual, non-government practices of heterogeneous communities. The attempt made in this chapter to present such communities as the elusive source of ethnicity and as a distinguishing unit of modern political thinking, like a phoneme in linguistics, reveals the anti-authority and anti-social layer of ethnicity, which is therefore called here “anarchic”. In the chapter “Maidan: Redefining Democracy,” through an analysis of the events that occurred in Ukraine in 2013, which resulted in a change in political power in the country, the author attempts to offer a different version of democracy. It was on the Kiev Maidan, in his opinion, that the event of depoliticization of protest took place, as a result of which many words, such as “freedom”, “justice”, “trust”, “dignity”, ceased to be moral and political tools for manipulating society, but they acquired the concreteness of practical action, not reducible to politics, morality, or economics. The article shows the Maidan effect from the side of its resistance to politics, where the dominance of affective trust exceeds possible political disagreements. It is this that Spinoza, and later Antonio Negri, describes as the “multitude” (multitudo) that underlies democracy. It is this kind of democracy that realizes “freedom”, “equality” and “justice” not as political concepts, but as affects of community, allowing for the realization of both trust and risk in a world filled with political falsehood and disinformation.

Disrupting the epistemic arrangements of nursing education canon: Reflections about a prelicensure Community Engagement series.

Nursing education, as with professionalization projects, is fraught with epistemicide, false separations, and a focus on expertise over relations and accountability. This is a critical reflection of the first 5 years of a four-semester prelicensure Community Engagement course series. As the course lead, I have consistently initiated adjustments, based on experiences teaching multiple sections and synthesizing comments and feedback from students and faculty, with an eye toward longstanding and pressing concerns in the world around us. Two broad epistemic arrangements emerge from this critical excavation: (1) naturalized hierarchy, false separations, and appraisals of relevance and (2) relationality and reflection as unsettling. There is a need for sustained collective examination and shift in how the nursing education and healthcare industries curate the meanings and practice of "community," "health," and "nursing," peering out from the regulatory oversight of neoliberal forces. How might we situate student progression, program implementation, institutional contracts, and curricular standards within the contexts of nursing programs' responsibilities to local communities in light of unfolding events locally and globally and their historical antecedents? How are we all, as faculty, disrupting siloes, false separations, and the contradictions of professionalism and the biomedical model to intentionally advance health equity? May we continue to illuminate the presence of community as being everywhere, not merely in juxtaposition to acute care. May we unsettle the prevailing theorization and practices of community throughout nursing education and commit to imagining and practicing relational praxis.

Exploring the Dynamic Interplay between Religion and Culture: A Multidisciplinary Inquiry

This interdisciplinary study explores the symbiotic relationship between religion and culture, analyzing their dynamic interaction across diverse historical and geographical landscapes. Religion, as a non-material facet of culture, operates as a central institution characterized by rituals, beliefs, and communal practices, addressing existential questions concerning life, death, and purpose. Conversely, culture provides the contextual framework within which religious beliefs and practices develop and are expressed, reflecting the values, norms, and traditions of a particular society. Through a qualitative research framework drawing insights from anthropology, sociology, history, and religious studies, this study examines historical texts, scholarly articles, ethnographic data, and case studies to elucidate the multifaceted dimensions of the relationship between religion and culture. By integrating insights from various disciplines, this study aims to provide a nuanced understanding of the dynamic interdependence between religion and culture, offering fresh perspectives on how religion shapes cultural identity, societal norms, and individual beliefs. Furthermore, by highlighting the adaptability and resilience of cultural traditions in the face of religious influences, this study contributes to a deeper understanding of the complexities of human societies and the enduring influence of religion on cultural evolution. Through its comprehensive analysis, this study underscores the importance of studying religion and culture as intertwined phenomena that shape human experience and identity across diverse contexts.

Climate policy as social policy? A comprehensive assessment of the economic impact of climate action in the UK

AbstractCo-benefits are central to the case for climate action but are side-lined in many economic analyses. This paper presents an evaluation of three dimensions of the costs and benefits of climate change interventions in six urban regions of the UK. Findings indicate that meeting the UK’s 2033–2037 climate targets could yield £164 billion in total benefits. Notably, only 13% of these benefits are financial, in contrast to the 79% of which are social benefits. These social benefits include improvements in public health, reduced traffic congestion, and increased thermal comfort in homes. These results underscore the need for economic evaluations to expand their scope and move beyond the narrow financial cost–benefit analysis that predominates. Moreover, the magnitude of the social benefits underscores the need for integrating social and climate challenges in policymaking. Concurrently, the results demonstrate the sensitivity of the social benefits of climate actions to the normative aspects of empirical analysis. Determining whether emissions reductions in the transport sector, for example, should be achieved through the deployment of electric cars, expansion of public transport, and/or increases in walking and cycling requires both technical analysis and value-based decision making. Ensuring that decision-making processes are deliberate and transparent in empirical analysis is therefore critical. We conclude by suggesting that institutions such as the UK Climate Change Committee and Scottish Climate Intelligence Service should take the opportunity to be more explicit in the normative decisions embedded in their empirical work to demonstrate best practice for the wider research community.

Hurdles and Straightaways: Building a Cross-School Community of Practice

ABSTRACT Research shows that building teacher expertise can be enhanced through collaboration among colleagues, potentially through communities of practice (CoP) and professional learning communities. However, much of this research primarily investigates student and teacher outcomes. Therefore, our collaborative case study explored the critical aspects of the process behind forming a multimembership CoP consisting of high school teachers from two different schools: one school in the Southeast and one school in the Southwest U.S. We wanted to understand their successes and challenges as they navigated the beginning stages of their work together. As noted in current research, this process was complicated; however, teachers noted success and challenges regarding collaboration, time, and communication. Notably, ample time was required to develop relationships and trust before participants could openly share their thinking and demonstrate a willingness to shift their perspectives about instructional planning. While more research is needed, our findings share initial teacher-reported information about moving past the potential power imbalance between CoP teams and navigating the ebbs and flows of the early stages of partnerships.

What are Universities For?

‘Public scholarship’ uses academic research to help social groups respond to civic problems. Drawing on two distinct genealogies of public scholarship, I elaborate on an internal distinction between the ‘public intellectual’ and ‘engaged scholar’. Then, mapping this distinction onto my own research trajectory from theory to practice to engagement, I argue that scholarly focus on community practices can be as removed from public problem-solving as academic theory, whereas engaged scholarship is more accountable to the demands of justice. As ‘public scholarship’ and its various cognates increasingly become corporate-speak in higher education, the scholars and communities who are the progenitors of engaged scholarship should lead the development of the ‘engaged university’.

Characterising a diversity of coastal community fisheries in Kiribati and Vanuatu

AbstractUnderstanding what diversity of small‐scale fisheries translates to in practice, and what this means for management regimes seeking sustainability, continues to be a challenging undertaking. This is particularly so in the tropical Pacific Islands region, where small‐scale coastal fisheries play a significant role in domestic food and livelihood systems. A renewed regional policy focus on supporting coastal fisheries, combined with momentum built from a decades‐long ‘Pacific renaissance’ in community‐based fisheries management approaches, has increased resourcing and support for coastal fishery data collection and knowledge production. In this context, there is growing demand to explicitly characterise diversity and complexity of community‐based coastal fisheries to inform how national co‐management programs can adequately support the many communities within national constituencies. This study presents findings from a community‐based coastal fisheries monitoring programme implemented in ten communities across Kiribati and Vanuatu between 2019 and 2021. Findings illustrate the intra‐ and inter‐country diversity of contextual drivers, fishing practices, and fisher participation. We discuss the implications of this enhanced understanding of community‐based fisheries for applied co‐management practice in these two countries. In doing so, we add to a growing knowledge base about fishing practices in Pacific Island coastal communities and elucidate avenues through which to incorporate this knowledge into adaptive co‐management practice.

Assisted Dying as Intimate Care

How does asking loved ones to help you die, to help you commit suicide, bend the limits of our relationships and perhaps of care itself? This paper traces the aesthetic and affective considerations of those deciding to die resist against depersonalizing experiences of medical care. Focusing on ethnographic interviews with members of the British right-to die group My Death My Decision, I explore how individuals recruit loved ones and doctors to actively participate in their death through “assistance”. This paper will specifically focus on what this assistance looks, or perhaps more accurately, feels like. It will question if the desire for an assisted death in which bodies, actions, and decisions touch and are touched by one another is a demand which exceeds the boundaries of “care”. My Death My Decision is campaigning to legalize assisted suicide based on a belief that the individual knows when it’s their time to die, regardless of a terminal diagnosis. One member, Pat, has decided that when the time comes, she will travel from London to a euthanasia center in Switzerland where, surrounded by loved ones, she can receive a “kind death” from doctors that care. Unlike colloquial uses of care, here, Pat references a relationship which is not defined by medical interventions to elongate life. This paper argues that presence and touch – both physical and emotional – can produce communal practices and ethics of care which challenge traditional expectations of biomedicine.

Electronic Medical Record-Based Nudge Intervention to Increase Comprehensive Molecular Genotyping in Patients With Metastatic Non-Small Cell Lung Cancer: Results From a Prospective Clinical Trial.

Less than half of the patients with newly diagnosed metastatic non-small cell lung cancer (NSCLC) undergo comprehensive molecular testing. We designed an electronic medical record (EMR)-based "nudge intervention" to prompt plasma-based molecular testing at the time of initial medical oncology consultation. A nonrandomized prospective trial was conducted at the University of Pennsylvania's academic practice and two affiliated community practices. Molecular genotyping was performed by tissue- and/or plasma-based next generation sequencing methods. Comprehensive testing was defined as testing for EGFR, ALK, BRAF, ROS1, MET, RET, KRAS, and NTRK. Guideline-concordant treatment was defined as the use of the appropriate first-line (1L) therapy as per the National Comprehensive Cancer Network (NCCN) guidelines. Proportion of patients with comprehensive molecular genotyping results available at any time, molecular results available before 1L therapy, and guideline-concordant 1L treatment were compared between the preintervention and postintervention cohorts using Fisher's exact test or Pearson's chi-squared test. Five hundred and thirty-three patients were included, 376 in the preintervention cohort and 157 in the postintervention cohort. After implementation of the EMR-based nudge, a higher proportion of patients underwent comprehensive molecular testing in the postintervention versus the preintervention cohort (100% v 88%, P = <.001), had results of comprehensive molecular testing available before initiating 1L treatment (97.3% v 91.6%, P = .026), and received NCCN guideline-concordant care (89.8% v 78.2%, P = .035). Across three practice sites in a large health system, implementation of a provider team-focused EMR-based nudge intervention was feasible, and led to a higher number of patients with NSCLC undergoing comprehensive molecular genotyping. These findings demonstrate that behavioral nudges can promote molecular testing and should be studied further as a tool to improve guideline-concordant care in both community and academic sites.

Supporting advanced practice: feedback from a mental health, community and primary care advanced practice support project in South Yorkshire, UK

Background: Despite the significant input from Heath Education England (HEE), now NHS England (NHSE), there are still significant variations around advanced practice programmes, support and training, particularly in less developed areas such as mental health, community posts and primary care. To help target these areas, and to support the NHS Long Term Plan (2023) to increase the number of advanced clinical practitioners (ACPs), the Faculty of Advanced Practice South Yorkshire recruited three ACP leads from mental health, community, and primary care backgrounds to establish a support project led by one professional lead. These leads were able to utilise their lived experience of completing the ACP MSc programme and working as an ACP to help trainee advanced clinical practitioners (tACPs) navigate their journey. The ACP leads also developed a variety of educational events, which further supported the trainees' needs. Aim: This article reports the feedback given via an online questionnaire from trainees that accessed the project, which ended in March 2024. Its aim is to highlight the often-undervalued concept of using clinicians personal experience regarding advanced training and practice, to mentor, support and ultimately retain the future ACP workforce. Methods: An email with a link to a questionnaire was sent to 128 tACPs or recently qualified ACPs that had applied for their training via the Faculty of Advanced Practice South Yorkshire. The questionnaire, created in Microsoft Forms, was completed anonymously, and produced both numerical and free-text data. The questionnaire solicited feedback around: the number of contacts they had and how they contacted; the ACP leads; types of support accessed; and the educational events available. Free text answers were analysed by the author (CJ) and a second reviewer (SF) to generate a consensus on themes. Results: A total of 64 clinicians responded, of which 43 were tACPs, 10 were ACPs, five had other job titles (community matron, pharmacist, practice nurse) and five did not state what their job title was. Responses suggest that the support accessed from the project was highly beneficial and could not be gained elsewhere. A key factor in the project's success was the ACP leads' lived experience of having previously completed advanced practice training, as well as their ability to tailor learning events to the trainees' needs. Conclusion: Meeting the demands of ACP training in areas where the role is less established remains an ongoing challenge. It seems some of these challenges relate to the lack of practical support being provided by employers or higher education institutions, such as lived experience of completing the task of ACP training. Support projects, like the one discussed in this article, appear aptly placed to help fulfil these needs and begs the question ‘why aren't there more?’, especially when advanced practitioners are fundamental to the future healthcare workforce.

Unconjugating Community with Fernand Deligny and Jean-Luc Nancy

This article takes as its point of departure unexpected similarities in the ways that the experimental educator, writer and filmmaker Fernand Deligny and Jean-Luc Nancy conceptualize community. Deligny is remembered for his alternative community for non-speaking children with autism, established in the Cévennes in 1967 and founded on the absence of language and relationality as it is commonly understood. This article probes the paradox that in this community we find a rapprochement with Nancy's relational ontology. Drawing on Deligny's theoretical responses to the dynamics he witnessed and the cartographical methods employed to trasce the movements of the children as they roamed, and placing these in dialogue with Nancy's texts on community through the decades, I suggest a kinship between the two thinkers which opens onto broader questions about the relationship between theories and practices of community.

Preservation Rhinoplasty by the Ones Who Do It: A Worldwide Survey.

Dorsal preservation (DP) rhinoplasty techniques, including surface techniques (STs) and foundation techniques (FTs) have garnered significant attention internationally over the past few years. The practice patterns and opinions from 117 of these surgeons were surveyed from a cohort of these surgeons who participate in an online Evidence-Based Rhinoplasty Research Group. The findings of the survey are merely a snapshot of the international rhinoplasty community's practices, yet did capture data from surgeons from a diverse geographic, years of experience, and training background. STs were most used for the bone changes, and the high-strip technique was preferred for the cartilaginous septal surgery. STs are mostly performed by younger surgeons (<10 years of experience), whereas FTs were more common in older surgeons (10-30 years of experience). STs were considered more stable (p < 0.001), more predictable (p < 0.001), and associate with a shorter learning curve (p = 0.015). Revision surgery rates were not different. Regarding why many surgeons using DP still perform structural rhinoplasty, the most cited concern was hump persistence/recurrence. In summary, among surgeons using DP rhinoplasty techniques, the majority perform DP in over half of their primary rhinoplasty surgeries, highlighting the importance of updating educational programs in medical training, conferences, and courses.

Mental health on the frontlines: Disaster psychiatry perspectives from Odisha

Abstract Disasters can have a profound impact on mental health, leading to stress, posttraumatic stress disorder (PTSD), depression, anxiety, grief, substance abuse, and suicidality. These issues can persist for years, affecting 30%–60% of survivors, and risk and resilience depend on factors such as socioeconomic status, cultural background, health, trauma exposure, age, sex, and community support. Early interventions and long-term interventions, such as skills building, communal practices, cooperative livelihood programs, clinical therapies, and addressing health-care disparities, can help in recovery. Trauma can lead to neurobiological changes, and culturally sensitive mental health care is essential. Climate change accelerates extreme events, and disaster response systems must integrate such care to enhance resilience and mitigate trauma to disrupted communities such as Odisha and broadly affected populations worldwide.