Front-line Professionals Research Articles

Neuroscientific Approaches to Understanding Adolescent Susceptibility to Substance Abuse

Adolescence is a pivotal developmental stage characterised by significant neurobiological changes that heighten susceptibility to substance abuse. This period is marked by the maturation of the brain regions responsible for decision-making and impulse control, alongside an increased sensitivity to rewards driven by dopaminergic pathways. This review aimed to understand adolescent susceptibility to substance abuse using a neuroscientific approach. In line with best practices, data were collected from a variety reliable source to ensure a comprehensive view of the topic. Research studies on adolescent neurodevelopment have contributed to a broader understanding of the physiological and psychological factors at play during adolescence, while grey literature, including expert interviews and focused group discussions, has offered practical insights from frontline professionals, such as psychologists, social workers, and healthcare providers, who deal directly with adolescent substance use. These results demonstrate that the relationship between genetic factors and environmental conditions, such as stress and trauma, intensifies this vulnerability, thereby heightening the likelihood of individuals participating in risky behaviours. This review examines the neuroscientific foundations of substance use during adolescence, highlighting the critical role of timely interventions that utilize neuroplasticity to enhance resilience and reduce risk. By integrating cognitive training and behavioural therapies into public health initiatives, adolescents' cognitive control mechanisms and their propensity for substance abuse can be reduced.

Protocolizing social prescribing in mental health and addiction services: barriers and opportunities

Abstract Issue Social Prescribing (SP) is a structured approach where health professionals recommend community activities to enhance well-being. Starting in Catalonia in 2012, it expanded to the entire primary care network by 2016. By 2023, 23,338 patients received SP, showing a 2.3-fold increase from 2022. Two-thirds experienced improvement in mental well-being. Now, efforts focus on applying SP to mental health and addiction services (MHAS), where SP can be used for restoring health and well-being. Description A literature review was conducted and a working group was initiated with MHAS professionals was initiated to exchange experiences and identify needs and best practices. This was done in preparation for designing a pilot experience, which will include a qualitative study through focus groups to validate the action plan and determine barriers and facilitators in MHAS. The groups will be segmented into MHAS users and frontline professionals. Results The results of the review process and the working group sessions demonstrated that SP can be useful and beneficial for the health MHAS users. However, barriers and opportunities were identified. The main barriers detected include: the need for strong support during referrals to community activities; increased awareness of addiction among activity providers to reduce stigmatization; define inclusion and exclusion criteria; determining monitoring and evaluation tools; and mapping and updating community assets. Regarding opportunities, the following were highligthed: the interest of MHAS professionals in promoting and implementing a SP program in this area; the existence of organizations already conducting community activities focused MHAS users; and political prioritization of this issue. Lessons The implementation of a SP program protocol in MHAS is considered beneficial. It is necessary to analyse barriers to effectively address them and to identify opportunities to leverage them. Key messages • Social Prescribing has significantly enhanced mental health outcomes in Primary Care, which can imply a potential improvement in well-being of mental health and addiction services users. • Implementing Social Prescribing in mental health and addiction services offers promising integrated care opportunities, requiring barriers resolution and maximizing existing prospects.

Bridging the gap: voices of teachers on inclusive literature

ABSTRACT This study explored teachers’ perspectives on utilising existing children’s books for students with intellectual and additional disabilities. 58 teachers from Israeli special education schools and kindergartens revealed widespread dissatisfaction with available materials. Strikingly, 70.7% were unsatisfied with existing children’s books, and 94.7% believed there were not enough accessible options. Qualitative analysis identified five major barriers: excessive text, inappropriate content for older age groups, challenges with the physical structure of books, mismatches between text and visuals, and specific challenges for teachers of children with multiple disabilities. These findings underscore the substantial need for more accessible literature tailored to the needs of children with disabilities. Despite legislation mandating societal inclusion of people with disabilities, teachers’ dissatisfaction highlights gaps in addressing their students’ literary requirements. The results shed light on these teachers’ vital roles in adapting books and indicate the need for greater collaboration between teachers, publishers, and policymakers. By highlighting the voices of frontline professionals, this study provides a crucial call to action to develop high-quality, customised educational resources for children and young people with disabilities.

How does performance feedback shape public managers’ inclination to involve frontline professionals? Evidence from a conjoint experiment

Research suggests that public managers sometimes struggle to make sense of and use performance feedback in decision making and that, importantly, involving frontline professionals could help with such evidence-based decision making. Therefore, this study investigates how different elements of performance feedback shape public managers’ inclination to involve frontline professionals by employing a conjoint experiment with 1,252 observations from 223 publicly employed clinical directors. The findings reveal the following. First, clinical directors are more inclined to involve frontline professionals when the feedback indicates a failure to reach organizational goals compared with reaching or exceeding organizational goals. Second, clinical directors are more inclined to involve frontline professionals when the feedback is tied to social, rather than historical, aspirations. Third, clinical directors are more inclined to involve frontline professionals in understanding the performance feedback, when the feedback relates to an output or outcome goal rather than an input goal. Implications for public management theory and practice are discussed.

Rethinking leadership approaches for community-wide opioid crisis intervention: harnessing positive inquiry to unearth front-line insight

Background/AimThe opioid crisis presents a complex and widespread health challenge for communities, necessitating a deeper exploration beyond simple solutions. To address this crisis, it is crucial to identify and disseminate...

Through the eyes of the involved: the extent to which different types of influence shape public employed frontline professionals’ perception of involvement in organizational decision-making

ABSTRACT This article offers a theoretical model on how frontline professionals form their perception of being involved in organizational decision-making by balancing perceived benefits and transaction costs of increased influence. The model suggests that frontline professionals find consultation most beneficial for decisions that are distal from their daily work tasks and prefer joint decision-making for decisions that are proximal to their daily work tasks. Results from a survey experiment with more than 600 public employed junior physicians reveal that, regardless of the proximity of the organizational decision, they perceive consultation as the most beneficial form of influence in organizational decision-making.

Pathways of front-line healthcare professionals’ information anxiety during the COVID-19 pandemic: A qualitative study in China

Pathways of front-line healthcare professionals’ information anxiety during the COVID-19 pandemic: A qualitative study in China

Wound Care Capacity of the Addiction Workforce in the Setting of Xylazine.

As xylazine increasingly adulterates the unregulated opioid supply, people who use drugs (PWUD) are more likely to experience sequalae from xylazine. Given xylazine exposure is consistently associated with development of wounds which can heal with medically directed wound care, we sought to understand the level of preparedness and ability of front-line addiction professionals who interact with PWUD to provide wound care treatment. We administered a 26-item online survey assessing participant and organizational characteristics, level of wound care training, ability to test for xylazine and treat xylazine-associated wounds, and funding and billing characteristics to a national sample of addiction professionals using a listserv of over 11,000 individuals. We had a response rate of 12.8% in which 1,280 met eligibility criteria and completed the survey, with the majority (23.7%) being nurses. While nearly all participants had cared for patients who had experienced any xylazine-associated harms, less than half (43.6%) had cared for patients with xylazine wounds and 43.4% had any training or certification in wound care, including 26.9% of physicians. Although 75.9% of participants had access to wound care supplies, just 19.5% provided wound care services onsite. Most addiction professionals, especially physicians, lack wound care training and do not provide onsite treatment for drug-associated wounds at the organizational level. There is a critical need to bridge this gap in knowledge and build capacity to provide evidence-based wound care services to PWUD in areas impacted by xylazine adulteration.

Bracing for the next wave: A critical incident study of frontline decision-making, adaptation and learning in ambulance care during COVID-19.

To explore frontline decision-making, adaptation, and learning in ambulance care during the evolving COVID-19 pandemic. Descriptive and interpretative qualitative study. Twenty-eight registered nurses from the Swedish ambulance services described 56 critical incidents during the COVID-19 pandemic through free-text questionnaires. The material was analysed using the Critical Incident Technique and Interpretive Description through the lens of potential for resilient performance. The findings were synthesized into four themes: 'Navigating uncharted waters under never-ending pressure', 'Balancing on the brink of an abyss', 'Sacrificing the few to save the many' and 'Bracing for the next wave'. Frontline decision-making during a pandemic contribute to ethical dilemmas while necessitating difficult prioritizations to adapt and respond to limited resources. Learning was manifested through effective information sharing and the identification of successful adaptations as compared to maladaptations. During pandemics or under other extreme conditions, decisions must be made promptly, even amidst emerging chaos, potentially necessitating the use of untested methods and ad-hoc solutions due to initial lack of knowledge and guidelines. Within ambulance care, dynamic leadership becomes imperative, combining autonomous frontline decision-making with support from management. Strengthening ethical competence and fostering ethical discourse may enhance confidence in decision-making, particularly under ethically challenging circumstances. Performance under extreme conditions can elevate the risk of suboptimal decision-making and adverse outcomes, with older adults being especially vulnerable. Thus, requiring targeted decision support and interventions. Enhancing patient safety in ambulance care during such conditions demands active participation and governance from management, along with decision support and guidelines. Vertical communication and collaboration between management and frontline professionals are essential to ensure that critical information, guidelines, and resources are effectively disseminated and implemented. Further research is needed into management and leadership in ambulance care, alongside the ethical challenges in frontline decision-making under extreme conditions. Findings are reported per consolidated criteria for reporting qualitative research (COREQ). No Patient or Public Contribution.

تطبيق دروس السلامة المستفادة من قطاع الطيران المدني التجاري على صناعة النفط والغاز

Commercial aviation safety-related protocols and initiatives have received considerable interest from several industries due to the widely recognition of their effectiveness as an ultra-safe industry. And yet, it’s not clear how to adopt these protocols in oil and gas sector. Thus, this article provides a typology of these protocols to apply to the oil and gas sector. This paper examines seven examples of error counter measures used in commercial aviation safety. Examples are Crew Resource Management (CRM) and Line Operations Safety Audit (LOSA) methodology. This would help in developing a conceptual typology that might potentially apply to the oil and gas industry. The initiatives examined in this article fall into twofold themes: concepts that seek to increase collective awareness of safety values; and concepts that promote safety by design. The results of this research revealed that all task checklists, joint safety briefings, and the confidential safety reporting system are protocols that help users routinely enhance workplace safety. However, initiatives such as the sterile cockpit system and LOSA approach in frontline operations fall under the responsibility of middle and upper management to ensure safety performance. Examining and discussing the proposed typology with the sector’s safety experts and front-line professionals before the implementation process would highlight any unanticipated challenges, and therefore proactively reduce them to promote an organizational safety culture in the oil and gas sector which enables operational cost reduction and mitigates loss-time injury. Finally, this study outlines that it is possible to benefit from aviation safety standards in the oil and gas sectors and achieve higher safety performance. Keywords: Oil & Gas Safety; Occupational Safety; Safety Management; Safety Culture; Aviation Safety; Threat and Error Management.

Dealing With a Stressful Extra Duty: The Intrapersonal Conflict Experiences of Nurses Caring for Survivors of Suicide Attempts on Medical-Surgical Wards.

Nurses are the frontline professionals caring for patients who have attempted suicide. When clinical nurses learn from medical records or nursing handover, or are proactively informed by patients or family members, that the patients they are caring for have suicidal tendencies, they often experience pressure and face challenges. However, little attention has been given to the experiences of the nurses caring for patients with suicidal intent on medical and surgical wards. We aimed to address this knowledge gap. The purpose of this study was to explore medical and surgical nurses' experiences, especially the internal conflicts they might experience while caring for patients who have a history of attempted suicide. A qualitative descriptive design and semi-structured interviews were used in this study. Twenty-three nurses were recruited and interviewed individually. Data were analysed by qualitative content analysis. The focus of this paper is to examine the emergent theme of intrapersonal conflict experienced by the participants. Nurses' experiences can be clustered into two themes: (1) Pity and annoyance and (2) Hard work does not necessarily pay off. Intrapersonal conflict was identified by participants as considerable fear and anxiety about the possibility of a patient's suicide, as well as a mixture of pity for and annoyance with the patients. Nurses feel sorry for such patients, but they are also annoyed by the extra work required to prevent suicide attempts in the ward. Additionally, having limited time and ability, they see that their hard work does not necessarily pay off and may sometimes lead to punishment. Our findings raise serious concerns about the adequacy of the knowledge of the nurses, their competence and their difficulties in caring for such patients. In addition, there is a need to provide them with appropriate on-the-job education and immediate emotional support relevant to caring for survivors of suicide attempts.

Lived Reality and Impacts Of COVID-19 on Nurses Who Provided Care in The First Wave on Brazilian Amazon

COVID-19 is an infectious disease caused by SARS-CoV-2, which was responsible for causing incalculable damage to humanity, especially during the 1st pandemic wave, which corresponds to a unique, disastrous, and emergency public health event global. In this sense, the individuals considered most exposed to the virus were frontline professionals, such as nurses. The purpose of this work was to evaluate the effects of the work activity of nurses who aid suspected or confirmed cases of SARS-CoV-2 on their health.

Do public frontline managers involve frontline professionals in managerial decision-making in response to crisis? Evidence from Danish hospitals during COVID-19

ABSTRACT This article investigates whether public frontline managers respond to crisis by involving frontline professionals more in managerial decision-making by utilizing a survey among physicians employed at public hospital departments before and during the COVID-19 crisis. The findings show a positive relationship between how affected the departments were by the crisis and how much the frontline professionals were involved in operational decisions about how to solve problems in the organization. Furthermore, exploratory analyses reveal a potential convex relationship between crisis affectedness and involvement in strategic decisions about the overall goals, direction, and priorities of the organization.

Universal mental health training for frontline professionals: evaluation of pilot trial in Ukraine.

Increasing accessibility of mental health services and expanding universal health coverage is possible worldwide by using a task-shifting approach as partial delegation of some mental health support tasks to trained non-mental health service providers in order to use the available workforce more efficiently. The Universal Mental Health Training (UMHT), which is dedicated to this aim, was developed and piloted in Ukraine. The UMHT is an educational program for frontline professionals on high-quality and evidence-based responses to the mental health needs of the population they serve. The pilot trial of UMHTs' effectiveness was conducted with 307 frontline professionals divided into 24 training groups. The control group included 211 persons with the same occupation background who participated in training later (waiting list). All the groups took part in eight-hour training, which includes one introductory module that introduces the mental health topic alongside a five-step model of UMHT, two disorders-focused modules with the steps adjusted to work with specific disorders, and the final module that considers possible difficulties frontline professionals might experience. Three effectiveness measurements were used in the outcome assessment: readiness to interact with people with mental health issues at work, mental health awareness and mental health proficiency. Analysis of the outcome data for the frontline professionals who underwent the UMHT revealed a moderate effect size related to the knowledge of mental health conditions, mental health awareness, and increasing the readiness to interact with people with mental health issues in comparison to the control group. High-level utilisation of the UMHT at work by trained professionals confirms the effectiveness of the developed intervention. Obtained results favour the continuation of the development of the UMHT and future implementation research in this field in Ukraine and potentially in other low- and middle-income countries.

Frontline Professionals in the Wake of Social Media Scrutiny: Examining the Processes of Obscured Accountability

Professional accountability is considered important to the legitimacy and survival of a profession. Prior research has examined the role of top-down scrutiny by audiences, such as supervisors, regulators, and certification agencies, in improving professional accountability. But the advent of social media platforms has increasingly enabled the bottom-up scrutiny of professionals—especially professionals on the front line—by audiences such as customers and the public. In this research, I examine how and when bottom-up scrutiny through social media (hereafter, social media scrutiny) impacts the accountability of frontline professionals. Conducting an ethnography of 911 emergency management organizations, I find that social media scrutiny of 911 call-takers—the frontline professionals in this setting—can obscure rather than improve professional accountability. I elaborate on how, why, and under what conditions social media scrutiny pushes frontline professionals to deviate from their mandate, which, in turn, obscures their sense of professional accountability. These processes also generate spillover effects on the everyday work and mandate of downstream professionals (e.g., 911 dispatchers, police officers), producing a cascading set of unintended consequences that further obscures accountability for multiple actors across the professional ecosystem.

Eyes on the pandemic: using photovoice in group and remotely with social professionals of aged care facilities

ABSTRACT The COVID-19 pandemic had a major impact on aged care services. In Portugal, social workers are key frontline professionals in aged care services. A photovoice program called “Eyes on the Pandemic” was carried out to capture the internal experiences of frontline social workers working in aged care services during the first year of the COVID-19 pandemic. Photovoice is a qualitative, participatory action-research method in which participants share key experiences of their lives through photographs and narratives (voices) presented and discussed with others. Thirteen social workers between 24 and 41 years old participated. This article describes the planning, implementation, and evaluation of this project. The findings suggest that the social workers’ experiences were defined by a reinvention of intervention, the maintenance of a balance between personal and professional life, the crucial importance of teamwork, management of the pandemic repercussions on older people’s well-being, and encounters with the uncertain future. The results illuminate the lived experience of the COVID-19 pandemic inside aged care facilities and could inform practices and policies by consolidating lessons learned during this difficult period. The benefits of attending the program referred by the participants, lead to conclude that photovoice proved to be a good group intervention tool.

The work of the Supervisor Nurse in the COVID 19 PANDEMIC - 2020/2021 “frontline professionals”

The work of the Supervisor Nurse in the COVID 19 PANDEMIC - 2020/2021 “frontline professionals”

Signs of front-line healthcare professionals' information anxiety during the COVID-19 pandemic: Grounded theory study in a Wuhan hospital.

Being front-line healthcare professionals is associated with possible severe information anxiety during the COVID-19 pandemic. Investigating signs of information anxiety is the first and key step of its targeted medical intervention. This study aims to explore the signs of front-line healthcare professionals' information anxiety during the COVID-19 pandemic. This study is qualitative research. Grounded theory was used to classify information anxiety signs of front-line healthcare professionals. Twenty-four front-line healthcare professionals from a general hospital with over 5000 beds in Wuhan were recruited to participate in semi-structured interviews. According to the frequency and frequency variation of signs appearing in interviews, the trends of signs during the virus encounter, lockdown, flattening and second wave were compared. Based on the interviews, those signs that were conceptually related to each other were extracted to construct a conceptual model. Psychological signs (emotion, worry, doubt, caution, hope), physical signs (insomnia, inattention, memory loss, appetite decreased) and behavioural signs (panic buying of goods, be at a loss, pay attention to relevant information, change habits) could be generalized from 13 subcategories of information anxiety signs. Psychological signs were the most in every period of the pandemic. Furthermore, psychological signs decreased significantly during lockdown, while behavioural and physical signs increased. Finally, severe psychological and behavioural signs were associated with physical signs.

Working conditions and health of frontline professionals in the COVID-19 pandemic

RESUMO Objetivou-se investigar as condições de trabalho e a saúde física e mental de profissionais de saúde atuantes na linha de frente da covid-19 em serviços de urgência, emergência e terapia intensiva no Brasil, no segundo ano da pandemia. Estudo transversal, com uso de questionário eletrônico, por meio do qual coletaram-se dados sobre condições de trabalho, saúde física e mental, além do instrumento Depression, Anxiety and Stress Scale (DASS-21). A amostra (n=209) incluiu enfermeiros (28,7%), técnicos de enfermagem (30,1%), fisioterapeutas (33%) e médicos (8,2%). Os profissionais possuíam idade média de 34,6 anos e relataram uma carga horária média de 53,5 horas/semana. Verificou-se aumento das horas trabalhadas (62%) e da quantidade de pacientes (84%). A maioria relatou bom relacionamento com o chefe (89%) e satisfação com o trabalho (87%). A prevalência de sintomas de estresse, ansiedade e depressão foi superior a 45%, com predomínio de sintomas graves ou extremamente graves. A prevalência de dor musculoesquelética e fadiga foi de 84,7% e 83,3%, respectivamente. Os profissionais de saúde apresentaram aumento de volume de trabalho e de exigência durante a pandemia de covid-19. Observou-se, ainda, intenso prejuízo à saúde física e mental desses trabalhadores.

Facilitating the Implementation of Midwifery Services: The Case of Montérégie, Quebec

Objectives: This study analyzed midwifery services implementation in one region (Montérégie) of Quebec. The objectives were to determine whether services were implemented as planned and to identify factors that facilitated or impeded implementation. The aspects studied included organizational components; types of midwifery services provided; levels of interprofessional collaboration among midwives, physicians, nurses, and community organizations; and training activities offered to perinatal care providers and students. Methods: This is a qualitative case study of one implementation experience and is based on three data sources: individual interviews and focus groups; policy and administrative documents related to the implementation; and a database compiled by the midwives on services provided. Data were collected and analyzed between July 2012 and March 2013. Results: The implementation of midwifery services in Montérégie was successful and largely accomplished as planned. Its success was due to the alignment of two categories of favourable conditions. The first category consisted of appropriate policies and regulations, demand from service users, and support from front-line professionals. The second category concerned the implementation process and governance and included effective governance structures and mechanisms, dedicated resources, and leadership from champions. Conclusion: The lessons from this study can be usefully applied to the introduction of midwifery services in jurisdictions where they are not currently present. They may also inform the implementation of other publicly funded health services or professionals in other jurisdictions. This article has been peer reviewed.