Key Professionals Research Articles

How Does Living in Temporary Accommodation and the COVID-19 Pandemic Impact under 5s' Healthcare Access and Health Outcomes? A Qualitative Study of Key Professionals in a Socially and Ethnically Diverse and Deprived Area of London.

Background: Children < 5 years living in temporary accommodation (U5TA) are vulnerable to poor health outcomes. Few qualitative studies have examined service provider perspectives in family homelessness; none have focused on U5TA with a cross-sector approach. This study explored professionals’ perspectives of the barriers and facilitators, including pandemic-related challenges, experienced by U5TA in accessing healthcare and optimising health outcomes, and their experiences in delivering services. Methods: Sixteen semi-structured online interviews were conducted. Professionals working in Newham (London) with U5TA families were recruited from non-profit organisations, the health sector, and Local Authority. A thematic analysis was conducted. Findings: Professionals described barriers including poor parental mental health; unsuitable housing; no social support; mistrust of services; immigration administration; and financial insecurity. Digital poverty, language discordance, and the inability to register and track U5TA made them even less visible to services. Professionals tried to mitigate barriers with improved communication, and through community facilitators. Adverse pandemic effects on U5TA health included delay and regression in developmental milestones and behaviours. In-person services were reduced, exacerbating pre-existing barriers. Interpretation: COVID-19 further reduced the ability of professionals to deliver care to U5TA and significantly impacted the lives of U5TA with potential life-long risks. Innovative and tailored cross-sector strategies are needed, including co-production of public health services and policies focusing on early development, mental health support, employment training, and opportunities for parents/carers.

School nurses’ experience of communicating growth data and weight development to parents of children 8 and 10 years of age

IntroductionThe prevalence of overweight and obesity among children has risen sharply during recent decades. School nurses are key health professionals in interventions targeting the early onset of overweight and obesity during childhood. Understanding how school nurses experience communication with parents concerning their child´s growth and weight development are essential. The aim of the study is to describe school nurses’ experience of communicating growth data and weight development to parents of school children ages 8 and 10 years.MethodThe design of the study is a descriptive, qualitative design with purposive and snowball sampling. Sixteen interviews with school nurses were conducted and analysed with qualitative content analysis.ResultThe analysis resulted in three main categories including subcategories. In Challenges in the professional role, the school nurses expressed a lack of knowledge, skills and tools in communication, described a perception of parental responsibility and stated using several different approaches in communicating growth data and weight development to parents. In Sustainable communication with parents, the school nurses described the value of creating a dialogue, a supportive approach to the parents, and the building of a relation between them and the parents as essential. In Barriers in communicating the child´s weight, the school nurses described the experience of stigma concerning the subject of overweight and obesity, increased concern when they detected underweight as well as an ambivalence towards measuring weight.ConclusionThe study highlights an educational challenge concerning the need for training, skills, and strategies for communication with parents. A variety of ways in school nurses’ communication with parents were identified in the present study and this shows an inconsistency in how School health services was offered and a need for the development of evidence-based procedures for communicating growth data and weight development to parents.

THE EXPERIENCES OF SOCIAL WORKERS PROVIDING MENTAL HEALTH SERVICES AT A MENTAL HEALTH FACILITY IN TSHWANE, SOUTH AFRICA

South Africa presents a high prevalence of mental health problems, with one in six South Africans being diagnosed with anxiety, depression and substance-use problems (excluding more severe conditions such as bipolar disorder or schizophrenia). The incidence of mental health problems is ranked third after HIV and other infectious diseases in determining the disease burden. Social workers are key professionals in rendering interventions and services aimed at treating persons with mental health problems. In this qualitative study, ten purposively sampled social workers providing mental health services at a mental health facility in Tshwane, South Africa were interviewed. The thematic analysis generated seven themes, four of which are discussed. The findings reveal that social workers are adequately capacitated to provide mental health services and are one of the key mental health service providers. Recommendations for practice are provided. Keywords: experiences, mental health, mental health services, mental healtcare user, social worker

Knowledge, attitude, and practice of vaccine vigilance among the post-graduates in tertiary care hospital, Telangana

Background: To make sure that the hazards of using medications do not outweigh the benefits, the safety of medicines has been given more consideration. This is the rationale behind the pharmacovigilance system’s development over many years. This is based on patient and health-care provider reports of adverse responses observed. Vaccinations are an integral part of the prevention of infectious diseases; therefore, good knowledge, a better attitude, and good practice toward its usage are of utmost importance. Being future key health-care professionals, medical post-graduates have an immense responsibility to report adverse drug reactions (ADRs). Hence, the present study was taken to determine the knowledge, attitude, and practice regarding vaccine vigilance among post-graduates. Aims and Objective: The aim and objective of the study are to evaluate the post-graduate knowledge, attitude, and reporting practices regarding adverse events following immunization (AEFI). Materials and Methods: The study was conducted on post-graduates in a tertiary care hospital. A standardized questionnaire on vaccinevigilance was distributed among 120 participants and ethical approval was taken before the study. A total of 38 questions about knowledge, attitude, and reporting practices regarding AEFI were developed and distributed to post-graduate students of respective clinical departments. Data were analyzed using SPSS software. For data comparisons, chi-square test was used. P ≤ 0.05* was considered as statistically significant. Results: The study showed that a majority (95.8%) in the 25–36 years of age group with female predominance (52.5%) and a high percentage (55.8%) of study participants were 2nd-year post-graduates. The knowledge (χ2 = 12.645, P = 0.03) of the participants was found to be accurate with a good attitude (χ2 = 69.082, P = 0.01) and practicing behavior (χ2 = 33.711, P = 0.01). Conclusion: Accurate knowledge, attitude, and practicing behavior were observed in post-graduates in the present study. The majority of medical post-graduate students felt that ADR reporting and monitoring are very important and add to patients’ safety.

FROM ‘VICTIM’ TO ‘SURVIVOR’: DECONSTRUCTING THE PERVASIVE NOTION OF VICTIMHOOD IN DISCOURSES AROUND PROGRAMMES DEALING WITH GENDER-BASED VIOLENCE

Social workers are among key professionals rendering empowerment services to people affected by gender-based violence in South Africa. These services are rendered within the developmental and empowerment approaches that were introduced in the post-apartheid era. Although the introduction of democracy brought a paradigm shift towards a developmental approach, social welfare and social work, there is paucity of research that investigates the utilisation of the concept of “victim” within the empowerment services rendered to people harmed by gender-based violence. The concept of “victim” has not been extensively researched theoretically and empirically. This article critically analyses the usage of the concept of “victim” in the empowerment social work services and posits a deconstruction of the pervasive notion of victimhood in discourses around programmes dealing with gender-based violence. It is hoped that this article will stimulate debates and research focused on the labels adopted in the empowerment services, as well as in developmental and social work in different societal contexts. Keywords: developmental approach, empowerment, social work, survivor, victim

The weak institutionalisation of prior consultation in Peru: ambivalent cooperation between indigenous organisations and state activists

This paper explains how a comparatively weak Indigenous movement succeeded in establishing a precedent of Indigenous prior consultation reform in a national context adverse to Indigenous rights. The in-depth study of Peru shows that alliances between civil society actors and people inside certain state institutions who supported Indigenous claims can explain this outcome. The paper focuses on the collaboration of many human rights lawyers who became part of the Peruvian state. Still, the analysis also shows the limits and challenges of these alliances, particularly in the regulation phase. The paper shows that progressive state activists without strong ties to social movements, and the barriers they face inside institutional settings, can also contribute to the reproduction of weak institutions, particularly during the regulation phase of approved norms. The paper is based on long-term qualitative research in Peru. Data is culled from various source documents and semi-structured interviews with key actors, bureaucrats, Indigenous leaders and human rights professionals.

Emerging industry 4.0 and Internet of Things (IoT) technologies in the Ghanaian construction industry: sustainability, implementation challenges, and benefits

Future construction projects will need the implementation of industry 4.0 and Internet-of-Things (IoT) technologies. The construction sector has, however, falling behind other industries in the application of these technologies and is currently facing considerable challenges. One of the industries that lag behind in the use of new innovative technological tools is the construction industry. This study reviews the research work in industry 4.0 and the Internet of Things as they relate to construction and examines key Ghana-based construction professionals and firms to ascertain their level of understanding of these emerging innovative technologies, including the challenges and benefits associated with their implementation. An extensive review of pertinent literature was done to help identify the important paradigms and variables which were cautiously tested. Adopting a quantitative research approach, the attained variables were used to design into a close-ended questionnaire. The sample frame was a survey of people from 154 construction experts and researchers with good standing by using the purposive sampling. Relative importance index (RII) analysis was used to analyzed the data. It was discovered from the findings that smart construction was the most popular industry 4.0 technology in the Ghanaian construction industry. The most important benefit of these technologies is that they will add sustainable policy requirements to tendering, with the most pressing technology being the lack of talent and skills in using industry 4.0 and IoT technologies. The scope of this research is based on the questionnaire survey, proving a sustainable pathway to the construction industry community, which creates its own significance by including key stakeholders and those affected by these technologies.

Where are the Women? Gendered Indian Digital Production Cultures Post #metoo

My article examines the influence of platformization in labor exchanges to assess how gendered expectations impact digital production cultures. It investigates the socio-cultural transactions that marginalized communities, especially women, from above-the-line professions have to navigate as they seek work opportunities on streaming services. Drawing on feminist production studies and media studies scholarships, the article discusses how gendered expectations become the norm in hiring creator labor. Through analysis of the data-set on the gender representation of key creative professionals in the Indian web series produced between 2014 and 2020, semi-structured interviews with creative professionals, and trade press literature, this research offers a nuanced understanding of how and why Indian on-screen dynamic representations and democratic entrepreneurial working structures do not eradicate gendered production norms. On the contrary, gendered interpretation of algorithmic data, the #metoo movement, and newer forms of sexism emerge alongside existing gendered production cultures to hamper the participation of women and minorities.

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future.

There are serious concerns with rising antimicrobial resistance (AMR) across countries increasing morbidity, mortality and costs. These concerns have resulted in a plethora of initiatives globally and nationally including national action plans (NAPs) to reduce AMR. Africa is no exception, especially with the highest rates of AMR globally. Key activities in NAPs include gaining a greater understanding of current antimicrobial utilization patterns through point prevalence surveys (PPS) and subsequently instigating antimicrobial stewardship programs (ASPs). Consequently, there is a need to comprehensively document current utilization patterns among hospitals across Africa coupled with ASP studies. In total, 33 PPS studies ranging from single up to 18 hospitals were documented from a narrative review with typically over 50% of in-patients prescribed antimicrobials, up to 97.6% in Nigeria. The penicillins, ceftriaxone and metronidazole, were the most prescribed antibiotics. Appreciable extended prescribing of antibiotics up to 6 days or more post-operatively was seen across Africa to prevent surgical site infections. At least 19 ASPs have been instigated across Africa in recent years to improve future prescribing utilizing a range of prescribing indicators. The various findings resulted in a range of suggested activities that key stakeholders, including governments and healthcare professionals, should undertake in the short, medium and long term to improve future antimicrobial prescribing and reduce AMR across Africa.

Primary Healthcare Nurses' Views on Digital Healthcare Communication and Continuity of Care: A Deductive and Inductive Content Analysis.

Primary healthcare in the Western world faces significant functional challenges, resulting in the implementation of digital communication tools. Nurses are key professionals in primary care and focusing on the impact of digital communication and continuity of care in primary care organisations is important. This qualitative descriptive study explores digital communication and continuity of care from primary healthcare nurses' perspective. Data from individual semi-structured interviews with 12 nurses were collected; deductive and inductive content analyses were performed. Three descriptive categories emerged from the deductive (digital communication as interpersonal, information, and management continuities) and inductive ('digital care does not suit everyone', 'new technology is contextually intertwined with daily work', and 'patient-positive aspects of digital information') phases. Additionally, a structural risk of obscuration of patients' needs by the contextual conditions emerged. To ensure digital communication-aligned continuity of care, compatible information technology systems should be developed. Allowing nurses to provide high-quality care based on their own values would enhance person-centred patient care.

How do students see the role of serious games in education?

Grabbing and holding student attention was a big challenge even before the Covid- 19 era; however, the coronavirus and the obligatory digital education showed that new methods are needed to resolve these issues. One of them could be implementation of digital serious games. This paper presents the findings of a questionnaire about the feelings of students toward digital serious games. In all, 1755 answers were collected and analyzed and the results showed that most students do not shy away from using these kinds of video games in a classroom environment, although there are various concerns and key aspects educational professionals must consider.

Transitioning from child to adult cleft lip and palate services in the United Kingdom: Are the NICE Guidelines reflected in young adults’ experiences?

ABSTRACT Cleft lip and/or palate (CL/P) is one of the most common congenital conditions worldwide. Individuals born with CL/P will embark on a long-term treatment pathway throughout childhood and often into adulthood. As they grow older, young people become more involved in medical decisions. The National Institute for Clinical Excellence (NICE) has published guidance for health professionals on how transitions of responsibility should be managed in health services. The aim of the current study was to examine the extent to which the NICE recommendations are currently being implemented in UK CL/P services according to young adults’ first-hand accounts. Semi-structured interviews were carried out with 15 young adults with CL/P aged 16-25 years. Interview questions were designed to map onto the NICE guidance. Data were analysed to assess whether each guideline was met, partially met, or not met for each individual participant. Overall, findings suggest that further consideration is needed as to how best to implement the recommendations effectively. The introduction of assigned transition workers in CL/P services to co-ordinate transition to adult care offers one possible solution. Focusing on the provision of holistic, patient-centred care, this aspect of the CL/P service could include giving patients access to medical history documentation, liaison with key health professionals including GPs and dental practitioners, and the development of age-appropriate resources to facilitate the transition process.

Managing risk: social workers’ intervention strategies in cases of domestic abuse against people with learning disabilities

Social workers in England are key professionals involved in addressing safeguarding concerns affecting adults with learning disabilities, including the risk of harm from domestic abuse. This article reports the findings from an empirical study conducted with 15 social workers who participated in a 2-stage interview process. The findings and discussion examine social workers’ approaches to risk management interventions in cases of domestic abuse against adults with learning disabilities. Informed by Beck’s Risk Society theory, our analysis finds that interventions often focus on individuals taking responsibility for managing risk, with either the victim or the social worker becoming the risk decision-maker. Furthermore, in carrying out their work, social workers used bureaucratic tasks to protect the organisation and individual decision-makers from blame. The article concludes with recommendations for practice which explores more holistic understandings of risk and which seeks to promote more collective responses to risk management.

How did living in temporary accommodation during the COVID-19 pandemic affect children younger than 5 years' access to health care and health outcomes? A qualitative study of key professionals in a socially and ethnically diverse and deprived area of London

BackgroundChildren younger than 5 years living in temporary accommodation due to homelessness (U5TA) are extremely vulnerable to the effects of the COVID-19 pandemic. Few qualitative studies have examined provider perspectives in family homelessness, but none focused on U5TA specifically. We aimed to qualitatively explore professionals' perspectives of pandemic-related challenges and barriers experienced by U5TA in accessing health care and optimising health outcomes, and their experiences of delivering U5TA services. Methods16 semi-structured interviews were done online. Professionals working in the London Borough of Newham with U5TA families were purposively sampled and recruited from non-profit organisations, the health sector, and local authority. A thematic codebook approach was used to analyse the data combining inductive and deductive codes using an adapted socioecological model as a guiding theoretical framework. FindingsTwo non-profit organisation professionals, seven health visitors, one GP, therapist, dietician, nurse, public health consultant, and two social workers from the local authority's No Recourse to Public Funds team described adverse pandemic effects on U5TA health: delay and regression in developmental milestones and behaviours—eg, toileting, feeding skills, emotional regulation, and social-communication skills. Pre-existing systemic barriers were exacerbated during the pandemic when the reduction of in-person services with professionals necessitated remote delivery of health and social care services. Differential effects of digital poverty, language discordance, and inability to register and track U5TA rendered this population invisible to services. Professionals highly agreed that barriers to optimal health outcomes and service access included poor mental health, unsuitable housing, no social support, mistrust of mainstream services, immigration administration, financial insecurity, and loss of informal jobs among U5TA families. Professionals sometimes mitigated these barriers with good communication skills, developing trusting relations, and through community facilitators. InterpretationCOVID-19 widened health inequalities and inequities, substantially affecting the lives of U5TA and ability of professionals to deliver quality care to U5TA. Innovative and tailored cross-sector strategies, including co-production of public health services, are required. Policies and services urgently need to focus on early development, mental health support, employment training, and opportunities for parents and carers, plus unambiguous definitions of what is deemed suitable accommodation and actionable planned steps to ensure enforcement. FundingNone.

Response of Care Services for Patients with HIV/AIDS during a Pandemic: Perspectives of Health Staff in Bolivia.

The COVID-19 pandemic has caused an unprecedented crisis striking health services, generating risks of setbacks in health care and affecting the most vulnerable populations such as HIV patients. This study aims to explore the impact of the COVID-19 pandemic on the operational management of health services for people living with HIV/AIDS in Cochabamba, Bolivia. We applied a qualitative approach using semi-structured in-depth interviews with ten key health professionals who care for patients with HIV/AIDS in Cochabamba, Bolivia. Interviews were transcribed verbatim and uploaded to Atlas.ti software for analysis. We used an ethnographic approach within the interpretive paradigm to carry out the thematic analysis, considering the “Determinants of health systems resilience framework” of five dimensions developed by the World Health Organization. Even though the provision of services in public care services was not interrupted during the COVID-19 pandemic, health service delivery was severely affected. Digital technology could be used to compensate in urban areas. Regarding the distribution of medications, adaptative strategies to reduce patient complications were implemented. Unfortunately, the complementary tests availability was limited. The COVID-19 pandemic had a significant impact on HIV/AIDS patient care services in Cochabamba, with repercussions for HIV treatment access and virologic suppression.

Part of the solution yet part of the problem: factors of schizophrenia stigma in mental health professionals

Background Stigma is highly prejudicial to persons with schizophrenia, their families, the society and the health care system. Mental health professionals (MHP) are considered to be one of the main sources of schizophrenia stigma. Objectives The aim of the study was to identify individual and contextual factors associated with stigma in MHP in its three dimensions (stereotypes, prejudices, discrimination, Fiske, 1998). Methods An online survey was conducted with specific measures of MHP stigma (stereotypes, prejudices and discrimination). Four categories of potential associated factors were also measured: sociodemographic characteristics, contextual characteristics (e.g., Work setting), individual characteristics (e.g., Profession, Recovery-oriented practices) and theoretical beliefs (e.g., Biological beliefs, Perceived similarities, Continuum versus Categorical beliefs). Results Responses of 357 MHP were analysed. Factors that were the most strongly associated with MHP stigma were Perceived similarities, Categorical beliefs, Biological beliefs, Recovery-oriented practice and Work setting (independent practice). Conversely, Gender, Specific trainings in stigma or recovery and Cognitive aetiology beliefs showed no association with any of MHP stigma dimension. Remaining factors show associations with a weak effect size. Conclusions The survey results suggest that MHP stigma is more influenced by individual factors such as theoretical beliefs and recovery-oriented practices than contextual factors. These original results provide perspectives for reducing stigma in mental health practices. Key points Mental health professionals (MHP) considering they share similarities with persons with schizophrenia or believing that schizophrenia is not a discrete social category but rather the extreme on a continuum between ‘normal’ and ‘pathologic’ reported less stigmatisation. MHP holding higher professional utility beliefs and using recovery-oriented practice reported fewer stereotypes, prejudice and discrimination. Other factors such as age, academic level, contact frequency, familiarity and multidisciplinary practice show associations with a weak effect size.

Moving forward: Implementing health psychology research to improve patient acceptance of biosimilars.

As more biosimilars enter the pharmaceutical market, patient acceptance remains a significant barrier to their uptake. Psychological factors, such as negative expectations, are important causes of patient hesitancy. As a result, patients can develop nocebo responses following a transition, discontinue biosimilar treatment early, or have poor adherence. These negative outcomes may offset some of the cost-saving potential of biosimilars. Key healthcare professionals such as pharmacists, physicians, and nurses already play a noteworthy role in educating and transitioning patients. However, given the psychological aspect of biosimilar acceptance, it is logical for healthcare professionals and researchers to draw on research and theory from health psychology. This commentary outlines how a multidisciplinary approach can add to the understanding of the mechanisms behind patient resistance to biosimilars and help engage patients in the transitioning process. It also explores how health psychology strategies that have been successful in similar areas can be translated to help conduct more effective transitions. Future directions in research are discussed.

Psycho-social support to children infested by jigger in Kisii county: social work perspective

Social workers are key professionals in assessing social care need and providing psychosocial support. Nonetheless the needs in jigger infiltration containment and control are not well managed. Tungiasis is both a social and public health concern worldwide. It affects the victim’s quality of life through localization in the foot causing walking difficulties that reduce the normalcy of the infested child. Both social and psychological problems such as low self-esteem and stigma has been identified among the children infested with jiggers. The purpose of this study therefore was to investigate the role of a social worker in the prevention of jigger infestation among children in Kisii County. The study utilized descriptive survey design. The sample size was 50 pupils, 50 parents,20 Key Informants and 20 practicing Social workers. The findings of the study reveal that in order to mitigate Tungiasis, the risk factors that contribute to their spread such as poverty, poor hygiene conditions, area sanitization, inadequate health facilities, sharing houses with domesticated animals, political negligence and controlled number of children in families should be addressed. social work practitioners should engage with children to assess challenges in social functioning, process information in ways that enhance their ability to maintain body hygiene, develop skills to curb tungiasis and create support for change. The study recommends a change of behaviour in the community and the superstitions perception on the causes of Tungiasis.

Activating the child’s own natural desire to learn: Using neuroscience as a way to understand key issues in early childhood development and education

Brains are built over time, and the foundations of brain architecture are constructed early in life (Center on the Developing Child at Harvard University, 2016, p. 7). Therefore, the experiences a human being encounters during the first years of their life affect how the brain will develop. Furthermore, this means that aspects of the brain may be reinforced whilst others may be pared down. This evidences the importance of focusing on the educational journey offered to our youngest learners in schools. The introduction of a different approach to a philosophy of education revolving around inquiry-based learning through an emergent curriculum in Malta (MEDE, 2015) has allowed educators to tap into a child-centred pedagogy which allows the development of skills, knowledge, and understanding through active learning. This necessitates, however, an understanding of how learning occurs. The Universal Design for Learning framework may assist in this paradigm, as it provides a neuroscientific and psychological background to the ‘why’, ‘what’ and ‘how’ of learning (Meyer et al., 2014). The narrative inquiry in this research paper will outline the salient links between the science of learning and the creation of a meaningful learning journey, by acquiring and sharing the experiences of a kindergarten educator as a research participant implementing the emergent curriculum, and interviews with two key professionals in the area, linking educational neuroscience to flexible learning environments.

Nurses’ Perceptions of Caring for Elderly Patients at University Teaching Hospital’s Adult Hospital and Levy Mwanawasa University Teaching Hospital: Implications for Training

Nurses are key health professionals involved in the frontline care of elderly patients. WHO predicted that the proportion of people aged over 60 years will increase from 11% to 22% between 2000 and 2050. Aligned with this increase in the ageing population is a greater demand for nursing care. Nurses’ perceptions of caring for elderly is of global interest because of many reported negative perceptions and limited number of qualified nurses interested in the field of caring for elderly patients. This study aimed at exploring the nurses’ perceptions of caring for elderly patients at University Teaching Hospital and Levy Mwanawasa University Teaching Hospital in Lusaka. The study used a mixed methods approach. Data were obtained from 148 randomly and 18 purposively sampled nursing staff. Binary Logistic Regression and content analysis of main themes were used to identify factors associated with perceptions of caring for elderly patients. Majority of the nurses (81%) had negative perceptions towards care of elderly patients. There was no statistical significance between social demographic data, knowledge of caring, availability of resources, staffing levels and management support and perceptions of caring for elderly patients. This could have been due to a small sample size which was used. The negative perceptions about caring for elderly patients in this study could be associated with the lack of knowledge specific on care of elderly patients, training units and geriatric specific guidelines for care of elderly patients. Therefore, the nursing curriculum content should be reviewed to include care of elderly patients, guidelines including hospital infrastructure, staffing and equipment friendly to care of elderly patients should be developed.