Practice In Conjunction Research Articles

Tailoring communication practices to support effective delivery of telehealth in general practice

BackgroundThe unprecedented increase in telehealth use due to COVID-19 has changed general practitioners’ (GP) and patients’ engagement in healthcare. There is limited specific advice for effective communication when using telehealth. Examining telehealth use in practice in conjunction with perspectives on telehealth as they relate to communication allows opportunities to produce evidence-based guidance for optimal use of telehealth, while also offering practitioners the opportunity to reflect on elements of their communicative practice common to both styles of consultation. The objective of this research was to develop evidence-based resources to support effective, person-centred communication when GPs and patients use telehealth. This included examination of interactional practices of recorded telehealth consultations, exploration of GP and patient perspectives relating to telehealth, and identifying priorities for guidance informed by these analyses as well as participant co-design.MethodsThis study involved recording telehealth consultations (n = 42), conducting patient surveys (n = 153), and interviewing patients (n = 9) and GPs (n = 15). These were examined using interaction analytic methods, quantitative analysis, and thematic analyses, to create a robust, integrated picture of telehealth practice and perspectives. The process of research translation involved a co-design approach, engaging with providers, patients, and policy makers to facilitate development of evidence-based principles that focus on supporting effective communication when using telehealth.ResultsThree key themes relating to communication in telehealth were identified across the different analyses. These were relationship building, conversational flow, and safety netting. The draft best practice principles drawn from these themes were modified based on co-design feedback into five Best Practice Principles for Communication between GPs and Patients using Telehealth.ConclusionsEffective communication is supported through relationship building and attention to conversational flow in telehealth consultations, which in turn allows for safety netting to occur. In telehealth, GPs and patients recognise that not being co-present changes the consultation and use both intuitive and strategic interactional adjustments to support their exchange. The mixed-method examination of experiences through both a detailed analysis of telehealth consultations in practice and comparative exploration of GP and patient perspectives enabled the identification of principles that can support effective communication when using telehealth. Co-design helped ensure these principles are ready for implementation into practice.

Understanding attrition of early career midwives in Australia

ProblemThere is a lack of understanding of the experiences of early career midwives which lead to workforce attrition. BackgroundIn the Australian midwifery setting, workforce attrition in conjunction with the ageing profile of the workforce is of increasing concern. Midwives in the earliest stages of their career are most vulnerable to career attrition, however limited research specifically engages with this cohort. AimTo understand the professional and social circumstances that led early career midwives to leave clinical practice, how their midwifery background influenced career trajectories, and what would compel them to return to clinical practice. MethodsSemi-structured interviews were conducted with 11 early career midwives who had left the profession within 5 years of qualification. Transcripts underwent thematic analysis. FindingsThree themes described early career midwives’ experiences: transition to professional practice, an untenable workplace culture, mental health impacts of early clinical midwifery practice. Two further themes emerged about experiences post-midwifery careers: influence of midwifery on subsequent career, and conditions for re-entry. DiscussionChallenges with transitioning to professional midwifery practice in conjunction with untenable workplace culture led to such deterioration in wellbeing that remaining within the profession became unfeasible for early career midwives. Desire to remain within health care was apparent, however re-entry to the profession was deemed by most to be out of the question. ConclusionEarly workforce retention strategies should be the focus of future workforce planning and policy. Larger scale inquiry foregrounding early career midwives is necessary to inform strategies for midwifery workforce retention in Australia.

Assessment of artificial intelligence model and manual morphokinetic annotation system as embryo grading methods for successful live birth prediction: a retrospective monocentric study

PurposeThe introduction of the time-lapse monitoring system (TMS) and the development of predictive algorithms could contribute to the optimal embryos selection for transfer. Therefore, the present study aims at investigating the efficiency of KIDScore and iDAScore systems for blastocyst stage embryos in predicting live birth events.MethodsThe present retrospective study was conducted in a private IVF Unit setting throughout a 10-month period from October 2021 to July 2022, and included the analysis of 429 embryos deriving from 91 IVF/ICSI cycles conducted due to infertility of various etiologies. Embryos incubated at the Embryoscope+ timelapse incubator were analyzed through the established scoring systems: KIDScore and iDAScore®. The main outcome measure was the comparison of the two scoring systems in terms of live birth prediction. Embryos with the higher scores at day 5 (KID5 score/iDA5 score) were transferred or cryopreserved for later use.ResultsEmbryos with high KID5 and iDA5 scores positively correlated with the probability of successful live birth, with KID5 score yielding a higher efficiency in predicting a successful reproductive outcome compared to a proportionally high iDA5 score. KID5 demonstrated conservative performance in successfully predicting live birth compared to iDA5 score, indicating that an efficient prediction can be either provided by a relatively lower KID5 score or a relatively higher iDA5 score.ConclusionThe developed artificial intelligence tools should be implemented in clinical practice in conjunction with the conventional morphological assessment for the conduction of optimized embryo transfer in terms of a successful live birth.

The historical aspect of the development of school theater

Introduction. In modern realities, the education system needs an innovative approach to teaching the younger generation, as it requires mobile and universal methods. One of the methods is theatrical practice in conjunction with pedagogical practice. Considering the path of development of school theater, we turn our attention to the interaction of these two areas, to how the approach changes through theatrical practice depending on the current time, highlight the positive features in the process of using school theater as a tool in the educational system.By studying Russian and foreign experience in the application of this technique, we note the details that require transformation, we study the methods of applying the technique that are suitable for use at the present time.Materials and Methods. When writing this article, a theoretical analysis of domestic and foreign literature, the study of scientific articles and other publications on the research topic, as well as generalization and systematization of the results of domestic and foreign studies were used.Results. The process of development of school theaters in the course of the historical transformation of society (in particular, in Russia) is considered; the features of the application of the theatrical system and the processes characteristic of it in conditions that relate to school theaters are indicated; the processes of development of school theaters in different historical periods in Russia and abroad were compared.Discussion and Conclusions. The processes of change observed in modern society require adjustment of the pedagogical and psychological approach and other ways of using the means of theatrical school pedagogy in the Russian system. Based on the methods of using school theater in other countries and the Russian experience of past years, we can make positive changes in the domestic practice of using theater in schools.

S-37-1: PROGNOSTIC UTILITY OF MORNING BLOOD PRESSURE SURGE

Morning blood pressure surge (MBPS), defined as the difference between morning systolic blood pressure and the lowest nighttime systolic blood pressure, is a normal physiological phenomenon of diurnal blood pressure variability (BPV). Exaggerated MBPS is associated with morning hypertension and has been associated with adverse cardiovascular and cerebrovascular events, especially hemorrhagic stroke. However, MBPS has low reproducibility and there is an ethnic difference in the amplitude of MBPS and its prognostic value. More evidence is needed to prove its clinical usefulness in the management of hypertension. Since the risk of MBPS is mainly attributable to the elevated morning blood pressure, the focus therefore has shifted from MBPS to the control of morning hypertension. Because MBPS focuses only on the amplitude rather than the rate of blood pressure rise, we calculated the MBPS rate as the slope of linear regression of sequential systolic blood pressure measures on the time intervals within the MBPS period. We found the reproducibility for the MBPS rate was better than the MBPS amplitude. The MBPS rate was a more sensitive and reliable prognostic factor of long term mortality than the MBPS amplitude. The prognostic values of MBPS rate were comparable in subjects with or without morning and nocturnal hypertension. Because the MBPS rate can easily be calculated from the ambulatory blood pressure monitoring data, it could become a routine parameter in daily practice in conjunction with other routinely derived parameters including MBPS amplitude.

A study of the patterns of prescriptions for heart diseases in The Four Tantras (rGyud bZhi) based on the Tibetan medicinal properties theory

Objective: To reveal the internal and effective rules of prescription compatibility for treating heart diseases in the four tantras. Method: To compare the four kinds of disease in the four tantras. Result: Formulas for the treatment of loong(rlung) disease were mainly formulated sweet, pungent flavors with hot and greasy effects; formulas for the treatment of tripa(mkris-pa) were mainly formulated sweet, pungent and bitter flavors with cold and blunt effects; formulas for the treatment of beygen(bad-kan) were mainly formulated sweet, pungent flavors with hot and dynamic effects; and formulas for the treatment of khrag khrugs nad () were mainly formulated sweet, bitter flavors with cold and blunt effects. Conclusion: It can be seen that the four tantras have a rigorous and regular theory of prescriptions and strong theoretical guidance, which we need to study and learn in depth, and apply in clinical practice in conjunction with the properties of the disease.

Lithium replacement dose recommendations using Monte Carlo simulations.

Missed medication doses are a common clinical problem, and cause consternation when prescribing lithium because its plasma levels must be kept within a narrow therapeutic window. Therefore, this study set out to determine the potential impact of missed lithium doses on its pharmacokinetics, and to explore the optimal compensatory dosing scheme. This is difficult to determine clinically and in research because of ethical constraints and therefore we modelled the effects using simulations. Monte Carlo simulations were used to simulate lithium concentrations under different missed dose scenarios. For patients with normal renal function, the optimal replacement dosing scheme was selected based on the lowest percentage of deviation from the full adherence scenario. However, for patients with renal impairment the appropriate dosing schedule was selected based on the lowest number of simulated concentrations above the upper range of 1.2mEq/L. The impact of a missed lithium dose depended on its daily dose. The higher the daily dose, the higher the deviation from full adherence. In patients with normal renal function, replacement with a regular dose was most appropriate. But in patients with renal impairment, replacement with a partial dose appeared to be most suitable. This study has enabled insights into the optimal suitable lithium replacement dosing schemes for patients with normal renal function and renal impairment. These proposed schemes can be used cautiously in clinical practice in conjunction with clinician judgment and can also be used as a basis for future clinical research.

Real world use of peanut component testing among children in the Chicago metropolitan area.

Background: Peanut component tests (PCT) have become important in the evaluation of peanut allergy. There remains a paucity of research across the United States in investigating the utility of PCT in clinical practice in conjunction with current standards of care. Objective: The primary aims were to evaluate the performance and sensitization patterns of PCT in clinical practice when first available at our institution. Methods: We performed a retrospective chart review of 184 children with PCT and oral food challenge (OFC) results between 2012 and 2017. Simple logistic regression models assessed the associations between PCT and OFC outcomes. Receiver operator characteristic curves were constructed, and a predicted probability curve was derived for Ara h2. Results: The median (interquartile range [IQR]) age at OFC was 4 years (2-7 years), and 111 patients (60%) were boys. Ara h 2 was the most commonly sensitized PCT. Sixty-one patients (33%) reacted at OFC. Ara h 2 specific immunoglobulin E (sIgE) ≥ 0.35 kUA/L was associated with increased odds of reacting at OFC (odds ratio 5.91 95% confidence interval, 2.93-11.89; p < 0.001); however, 19 patients (37%) positive for Ara h 2 did not react. Ara h 2 sIgE of 0.49 kUA/L and 4.58 kUA/L were associated with 50% and 90% probability, respectively, of reacting at OFC. Among those sensitized only to Ara h 8 or 9 (n = 21), 86% had no reaction. There was no statistically significant association with polysensitization to Ara h 1, 2, and 3, and peanut OFC outcome. Conclusion: Although the Ara h 2 sIgE value was associated with clinical reactivity, a significant proportion of the patients sensitized to Ara h 2 tolerated peanut. OFC remains an important tool in the evaluation of peanut allergy.

Developmental evaluation of teaching quality: Evidencing practice

The evaluation of teaching quality and practice is increasingly important in higher education and usually done via student surveys (quantitative data) alone. Much less attention is given to teachers’ self-evaluations of teaching practice (qualitative data). This emphasis on quantitative over qualitative data can result in incomplete and biased measures of teaching quality, and inappropriate changes to educational practice, which may, in turn, negatively impact outcomes, experiences and university micro-cultures. In this paper, we present a case study of an international residential masters module, in rapid transition to online delivery during the COVID-19 pandemic, to demonstrate: 1) how developmental evaluation (DEval) can be used for rigorous critique of teaching practice in conjunction with student satisfaction data; and 2) how qualitative reflections on teaching practice can be transformed into justifiable evaluative evidence, using DEval theory and techniques. Our DEval approach, theorised and enacted using the community of inquiry framework, increased the teachers’ skills and confidence to plan and continually evaluate teaching-learning enhancements. We discuss the implications and benefits of DEval for teachers and universities when used to assess teaching quality. In addition, we expand on existing knowledge to provide clarification on the purposes and appearances of all levels of evaluation in higher education.

The Potential to Build Collective Capacity for Organisational Learning in the Context of Teachers’ Use of Digital Technology for School Improvement

This article considers how digital spaces focused on whole school improvement combined with supportive leadership may be mobilised towards building collective capacity for evidence-informed practice and organisational learning. This topic originated from a qualitative, multi-method design-based research (DBR) project that studied practitioners’ use of an online resource for primary school practitioners called Pathways for school improvement, designed by Oxford University Press (OUP). Semi-structured interviews, participant observations and a documentary analysis were conducted with teachers and senior leaders in five primary schools across England between 2014 and 2016. Connections were made with the dynamic approach to school improvement (DASI) that encourages practitioners to systematically engage with a variety of evidence in their reflections and efforts to design school and classroom improvement strategies. Pathways’ four-step system and series of systematised tasks under each step seemed to provide opportunities for practitioners to explore elements of theory and practice in conjunction with empirical and pupil performance data, and potentially guide them through how to collaborate with others in developing specific whole school approaches to improvement. Opportunities and challenges in developing collective capacity for improvement are also explored.

Detection of Preventable Fetal Distress During Labor From Scanned Cardiotocogram Tracings Using Deep Learning.

Despite broad application during labor and delivery, there remains considerable debate about the value of electronic fetal monitoring (EFM). EFM includes the surveillance of fetal heart rate (FHR) patterns in conjunction with the mother's uterine contractions, providing a wealth of data about fetal behavior and the threat of diminished oxygenation and cerebral perfusion. Adverse outcomes universally associate a fetal injury with the failure to timely respond to FHR pattern information. Historically, the EFM data, stored digitally, are available only as rasterized pdf images for contemporary or historical discussion and examination. In reality, however, they are rarely reviewed systematically or purposefully. Using a unique archive of EFM collected over 50 years of practice in conjunction with adverse outcomes, we present a deep learning framework for training and detection of incipient or past fetal injury. We report 94% accuracy in identifying early, preventable fetal injury intrapartum. This framework is suited for automating an early warning and decision support system for maintaining fetal well-being during the stresses of labor. Ultimately, such a system could enable obstetrical care providers to timely respond during labor and prevent both urgent intervention and adverse outcomes. When adverse outcomes cannot be avoided, they can provide guidance to the early neuroprotective treatment of the newborn.

The Gut-Brain Axis: Literature Overview and Psychiatric Applications.

Literature exploring the relationship between the intestinal microbiome and its effects on general health and well-being has grown significantly in recent years, and our knowledge of this subject continues to grow. Mounting evidence indicates that the intestinal microbiome is a potential target for therapeutic intervention in psychiatric illness and in neurodegenerative disorders such as Alzheimer disease. It is reasonable to consider modulating not just a patient's neurochemistry, behavior, or cognitive habits, but also their intestinal microbiome in an effort to improve psychiatric symptoms. In this review paper, we show that intestinal microbiota possess the ability to directly influence both physical and mental well-being; therefore, should be included in future discussions regarding psychiatric treatment. Clinicians are encouraged to consider patients' gut health when evaluating and treating psychiatric conditions, such as anxiety and depression. Optimization and diversification of gut flora through the use of psychobiotics-probiotics that confer mental health benefits-may soon become standard practice in conjunction with traditional psychiatric treatment modalities such as pharmacotherapy and psychotherapy.

Effects of Knowledge Sharing Practices in conjunction with Empowerment Program in Adolescent Pregnant Women towards Promoting Exclusive Breastfeeding: a randomized controlled trial

Background and importance of the problem: Even though the best natural diet to feed a baby is milk, therate of exclusive breastfeeding in the first six months of postpartum period remains below the threshold of International HealthOrganization especially in pregnant adolescents. The purpose of the research was to study the effects of the Knowledge SharingPractices with Empowerment Program in adolescent pregnant women towards promoting exclusive breastfeeding during the first6months of postpartum period compared to obtaining a standard knowledge program of normal maternal breastfeedingtechniques.Instruments and methods: The study was conducted in 10 to 19-year-old pregnant women who were more than 32 weekspregnant, using randomized controlled trial (RCT), which divided the samples into two groups of the equal number: the studygroup and the control group. Each group has 40 people. The study group was given a knowledge sharing practices in conjunctionwith empowerment in pregnant adolescent women towards promoting exclusive breastfeeding as well as techniques to followup during 6 months of postpartum period while the control group received a standard knowledge program of normal maternalbreastfeeding techniques and follow-up during the postpartum period. The research tools included a Knowledge Sharing Practiceswith empowerment, and a strategy to track during the first 6 months of postpartum period, created by the researchers based onthe concept and theory of knowledge sharing practice in conjunction with empowerment strategies according to Gibson’s theory(1991) to stimulate exclusive breastfeeding during the first 6 months of postpartum period. The statistics used in the researchwere paired t-test, unpaired t-test, Chi-square test and multivariate logistic regression analysis.Findings: The exclusive breastfeeding rates during the first six months of postpartum in the study group was statisticallysignificantly higher than the control group at .05 level in the first 14 days (82.5% and 50.0%, P=0.005), the first month (77.5%and 50.0%, P=0.021), the first 2 months (62.5% and 35.0%, P=0.023), first 4 months (35.0% and 7.5%, P=0.008), first 5 months(25.0% and 2.5%, P=0.012) and the first 6 months during postpartum period (40.0% and 5.0%, P=0.002) and the mean score ofknowledge , including attitudes and perceptions of self-management competencies in breastfeeding in the study group after beinggiven the program was higher than the control group’s statistically significant at the .05 level (P<0.001).Conclusion of the research: Knowledge Sharing Practices in conjunction with Empowerment Program and follow-up strategiesto support postnatal breastfeeding could promote the rate of exclusive breastfeeding of adolescent mothers during the first 6months of postpartum period, statistically significant at the .05 level

Managing Patients with Insulin Pumps and Continuous Glucose Monitors in the Hospital: to Wear or Not to Wear.

Purpose of ReviewAs the prevalence of diabetes mellitus in the USA continues to rise, so does the popularity of diabetes management devices such as continuous glucose monitors (CGMs) and insulin pumps. The use of this technology has been shown to improve outpatient glycemic outcomes and quality of life and oftentimes may be continued in the hospital setting. Our aim is to review the current guidelines and available evidence on the continuation of insulin pumps and CGMs in the inpatient setting.Recent FindingsPatients with diabetes are at higher risk for hospitalizations and complications due to hyper- or hypoglycemia, metabolic co-morbidities, or as seen recently, more severe illness from infections such as SARS-CoV-2. The maintenance of euglycemia is important to decrease both morbidity and mortality in the hospital setting. There is consensus among experts and medical societies that inpatient use of diabetes technology in carefully selected patients with proper institutional protocols is safe and can improve inpatient glycemic outcomes and reduce hypoglycemia. During the COVID-19 pandemic, CGMs played a vital role in managing hyperglycemia in some hospitalized patients.SummaryInsulin pumps and CGMs have the potential to transform glycemic management in hospitalized patients. In order for institutions to safely and effectively incorporate these technologies on their inpatient units, hospital-based providers will need to be able to understand how to manage and utilize these devices in their practice in conjunction with diabetes experts.

Harmonic motion imaging of human breast masses: an in vivo clinical feasibility

Non-invasive diagnosis of breast cancer is still challenging due to the low specificity of the imaging modalities that calls for unnecessary biopsies. The diagnostic accuracy can be improved by assessing the breast tissue mechanical properties associated with pathological changes. Harmonic motion imaging (HMI) is an elasticity imaging technique that uses acoustic radiation force to evaluate the localized mechanical properties of the underlying tissue. Herein, we studied the in vivo feasibility of a clinical HMI system to differentiate breast tumors based on their relative HMI displacements, in human subjects. We performed HMI scans in 10 female subjects with breast masses: five benign and five malignant masses. Results revealed that both benign and malignant masses were stiffer than the surrounding tissues. However, malignant tumors underwent lower mean HMI displacement (1.1 ± 0.5 µm) compared to benign tumors (3.6 ± 1.5 µm) and the adjacent non-cancerous tissue (6.4 ± 2.5 µm), which allowed to differentiate between tumor types. Additionally, the excised breast specimens of the same patients (n = 5) were imaged post-surgically, where there was an excellent agreement between the in vivo and ex vivo findings, confirmed with histology. Higher displacement contrast between cancerous and non-cancerous tissue was found ex vivo, potentially due to the lower nonlinearity in the elastic properties of ex vivo tissue. This preliminary study lays the foundation for the potential complementary application of HMI in clinical practice in conjunction with the B-mode to classify suspicious breast masses.

Role of IP Due Diligence in Patent Area under Chinese Jurisdiction

With the advent of economic globalization, a growing number of countries have realized the value of IPRs in enhancing their competitiveness in the world economy. Intellectual property protection has become a worldwide concern in terms of cross-border competition. The acceleration in technology development and money-spinning compensation in lawsuit makes patents particularly crucial among other IPRs for a company to compete towards market rivals. IPDD is of great legal importance in terms of listing, M&A, independent R&D and infringement lawsuits. IP assets, including but not limited to patents drive many high technology strategies. For a variety of reasons, too many high-tech companies own patent rights without having an accurate understanding of the true value and real/potential risks associated with their patent portfolios or without initially developing and executing an assessment to thoroughly understand what their patent portfolios will entail. Serious consequences of IP due diligence failures take place again and again. As a consequence, it is of particular importance to conduct specific IPDD based on different needs in different scenarios. From the perspective of patent rights, the IPDD project mainly includes dealing with patentable subject matter, patentability requirements, scope of protection, prosecution of patent applications, and, e.g. enforcement and patent litigation. All these issues find a close match in statutory rules and their court interpretation. Thereby the sight for many issues decisive for successful exploitation of patents, but also all other forms of IP rights, as well as the reasons underlying their justification, often fall short. This applies to decisions such as: whether to invest into a risky RD whether and where to file and prosecute a patent application; whether to exploit a patent in own manufacturing activity, or to use it as a strategic tool against competitors; whether to license or assign a patent to a third party, or whether to take a license, or acquire a third party patent; finally, e.g., whether to acquire or not to acquire a company or to merge with it, in view of its patent portfolio. Taken these into consideration, the main discussion of the thesis includes the discussions on the objectives and limitations of IPDD, the instrument of IPDD and the role of due diligence in different scenarios. The study shows that conducting an IPDD will not only provide a pre-warning of a potential IP infringement but also assist in building up a promising business plan. IPDD can also help a company to determine the nature of IP protection in demand, estimate the possibility of IP disputes, avoid pitfalls in M&A and minimize the damage in the event the infringement established. For China, an IP latecomer, the experience and development of other jurisdictions may shed some light on how to make full use of IPDD in China. However, it is not advisable to transplant the other jurisdiction into China’s legislation totally and uncritically. China's IP protection system still leaves room for the judicial practice to evolve in many aspects. The full utilization of IPDD needs to be refined in the ongoing practice in conjunction with China's national conditions.

Building a foundation for utilizing evidence based practice in conjunction with research in baccalaureate nursing program

Less is known about the undergraduate nursing students’ ability to conduct beginning research. This study aims to explore and describe nursing students' experiences in planning and implementation of community health fairs; and utilizing evidence based practice integrated with research as a learning outcome. The study using a quantitative and descriptive design was conducted by senior nursing students during diverse community health events as a part of Gerontological nursing clinical. The students utilized three fall assessment tools: Balance and Gait test, Timed Up and Go test, and 10-year Fracture Risk Calculation. A total of 74 students participated in seven community health fair events focused on Fall Prevention. This health fair event was in conjunction with the National Fall Prevention Awareness week. A total of 201 older adults were served during the event by nursing students who provided screening process and related health education. Data were gathered and a group of students volunteered to complete the research process. The students participated in oral presentation in the Annual University Research Student Symposium and had poster presentation in the professional academic conference. Early systematic organized planning of the clinical experience gives students opportunity to integrate evidence based practice into research. Application of varied evidence based assessment tools focused on older adults enables students to understand the health issue in depth and the need for additional services. Health fair experiences improve students’ communication and education skills, reality of health issues of the target population in a community, and evidence based research.

Transitioning from expert nurse to novice educator

Transitioning from expert nurse to novice educator

Enhancing Direct Practice with Forgotten Australians: What is the Experience of Service Providers?

ABSTRACT The term “Forgotten Australians” refers to adults who as children were placed in out-of-home care in Australia between 1920 and 1989. Following the Australian Government’s apology to Forgotten Australians in 2009, the Federal and State Governments funded specific services to address the lifelong consequences of abuse and neglect inflicted upon Forgotten Australians. The impacts include difficulty forming and maintaining relationships, poor educational outcomes, unemployment, and poverty. The ability of service providers to engage Forgotten Australians and provide appropriate counselling has been given little research attention. This article reports on a survey of providers delivering counselling to Forgotten Australians regarding their knowledge and experiences in delivering services. Effective practice with Forgotten Australians requires knowledge of the history of Forgotten Australians, the uniqueness of the experiences of individual Forgotten Australians, and working within respectful relationships. The study highlights that preparing counsellors to work with Forgotten Australians requires specific training. IMPLICATIONS Service providers who work with Forgotten Australians (care leavers) require an understanding of the historical context in which Forgotten Australians experienced abuse and neglect while in institutions and out-of-home care. The compounding long-term impacts of institutionalisation affect Forgotten Australians in numerous ways, pointing to a need for targeted service delivery for this group. Key professional disciplines need to include knowledge and skills to work with Forgotten Australians (care leavers) in their curricula to promote best practice in conjunction with training across a range of services that promote service providers’ understanding of the experiences of Forgotten Australians. Service delivery should be empowering, non-hierarchical, and encompass understandings of trauma and attachment.

Costume, nostalgia and sexuality in murder mysteries by Maria Lang and their adaptations

Crime novels by the prolific Swedish writer Maria Lang have been adapted into films during two periods: 1960–61 and 2013. This article situates the resulting films as media products of their time and examines the functions of costume and film style in the two adaptation periods. The article identifies nostalgia in Arne Mattsson’s 1960–61 films in how they contribute towards an old-fashioned film style. The string of films from 2013 engages in nostalgia-as-tourism and positions itself as ‘cosy crime’ by activating viewers partly as consumers and inviting them to a viewing mode of vintage window-shopping. The article locates nostalgic pastness in the assembling or dissembling of layered outfits, exploring this practice in conjunction with murder, vulnerability and culpability. Finally, the article traces attitudes towards sexuality and sexualization, addressing notions of respectability, the sexual liberation of contemporaneous Sweden (the ‘Swedish sin’) and points of contact between good taste, dress style and sexuality.