Pro Bono Research Articles

Simplifying acquisition of essential diagnostics: A comprehensive costing tool for anatomic pathology.

Histopathology is the core diagnostic tool for cancer in pathology laboratories around the world, but there are disparities in access to diagnostics globally. As recognition of the need for cancer care and treatment grows, especially in the wake of World Health Organization programs for cervical, breast, and pediatric cancers, policymakers and health care funders are seeking tools and processes that allow for the largest number of patients to receive a diagnosis at the lowest cost. As histopathology represents the most cost-effective diagnostic method by sheer number of tumor types and volume, understanding the detailed logistics and costs for histology as well as the impactful benefits of economies of scale (ie, larger volumes are less expensive per patient) and scope (ie, the multiple stains available after basic histology sectioning) is paramount to planning an effective publicly funded or government laboratory. Understanding the economic structure of a country's population along with the financial model of a histology laboratory also leads to a market understanding of private laboratories, which can provide services at a profit as well as pro bono services more cost-effectively than purely public laboratories. We have developed a comprehensive, scalable costing tool of a functioning histology laboratory that accounts for all feasible costs and variations in models of service. The tool allows for a standardized approach to selecting goods needed to provide histology services and serves as a guide for implementation of pathology services. Using the tool, laboratories can achieve self-sustainment and long-term financial health while incorporating a proportion of impoverished patients who cannot afford out-of-pocket expenses.

Civil engineering employers engagement in work-integrated learning

In this paper I provide two case studies of enhancing undergraduate students’ learning through Work-Integrated Learning (WIL). Both interventions involve university-industry partnerships with local and regional civil engineering employers. Industry Mentoring (2010-2024) is a curricular activity with an authentic assessment. Third-year students mentees (N=1130) were mentored by 298 practising civil engineers, representing 80 employers. Civil Engineering 4 Real (CE4R, 2012-2024) is a co-curricular hybrid programme of problem / project-based evening workshops (N=133), attended by 594 students with circa 2867 student attendances, supported by 218 engineers, representing 76 employers. Industry Mentoring and CE4R support students to network with employers, enhance their employability skills, and shape their professional identity. Through their pro bono assistance, employers have established a talent pipeline, recruiting students for summer placements and graduate jobs. For employers, their engagement provides evidence of enacting their Corporate Social Responsibility (CSR) through providing a social value contribution to a local university.

The American Academy of Emergency Nurse Practitioners: The First Years.

In 2014, Dr. Elda Ramirez, alongside Dr. Arlo Weltge and Dr. Kyle Kincaid, founded the American Academy of Emergency Nurse Practitioners (AAENP) to support nurse practitioners working in emergency care. With initial support from 39 dedicated individuals, AAENP was incorporated in Texas and received pro bono management from an association management company. Over the years, AAENP has focused on defining the emergency nurse practitioner (ENP) role, developing a board certification examination, and creating standardized curricula for ENP programs. Strong collaborations with organizations such as the American Association of Nurse Practitioners (AANP) and the American College of Emergency Physicians (ACEP) have been pivotal. AAENP has grown significantly, now boasting over 1100 members, and has produced numerous evidence-based position statements and publications. This article highlights AAENP's achievements, and the challenges faced in its formative years, showcasing its commitment to advancing the ENP profession and ensuring quality care in emergency settings.

“Have we lost a part of our soul … [to] the result on the bottom line”? Reconfiguring professional spaces and the development of lawyers’ pro bono work as a professional project in Denmark

ABSTRACT Danish lawyers have long positioned themselves as fundamental pillars of the Rechtsstaat, portraying their independence and adherence to professional ideals as central to serving the public good. However, this traditional image has been increasingly challenged by the rise of large law firms taking advantage of deregulation and globalization. This has placed lawyers under a cross-pressure forcing them to compromise on their traditional defining characteristics. Large law firms, serving as advisors to clients such as major corporations and organizations, have distinguished themselves from the rest of the legal field with new professional projects. To regain some of the lost credibility, the largest law firms reformulated voluntary work as a professional project from being legal aid to individuals to US models of pro bono directed at NGOs and charity leading to further differentiation between lawyers. This article examines this dilemmatic cross-pressure between the differentiation of professional spaces in Denmark and the development of voluntary work as professional projects to regain the lost credibility as a profession working for the common good. It is based on a qualitative document analysis of 632 issues of the Danish Bar and Law Society's trade magazine for the period between 1976 and 2018 and qualitative interviews.

Pro bono in the real World: A comprehensive review of the literature and recommendations for meaningful engagement

Background and PurposeThe APA’s Ethical Principles for Psychologists explicitly addresses and humbly encourages pro bono work: “psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.” Yet, there is ambiguity surrounding the specifics, including frequency, time commitment, eligible services, and fair selection process to determine who will receive services. Materials and Methods: This manuscript provides the results of a comprehensive literature review on pro bono work. Initially focused on psychological assessment (e.g., neuropsychological, psychoeducational), the literature search expanded to therapy, community-based practice, and fee/paid assessment studies due to the dearth of literature. The purpose of the review to explore pro bono services in order to better understand in the future how services impact a child’s access to education, family engagement, and school relationships. Results: Two primary and secondary searches were completed. The primary search investigated the involvement of the family system when working with children and adolescents. The secondary search looked at the effectiveness of psychological, neuropsychological, and psychoeducational assessments to bolster results and provide additional recommendations and future directions. Discussion: The paper also features detailed recommendations based on the search results for how clinicians can engage meaningfully in pro bono work in their current practice along four main themes: community clinic, crisis, equity, and family support. Conclusion: Finally, future directions will address the substantial gaps in the literature on this subject.

Impact of Experiential Learning in a Pro Bono OT Clinic on Clinical Reasoning Development

Abstract Date Presented 03/23/24 This poster will describe the impact of a pro bono OT clinic on clinical reasoning development. It will summarize factors that influence student growth, such as specific clinic structure and learning activities to foster professional growth. Primary Author and Speaker: Julie A. Sandvig Additional Authors and Speakers: Paula H. Kitzenberg, Debra Hanson

Operations of a Student-Run Asylum Clinic: Frameworks, Challenges, and Recommendations

Abstract Student-run asylum clinics within medical schools represent a promising alternative to costly medicolegal services for people seeking asylum by providing pro bono forensic medical evaluations. However, there exist significant operational barriers to creating and developing such clinics, which depend largely on volunteerism and limited financial budgets. This policy and practice note not only presents a framework aimed at navigating these barriers in developing a student-run asylum clinic but also outlines critical challenges and recommendations for addressing them. We describe three principal components of clinic structure: community outreach and service, administration of forensic medical evaluations, and continuity of care. We also highlight challenges, such as access to a physical space for evaluations, maintenance of interpreter access and quality, standardization of clinician evaluator expectations, clinician evaluator availability, and evaluator wellbeing. Recommendations include the incorporation of a diversity of referral sources, opportunities for clinician-clinician shadowing, evaluation quality assessment, affidavit standardization, and development of interdisciplinary partnership.

Elizabeth Bagshaw: Pioneer of Canadian Women's Health.

Dr. Elizabeth Bagshaw, an esteemed figure among Canada's female physicians, devoted over seven decades to advancing obstetrics and reproductive health. She defied conventional norms by pursuing medical education and graduating from the Ontario Medical College for Women in 1905. Throughout her illustrious career, Bagshaw demonstrated exceptional perseverance, navigating familial obligations following her father's untimely passing during her academic pursuits. Establishing her practice in Hamilton, Ontario, Bagshaw delivered over 3,000 neonates, frequently offering pro bono care to immigrant populations. Notably in 1932, Bagshaw assumed the role of Medical Director of Canada's first birth control clinic, challenging restrictive legislation and paving the way for the legalization of contraception in 1969. Bagshaw's efforts provided women with vital reproductive health services and information, significantly impacting public attitudes and legislation. Beyond her medical practice, Bagshaw also played a pivotal role in mitigating public health crises, including the Spanish flu, and ventured into politics with a city council campaign in 1934, supported by The Women's Civic Club. Her extensive contributions earned her numerous accolades, including posthumous induction into the Canadian Medical Hall of Fame in 2007. Bagshaw's enduring legacy is reflected in the Elizabeth Bagshaw Clinic, which continues to offer reproductive and abortion care in a confidential and supportive setting. Bagshaw's pioneering work significantly advances health equity and women's reproductive rights, leaving a lasting impact on healthcare worldwide. Her life and achievements underscore her role as a tireless advocate for women's health and a transformative influence in medical history.

Institutional discrimination and local chauvinism. The combative role of pro bono lawyers in defence of migrant minorities’ welfare rights

ABSTRACT The paper deals with the issue of institutional discrimination in relation to the welfare access of migrant minorities in Italy, with a specific focus on the subnational level. Adopting a socio-legal approach that is based on a series of lawsuits, it discusses the role of pro bono legal advocacy in identifying and removing bans introduced by territorial administrations against migrant minorities. First, the paper examines what kind of explicit and implicit criteria of exclusion were introduced. Second, it explores the reasons behind, highlighting why and how «Italians first» has become a widespread welfare politics at subnational level as well as to what extent such sentiment has led to an obstinate resistance for the application of anti-discriminatory principles. Third, the paper brings to the attention the series of obstacles that pro bono lawyers encounter in their activity, showing which problems influence their mission against institutional discrimination in Italy.

Once a Muslim Always a Muslim: The Rise and Fall of the Muslim American Protagonist in Ayad Akhtar’s Disgraced

The post 9/11 atmosphere of terror made Muslim Americans highly visible in the U.S.and they have been viewed as potential terrorist suspects. Therefore, in the light of these circumstances, Ayad Akhtar’s Play Disgraced is most apropos to be revisited as his works focus on the existence of Muslims in America as a post-colonial contact zone. In fact, the play puts the interracial marriage of Amir, and his wife Emily, a White American woman on center stage and makes it fall down before our eyes. Despite the fact that Amir’s credentials qualify him to be a model minority citizen, and reach the American Dream, he falls out of grace as soon as he appears in court to show support as a pro bono lawyer to a Muslim Imam who is tried for raising fund for a mosque in the Middle East. This paper belabors the reasons that led to the reversal of the hero’s fortune from prosperity to misery in the wake of the collapse of New York twin towers.

Clinical Legal Education and Social Justice: Assessing the Impact on Law Students in a Law Clinic in Nigeria

One of the core missions of clinical legal education is to expose students to the legal needs of society while enhancing access to justice for indigent members of the community. This, the University of Ibadan Women’s Law Clinic (UI-WLC) does by offering pro bono legal aid to indigent women in the community who lack access to justice. In the process, law students are engaged in clinic experiences involving interaction with real clients and conduct of outreach programs for different target audiences within the community. Through these experiences, it is expected that professionalism, empathy, equality and and a sense of fairness is inculcated in the students. Students trained with these values ideally have a strong sense of what is just and fair, and are able to choose careers and lifestyles that support their immediate communities. Since its establishment, the UI-WLC has groomed over 960 law students; and currently has about 120 students spread over third, fourth and fifth year students, however, an assessment of the impact of social justice values which the clinic seeks to impart to the students through the training they receive at the clinic has not been carried out. This research seeks to achieve this aim through a mixed methods approach. Using a quota sampling method, 90 law graduates were identified and interviewed through self- administered pre-tested questionnaires and in-depth interview guides. Two sessions of focus group discussions were also conducted. Findings in this study revealed how participation in the UI-WLC through various activities and programs has had both positive and negative outcomes for the students. It also showed an aspect of group dynamics which has to be improved upon at the UI-WLC to better equip students to impact the society.

Navigating Vicarious Trauma: The Importance of Planning, Teaching, and Delivering Vicarious Trauma Training to Support Law Students and the Legal Profession

The significant effects of Vicarious Trauma (VT) are now being recognised in various professions, including law where the requirement for trauma informed practice’”[1] is now starting to be recognised. VT can be defined as: “a process of change resulting from empathetic engagement with trauma survivors. Anyone who engages empathetically with survivors of traumatic incidents, torture, and material relating to their trauma, is potentially affected” . Trauma- informed practice then focusses on how to work with those who have been impacted by their traumatic experience as a result of exposure to reading, writing, and hearing details of cases that they deal with. This may lead to a one-off feeling of despair or may be the result of the cumulative effect from working constantly with complicated, sensitive, and emotional materials and people. The legal professional may take on the emotions of a client and experience trauma that puts them in the place of the individual that they are trying to assist. Certain areas of the profession may be more prone to such experiences, for example criminal lawyers dealing with such cases as murder, manslaughter, and serious sexual offences. These feelings can be overwhelming, even for the most experienced practitioner. VT too, may also be experienced by students participating in Clinical Legal Education (CLE) undertaken in universities, again impacting on those involved in criminal case work where students have their first exposure to complicated and sensitive cases. This article considers the experience of members of the Criminal Justice Clinic (CJC), within the Open University (OU) and looks at the scope and impact of the VT training that is being delivered and its importance in preserving students’ mental well-being. Added is the factor of this being an online only clinic where isolation can also be an issue. There is a need to provide VT training to support the mental welfare of students, and staff alike. This training is paramount to the success of the CJC and is pivotal to any CLE provision and should be expanded to the law curriculum and onto legal practice. This article argues that the experience in the CJC demonstrates that there is a need for professional legal education to recognise and address the incidence of VT and to provide skills to those who may be affected. Consideration is given to measures that should be adopted in the delivery of CLE to support students participating in pro bono projects. This should carry on beyond university into their future careers. A brief mention will be made of the provisional results of a small-scale research project in this area. Another article is planned to discuss those results fully in the future. [1] Victims, Witnesses, and Justice Reform (Scotland) Bill as introduced references the introduction and definition of trauma -informed practice. https://www.parliament.scot/-/media/files/legislation/bills/s6-bills/victims-witnesses-and-justice-reform-scotland-bill/introduced/https://www.parliament.scot/-/media/files/legislation/bills/s6-bills/victims-witnesses-and-justice-reform-scotland-bill/introduced/bill-as-introduced.pbill-as-introduced.pdf (accessed 12th January 2024).

Lawyers' legal aid participation: A qualitative and quantitative analysis

AbstractThis article develops a framework to understand the legal profession's participation in providing services to indigent clients. Our theory is based on two factors: whether lawyers have successful practices, and whether the legal aid delivered to indigent clients is free or below market price. Pro bono signals moral high ground in the profession. Conversely, a regime in which legal assistance is provided at a discounted market price (“low bono”), an under‐explored area in the literature, attracts less competitive attorneys, and doing legal aid cases is perceived as signifying incompetence in one's professional capacity. Using a unique, comprehensive data set on all legal aid lawyers in Taiwan (nearly 4000), two nationwide attorney surveys, and 143 in‐depth interviews with practicing lawyers across the country, we offer the first comprehensive empirical analysis of legal aid lawyers and explain that the design of a legal aid regime attracts lawyers of different hemispheres into the endeavor.

Occupation-Related Volunteering: A Qualitative Systematic Literature Review, Conceptualization, and Directions for Future Research

This review investigates the volunteering-work nexus, where an individual’s paid occupational work in the business, government, or voluntary sector is akin to their volunteer work: tasks and responsibilities are similar, but the structure, conditions, and relationships differ. Performing work spans their business and volunteer worlds and brings dynamic interactions between work and volunteering. Pro bono, skills-based, or corporate volunteering are terms in use; however, these conceptualizations of the underlying and interconnecting practices of work and volunteering are too limited. This transdisciplinary, qualitative systematic literature review of 62 scientific articles studies individuals using conceptualizations of work, volunteering, and occupations over their working life, from service-learning to retirement. With ambiguous boundaries and terminology in the literature, we introduce a new term— occupation-related volunteering—defined as an individual acting to benefit others without payment or coercion, developing, using, or maintaining their occupational knowledge, skills, and abilities, and drawing upon their economic, social, and cultural capital. The definition anticipates that an individual’s occupational resources change over their working life and vary depending on whether the volunteer is acting independently or with the support of their workplace. Occupation-related volunteering extends paid-unpaid and formal-informal boundaries to include volunteering in “paid” work time and in informal, community-based organizations and less public roles, such as mentoring. Finally, we encourage future research using the bibliometric data, suggestions in the reviewed articles, and our synthesis of the individual’s perspective of performing their occupational work as a volunteer.

LIVE IN SCIENCE AND EDUCATION: OLENA SMYNTYNA

This article is about Pr. Olena V. Smyntyna, DSc in History, Head of the Department of Archaeology, Ethnology and World History of the Faculty of History and Philosophy, co-ordinator of certificate programs, and the pro bono Head of the J. Garibaldi Center for Italian History and Culture at Odesa I. I. Mechnikov National University.

Hybrid board governance: Exploring the challenges in implementing social impact measurements

This paper focuses on hybrid board governance and the challenges faced by the board of directors when implementing social impact measurements. Interviews with 36 board chairs and general secretaries in social hybrids in Sweden show that while boards support social impact measurements, they face obstacles in implementing them. Drawing on the institutional logics framework, we identify three main reasons for these implementation problems. First, amid field level regulations focusing on cost efficiency, boards find it difficult to switch to a social impact that lacks a single metric that can be measured annually. Second, board members struggle to find sufficient time when they serve on a pro bono basis, and it is difficult to hold them accountable when limited progress occurs. Finally, acknowledging board practice variation, we highlight the need to distinguish between “beneficiary-driven” and “membership-driven” social hybrids. In the former, boards face the challenge of operationalizing the long-term benefits for end beneficiaries; in the latter, interactions with members are so operationally focused that boards struggle to maintain a long-term agenda for implementing social impact measurement. Given these challenges, we propose that future research should explicitly incorporate the board level in theorizing how hybrid organizations manage institutional logics and performance measurement.

Diagnostic outcome of pro bono neurogenetic diagnostic service in Sri Lanka: A wealth creation

The inherited disease community in Sri Lanka has been widely neglected. This article aimed to present accumulated knowledge in establishing a pro bono cost-effective national, island-wide, free-of-charge molecular diagnostic service, suggesting a model for other developing countries. The project provided 637 molecular diagnostic tests and reports free of charge to a nation with limited resources. We pioneered the implementation of mobile clinics and home visits, where the research team acted as barefoot doctors with the concept of the doctor and the researcher at the patient’s doorstep. Establishing pro bono, cost-effective molecular diagnostics is feasible in developing countries with limited resources and state funding through the effort of dedicated postgraduate students. This service could provide an accurate molecular diagnosis of Duchenne muscular dystrophy, Huntington’s disease, Spinocerebellar ataxia, and Spinal muscular atrophy, a diagnostic yield of 54% (343/637), of which 43% (147/343) of the patients identified as amenable for available gene therapies. Initiated human resource development by double doctoral degree opportunities with international collaborations. Established a neurobiobank and a national registry in Sri Lanka, a rich and unique repository, wealth creation for translational collaborative research and sharing of information in neurological diseases, as well as a lodestar for aspiring initiatives from other developing countries.

ПСИХІЧНИЙ, СОЦІАЛЬНИЙ ТА ЕКОНОМІЧНИЙ ДОБРОБУТ

The issue of well-being is a constantly important issue for the existence of humanity in terms of its components. The ideology of the dominance of the "mother" model increasingly appears as a marked kind of animation, becoming at the same time a universally recognized priority and a cultural and "status" compulsion related to the quality of life. The purpose of the article is to determine the interdisciplinary principles of well-being in terms of its mental, social and economic components. The subject of research is the conceptual foundations of mental, social and economic well-being. Research methods: analysis and synthesis, comparison, grouping and analogies. Presenting main material. The article reveals the authors' reflections on well-being. Arguments and reasons are presented to confirm the principle of equal opportunities in access to social and economic benefits of individuals, which in turn predict their mental well-being. Issues related to well-being in the above dimensions will be considered in the context of the need for changes that are introduced in social life through, among other things, man's opus magnum, which is the phenomenon of globalization. The issue of well-being and, as a result, happiness is presented as a subject of interdisciplinary analysis carried out by representatives of many scientific disciplines, including philosophy, psychology, sociology, economics and ethics. Different interpretations of approaches to well-being and well-being are presented. The essence of the concept of well-being in the system of related concepts, such as wealth, standard of living, quality of life, economic well-being and social well-being, is revealed. Attention is focused on socio-economic well-being, which is revealed in the context of the implementation of the above-mentioned principle of equal opportunities in access to benefits related to the spheres of mental, social and economic components. Originality and practical significance of the research. The practical value of the research lies in the fact that the obtained results deepen in the conditions of globalization and consist, among other things, in supporting poor countries and equalizing differences in the income levels of citizens of different countries. Access to and use of even basic economic goods and services is critical to the integration of members of modern society. Research conclusions. In the conditions of deepening globalization, the problem of economic and social well-being takes on a new expression. On the one hand, it will be economic alienation, and on the other - alienation in the social sphere. It should be remembered that economic and social exclusion (caused, among other things, by low income or even no access to the labor market, inability to meet certain needs, services, etc.) is closely related to mental well-being. Therefore, the modern world must face the problem of economic and social inequality and organize social life in such a way that it promotes the development of all people as much as possible, i.e. "pro publico bono", which in turn will contribute to the equalization of their mental well-being

Beyond Digital Financial Services: Exploring Mobile Money Agents in Tanzania as General ICT Intermediaries

Tanzanian mobile money and telecom agents (called wakala(s) in Swahili) have played a crucial role in expanding digital financial services (DFS) to rural areas. However, wakalas are losing their ability to financially sustain themselves providing intermediation services that their communities require. This work explores the potential for the wakala network to extend intermediation services to emerging information and communication technologies (ICTs) beyond the scope of commercial DFS by uncovering the social and institutional factors that currently shape wakala practices. First, we investigate how two different models of intermediation from information and communication technologies for development literature can inform broader strategies for intermediation through human infrastructures. We then complement this analysis with an on-the-ground quantitative survey and focus groups with community members and wakalas in Kagera, Tanzania. Our focus groups reveal that community members face challenges with new ICTs that require sustained intermediation and that wakalas encounter mounting financial instability and are thus receptive to intermediating for other ICTs. Finally, we present three factors that influence the broadening of the wakalas’ role of general ICT intermediaries: (1) aligning incentives and addressing the limits of pro bono actions, (2) providing appropriate training and a suitable support infrastructure, and (3) fostering trust-building and reciprocity.

An Exploratory Evaluation of Implementing a Rapid-response Online Mental Health Service During the COVID-19 Pandemic: A Mixed Methods Study from India.

Strict social distancing and lockdown measures imposed to curb transmission during the early phase of the outbreak of the COVID-19 pandemic posed challenges to people's psychological wellbeing, limited access to social support, and disrupted routine mental health service delivery. In response, a consortium of mental health stakeholders from Goa, India launched the COVIDAV program, which provided pro-bono virtual psychiatric and counselling consultations across India through an online platform. This study describes the acceptability and feasibility of the program from the perspective of various stakeholders. Data were collected via a survey with clinicians who had volunteered on COVIDAV (n = 40), in depth interviews of the clinicians (n = 14), and focus group discussion with key collaborators (n = 1). Process data were mapped at various stages during the online platform's development and use. The qualitative and quantitative data was analysed using thematic analysis and a descriptive analysis respectively. Over 17 months, 63 clinicians conducted 2245 online sessions through the COVID platform, primarily accessed by youth across the country. The clinicians acknowledged the online platform's ability to enhance access and reduce stigma. Challenges included session time constraints, connectivity issues, and user interface inconsistencies that interfered with clients' accessibility to the services. High satisfaction rates amongst the service providers were reported, with 79.3% content with the service provision and 82.8% with pro bono contributions through the platform. This study illustrates the feasibility, flexibility, and applicability of a rapidly designed pro-bono online platform for delivering mental health care services through the collaboration of stakeholder groups in the mental health care, private, social, and governmental sector. Our findings highlight the potential of rapidly deployed digital platforms, developed via cross-sector partnerships, to meet mental health care needs during unprecedented global emergencies such as the COVID-19 pandemic.