Professional Understanding Research Articles

Healthcare Professionals' Perceptions about the Implementation of Shared Decision-Making in Primary Care: A Qualitative Study from a Virtual Community of Practice.

The incorporation of shared decision making (SDM) is a central part of empowerment processes, as it facilitates greater activation on the part of patients, increasing the likelihood of them gaining control over their healthcare and developing skills to solve their health problems. Despite these benefits, there are still difficulties in the implementation of SDM among healthcare professionals due to internal and external factors related to the context and health systems. To explore primary care professionals (PCPs)' perceptions of the SDM model, based on their preconceptions and experience in clinical practice. A framework analysis was conducted on qualitative data derived from a virtual community practice forum, within a cluster-randomized clinical trial developed in the e-MPODERA project. The most important points in the opinions of the PCPs were: exploring the patients' values, preferences and expectations, providing them with and checking their understanding of up-to-date and evidence-based health information. The analysis revealed three themes: determinants of the implementation process of SDM, lack of consistency and dilemmas and benefits of PCP active listening, motivation and positive expectations of SDM. In our initial analysis, we examined the connections between the categories of the TDC model and its application in the primary care context. The categories related to the model reflect the theoretical understanding of professionals, while those related to perceptions of its application and use show certain discrepancies. These discrepancies could indicate a lack of understanding of the model and its real-world implications or insufficient commitment on the part of professionals or the organization to ensure its effective implementation. Specific targeted training that addresses knowledge, attitudes and practice may resolve the aforementioned findings.

Adoption of evidence-based end-of-life and bereavement support to families in cancer care: A contextual analysis study with health professionals.

To investigate the level of adoption of evidence-based family engagement and support during end-of-life cancer care and subsequent bereavement and its contextual facilitators and barriers from health professionals' perspectives, and to explore differences between professional groups. Contextual analysis using an online cross-sectional survey. This study was conducted in four Swiss hospitals and three home care oncology and palliative care services. Non-parametric testing was used to investigate the level of adoption and differences between nurses, physicians, occupational- and physiotherapists and psychosocial professionals (chaplains, onco-psychologists and social workers). The STROBE checklist for cross-sectional studies was followed. The majority of the 111 participating health professionals were nurses. Adoption was statistically significantly higher during end-of-life care than bereavement, with nurses and physicians reporting higher levels than the other professional groups. Guidance on end-of-life family care was available in about half of the cases, in contrast to a quarter for bereavement care. Self-perceived knowledge, skills and attitudes were moderate to high, with nurses and physicians reporting higher levels than others, except for general skills in working with families. Organisational structures were experienced as rather supportive, with the psychosocial group appraising the organisational context as significantly less conducive to fully implementing end-of-life and bereavement care than others, particularly during the end-of-life phase. Evidence-based family engagement and support were better adopted during end-of-life care than bereavement. Overall, nurses and physicians felt better enabled to care for families compared to other professional groups. No patient or public contribution. https://osf.io/j4kfh. Implementation and quality improvement efforts should focus particularly on the bereavement phase and be tailored to professional groups. The findings show that evidence-based family engagement and support practices during end-of-life were rather well adopted in contrast to subsequent bereavement care, with nurses and physicians better enabled than other professionals to provide care. A better understanding of health professionals' contributions and roles in family care is important to build interprofessional capacity for evidence-based end-of-life and bereavement support. The STROBE checklist for reports of cross-sectional studies was followed (von Elm etal., 2007).

Developmental language disorder and neurodiversity: Surfacing contradictions, tensions and unanswered questions.

Neurodiversity is increasingly discussed in relation to autism research and practice. However, there is a lack of scholarship concerning the neurodevelopmental condition of Developmental Language Disorder (DLD) and the neurodiversity movement. While this movement may hold opportunities for the DLD community, the application of the concept of neurodiversity to DLD research and practice needs consideration, as DLD and autism have very different levels of public and professional awareness and understanding. In this article, we discuss what the concept of neurodiversity and the associated neurodiversity movement could mean for DLD research and practice. We aim to critique some assumptions that may arise from the application of neurodiversity principles (or assumed principles) to the field of DLD. This is a discussion paper, drawing on the personal experiences and reflections of the author team. We make the case for why DLD should be included in discussions about neurodivergence and outline considerations for doing so, and why some issues and applications may be particular to DLD. We outline points of similarity and contrast with autism in relation to our understanding of neurodiversity. We consider the issues around diagnosis and terminology and urge practitioners to continue to diagnose DLD using currently agreed terminology, so as not to undermine recent awareness efforts. We note that a neurodiversity-informed perspective challenges us to offer interventions that operate at the level of our environments, not just at the level of an individual. Indeed, neurodiversity offers a platform to argue for better rights and more inclusive spaces in mental health settings, education and work for children and adults with DLD. DLD should be considered from a neurodiversity-informed perspective, and it is our hope that this will lead to neurodiversity-affirming practice that will afford young people with DLD better understanding from members of the public and the professionals who work with them. Further work is needed to better support children, young people and adults with DLD to have a voice in the neurodiversity movement. What is already known on the subject Neurodiversity approaches are increasingly being taken up in research and practice in relation to autism, meaning that our understanding of autism and how autistic people are supported is increasingly drawing on the principles of neurodiversity. However, autism is not the only neurodivergent population. Developmental Language Disorder (DLD) is another neurodevelopmental condition; however, relative to autism, DLD has lower awareness amongst professionals and the public. There has been no scholarship that has examined DLD through the lens of neurodiversity, or considered the application of neurodiversity-affirming approaches to DLD. What this paper adds to existing knowledge In this paper, we examine what the neurodiversity movement means for DLD research and practice. In particular, we consider what neurodiversity in the field of autism might teach us about the application of neurodiversity in the field of DLD, and highlight where we believe there are important differences between the two populations. We reflect on what neurodiversity means for intervention, diagnosis, terminology and championing the need for accessibility, especially with regard to mental health support, education and employment. What are the potential or actual clinical implications of this work? Neurodiversity highlights the need to consider interventions at the level of an individual's environment (e.g., how can we make this space more inclusive?) as well as interventions operating at the level of the individual themselves (e.g., interventions focusing on an individual's language skills). We challenge the notion that neurodiversity-affirming approaches mean not diagnosing DLD or changing DLD's terminology: we argue that this is not in the spirit of the original neurodiversity movement, but also that for a condition with such low public awareness, these actions could do more harm than good for families affected by DLD. We call for more in-depth scholarship and discussion around the application of neurodiversity approaches to DLD and argue that the neurodiversity movement offers an important opportunity to raise better awareness and understanding of DLD in multiple sectors, including (but not limited to) mental health, education and employment.

Evaluation of an online interprofessional course on ethics and professionalism: experience of medical, dental, and pharmacy students

IntroductionEthics and professionalism in the health professions reflect how health professionals behave during practice, based on their professional values and attitudes. Health professions education institutions have implemented various strategies for teaching ethics and professionalism, including interprofessional education. The aim of the study was to evaluate the perception of undergraduate health professions students about the outcomes of an online interprofessional course in ethics and professionalism as well as their perception of interprofessional education and the importance of ethics and professionalism after taking the course.MethodsThis is a descriptive cross-sectional study that targeted medical, dentistry, and pharmacy students. A researcher-made 31-item questionnaire was used. The questionnaire was tested for face, content, and construct validity. Reliability of the questionnaire was estimated by Cronbach alpha test. Descriptive statistics were used. T-test was performed to compare the results of male and female students and ANOVA was performed to compare the results of medical, dentistry, and pharmacy students. Statistical significance was set at p < 0.05.ResultsFactor analysis of the questionnaire yielded three factors, namely course evaluation, perception of interprofessional education, and importance of ethics and professionalism in health professions education. The study participants expressed positive perceptions of all aspects of the course. They reported positive perceptions of interprofessional education, highlighting its benefits in enhancing understanding, teamwork skills, and respect for other healthcare professionals. The findings reveal some program-related differences in participants’ responses, where medical students showed higher ratings of all aspects of the course, interprofessional education and importance of ethics and professionalism.ConclusionStudents of the three programs showed positive perceptions of the online IPE course on ethics and professionalism as well as the benefits of IPE and the importance of ethics and professionalism. This highlights the effectiveness of the course in addressing such important aspects of health professions education.

Parenting and family life experiences of mothers diagnosed with schizophrenia within Chinese cultural context.

WHAT IS KNOWN ON THE SUBJECT?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs). Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Unlike in Western society, Chinese society is characterised by a family-centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter-in-law. While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re-establish connections with intimate family members. The findings highlight the following important considerations when offering family-based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents-in-law, while offering psychoeducation to MDWSs and their family members. ABSTRACT: Introduction In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method In-depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self-stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family-based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents-in-law. Implications for Practice The results highlighted the significance of culturally sensitive nursing care for MDWSs and family-centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members.

Pharmacy professionals' understanding, attitude and practice toward pharmaceutical care in Motta town, Northwest Ethiopia: A cross-sectional study.

Although pharmaceutical care provision is the primary goal of the pharmacy profession, its actual implementation has been lacking in developing nations. Therefore, this study investigated pharmacy professional's understanding, attitudes, and practice toward pharmaceutical care. A cross-sectional study was conducted from 30 July 2022 to 30 August 2022, at all community and hospital pharmacies in Motta town, Northwest Ethiopia. Data were gathered using a self-administered questionnaire and analyzed using SPSS version 26.0. A logistic regression model with a p-value of 0.05 and a 95% confidence interval was applied to identify factors associated with understanding, attitude, and practice. The study had a 97.7% response rate. Of the 130 participants, 71 (54.6%) were females. Slightly more than half (56.2%) of the participants were aware of the aim (56.2%) of pharmaceutical care and responsibilities (56.9%) of pharmacy professionals in the pharmaceutical care process. However, most participants lack awareness of the similarities and differences between clinical pharmacy and pharmaceutical care. Concerning their attitude, most participants (66.9%) believed that pharmaceutical care provision should be the primary responsibility of pharmacy professionals, and it will benefit patients (61.6%) and the healthcare system (60.8%). Pharmacy professionals frequently evaluate their patients and identify health or drug therapy-related problems and potentially available therapeutic alternatives. However, they rarely engaged in any health screening activities or provided feedback to the doctor on the patient's progress. Training status, sex, and years of practice/understanding were significantly related to pharmacy professionals' level of understanding, attitudes, and practice toward pharmaceutical care, as both years of practice and understanding are related to practice. Our study revealed a deficit in pharmacy professionals' understanding, attitude, and practice toward pharmaceutical care in Motta town, Northwest Ethiopia. Policymakers, health authorities, and educational institutions should work together to develop strategies and instructional initiatives that optimize pharmaceutical care provision and thus achieve optimal patient outcomes and lower healthcare costs.

Diagnostic services for developmental coordination disorder: Gaps and opportunities identified by parents.

Affecting one in 20 children, Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder impacting a child's ability to learn motor skills. Despite its high prevalence, DCD is under-recognized and under-diagnosed, causing unnecessary frustration and stress for families who are seeking help for their child. This study aimed to understand how parents procure diagnostic services and their perspectives on needed supports and services to improve early identification and diagnosis of DCD. Using a multi-pronged recruitment strategy, we circulated the impACT for DCD online questionnaire to parents of children (<18 years) in British Columbia with suspected or diagnosed DCD. Data were analysed descriptively using medians/interquartile ranges for continuous data and frequencies/percentages for categorical data. Open-ended questions were analysed using exploratory content analysis. A total of 237 respondent data were analysed. Parents identified poor awareness and understanding of health care professionals and educators regarding aetiology, symptomology, and impacts of DCD, affecting timely access to diagnostic services. Long waitlists were also a barrier that often led families with financial means to procure private diagnostic assessments. A standard of care is needed for streamlined diagnostic services, enabling early identification and early intervention. A publicly funded, family-centred, collaborative care approach is critical to assess, diagnose, and treat children with this disorder and to mitigate the secondary physical and mental health consequences associated with DCD.

A real-world pharmacovigilance analysis for transthyretin inhibitors: findings from the FDA adverse event reporting database.

The purpose of this study is to investigate the drug safety of three Transthyretin (TTR) inhibitors in the real world using the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. This study extracted reports received by the FAERS database from the first quarter of 2018 to the third quarter of 2023 for descriptive analysis and disproportionality analysis. Safety signal mining was conducted at the Preferred Term (PT) level and the System Organ Class (SOC) level using reporting odds ratio (ROR). The characteristics of the time-to-onset curves were analyzed using the Weibull Shape Parameter (WSP). The cumulative incidence of TTR inhibitors was evaluated using the Kaplan-Meier method. Subgroup analyses were conducted based on whether the reporter was a medical professional. A total of 3,459 reports of adverse events (AEs) caused by TTR inhibitors as the primary suspect (PS) drug were extracted. The top three reported AEs for patisiran were fatigue, asthenia, and fall, with the most unexpectedly strong association being nonspecific reaction. The top three reported AEs for vutrisiran were fall, pain in extremity and malaise, with the most unexpectedly strong association being subdural haematoma. The top three reported AEs for inotersen were platelet count decreased, blood creatinine increased, and fatigue, with the most unexpectedly strong association being blood albumin decreased. Vitamin A decreased, arthralgia, and dyspnea were the same AEs mentioned in the drug labels of all three drugs, while malaise and asthenia were the same unexpected significant signals. This study offers evidence of the variability in the onset time characteristics of AEs associated with TTR inhibitors, as well as evidence of differences in adverse event reporting between medical professionals and non-medical professionals. In summary, we compared the similarities and differences in drug safety of three TTR inhibitors in the real world using the FAERS database. The results indicate that not only do these three drugs share common AEs, but they also exhibit differences in drug safety profiles. This study contributes to enhancing the understanding of medical professionals regarding the safety of TTR inhibitors.

Percepção de profissionais de saúde frente aos cuidados paliativos

Abstract A growing body of evidence based on experience shows the importance of observing and refining knowledge about palliative care. This integrative literature review focuses on identifying the perceptions of health professionals towards patients in palliative care, an occupational phenomenon that results in instability in the emotional, occupational and social life of professionals and negative impacts on the care provided. This is a qualitative, exploratory and descriptive study, with data analysis by categorization in which, after assessing the evidence, the understanding of health professionals with patients in palliative care is drawn. The main contributions of works on the proposed topic are collected, drawing attention to the problem.

Exploring the Teaching of In-Class Practice Sessions in the Context of Big Data--Taking Chinese Language and Literature Major as an Example

Abstract This paper establishes a comprehensive framework for the in-class practical teaching curriculum tailored to majors in Chinese Language and Literature. It comprises four core components: a system of practical teaching content, specified practical teaching requirements, practical training modules, and a target index system for practical teaching outcomes. Through the application of single-factor and two-factor analyses, this study investigates the correlation among course outcomes to refine the scheduling arrangements and the model itself. It introduces a scheduling process designed using a genetic algorithm, which is also employed to allocate instructors and courses within the practical course curriculum, calculating the average teaching hours per instructor. Additionally, the research examines the impact of students’ gender and their varying levels of comprehension regarding professional practice abilities on their practical skills in the field. Specifically focusing on the discipline-related practical activities in Chinese language and literature, the study identifies key courses within the major. Notably, it found a significant correlation coefficient of 0.691 between literary writing and literary appreciation courses. Moreover, the overall average for career development capabilities, based on different levels of professional understanding, is 3.9975, indicating that a deeper comprehension of career development in this major positively influences students’ practical skills in Chinese Language and Literature.

The development and evaluation of a multidisciplinary consultation between professionals from the medical, social, and public health domains to deliver tailored care and support for pregnant women and young families in vulnerable positions.&amp;nbsp;

The population in the region South-Limburg (NL) suffers from a deprived health status compared to rest of the Netherlands, including unfavorable perinatal health outcomes that impact the child’s health and development in later life. To turn the tide, South-Limburg aims to achieve a ‘promising start to life’ by focusing on the first 1,000 days of life: pregnant women and families with children aged 0-2 years. In particular, the focus is on pregnant women and families in a vulnerable position, facing (a combination of) medical and, especially, social problems (e.g., housing, financial, relational, psychosocial, addiction). Delivering timely and appropriate tailored care and support to this target group requires close cooperation between professionals from the medical domain (i.e., midwife, maternity care, GP), social domain (i.e., social work, municipal support), and public health domain (youth health care). &#x0D; In three low socioeconomic status municipalities in South-Limburg, a co-creation process was started in 2020 to strengthen cross-domain collaboration in delivering timely care and support tailored to the needs of pregnant women and families with children aged 0-2 years in a vulnerable position. Professionals’ input was derived during meetings with stakeholders from the three domains. Input from pregnant women/young families in a vulnerable position was gained through interviews regarding their experiences with current care/support during pregnancy and in the first years of the child’s life. These showed that, among others, they often feel unheard or ignored by professionals; lack of clarity about who is in charge when several professionals are involved; lack of attention for psychosocial problems; insufficient father involvement by professionals.&#x0D; As a result of the co-creation process, a case-based multidisciplinary consultation was developed. Essential elements are: professionals from the medical, social, and public health domain join in, as well as the pregnant woman or family involved; professionals use the shared language of ‘Positive Health’ to match the family’s needs and wishes; agreements on referral to care or support are noted in a care plan and the family is assigned a case director.&#x0D; The case-based multidisciplinary consultations in the three municipalities started at the beginning of 2022. A practice-based action research is conducted to gain insight into its creation, implementation, functioning, and further development. Research methods include interviews, observations, and questionnaires. First results are available from 24 interviews with professionals involved in the co-creation process about their views on cross-domain collaboration. Themes addressed are among others: importance of early identification of problems; better understanding of other professionals’ expertise; conditions that facilitate or hinder cross-domain collaboration. Results are discussed in the four-yearly meetings per municipality with professionals from the medical, social, and public health domain. Points for action are prioritized and will be monitored over time. Also, client journeys will be conducted to address families’ experiences with the multidisciplinary consultation and referral to care and support.&#x0D; This form of cross-domain collaboration, supported by a practice-based action research, can serve as an example for the international audience interested in improving population health by investing in prevention at the very early onset of life.

Canvases of Professional Erudition in STEAM Education

The delivery of instruction in Science, Technology, Engineering, Art, and Mathematics (STEAM) requires layers upon layers of professional knowledge concerning STEAM pedagogy, methodologies, technology, and active involvement strategies to support student learning. A professional understanding of these critical areas is relevant for supporting student learning and is germane in actively involving parents in STEAM learning. While educators commonly engage in professional development opportunities, professional development is principally singular and typically ends without continuance or re-examination. Professional learning, on the other hand, is ongoing and revisits professional growth needs for educators. In this article, the researcher utilized targeted professional growth needs for STEAM educators that included qualities of site-based professional development and professional learning referred to as professional erudition. This study employed targeted professional erudition for providing high school science teachers skills related to constructivism, experiential learning, communications and dialogue, reflection and self-evaluation, and active parental involvement. Students and parents participating in the study maintained journals regarding their experiences during science inquiry learning and teachers maintained journals concerning their experiences and perceptions regarding targeted professional erudition. Qualitative data indicated providing professional erudition for STEAM teachers results in authentic professional growth, improved communications, and skills and strategies for supporting participatory science learning.

Summaries of the Padua symposium on myofascial pain, fibromyalgia, and fascial pain disorders, June 2023, Aula Falloppio at the Human Anatomy Institute of the University of Padova, Italy.

The International Symposium on Myofascial Pain, Fibromyalgia, and Fascial Pain Disorders was held at the University of Padua, Padua, Italy in June of 2023. This report presents a summary of the presentations from scientists and clinicians from around the world who presented to the symposium. The purpose of this symposium and resultant paper is improve health professional's recognition and understanding of the clinical characteristics, co-morbidities, mechanisms, and treatment strategies for these common conditions to better understand and manage their pain, dysfunction, and quality life.

A Reflection on Paradoxes and Double Binds in the Workplace in the Era of Super-Diversity

Occupational health and safety (OHS) is a largely technical field, still guided by a biomedical model of health that seeks to isolate factors that cause injury. Despite a growing literature on organisational and managerial factors influencing occupational health, their full integration into the OHS concept has been slow. A broader understanding is still needed to recognise the restructuring of work and the link between well-being at work and management style. In the context of a rapidly changing world of work, increasing workforce diversity, and inequality, OHS needs to take account of the social sciences and humanities to broaden its reductionist vision. Occupational illnesses, distress, and suffering, especially in relation to relational or organisational issues, have no initial cause or specific ontology; they result from a long-standing process or repetitive relational pattern that needs to be exposed and understood in greater depth, considering contextual factors and dynamics. Using the authors’ anthropological backgrounds and the basic principles of the double bind theory developed many decades ago by Gregory Bateson and his colleagues at the Palo Alto School of Communication, we propose a reflection on pragmatic paradoxes or double bind situations in the workplace (which can be briefly defined as the presence of contradictory or conflicting demands or messages), their potential impact on workers’ health and well-being, and how to resolve them. This paper sought to explore the world of pragmatic paradoxes and double binds by discussing different categories, types, or forms of paradoxes/double binds that occur in the context of occupational health and their underlying mechanisms. It also includes a discussion of the possible link to the concept of super-diversity, as it too is associated with migration channels, employment, gendered flows, and local systems. Finally, we discuss the practical implications of this understanding for health professionals, researchers, and policymakers, from a perspective of promoting more holistic and context-sensitive interactional approaches to occupational health.

Wolf Girls and Mechanical Boys: Whiteness and Assimilation in Bruno Bettelheim’s Narratives of Autism

In March of 1959, public intellectual, principal of the Sonia Shankman Orthogenic School at the University of Chicago, and Jewish concentration camp survivor, Bruno Bettelheim published two articles that presented seemingly disparate narratives of autism. One of these narratives, that of the mechanical boy, has become ubiquitous in discussions of autism history. The other article centered on Bettelheim’s posthumous diagnosis of Kamala, who had been known as the Wolf Girl of Midnapore India due to claims that she was raised by wolves, as autistic. Bettelheim compared Kamala to other “wild” autistic children he had worked with, especially Anna, a Polish Jewish refugee who had spent her earliest years hiding in a dugout from Nazi persecution. This article argues that in order to understand Bettelheim’s portrayal of autism, it is necessary to read the narrative of the mechanical boy alongside Bettelheim’s other narratives of autism. Specifically, it is necessary to read it alongside Bettelheim’s narratives of the autistic child as “wild child/wolf girl,” as well as his comparison between autistic children and some of his fellow concentration camp inmates, who he referred to as “moslems.” While seemingly disparate, these narratives are actually deeply intertwined. These narratives of incurable “wild children” and “moslem” concentration camp inmates served as the necessary contrast to the rehabilitation/assimilation/cure narrative of the mechanical boy. Reading these narratives of autism alongside each other helps uncover the often-elided role of race in shaping professional and public understandings of autism. This article problematizes contemporary and historical formations of autism as a white, middle-class, male “disorder” by making explicit the role of race in the construction of early narratives of autism. This article will also argue that in the late 1950s and the 1960s Bruno Bettelheim used narratives of autism to promote a new model of white technocratic masculinity in the United States. The creation of this new model of white masculinity was bound up with the whitening of Ashkenazi Jewish identity. Bettelheim presented whiteness as something that Ashkenazi Jews in America could achieve through a process of rehabilitation/assimilation/cure that rid them of pathological “Jewish” traits.

The Role of Administrative Services in Supporting the Implementation of Efficient Governance in Elementary Schools

This research investigated the role of Administrative Services (TU) in supporting the implementation of efficient governance in Elementary Schools (SD). Using a qualitative approach, the study involved in-depth interviews, observations, and document analysis to comprehend the role of TU and the impact of information technology integration in the school environment. Findings indicated that TU staff played a crucial role in administrative, financial, and daily operational management, while information technology integration contributed positively to efficiency. Challenges such as resource limitations became a focal point of discussion. The results of this research provide a foundation for the development of best practices and policies at the elementary school level. Future prospects involve a deeper understanding of information technology implementation and TU professionalism. Further studies can explore broader impacts on educational quality and contribute positively to the elementary education system in Indonesia

Analysis Of The Influence Of Clinical Pathway In Hospitals On Length Of Stay: A Scoping Review

Clinical pathway is a management tool used in healthcare to coordinate patient care efficiently, thereby reducing the length of stay required by patients in hospitals. The purpose of this study was to determine the effect of Clinical Pathway in hospitals on Length of Stay. This study was a scoping review using the PRISMA diagram. Article search was conducted based on the eligibility criteria of the PICO Model: P: Hospital Patients, I: Clinical Pathway, C: -, O: Length of Stay. The articles used were from 4 databases, namely: Google Scholar, Research Gate, PubMed, and Elsevier. With keywords including "Clinical pathway" AND "Length of Stay" AND "hospital". The implementation of clinical pathway is one of the strategies that can be used to reduce patient length of stay. Clinical pathway can help improve efficiency, quality, and compliance with healthcare standards. Based on the results of the study, the researchers recommend that effective socialization and training be conducted to improve the understanding and compliance of healthcare professionals with clinical pathway, develop clinical pathway based on strong scientific evidence, and conduct periodic monitoring and evaluation to ensure the effectiveness and suitability of the clinical pathway implemented.

Effect of academic stress, educational environment on academic performance & quality of life of medical & dental students; gauging the understanding of health care professionals on factors affecting stress: A mixed method study.

Throughout their academic careers, medical and dental students face challenges that cause varying levels of stress, affecting their academic performance and quality of life (QoL). Our study aims to ascertain the effect of academic stress and the educational environment on the QoL and academic performance of medical and dental students, encompassing the perspectives of both students and healthcare professionals. A mixed-method research was conducted from February to May 2022, comprising students from a medical and dental college in Pakistan. During Phase 1, the students participated in the cross-sectional survey and completed the WHO Quality of Life Scale (WHOQOL-BREF), Academic Stress Scale, and Dundee Ready Educational Environment Measure (DREEM) Inventory questionnaires. Academic performance was evaluated through last year's annual assessment results of the students. During Phase 2 of the study, interviews with healthcare professionals who had experience as the students' counsellors were conducted. The mean age of the sample (n = 440) was 22.24 ±1.4 years. The Cronbach Alpha reliability of the DREEM inventory was 0.877, that of the Academic Stress Scale was 0.939 and the WHOQOL scale was 0.895. More than half of the students (n = 230, 52.3%) reported better QoL and the majority perceived a positive educational environment (n = 323, 73.4%) and higher academic stress (n = 225, 51.1%). Males had significantly more academic stress (p<0.05). Those who perceived a positive educational environment and better QoL had better academic performance (p<0.05). Academic performance was positively and significantly correlated with QoL and academic stress (p = 0.000). In qualitative analysis, 112 codes were generated which converged into 5 themes: challenging educational environment, psychological need and support, individual differences, relationship and family life, and adjustment issues. Medical and dental students encounter a myriad of challenges, along with significant academic stress, which detrimentally affects their academic performance, despite perceiving a positive educational environment. Conversely, a better QoL is associated with improved academic performance.

SPIRAL: parents’ experiences of emotionally-based school non-attendance (EBSNA) informing a framework for successful reintegration

ABSTRACT Emotionally-based school non-attendance (EBSNA) is believed to impact one to two percent of children and young people (CYP): it is understood to present as severe emotional upset at the prospect of attending school. The aim of this study was to further understand parental experiences of EBSNA to enhance professional understanding and support. Adopting a “solution-oriented”, exploratory qualitative design, this phenomenological research gathered retrospective experiences of successful EBSNA support, aiming to uncover “what works” when supporting children and families experiencing this difficulty. Participants completed semi-structured interviews (n = 5), and transcripts were analysed using reflexive thematic analysis. Themes generated provided insights into different forms of support accessed by parents, identifying potential areas for improvement arising from their experiences of challenge and successes, as well as lessons learnt from the COVID-19 pandemic. The themes (Supporting Parents; Promoting CYP’s Sense of Belonging; Including and Informing Parents; Raising Awareness of EBSNA; Accessing External Professionals; Lessons Learnt from Covid-19) are presented as a framework for professional practice (SPIRAL), which has practical implications for schools and local authorities in providing support to families experiencing EBSNA. Recommendations for practice and future research are discussed, informing developments across multiple systems, and highlighting the potential of the EP role.

‘The collar never comes off’: A qualitative study of clergy professionalism

Abstract In this study, we examine clergy use of verbal and nonverbal communicative behaviors of professionalism within the pastor–parishioner dyad. In doing so, we interviewed 21 clergy from disparate Christian denominations—The Episcopal Church, USA, and The Assemblies of God, and analyzed data via modified constant comparative analysis. Findings, conceptualized through Uhl-Bien’s Relational Leadership Theory (RLT), produced answers as to why clergy members employ professionalism-based behaviors, which behaviors they frequently employ, and the benefit of professionalism to the pastor–parishioner leadership dyad. Findings theoretically contribute (1) an introduction toward the development of a clergy framework of professionalism, (2) an expansion on the understanding of professionalism, (3) a mechanism of influence and control inside RLT—professionalism, and (4) demonstrates that co-construction within a leadership relationship is guided by underlying assumptions of power within the dyad. The authors conclude with pragmatic implications for all leaders.