Municipal Services Research Articles

Examining the health and wellbeing of women sanitation workers in Ghana and Kenya

About 3.6 billion people worldwide lack access to safely managed sanitation service. To bridge service gaps, informal sanitation businesses have emerged as alternative service providers to meet the sanitation needs of unserved populations. Informal sanitation workers include persons who empty septic tanks, clean toilets, sewers, and manage public toilets. They provide a fundamental public service particularly in areas where access to municipal sanitation service is limited. Through qualitative methodologies, this paper explores the lived experiences and associated health risks of women working in the informal sanitation sector in urban Ghana and Kenya. Our findings show that female informal sanitation workers were exposed to injuries and infections, stigma and discrimination, emotional and psychological distress, sexual harassment, and unhealthy coping strategies. Distinctively, younger female participants were more likely to experience sexual harassment. Because of social stigma, many of the women developed unsafe work practices such as refusal to wear PPE and working at night. By paying close attention to the embodied effects of informal sanitation work, we can better comprehend the daily politics, lived experiences, and urban social infrastructure regimes that have a significant impact on the quality of life of informal sanitation workers. The results are also crucial for developing programs for women's empowerment and labour and social protection policies, especially in lowincome settings where gender norms interact with income disparities and other sociopolitical issues to affect women's participation in the labor market.

Evaluation of community basic public health service effect in a city in Inner Mongolia Autonomous Region--based on entropy weight TOPSIS method and RSR fuzzy set.

By analyzing 23 evaluation indicators included in 14 national basic public health service programs in a region of Hohhot City, Inner Mongolia Autonomous Region, China, the performance of basic public health services in the region in 2021 were analyzed to clarify the implementation and conduct of relevant programs. We also use this study as a basis to radiate the work of municipal basic public health services centered on the region and the outstanding problems reflected and to provide theoretical contents and suggestions that can be referred to for the same regions in central and western China as well as worldwide. Using the TOPSIS method as the basis for the data analysis method, the evaluation indexes are ranked in terms of their proximity to the idealized target, and combined with the entropy value method, Technique for order preference by similarity to an ideal solution (TOPSIS) and rank-sum ratio (RSR) were used to rank 14 basic health care providers by grade. A comprehensive evaluation of the performance of basic public health services in a region of Hohhot City, Inner Mongolia Autonomous Region in 2021 was conducted through a joint model of entropy -weighted TOPSIS and RSR, making full use of the characteristics and advantages of the fuzzy joint, and conducting a comprehensive analysis from the perspective of the ratio weight and the method of graded calculation, making the study more distinguishable and measureable. In this study, for the regional basic public health services, a total of 23 evaluation indicators of basic public health service projects were included, among which the top three indicators with the weight of the entropy value method indicators were found to include the rate of Chinese medicine health management for the elderly, the rate of health management for the elderly, and the BCG vaccination rate after the analysis of the weight of the indicators; After the entropy-weighted TOPSIS evaluation showed that the Ci values of the regions were found to be between 0.378 and 0.715 through the calculation of the positive and negative ideal values of each indicator; RSR staging method evaluation showed that three community health centers (X2, X10, X12) had excellent evaluations of basic public health services; The number of evaluations as poor and moderate are 2 (X3, X9) and 9 (X1, X4, X5, X6, X7, X8, X11, X13, X14), respectively; Finally, the results of the entropy-weighted TOPSIS method and the fuzzy joint model of RSR staging method are basically consistent with the overall trend of the above two methods, and the reliability and credibility of the research results are high. The entropy-weighted TOPSIS and RSR joint model can evaluate the effectiveness of basic public health services in a more comprehensive and holistic way. The results of the RSR staging results and the related weight ratio analysis show that the basic public health service programs in Hohhot, Inner Mongolia Autonomous Region are relatively balanced, but there are some differences; The same genus of elderly Chinese medicine health management rate, health management rate of the elderly, BCG vaccination rate several indicators accounted for a higher weight, its correlation with the key population-related items is high, suggesting that the future key population health service items should be focused on, and future research should be suggested from two key research.

Evaluation of the Influence on the Use of Additional Filtration in Pelvic Radiographic Examinations Using a Phantom Object

Aims: This study aimed to determine the effect of additional filtration on the image quality and dose reduction in pelvic radiographic examinations.
 Study Design: Mention the design of the study here.
 Place and Duration of Study: The research was conducted at a municipal emergency service radiology department in Rio Grande do Sul, Brazil.
 Methodology: Using a simulator object to replicate clinical examination conditions. The radiographic equipment was fitted with aluminum, copper, and copper-aluminum composition filters to identify the optimal filtration for reducing radiation doses and maintaining image quality.
 Results: Results showed that filtration effectively reduced dose and average absorbed dose in internal organs, with the greatest reduction observed with the copper filter. However, excessive filtration resulted in a decrease in image quality, particularly with the copper filter. The Figure of Merit (FOM) demonstrated that keeping the electrical factors of the X-ray tube consistent (70 kVp and 32 mAs) and using an additional 2.5 mmAl filter could optimize pelvic radiographic examinations, based on the diagnostic IQ criteria established by the service.
 Conclusion: In conclusion, the FOM revealed that using additional filtration of 2.5 mmAl and maintaining the X-ray tube's electrical factors at 70 kVp and 32 mAs could reduce the KERMA in air by 49.8% in the patient, 41.5% in the testes, 35.5% in the bladder, 30.4% in the ovaries, 29.7% in the bone marrow, and 35.3% in the total effective dose of the examination, while maintaining equivalent image quality.

Family Partner: study protocol for a pilot randomised study of a home-visitation intervention in Norway.

Every year, about 5% of children in Norway experience severe child maltreatment and need support from the child welfare services. However, research-supported interventions for this group are lacking. The current study piloted an intensive home-visitation intervention, Family Partner, which aims to reduce child maltreatment among at-risk parents by improving parental skills, agency and trust in the welfare services, and children's well-being. The randomised controlled trial piloted in this study examines the acceptability of the Family Partner intervention for staff and families and evaluates its feasibility for a full-scale randomised controlled trial. This protocol outlines a prospective, parallel, pilot randomised trial of the Family Partner intervention in three Norwegian municipal child welfare services. The participants are families with children under 12 years of age, where the parents are identified as having challenges. Families in the treatment group receive the Family Partner intervention, while families in the control group receive ordinary child welfare services. Data are collected at baseline, and at 3, 6, 12 and 18 months after recruitment. The pilot study monitor retention and adherence to inform the feasibility of a future full-scale randomised study. To assess the acceptability of the trial and intervention, a subsample of the participating families, as well as the family partners and representatives of the child welfare services in each municipality, are invited to complete qualitative interviews. The results will guide the design of a fully powered randomised controlled trial of the Family Partner intervention compared with ordinary child welfare services. ClinicalTrials.gov identifier: NCT04957394; Pilot Trial of Family Partner: a Child Maltreatment Prevention Intervention (FAMPART); registered on 12 July 2021.

Shared management in emergency care services: mixed methods study

Objective: To analyze the management model adopted in Emergency Services in municipalities that are part of a Regional Health Department. Methods: Mixed methods study with a concomitantly incorporated design. It was conducted in 2017 with six managers and 223 health workers (physicians, nurses and nursing technicians/assistants) from ten Emergency Care Units in eight municipalities of the Regional Health Department XIII, São Paulo. The data collection instrument composed of six closed questions and four open questions was delivered to participants. Quantitative data were analyzed using descriptive statistics; qualitative data were developed using the Collective Subject Discourse technique and analyzed using the DSCSoft® software. Results: There was a predominance of female professionals, 173 (75.2%), in the position of nursing assistants, 78 (33.9%). Managers evaluated the institution’s management model as contemporary and participatory, enabling workers to participate in decision making and giving them autonomy to decide on day-to-day issues, while workers evaluated it as traditional management, highlighting its formal structure. Conclusion: It was observed that managers and workers have a different view of the management model of health institutions. The assumptions of the shared management model encompass valuable concepts, such as dialogic communication, decentralization of power and greater autonomy for decision making. However, when analyzing the opinion of most workers who participated in this study, the wide use of a hierarchical model in institutions is still observed.

Efficiency of water service management alternatives in Spain considering environmental factors

The main aim of this study is to identify the most efficient forms of management for municipal water supply services, taking into account exogenous factors. The study is based on a sample of 1518 Spanish municipalities, all with 1000 to 50,000 inhabitants, for the year 2019. The study method consists of analysing order-m partial frontiers subjected to environmental factors. The main results obtained indicate that mixed management forms achieve the highest levels of efficiency.

Представление и отношение студентов и магистрантов-социологов к выбранной специальности и будущей профессии

The article analyzes the attitude of sociology students towards their chosen specialty and future profession. The author conducted a sociological study among students studying sociology in leading universities of the country. It was found that girls, unlike boys, rely on the advice of their family, relatives, and friends when choosing their field of study and university. It was also established that master's students, unlike undergraduate students, rely primarily on the advice of friends and acquaintances when choosing their field of study and university, rather than the opinions of their family and relatives. Only about one third of the students believe that the profession of ‘sociologist’ is in demand on the job market. Thus, the majority of students believe that the knowledge, skills, and abilities obtained in the university correspond to the requirements of the modern market. It has been found that the quality of education in the university affects the attitude towards the chosen specialty and future profession. The lower the quality of teaching at the university, the more likely it is that the sociology student will become disappointed in the chosen specialty and profession. It has been established that only a small proportion of students who (unconsciously) enrolled in the sociology program decided to work in the field after completing their studies. It has been established that male students, unlike female students, strive to secure more prestigious (status-oriented) jobs in government or municipal service after graduation, despite their lower pay. For them, status is more important than money. On the other hand, female students aim to get jobs that are not necessarily prestigious, but better paying (such as firms conducting marketing research, etc.). For senior-level students and master’s degree students in sociology, the most important aspect of their future job as a sociologist is the opportunity to influence important decisions in their region or country. First year students aspire to become sociologists mainly because it is a well-compensated profession. Measures aimed at improving career guidance activities are proposed.

About the development of tools financial management in the public administration sector

The authors describe the mechanism of reforming the budget process since 2004, the basic setting of which was the shift of the emphasis of the budget process from "management of budget resources (costs)" to "results management" by increasing responsibility and expanding the independence of participants in the budget process and administrators of budget funds within clear medium-term guidelines. Results-based budgeting (RBB) is defined as the basic tool for public finance management in the budget reform. It is noted that the main goal of effective and responsible public finance management, that is, ensuring the quality of financial management in the public administration sector, is to provide public (state and municipal) services of high quality while increasing the efficiency and effectiveness of budget expenditures. At the same time, it is emphasized that the development of financial management tools in the public administration sector is based on the use of a managerial approach to the management of public (municipal) finances. The rationale for the need to implement a mechanism for monitoring the quality of financial management is illustrated and a multistage process of its improvement in the period 2007-2022 is described.

Modes and models of care delivery in municipal long-term care services: a cross-sectional study from Norway

BackgroundNumerous forces drive the evolution and need for transformation of long-term care services. Decision-makers across the globe are searching for models to redesign long-term care to become more responsive to changing health and care needs. Yet, knowledge of different care models unfolding in the long-term care service landscape is limited. The objective of this article is twofold: 1) to identify and characterise models of care in Norwegian municipal long-term care services based on four different modes of service delivery: Specialised municipal services, Assistive technology, Planning and coordination, and Health Promotion and Activity, and 2) to analyse whether the identified care models vary with regard to municipal characteristics, more specifically ‘population size’ and ‘income’.MethodsWe adopted a cross-sectional approach and used data from a web-based survey conducted in 2019 to identify and characterize models of care in Norwegian long-term care services, based on four modes of service delivery. The questionnaire was developed through a comprehensive review of national healthcare policy documents and previous research and amended in collaboration with a user panel. A set of questions from the questionnaire were used to create four modes of service delivery. Hierarchical cluster analysis was used to cluster the municipalities based on the mean scores of the modes to identify care models.ResultsIn total, 277 municipalities (response rate 66%) completed the survey. The four modes made it possible to identify four care models that differ on the level of Specialised municipal services, Assistive technology, Planning and coordination, and Health Promotion and Activity. Additionally, the models differed regarding municipal population size (p < 0.001) and income (p = 0.006).ConclusionsWe put forward a theoretical description of the variety of ways long-term care services are provided, offering a way of simplifying complex information which can assist care providers and policymakers in analysing and monitoring their own service provision and making informed decisions. This is important to the development of services for current and future care needs.

Evaluating the implementation of a municipal credit management policy

Background: In South Africa, the growth in the amount owed to municipalities for municipal services rendered, is at an all-time high. The culture of non-payment of rates and taxes for the municipal services is not a new phenomenon. This study is undertaken to determine whether a selected municipality applies its credit management policy to manage the phenomenon of non-payment.Aim: The study investigated the effectiveness of a municipal credit management policy, from the residents’ perspective, within a municipality in the Sedibeng district.Methods: Quantitative analysis was applied through a descriptive research design. Primary data were collected from residents through a self-administered questionnaire. The Statistical Package for the Social Sciences (SPSS) (version 28) was applied to perform a descriptive analysis and exploratory factor analysis.Results: The sampled municipality failed to enforce its credit management policy and was also unable to fulfill its service delivery responsibilities, according to residents’ responses.Conclusion: This article recommends that a municipality must enforce its credit management policy to generate responsiveness from residents. This can be done through introduction of debt recovery policies and offering discounts for timeous payment. In addition, the municipality needs to improve its service delivery.Contribution: This article proposes that residents’ responsiveness to the municipal credit management policy is affected by negative attitudes towards the municipality due to poor service delivery as well as challenges with affordability of municipal services.

Municipal International Cooperations (MICs) in Zimbabwe’s local authorities: An exploratory study of the Harare Metropolitan City

The Constitution of Zimbabwe Amendment No. 20 of 2013 recognises local authorities as key actors in local and national development, thus capacitating them to engage in international and regional relations so as to assist in matters of municipality management and service delivery. In this vein, such relations should promote growth through investments, innovation and information exchanges among others. The study examines the utility of MICs in promoting sound management and the enhancement of service delivery at the Harare Metropolitan City. The study used a qualitative research design where participants were purposively selected to provide data. Data was gathered using interviews and an extensive review of written documents. Data was analysed using thematic and content analysis techniques. The study established that MICs are a reliable tool to promote sustainable development in areas of human capacity development, information technology, and knowledge sharing among others. Additionally, MICs also promote effective and efficient service provision in Harare Metropolitan City. The study recommends the restructuring and fortification of the MICs’ legal and financial frameworks as well as the provision of central government support so that Harare Metropolitan City can autonomously venture into partnerships and be productive without any central government interference.

Proposal of a regulatory index of quality of water supply services-RIQS.

Among the challenges faced by regulatory authorities in the water sector, the large number of municipal supply services to be inspected and the cost of on-site inspections are prominent. To overcome these issues, decisions regarding the priority of inspections based on indicators is an alternative. Therefore, this research aims to propose and evaluate the Regulatory Index of Quality of Water Supply Service (RIQS) to triage on-site inspections of water supply systems in cities of the state of Minas Gerais. The study was conducted with information from the Regulatory Agency of Water Supply and Sanitation Services of Minas Gerais (Arsae-MG). The methodology followed seven steps: (i) selection of available indicators; (ii) grouping of indicators according to their typology; (iii) screening of indicators; (iv) establishment of standardized scale; (v) evaluation of the relative importance of typologies and indicators, through the adaptation of the analytic hierarchy process (AHP); (vi) determination of the RIQS; and (vii) analysis of results. As a result, we selected 12 indicators to compose the RIQS, which deal with efficiency, effectiveness, and customer relationship. We noticed that the indicator of water supply service coverage (17.2%) had the highest weight in the calculation of the RIQS, and the index of requests for an inspection of the water connection served on time (2.1%) had the lowest weight. In addition, 95.1% of the 591 municipalities evaluated presented excellent or good performance. Based on these results, we show that the RIQS can be used to identify cities with low performance and prioritize inspections in the most urgent water systems. Furthermore, these outcomes reveal the possibility of extending and adapting the methodology to other regulatory agencies around the world for identifying the priority of inspections in water supply systems at a municipal level.

The influence of individual and municipality characteristics on allocation of long-term care services: a register-based cross-sectional study

BackgroundVariation in service allocation between municipalities may arise as a result of prioritisation. Both individual and societal characteristics determine service allocation, but previous literature has often investigated these factors separately. The present study aims to map variation in allocation of long-term care services and investigate the extent to which service allocation is associated with characteristics related to the individual care recipient and the municipality.MethodsThis cross-sectional study used register data from the Norwegian Registry for Primary Health Care on all 250 687 individuals receiving municipal health and care services in Norway on 31 December 2019. These individual level data were paired with municipal level data from the Municipality-State-Reporting register and information on the care models in Norwegian long-term care services, derived from a nationwide survey. Multilevel analyses were used to identify individual and municipal factors that were associated with allocation of home care, practical assistance and long-term stay in institutions.ResultsIn total, 164 634 people received home care services and 97 380 received practical assistance per 31 December 2019. Furthermore, 64 404 received both types of home-based services and 31 342 people had a long-term stay in an institution. Increased disability was strongly associated with being allocated more hours of home care and practical assistance, as well as allocation of a long-term institutional stay. The amount of home care and practical assistance declined with increasing age, but the odds of institutional stay increased with age. Care recipients living alone received more home-based services, and women had higher odds of a long-term institutional stay. Significant associations between the proportion of elderly in nursing homes and allocation of a long-term institutional stay and more practical assistance emerged. Other associations with municipalities’ structural characteristics and care service models were weak.ConclusionsThe influence of individual characteristics outweighed the contribution of municipality characteristics, and the results point to a limited influence of municipality characteristics on allocation of long-term care services.

Оценка социокультурных детерминант адаптации иностранных студентов в вузах Курской области

The article introduces the results of a study conducted by the Expert Analytical Center of the Kursk Academy of State and Municipal Service. The general respondents of this study were foreign students studying in higher education institutions of Kursk region, with a total number of more than 4,000 people. The sample population of respondents in 2022 was of 350 people, with a 95 % confidence interval for the survey (margin of error ±5 %). The sample was formed from the number of individuals studying in 2 major Kursk universities, the share of foreigners in which makes up the majority of the general population: Southwest State University, Kursk State Medical University. Non-repeat random quota sampling was carried out according to such socio-demographic characteristics as gender, age, year of study, field of study. Representative sociological survey of foreign citi-zens studying in higher education institutions of Kursk region over the age of 18 was used as the main quantita-tive method of research via personal formalised face-to-face interview at the respondent's place of residence using paper questionnaires (PAPI method).

Understanding the Elderly's Needs and Services regarding Services in Public Spaces in Yazd

Introduction: Active aging is among the important concepts of health influenced by effective public services; understanding adults' needs and services are of great importance. This study aims to explain understanding older adults' needs for services in public places in Yazd city. Methods: This qualitative study was done as conventional content analysis. Participants were 20 elderly people from Yazd selected by purposive sampling. Data were collected through semi-structured interviews. Data analysis was done in three levels of open coding and formation of sub categories and main categories. The study was evaluated and approved by four criteria of creditability, tranformability, reliability, and confirmability. Results: In total, 564 open codes were extracted. Then, primary codes were compared based on similarity, compatibility, and appropriateness, and 66 subclasses were obtained. 14 main categories were obtained by compressing the subcategories. The 8 main categories regarding different services included: healthcare, recreational, government agencies, transportation, communication and interaction, educational and research, religious and pilgrimage. In addition, regarding the older adults' needs, the 6 main categories included: improving the safety of places; providing effective education, mental, spiritual and social health development programs; improving services quality, reorganizing municipal services and provision of amenities. Conclusion: Paying attention to the needs of the elderly is necessary in planning for public spaces in cities. Regarding the need for comprehensiveness of services, it is suggested that the findings of this study be used in designing, implementing, and evaluating services in public places to their service needs and solve their problems.

Storage conditions, microbial quality, and transport costs of drinking water from alternative sources in a South African municipality.

Makana Local Municipality is located in the Eastern Cape Province of South Africa. The area is water-scarce and has been undergoing aridification in recent years, ie, there has been a 7-year long drought. At the same time, there has been a breakdown in provision of municipal services, such as drinking water, to the population since at least 2008. Mi-crobial water quality has been a result of this, and monitoring has been a challenge. Given the drought and the prob-lems with drinking water delivery, it was necessary to conduct this study to investigate the microbial quality of alterna-tive water resources that the Makana population can use during the municipal water outage. The microbial water quality of alternative sources of drinking water in the Makana Local Municipality was examined using the H2S test kit and enumeration of the fecal coliforms. Storage of the collected water was examined for potential factors influencing the microbial water quality of the alternative sources of drinking water. The costs of the water provision from the most suitable alternative sources of potable water were calculated. There was a general correlation between the H2S test kit results and the fecal coliform concentrations, with the latter values ranging from <0 to 23 ± 7 colony-forming units/100 mL. The bottled water from two retail outlets was provided the best alternative source of potable/drinking water, which is microbially safe, for the Makana population. If the consumption of the drinking water from an alternative source takes place within 24 hours of collection, then the Fairview spring could also be used as a source of drinking water for Maka-na residents. The total cost per 1 L of drinking water from alternative sources was estimated to be from 1.51 to 5.81 ZAR. Therefore, the maximum cost of daily provision of drinking water from alternative sources would account for a maximum of 0.88 percent of the monthly household expenditure in the middle-to-high-income household. However, the daily costs of such provision of drinking water would account for a maximum of 8.11 percent of the monthly household expenditure in the low-income household. Provision of the drinking water from the alternative sources would have a minor impact of the monthly ex-penditure in the middle-to-high-income households. However, it is likely that the low-income households would not be able to sustain their water supply from alternative sources for longer than 24 hours, during a municipal outage in the drinking water supply.

Excessive rightsizing? The interdependence of public school closures and population shrinkage

AbstractShrinking cities have, by definition, lost population. Rightsizing is a strategic planning approach to mitigate the challenges of population loss by adjusting a municipality's services, amenities, or even footprint to fit a new demographic reality. While studies have documented the unacceptability and ineptitude of municipality‐driven rightsizing, public school closures have proliferated and quietly become a noteworthy material manifestation of population change. However, as public schools are widely considered to be a foundational component of community cohesion, identity, and prosperity, it begs the question of whether their closure may accelerate the decline feedback mechanisms already present in many shrinking cities. Our study examines public school closures in Ontario, Canada, from 2011 to 2016 to determine the relationship between municipal population trajectories and size and public school closures, and to explore the prevalence of school closures and the community context in shrinking Ontario municipalities. We find that public school closures occurred disproportionately in shrinking and smaller municipalities. Furthermore, public school closure prevalence is associated with low income, low ethnoracial diversity, and low educational attainment.

The daily updated Dutch national database on COVID-19 epidemiology, vaccination and sewage surveillance

The Dutch national open database on COVID-19 has been incrementally expanded since its start on 30 April 2020 and now includes datasets on symptoms, tests performed, individual-level positive cases and deaths, cases and deaths among vulnerable populations, settings of transmission, hospital and ICU admissions, SARS-CoV-2 variants, viral loads in sewage, vaccinations and the effective reproduction number. This data is collected by municipal health services, laboratories, hospitals, sewage treatment plants, vaccination providers and citizens and is cleaned, analysed and published, mostly daily, by the National Institute for Public Health and the Environment (RIVM) in the Netherlands, using automated scripts. Because these datasets cover the key aspects of the pandemic and are available at detailed geographical level, they are essential to gain a thorough understanding of the past and current COVID-19 epidemiology in the Netherlands. Future purposes of these datasets include country-level comparative analysis on the effect of non-pharmaceutical interventions against COVID-19 in different contexts, such as different cultural values or levels of socio-economic disparity, and studies on COVID-19 and weather factors.

Effectiveness and acceptability of the physical exercise and dietary therapy in a healthy life center.

The high burden of eating disorders (EDs) and limited availability of treatment speaks of a need to explore new avenues for treatment delivery. To understand if new treatment avenues are helpful and acceptable to patients, we investigated the effectiveness of Physical Exercise and Dietary Therapy (PED-t) in participants with bulimia nervosa or binge-eating disorder, and acceptability when the PED-t was implemented in a Healthy LifeCenter in a municipal primary healthcare service. Exercise physiologists and one dietitian were trained in ED literacy and to run PED-t, before screening women for eligibility. Effectiveness (n = 16) of PED-t and participants' experiences (n = 8) were evaluated by a mixed methods study design. Results were analyzed by relevant statistics and reflexive thematic analysis. Of 19 eligible participants, 16 completed treatment. At post-treatment, the Eating Disorder Examination Questionnaire global score, binge-eating frequency, and symptoms of depression were lower, and nine (56% of completers) were in remission. Participants' treatment experiences were classified into two overarching themes: "competence" and "emotional support." Participants reported high acceptance for PED-t, the local venue and group format, and felt that PED-t provided them with coping tools and increased mental strength. However, many also spoke of an unmet need to address emotional eating. Findings point to a potential for making an effective ED therapy more accessible, and that participants find the local low-threshold delivery within a group-format helpful. With small adjustments, the PED-t could emerge as a promising first-line treatment for bulimic EDs. Limited access to treatment for EDs, patients' high barriers to help-seeking, and the high rates of limited efficacy from psychotherapy speak of a need to explore new therapies and avenues for delivery. In this study, we build on findings from a controlled ED treatment trial and replicate the beneficial effects and find a high patient acceptance of "physical exercise and diet therapy" implemented in a real, non-clinical setting.

Collaborative mental health treatment: current practices among mental health providers in Norway

ABSTRACT The objective of this study is to examine the frequency of collaboration among mental health providers' and assess perceptions of whether collaborative practices have an impact on the help that patients receive during treatment. This is a cross-sectional study comprising 201 mental health providers recruited from municipal mental health services and specialised clinics across Norway. Participants were asked about their attitudes toward collaborative practices, routines, and beliefs about collaborative mental health care. Regression analyses suggest that frequent contact with social services predicts more perceived adequate psychosocial and socioeconomic help by discharge from the perspective of mental health providers. In addition, results demonstrated a varying degree of frequency and type of collaborative practices. Mental health providers most frequently engage with general practitioners, and least frequently with volunteer services. There are substantial variations in when mental health providers are contacted by external service providers, and when they themselves initiate contact, which may be influenced by a range of factors and vary depending on their professional background and area of service The importance of strengthening collaborative care in mental health treatment and social services is highlighted to tackle overlapping challenges such as financial problems, unemployment, and mental illness.