Time for a smile: Medical clown one-on-one visits in a residential home.

Beyond the no-show: A case study highlighting the hidden scope of barriers to radiotherapy adherence in cancer care.

To estimate and compare the economic burden of obesity across three Integrated Care Boards in England, with a specific focus on the contribution of Type 2 diabetes and related complications. An adapted burden of obesity model integrating estimated national health costs data with local population metrics was applied to the integrated care boards to estimate health care, social care, productivity and economic and quality of life associated costs. Data were stratified by sector, age, sex, BMI and prevalence of obesity-related complications. Across the regions, 599,248 adults were living with obesity. Total economic burden reflected obesity prevalence, with the highest costs in Leicester, Leicestershire and Rutland, followed by Bedfordshire, Luton and Milton Keynes and then Northamptonshire. Despite this, Bedfordshire, Luton and Milton Keynes had the highest per-patient costs across all cost categories. Social care and productivity losses each contributed approximately 30% of total costs, with informal care comprising 96% of social care expenditure. Per-patient healthcare costs increased with BMI. Type 2 diabetes and hypertension were among the most prevalent and costly complications, while stroke and coronary heart disease had the highest per-patient costs. Coexisting coronary heart disease with Type 2 diabetes significantly increased treatment costs. Obesity was more prevalent among working-age adults, with males incurring higher per-patient complication costs across all conditions and integrated care boards. This study demonstrates the significant and variable local economic burden of obesity. Disparities in per-patient costs, sex and complication profiles highlight the need for stratified, data-driven commissioning. Targeted prevention in high-burden areas can help ICBs reduce system pressures and guide effective local strategies.

Children’s experience of a new approach to family safeguarding in Oxfordshire Children’s social care services

Impaired awareness is common among people with Alzheimer's disease (AD) and the related disorders Huntington's disease (HD), and Korsakoff's syndrome (KS). Individuals with impaired awareness have an altered perception of their situation or functioning, which may pose challenges for care staff in nursing home settings. Yet, little is known about their experiences with impaired awareness. We conducted five focus groups with professional caregivers (N = 28) of nursing home residents with AD, HD and KS about their experiences with impaired awareness (two AD, one HD, one KS and one mixed focus group). Participants were certified nursing assistants, vocationally trained nurses and social workers. Conversations were audio-taped and transcribed verbatim. Data were analyzed using thematic analysis. We identified three main themes: (1) Manifestations of impaired awareness, including observed expressions of impaired awareness and impact on resident interactions. These manifestations were consistent across all three disease groups. (2) Reflections and emotions on these manifestations (characterized by compassion, astonishment and uncertainty). Impaired awareness increased the overall emotional burden for professional caregivers. Additionally, they sometimes felt uncertain about whether impaired awareness was intentional or disease-related. (3) Dealing with impaired awareness, by balancing between moving along and setting boundaries. Caregivers had difficulties determining the most effective approach to deal with impaired awareness. Impaired awareness impacts the work of caregivers of residents with AD, HD and KS. Gaining a better understanding of how impaired awareness affects residents' emotions and behavior can contribute to the development of effective care approaches for caregivers.

Psychotherapy and Problematic Behavior Reduction in Long-Stay Nursing Home Residents With Alzheimer's Disease and Related Dementias.

Psychometric Analysis of an Advance Care Planning Implementation Quality Assessment Tool (ACP-QAT) for Nursing Homes.

Geriatrics cognitive assessment and resource engagement day: Piloting an interdisciplinary outpatient cognitive care model.

To describe sociodemographic characteristics, facility use and health conditions among adult men residing in homeless shelters in Gdańsk, Poland. Retrospective, cross-sectional analysis of routinely collected non-governmental organization's operational records. From 551 male shelter residents supported by the Saint Brother Albert's Aid Society in 2023, a random sample of 226 was selected. We summarized age, disability status, hospitalizations, diagnoses (ICD-10) and shelter use with descriptive statistics. Median age was 60 years; 42% had certified disability. In 2023, 31% were hospitalized at least once and 17 individuals had ≥3 admissions. Frequent diagnoses included essential hypertension (20%), epilepsy (11-12%) and heart failure (10%); alcohol dependence was documented in 40%. Infectious burdens were present, including tuberculosis (∼6%). Facility use concentrated in shelters with care services; night-shelter users had more admissions/removals and more fragmented stays. Adult men experiencing homelessness in Gdańsk have substantial cardiovascular, neurological and infectious disease burdens with frequent hospital use. More studies based on medical registers and social services data should be conducted in the future.

Social work with LGBTQIA+ youth from the perspective of child protection professionals in France and Italy

Gender-specific developmental trajectories of anxiety and depression among college students: Risk of attitudes toward suicide and suicidal behavior.

In Estonia, Latvia, and Lithuania, the push for care integration has gained momentum, being seen as an innovative approach to allocate resources more efficiently and improve patient outcomes. This study investigates the progress of integrating care in the Baltic countries from 2019 to 2024 to detail key learnings. We undertook a cross-country study to better understand the progress in care integration in the Baltics with a two-round, 21-item questionnaire on the adoption of integrated care reforms in 2019 and 2024. Responses were analyzed to capture countries' policy environments and their conduciveness to the uptake of integrated care. Country-specific experiences with implementation of care were further explored via case studies of pilot programmes. The pace of implementing integrating care varied. Existing barriers, workforce challenges and payment schemes have impeded integration across health and social care. Despite this, political commitment across successive governments to new and innovative service delivery and collaboration for chronic care management underscores an important prerequisite toward achieving more integrated and person-centred healthcare. The three case studies illustrate hurdles that come with shifting care settings and expanding roles for some workers. Integrating care across providers and the social and health sectors is an incremental process that needs long-term political support to address persistent barriers. The Baltic countries' experiences indicate challenges in bringing together stakeholders in areas such as data interoperability, new financing models and reorganization of workforce and skills mixing. Further work should advance evidence on patient-centred solutions for evolving needs.

The present study examined how several career shocks experienced by students in the health care fields during the COVID-19 pandemic shaped their subsequent occupational calling. Drawing on social information processing theory, we posit that the perceived impact of career shocks is positively related to an improvement in the perceptions of occupational characteristics (i.e., perceived task significance and social worth) and resultant improvement in psychological states (i.e., meaningful work and prosocial motivation), which in turn are expected to be positively related to an improvement in occupational calling. We further posit that intrinsic motivation should weaken the above links through the perceptions of occupational characteristics. A four-wave prospective field study with baseline measures was conducted with 703 students in the health care fields in China during the COVID-19 pandemic. Results based on path analysis largely supported the hypothesized moderated chained mediation model. In addition, several novel relationships were discovered between perceived occupational characteristics and psychological states (i.e., the perceived task significance-prosocial motivation link and the perceived social worth-meaningful work link). Theoretical and practical implications, as well as future research directions, were discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Standardized surgical approach to gastrostomy tube placement: A quality improvement initiative at a multi-hospital Children's health care system.

A formative service evaluation exploring the experience and levels of satisfaction of patients attending a nurse led bone marrow clinic in one Health and Social Care Trust in Northern Ireland.

Informed consent is a legal requirement under The Health and Social Care Act 2008 and a vital part of patient-centred care. Despite national frameworks and guidance, there is significant variability in informed consent implementation across settings. This national service evaluation aimed to assess policies, processes, and principles guiding informed consent for gynaecological radiotherapy across United Kingdom (UK) NHS departments. A survey exploring processes and training, principles, and values was sent to 58 NHS radiotherapy departments. Data were obtained from 38 departments (66 % response rate), representing all UK nations. Ethical approval was obtained. Variation was observed in staff training, use of best-practice guidelines, and content of consent documentation. While 71 % of departments used Royal College of Radiologists (RCR) consent forms, fewer identified professional guidance indicating a potential gap in guideline familiarity. Documentation varied in the number and detail of side-effects described but alignment was observed in core ethical principles. Respondents highlighted structural challenges, notably time and staffing constraints, which limited processes and patient support. This is the first study to provide a national overview of informed consent policies and practices in NHS radiotherapy departments for gynaecological cancers. It identifies inconsistencies in training, documentation, and guideline awareness, but highlights shared professional values. Findings support the need for national guidance, standardised consent materials, and targeted staff education to ensure equitable and fully informed patient decision-making. Informed consent should be treated as an ongoing, patient-centred process that extends beyond the clinician-patient interaction. All staff should be familiar with policies and procedures to support patients' understanding of treatment and long-term impacts. Standardised materials must be tailored to individual needs to facilitate meaningful, patient-centred discussions.

Stigma and discrimination make healthcare challenging for people living with Long Covid, especially those from ethnic minority groups. Since their experiences are under-researched and may differ from other groups, it is crucial that healthcare guidance is informed by the lived experiences of diverse groups. Findings from underpinning research (hearing from the unheard: Impact of Long Covid in Black and minority ethnic groups in the UK: HI-COVE - 31 interviews with ethnic minority individuals living with Long Covid) informed the development of two resources aimed at raising awareness of the challenges faced by ethnic minority groups and offer ways to best support these groups. People living with Long Covid (N = 4) provided feedback on the two resources. Feedback was guided by a topic guide. Minimal changes were made following feedback. Resource 1: Four participants who took part in the underpinning research, worked with an Artist (AW) to curate artwork. The artwork created was a video called 'Still Looking for Answers' https://www.youtube.com/watch?v=GDt-Ro1Cql8&t=1s. It comprises anonymised patient narratives and imagery (performed by actors) and a soundscape to convey ethnic minority lived experiences of Long Covid. Resource 2: an online learning tool called 'Health and Social Care PROfessional-Long Covid': H-Pro-LC tool: https://clineduniverse.org/hicove/story_html5.html shares challenges people from ethnic minority groups face when accessing healthcare for Long Covid. The resource includes guidance on supporting people, particularly people from ethnic minority backgrounds, presenting to primary care with (probable) symptoms of Long Covid. These publicly available resources aim to raise awareness of Long Covid: they encourage viewers to emotionally connect with experiences of Long Covid as well as offer ways to support people living with the condition, particularly among people from ethnic minority groups. The underpinning research of these resources were extensively informed by both patient (N = 7) and expert advisory groups (N = 6). Co-creation approaches (through workshops, meetings and written feedback) from people living with Long Covid, carers, stakeholders and members of the public informed the design, development, innovation and impact of resources developed. People with lived experience of Long Covid provided feedback on the resources developed in this study.

The main goal of current research was to examine the students competence and academic achievement in higher education: a conditional process. The descriptive research design with quantitative study type was considered suitable for the current research. Population for the study was teachers and pupils of University of Sargodha. By using convenience sampling method, students and teachers from Sargodha Medical College, Department of Plant Pathology, Department of Social Work and Department of English were selected. Total sample was collected from 21 teacher and 320 students in total. Two adopted scales i.e., Teacher-Class Relationship Inventory and Generic Competence Scale were adopted. Both instruments were reliable according to the Cronbach’s’ value . By using the SPPS version 27, data was analyzed and moderation and mediation analysis techniques was utilized. The results revealed that the moderating and mediating effect of teacher-class relationship in the students competence as well as academic achievement of the respondents was found statistically insignificant. It was recommended on the basis of findings that teachers and experts need to conduct seminars and workshop to aware the students about the competencies importance as well as it will also improve their academic achievements.

ABSTRACT Incorporating family members in substance use treatment enhances treatment prognosis in substance use (SU) treatment. Yet the family members are seldom included, leaving them mostly untreated. They live silently or unconsciously with the detrimental effects of alcohol or drugs gnawing them each moment. Additionally, the treatment modalities existing worldwide—focusing mostly on the individual user, the long term, and institutional services—prevents them from getting professional help or any other alternative help. Thus, to fill in this treatment gap of inaccessibility and unavailability, and to reach the unreached family members, the current study was conducted with 80 family members from the Tirap and Longding Districts of Arunachal Pradesh. This study found that the scope of social work intervention with family members showed minimal knowledge on substance use disorders and its treatment approach. The three-month social work intervention with four psychoeducational family support groups had been found effective. It was ineffective in enhancing knowledge on understanding SUD as a disease due to a reactive and regression effect. The data was analyzed using ANCOVA and SPSS V26. It recommends policymakers to incorporate family members in substance use treatment. Social workers can provide primary care services at community level.

ABSTRACT The discipline of social work operates within a persistent ontological tension between defending universal human rights and respecting local cultures. Traditionally managed through cultural competence, this approach risks reducing deeply structural problems—such as poverty and institutional racism—into static cultural codes, inadvertently reproducing an Orientalist binary that obscures structural violence in Western democracies. To revitalize social work’s foundational commitment to social justice and genuine solidarity, this conceptual article proposes a paradigm shift toward a dual framework: cultural humility as an ethical stance and structural competency as an analytical mandate. Drawing on ethnographic sensibility, the paper explores how practitioners can interpret client resistance not as cultural deficits, but as rational survival strategies forged under institutional duress. Furthermore, the neoliberal bureaucratization of the Turkish welfare system is examined as an analytical illustration of global audit cultures to highlight the limitations of purely theoretical education. Bridging theoretical critique and concrete pedagogical action, the article presents actionable mechanisms for curricular restructuring, including structural vulnerability assessments, mobile supervision (walking classrooms), university-community legal coalitions, and explicit ECTS integration. Ultimately, these pedagogical interventions equip future practitioners to actively dismantle systemic barriers rather than merely manage cultural symptoms.