Staff Knowledge Research Articles

Survey of antimicrobial and probiotic use practices in wildlife rehabilitation in the United States.

Antimicrobial resistance is a global health concern. As such, there have been increased efforts to monitor and standardize antimicrobial prescribing practices in humans and domestic animals. In contrast, there is relatively little known about specific prescribing practices in wild animals despite the wide use of antimicrobials and other microbial interventions, such as probiotics to treat captive wildlife. Therefore, the goal of this study was to examine current antimicrobial and probiotic use from a cross-section of wildlife rehabilitation facilities in the United States. An anonymous electronic survey was sent to 105 United States permitted wildlife facilities to collect information about admissions, current antimicrobial and probiotic use practices, and current staff knowledge and attitudes surrounding antimicrobial resistance and probiotic effectiveness. Respondents from over 50% of facilities participated in the survey (54/105), including 45 facilities that treated birds. All facilities reported using antimicrobials, including some from groups considered critically important for human medicine, for a wide range of medical conditions and prophylaxis. Among antibiotics, enrofloxacin and amoxicillin-clavulanic acid were the most commonly used. Antifungals were not as widespread, but itraconazole was the most commonly used. Over 75% of respondents said that their facilities would benefit from having standardized antimicrobial guidelines in place. Probiotics were also used in more than 50% of facilities, but there was notable disparity in opinions regarding their efficacy. The results of this survey are a first step towards understanding antimicrobial and probiotic use practices in the treatment of captive wildlife and developing an antimicrobial stewardship program for wildlife rehabilitation.

Assessment of Nursing Staff's Knowledge, Attitude and Practice Regarding Oral Hygiene Care in Intensive Care Unit Patients: A Multicenter Cross-sectional Study.

Oral care is one of the fundamental nursing care procedures used to decrease oral colonization, dental plaque, respiratory infections, patient stay, and cost. The importance of good oral hygiene for patients in intensive care units (ICUs) is well recognized, however, the most effective way to achieve good oral care in the ICU is unclear. Therefore, the aim of this study was to assess the knowledge, attitude, and practice of nursing professionals regarding oral healthcare in ICUs among various medical institutes across India. A questionnaire-based multicentric cross-sectional survey was conducted among registered nursing professionals employed at ICUs of three government tertiary healthcare centers (THC) of India: THC-I, THC-II, and THC-III located in the eastern and northern parts of India between February 2022 and July 2022. A total of 150 nurses completed the questionnaire form (response rate: 62.5%) comprised of 49 (32.7%) males and 101 (67.3%) females with a mean age of 35.69 ± 7.7 years. Nursing officers' knowledge surpassed that of staff nurses regarding the duration of toothbrushing (p = 0.033). Among interinstitutional comparisons, THC-I nurses showed the greatest knowledge regarding the duration of toothbrushing and the mechanism of preventing saliva accumulation to reduce microbial growth (p = 0.013 and p = 0.003, respectively). Based on total work experience, participants were segregated into three groups: Group I (<7 years), group II (7.1-13.9 years), and group III (>14 years). Group II surpassed the knowledge of denture removal during sleep, cleaning after every meal, and storing in personalized air-tight containers (p = 0.001 and p = 0.036, respectively). The majority from group II recommended plain saline as the material for oral hygiene maintenance in ICU patients (p = 0.008). Group III predominantly practiced the ideal handwashing technique pre- and post-patient contact which was statistically significant (p = 0.001). This study observed that a knowledge gap exists among the nurses of the three institutes across India pertaining to the oral hygiene care of ICU patients. Nurse's education and implementation of the proper oral hygiene measures for intubated patients in ICU setup is an essential need. Kumar S, Singh B, Mahuli AV, Kumar S, Singh A, Jha AK. Assessment of Nursing Staff's Knowledge, Attitude and Practice Regarding Oral Hygiene Care in Intensive Care Unit Patients: A Multicenter Cross-sectional Study. Indian J Crit Care Med 2024;28(1):48-57.

Assessment of Psychopathological Changes and Mental Functioning in Patients with Multiple Sclerosis – a Literature Review

MS (Multiple sclerosis) is the most common primary disease of the central nervous system. Although neurological symptoms predominate, an increased incidence of mental health disorders is also observed. The most common are depression and anxiety disorders. Cognitive impairment occurs in half of MS patients. Most often, they are associated with difficulties in concentration, memory disorders, and slower information processing. Changes occurring in the CNS cause long-term chronic fatigue. The loss of sexual drive may be caused by CNS pathology, especially the limbic system and brain stem nuclei, or by psychological mechanisms in response to the impact of MS symptoms. Pain is very troublesome for patients and makes it difficult to function, disturbing the quality of sleep, negatively affecting mood, causing anxiety and depression. A complete understanding of all aspects of MS in the bio-psycho-social dimension is necessary to provide holistic care to a patient with MS. The knowledge of medical staff regarding the image of psychopathological changes in the course of MS may be of great importance for the proper assessment of the mental state of patients and for undertaking adequate medical and nursing interventions. This will undoubtedly contribute to reducing psychopathological symptoms in patients themselves and thus improving the quality of life. (JNNN 2023;12(4):177–182)

Strengthening Competence of Hospital Data Management to Control The Quality Of Cesarean Section Rate in Banten Province, Indonesia

Cesarean delivery dramatically increased worldwide, including in Indonesia, especially after the implementation of National Health Insurance, with a steady increase of 2-3% every year. This study aims to evaluate the effect of guidance in implementing the Robson Classification in cesarean section quality control in hospitals. Three hospitals in Banten were enrolled in this study: one public hospital and two private hospitals. Each hospital’s staff were given online and offline training on quality control of cesarean section, managing cesarean section data, data entry, data analysis and presentation using Robson Classification. Participant’s knowledge and attitude were collected before and after intervention using a standardized questionnaire. The results showed that the intervention improved many aspects of the workflow and knowledge of the hospital staff regarding cesarean section. There was an increase of up to 77.7% in digital data management, a 23.6% increase in routine meeting activities, and a 29.5% increase in cesarean quality control. The Robson classification system was implemented successfully, increasing the staff's ability to identify the groups needing cesarean sections more effectively. Guidance on data management for cesarean section increases the ability of the three hospitals in Banten to control cesarean section using Robson's Classification. Guidance methods can be used to assist other hospitals in controlling cesarean section.

From qualitative reflection to reflexive quality: an intersectoral approach to quality of care

Background: All over the continent, organizations in healthcare and welfare are increasingly being challenged to be transparent about what they are doing and to provide evidence regarding the results they achieve. Some organizations choose to develop policy and practice based on a variety of indicators and strictly scientifically based criteria. In this perspective, quality of care is measured against the background of those standardized indicators. Other organizations consider care as a craft or even an art which is impossible to capture in strictly standardized norms and indicators. In such organizations, scientific knowledge is often seen as subordinate to the experiential knowledge of service users and practical knowledge of staff members. Hence, quality of care is measured by – amongst other things – proximity and involvement with service users.&#x0D; Within Emmaüs vzw, an organization that overarches a variety of facilities in the fields of healthcare and welfare in Belgium, forces were joined to develop a new framework for quality of care in which an effort is made to transcend the contradiction that is outlined above. In order to do so, the experiential knowledge of service users, the practical knowledge of staff and research based knowledge were combined and considered to be equally valuable in tackling issues regarding quality of care.&#x0D; The project: Building on participatory action research with service users, their social context, staff members, policy makers and academics, we co-constructed a value-driven and intersectoral framework for quality of care that is underpinned by rhizome theory (Guattari &amp; Deleuze, 2014). The ecological approach to quality of care entails an effort to capture and do right by the complexity that characterizes the fields of care and welfare. Furthermore, we connected the concepts of quality and reflexivity in a meta-model that can be used to fuel quality improvement across healthcare en welfare organizations. In our project, service users and staff were involved as respondents and as co-researchers. We use the CAIMeR theory (Blom &amp; Morèn, 2010) as an analytical framework to describe processes of change and to capture effective practice. Although the project is still ongoing, our research shows that the intersectoral framework is widely accepted across organizations in youth care, mental healthcare, elderly care and support of people with disability. Recently also a general hospital expressed their interest in our intersectoral framework and reflexive meta-model.&#x0D; Presentation: We will present the highlights of our co-constructed framework for quality of care and the reflexive meta-model that is currently piloted in different organizations.&#x0D; Learning objectives: After this session, participants will be able to:&#x0D; &#x0D; Understand how participatory action research can help further policy and practice on quality of care across healthcare and welfare organizations.&#x0D; Understand how the reflexive meta-model we developed can be used in practice.&#x0D;

A systematic review of ‘equity-focused’ game-based learning in the teaching of health staff

BackgroundAn unequal distribution of the social determinants of health drives health inequalities. Existing training fails to communicate the impossible circumstances that disadvantaged groups face. Game-based learning is increasingly used as an innovative method with the potential to enhance health staff's ability to address health inequalities, but its effectiveness is unknown. Therefore, the aim of this systematic review was to evaluate the effectiveness of ‘equity-focused’ game-based learning in training health staff. Study designSystematic Review. MethodsThree databases (Ovid Medline, Embase, Web of Science) and a citation search were systematically searched for articles from January 2010 to July 2023, reporting on effectiveness of ‘equity-focused’ game-based learning. Titles and abstracts were screened using eligibility criteria to identify relevant studies. Data was extracted and the ROBINS-I tool was used to assess quality. ResultsThe search identified 7615 articles, of which thirteen were included involving 2412 healthcare workers. A variety of game-based learning tools were found to have an overall positive effect on motivation, knowledge, attitudes, and engagement of health staff. However, the significance of the results varied depending on specific game context. All included studies were judged to have serious to critical risk of bias. ConclusionsGame-based learning has the potential to improve the effectiveness of ‘equity-focused’ training for health staff. Educators and researchers should further collaborate to expand the tools available and evaluate their effectiveness on long-term clinical practice.

Tracheostomy tube changes in patients with tracheostomy: A quality improvement project.

Tracheostomy tube changes are a considerable part of the management of patients with tracheostomy and are necessary for preventing aspiration pneumonia, especially in patients with long-term tracheostomy. The process of tracheostomy tube changes in many patients may not be timely, safe or efficient. The objectives were to implement a quality improvement intervention that reduces the incidence of aspiration pneumonia in patients with tracheostomy, improve staff knowledge about tracheostomy tube changes and improve staff adherence to documentation. A pre-post intervention design was used in this quality improvement project. We created a change strategy bundle that included identification of the need for and observation determination of the timing of tube changes timing, change assessments, identification of the person and location, preparation, co-operation and maintenance. A tracheostomy tube change workflow was also created. Then, the intervention was implemented in the clinic after staff training. The incidence of aspiration pneumonia, staff knowledge and staff adherence were compared before and after the intervention. Two hundred and 20 patients were enrolled (105 in the preintervention group; 115 in the postintervention group) with 88 tracheostomy tube change episodes (23 in the preintervention group; 65 in the postintervention group). Thirty-five staff members completed the training and surveys. The incidence of pneumonia decreased from 43.8% to 27.8% after the intervention (p = .013). The knowledge score of staff increased from 46.57 ± 11.10 to 88.14 ± 6.76, and the implementation rate of the audit increased to 67.32%-100%. This quality improvement project regarding tracheostomy changes reduced the incidence of pneumonia, increased staff knowledge about tracheostomy tube changes and improved staff adherence. A standardized tracheostomy tube change bundle, education, interprofessional collaboration and culture changes were important to ensure the best outcomes in this quality improvement project. These factors improved the timeliness, efficiency and safety of tracheostomy tube changes.

Introduction of the Hepatitis B Vaccine-Birth Dose: Methods of Improving Rates in a Milieu of Vaccine Hesitancy.

The hepatitis B virus is a public health threat, chronically infecting over 240 million persons worldwide. The hepatitis B vaccine is 90% effective in preventing perinatal transmission if the first dose is given within the first 24 h of life, followed by a minimum of two subsequent doses. Antigua and Barbuda instituted a hospital-based birth dose vaccination policy in October 2021. Data were extracted from hospital logbooks from November 2021 to October 2022, and a database was created. Frequency distributions of the hepatitis B birth dose, barriers to administration, and maternal and healthcare system factors were analyzed. The positive maternal HBsAg prevalence rate was 0.6%. The timely and total birth dose coverage was 72% and 81%, respectively. In total, 10.5% of parents refused the vaccine, of which 76% either felt uncomfortable or preferred to wait. Moreover, 100% of hepatitis B-exposed babies were vaccinated, with 83% of them receiving the Hepatitis B Immunoglobulin. Barriers to vaccine administration included vaccination hesitancy, gaps in knowledge of medical staff, and the inconsistent vaccination supply. Instituting a quality improvement team, health information system, robust educational efforts, and addressing barriers will make achieving the WHO programmatic targets of eliminating mother-to-child transmission of hepatitis B by 2030 possible.

“Giving the People Who Use the Service a Voice”: Student Experiences of University Disability Services

Disabled students are systematically disadvantaged compared to their non-disabled peers and Disability Services can provide important access to accommodations and support. Such services are not, however, without issues. The present study investigates student experiences with University Disability Services in order to identify shared barriers to inclusion and recommendations for practice. Individual semi-structured online interviews were conducted with twelve female students. Each student discussed their engagement with Disability Services as an undergraduate or postgraduate student, and each student disclosed a long-term, nonvisible condition. A thematic analysis was used to identify three themes. These were (1) Identity and Legitimacy (Identification as Disabled, Perceived Legitimacy, The Importance of Evidence), (2) Knowledge and Understanding (Knowledge of Specific Conditions, Knowledge of Disability Services, Disability Services Staff Knowledge and Understanding, Peer Knowledge and Understanding), and (3) Independence and Support (Desire for Autonomy, The Importance of Self-Advocacy, Additional Support). The findings highlight shared barriers to support experienced by students with different diagnoses who engage with University Disability Services. A range of recommendations are provided to improve Disability Services provision (e.g., universities are advised to review the language used to advertise Disability Services).

IMPLEMENTING REABLEMENT IN COMMUNITY CARE: HOW DO WE SUCCEED?

Abstract In the Netherlands, reablement is high on the agenda for inclusion in future health care policy, resulting in more and more care providers wanting to implement reablement into their everyday practice. So far, it has been implemented, resourced and organized in multiple ways. To support the implementation on an (inter)national level, insight is needed into what preconditions and influencing factors are regarding the successful implementation of reablement. Within a qualitative exploratory research design, four focus group interviews were conducted with stakeholders from three Dutch care organizations that have been providing reablement services for at least 6 months prior. Care staff, as well as project leaders, managers, directors, policymakers, and health insurance company representatives, were represented in the interviews. Data were analyzed using the framework method guided by the Consolidated Framework for Implementation Research. In total, 34 stakeholders, distributed over the four focus group interviews, participated in the study. Facilitators included interdisciplinary collaboration, organizational support in terms of leadership engagement and implementation climate, innovation design, and adaptability of the innovation. Barriers included costs and funding of the innovation, time investment (i.e. reporting, number of care visits), and communication. Some factors were listed as both hindering and facilitating such as knowledge and beliefs of care staff, staff’s and clients’ self-efficacy to change, and motivation of clients and family caregivers. These results enhance the understanding of factors influencing the implementation of reablement in community care. The next step is to identify strategies to overcome the identified barriers.

ACCEPTABILITY OF A REMINISCENCE THERAPY TABLET APP: IMPACT ON RESIDENTIAL CARE STAFF OF PERSONS LIVING WITH DEMENTIA

Abstract With dementia prevalence rapidly on the rise and no viable pharmacological treatments currently available, the development of accessible, efficacious, and low-cost non-pharmacologic interventions for persons living with dementia (PLWD) has become critical. Reminiscence therapy (RT) and life story can be built into residential care provision to provide person-centered solutions that elicit conversation, engagement, and socialization with staff. RT tools can also help inform care staff about residents’ lives and preferences to provide higher quality and meaningful interactions. This paper details the development and evaluation of LifeBio Memory, a tablet application designed to record the life stories and care preferences of PLWD in residential care communities. Care staff (n = 60) from 10 communities in Ohio, including memory care, assisted living and nursing homes, were trained to implement LifeBio Memory in their organizations. A pre-post design was used with staff, mainly comprised of life enrichment, administration, social work, rehab, and direct care staff. Outcomes presented include but will not be limited to: 1) acceptability, feasibility, and satisfaction with the tablet app, 2) staff knowledge of resident care preferences and interests, 3) utilization of person-centered care practices, 4) quality of communication between the resident and themselves and other staff, 5) their current understanding of that resident’s life history, and 6) level of tension and frustration with the resident. Discussion will focus on the need for sustainable RT interventions that promote person-centered care for PLWD and ways in which technological advancements can be integrated into residential care staff workflow.

Staff Capacity and Management of Diabetic Patients at Mnazi Mmoja Hospital in the Urban District of Unguja, Zanzibar

Non-communicable diseases (NCDs) stand as a formidable global public health challenge, casting a shadow over populations and contributing significantly to global mortality rates. Among the primary culprits in this health crisis are cardiovascular diseases, diabetes, chronic respiratory diseases, and cancer. This study zeroes in on a critical facet of this challenge - the staff capacity and management of diabetic patients at Mnazi Mmoja Hospital in the Urban District of Unguja, Zanzibar. The urgency of this research is accentuated by the staggering statistic that approximately 415 million people worldwide are grappling with diabetes, catapulting it into the forefront of global health emergencies in the twenty-first century. In response to this pressing need, 205 questionnaires were distributed among diabetes health workers at Mnazi Mmoja Hospital, creating a comprehensive foundation for analysis. Employing statistical techniques with SPSS version 26, the study sought to unravel the intricate landscape of staff knowledge and the challenges faced in managing diabetic patients.&#x0D; The findings of the study paint a nuanced picture, revealing that 38.6% of the staff possessed specialized knowledge in managing diabetic patients, while 61.4% had general knowledge. Alarmingly, only 36.3% of diabetic health workers were available for the management of diabetic patients. The study sheds light on the multifaceted challenges faced by the staff, with issues related to equipment, drugs, support from relatives, psychotherapy treatment, and drug adherence and compliance all surfacing as significant concerns, reported by varying percentages. In the face of these challenges, the study underscores a compelling message: the critical importance of hospital management in recruiting staff with expertise in diabetic treatment and care. This strategic hiring approach is seen as a linchpin for ensuring the efficient and effective management of diabetic patients. Moreover, the study advocates for ensuring the availability of adequate equipment, medical supplies, and materials essential for investigating diabetes and its complications, such as diabetic foot, renal failure, and cardiovascular diseases. This comprehensive approach is deemed crucial for providing holistic care to patients grappling with the complexities of diabetes.

Factors Impacting Compliance with Infection Control Guidelines among healthcare providers in Neonatal Intensive Care Unit, referral hospital, Saudi Arabia

Healthcare-associated infections continue to be a major problem that endangers patient safety, especially for critically ill hospitalized patients. Reducing the risk of this infection can be achieved through improving compliance with infection control guidelines and identifying and controlling the associated factors. This study aim to investigate factors impacting compliance with infection control guidelines and increasing the risk of healthcare-associated infections in neonatal intensive care units. A qualitative approach, a one-to-one interview design, was used, between April 15 and May 15, 2021, to interview ten participants who worked in the neonatal intensive care unit at a Saudi Arabian referral hospital. Through data analysis, two major themes and four sub-themes were found, which include a factor related to the workforce (shortage of staff and lack of knowledge) and factors related to the workplace (shortage of supplies and lack of monitoring). In conclusion, healthcare-associated infections in neonatal intensive care units are a serious issue that could lead to an increase in mortality and morbidity rates among patients. Thus, healthcare settings' commitment to improve compliance with the infection control guidelines is essential to lowering the incidence of healthcare-associated infections. This can be achieved through proper staffing, sufficient supplies, and effective monitoring.

Increasing Managerial Capabilities in Non-Profit Organizations in Leles Garut

This community service activity aims to analyze strategies for increasing managerial capabilities in non-profit organizations in Leles Garut, Indonesia. Non-profit organizations are faced with unique challenges in their management and operations, requiring innovative approaches to increase effectiveness and social impact. The methods used in this activity include literature analysis, surveys of non-profit organizations in Leles Garut, and interviews with organizational leaders. The results of the activities show that technology integration, human resource development, and business strategy adaptation are key factors in improving managerial capabilities. Technology integration, such as the use of digital platforms for project management and data digitization, has been proven to increase operational efficiency. Training also plays an important role in updating the knowledge and managerial skills of staff. Human resource development through leadership training, mentoring programs, as well as regular evaluation and feedback, supports the formation of competent and adaptive teams. In addition, adapting business strategies through SWOT analysis strengthens an organization's capacity to face competition and changing needs. This activity concludes that non-profit organizations in Leles Garut can achieve improved performance and greater social impact by implementing managerial strategies tailored to their local needs and context. These results provide practical guidance for non-profit organizations in developing managerial capabilities, as well as a theoretical contribution to the non-profit organization management literature.

Evaluation of the Infection Control Training in The Sulaimani City Governmental and Nongovernmental Hospitals

The healthcare staff, to apply prevention and control Health associated infection guidelines need basic knowledge on standard precaution and the medical staff to gain this knowledge they need education through effective training. For that reason, training is a fundamental part of every infection control programs. Aim of the study is to evaluate the Sulaimni governmental and non-governmental hospitals training process on the infection control. A descriptive cross-sectional study was carried at inside Sulaimani city (11 governmental and 7 non-governmental) hospitals in the Kurdistan Region of Iraq and the data collected by constructed questionnaire form from both hospital administrations and also from 200 healthcare workers who working in those hospitals from 2nd October 2022 to 25th February 2023. The result show that most of the Sulaimni hospitals their infection control responsible of staff training 11 (61.1%), provide continuous training on the infection control 16 (88.9%) and 9 (56.25%) provide training when the workers need it. For healthcare staff, majority of the healthcare staff 111 (55.5%) did not attended any training on the infection control and 142 (71%) did not attended any training in the current hospitals they working in it now. In conclusion, the study reveals that most of the Sulaimni hospitals claim that they having a continuous training based on the evaluated data on the healthcare staff knowledge. Contrast majority of the healthcare staff reported that they did not attend any infection control training in the previous or the current hospital.

Effectiveness of Nurse’s Knowledge and Practices Program Toward Care of Patient Undergoing Cardiopulmonary Bypass

Abstract&#x0D; Objective : the aim of the study is to evaluate the effectiveness of nurse’s practices and knowledge program toward care of patient with cardiopulmonary bypass .Methodology: A pre-experimental design (one group pretest- posttest design) was used to carry out this study in three governmental hospitals in Baghdad ( Iraqi Centre for Heart Diseases , Ibn – Albitar Centre for Cardiac Surgery and Ibn – Alnafees Centre for Cardiothoracic and Vascular Surgery ) for the period from 15th of May 2022 into 20th of April 2023.The construction and development of the program and instruments had carry out by the researcher to measured the purposes of the study , twenty two nurses was purposively assigned for the study group . The study instrument consisted from three parts ,socio – demographic data that consist from ( 4 ) items , knowledge part that consist from ( 25 ) items , and observational checklist for practices part that consist from ( 26 ) items . Descriptive and inferential statistics was used to analyse the study data .Results : The results of the study presented that effect of nurses practices and knowledge program toward care of patient with cardiopulmonary bypass was positive with highly significant level between pretest and posttest for knowledge and practices. Conclusion :Nursing care for the patient with cardiopulmonary bypass have been improved related to the enhancement of nursing staff knowledge and practices toward cardiopulmonary bypass.Recommendations : The study recommended to apply this program as apart of continues education in hospital that perform cardiac surgery in Iraq , also encourage the ministry of health to provide educational programs that depending on standards guidelines and advanced research on cardiopulmonary bypass .&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Deployment of academic staff and disciplinary contexts in strategies for curriculum internationalization: a dynamic resource-based view of organizational change

ABSTRACT In higher education literature, academic staff have long been considered the main blockers in internationalizing study programs, but recent research suggests that the real blockers are the many changes required in their disciplinary contexts. However, both perspectives have not been based on organizational change theory including academics and their disciplinary contexts. This article examines the recurring institutional issues with strategies, resources, and connections with curriculum internationalization from a Dynamic Resource-Based View of organizational change. The dimensions of this resource-based organizational change theory have been decomposed into five propositions for investigating the value of strategies for curriculum internationalization as perceived and experienced by academic staff in specific disciplinary contexts. In a multiple case study of four disciplinary contexts in a West-European university from 2012 to 2020, we studied 56 strategic documents and 29 in-depth interviews with academic staff. Our theory-based approach and value-adding analysis with multiple data, cases, and researchers allow for theoretical generalization with implications for higher education strategy development in various regions of the world. Our findings reveal that, as a process involving organizational changes, curriculum internationalization requires more explicit, integrative strategies, adequate deployment of leadership, knowledge, and academic staff competencies, and strategic alignment with core processes and the specifics, commonalities, and dynamics of disciplinary contexts. Based on the selected theoretical perspective of organizational change, we present new explanations and practical guidelines to substantiate and improve the process of internationalizing study programs. At the same time, we demonstrate the critical role of academic staff and their disciplinary contexts.

Antibiotic Prescribing Pattern: Pharmacy Staff Knowledge about Antibiotics at Primary Health Care Centers in Riyadh City, Saudi Arabia

Antibiotic Prescribing Pattern: Pharmacy Staff Knowledge about Antibiotics at Primary Health Care Centers in Riyadh City, Saudi Arabia

Development of an Aboriginal Resilience and Recovery Questionnaire – a collaboration between practitioners and help-seeking clients of a Victorian Aboriginal community controlled health service

BackgroundIndigenous experiences and perspectives of resilience, healing and recovery from trauma is gaining increasing attention, with a growing qualitative literature that spans multiple indigenous cultural groups. However, few quantitative measures are available. In this article, development of a preliminary version of the Aboriginal Resilience and Recovery Questionnaire is described.AimThe first aim of this study was to describe findings from two focus groups that provided theoretical knowledge and development of items for a draft version of an Aboriginal Resilience Recovery Questionnaire. The second aim of the study was to conduct a preliminary psychometric analysis of the properties of the measure.DesignMulti-method research design grounded in indigenous research methodologies.MeasuresAboriginal Resilience and Recovery Questionnaire, Australian Aboriginal Version of the Harvard Trauma Questionnaire Trauma symptom subscale, Growth and Empowerment Measure.Results(1) Two focus groups with six counselling staff from an Aboriginal health service were run that explored Victorian Aboriginal understandings of resilience, healing, and recovery from trauma. Sixty different protective factors viewed as potentially important to resilience, healing and recovery from trauma were identified by participants. (2) Following a review of the resilience literature, 75 items were reviewed and revised, with additional items developed by the focus group. (3) The final outcome was 60 items selected for a preliminary version of the Aboriginal Resilience Recovery Questionnaire, 50 of which made up 19 different subscales in addition to 10 single items. (4) Structured interviews were conducted with 81 help seeking Aboriginal clients recruited from the same health service. Preliminary psychometric assessment of the Aboriginal Resilience Recovery Questionnaire was undertaken using Principal Components Analysis. Two component subscales were extracted with adequate internal consistency and good convergent and discriminant validity. For both subscales there were moderate to strong positive associations with empowerment, and moderate to strong negative associations with trauma symptom severity.ConclusionThe preliminary results are promising for a strength-based resilience measure developed from the knowledge of Aboriginal practitioners and staff of a counselling service. Further research to address some psychometric limitations in the measure is required. A larger sample size will allow for a common factor analysis to be conducted. The Aboriginal Resilience Recovery Questionnaire has potential to assist Aboriginal Community Controlled Health Organisations and other organisations to evaluate whether services and programs can effectively support community members to strengthen individual, relational, community and cultural resilience resources.

Strategies to improve the magnetic resonance imaging experience for autistic individuals: a cross-sectional study exploring parents and carers’ experiences

BackgroundAutistic individuals encounter numerous barriers in accessing healthcare, including communication difficulties, sensory sensitivities, and a lack of appropriate adjustments. These issues are particularly acute during MRI scans, which involve confined spaces, loud noises, and the necessity to remain still. There remains no unified approach to preparing autistic individuals for MRI procedures.MethodsA cross-sectional online survey was conducted with parents and carers of autistic individuals in the UK to explore their experiences, barriers, and recommendations concerning MRI scans. The survey collected demographic information and experiential accounts of previous MRI procedures. Quantitative data were analysed descriptively, while key themes were identified within the qualitative data through inductive thematic analysis.ResultsSixteen parents/carers participated. The majority reported difficulties with communication, inadequate pre-scan preparation, and insufficient adjustments during MRI scans for their autistic children. Key barriers included an overwhelming sensory environment, radiographers’ limited understanding of autism, and anxiety stemming from uncertainties about the procedure. Recommended improvements encompassed accessible communication, pre-visit familiarisation, noise-reduction and sensory adaptations, staff training on autism, and greater flexibility to meet individual needs.ConclusionsThere is an urgent need to enhance MRI experiences for autistic individuals. This can be achieved through improved staff knowledge, effective communication strategies, thorough pre-scan preparation, and tailored reasonable adjustments. Co-producing clear MRI guidelines with the autism community could standardise sensitive practices. An individualised approach is crucial for reducing anxiety and facilitating participation. Empowering radiographers through autism-specific education and incorporating insights from autistic individuals and their families could transform MRI experiences and outcomes.