Professional Understanding Research Articles

Barriers and facilitators to conducting randomised controlled trials within routine care of neurorehabilitation centres: a qualitative study

BackgroundRandomised controlled trials (RCTs) are considered the gold standard for generating clinical evidence. The focus on high internal validity in RCTs challenges the external validity and generalisability of findings, potentially hindering their application in routine care. In neurorehabilitation, limited literature addresses conducting RCTs feasibly and efficiently. We investigated barriers and facilitators to conducting RCTs within routine care of neurorehabilitation centres from the perspective of stakeholders in neurorehabilitation in Germany and Austria.MethodsWe conducted semi-structured interviews with stakeholders in neurorehabilitation from four centres in Germany and Austria, informed by the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation and Behaviour model (COM-B). Employing a hybrid approach, the interview analysis integrated both deductive, theory-driven analysis based on the TDF domains and COM-B model and inductive, reflexive thematic analysis.ResultsTwelve stakeholders (4 physicians, 4 therapy managers, 4 therapists; 5 females, 7 males; with research experience spanning 0–40 years) were interviewed. Key barriers to conducting RCTs in neurological rehabilitation centres include limited financial, human, and time resources, high clinical workloads, and a lack of interest of some therapists. Ineffective leadership, perceived lack of research expertise, and communication issues were also significant barriers. Social influence factors such as lack of employer support and inadequate training access further contributed to the challenges. Additionally, barriers included insufficient research infrastructure, limited space, internal power struggles, and rigid cost bearer specifications. Key facilitators included physicians’ and therapists’ motivation to advance the field, contribute to knowledge, and to prioritise patient health. Support from supervisors, joint decision-making, and efficient organisation were crucial facilitators. Flexible therapy planning, mutual support, and interdisciplinary collaboration also played important roles.ConclusionOur results suggest that increasing professional development and understanding, along with providing adequate financial, human, time, and spatial resources to support research endeavours, implementing effective communication strategies to enhance interdisciplinary collaboration and coordination among team members may contribute to increased motivation and facilitate RCTs within the setting of neurorehabilitation centres.Trial registrationThis study was prospectively registered with the German Clinical Trials Register (08.04.2021 DRKSID DRKS00024982).

Key to successful legislation on the role of professional commitment, organizational behavior and understanding of legislation

This study aims to examine the effect of Professional Commitment (X1) and Organizational Citizenship Behavior (X2) on Legislative Function Performance (Y) through Legislative Function Understanding (Z) as a mediating variable among members of the South Kalimantan Provincial DPRD. The research method uses a quantitative design with mediation analysis. Data were collected from 117 DPRD member respondents using a questionnaire that was tested for validity and reliability. The results of the analysis showed that X2 did not have a significant effect on Y (p-value = 0.089), while X2 had a significant negative effect on Z (p-value = 0.000). On the other hand, X1 showed a significant negative effect on Y (p-value = 0.000), but was not significant on Z (p-value = 0.337). Legislative Function Understanding (Z) did not function as a mediator between X2 and Y (p-value = 0.882) and between X1 and Y (p-value = 0.905). These findings emphasize the importance of increasing the professional commitment of DPRD members and paying attention to organizational citizenship behavior in an effort to improve legislative performance, while also showing that understanding the legislative function does not strengthen the relationship between independent and dependent variables. Further research is needed to explore other factors that may affect legislative performance.

PERCEPTIONS OF THE APPLICATION OF THE CARE MODEL FOR CHRONIC CONDITIONS IN PARANÁ, BRAZIL

The current healthcare model for users with chronic conditions in the Unified Health System needs to be transformed. In Paraná, there are strategies for continuing education and co-financing of services focused on the Chronic Conditions Care Model. This is a descriptive and exploratory study with a qualitative approach that analyzed the perceptions of Primary Health Care and Specialized Outpatient Care professionals about the implementation of the Chronic Conditions Care Model. Four focus groups were held, with the participation of 37 professionals, and the discussions permeated the work processes from the perspective of thematic analysis. The statements identified elements such as risk stratification of the health condition, organization of care, and team rapprochement. The development of the care plan is incipient due to the lack of understanding of professionals and users about the tool. In health units, access occurs according to the logic of acute care, and care sharing through regulatory centers. Continuing education strategies, structured public policies and specific financing are drivers for the consolidation of the Model.

Analysis of School Financial Management in the Context of Tax Accounting: A Case Study at SMP Negeri 3 Hilisalawa'ahe

Schools as educational units manage their finances independently and are bound by tax obligations. Therefore, knowledge of tax accounting is very important in planning and implementing school activities and budgets. School principals, treasurers and BOS teams must understand tax regulations related to school revenues and expenditures; such as income tax (PPh), value-added tax (VAT) and local tax. With the above premise, the author is interested in conducting research on School Financial Management in the Context of Tax Accounting: Case Study at SMP Negeri 3 Hilisalawa'ahe. The purpose of this study is to describe financial management at SMP Negeri 3 Hilisalawa'ahe, analyze the suitability of its management for tax accounting provisions, identify the obstacles faced by the financial management team of SMP Negeri 3 Hilisalawa'ahe and formulate solutions to overcome these obstacles. This research uses a qualitative approach, which is a research procedure that produces descriptive data in the form of speech or writing and observable behavior of the person (subject) itself. The data collection methods used are observation, interviews, and document review with the object of research is the financial management of SMP Negeri 3 Hilisalawa'ahe. Based on the results of the study, it was found that the Financial Management and Reporting of SMP Negeri 3 Hilisalawa'ahe is in accordance with the general provisions and procedures of taxation and there are no obstacles faced in the financial management of SMP Negeri 3 Hilisalawa'ahe because the management team is in accordance with the professional field and understands tax regulations. Translated with DeepL.com (free version).

Psychological Determinants of Investment Decisions: Analyzing Financial Behavior in Personal Investments

Understanding the psychological factors that influence investor behavior is critical in the dynamic world of financial markets. Financial conduct encompasses the decisions and behaviors individuals exhibit in managing their finances, including investments in various asset classes. Factors such as risk tolerance, cognitive biases, emotional influences, and financial knowledge significantly shape investment outcomes. Gaining long-term financial success requires mastery over these behavioral aspects. This study investigates the influence of three psychological factors—information asymmetry, problem framing, and risk propensity—on the investment decisions of 220 active investors trading on the National Stock Exchange (NSE) and Bombay Stock Exchange (BSE). A quantitative research approach was employed, utilizing a structured questionnaire to collect data. Statistical analyses, including regression and correlation analysis, were used to assess the relationships between these psychological variables and investment behaviors. The results reveal significant correlations between psychological factors and investment decisions. Information asymmetry, problem framing, and risk propensity were found to strongly influence individual investor choices. These findings shed light on the intricate role that cognitive biases and psychological processes play in shaping financial decision-making. The study's findings offer valuable insights into the psychological drivers behind investment behavior. By highlighting the impact of these factors, the research contributes to both academic understanding and practical applications for financial professionals. The results underscore the importance of enhancing financial literacy and investor education, enabling more informed decision-making and promoting improved financial outcomes.

Awareness of Interventional Radiology and The Associated Radiation Exposure Risk Among The Public Population and Primary Care Physicians in Saudi Arabia

Introduction: The imperative for healthcare professionals to possess a comprehensive understanding of radiation doses and the associated risks of the diagnostic imaging processes they recommend is underscored by the evolving landscape of medical diagnostics and treatment. Interventional radiology (IR) plays a crucial role in modern medicine, offering minimally invasive alternatives to traditional surgery. However, public and healthcare practitioner awareness of IR and its associated radiation risks remains inadequately explored, particularly in regions like Saudi Arabia. Purpose: This study aimed to evaluate the awareness of interventional radiology (IR) and the associated risks of radiological procedures among the general public and healthcare practitioners in Saudi Arabia, identify knowledge gaps, and inform future educational initiatives. Methods: Participants undergoing radiological procedures were selected using a random sampling technique, with stratification based on gender, age, nationality, and education level. The survey, conducted in Saudi Arabia, comprised 48 questions in yes-or-no and multiple-choice formats, covering demographic information, comprehension of interventional radiology, and awareness of radiation exposure risks. Results: Out of 625 respondents, 62.7% had no prior knowledge of IR, and 94.2% had never undergone IR procedures. A significant proportion (55%) lacked information about the radiation exposure associated with IR, and 57.9% perceived risks from radiation in imaging devices. In the post-educational video, 88.2% favoured IR over traditional treatment methods, with 57.8% expressing a willingness to undergo IR procedures in the future. Conclusion: The study reveals a substantial lack of awareness and knowledge about interventional radiology and radiation risks among the Saudi Arabian population and healthcare practitioners. There is a critical need to enhance public and professional understanding of IR to ensure informed decision-making and patient consent, necessitating targeted educational programs to bridge these knowledge gaps.

Ground failure and soil erosion caused by bursting of buried water pipeline: experimental and numerical investigations

Pressurized water pipelines buried in an urban environment are prone to bursting failures, threatening public safety and traffic convenience. The limited studies in literature just focused on soil fluidization while few studies considered ground failure, shear strain, soil erosion and the influence of leakage locations during pipe bursts. In this study, extensive experimental tests along with a finite difference method – discrete element method (FDM-DEM) solid–fluid coupling analysis were conducted to investigate these issues. It was disclosed that the failure development during pipe bursts can be divided into three stages, i.e., seepage diffusion, erosion cavity expansion, and soil fluidization. By digital image correlation (DIC) analysis of the experimental results, a wedge-shaped displacement zone in ground was identified, with peak shear strain near its boundaries. Moreover, it was revealed that leakage locations affected the expansion origin of erosion cavity; as the burial depths increased, the ground heave range increased linearly; the maximum water outflow distance was closely related to the internal pressures of buried pipeline, which could be modeled by a square root formula based on turbulent jet theory. Mesoscopic analyses revealed that finer particles were more susceptible to erosion during pipe bursts because of the low possibility of forming strong connections with surrounding particles. The findings yielded from this study can enhance the understanding of pipe bursts and help professionals mitigate potential damage.

Exploring Nursing Professionalism: A Focused Ethnography of Community Nurses in Slovakia.

Background: Professionalism is a multidimensional and dynamic concept that is a fundamental requirement to providing safe, quality nursing care. In the Slovak sociocultural context, professionalism is given only limited attention, and research in this area is completely lacking in community nursing. Purpose: To explore how community nurses (CNs) working in home care agencies understand professionalism in the context of their practice in Slovakia. Methods: This focused ethnography involved 10 CNs working in home care in two Slovak regions. The study was conducted between January and July 2022 and employed semistructured interviews, field notes, and reflexive thematic analysis. Findings: In this specific group and setting, understanding of professionalism was reflected through four themes: professional socialization, community service provision, job satisfaction, and professionalism in danger. Conclusions: The findings showed the need to improve the conditions of the working environment of nurses in the community setting. Implications for practice: The findings have implications for local policy, home care agency management, and nursing education in terms of strengthening professionalism in this specific nursing setting and cultural context.

Analisis Kompetensi Pedagogi Guru Pendidikan Agama Hindu Jenjang Sekolah Dasar Di Kabupaten Bangli

The teacher is one of the determining factors of education quality. A professional teacher understands and can apply four competencies: pedagogical, professional, social, and personal competencies. This study aims to describe and analyze the pedagogical competencies of Hindu Religion subject teachers at the Elementary School level in Bangli regency. This research is classified as quantitative descriptive research. The research instrument used was a questionnaire on pedagogical competency consisting of five indicators. Data were analyzed descriptively. The results of the study indicate that the pedagogical competency of Hindu Religion subject teachers at the Elementary School level in Bangli regency overall falls within the category of sufficient. Among the five indicators, the indicator of deep understanding of the subject taught is categorized as good, while the other indicators are categorized as sufficient. This research can serve as a reference for formulating models or strategies for developing the competencies of Hindu Religion and Ethics teachers.

Four Years in, What Are the Research Priorities for Long COVID? A Research Priority-Setting Partnership Between People With Lived Experience, Carers, Clinicians and Researchers.

Long COVID is a life-limiting condition that affects 65 million people worldwide. It devastates lives with uncertain illness trajectories, and yet, there are many research uncertainties as there is a lack of understanding of its causes, effective treatments and management plans. We set out to identify current research priorities for people with Long COVID, carers, healthcare professionals and researchers. A systematic literature review and previous Long COVID priority-setting exercises identified three broad under-researched areas of Long COVID research within the fields of Public Health and Health Services Research: symptoms; managing day-to-day life; and the emotional impact of Long COVID. We disseminated an elicitation survey that asked for research questions in these areas; responses were analysed and summarised into 42 research questions. A survey was then disseminated, asking respondents to prioritise these 42 questions. Workshops were held with people with Long COVID, carers, healthcare professionals and researchers to analyse responses and agree the top 10 priorities. The top priorities in order were pharmacological treatment of Long COVID; understanding the pathophysiology; nonpharmacological symptom management; improving public and professional understanding of Long COVID; understanding of the long-term risks of Long COVID; improving financial and social supports; improving understanding of postviral syndromes; diagnostics; service redesign/pathways; and the well-being of children with Long COVID. Four years into the pandemic, there is an emphasis on the need for research on treatment, understanding and support for people living with Long COVID. People with Long COVID and carers were involved in the study design, survey design, dissemination, data analysis, interpretation and reviewing and editing the manuscript.

Assessing stigma: Health and social worker regard towards working with people using illicit drugs in Athens, Greece

BackgroundAfter the 2008 Global Financial Crisis and resulting economic austerity, the rise in illicit drug use engendered an increased need for people who use drugs (PWUD) to access medical care, compounded by the COVID-19 pandemic. Research shows that perceptions of medical staff towards PWUD facilitate or act as a barrier to accessing health care. This study provides a better understanding of health and social work professionals’ perceptions by assessing stigma levels towards PWUD in Athens, Greece.MethodsThis is a mixed-method study. It calculates the stigma score for professionals (n = 60) and the stigma score associated with specific drugs based on the Medical Condition Regard Scale through a quantitative analysis of responses to a semi-structured online survey about attitudes of health and social work professionals towards PWUD. It draws on the qualitative analysis of 12 semi-structured interviews with 16 service managers, providers, and health services advocates working in the charity sector to determine whether perceptions of PWUD affect writing and implementing policy and protocols for services.ResultsStigma towards PWUD exists amongst health and social work professionals in Athens. Professionals who have worked with PWUD for longer periods of time, professionals who have had specific training on working with PWUD, and professionals who feel that they have the necessary training to work with PWUD all demonstrated a higher stigma score than those reporting the opposite. Cannabis and opioids were associated with lower stigma scores while shisha had the highest level of stigma associated with it. Finally, professional environments are not conducive to alleviating stigma as the lack of training specific to stigma, the lack of professional supervision, and worker burn-out are key barriers faced by professionals in their everyday practice.ConclusionsReducing and eliminating stigma towards PWUD among health and social workers requires immediate action. Measures to be taken include: introducing training programs focused on stigma towards PWUD to healthcare providers, social workers, lawyers, police, the media; increasing professional supervision on field work for health and social workers; introducing low barrier health care and specialist units. Peers and field-focused organisations should meaningfully participate in drug and alcohol policymaking, program development, and implementation.

Abstract B147: Avanzando Equidad de Salud: Latino Cancer Health Equity Research Center

Abstract South Texas (STX), spanning from San Antonio to the Texas-Mexico border, includes 25 rural counties, with 96% designated as primary care shortage areas, are notably the nation’s poorest and most medically underserved regions in the United States. Hispanic/Latinos (H/Ls) in the U.S. face challenges related to social determinants of health (SDoH), contributing to disparities in cancer prevention, diagnosis, treatment, and outcomes. H/Ls have higher risks of invasive cancers compared to peers, emphasizing the critical need to address SDoH to mitigate cancer disparities. Addressing these causes can improve access to healthcare, promote early detection, enhance patient education, and provide culturally competent care. The Avanzando Center (AC) aims to reduce health disparities across STX with community-engaged research, training, patient assessment, and advocacy that addresses the SDoH that deter Latinos from equitable access to cancer care, prevention, early detection, treatment, and improve patients’ cancer outcomes. To achieve its mission, the AC will 1) coordinate Research Scholars on SDoH-related cancer control projects, providing leadership, mentoring, and support in SDoH screening, clinical informatics, and outreach dissemination, 2) implement the SDoH Screener to screen patients at UT Health San Antonio’s Mays Cancer Center, Primary Care Center, and clinics across STX, ensuring they receive necessary support, 3) utilize the Salud America! (SA!) Latino health communications network for community education, empowering STX community members to advocate for local system and policy changes addressing structural SDoH, and 4) provide mentoring and career development in health equity (HE) and SDoH fundamentals to enhance cancer patient care and research advancements in the community. Research Scholars are actively employing interventions for 1) adolescent and young adult cancer survivors by establishing training programs for oncology providers to ensure proper guidance on vaccinations against HPV-related cancers, 2) using technology to improve treatment adherence among Latina breast cancer patients, and 3) addressing disparities in colorectal cancer screening and healthcare access among persistently impoverished populations. These studies will result in rigorous evaluation of intervention effectiveness by addressing the specific needs of cancer patients facing barriers related to SDoH and inform policy and practice initiatives to eliminate cancer as a major health concern. In addition, training and mentoring programs will enhance the knowledge and understanding of cancer care and research professionals, while the SA! Latino HE communication program to raise awareness about SDoH and cancer HE that includes blog posts featuring resources, inspirational stories, and promotional HE tools. The efforts focused on SDoH have the potential to significantly impact cancer outcomes and reduce disparities in Latino communities, ultimately advancing HE and improving overall well-being; specifically improving cancer outcomes, survivorship, and quality of life. Citation Format: Amelie G. Ramirez, Derek Rodriguez, Cliff Despres, Rebecca T. Jones, Ramon S. Cancino, Allison C. Grimes, Jonathan Gelfond, Byeongyeob Choi, Edgar Munoz, Patricia Chalela. Avanzando Equidad de Salud: Latino Cancer Health Equity Research Center [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B147.

Barriers to professional psychological help among pregnant women in China: a qualitative study

BackgroundPregnant women face significant physiological and psychological stressors, which can lead to mental health issues such as anxiety and depression. Despite the importance of professional psychological assistance, many pregnant women in China do not seek help due to various barriers. This study aims to explore the experiences and challenges of pregnant women in seeking psychological help in China through qualitative methods.MethodsPurposive sampling was employed to select 20 pregnant women from a Class III Type A hospital in Hainan. Semi-structured in-depth interviews were conducted from July to August 2023, focusing on psychological states, help-seeking experiences, encountered challenges, and suggestions for improving psychological support. Colaizzi’s 7-step method was used to synthesize the themes.ResultsWe distilled five themes: (1) Psychological conditions during pregnancy, which includes stress and emotional fluctuations and anticipations of postpartum challenges; (2) Barriers to seeking help, underscored by societal misconceptions, limited professional access, and varied familial support; (3) Sources of psychological stress, highlighting physical changes, familial and work pressures, and societal expectations; (4) Expectations for psychological assistance, emphasizing the need for professional understanding and societal awareness; (5) Impact of psychological issues on daily life, such as decreased work efficiency and affected social activities.ConclusionPregnant women in China confront significant psychological stress and face multiple barriers in accessing help. There is an urgent need for personalized and professional psychological services for pregnant women. Addressing barriers such as societal stigma and poor accessibility, along with increasing public awareness and improving mental health services, is crucial. These findings provide a foundation for developing effective psychological support strategies aimed at enhancing the mental health of pregnant women in China.

International social work as a human rights profession in the global society: Challenges and implications of the Sustainable Development Goals

This article discusses the importance of international social work in a global society. In an increasingly globalised world, we are interconnected in many ways and interdependent in a complex geopolitical (dis)order. This also applies to those involved in social work as a human rights profession. For a long time, the idea was that social workers had to act solely on a national level and that looking beyond one's own country could be refreshing but was unnecessary. However, we know how important international relationships, networks, and scientific exchanges are today. Geopolitical decisions often affect social work and its target groups at their core. Existential poverty and unemployment in countries of the Global South led to flight and migration to countries of the Global North. Crises such as wars or natural disasters have a wide range of effects on global value chains. The unequal distribution of poverty and wealth leads to asymmetrical power relations, which are not least the legacy of colonial and apartheid influence. This makes the Sustainable Development Goals (SDGs) set by the United Nations even more important. If, for example, the first goal in SDG 1 is formulated as "No poverty", then this poses numerous challenges for social work stakeholders in municipalities, states, and nations, to which they must find an answer. These challenge social work on several levels. The following article aims to discuss these challenges at macro-, meso- and micro levels and formulate mandates for action for international social work stakeholders. The aim is to contribute to forming a professional understanding that is defined beyond national structures and mandates.

Mengoptimalkan Pengimplementasian Pelatihan dan Pengembangan Pelayanan Tenaga Kerja kesehatan di RSUD Sawerigading

This article discusses the implementation of training and development of health workforce services at Sawerigading Hospital to overcome cases of discrimination between BPJS and non-BPJS patients. This research uses a literature review method with a qualitative approach and highlights the need for increased HR training and development for the optimization of health services. The results showed the importance of improving the skills, knowledge, and inclusive culture of health workers, as well as involving the community in efforts to improve service effectiveness. RSUD Sawerigading has committed to improving employee competencies through technical, soft skills, self-development, and specialization training programs to improve overall health services. Concrete steps are needed to address discrimination against BPJS patients and improve staff understanding of ethics and professionalism in health services to achieve optimal service.

A systematic review of healthcare professionals and women's experiences and perceptions of colposcopy method of cervical cancer screening in Nigeria

Background: Cervical cancer continues to pose a significant public health issue in Nigeria, characterized by high rates of incidence and mortality. Colposcopy is integral to the cervical cancer screening process and its early detection. However, the uptake of colposcopy screening in Nigeria remains suboptimal, with various factors contributing to this phenomenon. Comprehending the experiences and perceptions of healthcare professionals and patients concerning colposcopy for cervical cancer screening is vital to enhance screening initiatives and alleviate the impact of cervical cancer in Nigeria. This systematic review aims to identify the gap in knowledge and synthesize the existing literature on the experiences and perceptions of healthcare professionals and patients regarding colposcopy for cervical cancer screening in Nigeria. Methods: A comprehensive search of the literature was conducted in Academic search elite, African journals online (AJOL), CINAHL, MBASE, psycho info, Cochrane, Medline (via PubMed) and Scopus databases from 2010 until March 2023. The quality of the included studies was assessed using Joanna Briggs Institute (JBI) critical appraisal tool. Thematic analysis was deployed to synthesize the extracted data. Results: Fourteen (14) studies satisfied the inclusion criteria. Most studies were conducted in developed countries and urban settings. The review revealed key themes that were categorized into four: insufficient knowledge/awareness, emotional factors, cultural/religious factors, and organizational/systemic factors. Conclusion: The review identified barriers to colposcopy screening in Nigeria, highlighting the need for targeted interventions to improve cervical cancer screening rates. Hence, the need for a qualitative study in rural parts of Nigeria to explore the in-depth understanding of patients' and healthcare professionals’ regarding colposcopy screening utilization.

Healthcare Professionals' Perspectives on the Use of Standing Frames for Children Diagnosed With Cerebral Palsy: An Explanatory Mixed Methods Study.

Standing frames are commonly used by healthcare professionals in their practice with children with cerebral palsy (CP) who do not have an independent standing function. A better understanding of healthcare professionals' attitudes and experiences with standing frames may impact practice and rehabilitation. Therefore, this study aimed to investigate the standing frame practice among healthcare professionals and expand their attitude and experience with the use of standing frames for children with CP. This is an explanatory sequential mixed methods study. A cross-sectional survey was conducted, providing quantitative data on 210 healthcare professionals' use of standing frames. The quantitative data were descriptively analysed. Subsequently, the results from the survey were followed up with five focus group interviews of healthcare professionals (n = 14). The qualitative data were analysed using thematic analysis, enabling integration between the quantitative and qualitative data. When quantitative and qualitative data are integrated, expansion between the two datasets occurred. The quantitative dataset emphasised the use of GMFCS levels as a guideline for recommending standing frames, whereas the qualitative data showed that the healthcare professionals' recommendations were based on individual needs. Furthermore, the healthcare professionals expanded the quantitative data, showing that the healthcare professionals' considerations regarding age and dosage were based on clinical experience, and saw the standing frame as having many benefits. The healthcare professionals had a child-centred approach, where the child's need for using a standing frame was assessed based on the functional level, stage of development, cognitive level and clinical assessment. All of these considerations showed that the use of standing frames for children with CP was individualised, thereby making it difficult to make unified descriptions.

The meanings of professional development: Perspectives of Malaysian piano teachers

In Malaysia, the work of music studio teachers outside of schools and in private settings is unregulated and teachers have limited access to professional development opportunities. Globally, research on the professional development of music teachers has mostly focused on classroom music teachers, where professional development is often mandated and official support provided. However, little is known about how music studio teachers view professionalism and how they access professional development in this context, nor what this development means for them. For this interpretative phenomenological analysis, we interviewed 12 piano teachers who work in Malaysia to understand the meanings of professionalism and professional development for them. Individual themes that arose from within-case analysis were conceptually combined to form eight superordinate themes. The first four superordinate themes relate to understandings of professionalism. Participants described a professional pride which involves not only a love and enjoyment of music and of teaching, but also manifests flexibility and responsiveness; it entails both teacher and student performing and understanding music, and demonstrates relationality, communication skills, and a positive character. The remaining four superordinate themes relate to understandings of professional development, including the ideas that professional development requires proactivity, that professional development opportunities are affected by environmental and material factors, that professional connections affect development, and finally that training, experience, and mentorship support professional development. In this article, we posit that the lack of formal structures in Malaysia means that professionalism is self-determined by the teacher, while professional development relies on the individual commitment and motivation of teachers. Teachers need greater access to support systems or learning opportunities, and the move to online teacher support sessions due to the COVID disruptions offers some opportunities for supporting professional development more effectively.

Trauma–Sensitive Residential Care: Perspectives of Portuguese Professionals to Spark Change

ABSTRACT Despite global pressure for deinstitutionalization of children in care, and recent legislative changes, Portugal remains a country with very high prevalence of residential care amongst at-risk children. These children were exposed to multiple traumatic events that can disrupt development. Thus, the expansion toward a truly sensitive approach to trauma is valuable, as it aims to increase awareness of its effects and ensure the best empathic care, providing a safe and healthy environment, with consequences also for the wellbeing of residential care staff. The present study aims to characterize the quality of residential care environments in Portugal through the lens of trauma-sensitive care, and to map professionals understanding of main domains, priorities and obstacles to change in this area. The study adopts a mixed method design, reporting on the perceptions of 85 professionals. Main findings show that professionals demonstrate better perceptions regarding physical environment but consider training and supervision as fragile dimensions. Qualitative data bring detail to these views, reinforcing the call for training to all staff and for continuous support to demanding job roles. This exploratory study highlights major aspects that urge to ensure trauma-sensitive residential care – supportive of professionals, to meet the needs of children and youth. Practice Implications The need to invest in training as the cornerstone to gather staff consensus around the importance of trauma-sensitive care and leverage change. The value of supervision in order to strengthen all residential care community. The importance of a shared theoretical background, common to all staff, to ensure secure and restorative relations with children and youth in line with trauma-sensitive care. The added value of the Trauma-Sensitive Care Evaluation Questionnaire for Welfare System as a tool to guide and monitor organizational change and its multilevel impact.

Asystemic Application of the System of Law

In the prism of a specific act of law enforcement, an urgent problem of systemic relations between norms and principles of various branches of law that are outside the traditional institution of bluntness has been identified. The theses were substantiated that the application of the rule of law should be based on a systematic approach to the entire legal space, that compliance or enforcement of a prescription within one branch of law should not be a tort-forming factor in another branch of law, the norms of one branch of law objectively cannot prohibit what is permitted by the norms of another branch of law; if this is the case, then this indicates a systemic problem of the legal space. And this question is addressed not so much to the legislator as to the law enforcement officer, the answer to it is in the plane of professional legal understanding. Only the formation of a systematic approach to the application not of a single rule of law, but of normative legal prescriptions in a system of corresponding links with the provisions of other norms of various branches of law can serve as a guarantee of proper law enforcement.