Understanding health system resilience in responding to COVID-19 pandemic: experiences and lessons from an evolving context of federalization in Nepal

From Springer Nature via Jisc Publications RouterHistory: received 2023-05-11, registration 2024-02-19, accepted 2024-02-19, epub 2024-04-04, online 2024-04-04, collection 2024-12Acknowledgements: The authors would like to acknowledge all stakeholders who participated in this study and shared their valuable experiences.Publication status: PublishedMaria Paolo Bertone - ORCID: 0000-0001-8890-583X https://orcid.org/0000-0001-8890-583XSophie Witter - ORCID: 0000-0002-7656-6188 https://orcid.org/0000-0002-7656-6188This record replaces https://eresearch.qmu.ac.uk/handle/20.500.12289/13690 for the AAM, which was deposited on 2024-03-05.Introduction: The COVID-19 pandemic has tested the resilience capacities of health systems worldwide and highlighted the need to understand the concept, pathways, and elements of resilience in different country contexts. In this study, we assessed the health system response to COVID-19 in Nepal and examined the processes of policy formulation, communication, and implementation at the three tiers of government, including the dynamic interactions between tiers. Nepal was experiencing the early stages of federalization reform when COVID-19 pandemic hit the country, and clarity in roles and capacity to implement functions were the prevailing challenges, especially among the subnational governments. Methods: We adopted a cross-sectional exploratory design, using mixed methods. We conducted a desk-based review of all policy documents introduced in response to COVID-19 from January to December 2020, and collected qualitative data through 22 key informant interviews at three tiers of government, during January-March 2021. Two municipalities were purposively selected for data collection in Lumbini province. Our analysis is based on a resilience framework that has been developed by our research project, ReBUILD for Resilience, which helps to understand pathways to health system resilience through absorption, adaptation and transformation. Results: In the newly established federal structure, the existing emergency response structure and plans were utilized, which were yet to be tested in the decentralized system. The federal government effectively led the policy formulation process, but with minimal engagement of sub-national governments. Local governments could not demonstrate resilience capacities due to the novelty of the federal system and their consequent lack of experience, confusion on roles, insufficient management capacity and governance structures at local level, which was further aggravated by the limited availability of human, technical and financial resources. Conclusions: The study findings emphasize the importance of strong and flexible governance structures and strengthened capacity of subnational governments to effectively manage pandemics. The study elaborates on the key areas and pathways that contribute to the resilience capacities of health systems from the experience of Nepal. We draw out lessons that can be applied to other fragile and shock-prone settings.pubpu

THE RELATIONSHIP BETWEEN SOCIODEMOGRAPHIC FACTORS AND TEENAGE PREGNANCY IN NIGERIA: INSIGHTS FROM SECONDARY DATA ANALYSIS OF DEMOGRAPHIC HEALTH SURVEYS

The aim of this study was to evaluate the occurrence of teenage pregnancy in Nigeria, with a specific focus on the influence of sociodemographic characteristics on girls between the ages of 15 and 19. The study employed the ecological systems theory as its framework to investigate the influence of religion, education, wealth index, and geographical area on teenage pregnancy. The ICF provided the secondary data from the 2018 Nigeria Demographic Health Survey. The study utilised data collected from a sample of women aged 15-49 residing in 40,427 households. The data were examined using percentages, a Binary Logistic Regression model, and the Pearson Chi-Square Statistic. The study findings indicate that both educational attainment and wealth index exert a substantial influence on the occurrence of adolescent pregnancy in Nigeria. The study also demonstrated that geopolitical zones have minimal impact on teenage pregnancy. Nevertheless, religion has no discernible influence on teenage pregnancy. The study demonstrates the influence of education and economic empowerment on decreasing rates of adolescent pregnancy. It emphasises the significance of developing intervention programmes tailored to individual regions, taking into account cultural subtleties. The study proposed the adoption of a multifaceted approach, encompassing comprehensive sex education, economic empowerment programmes, culturally sensitive interventions, and community-based efforts that engage healthcare practitioners and religious leaders. This study provides valuable insights into the complex nature of adolescent pregnancy and offers ways to address reproductive health issues among teenagers in Nigeria. As a result, it contributes to policy making, education, and the growth of healthcare in the country

Community music therapy with refugee children in transit camps on the Greek island of Chios: ‘Like one family, together’

Giorgos Tsiris - ORCID: 0000-0001-9421-412X https://orcid.org/0000-0001-9421-412XItem is not available in this repository.This chapter is based on a five-year practice-led exploration of group music therapy with refugee children on the Greek island of Chios. Although an increasing number of music therapists work with refugees, practice is only sparsely documented, and there are rare accounts of work within transit camps to date. This chapter seeks to contribute to this gap. Extending beyond trauma-specific considerations, we outline the development of a community-oriented approach to music therapy in relation to the everyday refugee experience within formal and informal transit camps. The narratives and insights emerging from this exploration are explored alongside the principles of Psychological First Aid (PFA). We reflect on the role of music therapy in relation to refugee children's experience of crisis and adversity. Future directions that are transferable to other similar contexts of practice are discussed.https://www.taylorfrancis.com/chapters/edit/10.4324/9781003265610-3/community-music-therapy-refugee-children-transit-camps-greek-island-chios-mitsi-akoyunoglou-giorgos-tsiris?context=ubx&refId=14738761-b628-47e5-bb4b-e821729c9664https://doi.org/10.4324/9781003265610pubpu

How to measure lineup fairness: Concurrent and predictive validity of lineup-fairness measures

This item is embargoed in this repository until 2025-02-01.Jamal Mansour - ORCID: 0000-0001-7162-8493 https://orcid.org/0000-0001-7162-8493The current study examined the concurrent and predictive validity of four families of lineupfairness measures—mock-witness measures, perceptual ratings, face-similarity algorithms, and resultant assessments (assessments based on eyewitness participants’ responses)—with 40 mock crime/lineup sets. A correlation analysis demonstrated weak or non-significant correlations between the mock-witness measures and the algorithms, but the perceptual ratings correlated significantly with both the mock-witness measures and the algorithms. These findings may reflect different task characteristics—pairwise similarity ratings of two faces versus overall similarity ratings for multiple faces—and suggest how to use algorithms in future eyewitness research. The resultant assessments did not correlate with the other families, but a multilevel analysis showed that only the resultant assessments—which are based on actual eyewitness choices—predicted eyewitness performance reliably. Lineup fairness, as measured using actual eyewitnesses, differs from lineup fairness as measured using the three other approaches.https://doi.org/10.1080/1068316X.2024.2307358aheadofprintaheadofprin

PRESENTING THE STATE OF GOLD MINING AFFAIRS IN GHANA: A SCOPING REVIEW TO INFORM NATIONAL POLICY PRIORITIES.

Background: Just like any other mineral rich country, Ghana is burdened with huge economic, health, social, and environmental challenges associated with gold mining activities (GMA). Literature shows massive societal gains as the result of the gold mining industry. However, there is substantial gap in literature on the effects and impact of gold mining on community’s health and livelihood. There is also lack of clarity on the response actions being undertaken by key stakeholders such as the government, mining companies and community members to address negative effects. This review therefore presents an overview of how GMA in Ghana affects communities’ health and livelihood and describes the various response actions that stakeholders have resorted to cope, or deal with the negative effects. Methods: Comprehensive literature searches were conducted in 3 databases (PubMed, Medline, and Scopus) and additional sources of evidence sought from 2 Ghana University databases, grey literature, social media, and websites. Data was extracted and imported into Excel for screening and 33 sources of evidence were included in this review. The scoping review was conducted based on the 6-stage methodological framework by Arksey and O’Malley and JBI Manuel for Scoping Reviews synthesis. The review is reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Results: The analysis of 33 sources of evidence highlights a growing interest in the gold mining industry, with over one-third (19) of the sources published since 2019. This review reveals the complex, non-linear effects of gold mining activities, encompassing reduced agricultural productivity, land-use conflicts, economic challenges, heightened disease burden, and potential health risks. Furthermore, it delineates the distinct roles played by gold mining corporations, the Ghanaian government, and local communities in addressing the adverse impacts of gold mining activities. Research Implication: While there exists a wealth of data on the environmental and health effects of gold mining in Ghana, much of it is derived from laboratory investigations and cross-sectional studies, with disproportionate attention placed on the activities of illegal miners (Galamsey). There are limited studies from community perspectives, so participatory research with communities is needed. The review also highlights the need for implementation research that will measure the effectiveness of interventions in improving economic livelihood, safety, and health of communities. Conclusion: Living in close proximity to gold mining companies exposes individuals and communities to various adverse effects on their health and livelihoods, even if they are not directly engaged in gold mining activities. Therefore, there is a critical need for a national shift in research, interventions, and policies to achieve an equilibrium between socioeconomic gains and health

Stakeholder perspectives on the impacts of inadequate sexuality education on adolescents’ health at schools: A qualitative study in Savar City, Bangladesh

Background: Sex education (SE) is regarded as essential to improving adolescents’ sexual and reproductive health and rights. In most impoverished nations, including Bangladesh, teenagers experience problems because they lack knowledge about sexuality, sex, physical changes, puberty, teenage pregnancy, early childbearing, and HIV/AIDS. For this reason, SE is essential. However, the schools in Bangladesh lack government guidance and an appropriate curriculum on SE, even though SE is not in the curriculum as a separate subject. Objectives: This study explored stakeholders’ perceptions regarding inadequate SE at schools and how it impacts adolescents’ health. Also, this study identified barriers that hinder SE provision in schools as well as will provide some suggestions that might be helpful to the school curriculum and other program reviews for ensuring appropriate information access to meet the sexual and reproductive needs of adolescents. Methods and materials: The research chose a phenomenological qualitative study design in a social constructivist paradigm. The study was conducted in Savar Upazila, Dhaka, Bangladesh, between May 2024 and July 2024. A non-probability purposive sampling technique was employed to select stakeholders as study participants Data was collected using two qualitative techniques: an In-depth Interview (IDI) and a Key Informant Interview (KII) followed by the semi-structured interview approach. Interviews were conducted both face-to-face and online. Data saturation was reached after 11 IDIs and 8 KIIs. A thematic analysis approach was utilized to analyze the collected data. Results: The study showed that adolescents had significant knowledge gaps regarding SE. Also, in this study, informants mentioned that SE should be stated at earlier grades as adolescents experience pubertal changes and menstruation earlier than before, and there is a risk of getting wrong information from the internet about sex and reproduction. The study found several perceived health impacts of adolescents due to inadequate SE in schools, such as sexual and reproductive (e.g., STDs, HIV/AIDS, uterine infection, etc.) and mental health (mood swings due to menstruation, stress, depression, and mental trauma), and experiencing teenage pregnancy due to early marriage. Despite numerous health effects, stakeholders mentioned that sexual and reproductive (SRH) content in school curricula is insufficient. Informants stressed that some content was already in the syllabus; however, teachers skipped those due to their shyness and discomfort. The current study discovered that parents were more aware of providing SRH information to girls than boys. Also, the study found that while all stakeholders value sexual education for adolescents, traditional social and cultural factors, religious beliefs, and taboo inhibits open discussion. Informants further mentioned that temporal factors, such as practicing short syllabi due to the COVID-19 emergency, hinder adolescents from knowing about SRH content. Stakeholders expressed the necessity to be supported in teaching SE in schools with an appropriate curriculum, teachers’ training, teaching materials, gender-specific teachers, and parental involvement in the teaching process. Informants also recommended that the imams and other influential people of the community (members and chairman) should be invited to understand the importance of SRH education, and later, they will motivate others. In addition, study results suggested that a separate subject in the curriculum highlighting SRH topics should be incorporated. Conclusion: The perceived health impacts of adolescents due to inadequate SE in schools converge among stakeholders, including adolescents. Moreover, barriers in SE provision in schools leading to SRH’s knowledge insufficiency exacerbate adolescent health impacts. This calls for well-designed interventions. This study also recommends that the government implements measures to assess and monitor SE curricula once integrated into the curriculum and evaluate how schools address it

Editorial: Exploring the links between social connections, care and integration

Marcia Vera Espinoza - ORCID: 0000-0001-6238-7683 https://orcid.org/0000-0001-6238-7683Arek Dakessian - ORCID: 0000-0001-7792-6862 https://orcid.org/0000-0001-7792-6862https://doi.org/10.3389/fhumd.2024.15018976pubpu

A Pig's Progress An arts-based research project exploring animation as a way to process setting up an art therapy service in an NHS Community Mental Health Team

This piece of arts-based research (ABR) uses animation to communicate the trials, tribulations and rewards of establishing an art therapy service as a trainee in an NHS Community Mental Health Team (CMHT). Although there are few resources on the topic, I propose that animation is useful to the art therapy profession and experiment with the art form by creating an animated response artwork. In the accompanying text, the research is grounded in existing literature exploring the therapeutic potential of animation, the difficulties that may arise when setting up a service and thoughts around response art by art therapists. As ABR, this project seeks to bridge the space between medicine and art. Animating does require time and some technical ability, but the findings suggest that it helped me to process my work, look after myself and make an accessible form of research. Additionally, there were many parallels to be found between the processes of animating and building an art therapy service. Subsequently, I recommend that other art therapists try animation themselves and share more about their experiences of setting up services. Animation is an empowering process that gives directorial power to its creator, so I also suggest that animating could be used by future clients to promote a sense of agency

Novel palm shortening substitute using a combination of rapeseed oil, linseed meal and beta-glucan

Corrigendum to “Novel palm shortening substitute using a combination of rapeseed oil, linseed meal and beta-glucan” [Food Chemistry, 457 (2024), 140134](S0308814624017849)(10.1016/j.foodchem.2024.140134) available at: https://doi.org/10.1016/j.foodchem.2024.140273. The authors regret to inform that they omitted to include in the manuscript that Julien Lonchamp and Catriona Liddle are co-inventors on the patent PCT/GB2023/051783 (Palm-based shortening substitute). The authors would like to apologise for any inconvenience caused. © 2024 The Author(s)This study investigated the potential of a novel sustainable ingredient composed of rapeseed oil, linseed meal and beta-glucan (PALM-ALT) to mimic palm shortening functionality in cake. The combined functional properties of linseed meal and beta-glucan led to stable semi-solid emulsion-gels (20–31 μm oil droplet size, 105–115 Pa.s viscosity and 60–65 Pa yield stress). PALM-ALT contained 25 and 88% less total and saturated fat than palm shortening, whilst PALM-ALT cakes contained 26 and 75% less total and saturated fat than the palm-based control. PALM-ALT cakes matched the flavour profile of the palm-based control, while rapeseed oil cakes tasted more sour and less sweet than the control (p < 0.05). PALM-ALT cakes proved less hard and more cohesive than the control (p < 0.05), with 100% of the consumer panel preferring PALM-ALT formulations. This study demonstrated the unique potential of PALM-ALT as healthier, sustainable and competitive alternative to palm shortening.https://doi.org/10.1016/j.foodchem.2024.140134457pubpu

CSP2023: 471 Advanced Practice Physiotherapists (APPs) in General Practice: A Service Evaluation

From Elsevier via Jisc Publications RouterHistory: epub 2024-06-18, issued 2024-06-30Article version: AMPublication status: PublishedItem is not available in this repository.Judith Lane - ORCID: 0000-0003-0413-8421 https://orcid.org/0000-0003-0413-8421pubpu