IENE 9 project: developing a culturally competent and compassionate LGBT + curriculum in health and social care education

Introduction The IENE projects (2008–2022) aim to promote a model for developing intercultural dialogue and enhance the ability to provide culturally competent and compassionate care for the health and social care professionals at national and European levels. The IENE 9 project, named “Developing a culturally competent and compassionate LGBT + curriculum in health and social care education,” builds on the work developed in the previous IENE projects and emphasizes the importance of addressing LGBT + issues in health and social care education. Method Through an innovative Massive Open Online Course (MOOC), professionals will learn the skills to work toward building an LGBT + inclusive health and social care system. Result Notwithstanding the progress made in recent years on LGBT + issues, research indicates that too little attention has been given to LGBT + needs in health and social care settings, and these remain substantial issues that are often ignored. Conclusion This letter to the editor aims to present the IENE 9 project given that greater efforts are needed to improve professionals’ skills regarding sexual and gender minority population. We strive to continue our efforts in promoting the well-being and mental health of LGBT + people in health and social care education

Empowering the migrant and refugee family's parenting skills: a literature review

Bachground: Worldwide, more than 79.5 million people are forcibly displaced, including a significant number of migrant and refugee families with children. Migration and refugeedom affect these families in different dimensions, such as mental, physical and spiritual health. Identifying family needs and enhancing parenting skills can improve family cohesion and health, as well as smooth integration into the host country. This review is part of the Erasmus+ funded project- IENE 8 (Intercultural Education for Nurses in Europe) aiming at empowering migrant and refugee families regarding parenting skills. Methods: This was a scoping review of literature. The IENE 8 partner countries (Cyprus, Germany, Greece, Italy, Romania, and United Kingdom) searched for peer reviewed papers, grey literature and mass media reports at international, European and national level. The time period for the search of scientific and grey literature was between2013-2018, and for mass media, it was between 2016 and 2018. Results: 124 relevant sources were identified. They included 33 Peer reviewed papers, 47 Grey literature documents and 44 mass media reports. This revealed the importance of understanding the needs of migrant families with children. Conclusion: It is evident from the literature that there is a need to support refugee parents to adjust their existing skill and to empower them to develop new ones. Healthcare and social services professionals have an essential role in improving the refugees' parenting skills. This can be done by developing and implementing family-centered and culturally-sensitive intervention programs

LGBT+ Training needs for health and social care professionals: a cross-cultural comparison among seven European countries

Introduction Research suggests that specific training on LGBT+ issues may improve the competencies and skills of health and social care (HSC) professionals, which reduces the negative attitudes toward LGBT+ people. Despite this, there seems to be a lack of coverage of LGBT+ needs in HSC education. The present study aims to explore the specific LGBT+ training needs of HSC professionals and to examine the relationship between these training needs and the four dimensions of the Papadopoulos model, i.e. cultural awareness, cultural knowledge, cultural sensitivity, and cultural competence. Methods The research used data from a cross-cultural project, “Intercultural Education for Nurses in Europe (IENE9),” which was administered to 412 HSC academics and workers (62% females; Mage=46.06, SDage=10.48) between February 2020 and July 2020, in seven European countries: UK (coordinator), Denmark, Spain, Germany, Cyprus, Italy, and Romania. Results Hierarchical multiple regression showed that higher training needs were associated with cultural awareness, cultural knowledge, and cultural competence. The need for training on LGBT+ issues was higher for Cyprus, Romania, Spain, Italy, and the UK, compared with Denmark (no differences between Germany and Denmark were found). Conclusions We believe that there has been a lack of focus on the LGBT+ training needs of HSC professionals: Greater efforts are required to develop a culturally competent and compassionate LGBT+ curriculum. Social Policy Implications Findings from the present study will inform the development of a free, Massive Open Online Course (MOOC), for culturally competent and compassionate HSC professionals in Europe to improve the quality of their car

Impact of Intermediate Hyperglycemia and Diabetes on Immune Dysfunction in Tuberculosis

Supplementary Data: Supplementary materials are available at Clinical Infectious Diseases online at https://academic.oup.com/cid/article/72/1/69/5857148#274319223 . Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author.Copyright © The Author(s) 2020. Background: People with diabetes have an increased risk of developing active tuberculosis (TB) and are more likely to have poor TB-treatment outcomes, which may impact on control of TB as the prevalence of diabetes is increasing worldwide. Blood transcriptomes are altered in patients with active TB relative to healthy individuals. The effects of diabetes and intermediate hyperglycemia (IH) on this transcriptomic signature were investigated to enhance understanding of immunological susceptibility in diabetes-TB comorbidity. Methods: Whole blood samples were collected from active TB patients with diabetes (glycated hemoglobin [HbA1c] ≥6.5%) or IH (HbA1c = 5.7% to <6.5%), TB-only patients, and healthy controls in 4 countries: South Africa, Romania, Indonesia, and Peru. Differential blood gene expression was determined by RNA-seq (n = 249). Results: Diabetes increased the magnitude of gene expression change in the host transcriptome in TB, notably showing an increase in genes associated with innate inflammatory and decrease in adaptive immune responses. Strikingly, patients with IH and TB exhibited blood transcriptomes much more similar to patients with diabetes-TB than to patients with only TB. Both diabetes-TB and IH-TB patients had a decreased type I interferon response relative to TB-only patients. Conclusions: Comorbidity in individuals with both TB and diabetes is associated with altered transcriptomes, with an expected enhanced inflammation in the presence of both conditions, but also reduced type I interferon responses in comorbid patients, suggesting an unexpected uncoupling of the TB transcriptome phenotype. These immunological dysfunctions are also present in individuals with IH, showing that altered immunity to TB may also be present in this group. The TB disease outcomes in individuals with IH diagnosed with TB should be investigated further.European Union’s Seventh Framework Programme (FP7 2007-2013 - Health) under grant agreement No 305279

Managing uncertainty: Public administrators dealing with 'wicked' issues in public policy

The current policy arena is crowded with elements of public sector ethos that are both traditional (such as legality and accountability) and new (such as boundary-spanning and leadership). The mix can be confusing to the public administrators who find themselves in the position to ensure a fine balance between the various paradigmatic forces in the sector while tackling complex policy problems under the constant fear of liability for failure. The study employs theories of complexity to illustrate the task demands on public administrators in three consecutive time periods and to emphasise that the current one is truly the most demanding of all, truly ‘on the edge of chaos’, hence requiring more skills from public administrators than ever before. After an account of three successive public administration paradigms and of the role played by public servants in each of them, the study concludes with the need for flexibility and ‘lean management’ in post-modern public administration, as a way for administrators at both front line and senior levels to address uncertainty in policy making

Leadership in public sector partnerships: a case study of Local Safeguarding Children Boards

In the complex cobweb of public sector organizational structures, the need to tackle intricate societal problems set the context for a new direction in leadership studies, one that enables the achievement of policy goals by creating collaborative capabilities. In the policy area of children and young people, Local Safeguarding Children Boards (LSCBs) can allow leadership to manifest itself through a number of media. First, the local authority is the statutory designated leader of this partnership in the local community. Second, the representatives of agencies with a duty to cooperate on children’s issues are themselves leaders of their organizations’ resources and commitment to the partnership’s goal. Third, in the light of unprecedented complexity in policy making, getting things done often depends on the leadership capabilities of people and of organizations to work with the tension between multiple sets of professional, organizational and sectoral values. Although, in theory, leadership should be an important element of inter-agency working, essentially being about making things happen beyond usual institutional constraints, in reality however, empirical findings have shown that leadership in LSCBs is systematically inhibited, hence endangering the outcomes of collaborative, inter-professional and inter-organizational work. The article concludes with the paradox of public servants demonstrating leadership in inter-organizational settings while remaining an impersonal administrator subjected to tight public scrutiny. The article seeks to make a contribution to the public policy and management field in general and to that of collaborative management in particular. To this end, the existing developments in the leadership literature have been used to shed light on one case study of one of the more controversial partnerships in the British public sector: LSCBs