Adventures by Stepping out of the Library

Background As a solo hospital librarian with a totally digital library, I am free to step out of the Library. Also, the Library organizationally placed on the Clinical Learning Team presents many interesting adventures for an information professional. Description This Lightning Talk will describe an ambitious daily rounding schedule, a month of direct observing to help out during the COVID period, active participation on the Nursing Research Council and Family and Patient Education Committee, work with the Nurse Residents and advising a vendor on a new product. Conclusions By stepping out of the Library, the Librarian can show support and share expertise for hospitalwide activities. Also, the Librarian can share expertise to a vendor of information resources

Concurrent partnerships and HIV: an inconvenient truth

The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS and the Southern African Development Community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers and Eileen Stillwaggon attempt to challenge the evidence for the importance of concurrency and call for an end to research on the topic. However, their "systematic review of the evidence" is not an accurate summary of the research on concurrent partnerships and HIV, and it contains factual errors concerning the measurement and mathematical modelling of concurrency

Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence

Higher prevalence of concurrent partnerships is one hypothesis for the severity of the HIV epidemic in the countries of Southern Africa. But measures of the prevalence of concurrency alone do not adequately capture the impact concurrency will have on transmission dynamics. The importance of overlap duration and coital exposure are examined here.We conducted a comparison of data from three studies of sexual behavior carried out in the early 1990s in Uganda, Thailand and the US. Using cumulative concurrency measures, the three countries appeared somewhat similar. Over 50% of both Thai and Ugandan men reported a concurrency within the last three partnerships and over 20% reported a concurrency in the last year, the corresponding rates among US men were nearly 20% for Blacks and Hispanics, and about 10% for other racial/ethnic groups. Concurrency measures that were more sensitive to overlap duration, however, showed large differences. The point prevalence of concurrency on the day of interview was over 10% among Ugandan men compared to 1% for Thai men. Ugandan concurrencies were much longer duration – a median of about two years – than either the Thai (1 day) or US concurrencies (4–9 months across all groups), and involved 5–10 times more coital risk exposure with the less frequent partner. In the US, Blacks and Hispanics reported higher prevalence, longer duration and greater coital exposure than Whites, but were lower than Ugandans on nearly every measure. Together, the differences in the prevalence, duration and coital exposure of concurrent partnerships observed align with the HIV prevalence differentials seen in these populations at the time the data were collected.There were substantial variations in the patterns of concurrent partnerships within and between populations. More long-term overlapping partnerships, with regular coital exposure, were found in populations with greater HIV epidemic severity

Simulations in Clinics, Contract Drafting, and Upper-Level Courses

I teach in a transactional clinic called the Urban Development Law Clinic. In my Clinic, we represent non-profit tax-exempt organizations that engage in real estate, economic, and community development. Some of our clients include Greater Cleveland Habitat for Humanity and Karamu House, which is a theater and community arts center. We serve as general counsel for some clients and provide legal advice on an as needed basis for others. The Clinic provides legal advice on real estate matters, corporate governance, transactions, and tax issues. The complexity of matters that we handle ranges from drafting a code of regulations to representing clients in large development projects such as a $5.1 million community center for seniors

Simulations in Clinics, Contract Drafting, and Upper-Level Courses

I teach in a transactional clinic called the Urban Development Law Clinic. In my Clinic, we represent non-profit tax-exempt organizations that engage in real estate, economic, and community development. Some of our clients include Greater Cleveland Habitat for Humanity and Karamu House, which is a theater and community arts center. We serve as general counsel for some clients and provide legal advice on an as needed basis for others. The Clinic provides legal advice on real estate matters, corporate governance, transactions, and tax issues. The complexity of matters that we handle ranges from drafting a code of regulations to representing clients in large development projects such as a $5.1 million community center for seniors

The invisibility of covert bullying among students: Challenges for school intervention

Covert bullying behaviours are at least as distressing for young people as overt forms of bullying, but often remain unnoticed or unacknowledged by adults. This invisibility is increased in schools by inattention to covert bullying in policy and practice, and limited staff understanding and skill to address covert behaviours. These factors can lead to a school culture that appears to tolerate and thus inadvertently encourages covert bullying. This study explores these dynamics in Australian primary and secondary schools, including the attitudes of over 400 staff towards covert bullying, their understanding of covert bullying behaviours, and their perceived capacity to address these behaviours both individually and at a whole-school level. While most respondents felt a responsibility to intervene in bullying situations, nearly 70% strongly agreed with statements that staff need more training to address covert bullying. Only 10% of respondents described their current whole-school strategies as very effective in reducing covert bullying, and fewer than 40% reported their school had a bullying policy that explicitly referred to covert bullying. These results suggest an urgent need for sustainable professional development to enhance school staff understanding, skills and self-efficacy to address covert bullying through school policy and practice, and the need to identify and consolidate effective strategies to better address these behaviours

HIV/AIDS Prevention Guidance for Reproductive Health Professionals in Developing-Country Settings

While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, social, cultural, and political factors. Of concern to reproductive health service providers are the burdens associated with providing additional services and resources needed for facilities, technologies, treatment options, and comprehensive training. This document provides an overview of the issues, challenges, and opportunities around integrating a broad range of HIV/AIDS interventions into existing reproductive and sexual health programs and services, and includes examples of successful interventions

National Safe Schools Framework: Policy and Practice to Reduce Bullying in Australian Schools

In 2003 Australia was one of the first countries to develop an integrated national policy, called the National Safe Schools Framework (NSSF), for the prevention and management of violence, bullying, and other aggressive behaviors. The effectiveness of this framework has not yet been formally evaluated. Cross-sectional data collected in 2007 from 7,418 students aged 9 to 14 years old and 453 teachers from 106 representative Australian schools were analyzed to determine teachers’ perceptions about the extent of implementation of the NSSF, teachers’ capacity to address student bullying, and students’ reports of bullying in their school, 4 years following the framework’s dissemination. While methodological issues limit the findings, schools appear not to have widely implemented the recommended safe school practices, teachers appear to need more training to address bullying, especially covert bullying, and bullying prevalence among students seems relatively unchanged compared to Australian data collected 4 years prior to the launch of the NSSF

Support and performance improvement for primary health care workers in low- and middle-income countries: a scoping review of intervention design and methods.

Primary health care workers (HCWs) in low- and middle-income settings (LMIC) often work in challenging conditions in remote, rural areas, in isolation from the rest of the health system and particularly specialist care. Much attention has been given to implementation of interventions to support quality and performance improvement for workers in such settings. However, little is known about the design of such initiatives and which approaches predominate, let alone those that are most effective. We aimed for a broad understanding of what distinguishes different approaches to primary HCW support and performance improvement and to clarify the existing evidence as well as gaps in evidence in order to inform decision-making and design of programs intended to support and improve the performance of health workers in these settings. We systematically searched the literature for articles addressing this topic, and undertook a comparative review to document the principal approaches to performance and quality improvement for primary HCWs in LMIC settings. We identified 40 eligible papers reporting on interventions that we categorized into five different approaches: (1) supervision and supportive supervision; (2) mentoring; (3) tools and aids; (4) quality improvement methods, and (5) coaching. The variety of study designs and quality/performance indicators precluded a formal quantitative data synthesis. The most extensive literature was on supervision, but there was little clarity on what defines the most effective approach to the supervision activities themselves, let alone the design and implementation of supervision programs. The mentoring literature was limited, and largely focused on clinical skills building and educational strategies. Further research on how best to incorporate mentorship into pre-service clinical training, while maintaining its function within the routine health system, is needed. There is insufficient evidence to draw conclusions about coaching in this setting, however a review of the corporate and the business school literature is warranted to identify transferrable approaches. A substantial literature exists on tools, but significant variation in approaches makes comparison challenging. We found examples of effective individual projects and designs in specific settings, but there was a lack of comparative research on tools across approaches or across settings, and no systematic analysis within specific approaches to provide evidence with clear generalizability. Future research should prioritize comparative intervention trials to establish clear global standards for performance and quality improvement initiatives. Such standards will be critical to creating and sustaining a well-functioning health workforce and for global initiatives such as universal health coverage

Australian covert bullying prevalence study

The safety of members of the school community is essential to enhance the academic, social development and well being of young people. In line with the United Nations\u27 Convention on the Rights of the Child, the National Safe Schools Framework (NSSF) is regarded as.a highly innovative, collaborative effort on behalf of the Commonwealth, State and Territory Governments to foster the development and implementation of a series of whole-of-school initiatives to produce an integrated national policy for the prevention and early intervention of bullying and other aggressive and violent behaviours. Yet despite the impact of the NSSF in terms of reducing direct, face-to-face \u27overt\u27 bullying, such as hitting, punching, kicking and teasing, evidence suggests that a less direct form of \u27covert\u27 bullying is becoming more prevalent and insidious, fuelled in part by the growth of new forms of Information and Communications Technology (ICT). From this perspective, the Australian Covert Bullying Prevalence Study (ACBPS), commissioned by the Department of Education, Employment and Workplace Relations (DEEWR), represents a significant first step to understand and tackle this phenomenon