Making community pharmacies psychologically informed environments (PIE):a feasibility study to improve engagement with people using drug services in Scotland

Funding: This work was funded by a research grant from Pharmacy Research UK: PRUK 2019-PA3-CM.Aim   This developmental study tested the feasibility of training pharmacy staff on the psychologically informed environments (PIE) approach to improve the delivery of care. Background: Community pharmacies provide key services to people who use drugs (PWUD) through needle exchange services, medication-assisted treatment and naloxone distribution. PWUD often have trauma backgrounds, and an approach that has been demonstrated to work well in the homeless sector is PIEs. Methods  Bespoke training was provided by clinical psychologists and assessed by questionnaire. Staff interviews explored changes made following PIE training to adapt the delivery of care. Changes in attitude of staff following training were assessed by questionnaire. Peer researchers interviewed patient/client on observed changes and experiences in participating pharmacies. Staff interviews were conducted six months after training to determine what changes, if any, staff had implemented. Normalisation process theory (NPT) provided a framework for assessing change. Findings Three pharmacies (16 staff) participated. Training evaluation was positive; all participants rated training structure and delivery as 'very good' or 'excellent'. There was no statistically significant change in attitudes. COVID-19 lockdowns restricted follow-up data collection. Staff interviews revealed training had encouraged staff to reflect on their practice and communication and consider potentially discriminatory practice. PIE informed communication skills were applied to manage COVID-19 changes. Staff across pharmacies noted mental health challenges for patients. Five patients were interviewed but COVID-19 delays in data collection meant changes in delivery of care were difficult to recall. However, they did reflect on interactions with pharmacy staff generally. Across staff and patient interviews, there was possible conflation of practice changes due to COVID-19 and the training. However, the study found that training pharmacy teams in PIE was feasible, well received, and further development is recommended. There was evidence of the four NPT domains to support change (coherence, cognitive participation, collective action and reflexive monitoring).Publisher PDFPeer reviewe

Comfort Women: The Forgotten Victims of World War II

https://scholarworks.moreheadstate.edu/student_scholarship_posters/1012/thumbnail.jp

"It's all about relationships": the place of boarding schools in promoting and managing health and wellbeing of Aboriginal and Torres Strait Islander secondary school students

Introduction: In recent years, Australian government policies have promoted access to secondary education through boarding schools for Aboriginal and Torres Strait Islander (hereafter respectfully termed Indigenous) students from remote communities. These students experience the poorest health of any Australian adolescent group. This exploratory study examines how boarding schools across Queensland promote and manage healthcare and wellbeing support for Indigenous students. Methods: Qualitative grounded theory methods were used to sample and collect data from the healthcare and wellbeing support staff of eight Queensland boarding schools using semi-structured interviews. Data were coded using NVIVO software and compared to identify the context, conditions, core process, strategies and outcomes of boarding schools' healthcare and wellbeing support. Preliminary findings were fed back to school staff and students' family members for discussion and response at an annual Schools and Communities meeting. Results: Boarding school health staff support Indigenous student-centred healthcare and wellbeing by weaving a relational network with students, families, school staff and external healthcare providers. Either through on-site or school-linked centres, they provide students with access to healthcare services, support wellbeing, and offer health education. Through these strategies, they enable students' participation in education and learning, receive quality healthcare improvement, "move to a better head space", and become responsible for their own healthcare. Enabling conditions are the professional and cultural capabilities of school staff, school leadership and commitment, compatibility of intersectoral systems and resourcing of healthcare and wellbeing support. Conclusions: Boarding schools are doing considerable work to improve the promotion and management of healthcare and wellbeing support for Indigenous students, but there is considerable variation across schools, impacts are not formally monitored or reported, and there are many opportunities for improvement. Working towards a best practice framework, school staff identified a need for a multi-levelled relational model of healthcare and wellbeing support to be iteratively embedded at each stage of the school cycle: at intake; enrolment; term one; and throughout the school year (including in emergencies/crises)

Long-term functional recovery after facial nerve transection and repair in the rat

BACKGROUND: The rodent model is commonly used to study facial nerve injury. Because of the exceptional regenerative capacity of the rodent facial nerve, it is essential to consider the timing when studying facial nerve regeneration and functional recovery. Short-term functional recovery data following transection and repair of the facial nerve has been documented by our laboratory. However, because of the limitations of the head fixation device, there is a lack of long-term data following facial nerve injury. The objective of this study was to elucidate the long-term time course and functional deficit following facial nerve transection and repair in a rodent model. METHODS: Adult rats were divided into group 1 (controls) and group 2 (experimental). Group 1 animals underwent head fixation, followed by a facial nerve injury, and functional testing was performed from day 7 to day 70. Group 2 animals underwent facial nerve injury, followed by delayed head fixation, and then underwent functional testing from months 6 to 8. RESULTS: There was no statistical difference between the average whisking amplitudes in group 1 and group 2 animals. CONCLUSION: Functional whisking recovery 6 months after facial nerve injury is comparable to recovery within 1 to 4 months of transection and repair, thus the ideal window for evaluating facial nerve recovery falls within the 4 months after injury

Asthma Discordance in Twins Is Linked to Epigenetic Modifications of T Cells

T cells mediate the inflammatory responses observed in asthma among genetically susceptible individuals and have been suspected to be prone to epigenetic regulation. However, these relationships are not well established from past clinical studies that have had limited capacity to control for the effects of variable genetic predisposition and early environmental exposures. Relying on a cohort of monozygotic twins discordant for asthma we sought to determine if epigenetic modifications in T cells were associated with current asthma and explored whether such modifications were associated with second hand smoke exposures. Our study was conducted in a monozygotic twin cohort of adult twin pairs (n = 21) all discordant for asthma. Regulatory T cell (Treg) and effector T cell (Teff) subsets were assessed for levels of cellular function, protein expression, gene expression and CpG methylation within Forkhead box P3 (FOXP3) and interferon gamma-γ (IFNγ) loci. Comparisons by asthma and current report of exposure to second hand smoke were made. Treg from asthmatic discordant twins demonstrated decreased FOXP3 protein expression and impaired Treg function that was associated with increased levels of CpG methylation within the FOXP3 locus when compared to their non-asthmatic twin partner. In parallel, Teff from discordant asthmatic twins demonstrated increased methylation of the IFNγ locus, decreased IFNγ expression and reduced Teff function when compared to Teff from the non-asthmatic twin. Finally, report of current exposure to second hand smoke was associated with modifications in both Treg and Teff at the transcriptional level among asthmatics. The results of the current study provide evidence for differential function of T cell subsets in monozygotic twins discordant for asthma that are regulated by changes in DNA methylation. Our preliminary data suggest exposure to second hand smoke may augment the modified T cell responses associated with asthma

Methodologies for Housing Justice Resource Guide

This Resource Guide is the outcome of a Summer Institute on Methodologies for Housing Justice convened by the Institute on Inequality and Democracy at UCLA Luskin as part of the Housing Justice in Unequal Cities Network, which is supported by the National Science Foundation (BCS 1758774). Held in Los Angeles in August 2019, the Summer Institute brought together participants from cities around the world. As is the case with the overall scope and purpose of the Housing Justice in Unequal Cities Network, it created a shared terrain of scholarship for movement-based and university-based scholars. Dissatisfied with the canonical methods that are in use in housing studies and guided by housing justice movements that are active research communities, the Summer Institute was premised on the assertion that methodology is political. Methodology is rooted in arguments about the world and involves relations of power and knowledge. The method itself – be it countermapping or people’s diaries – does not ensure an ethics of solidarity and a purpose of justice. Such goals require methodologies for liberation. Thus, as is evident in this Resource Guide, our endeavor foregrounds innovative methods that are being used by researchers across academia and activism and explicitly situates such methods in an orientation towards housing justice

Planning and implementing community-based drug checking services in Scotland: a qualitative exploration using the consolidated framework for implementation research

Background: Drug checking services (DCS) provide harm reduction support and advice to individuals based on chemical analysis of submitted substances of concern. Whilst there are currently no DCS in Scotland, community-based services are being planned in three cities. Methods: In this paper, we report qualitative findings based on interviews with 43 participants, focused on perceptions of DCS and their implementation. Participants were relevant professionals, those with experience of drug use, and family members of those with experience of drug use. The Consolidated Framework for Implementation Research (CFIR) was used to inform data collection and analysis. We report findings under nine constructs/themes across the five CFIR domains. Results: Participants noted the importance of DCS being implemented in low-threshold, trusted services with a harm reduction ethos, and outlined a range of further service design considerations such as speed of testing, and information provided through the analysis process. In relation to the ‘inner setting’, a key finding related to the potential value of leveraging existing resources in order to expand both reach and effectiveness of drug trend communication. The approach of local and national police to DCS, and the attitudes of the public and local community, were described as important external factors which could influence the success (or otherwise) of implementation. Bringing together a range of stakeholders in dialogue and developing tailored communication strategies were seen as ways to build support for DCS. Overall, we found high levels of support and perceived need for DCS amongst all stakeholder groups. Conclusions: Our findings present initial implementation considerations for Scotland which could be further explored as DCS are operationalised. Further, our focus on implementation contexts is relevant to research on DCS more generally, given the minimal consideration of such issues in the literature

“It would really support the wider harm reduction agenda across the board”: A qualitative study of the potential impacts of drug checking service delivery in Scotland

Drug checking services (DCS) enable individuals to voluntarily submit a small amount of a substance for analysis, providing information about the content of the substance along with tailored harm reduction support and advice. There is some evidence suggesting that DCS may lead to behaviour and system change, with impacts for people who use drugs, staff and services, and public health structures. The evidence base is still relatively nascent, however, and several evidence gaps persist. This paper reports on qualitative interviews with forty-three participants across three Scottish cities where the implementation of community-based DCS is being planned. Participants were drawn from three groups: professional participants; people with experience of drug use; and affected family members. Findings focus on perceived harm reduction impacts of DCS delivery in Scotland, with participants highlighting the potential for drug checking to impact a number of key groups including: individual service users; harm reduction services and staff; drug market monitoring structures and networks; and wider groups of people who use and sell drugs, in shaping their interactions with the drug market. Whilst continued evaluation of individual health behaviour outcomes is crucial to building the evidence base for DCS, the findings highlight the importance of extending evaluation beyond these outcomes. This would include evaluation of processes such as: information sharing across a range of parties; engagement with harm reduction and treatment services; knowledge building; and increased drug literacy. These broader dynamics may be particularly important for evaluations of community-based DCS serving individuals at higher-risk, given the complex relationship between information provision and health behaviour change which may be mediated by mental and physical health, stigma, criminalisation and the risk environment. This paper is of international relevance and adds to existing literature on the potential impact of DCS on individuals, organisations, and public health structures

Metodologías para la justicia de la vivienda: Guia de recursos

Esta Guía de Recursos es el resultado de un Instituto de Verano sobre Metodologías para la Justicia en la Vivienda convocado por el Instituto sobre Desigualdad y Democracia de UCLA Luskin como parte de la Red de Justicia en la Vivienda en Ciudades Desiguales, que es apoyada por la Fundación Nacional de Ciencias (BCS 1758774). Celebrado en Los Ángeles en agosto de 2019, el Instituto de Verano reunió a participantes de ciudades de todo el mundo. Al igual que el alcance y el propósito general de la Red de Justicia en las Ciudades Desiguales, creó un terreno compartido de para estudiosos del movimiento y académicos de universidades. Con una insatisfacción a los métodos canónicos que se utilizan en los estudios sobre la vivienda y guiado por los movimientos de justicia de la vivienda que son comunidades de investigación activa, el Instituto de verano se basó en la afirmación de que la metodología es política. La metodología se basa en argumentos sobre el mundo e implica relaciones de poder y conocimiento. El método por sí mismo -ya sea el contra ataque al mapeo o los diarios de la genteno asegura una ética de solidaridad y un propósito de justicia. Tales objetivos requieren metodologías para la liberación. Por lo tanto, como es evidente en esta Guía de Recursos, nuestro esfuerzo pone en primer plano los métodos innovadores que están siendo utilizados por los investigadores en todo el mundo académico y el activismo y sitúa explícitamente tales métodos en una orientación hacia la vivienda la justicia