Changing the Quality of Conflict Interaction: The Principles and Practice of Transformative Mediation

Many practitioners now identify themselves as transformative mediators, who practice from the transformative perspective in some or all of their work. This article explains the unique character of transformative mediation by offering answers to three basic questions: Why is transformative mediation being sought and used by parties in conflict? What is the basic nature of the mediation process, especially the mediator\u27s role, according to this model? How does a mediator work with the parties in transformative mediation? Answering these three questions why, what and how-will provide the reader a good overview of the transformative model in theory and practice. We begin in the first section with the why of transformative mediation, because we believe the answer to this question provides the only solid foundation for answering the other two. Based on that answer, we offer a brief description of the process and the mediator\u27s role in the second section. Then, in the final section, we discuss at greater length the how of transformative mediation practice

Profiling the injuries sustained by police trainees undergoing initial training: a retrospective cohort study

The tasks performed by police officers are unique, varied and can be performed in unexpected situations. Initial police college training is used to prepare new police officers to conduct these tasks and is known to be a time when police trainees are at an elevated risk of injury. The aim of this study was to profile injuries occurring within a national Police Force during initial training to inform injury prevention strategies. Using a retrospective cohort design, point-of-care injury data including injury body site, nature, mechanism, and the activity being performed at the time of injury were provided. A total of 564 injuries were recorded over the 22-month period, with the mean age of recruits reporting an injury being 28.83 years ± 6.9 years. The incidence of injuries ranged across training periods, from 456.25 to 3079 injuries per 1000 person-years with an overall incidence rate of 1550.15 injuries per 1000 person-years. The shoulder was the most injured site (n = 113, 20% of injuries), with sprains and strains being the most common nature of injury (n = 287, 50.9% of injuries). Muscular stress with physical exercise was the most common mechanism of injury (n = 175, 31.0% of injuries) with the activity responsible for the largest proportion of injuries being “unknown” (n = 256, 45.4% of injuries), followed by police training (n = 215, 38.1%). Injuries appear to be typically joint related—commonly the shoulder—with police training being a primary known activity at the time of injury. Prescreening protocols may be of benefit, and efforts should be made to recruit and train physically resilient trainees. Injuries, whether they occurred pre-enlistment or during training, should be fully rehabilitated prior to the individual’s commencement as a qualified officer

What can volunteer co-providers contribute to health systems? The role of people living with HIV in the Thai paediatric HIV programme

In Thailand people living with HIV (PLHIV) have played a major role in shaping policy and practice. They have acted as volunteer co-providers, although their potential in terms of paediatric service provision has seldom been explored from a health systems perspective. We describe the Thai paediatric HIV care system and use both demand- and supply-side perspectives to explore the impact, opportunities and challenges of PLHIV acting as volunteer co-providers. We employed qualitative methods to assess experiences and perceptions and triangulate stakeholder perspectives. Data were collected in Khon Kaen province, in the poorest Northeastern region of Thailand: three focus group discussions and two workshops (total participants n = 31) with co-providers and hospital staff; interviews with ART service-users (n = 35). Nationally, key informant interviews were conducted with policy actors (n = 20). Volunteer co-providers were found to be ideally placed to broker the link between clinic and communities for HIV infected children and played an important part in the vital psychosocial support component of HIV care. As co-providers they were recognized as having multiple roles linking and delivering services in clinics and communities. Clear emerging needs include strengthened coordination and training as well as strategies to support funding. Using motivated volunteers with a shared HIV status as co-providers for specific clinical services can contribute to strengthening health systems in Asia; they are critical players in delivering care (supply side) and being responsive to service-users needs (demand side). Co-providers blur the boundaries between these two spheres. Sustaining and optimising co-providers' contribution to health systems strengthening requires a health systems approach. Our findings help to guide policy makers and service providers on how to balance clinical priorities with psycho-social responsiveness and on how best to integrate the views and experience of volunteers into a holistic model of care

Listing of Inherited Disorders in Animals (LIDA) for cats: an on-line relational database, using non-technical descriptions written by veterinary students

The Listing of Inherited Disorders in Animals (LIDA) for cats has implemented research-led approaches to learning and teaching and used these to showcase student output of high quality. The Listing of Inherited Disorders in Animals (LIDA) is a leading example of how learning outcomes can be aligned with assessment and the students’ deliverables then developed into a learning resource. Exemplifying the high standard of work students can produce when thoughtfully guided and advised, LIDA began as a library-based activity offered to Veterinary Science undergraduate students. The exercise was designed for students to develop an appreciation of the variety of congenital and inherited disorders in cats, and to reflect on the impact of these on cat welfare, describing their effects in clear, plain English. Much of the written work submitted by students for this assignment was incorporated, with their permission and acknowledgment, into the LIDA database. It now constitutes an online relational database, using non-technical descriptions, almost all credited to individual students

Impact of Motivational Interviewing by Social Workers on Service Users - a systematic review

Purpose: This systematic review was undertaken to determine the effectiveness of motivational interviewing (MI), by social workers, on service user outcomes. Methods: A literature search was undertaken between 2007 and 2018. All eligible studies were analyzed using the Critical Appraisal Skills Programme tool. As heterogeneity was high, a narrative synthesis approach was employed, using thematic analysis for categorizing data. Results: Eleven studies met the inclusion criteria and were included in this review. MI had a positive effect on service user experience, but this was not consistent. Training was variable, but the evidence suggests that practitioner’s need ongoing training, supervision, or coaching while providing MI. Discussion: There is a paucity of research examining the impact of MI on children, which was a limitation of this review. There is a need for more qualitative research to surface views and experience of service users to determine why MI is effective

Development and validation of self-reported line drawings for assessment of knee malalignment and foot rotation: a cross-sectional comparative study

<p>Abstract</p> <p>Background</p> <p>For large scale epidemiological studies clinical assessments and radiographs can be impractical and expensive to apply to more than just a sample of the population examined. The study objectives were to develop and validate two novel instruments for self-reported knee malalignment and foot rotation suitable for use in questionnaire studies of knee pain and osteoarthritis.</p> <p>Methods</p> <p>Two sets of line drawings were developed using similar methodology. Each instrument consisted of an explanatory question followed by a set of drawings showing straight alignment, then two each at 7.5° angulation and 15° angulation in the varus/valgus (knee) and inward/outward (foot) directions. Forty one participants undertaking a community study completed the instruments on two occasions. Participants were assessed once by a blinded expert clinical observer with demonstrated excellent reproducibility. Validity was assessed by sensitivity, specificity and likelihood ratio (LR) using the observer as the reference standard. Reliability was assessed using weighted kappa (κ). Knee malalignment was measured on 400 knee radiographs. General linear model was used to assess for the presence of a linear increase in knee alignment angle (measured medially) from self-reported severe varus to mild varus, straight, mild valgus and severe valgus deformity.</p> <p>Results</p> <p>Observer reproducibility (κ) was 0.89 and 0.81 for the knee malalignment and foot rotation instruments respectively. Self-reported participant reproducibility was also good for the knee (κ 0.73) and foot (κ 0.87) instruments. Validity was excellent for the knee malalignment instrument, with a sensitivity of 0.74 (95%CI 0.54, 0.93) and specificity of 0.97 (95%CI 0.94, 1.00). Similarly the foot rotation instrument was also found to have high sensitivity (0.92, 95%CI 0.83, 1.01) and specificity (0.96, 95%CI 0.93, 1.00). The knee alignment angle increased progressively from self reported severe varus to mild varus, straight, mild valgus and severe valgus knee malalignment (p_trend<0.001).</p> <p>Conclusions</p> <p>The two novel instruments appear to provide a valid and reliable assessment of self-reported knee malalignment and foot rotation, and may have a practical use in epidemiological studies.</p

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand

<p>Abstract</p> <p>Background</p> <p>Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children.</p> <p>Methods</p> <p>A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis.</p> <p>Results</p> <p>Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families.</p> <p>Conclusions</p> <p>The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations.</p

A qualitative exploration of the human resource policy implications of voluntary counselling and testing scale-up in Kenya: applying a model for policy analysis

Background: Kenya experienced rapid scale up of HIV testing and counselling services in government health services from 2001. We set out to examine the human resource policy implications of scaling up HIV testing and counselling in Kenya and to analyse the resultant policy against a recognised theoretical framework of health policy reform (policy analysis triangle). Methods: Qualitative methods were used to gain in-depth insights from policy makers who shaped scale up. This included 22 in-depth interviews with Voluntary Counselling and Testing (VCT) task force members, critical analysis of 53 sets of minutes and diary notes. We explore points of consensus and conflict amongst policymakers in Kenya and analyse this content to assess who favoured and resisted new policies, how scale up was achieved and the importance of the local context in which scale up occurred. Results: The scale up of VCT in Kenya had a number of human resource policy implications resulting from the introduction of lay counsellors and their authorisation to conduct rapid HIV testing using newly introduced rapid testing technologies. Our findings indicate that three key groups of actors were critical: laboratory professionals, counselling associations and the Ministry of Health. Strategic alliances between donors, NGOs and these three key groups underpinned the process. The process of reaching consensus required compromise and time commitment but was critical to a unified nationwide approach. Policies around quality assurance were integral in ensuring standardisation of content and approach. Conclusion: The introduction and scale up of new health service initiatives such as HIV voluntary counselling and testing necessitates changes to existing health systems and modification of entrenched interests around professional counselling and laboratory testing. Our methodological approach enabled exploration of complexities of scale up of HIV testing and counselling in Kenya. We argue that a better understanding of the diverse actors, the context and the process, is required to mitigate risks and maximise impact

Social cohesion through football: a quasi-experimental mixed methods design to evaluate a complex health promotion program

Social isolation and disengagement fragments local communities. Evidence indicates that refugee families are highly vulnerable to social isolation in their countries of resettlement. Research to identify approaches to best address this is needed. Football United is a program that aims to foster social inclusion and cohesion in areas with high refugee settlement in New South Wales, Australia, through skills and leadership development, mentoring, and the creation of links with local community and corporate leaders and organisations. The Social Cohesion through Football study’s broad goal is to examine the implementation of a complex health promotion program, and to analyse the processes involved in program implementation. The study will consider program impact on individual health and wellbeing, social inclusion and cohesion, as well as analyse how the program by necessity interacts and adapts to context during implementation, a concept we refer to as plasticity. The proposed study will be the first prospective cohort impact study to our knowledge to assess the impact of a comprehensive integrated program using football as a vehicle for fostering social inclusion and cohesion in communities with high refugee settlement