Key issues of health and safety for workers in residential aged care: An expert study

Introduction: Residential aged care (RAC) represents a fast-growing sector within Australia's health care system and is characterized by high levels of workplace injury. To better understand this injury problem, this study investigated key informant perspectives concerning sector occupational health and safety (OHS) focused on key issues associated with the risk of worker injury. Method: Semi-structured interviews were undertaken with nine key informants representing (OHS) specialists, healthcare employers, regulators, worker association representatives, and academic researchers in OHS or healthcare. Interviews were transcribed verbatim and analyzed using thematic analysis. Results: This study identified six themes on OHS within RAC including (i) the physical and emotional nature of the work, (ii) casualization of employment, (iii) prioritization, (iv) workforce profile, (v) OHS role construction, and (vi) clinical standards. The study highlighted differences in OHS roles between RAC and other safety-critical sectors regarding governance and management of OHS. The key informants identified a propensity within RAC to downplay or disregard worker OHS issues justified through prioritizing resident safety. Further, neither OHS professional nor institutional logics are prominent in RAC leadership and decision-making where the emphasis is placed on mandatory standards to maintain funding purposes. Several recommendations are made to address identified issues

Developing and evaluating interventions for women firesetters in high secure mental healthcare

Purpose The purpose of this paper is to discuss the implementation and evaluation of interventions for women firesetters in high secure mental healthcare at the UK’s National Women’s Service. Design/methodology/approach Two types of Arson treatment programmes for women, one delivered to individuals, the other within a group context, were developed, delivered and evaluated. The evaluation incorporated qualitative and quantitative data, including psychometric measures. Qualitative data were analysed using thematic analysis. Findings The evaluation evidenced very high engagement with and attendance at treatment programmes, and several post-treatment gains. Participants’ ratings of programmes and qualitative feedback were similarly very positive. The study demonstrated that engaging women firesetters in their treatment is paramount and can be facilitated by consistent boundaries around therapy provision balanced with sensitivity, empathy and flexibility; providing interactive and varied teaching methods; ongoing service user involvement and recognising participants’ achievements; employing a mixed cognitive analytic therapy and cognitive behavioural therapy therapeutic approach; having input from fire service staff; and maintaining organisational support for firesetting interventions. Practical implications In all, 12 key recommendations are made for clinicians considering offering treatment programmes for women firesetters. Originality/value Amid few published papers on treating women firesetters this paper guides forensic clinicians in establishing and delivering interventions for women firesetters

Key issues of health and safety for workers in residential aged care: An expert study

IntroductionResidential aged care (RAC) represents a fast-growing sector within Australia's health care system and is characterized by high levels of workplace injury. To better understand this injury problem, this study investigated key informant perspectives concerning sector occupational health and safety (OHS) focused on key issues associated with the risk of worker injury.MethodSemi-structured interviews were undertaken with nine key informants representing (OHS) specialists, healthcare employers, regulators, worker association representatives, and academic researchers in OHS or healthcare. Interviews were transcribed verbatim and analyzed using thematic analysis.ResultsThis study identified six themes on OHS within RAC including (i) the physical and emotional nature of the work, (ii) casualization of employment, (iii) prioritization, (iv) workforce profile, (v) OHS role construction, and (vi) clinical standards. The study highlighted differences in OHS roles between RAC and other safety-critical sectors regarding governance and management of OHS. The key informants identified a propensity within RAC to downplay or disregard worker OHS issues justified through prioritizing resident safety. Further, neither OHS professional nor institutional logics are prominent in RAC leadership and decision-making where the emphasis is placed on mandatory standards to maintain funding purposes. Several recommendations are made to address identified issues

Involving men to improve maternal and newborn health: A systematic review of the effectiveness of interventions

Background: Emerging evidence and program experience indicate that engaging men in maternal and newborn health can have considerable health benefits for women and children in low- and middle-income countries. Previous reviews have identified male involvement as a promising intervention, but with a complex evidence base and limited direct evidence of effectiveness for mortality and morbidity outcomes. Objective: To determine the effect of interventions to engage men during pregnancy, childbirth and infancy on mortality and morbidity, as well as effects on mechanisms by which male involvement is hypothesised to influence mortality and morbidity outcomes: home care practices, care-seeking, and couple relationships. Methods: Using a comprehensive, highly sensitive mapping of maternal health intervention studies conducted in low- and middle-income countries between 2000 and 2012, we identified interventions that have engaged men to improve maternal and newborn health. Primary outcomes were care-seeking for essential services, mortality and morbidity, and home care practices. Secondary outcomes relating to couple relationships were extracted from included studies. Results: Thirteen studies from nine countries were included. Interventions to engage men were associated with improved antenatal care attendance, skilled birth attendance, facility birth, postpartum care, birth and complications preparedness and maternal nutrition. The impact of interventions on mortality, morbidity and breastfeeding was less clear. Included interventions improved male partner support for women and increased couple communication and joint decision-making, with ambiguous effects on women\u27s autonomy. Conclusion: Interventions to engage men in maternal and newborn health can increase care-seeking, improve home care practices, and support more equitable couple communication and decision-making for maternal and newborn health. These findings support engaging men as a health promotion strategy, although evidence gaps remain around effects on mortality and morbidity. Findings also indicate that interventions to increase male involvement should be carefully designed and implemented to mitigate potential harmful effects on couple relationship dynamics

Challenging gender inequity through male involvement in maternal and newborn health: critical assessment of an emerging evidence base

Men\u27s involvement in the health of women and children is considered an important avenue for addressing gender influences on maternal and newborn health. The impact of male involvement around the time of childbirth on maternal and newborn health outcomes was examined as one part of a systematic review of maternal health intervention studies published between 2000 and 2012. Of 33,888 articles screened, 13 eligible studies relating to male involvement were identified. The interventions documented in these studies comprise an emerging evidence base for male involvement in maternal and newborn health. We conducted a secondary qualitative analysis of the 13 studies, reviewing content that had been systematically extracted. A critical assessment of this extracted content finds important gaps in the evidence base, which are likely to limit how ‘male involvement’ is understood and implemented in maternal and newborn health policy, programmes and research. Collectively, the studies point to the need for an evidence base that includes studies that clearly articulate and document the gender-transformative potential of involving men. This broader evidence base could support the use of male involvement as a strategy to improve both health and gender equity outcomes

Expectant fathers’ participation in antenatal care services in Papua New Guinea: a qualitative inquiry

Background: The importance of engaging men in maternal and child health programs is well recognised internationally. In Papua New Guinea (PNG), men’s involvement in maternal and child health services remains limited and barriers and enablers to involving fathers in antenatal care have not been well studied. The purpose of this paper is to explore attitudes to expectant fathers participating in antenatal care, and to identify barriers and enablers to men‘s participation in antenatal care with their pregnant partner in PNG. Methods: Twenty-eight focus group discussions were conducted with purposively selected pregnant women, expectant fathers, older men and older women across four provinces of PNG. Fourteen key informant interviews were also conducted with health workers. Qualitative data generated were analysed thematically. Results: While some men accompany their pregnant partners to the antenatal clinic and wait outside, very few men participate in antenatal consultations. Factors supporting fathers’ participation in antenatal consultations included feelings of shared responsibility for the unborn child, concern for the mother’s or baby’s health, the child being a first child, friendly health workers, and male health workers. Sociocultural norms and taboos were the most significant barrier to fathers’ participation in antenatal care, contributing to men feeling ashamed or embarrassed to attend clinic with their partner. Other barriers to men’s participation included fear of HIV or sexually transmitted infection testing, lack of separate waiting spaces for men, rude treatment by health workers, and being in a polygamous relationship. Building community awareness of the benefits of fathers participating in maternal and child health service, inviting fathers to attend antenatal care if their pregnant partner would like them to, and ensuring clinic spaces and staff are welcoming to men were strategies suggested for increasing fathers’ participation in antenatal care. Conclusion: This study identified significant sociocultural and health service barriers to expectant fathers’ participation in antenatal care in PNG. Our findings highlight the need to address these barriers – through health staff training and support, changes to health facility layout and community awareness raising – so that couples in PNG can access the benefits of men’s participation in antenatal care

Understanding how children and young people with chronic non-cancer pain and their families experience living with pain, pain management and services: a metaethnography

AbstractBackgroundChildhood chronic pain is a widespread public health issue. We need to understand how children with chronic pain and their families experience chronic pain and its management.ObjectivesTo conduct a meta-ethnography on the experiences and perceptions of children with chronic pain and their families of chronic pain, treatments and services. We investigated how children and their families conceptualise and live with chronic pain; what they think of and want from health and social care services; and what they conceptualise as ‘good’ pain management.DesignMeta-ethnography with stakeholder and patient and public involvement in the design, search and sampling strategies, analysis and dissemination.Review strategy: comprehensive searches of 12 bibliographic databases and supplementary searches in September 2022, to identify qualitative studies with children aged 3 months to 18 years with chronic non-cancer pain and their families. We included studies with rich explanatory data; appraised methodological limitations using the Critical Appraisal Skills Programme tool; and extracted, analysed and synthesised studies’ findings. We used Grading of Recommendations Assessment, Development and Evaluation-confidence in the evidence from reviews of qualitative research to assess confidence in review findings. We integrated findings with 14 Cochrane treatment effectiveness reviews on children’s chronic non-cancer pain.ResultsWe synthesised 43 studies sampled from 170 eligible studies reported in 182 publications. Studies had minor (n = 24) or moderate (n = 19) methodological limitations. Grading of Recommendations Assessment, Development and Evaluation-confidence in the evidence from reviews of qualitative research assessments of review findings were high (n = 22), moderate (n = 13) or very low confidence (n = 1).Moderate and severe chronic pain had profound adverse impacts on family members’ well-being, autonomy and self-identity; family dynamics; parenting approaches; friendships and socialising; children’s education and parental paid employment. Most children and families sought a biomedical cure for pain. They experienced difficulties seeking and receiving support from health services to manage pain and its impacts. Consequently, some families repeatedly visited health services.Cochrane reviews of intervention effects and trials did not measure some outcomes important to children and families, for example effects of pain on the family and resolution of pain. Reviews have mainly neglected a biopsychosocial approach when considering how interventions work.LimitationsThere were limited data on common pain conditions like migraine/headache, abdominal pain; some rarer conditions; children with learning disabilities and under-fives; siblings; fathers and experiences of treatments/services. We excluded studies on cancer, end-of-life pain and experiences of healthcare professionals.ConclusionsWe developed the family-centred theory of children’s chronic pain management, integrating health and social care with community support

Male involvement interventions and improved couples’ emotional relationships in Tanzania and Zimbabwe: ‘When we are walking together, I feel happy’

Male involvement in maternal and child health is recognised as a valuable strategy to improve care-seeking and uptake of optimal home care practices for women and children in low- and middle-income settings. However, the specific mechanisms by which involving men can lead to observed behaviour change are not well substantiated. A qualitative study conducted to explore men’s and women’s experiences of male involvement interventions in Tanzania and Zimbabwe found that, for some women and men, the interventions had fostered more loving partner relationships. Both male and female participants identified these changes as profoundly meaningful and highly valued. Our findings illustrate key pathways by which male involvement interventions were able to improve couples’ emotional relationships. Findings also indicate that these positive impacts on couple relationships can motivate and support men’s behaviour change, to improve care-seeking and home care practices. Men’s and women’s subjective experiences of partner relationships following male involvement interventions have not been well documented to date. Findings highlight the importance of increased love, happiness and emotional intimacy in couple relationships – both as a wellbeing outcome valued by men and women, and as a contributor to the effectiveness of male involvement interventions

LMDA Review, volume 11, issue 1

Contents include: Advocacy Guidelines,LMDA Members Meet with the NEA, Update The Elliot Hayes Award,Update Script Exchange, Presentation Of Elliott Hayes Award to Rebecca Rugg, To Lynn Thomson, Conference Panels and Sessions, Conversations About Digital Dramaturgy, Key Note, Dramaturg As Generator, Multi-Authorship: Too Many Cooks?, Desperately Seeking Research, On Copyright, The Dramaturg As Advocate For The Arts On City, State/Provincial, And National Levels, Entrances And Exits, The (New Play) Workshop\u27s The Thing, Anne Cattaneo On Commissioning New Work, LMDA Regions And VPs, News From Canada, News from Baltimore, News from Chicago, The Past Two Years, and On, Notes to Fellow LMDA Members, Spotlight on Early Career Dramturgs, Dramaturgy Opening Arena Stage, Internship at the Women\u27s Project, Literary Residency in New York, Dramaturgy/Literary Management Internship at Arena Stage, Job Opening at UCSD, A Note to LMDA Members, Unity Fest 2001 Call for Scripts, Call for Directors, Actors, Dramaturgs, and Call for Updates to the LMDA Guide to Programs in Dramaturgy.https://soundideas.pugetsound.edu/lmdareview/1022/thumbnail.jp

LMDA Review, volume 9, issue 1

Contents include: Mid-Year Meetings, Words of Thanks from Jayme Koszyn Outgoing President of LMDA, Anne Cattaneo of Lincoln Center Theater Receives Dramaturgy Award, May I have the Envelope, Please?, Rent Settlement, On Advocacy, A VP is a VIP is a VP, LMDA Canada, Next Annual LMDA Conference, Early Career Dramaturg Program, Script Exchange, ATHE \u2799 Toronto Border to Board, ATHE \u2799 Toronto Debut Panel, ATHE \u27 99 Toronto Call for Directors, Actors, Dramaturgs for the New Play Development Workshop, Report on Last June\u27s Conference, Report on Last June\u27s Conference LMDA University Caucus Pre-Conference and Source Books, Minutes June 1998, LMDA Job Line, Job Listings, and the Membership Directory, LMDA Online, Supplement to the LMDA Bibliography, and Call for Papers Theatre Topics: Dramaturgy, Pedagogy, Performance.https://soundideas.pugetsound.edu/lmdareview/1018/thumbnail.jp