When doctors and parents disagree on how to treat a sick child the emotional and financial costs can be huge

First paragraph: When a child is sick and parents and doctors disagree about what to do next, who is best placed to make that decision? This is a tricky but not uncommon question – with a number of recent high-profile legal cases highlighting the limits of parents’ rights to decide what treatments should be offered.https://theconversation.com/when-doctors-and-parents-disagree-on-how-to-treat-a-sick-child-the-emotional-and-financial-costs-can-be-huge-12467

The Swiss NEHAP: why it ended

While European countries tend to increase the importance given to their national environmental health action plan (NEHAP), Switzerland stopped implementing its NEHAP in 2007. This study investigates the reasons for this surprising decision. The results provide an explanation of a relatively unique case and should inform any person interested in understanding common obstacles in the making and implementation of coordinated environmental health policies and programs. Data used in this study have been obtained from interviews conducted among experts of the Swiss environmental health policies and from survey results provided by the WHO Regional Office for Europe. Findings show that financial constraints were only partly responsible for the abandonment of the NEHAP and that many of the shortcomings observed arose from the creation and the functioning of the Environmental and Health Section at the Federal Office of Public Health, which was devoted to the NEHAP. Lack of scientific knowledge and capacity to build intersectoral collaboration, compounded by a limited conception of environmental health, resulted in a lack of political awareness of environmental health issues. In consequence, the study highlights the necessity of a true interdisciplinary and intersectoral approach for environmental health policies. Policy makers should also be concerned with the creation of relevant systems of indicators, since they appear to be fundamental to the success of environmental health policie

Opportunities and Challenges to Increase Inter- and Transdisciplinarity: A Qualitative Study of the FloodRISE Project

Background: The FloodRISE project, which started in 2013 in Southern California, aimed at better understanding how to promote resilience to coastal flooding. It was based on a cross-disciplinary approach, involving several research teams and local communities. Purpose: We conducted a qualitative study of the first phase of the project (2013-2015) in order to analyze its inter- and transdisciplinary aspects. Setting: We conducted this evaluation as a visiting postdoctoral researcher at UCI, not participating in the FloodRISE project. Intervention: Not applicable. Research design: We conducted 18 semi-structured interviews with members of the three project teams - modeling, social ecology and integration & impact - at UCI in 2015. Data were analyzed and interpreted to identify key aspects of the collaboration within and between project teams, as well as their relationship to local stakeholders. Findings: The analysis showed that an intensive dialogue-based method of interaction and the presence of boundary researchers played a fundamental role in bridging the conceptual and methodological gaps between social and engineering sciences. These results thus exemplify several possibilities for developing more efficient interactions between researchers in a cross-disciplinary project. However, any cross-disciplinary project should: carefully evaluate potential for participants to become boundary researchers, since participants with multiple disciplinary expertise may be underemployed; improve researchers’ level of readiness, in order to facilitate further interaction and increase time efficiency; and clearly address remoteness issues to avoid lower collaboration between central and peripheral locations. Keywords: interdisciplinarity; transdisciplinarity; qualitative study; project evaluation; flood ris

Prostate cancer: Exploring the reasons for timing of presentation and diagnosis. Summary Report

There has been little research looking specifically at the reasons for the timing of when men are diagnosed with prostate cancer. This study investigated the profile of men diagnosed in Greater Glasgow over a two-year period (2008-9). This report explores the experiences of men before they were diagnosed and includes what triggered them or prevented them from presenting their symptoms to a healthcare professional. The study is based on clinical information of the patient population, a postal survey and interview data

When a friend dies the impact can be as traumatic as losing a family member

First paragraph: The death of a friend is a loss that most people face at some point in their lives – often many times. But it is a grief that may not be taken seriously by employers, doctors or others. The so-called hierarchy of grief, a scale used to determine who is considered a more legitimate mourner than others, puts family members at the top. For this reason, the death of a close friend can feel shunted to the periphery and has been described as a disenfranchised grief.https://theconversation.com/when-a-friend-dies-the-impact-can-be-as-traumatic-as-losing-a-family-member-11647

Reducing healthcare conflict: outcomes from using the conflict management framework

Objective To test a new conflict management framework (CMF) to help staff identify and de-escalate conflict between staff and patients/families. Design Before/after study that reports staff quality of life, frequency/severity of conflicts and qualitative interviews on using the framework. Data were collected from May 2017 to September 2017. Setting A paediatric oncology department day-patient and 23-bed inpatient ward. Intervention A two-stage CMF used by staff during daily handovers to identify and then manage conflict cases with families. Results Staff found the CMFto be helpful in identifying and de-escalating conflicts. The number of conflicts reported decreased by 64% from baseline to follow-up. Communication regarding conflict identification improved. Reports of staff burn-out decreased between the two time-points (n=55 at baseline, n=31 at follow-up; p=0.001). Scores on compassion and secondary traumatic stress did not change. Conclusions The CMF substantially reduces the incidence of conflicts and is an acceptable approach for staff. Continued use of the framework would require it to be fully integrated into the working of the ward, which would need to include senior medical buy-in. Further refinements to the framework have been made and will be tested in four UK sites in 2018/2019

Older people with learning disabilities affected by cancer: Involvement and engagement work to inform a research agenda: Final Report

Summary: The Cancer Care Research Centre (CCRC) works with people affected by cancer to find out about their experiences of cancer and what they think about the treatment and care they have had. The CCRC has 16 Advisory Groups of people affected by cancer across Scotland. These groups help the Centre develop research plans by discussing their experiences and views of cancer services. This project worked with adults with learning disabilities affected by cancer. Four people with learning disabilities met with the researchers to talk about their experiences of cancer. Three people had a family member with cancer. One person had breast cancer and talked about her care. By speaking to the researchers, these people advised the researchers on the important issues to research for people with learning disabilities affected by cancer. The project found that new research should focus on: communication in hospitals between professionals and people with learning disabilities; how families cope when someone gets cancer; how to support people with learning disabilities, their families and staff when someone is very ill or dies from cancer; how many people with learning disabilities develop cancer

People with cancer and an intellectual disability: an international issue with local significance

Introduction: The workshop "People with cancer and an intellectual disability: an international issue with local significance" took place in Edinburgh on February 22nd 2008. The workshop was organised by the Centre for the Older Person's Agenda, Queen Margaret University and the Cancer Care Research Centre, University of Stirling. The workshop aims were to engage in a sharing of knowledge and experience and through discussion to drive forward change by creating agendas for policy, practice and research. The objectives were to: 1. present a range of current perspectives on policy, practice and research in cancer care for people with intellectual disabilities; sharing international perspectives; 2. identify and explore key issues; 3. share current practice and research concerns based on practitioner and personal experiences of cancer care; 4. to identify what a community of researcher, policy makers and practitioners would look like; 5. develop practice and research agendas with action plans for taking such agendas forward. The programme for the day revolved around five presentations and two group discussions. See appendix 1 for a copy of the programme, appendix 2 for a list of delegates and appendix 3 for copies of the presentations. This report is organised according to the main themes that emerged from the presentations and discussion sessions. They are linked to the four objectives outlined above and the overall aim of developing an international and comparative understanding of these issues

The Healthcare Conflict Scale: development, validation and reliability testing of a tool for use across clinical settings

Despite the widespread incidence of conflict and its detrimental impact across a range of health-care settings, there is no validated tool with which to measure it. This paper describes the international innovation of a tool to measure staff-family conflict in pediatrics, intensive care, emergency, palliative care, and nursing homes. Sixty-two health-care workers contributed to focus group discussions to refine a draft tool developed from the literature. Subsequently, 101 health-care workers applied the tool to fictionalized vignettes. The psychometric properties (construct validity, internal consistency, repeatability, and reliability) were explored using principal component analysis, Cronbach’s alpha, and intra-class correlation (ICC) tests. The initial 17-item tool was reduced to seven items within three factors that explained 70.2% of the total variance in overarching construct. The internal consistency of the final overall scale was good (Cronbach’s alpha: 0.750); test–retest reliability of each item was excellent with ICCs ≥0.9. This new tool can be used to identify and score conflict, making it a key reference point in healthcare conflict work across clinical specialties. It's development and testing across specialities and across countries means it can be used in a variety of contexts. The tool provides health-care professionals with a new way to identify and measure conflict, and consequently has the potential to transform health-care relationships across disciplines and settings