Search Results (136)

Background/Objectives: Collaboration in mental health care is essential for implementing a model oriented towards the psychosocial rehabilitation of people based on multifaceted interventions involving different actors and sectors of society to respond to demands. Despite the benefits presented by the scientific evidence, there are still many barriers to collaborative care, and professionals continue to struggle in reorienting their conduct. The current situation demands organization and the framing of well-founded action plans to overcome challenges, which in turn requires a detailed understanding of collaborative practices in mental health care and their conceptual boundaries. A concept analysis was undertaken to propose a working definition of collaborative practices in mental health care (CPMHC). Methods: This paper used the Walker and Avant concept analysis method. This includes identifying the defining concept attributes, antecedents, consequences, and empirical referents. A literature search was carried out from November 2024 to February 2025 in three databases (Medline, CINAHL, and LILACS), considering studies published between 2010 and 2024. Results: The final sample of literature investigated consisted of 30 studies. The key attributes were effective communication, building bonds, co-responsibility for care, hierarchical flexibility, articulation between services, providers and community, monitoring and evaluating of care processes, and attention to the plurality of sociocultural contexts. Conclusions: This comprehensive analysis contributes to guiding future research and policy development of collaborative practices in mental health, considering the individual, relational, institutional, and social levels. Further research is possible to deepen the understanding of the production of collaborative practices in mental health in the face of the complexity of social relations and structural inequities. Full article

Background/Objectives: Improving health outcomes for Indigenous people by strengthening the cultural safety of care is a vital challenge for the health sector. University Departments of Rural Health (UDRH), academic centres based in regional, rural, and remote (RRR) locations across Australia, are uniquely positioned to foster a culturally safe rural health workforce through training, education, and engagement with Indigenous communities. This narrative review examines the contributions of UDRHs to health workforce issues through analysis of their publications focused on Indigenous health. Methods: Research articles relating to workforce were identified from an established database of UDRH Indigenous health-related publications published 2010–2021. Results: Of 46 articles identified across the 12 years, 19 focused on developing the understanding and cultural safety skills of university students studying in a health field, including campus-based Indigenous health education and support for students undertaking rural clinical placements. Twelve articles investigated cultural safety skills and recruitment and retention of the rural health workforce. Fifteen articles focused on Indigenous people in the health workforce, examining clinical training and resources, and the enablers and barriers to retaining Indigenous students and workers. Conclusions: This analysis highlights the sustained efforts of UDRHs to improve Indigenous health through multiple areas within their influence, including curriculum design, health student training on campus, and rural placement opportunities to transform understanding of Indigenous strengths and disadvantages and rural health workforce development. A continuing effort is needed on ways UDRHs can support Indigenous health students during their studies and while on placement, how to improve cultural safety in the health workforce, and ways to better support Indigenous health professionals. Full article

Background/Objectives: There is a need for randomized clinical trials with higher quality, especially for older people at high risk of falls, with interventions that consider individual needs, comprehensiveness of care, and connection with primary health care. We designed a randomized controlled trial to examine the effects of a case management intervention combined with a physical exercise protocol on risk factors for falls, falls data, adherence, satisfaction, costs, and implementation in community-dwelling older adults with high risk of falls. Methods: A minimum of 60 community-dwelling older people with high falls risk will participate in the randomized controlled assessor-blinded trial (MAGIC—v. 2). The trial will be conducted in a regional health department of São Paulo state (Brazil), which includes 6 cities. Participants will be randomized to the Intervention Group (case management intervention based on all individual risk factors for falls identified by a multidimensional assessment, over 16 weeks, once a week, by telephone calls). Both groups will perform a physical exercise protocol based on falls prevention for 16 weeks (twice a week) in Health Units. The assessment will be performed at baseline, after 16 weeks of intervention, after 6-month follow-up, and after 12-month follow-up. Primary outcome measures include falls data and potentially modifiable risk factors for falls. Discussion: This study has the potential to facilitate the future implementation of the intervention based on case management with a focus on fall prevention in the health sectors. Trial registration: Brazilian Registry of Clinical Trials (ReBEC). Full article

Objective: There is growing interest in analyzing whether ethical climates influence the emotional states of organizational members. For this reason, the main objective of this study is to evaluate the relationship between a benevolent ethical climate, emotional exhaustion, and depersonalization, taking into account the mediating effect of job autonomy. Methodology: To evaluate the research hypotheses, data were collected from 448 people belonging to six organizations in the Colombian electricity sector. Statistical analysis was performed using two structural equation models (SEMs). Results: The results show that a benevolent climate and its three dimensions (friendship, group interest, and corporate social responsibility) mitigate the negative effect of emotional exhaustion and depersonalization. A work environment focused on people and society triggers positive moods that prevent the loss of valuable psychological resources. On the other hand, job autonomy is a mechanism that has a direct impact on the emotional well-being of employees. Therefore, being able to intentionally direct one’s own sources of energy and motivation prevents an imbalance between resources and demands that blocks the potential effect of emotional exhaustion and depersonalization. Practical implications: This study has important practical implications. First, an ethical climate that seeks to build a caring environment needs to strengthen emotional communication among employees through a high perception of support. Second, organizations need to grow and achieve strategic objectives from a perspective of solidarity. Third, a benevolent ethical climate needs to be nurtured by professionals with a clear vocation for service and a preference for interacting with people. Finally, job autonomy must be accompanied by the necessary time management skills. Social implications: This study highlights the importance to society of an ethical climate based on friendship, group interest, and corporate social responsibility. In a society with a marked tendency to disengage from collective problems, it is essential to make decisions that take into account the well-being of others. Originality/value: This research responds to recent calls for more studies to identify organizational contexts capable of mitigating the negative effects of emotional exhaustion and depersonalization. Full article

This paper is based on our engagement in a cross-sector network in Leeds, UK, taking local climate action. It draws on in-depth engagements with participants in this network, to explore how they negotiate being in, while at the same time wanting to push beyond, a climate emergency. We found three emergent trends: a reworked interpretation of the climate emergency through longer-term, holistic, historically grounded, and politicised definitions; novel forms of disruptive, collaborative place leadership that could help respond to this longer emergency; and a value-based focus on a reparative ethics of self-care, people-care, and Earth-care that foregrounds climate justice and accountability to frontline communities. We end by recommending that place-based actors can enhance the effectiveness of their collective action by broadening emergency definitions, developing politics and strategy, and supporting values-based climate justice and equity. Full article

Older adults make up about 12% of the public sector, primary care, and hospital use and represent a large proportion of the users of healthcare services. Older people are also more vulnerable to serious injury from unexpected falls due to tripping, slipping, or illness. This underscores the immediate necessity of stable and cost-effective e-health technologies in maintaining independent living. Artificial intelligence (AI) and machine learning (ML) offer promising solutions for early fall prediction and continuous health monitoring. This paper introduces a novel cooperative AI model that forecasts the risk of future falls in the elderly based on behavioral and health abnormalities. Two AI models’ predictions are combined to produce accurate predictions: The ${AI}_1$ model is based on vital signs using Fuzzy Logic, and the ${AI}_2$ model is based on Activities of Daily Living (ADLs) using a Deep Belief Network (DBN). A meta-model then combines the outputs to generate a total fall risk prediction. The results show 85.71% sensitivity, 100% specificity, and 90.00% prediction accuracy when compared to the Morse Falls Scale (MFS). This emphasizes how deep learning-based cooperative systems can improve well-being for older adults living alone, facilitate more precise fall risk assessment, and improve preventive care. Full article

Intersectoral collaboration between health care, social care and other sectors has been widely advocated to improve population health outcomes. Similarly, the active role of citizens as coproducers is increasingly described in the literature as an important element for improving people’s health and well-being. Yet, there is little understanding of the role of coproduction in intersectoral collaboration, particularly in neighborhoods with low socioeconomic scores (SESs). In this empirical study, we analyze two aspects of coproduction that potentially drive positive health outcomes in intersectoral collaboration: How do coproducers in neighborhoods with low socioeconomic scores actively contribute to intersectoral collaboration, and what role does the relationship between professionals and citizens play in shaping these contributions? The study was conducted in a low-SES neighborhood in The Hague, the Netherlands. In this study, we explored the team ‘the Connectors’, an intersectoral collaboration of professionals and citizens with various (professional) backgrounds, focusing on accessible support for mental health services. The cause of mental health problems in low-SES neighborhoods varies; therefore, intersectoral collaboration is required in the approach to addressing these mental health problems. Using an action research approach, we demonstrated the importance of a reciprocal relationship between coproducers and professionals. We also found that ‘boundary spanners’ can help to improve this relationship, regardless of whether they are professionals or coproducers. We conclude that citizens in a low-SES neighborhood can not only benefit from coproduction, but can also contribute to it, because they have a high incentive to improve their neighborhood together with professionals in the intersectoral collaboration. Full article

Objectives: This study investigates the presence of crowding-in or crowding-out effects of long-term care insurance (LTCI) on older adults’ care in Korea. Additionally, it examines the influence of old-age income security and private systems, including private transfer income and private health insurance, on these effects. The analysis focuses on three aspects: family-provided care, private non-family care, and total care expenses. Methods: This study conducted logistic and linear regression. Logistic regression was used to examine the likelihood of receiving family-provided and private non-family care, while linear regression analyzed factors associated with total care expenditures. Results: The results reveal a crowding-in effect for family care, as greater utilization of public LTCI is positively associated with family-provided care. However, the relationship between public LTCI and private non-family care was not statistically significant, suggesting that the crowding-in effect on private care systems remains limited. Lastly, LTCI utilization was significantly associated with higher care expenditures. It is noteworthy that the current public LTCI in Korea has low coverage, resulting in insufficient care provision. Consequently, there is growing activity in the private care sector. Conclusions: These findings highlight the need for a more integrated approach to long-term care in Korea, balancing public, private, and family care resources. To achieve quality integrated long-term care for older people, policymakers should focus on expanding public LTCI coverage while fostering coordination between family caregivers and professional care services, ensuring a comprehensive and high-quality care system that meets the diverse needs of Korea’s aging population. Full article

Background/Objectives: The perspective from which future healthcare professionals view intellectual disabilities affects how people with intellectual disabilities (PWIDs) are perceived and informs care policies and practices. This study aimed to assess healthcare science students’ perceptions of the rights of PWIDs, the students’ social distances toward PWIDs in healthcare, and the students’ competence in providing care, exploring differences by study programs and demographics and examining correlations between them. Methods: The convenience sample comprised 221 medical and 120 nursing students. A general questionnaire for obtaining sociodemographic data, the scale of beliefs about the rights of PWIDs in healthcare (BS), the scale of social distance toward PWIDs (SD), and the “self-assessment of competency (CS) to provide care for PWIDs” scale were used as students’ report measures. Results: The students’ scores on the BS, SD, and CS scales revealed that they generally recognized the rights of PWIDs in healthcare but expressed a moderate level of social distance and limited self-perceived competence in providing care. Medical students demonstrated slightly more progressive beliefs regarding the rights of PWIDs than nursing students (r = 0.12), while nursing students reported higher self-assessed competence levels (r = 0.19). A small gender-related difference was observed in social distance, with female students showing more favorable attitudes. Significant positive correlations were found between beliefs about the rights of PWIDs and social distance (p = 0.435; p < 0.01) and between social distance and self-assessed competence (p = 0.234, p < 0.01), suggesting that students who felt more competent tended to report less social distance. Conclusions: This study provides new data for understanding healthcare science students’ perceptions and readiness to care for PWIDs in the healthcare sector in Serbia. Namely, our students had moderately positive beliefs and a moderate social distance toward PWIDs and reported low competence in providing care. Full article

Forcibly displaced people in Scotland face multiple barriers in accessing health, social care, and policing services. This paper explores how social connections shape engagement with these services, particularly the role of police in community safety and wellbeing. Drawing on qualitative interviews and social connections mapping workshops, this study examines how third-sector organisations act as key intermediaries, shaping how people access statutory services. The findings show that while community policing and partnerships with trusted organisations can improve accessibility, concerns about racial discrimination, the underreporting of hate crime, and the lack of language support continue to undermine confidence in policing. Additionally, the growing reliance on police officers to respond to mental health crises reflects wider gaps in specialist service provision. This paper argues for a shift towards a cross-sector approach that strengthens community-led safety strategies, reduces police involvement in non-criminal matters, and improves language and cultural competency within public services. Strengthening institutional accessibility and trust-building initiatives is key to improving engagement with policing and health and social care services for forcibly displaced communities. Full article

Introduction: The World Health Organization has identified dementia as a growing global health concern with 10 million new cases diagnosed every year. The growing number of people living with dementia (PLWD) heightens the need for effective interventions that support PLWD and their caregivers. The most effective interventions supporting PLWD and caregivers combine education, care, and services to increase knowledge, decrease stigma, improve care, heighten empathy, and increase engagement of PLWD in their communities. Dementia Friendly America (DFA), administered by USAging, promotes a Dementia Friendly Community (DFC) initiative designed to engage multiple sectors (e.g., business, healthcare, community services) and engage PLWD in a comprehensive community change process. A center for healthy aging and wellness at a midwestern public university developed a network approach in its regional support of eight DFCs, as a part of its Geriatric Workforce Enhancement Program funded by the U.S. Health Resources and Services Administration. Objective: This article documents a mid-size university’s approach to establishing a regional DFC network of urban and rural communities surrounding the university, describing the support the university provided as well as how communities implemented the four-phase DFC process and emulated guiding principles. Results: A retrospective evaluation found engagement with the DFA guiding principles and varying levels of adherence to DFC phases. Discussion: The project team suggests that there are unique roles that universities can play in supporting the DFC movement and that developing a network of communities is a helpful strategy to use in providing this support. Additionally, the authors propose the integration of a community change model to guide future DFC work. Conclusions: This article helps to fill an existing research gap concerning DFC implementation and explores the unique role academic partners can play in cultivating regional hubs of DFC activity. Full article

We conducted a survey to learn what guides current dementia-related practice to support community-dwelling adults with intellectual and developmental disabilities who may be experiencing dementia in Canada. We invited organizations working in health, disability, or senior sectors in 4 Canadian provinces to complete an online cross-sectional survey between April and July 2023. A total of 173 people completed the survey, representing 125 unique organizations, and nearly half resided in Ontario. The most common support and services provided to adults with intellectual and developmental disabilities and their families were related to residential care, day programming, and group home living. Half of our survey respondents reported that they followed dementia-related practice guidelines. The most common guideline followed and early detection tool used were from the National Task Group on Intellectual Disabilities and Dementia Practices and the National Task Group-Early Detection and Screen for Dementia, respectively. Lack of awareness about guidelines and detection tools, challenges to implement the same, and organizational needs for future training and service provision were identified. Commitment to resources to monitor adults with IDD who may be experiencing dementia is recommended to provide meaningful support and service to them and their families. Full article

In response to the urgent need for environmental education in the world, the Environmental Care with a One Health approach (ECOH) project aimed to promote sustainable environmental practices in educational institutions in Sucre, Bolivia. The ECOH project was implemented in four phases: (1) building alliances with local leaders and communities; (2) identifying practices and perceptions of the environmental situation among the general population and educational units (Online survey); (3) implementing educational interventions; and (4) disseminating educational materials. During the second phase, most of the participants (86%) identified the local environmental situation as poor and waste and solid waste management (SWM) as the main concern (64%). Although 70% of the participants were interested in environmental issues, only 44% practiced waste separation. Considering this, and the feasibility of implementing subsequent actions, educational interventions on SWM were developed in schools, and waste sorting bins were delivered. Educational materials were distributed through social networks, and a mobile app was launched to increase outreach. The project promoted cross-sectoral cooperation, raised awareness, and encouraged active participation in environmental protection focused in academic units. ECOH project demonstrated that participatory educational interventions can effectively address local challenges and promote sustainable practices, contributing to a healthier environment for people and animals. Full article

Background: Major trauma is a leading cause of death and disability in children and young people (CYP) in the United Kingdom (UK). Since 2012, major trauma centres (MTCs) have been created with specialist expertise to treat patients suffering with lifechanging injuries. Much research has focused on the physical recovery of patients; however, the psychological and psychosocial impacts of major trauma are significant and often neglected/deprioritised. Less is known about this area in relation to a paediatric population. Methods: This service evaluation reports on the first year of an integrated psychological pathway within a London paediatric MTC. The proactive approach involves inpatient and outpatient psychological support, screening children and families for trauma symptoms and emotional distress, offering psychological intervention where required, and liaison with community mental health teams, social care services and third sector organisations. Descriptive statistics are reported on the patient demographics and mechanism of injury, as well as screening scores at 6 weeks and 3 months following the traumatic incident. Patient feedback is also presented. Results: The results demonstrate a significant increase in the numbers of children and families offered psychological support following the creation of the pathway and an overwhelmingly positive response from service users. Conclusions: Clinical implications are outlined, and areas for further development are discussed. Full article

The usage of digital twins (DTs) is growing across a wide range of businesses. The health sector is one area where DT use has recently increased. Ultimately, the concept of digital health twins holds the potential to enhance human existence by transforming disease prevention, health preservation, diagnosis, treatment, and management. Big data’s explosive expansion, combined with ongoing developments in data science (DS) and artificial intelligence (AI), might greatly speed up research and development by supplying crucial data, a strong cyber technical infrastructure, and scientific know-how. The field of healthcare applications is still in its infancy, despite the fact that there are several DT programs in the military and industry. This review’s aim is to present this cutting-edge technology, which focuses on neurology, as one of the most exciting new developments in the medical industry. Through innovative research and development in DT technology, we anticipate the formation of a global cooperative effort among stakeholders to improve health care and the standard of living for millions of people globally. Full article