Encouraging entrepreneurship in dietetics: A qualitative exploration of the experiences of new graduate dietitians participating in an entrepreneurship mentoring circle.

AIMS: Healthcare needs of the Australian population are changing, providing an opportunity for dietitians to embrace innovation and entrepreneurship to meet evolving demands. This study explored the expectations and experiences of participants in a 12-month mentoring circle designed to provide entrepreneurship learning and formal mentoring for the Provisional Accredited Practising Dietitians Program. METHODS: A qualitative study design was employed. New graduate dietitians (<2 years) participating in the Entrepreneurial Dietetics Mentoring Circle in 2019, 2020 or 2021 were invited to participate. Baseline demographic and employment data were collected via survey. Semi-structured interviews were conducted before mentoring circle session 1 (baseline) and after the final session (completion), exploring insights into participant expectations and experiences in entrepreneurship. Thematic analysis, using methods outlined by Braun and Clark, was conducted to identify themes and subthemes. RESULTS: Twenty-eight dietitians participated (85% of mentees). Participants were mostly female (89%), less than 12 months post-graduation (75%), registered as Provisional Accredited Practising Dietitians (82%) and employed at least part-time (55%). Forty five interviews were conducted (28 baseline, 18 completion). Themes developed were: (1) entrepreneurial career path as a deliberate choice; (2) the value of being prepared for entrepreneurial careers; and (3) the importance of networks to support entrepreneurship. CONCLUSION: The mentoring circle at this single university was seen by participants as supporting their transition into entrepreneurial careers, while meeting their requirement to be formally mentored through their Provisional status. Future research could consider the applicability of the mentoring circle model across a wider graduate population to support innovative practice.

A Comparative Analysis of Student and Practising Nurses' Health Literacy Knowledge in Ghana.

This study examined student and practising nurses' health literacy knowledge, and its correlates in Ghana. It was underpinned by an adapted version of the Institute of Medicine's (IOM) conceptual framework of health literacy. We used convenience and snowball sampling techniques to collect data from 876 nurses (477 student nurses and 399 practising nurses) in a cross-sectional survey from February 2019 to June 2019. The respondents were drawn from all the former ten administrative regions of Ghana. Approximately 75.4% of the respondents had heard of health literacy. However, health literacy knowledge was generally low (average score of 6.6 out of 20) among both groups, with student nurses (average score of 5.8 out of 20) having significantly lower scores than practising nurses (average score of 7.4 out of 20). Factors associated with health literacy knowledge among student nurses included gender (male, B = -0.499, p < 0.01), trust in others (B = -0.874, p < 0.001), cultural values (B = 0.276, p < 0.001), year of study (B = 0.244, p < 0.05), and frequency of curative care use (B = -0.236, p < 0.05). For practising nurses, trust (B = -1.252, p < 0.01), cultural values (B = 0.357, p < 0.01), and working experience (B = 0.612, p < 0.01) were associated with their health literacy knowledge. Thus, responses targeted at gaps in health literacy knowledge of student and practising nurses must be sensitive to personal characteristics (e.g., gender), social values (e.g., issues of trust, and cultural beliefs and practices), as well as factors relating to nursing education and experience.

The impact of planning for COVID-19 on private practising midwives in Australia.

PROBLEM: The COVID-19 pandemic response has required planning for the safe provision of care. In Australia, privately practising midwives are an important group to consider as they often struggle for acceptance by the health system. BACKGROUND: There are around 200 Endorsed Midwives eligible to practice privately in Australia (privately practising midwives) who provide provide the full continuum of midwifery care. AIM: To explore the experience of PPMs in relation to the response to planning for the COVID-19 pandemic. METHODS: An online survey was distributed through social media and personal networks to privately practising midwives in Australia in April 2020. RESULTS: One hundred and three privately practising midwives responded to the survey. The majority (82%) felt very, or well informed, though nearly half indicated they would value specifically tailored information especially from professional bodies. One third (35%) felt prepared regarding PPE but many lacked masks, gowns and gloves, hand sanitiser and disinfectant. Sixty four percent acquired PPE through social media community sharing sites, online orders, hardware stores or made masks. Sixty-eight percent of those with collaborative arrangements with local hospitals reported a lack of support and were unable to support women who needed transfer to hospital. The majority (93%) reported an increase in the number of enquiries relating to homebirth. CONCLUSION: Privately practising midwives were resourceful, sought out information and were prepared. Support from the hospital sector was not always present. Lessons need to be learned especially in terms of integration, support, education and being included as part of the broader health system.

Estrategia Integral para la Ampliación del Rol de Enfermería en la Atención Primaria de Salud / Primary Healthcare Nursing Role Enhancement Integral Strategy / Estratégia Integral para a Ampliação do Papel de Enfermagem na Atenção Primária de Saúde

RESUMEN Introducción: Los desequilibrios entre la carga de enfermedades crónicas y la insuficiente respuesta del sistema de salud, agudizan las desigualdades en cobertura así como el acceso efectivo a los servicios. La Secretaría de Salud, integró grupos de trabajo para diseñar una estrategia que contribuya a la solución de esta problemática a través de la optimización y distribución de las funciones de enfermería. Objetivo: Explicar la Estrategia Integral para la Ampliación del Rol de Enfermería, con el fin de establecer la política de formación de recursos humanos e incorporar este nuevo rol al sistema público de salud en México. Metodología: Este documento describe cómo se realizó la Estrategia, su proceso de desarrollo y los componentes que la integran; así como el Marco Mexicano de Competencias para la Ampliación del Rol de Enfermería. Resultados: Se identificaron las acciones necesarias para la implementación de la Estrategia y se clasificaron en tres componentes: Laboral, Educativo/formación y Legal/normativo; así como los ejes transversales de Abogacía y Difusión. Discusión: Las estrategias para fortalecer el modelo de prestación de servicios de salud a nivel comunitario no han cambiado en muchos años. La implementación de la Estrategia proyecta la transformación hacia un modelo resolutivo donde los recursos humanos se desplieguen a la comunidad activamente. Conclusiones: La Estrategia busca adaptar la composición de la fuerza laboral en el Primer Nivel de Atención y optimizar su desempeño, para contribuir a mejorar la respuesta a las necesidades progresivas de salud.

ABSTRACT Introduction: Disparities between the burdens resulting from chronic illnesses and the corresponding responses by the health systems increase the inequalities in terms of coverture and effective access to the health services. In response to this situation, the Secretaría de Salud de México integrated diverse groups to work with the aim of designing strategies which can contribute to finding solutions to this problematic through the optimization and distribution of the nursing functions. Objective: To Inform on the Nursing Role Enhancement Integral Strategy in order to establish corresponding policies related to human resources formation, and incorporate this new role into the health public system in Mexico. Methodology: This document informs on how this Strategy was designed, its development process, and the components which integrate it, all within the Mexican Framework on Competencies to the Enhancement of the Nursing Role. Results: The needed actions to implement this Strategy were identified and further classified into three components: Work-related, Education-formation-related, and Legal-normative-related. Advocacy and Diffusion were determined as the transversal axes. Discussion: Strategies to strengthen the health service provision model in a community level have not changed in many years. The implementation of the Strategy, matter of this document, projects a transformation towards a resolutive model in that human resources are actively deployed into the community. Conclusions: This Strategy seeks adapting the composition of the primary healthcare working force and optimizing its performance in order to better address the health needs of the community.

RESUMO Introdução: Os desequilíbrios entre a carga de doenças crónicas e a resposta insuficiente do sistema de saúde, agudizam as desigualdades na cobertura e acesso efetivo aos serviços. O Secretaría de Salud integrou grupos de trabalho para traçar uma estratégia que contribua para a solução desta problemática, através da otimização e distribuição de funções de enfermagem. Objetivo: Explicar a Estratégia Integral para a Ampliação do Papel de Enfermagem, para estabelecer a política de formação de recursos humanos e incorporar este novo rolo ao sistema público de saúde no México. Metodologia: Este documento descreve como se realizou a Estratégia, seu processo de desenvolvimento e os componentes que a compõem, bem como o Quadro Mexicano de Competências para a Ampliação do Papel de Enfermagem. Resultados: Foram identificadas as ações necessárias para a implementação da Estratégia e classificaram-se em três componentes: Trabalhista, Educacional/formativo e Jurídica/normativo; bem como os eixos transversais de Advocacia e Difusão. Discussão: As estratégias para fortalecer o modelo de prestação de serviços de saúde a nível comunitário não cambiou em muitos anos. A implementação da Estratégia projeta a transformação para um modelo de resolução onde os recursos humanos ativamente direcionam-se à comunidade. Conclusões: A Estratégia busca adaptar a composição da força laboral no Primeiro Nível de Atenção e otimizar seu desempenho, para contribuir a melhorar a resposta às necessidades progressivas de saúde.

Doing care work on the fly - exploring the unnoticed socio-emotional skills of male ambulance staff.

Prehospital ambulance work is a healthcare arena hitherto neglected by sociologists of health and illness. This is unfortunate because it is an interesting and dynamic area, and in contrast to most healthcare sectors, it is male dominated. Via ethnographic fieldwork, this article examines the particular caring practices and socio-emotional skills that ambulance staff use in practising prehospital care work. The empirical analysis outlines six recurring prehospital practices: medicine work, machine work, scene management, becalming work, communication work and bodywork. Each practice represents a different element of prehospital care practice and is best understood as a repertoire, as many different assemblages of these care practices can work effectively in prehospital situations. The article concludes that despite institutionalised blue-collar masculinity, numeric dominance and scarce formal education in ambulance psychology, male ambulance staff are generally proud and reflexive care practitioners.

Protestant Christian attitudes to ART.

STUDY QUESTION: How do Christian religious beliefs affect attitudes to ART? SUMMARY ANSWER: Attitudes to ART depend on the religiosity of the respondent, and although the majority of those that had successfully used ART were positive or moderately positive in their views, the acceptability of procedures fell when damage to the marriage relationship or the embryo was a potential outcome. WHAT IS KNOWN ALREADY: Religion can impact views on ART. Sanctity of marriage and sanctity of the embryo are major concerns for some Christians, but details are unclear. METHODS: A cross-sectional online survey was used to collect data from 1587 participants over a 3-month period in 2013, of which 1334 were of the Christian faith and included in this study. Descriptive statistics were reported for individual ARTs, and a general score of all ART approval was calculated. A multivariable linear and logistic regression was conducted on general approval for ART to identify predictors of ART approval. MAIN RESULTS AND THE ROLE OF CHANCE: Indicators of religiosity (religious meeting attendance and Bible reading frequency) showed that this was a highly religious sample. We found that in this cohort of English-speaking, well-educated, practising and mainly Protestant Christians 164 (12.3%) of those had personal experience of ART. Most participants that had successfully used ART were positive or moderately positive in their views. Throughout the cohort, procedures were less acceptable if there was a perception that the marriage relationship or the life of the embryo was threatened: including donated gametes (28.7-29.1% approval), surrogacy (22.7-33.1% approval), and PGD (1.0-23.8% approval). A multivariable analysis of the ART approval score found that it was higher among those with Protestant compared with Catholic/Orthodox faith (P < 0.001; mean score difference, 5.06; 95% CI 4.36-5.81) and those who believe life begins after fertilisation (P < 0.001; mean score difference, 4.86; 95% CI 4.14-5.57). Approval was also higher, but to a lesser extent, in women than men (P = 0.008; mean score difference, 0.73; 95% CI 0.18-1.28), and those with lower religiosity (P < 0.001). The area raising most indecision for this cohort was disposal of excess embryos. LIMITATIONS REASONS FOR CAUTION: This sample includes an uneven geographical spread of respondents and restriction to English-speaking participants. Different views may be expressed by a different religious cohort. Use of an online survey platform means that a bias towards those with computers (consistent with education levels of this cohort) could exist. Use of this platform also makes it impossible to know the response rate, and the veracity of responses cannot be verified. However, despite these limitations we believe this survey gives us insight into the reservations held among a certain population of Christians regarding the use of reproductive technology. WIDER IMPLICATIONS OF THE FINDINGS: Our findings highlight the need for ART clinicians to consider the influence of patient spiritual beliefs on therapeutic options and provide detailed information that will allow them to be accommodated. Practices such as widening the options for collecting semen and limiting the number of embryos created through IVF so as to reduce or eliminate excess embryos may be helpful for these patients. STUDY FUNDING/COMPETING INTERESTS: This study was supported by a grant from The Center for Bioethics & Human Dignity in Deerfield, Illinois, USA. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: N/A.

Graduate mobility: Where do dentistry graduates choose to practise?

BACKGROUND AND OBJECTIVE: The international higher education market has grown and developed rapidly. International students generate attractive income for host universities, and gaining an international education benefits students in an increasingly globalised world. However, there is little research regarding where international students intend to work and settle beyond graduation. This study investigated where dentistry students intended to practise after graduation, and whether international students who graduated between 2001 and 2016 are currently practising in their host country (New Zealand) or have migrated overseas. METHODS: A cross-sectional survey was used to investigate current students' intended destination of practice after graduation. Additionally, names of international graduates since 2001 were matched against the 2017 register of practitioners to determine if they were currently registered to practise in their host country. A frequency and bivariate analysis was conducted. RESULTS: Almost 64% of current international students indicated their intention to stay in their host country after graduation. However, only 22% of graduates since 2001 were currently practising in New Zealand. The number of international graduates who registered to practise in New Zealand increased between 2001 and 2016. CONCLUSION: Less than one-quarter of international graduates were currently practising in their host country; however, longitudinal data showed that this is an increasing trend. These findings can be used to inform how we might prepare current and future graduates for both local and globalised labour markets.

'There's so much to it': the ways physiotherapy students and recent graduates experience practice.

Health science courses aim to prepare students for the demands of their chosen profession by learning ways appropriate to that profession and the contexts they will work and live in. Expectations of what students should learn become re-contextualised and translated into entry-level curriculum, with students operating as a connection between what is intended and enacted in curriculum, and required in the real world. Drawing on phenomenology, this paper explores how students understand practice-the collective, purposeful knowing, doing and being of a community-in entry-level physiotherapy programs. Ways of thinking and practising (WTP)-a framework attentive to the distinctive nature of a discipline, its values, philosophies and world-view (McCune and Hounsell in High Educ 49(3):255-289, 2005)-provides the conceptual lens. Six themes describing how students see the WTP of physiotherapy practice emerged from the analysis: discovery of new knowledge; problem solving client related contexts; adopting a systems based approach to the body; contributing to a positive therapeutic alliance; developing a sense of self and the profession; and the organisation of the workforce. The study produces knowledge about practice by focusing on physiotherapy students' experiences of disciplinary learning. Including students in educational research in this way is an approach that can help students realise their potential as part of a community of practice.

Developing nurses' intercultural/intraprofessional communication skills using the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps.

AIMS AND OBJECTIVES: To examine how the use of Social Interaction Maps, a tool in the EXCELLence in Cultural Experiential Learning and Leadership Program, can enhance the development of nurses' intercultural/intraprofessional communication skills. BACKGROUND: Nurses face communication challenges when interacting with others from similar background as well as those from a culturally and linguistically diverse background. We used the EXCELLence in Cultural Experiential Learning and Leadership Program's Social Interaction Maps tool to foster intercultural/intraprofessional communication skills in nurses. Social Interaction Maps describe verbal and nonverbal communication behaviours that model ways of communicating in a culturally appropriate manner. The maps include four stages of an interaction, namely Approach, Bridging, Communicating and Departing using the acronym ABCD. DESIGN: Qualitative approach was used with a purposeful sample of nurses enrolled in a postgraduate course. METHODS: Fifteen participants were recruited. The Social Interaction Map tool was taught to participants in a workshop where they engaged in sociocultural communication activities using scenarios. Participants were asked to apply Social Interaction Maps in their workplaces. Six weeks later, participants completed a semistructured open-ended questionnaire and participated in a discussion forum on their experience of using Social Interaction Maps. Data were content-analysed. RESULTS: Four themes identified in the use of the Social Interaction Maps were (i) enhancing self-awareness of communication skills; (ii) promoting skills in being nonconfrontational during difficult interactions; (iii) highlighting the importance of A (Approach) and B (Bridging) in interaction with others; and (iv) awareness of how others interpret what is said C (Communicating) and discussing to resolve issues before closure D (Departing). CONCLUSIONS: Application of the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Mapping tool was shown to be useful in developing intercultural/intraprofessional communication skills in nurses. RELEVANCE TO CLINICAL PRACTICE: Professional development programmes that incorporate EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps can enhance nurses' intercultural/intraprofessional communication competencies when engaging with others from culturally and linguistically diverse backgrounds and improve the way nurses communicate with each other.

Methods for Practising Ethics in Research and Innovation: A Literature Review, Critical Analysis and Recommendations.

This paper provides a systematic literature review, analysis and discussion of methods that are proposed to practise ethics in research and innovation (R&I). Ethical considerations concerning the impacts of R&I are increasingly important, due to the quickening pace of technological innovation and the ubiquitous use of the outcomes of R&I processes in society. For this reason, several methods for practising ethics have been developed in different fields of R&I. The paper first of all presents a systematic search of academic sources that present and discuss such methods. Secondly, it provides a categorisation of these methods according to three main kinds: (1) ex ante methods, dealing with emerging technologies, (2) intra methods, dealing with technology design, and (3) ex post methods, dealing with ethical analysis of existing technologies. Thirdly, it discusses the methods by considering problems in the way they deal with the uncertainty of technological change, ethical technology design, the identification, analysis and resolving of ethical impacts of technologies and stakeholder participation. The results and discussion of our literature review are valuable for gaining an overview of the state of the art and serve as an outline of a future research agenda of methods for practising ethics in R&I.

Sport, how people choose it: A network analysis approach.

In order to investigate the behaviour of athletes in choosing sports, we analyse data from part of the We-Sport database, a vertical social network that links athletes through sports. In particular, we explore connections between people sharing common sports and the role of age and gender by applying "network science" approaches and methods. The results show a disassortative tendency of athletes in choosing sports, a negative correlation between age and number of chosen sports and a positive correlation between age of connected athletes. Some interesting patterns of connection between age classes are depicted. In addition, we propose a method to classify sports, based on the analyses of the behaviour of people practising them. Thanks to this brand new classifications, we highlight the links of class of sports and their unexpected features. We emphasise some gender dependency affinity in choosing sport classes.