La integración de la inteligencia artificial en la educación médica y su impacto en la práctica clínica / The integration of artificial intelligence in medical education and its impact on clinical practice

Introducción: La integración de la inteligencia artificial (IA) en la educación médica redefine paradigmas, optimiza méto-dos y forja una simbiosis tecnológica. Desarrollo: La IA potencia simulaciones clínicas, mejora evaluaciones y desarrolla habilidades blandas, redefiniendo lainteracción médico-paciente. Conclusiones: Aunque persisten desafíos éticos, la colaboración interdisciplinaria y la adaptabilidad son cruciales. La IA marca un hito en la evolución médica al elevar la calidad asistencial y establecer estándares para una colaboración armoniosa entre tecnología y compasión.(AU)

Introduction: The incorporation of artificial intelligence (AI) into medical education redefines paradigms, optimisesmethods and forges a technological symbiosis. Development: AI enhances clinical simulations, improves assessments and develops soft skills, thereby redefining doctor-patient interaction. Conclusions: Although ethical challenges remain, interdisciplinary collaboration and adaptability are crucial. AI marks a milestone in the evolution of medicine by raising the quality of care and setting standards for harmonious collaboration between technology and compassion.(AU)

Primate conservation: A public issue?

Nonhuman primates (primates) are one of the most endangered mammalian taxa in the world. In the Global North, primates are considered exotic species and, as such, humans' impact on primate conservation and responsibility to protect primates is often ignored. This view differs from the spectrum of relations and attitudes of humans that live in connection to primates, which can include viewing these animals as culturally/religiously significant, cohabitors of forests, nuisances, or sources of protein. While conservationists argue that primates deserve our protection, the conservation crisis facing primates is rarely framed as a public issue, in contrast to other global crises, such as climate change. However, over half of the world's human population lives within 100 km of primate habitat. Thus, humans and primates share the same environments. We suggest leveraging a holistic approach, such as One Health, that considers the interconnectedness of primates, humans, and their shared environments, through the lens of public anthropology. By approaching primate conservation as an intersectional issue that affects and is affected by humans, researchers and conservationists can identify strategies that simultaneously protect primates and address global inequities that frequently affect people in primate range countries. Reflexive research practices further allow academics to consider the broader impact of their ecological research through means such as publicly accessible dissemination of results, equitable capacity-building of high-quality personnel in primate range countries, and social activism. The use of inter-, multi-, and transdisciplinary concepts and methodology can address the intersectional challenges associated with implementing ethical and sustainable primate conservation measures.

Mental health practices in rehabilitation for youth with physical disabilities: a chart review study.

PURPOSE: Evidence on co-occurring mental health problems in youth with physical disabilities is growing, however how services are provided remains unclear. This study examined current interprofessional rehabilitation practices for physical and mental health services. METHODS: Youth (aged 15-24) followed for a physical disability that had mental health problems were identified. Chart reviews were used to identify practices. Mental health-related diagnoses/symptoms, assessments, goals, interventions, and referrals were extracted for inductive content analysis. RESULTS: Sixty charts were reviewed. Mental health problems included anxiety (n = 53), depression (n = 25), neurodevelopmental (n = 19) and personality disorders (n = 8), often (n = 36) citing more than one. No mental health assessments were found, and in 43%, no goals or interventions were evident. Relevant goals (n = 98) targeted emotional management, autonomy/communication of needs, acceptance of physical condition, socialization, routines/energy levels, school/work supports, and leisure/calming environments. Interventions (n = 104) included emotional management, formal individual/group therapy, links with external supports, routines/activities, reflection/acceptance, and school/work support. Mental health services were received in-house (n = 24) and/or externally (n = 30), plus 18 referrals pending and 14 not referred. CONCLUSION: Many had more than one mental health problem, suggesting the complexity of their condition. While some mental health goals/interventions are documented, problems may often not be reported or addressed in this context.

Further attention can be directed to the needs of youth with physical disabilities and co-occurring mental health problems as they are not fully addressed by current interdisciplinary rehabilitation practices.Follow-up (services and referrals) should be adapted to the holistic needs of youth and their goals within the rehabilitation context.Rehabilitation professionals can be provided with training to build workforce capacity in mental health screening and have access to guidance when addressing situations related to mental health or referring to external services.

Psychologists and Integrated Behavioral Health Simulation Training: A Survey of Medical Educators and Perspectives of Directors of Clinical Training.

It is well established that the integration of behavioral healthcare into the medical home model improves patient outcomes, reduces costs, and increases resident learning. As academic health centers increasingly integrate behavioral healthcare, targeted training for interprofessional collaboration around behavioral healthcare is needed. Simulation educational approaches potentially can provide this training. Health service psychologists are well-poised to support this because of their specialized training in integrated healthcare. The present exploratory study aimed to evaluate existing simulation programs and develop recommendations for integrated behavioral health training and evaluation. Directors of ACGME accredited residency programs that are high utilizers of the medical home model (Pediatrics, Internal Medicine, Medicine/Pediatrics, Family Medicine) as well as Psychiatry residencies and medical schools with membership in the Society for Simulation in Healthcare were recruited to complete a 26-item survey to assess program usage of psychologists as part of simulation training for integrated behavioral healthcare services. Of 79 participants who completed initial items describing their training program, only 32 programs completed the entire survey. While many academic health centers offered integrated team and behavioral health simulations, few utilized psychology faculty in design, implementation, and evaluation. Other behavioral health providers (psychiatrists, social workers) were often involved in medical school and pediatric residency simulations. Few institutions use standardized evaluation. Qualitative feedback and faculty-written questionnaires were often used to evaluate efficacy. Survey responses suggest that psychologists play limited roles in integrated behavioral healthcare simulation despite their expertise in interdisciplinary training, integrated behavioral healthcare, and program evaluation.

Providing holistic end-of-life care for people with a history of problem substance use: a mixed methods cohort study of interdisciplinary service provision and integrated care.

Harmful use of illicit drugs and/or alcohol is linked to life-limiting illness and complex health and social care needs, but people who use substances and have complex needs do not receive timely palliative care and fail to achieve quality standards for a good death. They and their families often require support from multiple health and social care services which are shown to be poorly integrated and fail to deliver interdisciplinary care. This study aimed to identify the existing barriers and facilitators within and between services in providing this population with a good death. Using a mixed methods approach of survey, focus groups and semi-structured interviews, we explored the perspectives of practitioner and management staff across a range of health and social disciplines and organisations in one combined authority in a large city in the north west of England. Our findings indicate that practitioners want to provide better care for this client group, but face structural, organisational and professional boundary barriers to delivering integrated and shared care. Differences in philosophy of care, piecemeal commissioning and funding of services, and regulatory frameworks for different services, lead to poor and inequitable access to health and social care services. Ways forward for improving care are suggested as bespoke hostel-based accommodation for palliative care for this client group, and specialist link workers who can transcend professional and organisational boundaries to support co-ordination of services and support. We conclude that it is no longer adequate to call for more training, better communication and improved joint working. Complex care at the end of life requires creative and cohesive systemic responses that enable multi-disciplinary practitioners to provide the care they wish to give and enables individuals using substances to get the respect and quality service they deserve.

Impacto de la implementación de un método de traspaso de información estandarizada interdisciplinar en sala de partos y unidad de cuidados obstétricos intermedios / Impact of the implementation of a standardised interdisciplinary information transfer method in the Delivery room and Intermediate Obstetric Care Unit

Objetivo Este estudio tiene como objetivo describir la implementación de la metodología estandarizada en la transferencia de información en sala de partos y unidad de cuidados obstétricos intermedios en un hospital de tercer nivel de Barcelona e identificar el impacto de esta implementación en los factores que actúan como facilitadores y barreras en el procedimiento. Método Estudio cuasiexperimental tipo pretest-postest sin grupo control en la unidad de cuidados obstétricos intermedios y sala de partos del servicio de Medicina Maternofetal de un hospital de tercer nivel de Barcelona. El personal sanitario autocumplimentó un cuestionario ad hoc antes y después de implementar la metodología estandarizada IDEAS en el servicio durante 2019 y 2020. Se evaluó la autopercepción personal en el procedimiento de transferencia de información. El test de Wilcoxon por pares se utilizó para la comparación antes y después. Resultados El uso de una metodología estandarizada ha mostrado un impacto en la mejora de la transmisión de la información. Se detectaron diferencias significativas antes y después de la intervención en las siguientes dimensiones: ubicación, personas implicadas, periodo de tiempo del procedimiento, estructurada ordenada y clara y tiempo suficiente para preguntas (p<0,001); mientras que no se observaron diferencias en transmisión al profesional referente, actuaciones bien definidas y realización de un resumen. Conclusiones Existen factores, como aspectos estructurales, organizativos y falta de tiempo, que dificultan la comunicación efectiva, por tanto, actúan como barreras en la transferencia de información. La implementación de una metodología con las personas implicadas, el tiempo y el espacio adecuado permite mejorar aspectos en la comunicación en el equipo multiprofesional y, por tanto, la seguridad del paciente. (AU)

Aim This study aims to describe the implementation of the standard methodology for information transfer in the labour ward and Intermediate Obstetric Care Unit and to identify the impact of this implementation on the factors that act as facilitators and barriers in the procedure. Method Quasi-experimental pretest-posttest study without a control group in an Intermediate Obstetric Care Unit and delivery room of the Maternal-Fetal Medicine Service of a tertiary hospital in Barcelona. Healthcare staff self-completed an ad hoc questionnaire before and after implementing the standardised IDEAS methodology in the service during 2019 and 2020. Personal self-perception in the information transfer procedure was assessed. The Wilcoxon pairwise test was used for comparison before and after. Results The use of a standardised methodology has shown an impact on improving the transmission of information. Significant differences were detected before and after the intervention in the following dimensions: location, people involved, time period of the procedure, structured, orderly and clear, and sufficient time for questions (p<0.001); while no differences were observed in: transmission to the referring professional, well-defined actions, and completion of a summary. Conclusions There are factors such as structural and organisational aspects and lack of time that hinder effective communication and therefore act as barriers to the transfer of information. The implementation of a methodology with the health professionals involved, the time and the appropriate space allows for the improvement of communication aspects in the multiprofessional team and, therefore, patient safety. (AU)

Social work practice in perinatal palliative care: an overview.

Social workers in Perinatal Palliative Care (PPC) play an essential role in caring for birthing people carrying a baby with a life-limiting condition and their families. Perinatal palliative care is consistent with social work values concerning fostering quality of life and promoting social justice and access to care. Social workers play a multidimensional role in providing a holistic approach to caring for the birthing person, baby, and family. Although social workers may be part of an interdisciplinary care team, their role is not defined solely by the goals of the greater team, nor has it been discussed in depth in the perinatal palliative care literature. The purpose of this paper is to describe the knowledge, values, and skills essential to the role of the social worker in a hospital-based perinatal palliative care team. A case study will be used to illustrate the relevant practices, and implications are outlined.

Fostering Pre-Professionals and Learning Experiences in End-of-Life Care Contexts: Music Therapy Internship Supervision.

Certified music therapists use music within therapeutic relationships to address human needs, health, and well-being with a variety of populations. Palliative care and music therapy are holistic and diverse fields, adapting to unique issues within end-of-life contexts. Palliative care music therapy has been formally practiced since the late 1970s and affords a variety of benefits, including pain and anxiety reduction, enhancement of quality of life, emotional expression, and relationship completion. The training of music therapists varies around the globe, but clinical supervisors play a key role in skill acquisition. Clinical supervisors support pre-professionals as they realize the application of their training, foundational competencies, and authentic therapeutic approaches in end-of-life care, while navigating the challenges and rewards of this work. This article is a narrative review which offers background information on palliative care music therapy, and reports the authors' viewpoints and reflections on supervision strategies and models employed with music therapy interns in palliative care settings based on their experiences. Approaches are shared on supporting pre-professionals as they begin working in palliative care contexts, as well as implications for supervision practices.

Inter-relationships between cardiovascular, renal and metabolic diseases: Underlying evidence and implications for integrated interdisciplinary care and management.

Cardiovascular, renal and metabolic (CaReMe) diseases are individually among the leading global causes of death, and each is associated with substantial morbidity and mortality. However, as these conditions commonly coexist in the same patient, the individual risk of mortality and morbidity is further compounded, leading to a considerable healthcare burden. A number of pathophysiological pathways are common to diseases of the CaReMe spectrum, including neurohormonal dysfunction, visceral adiposity and insulin resistance, oxidative stress and systemic inflammation. Because of the shared pathology and common co-occurrence of the CaReMe diseases, the value of managing these conditions holistically is increasingly being realized. A number of pharmacological and non-pharmacological approaches have been shown to offer simultaneous metabolic, cardioprotective and renoprotective benefits, leading to improved patient outcomes across the CaReMe spectrum. In addition, increasing value is being placed on interdisciplinary team-based and coordinated care models built on greater integration between specialties to increase the rate of early diagnosis and adherence to practice guidelines, and improve clinical outcomes. This interdisciplinary approach also facilitates integration between primary and specialty care, improving the patient experience, optimizing resources, and leading to efficiencies and cost savings. As the burden of CaReMe diseases continues to increase, implementation of innovative and integrated care delivery models will be essential to achieve effective and efficient chronic disease management and to ensure that patients benefit from the best care available across all three disciplines.

Conceptualizations of interprofessional communication in intensive care units: findings from a scoping review.

BACKGROUND: Clinical errors in intensive care units (ICUs) are consistently attributed to communication errors. Despite its importance for patient safety and quality in critical care settings, few studies consider interprofessional communication as more than the basic exchange of information. METHODS: We conducted a scoping review of interprofessional communication in ICUs to (1) characterize how communication is defined and measured and (2) identify contributions the field of health communication can make to team communication in ICUs. Through a series of queries in PubMed and Communication and Mass Media Complete databases, we identified and compared persistent gaps in how communication is framed and theorized in 28 publications from health services and 6 from social science outlets. We identified research priorities and suggested strategies for discussing communication more holistically in future health services research. RESULTS: 34 articles published from 1999 to 2021 were included. Six explicitly defined communication. Six were published in social science journals, but none were authored by a communication studies scholar. Half of the articles addressed communication as a transaction focused on information transfer, and the other half addressed communication as a process. CONCLUSIONS: Methodological implications are identified with the intent to encourage future interdisciplinary collaboration for studying communication in ICUs. We discuss the importance of (1) using language to describe communication that facilitates interdisciplinary engagement, (2) prioritizing communication as a process and using qualitative methods to provide insight, and (3) engaging health communication theories and experts to assist in developing more fruitful research questions and designs.

Evaluation of a virtual practice placement: A model to increase student capacity.

AIM: To describe the development and evaluation of a novel virtual practice placement. BACKGROUND: Health systems around the world face the challenge of recruiting and retaining sufficient nursing staff to provide high quality care. The need to train more nurses makes it hard to provide sufficient and varied high quality student placements to all students. This paper reports the result of one approach to the provision of a novel virtual placement for pre-registration student nurses. DESIGN: Online virtual placement evaluated by a questionnaire conducted after the placement. METHODS: A total of 195 students attended the virtual practice placement between 10th October 2022 and the 10th March 2023. The survey consisted of eight questions, of which one invited a qualitative response. RESULTS: A total of 188 students completed the questionnaire and provided feedback. Of these 84 were adult nursing students, 67 child, 36 mental health and one learning disability student. The virtual placement required considerable resources to run, however was deemed as valuable by most students. When asked to rate the overall experience out of 5, the median scores were consistently high: adult (Mdn=5), child (Mdn=4), learning disability (Mdn=5) and mental health (Mdn=5) and mean values consistently high across fields: adult (M=4.73), child (M=5), learning disability (M=5) and mental health (M=4.67). Qualitatively, there were four main themes that emerged from the questionnaire responses: increased understanding of community healthcare and holistic approaches to care; developing interpersonal skills; a positive impact on their future career opportunities and the value of realistic case studies. CONCLUSIONS: Virtual placements are a viable addition to traditional placements. However, they require careful planning and considerable resources including experienced and dedicated facilitators. Principles for the delivery of virtual placements were produced to replicate and share best practice.

Metalloproteinases as Biomarkers and Sociomarkers in Human Health and Disease.

Metalloproteinases (MPs) are zinc-dependent enzymes with proteolytic activity and a variety of functions in the pathophysiology of human diseases. The main objectives of this review are to analyze a specific family of MPs, the matrix metalloproteinases (MMPs), in the most common chronic and complex diseases that affect patients' social lives and to better understand the nature of the associations between MMPs and the psychosocial environment. In accordance with the PRISMA extension for a scoping review, an examination was carried out. A collection of 24 studies was analyzed, focusing on the molecular mechanisms of MMP and their connection to the manifestation of social aspects in human disease. The complexity of the relationship between MMP and social problems is presented via an interdisciplinary approach based on complexity paradigm as a new approach for conceptualizing knowledge in health research. Finally, two implications emerge from the study: first, the psychosocial states of individuals have a profound impact on their overall health and disease conditions, which implies the importance of adopting a holistic perspective on human well-being, encompassing both physical and psychosocial aspects. Second, the use of MPs as biomarkers may provide physicians with valuable tools for a better understanding of disease when used in conjunction with "sociomarkers" to develop mathematical predictive models.

Music and Medicine: Promoting Harmony for Health.

A multitude of clinical trials measuring hemodynamic and psychological parameters have shown the beneficial effects of music on health. However, there are no clear instructions on how to utilize the potential benefits of music to improve health outcomes. Moreover, whether the effect of music is transient or enduring has yet to be determined. To address the effect of music on vital parameters and emotional well-being of patients we provide an overview of methods and findings of some studies that have evaluated the physiological or psychological impacts of music. This review puts forward a proposed model for fostering an individualized approach that can examine the therapeutic effects of music.

A interdisciplinaridade como ferramenta para mergulhos mais profundos na graduação em Medicina / Interdisciplinarity as a tool for deeper dives in undergraduate Medicine

RESUMO Introdução: Demandas sociais suscitaram questionamentos sobre o ensino médico. Assim, surgiram tendências de formação generalista, que atendam às necessidades da população. A matriz curricular da Faculdade de Medicina da Universidade Federal de Alagoas é composta pelos eixos: teórico-prático integrado, aproximação à prática médica e à comunidade, e desenvolvimento pessoal, indissociáveis e de caráter interdisciplinar. Objetivo: Este estudo teve como objetivo desenvolver atividades interdisciplinares entre os três eixos curriculares no curso de Medicina de uma universidade pública. Método: Utilizou-se a pesquisa-ação como estratégia metodológica com análise de conteúdo, e adotou-se o software Iramuteq para análise das discussões entre pesquisadores e participantes, as quais foram divididas em cinco encontros permeados por obras literárias e música motivadora, correlacionando-se com a interdisciplinaridade. Resultado: Em relação aos debates sobre a temática, foram geradas nuvens de palavras, análises de similitude e dendrogramas que refletiram o pensamento dos participantes e a complexidade da temática. Os participantes focaram o discurso na saúde do aluno, nas relações interpessoais, em espaços que propiciem a interdisciplinaridade, bem como na comunicação entre os professores. Além disso, discutiram-se a necessidade da interdisciplinaridade no currículo médico e a importância da relação médico-paciente e da visão holística da medicina. Por fim, foram criados dois casos clínicos que evidenciaram os aspectos socioeconômicos e patológicos das doenças. Conclusão: A pesquisa-ação e a utilização do Iramuteq foram de suma importância para a coleta de dados de maneira fidedigna e rápida. Observou-se que o curso de Medicina prima pelo ensino da ética e da bioética nas disciplinas eletivas e obrigatórias até o sexto período e tem uma lacuna nos demais períodos, sendo sugerida a criação da disciplina de Humanidades para o sétimo período. Há uma demanda por uma interação mais expressiva nos projetos de extensão e por maior socialização dos professores e comunicação entre as disciplinas intra e intereixos.

ABSTRACT Introduction: Social demands have raised questions about medical education. This has led to trends towards generalist training that meets the needs of the population. The curricular matrix of the Faculty of Medicine of the Universidade Federal de Alagoas is made up of the following axes: integrated theoretical-practical, approach to medical practice and the community, and personal development, which are inseparable and interdisciplinary in nature. Objective: This study aimed to develop interdisciplinary activities between the three curricular axes in the medical course of a public university. Method: Action research was used as a methodological strategy with content analysis using Iramuteq software to analyse the discussions between researchers and participants, which were divided into five meetings, permeated by literary works and motivating music, correlated with interdisciplinarity. Results: Word clouds, similarity analyses and dendrograms were generated from the debates on the subject, reflecting the participants' thoughts and the complexity of the subject. Participants focused their discourse on student health, interpersonal relationships, spaces that foster interdisciplinarity and communication between teachers. They also discussed the need for interdisciplinarity in the medical curriculum and the importance of the doctor-patient relationship and a holistic view of medicine. Finally, two clinical cases were created which highlighted the socio-economic aspects of disease.

La prevención del embarazo en la adolescencia desde un enfoque interdisciplinario, humanista, activo y transformador

Introducción: El embarazo en la adolescencia constituye un problema de salud de carácter complejo que exige para su prevención el empleo de un enfoque holístico, sustentable desde posicionamientos colaborativos e intersectoriales. Objetivo: Elaborar una estrategia para la prevención del embarazo en la adolescencia desde un enfoque interdisciplinario, humanista, activo y trasformador. Materiales y métodos: Investigación descriptiva, longitudinal y retrospectiva, comprendida entre mayo y diciembre de 2023. Entre los métodos empleados se encuentran el histórico-lógico, el analítico-sintético, la sistematización y la modelación, aplicados fundamentalmente en el diseño categorial de la estrategia y sus contenidos estructurales. También se empleó la revisión de documentos, la encuesta y la conformación de un grupo focal para la recogida de información empírica vinculada al proceso de prevención y a la obtención de criterios valorativos. Resultados: Se evidencia, en el diseño de las acciones estratégicas, la integración de varias disciplinas como medicina familiar, sicología, derecho médico, ginecobstetricia y educación para la salud, así como relaciones interprofesionales entre especialistas de la salud, docentes, trabajadores sociales y líderes comunitarios. Concluida la implementación de la estrategia, en el orden cognitivo-comunicacional, se constata un posicionamiento proactivo de los adolescentes en el autocuidado y la autogestión de salud, desde una proyección trasformadora e intersectorial. Conclusiones: Prevalecen criterios valorativos favorables y un ordenamiento organizacional de alcance intersectorial, que indican la pertinencia del enfoque interdisciplinario, humanista, activo y trasformador aplicado a la estrategia para la prevención del embarazo en la adolescencia, constatándose el cumplimiento del objetivo propuesto.

Introduction: Adolescent pregnancy is a complex health problem that requires the use of a holistic approach, sustainable from collaborative and intersectoral positions, for its prevention. Objective: To prepare a strategy for the prevention of pregnancy in adolescence from an interdisciplinary, humanistic, active and transformative approach. Materials and methods: Descriptive, longitudinal and retrospective research carried out between May and December 2023. Among the methods used are historical-logical, analytical-synthetic, systematization and modeling, mainly applied in the categorical design of the strategy and its structural contents. The review of documents, the survey and the formation of a focal group for the collection of empirical information linked to the prevention process and to obtain evaluative criteria were also used. Results: In the design of strategic actions, the integration of several disciplines such as family medicine, psychology, medical law, gyneco-obstetrics, and health education, as well as inter-professional relationships between health specialists, teachers, social workers and community leaders, is evidenced. After the implementation of the strategy, in the cognitive-communicational order, it was stated a proactive positioning of adolescents in self-care and self-management of health, from a transformative and intersectoral projection. Conclusions: Favorable evaluative criteria and an organizational arrangement of intersectoral scope prevail, which indicate the relevance of interdisciplinary, humanistic, active and transformative approach applied to the strategy for the prevention of pregnancy in adolescence, confirming the fulfillment of the proposed objective.

Psychosocial Functioning of Parents of Youth Receiving Intensive Interdisciplinary Pain Treatment.

OBJECTIVE: Parents of youth with chronic pain report psychosocial difficulties, yet treatment often focuses on improving their child's functioning and pain. This study evaluated changes in parents' social and emotional functioning and explored predictors of change, as they completed a parent-focused intervention while their child was enrolled in an intensive interdisciplinary pain treatment (IIPT) program. METHODS: Parents (n = 69) completed questionnaires at baseline and weekly (average duration of 4 weeks) during their child's participation in IIPT. Parents engaged in 3 groups per week providing education, therapeutic art, and psychotherapy (3 hr/week total). RESULTS: At baseline, 38% of parents reported scores in the clinically elevated range for at least 1 psychosocial variable. Linear mixed modeling for the full sample indicated reduced parent anxiety (t = -2.72, p <.01) and depression (t = -3.59, p <.001), but not increased emotional support (t = 1.86, p >. 05) or reduced social isolation (t = -1.20, p >.05). For parents with at least moderately elevated psychosocial concerns, statistically significant improvements were observed for all 4 outcomes (all p's<.01). Psychological flexibility, cognitive reappraisal, and emotional suppression were found to be related to changes in parent outcomes (anxiety, depression, isolation, and support). CONCLUSIONS: Findings support the benefit of parent-focused interventions in addition to child-focused interventions. Many parents of youth participating in IIPT had elevated scores for at least 1 psychosocial concern at baseline. Brief, parent-focused intervention including psychoeducation, therapeutic art, and psychotherapy targeting mindfulness, acceptance, and values had a significant impact on these parents, particularly those with greater struggles at baseline.

An Overview of One Health Concept Focusing on Toxoplasmosis.

The "One Health" concept is a universal approach to sustainably balancing and optimizing the health of humans, animals, and ecosystems. This approach is based on the health of humans, domestic and wild animals, and plants in a wider environment in which self-renewable ecosystems exist, with essential characteristics of integration, unifying and holistic perspective. Toxoplasmosis, one of the most common zoonotic infections in both terrestrial and oceanic ecosystems in the world, is an ideal model disease for the "One Health" approach. Toxoplasmosis is a zoonotic disease caused by the obligate intracellular pathogen protozoan Toxoplasma gondii. In the life cycle of T. gondii, the definitive host is domestic cats and felines, and the intermediate hosts are all mammals (including humans), birds and reptiles. The infected cats have primary importance and play a crucial role in the contamination of habitats in the ecosystems with T. gondii oocysts. Thus, ecosystems with domestic cats and stray cats are contaminated with cat feces infected with T. gondii oocytes. T. gondii positivity has been scientifically demonstrated in all warm-blooded animals in terrestrial and aquatic habitats. The disease causes deaths and abortions in farm animals, resulting in great economic losses. However, the disease causes great problems in humans, especially pregnant women. During pregnancy, it may have effects such as congenital infections, lesions in the eye and brain of the fetus, premature birth, intrauterine growth retardation, fever, pneumonia, thrombocytopenia, ocular lesions, encephalitis, and abortion. The mechanism of death and abortion of the fetus in a pregnant woman infected with T. gondii occurs as a result of complete disruption of the maternal immune mechanism. The struggle against toxoplasmosis requires the universal collaboration and coordination of the World Organization for Animal Health, the World Health Organization and the World Food Organization in the "One Health" concept and integrative approaches of all responsible disciplines. Establishing universal environmental safety with the prevention and control of toxoplasmosis requires the annihilation of the feces of the infected cats using suitable techniques firstly. Then routinely, the monitoring and treatment of T. gondii positivity in cats, avoiding contact with contaminated foods and materials, and development of modern treatment and vaccine options. Particularly, mandatory monitoring or screening of T. gondii positivity during the pregnancy period in humans should be done. It would be beneficial to replace the French model, especially in the monitoring of disease in humans. In this article, the ecology of toxoplasmosis was reviewed at the base of the "One Health" concept.

Fostering interdisciplinary colorectal and gynaecology surgery networks during training is crucial to maximise expertise and innovate patient care.

The importance of interdisciplinary collaboration between specialties has gained significant recognition in recent years, and rightly so with notable benefits to skills acquisition and patient outcomes. Due to the scope of overlapping procedures and clinical scenarios, developing trustable networks between colorectal and gynaecology surgeons must be encouraged as a focus of trainee education. This article highlights the benefits, challenges, and recommendations for fostering such networks.