Nutrition, Chronic Care, Measurement Scales and COVID-19.

In the year of the Olympics (Paris, 2024), this issue of JORH explores nutrition and chronic care, offers a caution regarding the use of religiosity and spiritual measurement scales, and revisits the topic of COVID-19. While the latter has been rapidly declining in terms of its global impact, each of these areas of inquiry generate a great deal of research from which humanity still has much to learn.

Retention of outer regional, remote, and very remote speech-language pathologists influenced by professional support and community connection.

PURPOSE: Addressing the retention challenges faced by non-metropolitan speech-language pathologists (SLPs) is crucial for achieving health services equity in Australia. This study assesses the applicability of previous literature findings to the current context of Australian SLPs. Furthermore, identifying specific factors influencing the retention of SLPs in outer regional, remote, and very remote areas of Australia. METHOD: Semi-structured interviews were conducted with 30 SLPs, who have been employed in non-metropolitan areas of Australia within the last 5 years. The collected data underwent online screening, with the interviews transcribed and analysed using content analysis techniques. RESULT: Retention rates of non-metropolitan SLPs in Australia were categorised into three themes: professional, personal, and latent. The professional category included professional support, professional development, premature responsibilities, generalist skills, and funding. The personal category included community, family/relationships, burnout, and social justice. The latent themes included finances, management, and faith. CONCLUSION: Retention rates of non-metropolitan SLPs in Australia are influenced by both protective factors and risk factors. Three recommendations to improve community access and reduce the current equity gap are outlined, namely: (a) tailored/bespoke professional education to maintain/enhance the clinical competence required, (b) prioritise community immersion and improve mentoring, and (c) strategies and policies to support SLPs.

Religion, Spirituality and Health Research: Warning of Contaminated Scales.

The relationship between religiosity, spirituality and health has received increasing attention in the academic literature. Studies involving quantitative measurement of religiosity and/or spirituality (R/S) and health have reported many positive associations between these constructs. The quality of various measures, however, is very important in this field, given concerns that some measures of R/S have been contaminated with indicators of mental health. When this occurs, that is when R/S is defined and measured a priori, this subsequently guarantees a positive association between R/S and health (especially mental health). Such associations are called tautological, which involves correlating a construct with itself, thus producing associations that are uninterpretable and misleading. In this article, concerns about the measurement of R/S are discussed, examples of contaminated and potentially probelmatic measures of R/S are noted, and recommendations are made regarding uncontaminated measures of R/S that should be used in future studies of R/S and health.

Faith and Health in Israel, Türkiye and the USA.

This issue of JORH focuses upon faith and health within three nations that have contributed a great deal in terms of religion and health research during this century-namely Israel, Türkiye and the USA.

Nurses, Clergy, Chaplains, Parkinson's Disease, Workplace Religiosity, Women's Health and Family Issues.

This issue of JORH explores a broad range of topics looking at the professions of nursing, clergy and chaplains. This issue also concludes the series on Parkinson's disease (Part 2), and for the first time, JORH presents a collation of articles relating to workplace religiosity. Finally, this issue revisits the topics of women's health and family issues in relation to religiosity and spirituality.

Tribal Healing, Suicide, Ethical Issues, Cancer and Measuring Religiosity and Spirituality.

This issue of JORH considers the 'good, the bad and the ugly' of tribal or traditional healers, as well as articles relating to ethical challenges due to contemporary medicine and environmental issues. The concluding series on suicide (Part 2) is also finalized in this issue, as well as a number of research articles from multiple countries relating to cancer. Similar to previous issues, JORH once again adds to its increasing collection of articles relating to the empirical measurement of religion, spirituality and health. Readers are also reminded of the European Congress on Religion, Spirituality and Health (ECRSH) (Salzburg, Austria, May 2024), as well as the inaugural International Moral Injury and Wellbeing Conference (IMIWC) (Brisbane, Australia, September 2024).

Military Perspectives on the Provision of Spiritual Care in the Australian Defence Force: A Cross-Sectional Study.

A module to explore perspectives on chaplaincy services was included in an online enterprise survey randomly distributed to members of the Australian Defence Force (ADF) during 2021. Up to eight questions were answered by 2783 active military personnel relating to their perception of chaplain activities and the impact of chaplaincy services. Of those military participants answering the question on religious status (n = 1116), a total of 71.6% (n = 799) of respondents identified as non-religious while 28.4% (n = 317) identified as holding a religious affiliation. Approximately 44.2% (n = 1230) of participants had sought support from a chaplain, of which 85.3% (n = 1049) found chaplaincy care to be satisfactory or very satisfactory. While the data suggest there is a lack of clarity around the multiple roles undertaken by chaplaincy, nevertheless respondents were just as likely to prefer chaplains for personal support (24.0%), as they were to seek help from non-chaplaincy personnel such as a non-ADF counsellor (23.2%), their workplace supervisor (23.1%) or a psychologist (21.8%). This evidence affirms that the spiritual care provided by military chaplaincy remains one of several preferred choices and thus a valued part of the holistic care provided by the ADF to support the health and wellbeing of its members.

Spirituality, Mental Health, and COVID-19.

This issue of JORH presents a broad range of articles that consider spirituality and spiritual care from various international perspectives. It also looks at a diverse range of articles relating to mental health disorders and addictions. Lastly, this issue considers the aftermath of COVID-19. Readers are also reminded of the European Congress on Religion, Spirituality, and Health (ECRSH) (Salzburg, Austria), as well as the inaugural International Moral Injury and Wellbeing Conference (IMIWC), Brisbane, Australia, 2024.

Global Citizenship: Cultural, Religious and Spiritual-An Exploratory Scoping Review.

This paper seeks to provide an exploration of the interplay between global citizenship, culture, religion and spirituality. Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) scoping literature review framework was utilised to qualify the research question, develop inclusion and exclusion criteria, select relevant studies, chart data and collate information. From the available peer-reviewed literature, a total of 44 articles were initially identified using the selection criteria, 19 of which were subsequently analysed. Eight main themes were identified within the literature; (1) development of global citizenship identity, (2) prosocial values and perspectives, (3) cultural competence and influence, (4) religion and religious teachings, (5) immersion experiences, (6) normative influence, (7) political compass and (8) spirituality. The literature suggests a clear link between global citizenship and spirituality. There were, however, some inconsistencies in the relationship between formalised religion and global citizenship across the studies, with evidence of religion both contributing to and detracting from prosocial values related to global citizenship. Additionally, cultural experiences, including immersion experiences, volunteering and study aboard were all positively linked to prosocial values related to global citizenship. Global citizenship provides individuals with an opportunity to develop intercultural skills, respect, sensitivity, empathy and concern for all of humanity. It is recommended that future global citizenship research should ensure adequate definitions of religion and spirituality, with caution to not generalise the two terms into one concept. Additional research into the relationship between spiritualty and global citizenship could provide a strong basis to increase understanding of the contributing factors to global citizenship identity.

Suicide, Moral Injury, Parkinson's Disease, Diabetes and Dialysis.

This issue of JORH presents the first of a two-part series specifically exploring suicide. Research relating to moral injury is also included-a topic which has previously been discussed within earlier editions of JORH and an issue that is increasingly recognised as being associated with suicide. Other topic areas explored within this issue are Parkinson's Disease, Diabetes, and Haemodialysis. Finally, readers are once again reminded of the 9th European Congress on Religion, Spirituality and Health (ECRSH) to be held in May 2024, 16-18th at the Paracelsus Medical University in Salzburg, Austria. We would also like to announce a proposed inaugural International Moral Injury and Wellbeing Conference (IMIWC), 19-20 September 2024, Brisbane Exhibition and Convention Centre, Australia.

Pastoral Narrative Disclosure: The Development and Evaluation of an Australian Chaplaincy Intervention Strategy for Addressing Moral Injury.

This paper describes the development and initial chaplaincy user evaluation of 'Pastoral Narrative Disclosure' (PND) as a rehabilitation strategy developed for chaplains to address moral injury among veterans. PND is an empirically informed and integrated intervention comprising eight stages of pastoral counselling, guidance and education that was developed by combining two previously existing therapeutic techniques, namely Litz et al's (2017) 'Adaptive Disclosure' and 'Confessional Practice' (Joob & Kettunen, 2013). The development and results of PND can be categorized into five phases. Phase 1: PND Strategy Formation-based upon extensive international research demonstrating that MI is a complex bio-psycho-social-spiritual syndrome with symptoms sufficiently distinct from post-traumatic stress disorder. The review also provided evidence of the importance of chaplains being involved in moral injury rehabilitation. Phase II: Development and Implementation of 'Moral Injury Skills Training' (MIST)-which involved the majority of available Australian Defence Force (ADF) Chaplains (n = 242/255: 94.9%) completing a basic 'Introduction to Moral Injury' (MIST-1) as well as an 'Introduction to PND' (MIST-2). Phase III: MIST-3-PND-Pilot evaluation-involved a representative chaplaincy cohort (n = 13) undergoing the PND eight-stage strategy to ensure the integrity and quality of PND from a chaplaincy perspective prior to wider implementation. The pilot PND evaluation indicated a favourable satisfaction rating (n = 11/13: 84.6%; M = 4.73/5.0 satisfaction). Phase IV: MIST-3-PND Implementation-involved a larger cohort of ADF Chaplaincy participants (n = 210) completing a revised and finalized PND strategy which was regarded favourably by the majority of ADF Chaplains (n = 201/210: 95.7%; M = 4.73/5.0 satisfaction). Phase V: Summation. In conclusion the positive satisfaction ratings by a significant number of ADF chaplaincy personnel completing MIST-3-PND, provided evidence that chaplains evaluated PND as a suitable counselling, guidance and education strategy, which affirmed its utilisation and justifies further research for using PND to address MI among veterans, that may also prove valuable for other chaplains working in community health and first responder contexts.

Care of the Aged, Women's Health, and Measuring Religion, Spirituality and Health.

This issue of JORH explores various concerns related to the care of the elderly within a number of countries (namely China, India, Iran, Israel, Turkey, USA). Issues relating to Women's Health are also considered across the life span but particularly with regard to gynaecology, paediatrics, cancer, mental health and wellbeing. Research is presented on the empirical measurement of religion, spirituality and health with scales developed and/or tested in Iran, India, Haiti, Taiwan, Jordan and the Netherlands. Finally, readers are reminded of the 9th European Congress on Religion, Spirituality and Health (ECRSH) during May 2024, 16-18th at the Paracelsus Medical University in Salzburg, Austria.

Towards a Holistic Model of Care for Moral Injury: An Australian and New Zealand Investigation into the Role of Police Chaplains in Supporting Police Members following exposure to Moral Transgression.

Police members can be exposed to morally transgressive events with potential for lasting psychosocial and spiritual harm. Through interviews with police members and police chaplains across Australia and New Zealand, this qualitative study explores the current role that police chaplains play in supporting members exposed to morally transgressive events. The availability of chaplains across police services and the close alignment between the support they offer, and the support sought by police, indicates they have an important role. However, a holistic approach should also consider organizational factors, the role of leaders, and access to evidence-based treatment in collaboration with mental health practitioners.

Examining the Association Between Moral Injury and Suicidal Behavior in Military Populations: A Systematic Review.

The increasing number of suicides among military populations cannot be fully accounted for by conventional risk factors like Post-Traumatic Stress Disorder (PTSD). As a result, researchers and theorists propose that delving into the concept of Moral Injury could offer a more comprehensive understanding of the phenomenon of suicide. Moral Injury is not currently a recognized mental health disorder but can be associated with PTSD. Moral Injury is a multi-dimensional issue that profoundly affects emotional, psychological, behavioral, social, and spiritual well-being. The objective of this systematic review is to examine the association between Moral Injury and suicidal behavior (suicide ideation, plans and or suicide attempt) within military populations. The review will specifically concentrate on identifying and analyzing studies that have investigated the connection between these variables, with a specific focus on the context of military personnel both serving and former serving members. Of the 2214 articles identified as part of this review, 12 studies satisfied the research criteria with a total participant sample having an average age of 40.7 years. The male population accounted for 78.6% of the overall sample. Two studies were identified as high-quality, while the remaining ten were rated as moderate. The analysis of these twelve studies consistently affirms a connection between Moral Injury and suicidal behavior; most obviously, that exposure to morally injurious events substantially amplify the risk of suicide, with higher levels of potential exposure being linked to increased Moral Injury and heightened levels of suicidal behavior. Our review uncovered noteworthy findings regarding the association between Moral Injury and suicidal behavior, marking a pioneering effort in exploring this association and offering valuable insights into this emerging issue. Several limitations are noted regarding this review and recommendations are made concerning the need to prioritize, expand and employ longitudinal research designs that include non-military populations such as first responders (e.g., police, paramedics, firefighters) and medical, nursing, or allied health professionals-all disciplines known to be impacted by Moral Injury.

Medical Practice, the Church and COVID-19.

This issue of JORH explores the importance of religion and spirituality in medical practice, as well as research relating to the Church and its clergy, and finally the lingering effects of COVID-19.

Chaplaincy, Clergy, Prayer, Cancer and Measuring Religion and Health.

This third issue of JORH for 2023 revisits a number of themes previously highlighted in JORH, along with the addition of two new themes. Since JORH's first special issue on 'Chaplaincy' (JORH, 2022, 61:2), this area of research within JORH has now flourished, with a total of three JORH issues now incorporating the allied health discipline of chaplaincy. Two new article collections in this JORH issue relate to clergy 'faith leaders' and research related to 'prayer.' This issue also revisits the topic of cancer-a recurrent focus within JORH which has, over the past six decades, examined nearly every type of known cancer in the context of religion/spirituality. Finally, JORH collates once again, a number of articles relating to the empirical measurement of religion and health-an increasingly important area of research.

The Impact of Faith-Based Pastoral Care in Decreasingly Religious Contexts: The Australian Chaplaincy Advantage in Critical Environments.

This article considers the contribution of faith-based chaplains who provide holistic pastoral and spiritual care within critical environments such as the military, first responders, and hospitals. The contribution of faith-based chaplains can sometimes be taken for granted or not properly understood, particularly in some Western countries which are currently experiencing a decline in religiosity. Following on from a previous paper regarding chaplaincy utilization (Layson et al. 2022), this article presents an alternative argument to the secularist-humanist perspective by noting five ways by which the faith based chaplaincy model provides best practice service and builds a capability advantage for organizations that engage faith-based chaplaincy services. The first section discusses faith-based chaplaincy and organizational holistic care; the second section considers the role of faith-based chaplains-much of which is largely unknown and poorly appreciated; the third section considers the unique capability of faith-based chaplains to provide spiritual and religious care to those of faith and for those of none; the fourth section explores how faith-based chaplains can leverage the positive impact of religious organizations to provide additional low-cost resources for other organizations and their staff; and lastly, the operational advantage of faith-based chaplains on the world stage is considered, particularly in light of culturally and linguistically diverse populations to whom religiosity is increasingly important.

Global citizenship and social justice among speech-language pathologists: A scoping review.

INTRODUCTION: This scoping review outlines the literature findings that relate to global citizenship and the interconnection between social justice among health professionals, specifically speech-language pathologists. The review aims to provide a synthesis of the relevant literature and thorough thematic identification of common themes. METHOD: Arksey and O'Malley's scoping review framework was used for the searching of critical databases, specifically CINAHL, Medline, the Cochrane Library and Google Scholar. Following the appraisal and synthesis process of the relevant literature, key themes were identified with particular reference to social justice among health professionals (especially speech-language pathologists). RESULTS: Four (4) key themes were identified, namely, (i) education and ongoing developmental support, (ii) ethical and moral obligations, (ii) cultural competency, and (iv) community engagement for intergroup empathy and helping. CONCLUSION: This review defines the parameters of a speech-language pathologists' practice as a global citizen interconnected with social justice and the accountabilities to enable impactful changes creating culturally sustaining practice.

Pediatrics, Students, Allied Health and COVID-19.

This second issue of JORH for 2023 considers research relating to (1) pediatrics, (2) students, (3) various allied health professions and their related practices, and lastly, (4) COVID-19. An additional reminder is also provided to readers on the call for papers regarding a future issue on "Religion, Spirituality, Suicide, and its Prevention", as well as a new call for papers with respect to "Spiritual Care for People with Parkinson's Disease and their Caregivers".