Working Together to Find a Voice: Recommendations for Voice Healthcare Based on Expert-By-Experience and Practitioner Consensus.

OBJECTIVES: Voice care services aim to provide effective and meaningful voice care. Current practice guidance recommends a multidisciplinary voice care approach, supported by the evidence-base and practitioner experience. However, unlike other areas of physical and mental health, current voice care guidance does not explicitly include the voices of experts-by-experience, meaning those who have lived experience of voice difficulties. The perspectives of those working within nonclinical voice professions, such as vocal coaches, are also often omitted. There is therefore a need for updated practice guidance which prioritizes expert-by-experience and nonclinical perspectives. METHODS: Vocal Health Education hosted a consensus meeting in London, UK. The meeting was coproduced with experts-by-experience, and attendees included those with lived experience of voice difficulties and practitioners across a range of disciplines within voice care. The content of the meeting was synthesized into themes and associated recommendations were drafted and agreed to by all attendees. RESULTS: The consensus statement offers practical advice to those working in voice care. Recommendations are offered for multidisciplinary and biopsychosocial voice care, with a focus on person-centered practice and the valuing of lived experience. Through discussion, consensus was reached regarding recommendations for voice care assessment and treatment, practitioner approach, psychosocial considerations, and service design. The need for greater expert-by-experience involvement, coproduction, and co-construction was emphasized throughout. CONCLUSIONS: This report emphasizes the voices of those with lived experience. It highlights ways of updating or improving current care, with the aim of informing clinical practice as well as research and service development. The consensus statement is the first in voice care to include experts-by-experience at the center of its recommendations, underlining the need for more coproduced and co-constructed research and practice within voice healthcare.

What does the American public know about child marriage?

Global efforts to eradicate 'child marriage' (<18 years) increasingly target governments, the private sector and the general public as agents of change. However, understanding of child marriage may be subject to popular misconceptions, particularly because of ambiguity in the age threshold implied by the term 'child', and because awareness campaigns routinely emphasize extreme scenarios of very young girls forcibly married to much older men. Here, we ascertain public knowledge of child marriage via an online survey. Half of those surveyed mistakenly believed that the cut-off for child marriage is younger than the threshold of 18 years, and nearly three-quarters incorrectly believed that most child marriages occur at 15 years or below (it primarily occurs in later adolescence). Most participants also incorrectly believed that child marriage is illegal throughout the USA (it's illegal in only 4/50 states), substantially overestimated its global prevalence, and mistakenly believed that it primarily takes place among Muslim-majority world regions. Our results highlight important popular misconceptions of child marriage that may ultimately undermine global health goals and perpetuate harmful stereotypes. Organizations seeking to empower women by reducing child marriage should be cautious of these misunderstandings, and wary of the potential for their own activities to seed misinformation.

Public health implications of animals in retail food outlets.

Growing societal interest to permit animals into retail food outlets presents both risks and benefits to the dining public and consumers. This article summarizes a literature review that evaluated the associated potential public health issues related to this subject. Using the EBSCOhost research protocol and Google search engines between March 2010 and June 2011, the authors have compiled and synthesized scientific research articles, empirical scientific literature, and publicly available news media. While pets are known carriers of bacteria and parasites, among others, the relative risk associated with specific pet-human interactions in the dining public has yet to be established in a clear and consistent manner. Much of the available health-risk-factor evidence reflects pets in domestic conditions and interaction with farm animals. Special consideration is recommended for vulnerable populations such as children, asthmatics, the elderly, pregnant women, and the immunocompromised.