Re-building Trust after Physical Restraint During Involuntary Psychiatric Hospitalization.

This study attempted to identify the elements which might best minimize the negative consequences of restriction of inpatients and rebuild therapeutic alliance and trust. Through in depth interviews with 15 psychiatric patients who had experience restrained during the last involuntary psychiatric hospitalization. Analysis of the data revealed three major themes with regard to trust between restrained patient and restraining staff members during restriction of the patient's freedom. Duration of Restriction, Contact with a Staff Member while Restrained, Supportive Interactions and Staff's Response to Restricted Patients' Needs were reported by patients as crucial in determining the way restrained is experienced and its later impact. Physical restraint in psychiatric hospitalizations generates many negative feelings and can even be traumatic. The patients interviewed help us learn how to provide more human and therapeutic interactions even in extreme situations of restrain which can be crucial to rebuild therapeutic alliance and trust.

Open Science in regulatory environmental risk assessment.

A possible way to alleviate the public skepticism toward regulatory science is to increase transparency by making all data and value judgments used in regulatory decision making accessible for public interpretation, ideally early on in the process, and following the concepts of Open Science. This paper discusses the opportunities and challenges in strengthening Open Science initiatives in regulatory environmental risk assessment (ERA). In this discussion paper, we argue that the benefits associated with Open Science in regulatory ERA far outweigh its perceived risks. All stakeholders involved in regulatory ERA (e.g., governmental regulatory authorities, private sector, academia, and nongovernmental organizations), as well as professional organizations like the Society of Environmental Toxicology and Chemistry, can play a key role in supporting the Open Science initiative, by promoting the use of recommended reporting criteria for reliability and relevance of data and tools used in ERA, and by developing a communication strategy for both professionals and nonprofessionals to transparently explain the socioeconomic value judgments and scientific principles underlying regulatory ERA. Integr Environ Assess Manag 2021;17:1229-1242. © 2021 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Building Trust to Save Lives in a Metro Manila Public-Private Network of Care: A Descriptive Case Study of Quirino Recognized Partners in Quezon City, Philippines.

At an overcrowded government multi-specialty hospital serving the most densely populated area of Metro Manila, inward referrals of women in a moribund state and high volumes of low-risk maternity cases added to significant overcrowding and quality challenges in the maternity wards, resulting in high rates of maternal and neonatal death and near-miss. This case study of the public-private Network of Care, Quirino Recognized Partners (QRP), describes a series of pragmatic steps taken to build and maintain the network, particularly: building trust through agreements with private and public birth centers within a ten-kilometer radius, rolling out antenatal use of a clinical and socio-economic risk scoring tool, reaching out to potential clients, and establishing clear communication channels and protocols for care. These actions, consistent with the schematic of an effective Network of Care, helped decongest the hospital, build rapport and teamwork among health providers, and improve maternal and neonatal outcomes throughout the network. The purpose of this descriptive case study was to explore how QRP was established to solve for particular contextual problems, especially congestion and poor maternal and neonatal health outcomes, with express attention to how actions taken related to the domains of Networks of Care. Data collected through semi-structured interviews with relevant health care and other workers, institutional documents, observations, and field notes were interpreted through the domains of Networks of Care and reported through rich description.

Empathy – The Essentials in Counselling People with HIV

The landscape of HIV has changed from an incurable disease to be more like a chronic disease as the result of advances in medications; the lifespan of People Living with HIV (PLHIV) has also lengthened, HIV defining diseases are delayed, and many of the complications of HIV prevented with adherence to medications. The stigma and discrimination of HIV remain however. PLHIV need to cope with emotional issues of guilt, shame, and self-blame; social issues of rejection, termination of employment, fear and bad social experiences. The paradigm shift from negative regard of PLHIV to that of empathy, which is a deliberate and conscious attitude to relate to PLHIV as fellow travellers in life, to be able to feel with them rather than against them, has therapeutic effects. Empathy has its processes of active listening, responding with appropriately chosen words to describe feelings of the patients, and reflecting the desire to understand more about the patient’s emotions and social turmoil. The benefit of empathy in counseling are the ability to connect with the patient, to build trust from the patient being counseled, and a more objective perspective of being able to see the patient from his/her perspective rather than from the therapist’s perspective. More importantly empathy is a positive response to emotional and social issues experienced by the patient compared to platitudes like “You will be alright; or “don’t worry”, which negate and minimise the opportunity to have a catharsis.