scholarly journals Patient, medical and legal perspectives on reentry: the need for a low-barrier, collaborative, patient-centered approach

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Zoe Pulitzer ◽  
Maria Box ◽  
Laura Hansen ◽  
Yordanos M. Tiruneh ◽  
Ank E. Nijhawan
Keyword(s):  
Service Providers ◽  
Psychosocial Support ◽  
The United States ◽  
Barriers And Facilitators ◽  
Legal Service ◽  
Psychosocial Needs ◽  
Patient Centered ◽  
Incarceration Rate ◽  
Self Sufficiency ◽  
Multiple Challenges

Abstract Background Worldwide, the United States has the highest incarceration rate per capita. Thousands of people are released from US correctional facilities each year, including many who are impacted by HIV infection and substance use disorder (SUD), two frequently comorbid conditions that present multiple challenges upon reentry. Reentry and care engagement research involving justice-involved people with HIV (PWH) with comorbid SUD has been largely limited to the perspective of those released. To formulate effective interventions for this population aimed at maintaining health and reducing recidivism, it is crucial to collect data from formerly incarcerated individuals with firsthand experience of the reentry process as well as other actors within the reentry framework. Insights from medical and legal service providers working in reentry systems have the potential to address key implementation concerns. To inform an intervention aimed at helping recently-released individuals PWH and SUD, we conducted a qualitative study to assess barriers and facilitators to community reentry from the perspectives of diverse consumers and providers of medical, legal, and reentry services. Results Fifteen stakeholders within XXX County participated in in-person interviews. Results indicated that 1) Patients/clients emphasized psychosocial support and individual attitude more than medical and legal participants, who chiefly focused on logistical factors such as finances, housing, and transportation; 2) Patients/clients expressed both medical and legal needs during the reentry period, though medical providers and participants from legal entities mainly expressed concerns limited to their respective scopes of work; 3) All three participant groups underscored the need for a low-barrier, collaborative, patient-centered approach to reentry with the goal of achieving self-sufficiency. Conclusions Findings support and extend existing literature detailing the barriers and facilitators to successful reentry. Our findings underscore the notion that an effective reentry intervention addresses both medical and legal needs, includes an individualized approach that incorporates psychosocial needs, and focuses on establishing self-sufficiency.

scholarly journals Refugee Student Integration: A Focus on Settlement, Education, and Psychosocial Support

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jan Stewart ◽  
Dania El Chaar ◽  
Kari McCluskey ◽  
Kirby Borgardt
Keyword(s):  
Service Providers ◽  
Psychosocial Support ◽  
Syrian Refugees ◽  
Promising Practices ◽  
Psychosocial Needs ◽  
Social Service Agencies ◽  
Cultural Brokers ◽  
Community Agencies ◽  
Student Integration ◽  
Service Agencies

The rapid response to settle Syrian refugees in Canada has had a profound effect on communities, schools, and social service agencies. This article discusses a research program that examined the integration and settlement of Syrian children and youth in Winnipeg and Calgary. Through the examination of the school and community contexts, the research focused on the educational and psychosocial needs of re-settled Syrian refugees and the reciprocal learning between refugee, immigrant and Canadian-born students. With contributions from youth, parents, and relevant stakeholders, the research identified gaps in programming and services as well as promising practices that support newcomers. Issues surrounding trauma, interrupted schooling, separation and loss, racism and discrimination complicated the settlement and integration efforts. Findings indicate that Canadians and Canadian service providers have a major role in supporting the successful integration of refugees. Cultural support workers, cultural brokers, and community liaison personnel are paramount to bridging the school to families and community agencies.

Approaching a Consensus: Psychosocial Support Services for Solid Organ Transplantation Programs

2001 ◽  
Vol 11 (3) ◽  
pp. 163-168 ◽  
Author(s):  
Christine E. Skotzko ◽  
Judith A. Stowe ◽  
Carol Wright ◽  
Kay Kendall ◽  
Mary Amanda Dew
Keyword(s):  
United States ◽  
Organ Transplantation ◽  
Support Services ◽  
Psychosocial Support ◽  
Solid Organ Transplantation ◽  
The United States ◽  
Solid Organ ◽  
Psychosocial Needs ◽  
Psychosocial Services ◽  
Transplant Patients

Background— Solid organ transplantation has become an accepted treatment for individuals with end-stage organ dysfunction. Criteria are being developed in the United States to determine medical eligibility for transplant candidates and competencies for transplant centers and physicians. To date, similar criteria for psychosocial services have not been developed. Design and Setting— We queried participants in a specialty psychosocial transplant meeting to determine their views of which psychosocial services are essential to the comprehensive care of transplant patients in the United States. Results— There was broad based multidisciplinary support for proactive pretransplant screening to discern individual psychosocial needs; focused pretransplant interventions to improve candidacy and future compliance; and posttransplant programs that address psychosocial, rehabilitation, and financial issues. Conclusion— Among psychosocial providers of solid organ transplantation services, there is support for expanding routine screening and support services to individuals who are candidates for and undergo solid organ transplantation.

scholarly journals Legal Tech in Legal Service: Challenging the Traditional Legal Landscape in Malaysia

2020 ◽  
Vol 28 ((S1)) ◽  
pp. 279-301
Author(s):  
Juriah Abdul Jalil ◽  
Shukriah Mohd Sheriff
Keyword(s):  
Service Providers ◽  
Legal Profession ◽  
The United States ◽  
Legal Service ◽  
The United Kingdom ◽  
The Uk ◽  
Impact Of Technology ◽  
Legal Technology ◽  
The Impact ◽  
Practice Regulation

Digital technologies are now extending its function to the legal profession. But the existence of these technologies otherwise known as legal tech or law tech is challenging the traditional legal profession. The nature of legal practice regulation in Malaysia and the United Kingdom (UK) permits only lawyers and authorised persons as legal service providers. As a result, the legal tech or law tech companies although able to facilitate the service in the legal profession are met with resistance and/or indifference. Should the traditional legal profession fear the invasion of this legal tech? This article aims to analyse the situation in Malaysia and the UK. It examines the impact of technology on legal service and legal profession in Malaysia and in the UK. The article also highlights the implication of this legal technology on the laws governing the legal profession in Malaysia. Through analyses of key Malaysian cases, the study finds that the Bar Council has the power to halt the operation of legal tech companies in providing any legal service in this country.As a result, the Bar has been criticised for being a hindrance to the development of legal tech in Malaysia. In contrast, the UK and the United States of America (US) have been very receptive to legal technology despite the exclusivity in the legal profession.

The Obligation of Listening: Caring for Patients With Chronic Dysphagia Through Illness Narratives

2020 ◽  
Vol 5 (1) ◽  
pp. 231-235
Author(s):  
Jinxu Bridget Xia
Keyword(s):  
Decision Making ◽  
Chronic Conditions ◽  
Chronic Care ◽  
The United States ◽  
Illness Narratives ◽  
Narrative Approach ◽  
Psychosocial Needs ◽  
Patient Centered ◽  
Treatment Plans ◽  
Provision Of Care

Purpose Chronic conditions affect the lives of thousands of people in the United States. Dysphagia is a symptom that co-occurs with many chronic conditions. This presents unique challenges to speech-language pathologists (SLPs) who work with patients that are physically and psychosocially burdened by chronic dysphagia. Clinical decisions in chronic care are characterized by context-dependent complexities. There is a theoretical framework in bioethics called narrative ethics , which suggests that engaging with patients' illness narratives informs patient-centered decision making and that exploring contexts is essential to provision of care. Conclusion Using a narrative approach in decision making in chronic dysphagia helps contextualize the symptoms and supports clinicians to form individualized treatment plans that better suit patients' health care and psychosocial needs.

Beyond the Walls: The Importance of Community Contexts in Immigration Detention

2019 ◽  
Vol 63 (9) ◽  
pp. 1250-1275 ◽  
Author(s):  
Emily Ryo ◽  
Ian Peacock
Keyword(s):  
Service Providers ◽  
The United States ◽  
Individual Characteristics ◽  
Fiscal Year ◽  
Legal Service ◽  
Immigration Detention ◽  
The Social ◽  
Multivariable Analyses ◽  
Detention Facilities ◽  
Community Contexts

Immigration detention facilities are commonly assumed to be insulated microcosms that maintain their existence separate and apart from the surrounding communities. Yet detention facilities are not hermetically sealed institutions. Drawing on unique and comprehensive data pertaining to all individuals held in immigration detention in the United States in fiscal year 2015, this study explores for the first time the importance of community contexts in immigration detention. Our multivariable analyses show a significant relationship between the characteristics of communities in which the facilities are located and detention length for individuals who were released pending the completion of their removal proceedings. Specifically, we find that the presence of legal service providers and social support networks in the communities is associated with shorter detention length, controlling for a variety of individual characteristics and contextual factors. These findings highlight the need for research on the social ecology of immigration detention—research that moves beyond the walls of detention facilities to consider the broader legal, social, and political contexts of surrounding communities in investigating the nature and consequences of immigration detention.

scholarly journals The profile of vulnerable students using the university psychosocial and medical care services

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Papadakaki ◽  
F Sarakatsianou ◽  
V Tsismeli ◽  
G Lapidakis ◽  
M Karapiperaki
Keyword(s):  
Higher Education ◽  
Family Income ◽  
Psychosocial Support ◽  
Academic Progress ◽  
Health Examination ◽  
The European Union ◽  
Psychosocial Needs ◽  
Development Education ◽  
Medical Unit ◽  
Set Up

Abstract Background Increasing the capacity of higher education institutes to address students' vulnerabilities has been deemed necessary due to the financial crisis. Multilevel interventions have thus been initiated at the Hellenic Mediterranean University of Crete, as part of a project co-financed by Greece and the European Union (European Social Fund-ESF) through the Operational Programme <<Human Resources Development, Education and Lifelong Learning 2014- 2020 >> (MIS 5045937). The project aims to offer support to students with low family income or a certified disability, monitor their bio-psychosocial needs, increase their accessibility to health and psychosocial care, and improve their academic outcomes. Methods As part of the project, a primary health care unit has been set up to offer medical and nursing care (medical unit) as well as psychosocial support (counseling centre) to students in need. An observatory has also been set up to monitor their health and psychosocial needs and their academic progress. Results A total of 228 eligible students used the services in the second half of 2019 (counseling centre 37; medical unit 191). Out of the 37 individuals who used the counseling centre, 30 (81.0%) were female and 16 (43.2%) were at the first 2 years of their studies. A total of 36 (97.3%) requested psychological support, 6 (16.2%) warranted social welfare services and 1 (2.7%) support for learning disabilities. As for the 191 individuals who used the medical services, 101 (52.8%) were male and 88 (46.0%) were at first 2 years of their studies. Most of them had a health examination to receive a health certificate (74.8%) followed by those who received emergency care (e.g. respiratory infection, allergic reaction, injury, etc), chronic disease management and medicine subscription, as well as vaccination. Conclusions Complex bio-psychosocial needs have been identified, recorded and analyzed to explain the academic progress of socially vulnerable students. Key messages The students’ journey through medical and counseling services is being mapped to offer important information for educational policy. Assessment and monitoring of students’ complex needs are important to achieve quality in higher education.

“Don’t talk to them about goals of care”: Understanding disparities in advance care planning

2021 ◽  
Author(s):  
Deepshikha Charan Ashana ◽  
Noah D’Arcangelo ◽  
Priscilla K Gazarian ◽  
Avni Gupta ◽  
Stephen Perez ◽  
...  
Keyword(s):  
Native American ◽  
Ethnic Groups ◽  
Health Systems ◽  
Advance Care Planning ◽  
Religious Beliefs ◽  
Barriers And Facilitators ◽  
National Study ◽  
Care Planning ◽  
Patient Centered ◽  
Advance Care

Abstract Background Structurally marginalized groups experience disproportionately low rates of advance care planning (ACP). To improve equitable patient-centered end-of-life care, we examine barriers and facilitators to ACP among clinicians as they are central participants in these discussions. Methods In this national study, we conducted semi-structured interviews with purposively selected clinicians from six diverse health systems between August 2018 and June 2019. Thematic analysis yielded themes characterizing clinicians’ perceptions of barriers and facilitators to ACP among patients, and patient-centered ways of overcoming them. Results Among 74 participants, 49 (66.2%) were physicians, 16.2% were nurses, and 13.5% were social workers. Most worked in primary care (35.1%), geriatrics (21.1%), and palliative care (19.3%) settings. Clinicians most frequently expressed difficulty discussing ACP with certain racial and ethnic groups (African American, Hispanic, Asian, and Native American) (31.1%), non-native English speakers (24.3%), and those with certain religious beliefs (Catholic, Orthodox Jewish, and Muslim) (13.5%). Clinicians were more likely to attribute barriers to ACP completion to patients (62.2%), than to clinicians (35.1%) or health systems (37.8%). Three themes characterized clinicians’ difficulty approaching ACP (Preconceived views of patients’ preferences; narrow definitions of successful ACP; lacking institutional resources), while the final theme illustrated facilitators to ACP (Acknowledging bias and rejecting stereotypes; mission-driven focus on ACP; acceptance of all preferences). Conclusions Most clinicians avoided ACP with certain racial and ethnic groups, those with limited English fluency, and persons with certain religious beliefs. Our findings provide evidence to support development of clinician-level and institutional-level interventions and to reduce disparities in ACP.

scholarly journals “Going Out” and Going In-House: Chinese Multinationals’ Internal Legal Capacity in the United States

2021 ◽  
pp. 1-31
Author(s):  
Ji Li
Keyword(s):  
United States ◽  
Emerging Market ◽  
Legal Profession ◽  
The United States ◽  
State Ownership ◽  
Legal Service ◽  
Legal Capacity ◽  
Service Market ◽  
Business Executives ◽  
Policy Debates

The “in-house counsel movement” of the past few decades, with its far-reaching implications for the legal profession, the legal service market, and corporate governance, has attracted a great deal of academic attention. Few scholars, however, have examined the global expansion of emerging market companies and their in-house legal capacity. To narrow the gap, this article investigates the in-house legal capacity of Chinese firms in the United States. In doing so, it focuses on two important yet underexplored questions: (1) whether and how institutions in China influence the capacity building; and (2) whether the Chinese investors’ ownership structure makes a difference in that regard. By analyzing a unique set of survey data and 122 interviews with lawyers, in-house counsel, and business executives, this article uncovers evidence of both multi-institutional influence and state-ownership effects. The findings contribute to theoretical and policy debates about the legal profession, the legal service market, and the ramifications of expanding Chinese multinational companies.

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