scholarly journals Boundary violation and sexual exploitation in psychiatry and psychotherapy: a review

2004 ◽  
Vol 10 (4) ◽  
pp. 312-320 ◽  
Author(s):  
Sameer P. Sarkar
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Empirical Study ◽  
Sexual Exploitation ◽  
Professional Roles ◽  
Professional Boundaries ◽  
Boundary Violation ◽  
Psychotherapeutic Practice ◽  
The Subject ◽  
Sexual Boundary Violations

In psychiatric and psychotherapeutic practice, ‘boundaries' delineate the personal and the professional roles and the differences that should characterise the interpersonal encounters between the patient/client and the professional. Boundaries are essential to keep both parties safe. The author outlines the various types of boundary violation that can arise in clinical practice, their consequences (both clinical and legal), how professionals can avoid them and how health care institutions might respond, should they occur. He concentrates on sexual boundary violations, because these have been the subject of most empirical study.

scholarly journals Responding to Sexual Boundary Notifications: The Evolving Regulatory Approach in Australia

2021 ◽  
Vol 107 (2) ◽  
pp. 25-31 ◽  
Author(s):  
Christine Gee ◽  
Anne Tonkin ◽  
Sharon Gaby ◽  
Veronika Urh ◽  
Sarah Anderson ◽  
...  
Keyword(s):  
Health Care ◽  
Lessons Learned ◽  
Health Practitioner ◽  
Cultural Changes ◽  
Boundary Violation ◽  
Australian Health ◽  
High Profile ◽  
Regulatory Approach ◽  
Independent Review ◽  
Sexual Boundary Violations

ABSTRACT A sexual boundary violation by a health practitioner has an immense impact on a patient, and the trust and confidence in the health care system and the health care regulator are negatively affected. The Australian Health Practitioner Regulation Agency (Ahpra) and the Medical Board of Australia (MBA) in 2017 commissioned an independent review in response to a specific high-profile case of multiple physician-patient* sexual boundary violations. In response to recommendations for process improvement, Ahpra and the MBA worked to transform the regulatory management of sexual boundary notifications.The purpose of this paper is to explore the structural and cultural changes that have been made to manage sexual boundary violation notifications and lessons learned through the process. Three factors — specialized decision-making, training for investigators and policy and cultural changes — were identified as key elements of the change process. Since the changes in 2017, the rate of immediate regulatory action taken in response to sexual boundary notifications has increased substantially, with a higher proportion of decisions resulting in suspension of a physician’s registration. Further work on the experience of those who are part of the notification process and supporting people to share their stories and experiences through the notification and tribunal process is ongoing.

Overview of Current Approaches to Aural Rehabilitation for Adults With Cochlear Implants

2020 ◽  
Vol 5 (5) ◽  
pp. 1175-1187
Author(s):  
Rachel Glade ◽  
Erin Taylor ◽  
Deborah S. Culbertson ◽  
Christin Ray
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Cochlear Implants ◽  
Practice Patterns ◽  
The United States ◽  
Care Providers ◽  
Aural Rehabilitation ◽  
Starting Point ◽  
Clinical Models ◽  
Hearing Health

Purpose This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States. Method Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population. Findings/Conclusions There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.

A view on Practical Utility of Paradi Gunas

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Sachin Bagali ◽  
Umapati Baragi ◽  
M. R. Sajjanshetti
Keyword(s):  
Clinical Practice ◽  
Professional Practice ◽  
Continuous Process ◽  
Clinical Activity ◽  
Successful Management ◽  
Knowledge Domain ◽  
Practical Utility ◽  
The Subject ◽  
The Way

In the present day scenario prime need of Ayurveda is practical applicability of Ayurvedic fundamental principles and research should be more focused on all aspects where scientific inputs should confirm Ayurveda’s principles and philosophy. In Ayurveda, Gunas are described as the way of presentation of action without which no Karma (action) can be possible. Ayurveda has provided significance to every Guna so that they become useful in clinical practice. Clinical practice or research is a continuous process including a series of events which need to be performed in a sequential manner. Though there are many factors on which accomplishment of treatment depends, among these Charaka has given prime importance to Paradi Gunas. In clinical practice, Guna which are to be with Bhishak are mainly the Paradi Gunas which can also be called as miscellaneous Gunas. As rightly quoted by Acarya Charaka, for getting success in the treatment Paradi Gunas are the best. The Sutra quotes "Sidhyupaya Chikitsayam" which means that Chikitsa i.e. Dhatusamya will be done mainly with the help of Paradi Gunas. Knowledge of Paradi Gunas are required to be present in pharmacists, physicians and Researchers. Acharya Charaka says that Chikitsa Siddhi i.e. successful management of disease is not possible without the knowledge of Paradi Gunas. Paradi Gunas play an important role in selection, adaption and manifestation of drug as per condition of the disease and the patient in particular Desha and Kala. The ultimate goal of any clinical activity is to contribute in the knowledge domain and to improve professional practice. Thus this literary review of Paradi Gunas serves to explore the subject of the clinical practice.

The Image of the Accountant in a German Context

2004 ◽  
Vol 4 (1) ◽  
pp. 62-89 ◽  
Author(s):  
Andreas Hoffjan
Keyword(s):  
Content Analysis ◽  
Empirical Study ◽  
Cost Reduction ◽  
Maximum Degree ◽  
Work Ethic ◽  
Personal Characteristics ◽  
Management Accountant ◽  
The Subject ◽  
Professional Context

This study introduces content analysis as a method of examining the accountant's role. The empirical study is based on 73 advertisements, which are directed primarily at employees who are affected by the management accountant's work. The findings of the study indicate that the subject of accountancy is used particularly in connection with promises of “cost reduction.” Consequently, the majority of advertisements use the accountant stereotype of “savings personified.” In a professional context, the work ethic of the management accountant is given particular emphasis in the advertisements. He/she identifies him/herself with his/her task to the maximum degree, is regarded as loyal to his/her company and, for the most part, is well organized in his/her work. However, the characterization of the management accountant as a well disciplined company-person conflicts with the negative portrayal of his/her professional qualities. In advertisements, the management accountant is portrayed as a rather inflexible, passive, and uncreative specialist who, as a result of these qualities, often demotivates others. The personal characteristics of the management accountant are shown in a negative light. This gives him/her the unappealing image of a humorless, envious, dissociated, and ascetic corporate-person.

scholarly journals Implementing Personalized Medicine in COVID-19 in Andalusia: An Opportunity to Transform the Healthcare System

2021 ◽  
Vol 11 (6) ◽  
pp. 475
Author(s):  
Joaquín Dopazo ◽  
Douglas Maya-Miles ◽  
Federico García ◽  
Nicola Lorusso ◽  
Miguel Ángel Calleja ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Practice ◽  
Personalized Medicine ◽  
Local Level ◽  
Individual Variability ◽  
Response To Therapy ◽  
Control Measures ◽  
Response To Treatment ◽  
Specific Patient

The COVID-19 pandemic represents an unprecedented opportunity to exploit the advantages of personalized medicine for the prevention, diagnosis, treatment, surveillance and management of a new challenge in public health. COVID-19 infection is highly variable, ranging from asymptomatic infections to severe, life-threatening manifestations. Personalized medicine can play a key role in elucidating individual susceptibility to the infection as well as inter-individual variability in clinical course, prognosis and response to treatment. Integrating personalized medicine into clinical practice can also transform health care by enabling the design of preventive and therapeutic strategies tailored to individual profiles, improving the detection of outbreaks or defining transmission patterns at an increasingly local level. SARS-CoV2 genome sequencing, together with the assessment of specific patient genetic variants, will support clinical decision-makers and ultimately better ways to fight this disease. Additionally, it would facilitate a better stratification and selection of patients for clinical trials, thus increasing the likelihood of obtaining positive results. Lastly, defining a national strategy to implement in clinical practice all available tools of personalized medicine in COVID-19 could be challenging but linked to a positive transformation of the health care system. In this review, we provide an update of the achievements, promises, and challenges of personalized medicine in the fight against COVID-19 from susceptibility to natural history and response to therapy, as well as from surveillance to control measures and vaccination. We also discuss strategies to facilitate the adoption of this new paradigm for medical and public health measures during and after the pandemic in health care systems.

scholarly journals Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain

2021 ◽  
Vol 18 (3) ◽  
pp. 932
Author(s):  
Samuel López-López ◽  
Raúl del Pozo-Rubio ◽  
Marta Ortega-Ortega ◽  
Francisco Escribano-Sotos
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Models ◽  
Financial Risk ◽  
Household Expenditure ◽  
Financial Protection ◽  
Logistic Regression Models ◽  
Ordered Logistic Regression ◽  
Out Of Pocket Payments ◽  
The Subject

Background. The financial effect of households’ out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little research in European countries, and is almost nonexistent after the financial crisis of 2008. The aim of the work is to analyze the incidence and intensity of financial catastrophism derived from Spanish households’ out-of-pocket payments associated with health care during the period 2008–2015. Methods. The Household Budget Survey was used and catastrophic measures were estimated, classifying the households into those above the threshold of catastrophe versus below. Three ordered logistic regression models and margins effects were estimated. Results. The results reveal that, in 2008, 4.42% of Spanish households dedicated more than 40% of their income to financing out-of-pocket payments in health, with an average annual gap of EUR 259.84 (DE: EUR 2431.55), which in overall terms amounts to EUR 3939.44 million (0.36% of GDP). Conclusion. The findings of this study reveal the existence of catastrophic households resulting from OOP payments associated with health care in Spain and the need to design financial protection policies against the financial risk derived from facing these types of costs.

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