Freedom in Osteoarthritis of the Knee

The first peak of the external knee abduction moment (KAM) is often used as a surrogate measure of the medial compartment loading and has been correlated with pain and progression of knee osteoarthritis (OA). As a result, reducing the KAM is often the target of conservative interventions. OA should be considered as a “Whole Person” disease, including ecological psychosocial aspects. Scientists have developed gait alteration strategies to reduce the KAM. They attempted to force into a new position any particular part without reference to the pattern of the whole. We propose an alternative approach: in the vicinity of a special configuration of the knee, some or all of the components of the knee become overloaded. This study has shown that when six lines $1′,$2′,$3′,$4′,$5′,$6′ are so situated that forces acting along them equilibrate when applied to one degree of freedom, 1° F knee, a certain determinant vanishes. We wish to define the six lines as the knee complex in involution by virtue of some constraint upon the knee.

How to think about pain with the whole person in mind

Too often, pain is reduced to a simple symptom of illness or injury – a puzzle piece to fit into the differential diagnostic jigsaw. Pain reports that fit the emerging pathoanatomical picture are validated and treated accordingly. But many reports don’t fit this picture, and the widespread stigma associated with persistent pain is most commonly directed toward these individuals, whose symptoms aren’t well explained by known pain mechanisms. A root problem is not seeing the person in pain or the suffering they experience. This presentation aims to help participants develop a more comprehensive perspective on pain that better integrates its complexities within clinical practice. Participants will be introduced to the Multi-modal Assessment model of Pain (MAP; Wideman et al, Clinical Journal of Pain 2019; 35(3): 212). MAP offers a novel framework to understand the fundamentally subjective natures of pain and suffering and how they can be best addressed within clinical practice. MAP aims to help clinicians view pain, first and foremost, as an experience (like sadness), which may or may not correspond to specific pathology or diagnostic criteria (like clinical depression). MAP aims to facilitate a more compassionate approach to pain management by providing a rationale for why all reported pain should be validated, even when poorly understood. Viewing pain in this manner helps highlight the central importance of listening to patients’ narrative reports, trying to understand the meaning and context for their experiences of pain and using this understanding to help alleviate suffering.

Queering whole person care in a pandemic

How can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to? In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat. The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic. A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat. The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices.

use of portraiture to foster humanistic care

It has been said that a picture says a thousand words, that art should speak for itself. Within the social sciences, there is recognition that images are not merely illustrations, but “texts” that can be read, studied and interpreted in different ways: they are visual narratives. When we look at a work of art, we respond with our own thoughts, feelings and ideas about what it communicates. When we look at a portrait specifically, we are not just looking at a picture of an individual, we are looking at a picture of someone being looked at. It is a visual record of an interaction, as much as a likeness of the person. The artist-sitter relationship has much in common with the doctor patient relationship involving trust, attention, and an openness to ambiguity and creativity. As clinicians that are tired and feeling overwhelmed, we may objectify patients. Engaging with art can help hone our skills to consistently see the whole person. It provides freedom to sit with ambiguity and maintain curiosity and can help us become more flexible in our thinking, to hold multiple possibilities in mind at the same time. Viewing art in a group provides opportunities to understand and appreciate others’ perspectives. Drawing on multiple portraiture projects related to pediatric epilepsy, youth mental health and dementia, this presentation will provide constructive ways in which portraiture can be used to foster humanistic, patient centred care, and to understand the power of distributed cognition.

How LAM Sector Can Improve Quality of Life for Underserved Groups via a Whole Person Approach

A Whole Person Approach (WPA) can be used in various parts of LAM (Libraries, Archives, and Museums) sector to provide effective services for underserved groups of society to achieve civic engagement with the communities it serves. WPA is a relatively new theoretical framework in the fields of social science and healthcare. It highlights the necessity and importance of having a holistic view in dealing with different life matters and challenges. This chapter focuses on the special services that LAM sector can offer to facilitate the way towards achieving the goal of enhanced civic engagement, as serving the unserved groups of society is an urgent priority for the sector. Several Creative strategies will be discussed that can be implemented in the current services to make sure the special needs of communities that a sector serves are considered and met. A limitation of this chapter is that it is not a case study, nor is it based on field experiences. It is in fact a critical exploration of the concepts to facilitate in building a theory in an interdisciplinary perspective.

Public Policy Issues Affecting Integrated Health Care: Challenges, Opportunities, and Implications for Clinical Mental Health Counselors

The growing need for the treatment of the whole person creates an opportunity for establishing a holistic integrated health care (IHC) system in various clinical settings. Considering the issues with existing IHC models and related public policies, and the current barriers facing clinical mental health counselors (CMHCs) who hope to become an integral part of IHC teams, we propose a new holistic IHC model. We highlight several practical implications of our proposed model that could be beneficial for the development of professional identity of CMHCs and their inclusion in IHC teams. We also offer numerous propositions for improving IHC-related policies in favor of CMHCs and the counseling profession.

COMMUNITY OUTREACH AND ENGAGEMENT IN THE TIME OF COVID 19: EFFORTS & APPROACHES OF ACADEMIC LIBRARIES

Objective. This paper aims to investigate the types and scope of community engagement and outreach activities of academic libraries while the physical library spaces remain closed or operating on a limited capacity. It also looks at the tools and methods employed to implement such activities. The paper also attempts to uncover patterns or emerging themes as libraries explore innovative ideas and take new initiatives for the betterment of the community they serve. Methods. The study employs a website and Facebook page survey of AUN (ASEAN University Network) Inter-Library Online (AUNILO) member-libraries. The following six outreach categories will be utilized: (1) Collection-Based Outreach; (2) Instruction & Services-Based Outreach; (3) “Whole Person” Outreach; (4) Just for Fun Outreach; (5) Partnerships and Community-Focused Outreach; and (6) Multi-Pronged Themed Events and Programming. Said categories were derived from Farrell and Mastel (2016) paper entitled “Considering Outreach Assessment: Strategies, Sample Scenarios, And A Call to Action.” Results. Findings of the study will offer some insights on how libraries strengthen their roles in transforming societies as they provide opportunities to bring about positive change in their communities. Moreover, this paper will also challenge libraries to take a closer look at their own activities and consider how they can design creative and inspiring ways to connect with their communities. Conclusions. In response to the COVID-19 crisis, libraries are proactively pivoting their community engagement and outreach efforts online and are finding new ways to serve faculty, students, and partners. Libraries are committed to strengthening the resilience and recovery of the community through working collaboratively with its members and building partnerships with relevant organizations.

Mapping a Strength-Oriented Approach to a Standardized Terminology: A Case Study

As a new era of healthcare advocates a more valuable and intelligent approach to care management and delivery based on values and outcomes, shifts toward risk management to boost performance should be considered that encompass the capitalization of health assets or health strengths. To make full use of individuals’ or populations’ health assets, data capture and representation are needed. This paper uses a strengths-oriented case study mapped to an inter-disciplinary standardized terminology, the Omaha System, to illustrate and compare the conventional problem-based approach to care management with the strengths-oriented approach to care that demonstrates whole-person data capture of an individual’s health and health assets leveraged to promote health values and performance. The Omaha system provides a standardized framework to organize the concepts of all of health from a whole-person perspective for documentation to enable data analysis, interoperability, and health information exchange.

Mental illness, personhood, and transcendence: Spiritual and religious assistance in Catholic psychiatric contexts

In recent decades, there have been many calls for the inclusion of spirituality and religion (S/R) in therapeutic contexts. In some contexts, this has been an institutionalized form of spiritual and religious assistance (SRA). This article examines the concepts and practices involved in SRA services at three psychiatric institutions in Portugal, a country with strong Catholic roots but increasing efforts at secularity and recognition of religious diversity. The case of a user who contacted the SRA service allows us to better grasp this new practice in action. Although some SRA practices have similarities with mindfulness, a systematic comparison allows us to explore the links between SRA and the global dynamics related to S/R in mental health and the particularities of Catholic spirituality. In the contexts observed, the transition from the Catholic hospital chaplaincy system to the SRA model is developing through the integration of features of the Catholic spiritual tradition with concepts and practices drawn from the psychology of religious experience. The accompaniment of the ‘whole person’ emerges as the central concept of this form of SRA. Spirituality gains significance as an integrative approach to the subjectivity fragmented by the illness and the fragmentation of care across multiple clinical specialties. Furthermore, the prioritization of the spiritual needs expressed by users suggests that SRA combines well with the individualistic rationales and the technification of care in the field of mental health.

Using an Implementation Framework to Survey Outcome Measurement and Treatment Practices in Aphasia

Purpose: Best practices in the field of aphasia rehabilitation increasingly acknowledge a whole-person approach that values interventions aimed at reducing impairments, while also recognizing the impact of aphasia on participation and quality of life. Guided by the Consolidated Framework for Implementation Research (CFIR), this study aimed to examine whether current clinical practices along levels of service provision reflect this whole-person, multifaceted approach. Method: Speech-language pathologists (SLPs) in the United States who provide intervention to people with aphasia across the continuum of care completed this cross-sectional online survey. Current outcome measurement and treatment practices were evaluated within the Living With Aphasia: Framework for Outcome Measurement via multiple-choice and open-text response questions. Data were analyzed descriptively and using ordinal logistic regression models to compare clinical practices along levels of service provision. Results: Data from 90 SLPs revealed that language and cognitive skills are assessed with equal consistency across clinical settings; however, functional communication, participation, and quality of life domains are prioritized in settings providing care to clients within the community. Psychological well-being is rarely assessed within clinical practice along most of the rehabilitation process and prioritized within the university clinic setting when clients are in the chronic stage of recovery. Conclusions: Clinical practices related to a multifaceted approach to aphasia intervention are variable across levels of service provision. Further exploration of barriers and facilitators to multifaceted aphasia care along the domains of the CFIR is needed to provide an informed approach to implementing change.