student-run free clinic project: lessons in compassion, community, and courage

For 25 years, UC San Diego Student-Run Free Clinic Project has provided free high-quality care to underserved communities, while inspiring the next generation of health professionals. Free thorough ongoing care is provided in community settings to people who have nowhere to turn and do not qualify for access to care. The clinic philosophy has four tenets: empowerment - creating environments where patients take charge of their lives and achieve wellbeing, a humanistic approach - embodying Rogerian principles of empathy, respect, and self-awareness, a transdisciplinary model, one where the patient and community are the teacher. This philosophy permeates the life of the clinic. These values are taught, modeled, expected, and observed in curricular components throughout the four years of medical school. 250 medical, 75 pharmacy, and 100 predental students are involved each year as well as students in law, social work, and acupuncture. Students learn to be healers, artists, teachers as they become health professionals. At each clinic session student leaders gather the team in a large circle, and lead a sharing of recent stories and experiences reflecting the core tenets. All work is directly supervised by licensed clinicians, many of whom were once free clinic students. During the era of COVID, care became virtual. Promotors helped patients learn to use Zoom to receive care. Visit attendance increased to 100%. Our Spanish language empowerment group met online. The clinic already provided healthy food bags to patients at medical visits. Students and volunteers organized to deliver food and medication to people’s homes.

A Social Capital Perspective on Social-Medical Collaboration in Community End-of-Life Care in Hong Kong

Recent developments in Hong Kong end-of-life (EOL) care have shifted some caring work for dying people and their families to cross-disciplinary collaboration in community settings. Social-medical collaboration becomes especially important. This study aims to use social capital as an analytical lens to examine the processes and mechanisms of social-medical collaboration in EOL care and elucidate practice implications for engaging in the care of dying people and their families. Qualitative data were collected using in-depth interviews. Three major conceptual categories were generated through grounded theory methodology. They are (a) establishing trust through keeping clear and simple boundaries, (b) cultivating mutuality in the multi-disciplinary meeting, and (c) fostering social-medical collaboration in EOL care. Each new stage is based on the social capital accumulated in the previous one through the social interactions between professionals. Such theorization also provides insights into how to achieve effective social-medical collaboration in this context.

Paediatric Nursing in Australia and New Zealand

The health of babies, children and young people is fundamentally different from that of adults, so their healthcare must reflect their unique needs and engage their parents, family members and communities. Paediatric Nursing in Australia and New Zealand introduces nursing students to the care of infants, children, young people and their families in a range of clinical and community settings across Australasia. This third edition includes New Zealand content and an increased focus on families. New chapters cover health services available for Aboriginal, Torres Strait Islander and Māori children, the transition to parenthood for new families, children's sleep patterns and behaviour, and paediatric health in school settings. Case studies and reflective questions encourage students to develop critical thinking and problem-solving skills. Written by an expert team, Paediatric Nursing in Australia and New Zealand equips future nurses with the knowledge and skills to provide evidence-based care to babies, children and their families.

Provider perspectives and reach of an evidence-based intervention in community services for toddlers

Best-practice recommendations for young children at high likelihood of autism include active involvement of caregivers in intervention. However, the use of evidence-based parent-mediated interventions in community practice remains limited. Preliminary evidence suggests that Project ImPACT for Toddlers demonstrates positive parent and child outcomes in community settings. Project ImPACT for Toddlers was adapted specifically for toddlers and teaches parents of young children strategies to build their child’s social, communication, and play skills in daily routines. This study reports implementation outcomes from the initial community rollout of Project ImPACT for Toddlers and examines the system-wide intervention reach, with the goal of informing continued community sustainment and scale-up. Participants include 38 community providers who participated in a Project ImPACT for Toddlers’ training study who completed an implementation survey and semi-structured interviews after approximately 3 months of community implementation. Participants perceived the training model as acceptable and appropriate, and identified several strengths of the approach. Interview themes also supported the feasibility, acceptability, and utility of the intervention in community settings. Quantitative findings complemented the thematic results from interviews. Intervention reach data indicate an increasing number of agencies delivering and families receiving Project ImPACT for Toddlers. Efforts to scale-up evidence-based interventions in early intervention should continue to build upon the model of the Bond, Regulate, Interact, Develop, Guide, and Engage Collaborative. Lay abstract Expert recommendations for toddlers who are likely to develop autism include caregivers being actively involved in the services children receive. However, many services available in the community may not follow these recommendations. Evidence suggests that an intervention named Project ImPACT for Toddlers demonstrates positive parent and child outcomes for families in the community. Project ImPACT for Toddlers was designed specifically for toddlers by a group of parents, clinicians, researchers, and funders. It teaches parents of young children strategies to support their child’s development in daily routines. This study reports the perspectives of early intervention providers who learned to use Project ImPACT for Toddlers on whether the intervention was a good fit for their practice and easy to use. The study also examines how many agencies are using Project ImPACT for Toddlers and how many families have received the intervention in the community. The goal of the study is to inform the continued use of Project ImPACT for Toddlers in the community and support offering the intervention in other regions. Participants include 38 community providers who participated in a training study of Project ImPACT for Toddlers and completed a survey and semi-structured interview after approximately 3 months of using Project ImPACT for Toddlers with families. Participants perceived the training model as acceptable and appropriate, and identified the group-based model of training, comprehensive materials, and agency support as strengths of the approach. Survey findings complemented the results from the interviews. Data indicate an increasing number of agencies and families accessing Project ImPACT for Toddlers. Efforts to expand evidence-based intervention in early intervention should continue to build upon the model used for Project ImPACT for Toddlers.

Profit versus Quality: The Enigma of Scientific Wellness

The “best of both worlds” is not often the case when it comes to implementing new health models, particularly in community settings. It is often a struggle between choosing or balancing between two components: depth of research or financial profit. This has become even more apparent with the recent shift to move away from a traditionally reactive model of medicine toward a predictive/preventative one. This has given rise to many new concepts and approaches with a variety of often overlapping aims. The purpose of this perspective is to highlight the pros and cons of the numerous ventures already implementing new concepts, to varying degrees, in community settings of quite differing scales—some successful and some falling short. Scientific wellness is a complex, multifaceted concept that requires integrated experimental/analytical designs that demand both high-quality research/healthcare and significant funding. We currently see the more likely long-term success of those ventures in which any profit is largely reinvested into research efforts and health/healthspan is the primary focus.

Assessment and Management of ID in Childhood

Intellectual disability is a neurodevelopment disorder that affects the intellectual and adaptive functioning. The individual fails to meet standards of personal independence and social responsibility in one or more aspects of daily life, including communication, social participation, academic or occupational functioning, and personal independence at home or in community settings. There is an immense need to understand and be aware of the signs and symptoms of the disorder. This chapter focuses on the process of the assessment which is necessary to identify intellectual deficiency and also the issues that should be taken care of during the process. The various principles and tools of assessment, which can be used to measure IQ, are mentioned. It also focuses on the various challenging behaviors and functional analysis. It also focuses on recent and efficient management strategies that can be used to help the affected person cope and acquire new skills.

Family-Centered Intervention for Deaf and Hard of Hearing Multilingual Learners

This chapter explores principles of family-centered listening and spoken language (LSL) intervention, research, and best practices for children who are d/Deaf or hard of hearing (DHH) using multiple spoken languages and their families. Children with any degree/type of hearing loss who are in environments where multiple languages are spoken are referred to as deaf multilingual learners (DMLs). The language landscape for these children is varied. Some DMLs acquire a first language (L1) at home and are exposed to subsequent spoken languages in school or community settings; others are born into families where multiple languages are spoken from the beginning. While the chapter focuses on a framework of family-centered intervention applied to language development for DMLs whose families have selected LSL outcomes, the principles discussed broadly apply to DMLs using varied language(s) or modality(ies). Through analysis of best practices for interventionists and case studies, readers will understand bi/multilingual spoken language development for children who are DHH.

Salutogenesis for Thriving Societies

This chapter is this handbook’s ‘grand finale’, addressing the potential of salutogenesis to nurture thriving societies. The handbook’s editors reflect on the advancement of salutogenesis concerning theory development, applying the salutogenic model in community settings and helping society tackle crises such as COVID-19.