Navigating Family Involvement in Domestic Violence Fatality Review: Conceptualising Prospects for Systems and Relational Repair

Purpose Family involvement is a key element of Domestic Homicide Review (DHR), the form of Domestic Violence Fatality Review (DVFR) found in England and Wales. Family involvement is framed as having dual purposes: first, as a benefit to DHRs, enabling a fuller picture of victims’ experiences; second, as a benefit to families themselves, notably as a therapeutic or cathartic opportunity. However, these dual purposes have been little considered. This conceptual article responds to this absence by interrogating the purpose, process and outcomes of family involvement within DHRs. Method To explicate purpose, process and outcomes, we synthesise policy, practice and the extant empirical and theoretical literature relating to family involvement in DHRs. We supplement this by engaging with a broader body of emerging research on family involvement in other review systems, analysing this through a lens of citizenship and participation. Results Family involvement in DHRs is little explicated and there is a need to better engage with how family are involved in DHRs, as a way of increasing transparency for family rights. By way of response, a tentative conceptual framework is proposed which situates family involvement as demonstrative of systems- and relational-repair. Conclusions The article concludes by arguing for greater attention to the Theory(s) of Change underpinning both the place of the family and their testimony, as well as the DHR system as a whole. Such clarity would benefit family, both as the subject of professional interactions but, critically, as agents in the DHR process in their own right.

Chronic condition self-management is a social practice

Self-management is widely promoted in Western health care policies as a way to address the impact of increasing rates of chronic conditions on health care systems. Mostly informed by psychological theories, self-management frameworks and interventions tend to target individual behaviours as demarcated from the many aspects of social life shaping these behaviours. Using Bourdieu’s theory of practice, we develop four propositions for a relational and socially situated (re)conceptualisation of self-management. First, self-management is a field with its own distinctive logics of practice; second, self-management goals are social practices, emerging through co-constituted patient–professional interactions; third, self-management is energised by legitimised capital; and fourth, what goals feel possible are shaped through embodied knowledge and lived experience (habitus), linked to capital. Collectively these propositions enable focus on both the meanings and resources patients and professionals bring to self-management, along with the dynamic and relational ways goals are produced through patient–professional interactions within the broader field of health care.

Fostering Meaningful and Creative Connections in Higher Education: Contributions from Music Education

This paper focuses on contributing to the reflection on the importance of providing opportunities to foster meaningful and creative connections in higher education. In a context of growing plurality, heterogeneity and diversity of backgrounds, languages, cultures, identities, roles, and purpose influences the sociocultural relations and professional interactions that occur and are formed within higher education communities of knowledge and learning, which are explored from the perspective of music education. A narrative approach on participant’s views about their participation in an elective music program was developed inside the framework of informal education. Issues that were discussed the most across the datasets by participants individual accounts are expressed through themes that fall into three broad areas: previous musical experiences, significant influences for music participation, and perceptions of the participation in the music program. Results suggest that the informal music program provided participants with a context for a safe emotional, social, cultural, and musical experience, and thus heterogeneity and diversity are seen as enriching factors. Some considerations are made on the ways through which music can help to foster connections and sense of humanity in higher education. This provides some insights into the relevance of fostering musical participation as part of the cultural responsibility of higher education institutions for participants.

Attitudes, beliefs and behaviors of religiosity, spirituality, and cultural competence in the medical profession: A cross-sectional survey study

Introduction Religion and spirituality play important roles in the lives of many, including healthcare providers and their patients. The purpose of this study was to examine the relationships between religion, spirituality, and cultural competence of healthcare providers. Methods Physicians, residents, and medical students were recruited through social platforms to complete an electronically delivered survey, gathering data regarding demographics, cultural competency, religiosity, and spirituality. Four composite variables were created to categorize cultural competency: Patient Care Knowledge, Patient Care Skills/Abilities, Professional Interactions, and Systems Level Interactions. Study participants (n = 144) were grouped as Christian (n = 95)/non-Christian (n = 49) and highly religious (n = 62)/not highly religious (n = 82); each group received a score in the four categories. Wilcoxon rank sum and Chi-square tests were used for analysis of continuous and discrete variables. Results A total of 144 individuals completed the survey with the majority having completed medical school (n = 87), identifying as women (n = 108), white (n = 85), Christian (n = 95), and not highly religious (n = 82). There were no significant differences amongst Christian versus non-Christian groups or highly religious versus not highly religious groups when comparing their patient care knowledge (p = .563, p = .457), skills/abilities (p = .423, p = .51), professional interactions (p = .191, p = .439), or systems level interaction scores (p = .809, p = .078). Nevertheless, participants reported decreased knowledge of different healing traditions (90%) and decreased skills inquiring about religious/spiritual and cultural beliefs that may affect patient care (91% and 88%). Providers also reported rarely referring patients to religious services (86%). Conclusions Although this study demonstrated no significant impact of healthcare providers’ religious/spiritual beliefs on the ability to deliver culturally competent care, it did reveal gaps around how religion and spirituality interact with health and healthcare. This suggests a need for improved cultural competence education.

Conceptualizing Empathy Competence: A Professional Communication Perspective

Empathy competence is considered a key aspect of excellent performance in communication professions. But we lack an overview of the specific knowledge, attitudes, and skills required to develop such competence in professional communication. Through interviews with 35 seasoned communication professionals, this article explores the role and nature of empathy competence in professional interactions. The analysis resulted in a framework that details the skills, knowledge, and attitudinal aspects of empathy; distinguishes five actions through which empathy manifests itself; and sketches relationships of empathy with several auxiliary factors. The framework can be used for professional development, recruitment, and the design of communication education programs.

The impact of antimicrobial stewardship programs on the appropriateness of prophylaxis and antimicrobial therapy: the experience of the “F. Miulli” Hospital of Bari

Introduction: The continuous increase of antimicrobial resistance (AMR) requires antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, including selection, dose, duration, and way of administration. Methods and Results: An “Antimicrobial Stewardship Team” (AST) was established at “F. Miulli” Hospital of Bari. The AST is a multidisciplinary group formed by a pharmacist, an infectious disease specialist, a microbiologist, an anesthetist and a hygienist. The AST has started a clinical path of professional interactions and optimization of antimicrobial use. The AST was focused on surgical antibiotic prophylaxis, planning events/meetings with 13 wards of “F. Miulli” hospital and writing 13 operating guidelines. The AST was focused on antimicrobial therapies too. On this occasion, the AST did not organize events or meetings but was focused on professional interactions with clinicians to optimize the antimicrobial use in the treatment of multi-drug resistant (MDR) pathogens. A reduction of antimicrobial use (defined daily dose, DDD) and pharmaceutical expenditure was reached in surgical wards during 2017-2018, while, in the same period, an increase of antimicrobial use (DDD) and pharmaceutical expenditure was observed in non-surgical wards. Conclusions: The “Antimicrobial Stewardship Team” programs are essential to monitor the hospital economic resources and to support the purchase of the innovative antimicrobial therapies to treat multi-drug resistant pathogens.

A cross-sectional study investigating the relationships between self-management abilities, productive patient-professional interactions, and well-being of community-dwelling frail older people

Worldwide, the maintenance of well-being in ageing populations with associated frailty has become increasingly important. To maintain well-being during ageing, investment in frail older people’s self-management abilities and the fostering of productive interactions with healthcare professionals may lead to higher levels of well-being. The aim of this study was to investigate the relationships between community-dwelling frail older people’s self-management abilities, productive patient-professional interactions and well-being, while controlling for socio-demographic characteristics. This cross-sectional study included 588 community-dwelling frail older people (aged ≥ 75 years) from 15 general practitioner (GP) practices in the Netherlands. Well-being (Social Production Function Instrument for the Level of well-being short), productivity of interactions with GPs (relational coproduction instrument), and self-management abilities (Self-Management Ability Scale short) were measured during in-home face-to-face interviews by trained interviewers. Data were analysed using descriptive statistics, correlation analyses, and linear mixed-effects models. Significant relationships were detected between self-management abilities and the overall, social, and physical well-being of older people, and between productive interactions with GPs and overall and social well-being, but not physical well-being. In a time of ageing populations with associated frailty, investment in frail older people’s self-management abilities and the productivity of patient-professional interactions may be beneficial for this population’s well-being.