The Radical Welcome Engagement Restoration Model and Assessment Tool for Community-Engaged Partnerships.

People experiencing addiction, houselessness, or who have a history of incarceration have worse health outcomes compared with the general population. This is due, in part, to practices and policies of historically White institutions that exclude the voices, perspectives, and contributions of communities of color in leadership, socio-economic development, and decision-making that matters for their wellbeing. Community-based participatory research (CBPR) approaches hold promise for addressing health inequities. However, full engagement of people harmed by systemic injustices in CBPR partnerships is challenging due to inequities in power and access to resources. We describe how an Allentown-based CBPR partnership-the Health Equity Activation Research Team of clinicians, researchers, and persons with histories of incarceration, addiction, and houselessness-uses the Radical Welcome Engagement Restoration Model (RWERM) to facilitate full engagement by all partners. Data were collected through participatory ethnography, focus groups, and individual interviews. Analyses were performed using deductive coding in a series of iterative meaning-making processes that involved all partners. Findings highlighted six defining phases of the radical welcome framework: (a) passionate invitation, (b) radical welcome, (c) authentic sense of belonging, (d) co-creation of roles, (e) prioritization of issues, and (f) individual and collective action. A guide to assessing progression across these phases, as well as a 32-item radical welcome instrument to help CBPR partners anticipate and overcome challenges to engagement are introduced and discussed.

[Welcoming learners, a DEPHI on the DMU!] / L'accueil des apprenants, un DEPHI sur le DMU !

The reception of learner-caregivers is a challenge for the care sectors in the context of clinical training, moreover in view of the current situation in connection with the health of our hospitals. Remember that internship periods represent 50 % of apprenticeship time in training institutes. So how does a Medical-University Department of Hematology and Immunology try to implement a policy of welcoming and supporting trainees, taking into account their level of training and promoting interest and emulation for future professionals health?

Older Adults' Perceptions of Campus Accessibility.

Attention should be devoted to the accessibility of campus facilities to older adults and as a means to increase age-diversity. In this paper, we sought to uncover older adults' perceptions of campus accessibility via an online survey. Participants were recruited through local newsletters, and word of mouth, and included 81 community members (M Age = 71.58 years; 79% female; 89% White). Descriptive analyses were conducted for closed-ended responses and a constant comparative method was used to code open-ended responses. Based on the closed-ended responses, participants felt that the campus was somewhat accessible, moderately easy to walk around, and felt somewhat welcome on campus. The following general themes emerged in the open-ended responses: 1) inaccessibility on campus was related to parking and topography constraints (e.g., due to stairs, distance, hills); 2) accessibility on campus was due to sidewalks and access to transportation; 3) feeling welcome on campus was related to people being helpful, and 4) not feeling welcome was related to not 'being in the know' and not feeling like they belonged. These findings have implications for campus initiatives that aim to attract older adults, especially for campuses that have topography constraints.

Survivors and the Response to the Ebola Virus Disease in the Provinces of North Kivu and Ituri in the Democratic Republic of Congo.

We explored issues around the integration of survivors in communities and the implications for the Ebola Virus Disease (EVD) response in the Democratic Republic of Congo (DRC). We conducted a survey with 800 randomly selected respondents using a structured questionnaire. Respondents were persons aged 18 years and above. Focus group discussions (FGDs) and in-depth interviews (IDIs) were employed to obtain contextual data on the issues. Community leaders, health workers, and response pillar leads engaged in IDIs, while community members were involved in FGDs. The results revealed that the survivors suffered stigmatization and, upon return to the communities, were avoided by the community members due to fear of contamination. Some thought that the survivors should be supported in adjusting to the community, while some recommended engaging the survivors in EVD response activities.

Influence of memorability on revisit intention in welcome back tourism: The mediating role of nostalgia and destination attachment.

"Welcome Back Tourism" is an important marketing strategy to help overseas Tourism destinations quickly recover from the crisis and enhance their core competitiveness. How to translate the memorability of tourists to revisit intention is the core key to open "Welcome Back Tourism." This study takes local residents in Guangzhou, Shenzhen and Foshan as the research objects, and tries to explore the influence relationship between memorability of a previous travel experience, nostalgia, destination attachment and revisit intention. The results of 291 valid data showed that memorability of a previous travel experience had positive influence on revisit intention; Nostalgia has a positive effect on destination attachment. Nostalgia and destination attachment play a mediating role in the influence of memorability of a previous travel experience on revisit intention. The contributions and management Recommendations of these findings are discussed.

[Student tutoring, an essential part of nursing practice]. / Le tutorat des étudiants, un acte essentiel de la pratique infirmière.

Tutoring nursing students in the field requires a strong involvement from the staff, tutors and supervisors. Tutoring is a real educational follow-up by peers, in collaboration with the training managers, and is also a sharing of experience with the students. Story of nurses highly committed to this function in an orthopaedic surgery department.

Omnibus testing approach for gene-based gene-gene interaction.

Genetic interaction is considered as one of the main heritable component of complex traits. With the emergence of genome-wide association studies (GWAS), a collection of statistical methods dedicated to the identification of interaction at the SNP level have been proposed. More recently, gene-based gene-gene interaction testing has emerged as an attractive alternative as they confer advantage in both statistical power and biological interpretation. Most of the gene-based interaction methods rely on a multidimensional modeling of the interaction, thus facing a lack of robustness against the huge space of interaction patterns. In this paper, we study a global testing approaches to address the issue of gene-based gene-gene interaction. Based on a logistic regression modeling framework, all SNP-SNP interaction tests are combined to produce a gene-level test for interaction. We propose an omnibus test that takes advantage of (1) the heterogeneity between existing global tests and (2) the complementarity between allele-based and genotype-based coding of SNPs. Through an extensive simulation study, it is demonstrated that the proposed omnibus test has the ability to detect with high power the most common interaction genetic models with one causal pair as well as more complex genetic models where more than one causal pair is involved. On the other hand, the flexibility of the proposed approach is shown to be robust and improves power compared to single global tests in replication studies. Furthermore, the application of our procedure to real datasets confirms the adaptability of our approach to replicate various gene-gene interactions.

The EU's Hospitality and Welcome Culture: Conceiving the "No Human Being Is Illegal" Principle in the EU Fundamental Freedoms and Migration Governance.

This article aims to highlight the theoretical and philosophical debate on hospitality underlining the normative elements of framing migrants and refugees as individual agents in the light of hospitality theory and migration governance. It argued the critiques of the neo-Kantian hospitality approach and the EU welcome culture with regard to refugees in the EU from a philosophical perspective. The "No human being is illegal" motto is proposed to be conceived as a principle of the EU Charter of Fundamental Rights. The cosmopolitan right to visit and the universal right to reside were discussed in the context of human rights and co-responsibility. Linking the hospitality approach with migration governance enables the reconstruction of reception policies and practices, diversification of non-state actors that engage in migration governance mechanism, and polarization of political initiatives (e.g., politics of allocation and dispersal, readmission negotiations, convergence/divergence of priorities and strategic interests). The research findings highlight that the EU adopted a neo-Kantian hospitality approach that combines both "co-responsibility" and "vertical/heterarchical relations." The EU's "New Pact on Migration and Asylum" was considered proof of how the EU follows neo-Kantian hospitality that is manifested in dualism and contradictory approach. The study presents a typology that splits co-responsibility into individual/institutional actions and human rights/migration governance.

"We Become a Madman to Be Calmed"-Patients' Voices: Crossing the Threshold of Psychiatric Emergency Departments.

Crossing the threshold of a psychiatric emergency room is a real ordeal. It is a passage that upsets, worries and sometimes paralyzes. However, it can also become an opportunity if psychological suffering is welcomed, accepted and understood. The welcome is the starting point for care. Our objective is to understand the meaning given to the phenomenon of "being welcomed" by patients experiencing psychiatric emergencies. The research is based on Grounded Theory Methodology (Glaser and Strauss, 1967) to explore and understand the complexity of the phenomenon. The results reveal that being welcomed can be considered as a rite of passage taking place in four successive phases, which are themselves organized into four interactive dimensions. The welcome as a rite of passage constitutes a powerful psychic support which arranges the transitional space in which the individual finds themself, and accompanies the identity transformations, the anguish, and the various sufferings which are not lacking in these moments of crisis.

Process evaluation of the response of nursing homes to the implementation of the dementia-specific case conference concept WELCOME-IdA: A qualitative study.

BACKGROUND: The implementation of clearly structured dementia-specific case conferences could be an important tool to enable nursing staff to properly analyse and manage challenging behaviour in nursing home residents with dementia. A process evaluation of the responses of nursing homes to the implementation of WELCOME-IdA (Wittener model of case conferences for people with dementia - the Innovative dementia-oriented Assessment tool) was carried out to gain insight into which key elements of the intervention were adopted by the nursing homes and which elements were adapted. METHODS: This study was part of a larger process evaluation using a qualitative design. Thirty-four semi-structured telephone interviews and 15 focus group interviews were conducted in four nursing homes. The interviews were analysed using deductive content analysis, although inductive categories have been developed. RESULTS: Nursing home staff adopted the roles of moderator, case reporter, keeper of the minutes and reflection partner in WELCOME-IdA, but the selection of the staff members who filled these roles differed across nursing homes. The recommended group size of 5-8 participants per case conference was sometimes adopted. The key element of having core nursing teams who participated continuously in all case conferences was not adopted at all. Instead, there was a high level of rotation among staff members. The pre-defined process structure of WELCOME-IdA was adapted in such a way that the assessment of the residents' behaviour and the selection of the relevant domain for the behaviour analysis were conducted in advance of the case conference. The evaluation of the interventions was also organized differently. CONCLUSION: The scope of the response implies that WELCOME-IdA requires further adaptation to the requirements of nursing processes in nursing homes. The results provide important information on the selection of role keepers and offer insights into a) how knowledge of the structured training was circulated and transformed into self-organized case conferences and b) how knowledge was circulated throughout the entire processing of one case. Thus, these results can be used to optimize intervention and implementation. Overall, the intervention should allow more possibilities for tailored adaptation than it currently does.

Struggling With Reciprocity and Compassion: Mentoring Pregnant and Parenting Mothers Experiencing Vulnerability.

Transitioning from pregnancy to parenthood is particularly challenging for women living with low income and experiencing social isolation, mental illness, addiction, and/or family violence. The purpose of this qualitative study was to evaluate one component of Welcome to Parenthood, a two-generation multiple intervention program including neuroscience-based parenting education, kin and non-kin mentorship, and an engagement tool (baby kit). From late pregnancy to 2 months postpartum, mentors kept a journal regarding their experiences of mentoring mothers experiencing vulnerability. We engaged in a modified constructivist grounded theory to explore hand-written text from the journals. The core category, Struggling with Reciprocity and Compassion, influenced processes of Becoming a Mentor. Mentoring mothers experiencing vulnerability was both challenging and rewarding, requiring an inordinate amount of physical, social, emotional, and economic resources. To foster maternal mental health and infant development, pregnant and parenting women experiencing vulnerability could benefit from long-term reciprocal and compassionate mentoring.

[Impact of cultural countertransference on the nursing interview]. / Impact du contre-transfert culturel dans l'entretien d'accueil infirmier.

The nursing interview, a key time point in patient care, is inhabited by mental representation, such as representation of the body, of the nurse and the patient. Whenever migratory dynamics are entangled in care dimensions, cultural counter-transfer has important repercussion in patient welcome. Training in transcultural clinic allows carers to have tools to counterbalance their cultural counter-transfer. A co-building of care process then becomes possible.

Process evaluation of the context, reach and recruitment of participants and delivery of dementia-specific case conferences (WELCOME-IdA) in nursing homes (FallDem): a mixed-methods study.

BACKGROUND: A system of dementia-specific case conferences (WELCOME-IdA) was evaluated using a stepped-wedge design in six nursing homes (NHs) to enable nursing staff to analyse properly the behavioural and psychological symptoms (BPSD) of residents with dementia. A process evaluation of the context, the recruitment and target populations reached (residents and nursing staff) and the delivery of the intervention and implementation strategy was carried out to explore the lack of effectiveness of WELCOME-IdA on the residents' prevalence of BPSD. METHODS: This study was part of a larger process evaluation using a mixed-methods design. Standardised questionnaires, semi-structured interviews, attendance lists, standardised protocols and written self-reports were used to collect the data. The quantitative data were analysed by calculating descriptive statistics. The qualitative interviews were analysed using deductive content analysis and the self-reports were analysed using a documentary analysis. RESULTS: None of the NHs had prior experience with dementia-specific case conferences on a specific concept related to BPSD. The number of residents for whom a dementia-specific case conference was held was lower than expected. The number of nursing staff reached was high, although as defined in the study protocol, core nursing teams continuously participating in all components of the intervention were not established throughout the study. An analysis of the delivery of the intervention showed a reduction in the frequency of dementia-specific case conferences and deviations in the process structure and role structure of WELCOME-IdA. The strategy used to facilitate the implementation of WELCOME-IdA was mostly followed. An analysis of the recruitment of residents indicated that the variation in which residents were included in the study sample was high and that the intended sample size required to achieve a power >80% was not reached. CONCLUSION: An analysis of the process evaluation data indicated that there were inaccuracies in the implementation of WELCOME-IdA and there were methodological limitations within the design of the effectiveness trial, both of which could explain the lack of effectiveness of WELCOME-IdA. To optimise the process structure of WELCOME-IdA, an assessment of BPSD and a pre-selection of possible domains for the behavioural analysis could be conducted prior to a dementia-specific case conference. TRIAL REGISTRATION: ISRCTN20203855 . Registered on 10 July 2013.

[The child and parent hospitalised in intensive care]. / L'enfant et son parent hospitalisé en réanimation.

Intensive care units are places which generate anxiety and stress, hospitalisations in these sectors often being sudden and a result of unexpected events. Furthermore, the family dynamics are often affected. This observation led to the creation of a surgical intensive care project at Caen university hospital, financed by the Fondation de France, which aims to ensure the parent-child bond is maintained.

Acolhimento com classificação de risco da demanda espontânea: as necessidades de aprendizagem de enfermeiros da atenção primária à saúde / Host classification of the spontaneous demand risk: the learning needs of nurses from primary health care

Objetivo: identificar as necessidades de aprendizagem sobre o acolhimento com classificação de risco da demanda espontânea na Atenção Primária à Saúde. Método: estudo descritivo com abordagem qualitativa; coleta de dados realizada entre junho a agosto de 2017, com 15 enfermeiros da Atenção Primária à Saúde e que participam de Núcleo de Educação Permanente e Humanização no interior do Estado de São Paulo. Resultados: os resultados foram organizados em categorias resultantes da análise de conteúdo, que são as seguintes: Entre a demanda de implantação do protocolo e a ausência de conhecimento teórico e prático; As incompreensões sobre a inserção do ACCR na Atenção Primaria à Saúde nas Redes de Atenção à Saúde; Entre a agenda do ACCR e os encaminhamentos: o que fazer?; Da obstinação ao modelo curativista às possibilidades do ACCR da demanda espontânea no SUS; A (in)compreensão das necessidades de saúde dos usuários e os possíveis preconceitos da equipe; e A necessidade da Educação Permanente em Saúde para o fortalecimento do ACCR. Assim, 80% nunca utilizaram o protocolo de Manchester; entre as necessidades de aprendizagem estão o conhecimento teórico-prático da clínica, em como articular as ações programáticas e as vulnerabilidades sociais com o atendimento da demanda espontânea, e como superar o modelo médico-centrado. Conclusão: o reconhecimento das limitações para implementação do protocolo, requer a sistematização de processo de educação permanente em saúde para problematizar a realidade da unidade de saúde e proporcionar a capacitação aos enfermeiros que são os responsáveis legais pelo protocolo de Manchester

Objective: to identify learning needs about the host with spontaneous demand risk classification in Primary Health Care. Method: descriptive study with a qualitative approach; data collection between June and August of 2017, with 15 primary health care nurses participating in the Permanent Education and Humanization Center in the interior of the State of São Paulo. Results: the results were organized into categories resulting from content analysis, which are as follows: Between the demand for implementation of the protocol and the lack of theoretical and practical knowledge; The misunderstandings about the insertion of the ACCR in the Primary Attention to Health in the Networks of Attention to Health; Between the ACCR agenda and referrals: what to do ?; From the obstinacy of the curative model to the possibilities of the CCR of spontaneous demand in the SUS; The (in) understanding of the health needs of users and the possible prejudices of the team; and The need for continuing education in health to strengthen the CRA. Thus, 80% never used the Manchester protocol; among the learning needs are the theoretical-practical knowledge of the clinic, how to articulate programmatic actions and social vulnerabilities with the attendance of spontaneous demand, and how to overcome the medicocentered model. Conclusion: the recognition of the limitations for the implementation of the protocol requires the systematization of a permanent health education process to problematize the reality of the health unit and provide training to nurses who are legally responsible for the Manchester protocol

Features of a Mobile Support App for Patients With Chronic Obstructive Pulmonary Disease: Literature Review and Current Applications.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a serious long-term lung disease in which the airflow from the lungs is progressively reduced. By 2030, COPD will become the third cause of mortality and seventh cause of morbidity worldwide. With advances in technology and mobile communications, significant progress in the mobile health (mHealth) sector has been recently observed. Mobile phones with app capabilities (smartphones) are now considered as potential media for the self-management of certain types of diseases such as asthma, cancer, COPD, or cardiovascular diseases. While many mobile apps for patients with COPD are currently found on the market, there is little published material on the effectiveness of most of them, their features, and their adoption in health care settings. OBJECTIVES: The aim of this study was to search the literature for current systems related to COPD and identify any missing links and studies that were carried out to evaluate the effectiveness of COPD mobile apps. In addition, we reviewed existing mHealth apps from different stores in order to identify features that can be considered in the initial design of a COPD support tool to improve health care services and patient outcomes. METHODS: In total, 206 articles related to COPD management systems were identified from different databases. Irrelevant materials and duplicates were excluded. Of those, 38 articles were reviewed to extract important features. We identified 214 apps from online stores. Following exclusion of irrelevant apps, 48 were selected and 20 of them were downloaded to review some of their common features. RESULTS: Our review found that out of the 20 apps downloaded, 13 (65%, 13/20) had an education section, 5 (25%, 5/20) consisted of medication and guidelines, 6 (30%, 6/20) included a calendar or diary and other features such as reminders or symptom tracking. There was little published material on the effectiveness of the identified COPD apps. Features such as (1) a social networking tool; (2) personalized education; (3) feedback; (4) e-coaching; and (5) psychological motivation to enhance behavioral change were found to be missing in many of the downloaded apps. CONCLUSIONS: This paper summarizes the features of a COPD patient-support mobile app that can be taken into consideration for the initial design of an integrated care system to encourage the self-management of their condition at home.

Treating liver fat and serum triglyceride levels in NAFLD, effects of PNPLA3 and TM6SF2 genotypes: Results from the WELCOME trial.

BACKGROUND & AIMS: Genetic variation in both patatin-like phospholipase domain-containing protein-3 (PNPLA3) (I148M) and the transmembrane 6 superfamily member 2 protein (TM6SF2) (E167K) influences severity of liver disease, and serum triglyceride concentrations in non-alcoholic fatty liver disease (NAFLD), but whether either genotype influences the responses to treatments is uncertain. METHODS: One hundred three patients with NAFLD were randomised to omega-3 fatty acids (DHA+EPA) or placebo for 15-18months in a double blind placebo controlled trial. Erythrocyte enrichment with DHA and EPA was measured by gas chromatography. PNPLA3 and TM6SF2 genotypes were measured by PCR technologies. Multivariable linear regression and analysis of covariance were undertaken to test the effect of genotypes on omega-3 fatty acid enrichment, end of study liver fat percentage and serum triglyceride concentrations. All models were adjusted for baseline measurements of each respective outcome. RESULTS: Fifty-five men and 40 women (Genotypes PNPLA3 I148M, 148I/I=41, 148I/M=43, 148M/M=11; TM6SF2 E167K 167E/E=78, 167E/K+167K/K=17 participants) (mean ± SD age, 51 ± 11 years) completed the trial. Adjusting for baseline measurement, measured covariates and confounders, PNPLA3 148M/M variant was independently associated with percentage of DHA enrichment (B coefficient -1.02 (95% CI -1.97, -0.07), p=0.036) but not percentage of EPA enrichment (B coefficient -0.31 (95% CI -1.38, 0.75), p=0.56). This genotype was also independently associated with end of study liver fat percentage (B coefficient 9.5 (95% CI 2.53, 16.39), p=0.008), but not end of study triglyceride concentration (B coefficient -0.11 (95% CI -0.64, 0.42), p=0.68). CONCLUSIONS: PNPLA3 148M/M variant influences the changes in liver fat and DHA tissue enrichment during the trial but not the change in serum triglyceride concentration.

Importância do acolhimento humanizado às mães na visita ao filho em uma Unidade de Terapia Intensiva Neonatal: relato de experiência / Importance of humanized welcome to the mothers when visiting the child in a Neonatal Intensive Care Unit: experience report / Importancia de la acogida humanizada a las madres en la visita del hijo a una Unidad de Cuidados Intensivos Neonatal: informe experiencia

Objetivo: descrever a vivência de uma graduanda de enfermagem durante as atividades realizadas no estágio na UTI Neonatal (UTIN) do Hospital Geral Clériston Andrade. Método: Estudo descritivo e observacional realizado durante as atividades práticas da enfermeiranda, no período de novembro/2013 a abril/2014, ressaltando a importância do acolhimento humanizado às mães na visita ao filho em uma UTIN através de ações de cunho educativo e sensibilizador a fim de incentivá-las a fazer parte do processo de cuidar dos seus filhos neste local. Resultados: as ações realizadas permitiram que as mães e os profissionais participassem da atividade para que cada um entendesse a sua importância na saúde do bebê. Conclusão: diante das ações apresentadas, percebeu-se o entendimento das mães como parte integrante na recuperação do filho e permitiu que os profissionais fossem instigados a ter um novo olhar a respeito do tema.(AU)

Objective: to describe the experience of a nursing graduate student during activities performed on internship at the Neonatal Intensive Care Unit (NICU) of the Hospital Geral Clériston Andrade. Method: this is a descriptive observational study conducted during the practical activities of that nursing student from November/2013 to April/2014 emphasizing the importance of humanized welcome to mothers when visiting the child in a NICU through educational and sensitizing actions, in order to encourage them to take part in the care process of their children in that unit. Results: the actions performed have allowed mothers and professionals to participate in the activity, allowing each to understand their importance for the baby's health. Conclusion: in face of the presented actions, we perceived understanding of mothers as components of the recovery of the child and this allowed professionals to be instigated to have a new look on the subject.(AU)

Objetivo: describir la experiencia de una graduanda de enfermería durante las actividades realizadas en la pasantía en UTI Neonatal (UTIN) del Hospital General Clériston Andrade. Método: Estudio descriptivo y observacional realizado durante las actividades prácticas de enfermera, en el período de noviembre/2013 a abril/2014, resaltando la importancia de la acogida humanizada a las madres en la visita al hijo en una UTIN a través de acciones educativas y sensibilizadoras a fin de incentivarlas a hacer parte del proceso de cuidar de sus hijos en este local. Resultados: las acciones realizadas permitieron que las madres y los profesionales participen de la actividad para que cada uno entendiese su importancia en la salud del bebe. Conclusión: frente a las acciones presentadas, se nota el entendimiento de las madres como parte integrante en la recuperación del hijo y permitió que los profesionales fuesen instigados a tener una nueva visión del tema.(AU)