no / Personalised Nutrition allows individual variation in dietary, lifestyle, anthropometric, phenotypic and/or genomic information to be considered when giving dietary advice. Compared to ‘generic’ dietary health messages, personalised dietary advice has been shown more likely to result in healthy dietary change. Personalised regimes can help clients in this endeavour by putting them in control and taking into consideration individual propensity for behaviour change, motives for food choice as well as social and lifestyle factors impacting upon the eating context. Provision of personalised nutrition services across Europe should consider inter-country differences in perceived barriers to uptake of personalised nutrition including those associated with the process from the collecting of information and taking of biological samples through to how the results are interpreted and delivered. Irrespective of European country, potential consumers appear to trust health professionals such as dietitians over commercial agents to provide personalised nutrition. Dieticians, therefore, are likely to play a key role in making personalised nutrition happen in the future. Organisations representing nutrition and dietetics professionals will need to be consulted for guidance on how to address the ethical and legal issues around personalised nutrition and regulate practice. A future is envisaged where commercial personalised nutrition will work with existing health providers in bringing the benefits of personalised nutrition to the wider public. / The full text is unavailable in the repository due to copyright restrictions.

No / Regulatory bodies governing health professions and professional education set clear expectations regarding fitness to practise. Within the UK, the Equality Act, 2010, poses a challenge to regulators, educators and employers to ensure that people are not excluded on the basis of disability and to facilitate inclusion. This research took a mixed methods approach to exploring the tensions between Higher Education providers and placement providers in the health sector. Disabled and nondisabled students and health professionals engaged in semistructured interviews and a survey in order to explore their beliefs and experiences. The findings suggest that applying equality legislation within health settings may be particularly difficult and that ¿disability¿ is an ambiguous and multifaceted concept. Whilst small in scale, the findings have given a voice to a professional group who are underrepresented in research and have raised a number of important issues that merit discussion and further scrutiny.

Yes / The use of problem-based learning (PBL) in Health Professional curricula is becoming more wide spread. Although the way in which the tutor facilitates PBL can have a major impact on students’ learning (Andrews and Jones 1996), the literature provides little consistency as to how the tutor can effectively facilitate PBL ( Haith-Cooper 2000 ). It is therefore important to examine the facilitation role to promote effective learning through the use of PBL. This article is the first of two parts exploring a study that was undertaken to investigate tutors’ experiences of facilitating PBL. This part focuses on the methodology and the combining of innovative processes with traditional philosophical traditions to develop a systematic educational research methodology. The study was undertaken respecting the philosophy of hermeneutic phenomenology but utilised alternative data collection and analysis technique. Video conferencing and e-mail were used in conjunction with more traditional processes to access a worldwide sample. This paper explores some of the issues that arose when undertaking such a study. The second article then focuses on exploring the findings of the study and their implications for the facilitation of PBL.

Yes / The profile of an effective facilitator has been likened to that of a saint, unfazed by ambiguity, undaunted by student irritation or personal frustration (Katz 1995, p 52). With the increasing popularity of using problem-based learning (PBL) within health professional curricula, it could be argued that the health lecturer’s role in education is changing. As a lecturer, I have only recently become involved in using PBL. With increasing exposure to the process and through reviewing the literature, I have come to realise that the role of the lecturer is fraught with difficulty. The literature is often conflicting with PBL meaning different things to different people (Barrows 1986). It provides no consistent guidelines as to how the lecturer should adapt to undertake this new role. This article explores the issues around the role of the lecturer within PBL and through reviewing the literature, investigates the level of intervention the lecturer should provide when students are undertaking the PBL process. Suggestions will be made to ‘facilitate’ the lecturer into facilitating an effective teaching strategy.

Yes / Allied Health Professionals (AHPs) have the capacity to promote healthy behaviours in young children through routine ‘contact points’, as well as structured weight management programmes. This scoping review aims to evaluate the impact of AHPs in the prevention of obesity in young children. Methods: Databases were searched for relevant evidence between 1st January 2000 and 17th January 2022. Eligibility criteria included primary evidence (including, but not limited to; randomised controlled trials, observational studies, service evaluations) evaluating the impact of AHPs on the primary and secondary prevention of obesity in young children (mean age under five years old). Results: AHP related interventions typically demonstrated improvements in outcomes such as nutritional behaviour (e.g., lower sweetened drink intake), with some reductions in screen time. However, changes in weight outcomes (e.g., Body Mass Index (BMI) z score, BMI) in response to an AHP intervention were inconsistent. There was insufficient data to determine moderating effects, however tentative evidence suggests that those with a lower socioeconomic status or living in an underprivileged area may be more likely to lose weight following an AHP intervention. There was no evidence identified evaluating how AHPs use routine ‘contact points’ in the prevention of obesity in young children. Conclusion: AHP interventions could be effective in optimising weight and nutritional outcomes in young children. However, more research is required to determine how routine AHP contact points, across the range of professional groups may be used in the prevention of obesity in young children.

Mental health has issues globally and Sweden is one of the countries where this phenomenon occurs. In light of the swedish psychiatric reform and regarding to contemporary psychiatry this study has the purpose of examine the perspective in recovery process by healthcare professionals in this field. The theoretical tools for this are based on concepts by Tor Wennerberg and Jaakko Seikkula. The methodological tools are inspired by phenomenology and hermeneutics and the approach is qualitative interviews with healthcare professionals from the swedish psychiatric field. The results show that the operations partly has weight and structural issues. Long-term direction, social factors, follow-ups and work with relatives is an important factor in recovery process. Pharmaceuticals is used for large scale and this is a dilemma though it can be a supportive role in psychiatric treatment and recovery process. Conclusions is that outpatient swedish psychiatry field may have adversials in regard to the goals and purpose of the psychiatric reform twenty years ago. Further conclusion is that inter- and intrapersonal balance of autonomy versus dependence is a complex phenomena by reason of not necessarily being affected by if whether liberty and self-determination occurs or not. Another is that the patient initiative of discharge has some interesting aspects in regard to recovery process. Long-term perspective, an alliance and group-based solidarity based on some of the theoretical concepts is important in regard to recovery process. The last three factors show some interesting perspectives in regard to information and time. In regard to the limited materials of this study it is hard to draw any concrete conclusions about what long-term directions the swedish authorities can take to conduct good psychiatric care achieving a lower rate of mental illness but the field may have lack of a nuanced definition of not just recovery but recovery process and what it can contain.

This is a study of several contentious issues in Canadian health policy involving the interaction of public and private payers and for-profit (FP) and not-for-profit (NFP) providers; the influence of health professionals on market structure; and the role of foreign investment. A case study was used, the Ontario physiotherapy market in 2003-2005, with its complex mix of payers and providers and foreign investment opportunities. Key market features were: fragmented but substantial payer influence, effective though uncoordinated cost control across payers, constrained labour supply, and fragmented patient referral sources. These features increased the complexity of providers’ interactions with patients and payers, reducing standardization and therefore favouring local, professional-owned small business FP providers (FP/s) for ambulatory care. NFP Hospitals’ market share declined. The findings generally confirmed expected behavioural differences between FP and NFP providers but expected differences between investor-owned FP providers (FP/c) and FP/s providers were not generally found. FP/s dominated the market, and FP/c providers appeared to mimic FP/s market behaviours, competing in local sub-markets. With no single or dominant payer, cost control difficulties were expected, but all 11 payer categories (public and private) used various cost control mechanisms, resulting in significant collective but uncoordinated influence. Generally, no payer alone supported a provider’s operations. The dominant labour suppliers, regulated physiotherapists, were scarce and exerted significant pressure, affecting market structure by asserting individual preferences and professional interests. FP/s dominance resulted, supported by the traditional patient referral source, physicians in small practices. Very little foreign investment was found despite little protection for domestic providers under NAFTA. In sum, this study showed FP and NFP provider stereotypes are subject to payer pressure: FP/c organizations can adapt by mimicking FP/s, and payers can modify NFPs’ assumed community orientation. Labour shortages and historical referral patterns can make individual professionals and their preferences more influential than their collective profession without diminishing the importance of professional interests. The degree and structure of payer control can make a market unattractive to foreign investors. Finally, this market – neither a planned or standard market – had a service provision pattern more broadly influenced by professionalism and practitioner interests than policies or prices.

This study examines the impact of the transition from diploma to degree on the initial education and training of three para-professions in England; chiropody, occupational therapy (OT) and radiography. It focuses on the nature of and reasons for changes to their initial professional education and training and the potential impact of these changes on their professionalisation. The study adopted a multiple method approach; a historical review, which included documentary sources and interviews with key informants, aimed at identifying how and why these three para-professions wanted to achieve all-graduate entry, and the use of case studies to explore the differences between the diploma and degree courses. It is concluded that the achievement of all-graduate entry for these para-professions was an unintended consequence of the policies of the then government. As a result of the achievement of all-graduate entry changes were made to the respective diploma courses of these para-professions. The extent of these changes were related to the level of control and influence that the professional bodies exercised over the diploma courses. All the degree courses shared the following features: the development of autonomous, reflective practitioners who are life-long learners, an emphasis on theory rather than practice, and emphasis on propositional knowledge and the study of research methods. Although the degree courses for these para-professions achieved approval from HEIs it is argued that degree education is a contested concept. It is apparent that the para-professionals believed that the achievement of all-graduate entry would improve their professional status. However, it is evident from the study findings that it served to maintain rather than enhance their social status and market position. Changes to the initial education and training of these para-professionals were the results of the para-professionals having to respond to prevailing social, political and economic circumstances. If they had not taken this action it is suggested that their social status and market position may have been adversely affected.

Bakgrund: Cytostatikabehandling är vanligt inslag vid behandling av bröstcancer och kan medföra en lång tid av kämpande mot både sjukdomen, behandlingen och andra svåra upplevelser. Cytostatikabehandling är förknippat med exempelvis diverse biverkningar som kan påverka bröstcancer patienterna. Syfte: Att undersöka underlättande hjälpmedel, som inte inkluderar materiella saker som proteser, kryckor och rullstolar, utan andra medel som vården kan bidra med för att skapa en mera positivare upplevelse av behandlingen samt att undersöka de psykiska upplevelser hos kvinnor med bröstcancer som genomgått cytostatikabehandling. Ett annat syfte var att ta reda på hur kvinnans syn på livet, alltså livskvalitén, påverkas. Metod: Litteraturstudie med hjälp av systematiska översikter, kvalitativa- och kvantitativa artiklar. Resultat:Olika hjälpmedel som hälso- och sjukvården kan implementera eller använda i större utsträckning för att hjälpa bröstcancer patienterna vid cytostatikabehandlingen. Mycket tyngd ligger på fysisk, psykiskt och socialt stöd, utbildning för personal- och patienter och information från hälso- och sjukvårdens sida. Denna studie visar dessutom att kvinnorna genomgår fyra faser under cytostatikabehandlingen i och med det får hälso- och sjukvården får en ökad förståelse om den psykologiska processen och kan hjälp lättare erbjudas. Psykiska upplevelser är starkt kopplat till uppkomna biverkningar och det finns kompletterande behandlingar som exempelvis guidade bildspråk, vilket underlättade upplevelsen av cytostatikabehandlingen. Att livskvalitén förändras är i de flesta fall relaterat till själva behandlingen och negativa biverkningar som uppkommer exempelvis ångest, depression och en allmän känsla av att vara mindre nöjd med sitt liv. Genom användande av olika behandlingsalternativ och kritiska åtgärdsstrategier kan biverkningarna reduceras och livskvalitén förbättras. Slutsats: Hälso- och sjukvårdpersonalen kan genom förbättrade insatser hjälpa bröstcancer patienterna under behandlingsperioden. / Introduction: Chemotherapy is a common element in the treatment of breast cancer and can lead to a long period of struggling against the disease, the treatment and other difficult experiences. Chemotherapy is also associated with, for example, various side effects that can affect the breast cancer patients. Purpose: To investigate tools, that doesn’t include material things such as prostheses, crutches or wheelchairs, other average that can contribute to creating a more positive experience of the treatment and to investigate the physical experiences of women with breast cancer undergoing chemotherapy. Another aim was to find out how the women feels about their lives, their quality of life, is being affected. Method: Literature study using systematic reviews, qualitative- and quantitative articles. Results: Different tools that healthcare can implement or use in a greater extent during the chemotherapy treatment to help the patients. Much emphasis is on physical, psychological and social support, training for staff and patients and information from the health care side. This study also shows that women undergoes four phases during chemotherapy and this leads to that health care gets a better understanding of the psychological process and can much easier offer assistance.Physical experiences are strongly linked to the side effects and there are complementary therapies such as guided imagery, which reduced the experience of chemotherapy. The quality of life changes are in most cases related to the treatment and adverse side effects that arise such as anxiety, depression and a general feeling of being less satisfied with their lives. By using different treatments and critical intervention strategies, the side effects can be reduced and the quality of life improves. Conclusion: The healthcare staff can through different enhanced efforts help breast cancer patients during the treatment period.

Summary: The subject of this paper is providing of lege artis health care in the system of public health insurance. The aim of the thesis is to analyse the basic terminology, current legislation and its application in practice. Lex artis is in law an uncertain term, difficult to define, therefore its frequent usage should be restricted in the future. Due to the personal experience of the author there are many practical examples from the Czech health care system used in the paper. Related case law is taken into account continuously with the exception of the separately stated recent court judgment of the Constitutional Court of the Czech Republic. The study is divided into four main chapters, introduction and conclusion. The first chapter is dedicated to the concept of lege artis in detail, its terminology and relation to the current legislation. Further subchapters deal with available health care standards and their obligation. The final parts analyze the lege artis restrictions and way of its assessment. The second chapter is dedicated to the concept of public health insurance. First, the term is defined and the current law is considered. The following parts examine the issue of health insurance companies and the network of health care facilities. Chapter three presents the labor law aspects of lege artis...