Purpose To assess patient satisfaction with the use of Portable Video Media (PVM) for the purpose of taking informed consent for common urological outpatient procedures performed under local anaesthesia. Methods Patients undergoing the following procedures were approached for recruitment: flexible cystoscopy with or without biopsy, transrectal ultrasound-guided prostate biopsy or flexible cystoscopy with insertion or removal of a ureteric stent. Audio-visual media were developed for each procedure, with each script translated from English into isiXhosa and Afrikaans. The study involved a cross-over for each patient between Standard Verbal Consent (SVC) and PVM consent, with each patient randomised to start with SVC or PVM consent. Each of these consent-arms were assessed via a questionnaire. Results 60 patients completed participation, with PVM as the first exposure for 28 patients and 32 patients receiving SVC as their first arm of the study. When comparing the overall satisfaction between SVC and PVM consent (the total scores out of 18 for the questionnaire), patients scored significantly higher for PVM consent (M = 16.3 ± 2.4) compared to SVC (M = 15.4 ± 2.9) (p = 0.002). 92% of the total patient sample preferred PVM consent. Conclusion PVM proved superior to SVC in improving satisfaction in the consent process for common outpatient urological procedures performed under local anaesthesia.

Although many people choose to sign consent forms and participate in research, how many thoroughly read a consent form before signing it? Across 3 experiments using 348 undergraduate student participants, we examined whether personality characteristics as well as consent form content, format, and delivery method were related to thorough reading. Students repeatedly failed to read the consent forms, although small effects were found favoring electronic delivery methods and traditional format forms. Potential explanations are discussed and include participant apathy, participants trying to save time by not reading the consent form, and participant assumptions about consent forms.

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Trauma-informed care (TIC) incorporates evidence about the prevalence and impact of early trauma on behavior across the lifespan. TIC is a person-centered response that focuses on improving client functioning by viewing and responding to maladaptive behavior in the context of traumatic experiences. TIC is grounded in the Adverse Childhood Experiences (ACE) study, a collaborative research project between the Centers for Disease Control and Prevention and Kaiser Permanente (Centers for Disease Control and Prevention, 2013a). The ACE study began in 1997 to collect information (n=17,337) via a 10-item survey about adverse childhood experiences related to abuse (emotional, physical, and sexual), neglect (emotional and physical), and household dysfunction (domestic violence, divorce, death of a parent, or the presence of a substance-abusing, mentally ill, or incarcerated member in the household). The ACE score reflects the total number of adverse experiences endorsed by that individual. Dozens of publications analyzing ACE data have revealed staggering evidence of the pervasive and enduring nature of early trauma. Findings are clear and consistent, demonstrating that as the number of early adverse experiences increases, the risk for myriad health, mental health, and behavioral problems in adulthood also increases in a robust and cumulative fashion (Centers for Disease Control and Prevention, 2013b). For example, as ACE scores increase, so does the likelihood of alcohol and drug abuse, smoking, chronic obstructive pulmonary disease, depression, suicide attempts, fetal death, obesity, heart disease, liver disease, intimate partner violence, early initiation of sexual activity, multiple sexual partners, sexually transmitted diseases, and unintended pregnancies. Furthermore, childhood adversity is associated with adult criminality, including sexual offending; sex offenders report significantly higher ACE scores than the general population (Reavis, Looman, Franco, & Rojas, 2013). Reavis et al. (2013) opined that it is therefore unsurprising that offense-specific models of sex offender treatment have produced mixed results in terms of effectiveness, and suggested that treatment programs should more strongly emphasize the role of early trauma on self-regulation and attachment. This 90-minute workshop will first provide an overview of the principles of trauma informed care. Participants will learn about the various ways that early trauma lays the groundwork for a range of interpersonal problems and maladaptive coping skills stemming from longstanding relational deficits and distorted cognitive schema about oneself and others. Then, workshop participants will learn to incorporate an interpersonal process approach to sex offender treatment, which combines elements of developmental, family systems, and cognitive models to conceptualize adult client behavior in the context of childhood trauma (Teyber & McClure, 2011). Participants will learn how to establish a nonthreatening sex offender treatment environment that facilitates trust, emotional safety, and intimacy. Participants will learn to utilize immediacy interventions to create corrective experiences; when clinicians respond effectively to relational themes and patterns as they present themselves in individual and group therapy, client skills can be enhanced, practiced, and reinforced. This workshop will reflect the conference theme of "Shouldering Responsibility: Making Society Safer" by introducing an innovative model and framework for promoting change. TIC recognizes the role of traumatic events in the development of high-risk behavior and values the subjectivity of trauma as a central function in the healing process. By exploring and understanding maladaptive and abusive behavior through the lens of early trauma, clinicians can help sex offender clients learn and generalize new skills, enhance their interpersonal relationships, and improve their general well-being (Teyber & McClure, 2011). This type of personal growth would be expected to mitigate future potential to reoffend as the client incorporates more healthy and successful strategies for relating to others and meeting emotional needs.

Fostering a Trauma Informed Mindset in the Criminal Justice System Lauren Ledford, Mary Jo Oliver M.S., Meredith Jordan, Chloe Salyer, Adam Walker, Andrea D. Clements Ph.D. The presence of early childhood adversity and trauma is disproportionately high in individuals involved with the criminal justice system compared to the non-criminally involved population. Childhood adversity and trauma is consistently linked to many adverse lifelong outcomes such as increased mortality, increased risk of mental illness, and increased risk of substance use disorder. In order to respond to this increased risk, empathy and community-wide interventions have emerged as effective means of responding and resisting re-traumatization. Community and empathy-based training of law enforcement officials may assist in understanding trauma and combatting its effects as they are often some of the first people to come in contact with individuals experiencing the effects of childhood adversity and trauma. This study sought to evaluate the effectiveness of Trauma-Informed Care (TIC) training for police officers in their ability to have knowledge of, believe to be relevant, understand, feel confident implementing, and apply TIC principles. We hypothesized knowledge, relevance, understanding, implementation confidence, and application of TIC would all increase from pre-assessment to post-assessment. As part of an initiative to increase TIC awareness and implementation, 64 police officers participated in a one-day training that began with a pre-survey and ended with a post-survey. Both surveys contained measures concerning TIC knowledge, relevance, understanding, implementation confidence, and application. The post survey also included an additional measure regarding training quality satisfaction. The sample consisted primarily of White (N = 44), middle-aged males (M = 42.27, SD = 8.588). There was a significant difference between TIC knowledge t(56) = -4.593, p<.001, d = 1.096, TIC relevance t(56) = -2.488, p = .016, d = .912, TIC understanding t(56) = -8.611, p <.001, d = 2.932, and implementation confidence t(56)= -5.942, p <.001, d = 1.326 from the pre to post assessment. However, there was not a significant difference between TIC application t(56) = -1.826, p = .073, d = .585 from pre to post assessment. The consistently significant increase in TIC scores indicate that a TIC training is an effective means of improving officer perception of trauma and willingness to implement TIC practices.

Ziele: Das Ziel der vorliegenden Arbeit ist eine standardisierte Analyse der Patientenzufriedenheit mit dem Aufklärungsgespräch und die mögliche Einflussfaktoren, die hier eine Rolle spielen können, zu bieten. Methodik: Es wurden 189 Fragebögen bzw. Aufklärungsgespräche in den Kliniken für Anästhesie und Innere Medizin im St. Josef Krankenhaus und Chirurgie und Kinder- und Jugendpsychiatrie im Leopoldina Krankenhaus in Schweinfurt untersucht. Ergebnisse: Der Fragebogen, der verwendet wurde, war reliabel. Es zeigte sich eine schlechte Item-Selektivität. Die Kriteriumsvalidität konnte bestätigt werden jedoch nicht die diskriminante Validität. Die Patienten waren zufriedener mit Ärzten, die Deutsch als Muttersprache angaben, mit längeren Aufklärungsgesprächen und mit Fachärzten im Vergleich zu Assistenzärzten. Eine höhere allgemeine Lebenszufriedenheit war mit höherer Patientenzufriedenheit mit dem Aufklärungsgespräch assoziiert. Der moralistische Bias kann einen Störfaktor der Validität der Messungen darstellen. Zusammenfassung: Eine angemessene Gesprächdauer, die deutsche Muttersprache und der Facharztstatus des aufklärenden Arztes haben einen positiven Einfluss auf die Patientenzufriedenheit mit dem Aufklärungsgespräch. Um sicher zu stellen, welche von diesen drei Faktoren besondere Wichtigkeit besitzt, werden weitere Untersuchungen benötigt. / Objective: The aim of the present study is to provide a standardized analysis of patient satisfaction with informed consent process and the possible influencing factors that can play a role here. Methoden: 189 questionnaires/informed consent were examined in the clinics for anesthesia and internal medicine in St. Josef Hospital and surgery and child and adolescent psychiatry in Leopoldina Hospital in Schweinfurt. Results: The questionnaire used was reliable. There was poor item selectivity. The criterion validity was confirmed but not the discriminant validity. Patients were more satisfied with doctors who spoke German as their native language, with longer duration oft the informed consent process and with specialists compared to assistant doctors. Higher general life satisfaction was associated with higher patient satisfaction. The moralistic bias can represent a confounding factor in the validity of the measurements. Conclusion: An appropriate duration of the conversation, the German native language and the doctor's specialist status have a positive influence on patient satisfaction with informed consent process. Further research is needed to determine which of these three factors is particularly important.

This dissertation explores Trauma-Informed Care (TIC) from the perspective of school-based occupational therapists (SB-OTs) to support students who may be negatively affected by adverse childhood experiences (ACEs). TIC focuses on creating an interpersonal culture of safety and respect and is becoming more well known in healthcare and education. Using the Nominal Group Technique (NGT), experienced SB-OTs from across the US participated in focus groups to identify priorities for delivery of TIC in school-based practice. Additionally, the 5 NGT focus groups (n=24) identified facilitators and barriers to effective TIC in schools. Drawing from these findings, the Pediatric Remediation Outcomes: Trauma-Informed Principles (PRO-TIP) program is proposed. PRO-TIP centers on refining fine motor skills through school-based occupations, guided by occupational therapy (OT) theory, and caters to educators and SB-OTs. The program is designed to support students, educators, SB-OTs, and improve the wider workplace culture. By offering fundamental priorities on TIC aspects, this dissertation serves as a valuable resource for entry-level occupational therapists (OTs), researchers, school staff, and administrators seeking to embrace a trauma-informed approach. The framework for the PRO-TIP program emerges as a practical, evidence-based tool designed to be further developed and piloted in elementary-school settings. With original research and a novel program design, this dissertation began with the end in mind: to help young, misunderstood learners with trauma related behaviors change their life trajectory for the better. / Temple University. College of Public Health / Health and Rehabilitation Sciences

In this groundbreaking Master's thesis, Rameesha Qazi explores the critical realm of survivor care policies and toolkits within the NGO space, driven by her own experience of sexual violence during my work abroad. Rooted in a survivor-centered and trauma-informed framework, my analysis encompasses an evaluation of policies from organizations and essential toolkits, revealing striking gaps in addressing systemic barriers, recognizing trauma's nuanced impact, and supporting diverse coping strategies. A unique contribution to the field and in recognizing contextual variations in survivor needs, I introduce a country guide as a practical tool for NGOs to enhance their survivor care policies, providing a roadmap for how to address gaps in support. Furthermore, extending the focus beyond policies, I scrutinize toolkits from prominent organizations and propose recommendations, emphasizing the crucial need to engage survivors, provide comprehensive support, and amplify survivor voices. The thesis not only underscores the urgency for trauma-informed, survivor-led approaches but also challenges prevailing norms in the development sector. It aims to reshape the discourse around sexual exploitation and abuse, advocating for tangible, sustainable change in policies and toolkits to ensure the safety, support, and empowerment of survivors within the NGO space. This research stands as a testament to the imperative role of survivor voices in shaping effective, adequate, and sustainable solutions for combating sexual violence within the development sector.