No / Purpose: The European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe. Methods: We undertook a mixed‐methods, situational analysis. This involved a purposeful literature search and two surveys: one to primary care clinicians and the other to a wider group of stakeholders across Europe. Results: The 10 papers identified all pointed out gaps or deficiencies in allergy care provision in primary care. The surveys also highlighted similar concerns, particularly in relation to concerns about lack of knowledge, skills, infrastructural weaknesses, reimbursement policies and communication with specialists as barriers to evidence‐based care. Almost all countries (92%) reported the availability of AIT. In spite of that, only 28% and 44% of the countries reported the availability of guidelines for primary care physicians and specialists, respectively. Agreed pathways between specialists and primary care physicians were reported as existing in 32%‐48% of countries. Reimbursement appeared to be an important barrier as AIT was only fully reimbursed in 32% of countries. Additionally, 44% of respondents considered accessibility to AIT and 36% stating patient costs were barriers. Conclusions: Successful working with primary care providers is essential to scaling‐up AIT provision in Europe, but to achieve this, the identified barriers must be overcome. Development of primary care interpretation of guidelines to aid patient selection, establishment of disease management pathways and collaboration with specialist groups are required as a matter of urgency.

The study of work-life balance, teleworking, and diversity, equity, inclusion, and accessibility are increasingly studied among scholars using different theoretical frameworks. However, no study examines work-life balance, teleworking, and diversity, equity, inclusion, and accessibility as needs in these contemporary times that, when met, lead to higher employee job satisfaction. Existing scholarship suggests that employee job satisfaction is a function of needs. However, with globalization, human needs have changed to include social justice concerns and the desire to have a more fulfilling family life. When organizations respond to these needs, it leads to employee job satisfaction, which ultimately improves organizational performance. This dissertation proposes a Contemporary Needs Theory of employee job satisfaction and contends that work-life balance, teleworking, and diversity, equity, inclusion, and accessibility (DEIA) are contemporary needs that influence employee job satisfaction. Just as physiological, safety, love, self-esteem, and self-actualization needs are important, so are efforts to meet needs that contribute to work-life balance, teleworking, and DEIA policies. Using the 2022 federal employee viewpoint survey data and multivariate regression analysis, the findings indicate that work-life balance, teleworking, and commitment to DEIA policies contribute to employee job satisfaction. The study's policy and management implications inform researchers and practitioners of the socio-demographic dimensions affecting federal employee job satisfaction, the need for the federal government to examine policies from a historical perspective, and more effective ways of managing organizations. The study recommends that policymakers constantly review their policies and evaluate the workplace for disparities, cultural changes, and policy effect on employee behavior.

Rapid changes in the drafting profession have left gaps in skills and resources which hinder the ability of community college drafting instructors to provide students with the advanced skills needed for employment. To minimize these problems and to facilitate the integration of CAD into drafting programs, local and state authorities must plan to allocate adequate resources to each program. They must also provide avenues for instructors to become proficient with CAD and to assess the instructor's perceptions about their needs. The purpose of this study was to identify areas of perceived need of community college drafting instructors in Virginia. A survey was mailed to 36 community college drafting instructors. For 14 categories of CAD skills, instructors were asked to indicate their (1) technical skill, (2) need for technical training, (3) level of CAD integration, (4) integration skill, and (5) need for integration training. The instructors were also asked to identify resource needs. The findings suggest that a high level of instruction exists in CAD categories related to traditional drafting tasks. Fewer instructors have ventured into the CAD categories related to design. Many of the instructors who have attempted to teach these categories feel uncertain about their technical skills and skills in integrating advanced CAD categories into their drafting curriculum. From the instructors' responses, it is concluded that a need for resources exists to help instructors to use and integrate CAD categories related to design and customization. / Ed. D.

Yes / Population ageing and fiscal austerity are set to increase the reliance on family carers, who already provide much of the support for people with long term health conditions. Although most carers are willing, providing care can be hugely stressful, affecting mental and physical health1 and resulting in social isolation and financial hardship.2 When under strain, carers are less likely to be effective, increasing the risk that the care recipient is admitted to hospital or a care home.3 Health systems could reduce strain on family carers by routinely considering carers’ needs alongside patients’ needs in everyday healthcare decisions—a concept we term “carer proofing”. / none

Yes / Provision of care and support for people with dementia and family carers is complex, given variation in how dementia manifests, progresses and affects people, co-morbidities associated with ageing, as well as individual preferences, needs, and circumstances. The traditional service-led approach, where individual needs are assessed against current service provision, has been recognised as unfit to meet such complexity. As a result, people with dementia and family members often fail to receive adequate support, with needs remaining unmet. Current research lacks a conceptual framework for explaining variation in satisfaction of care needs. This work develops a conceptual framework mapped onto the care delivery process to explain variations in whether, when and why care needs of people with dementia are met and to expose individual-, service-, system-level factors that enable or hinder needs satisfaction. METHODS: Data collected through 24 in-depth interviews and two focus groups (10 participants) with people with dementia and family carers living in the North East of England (UK) were analysed thematically to develop a typology of care needs. The need most frequently reported for people with dementia (i.e. for support to go out and about) was analysed using themes stemming from the conceptual framework which combined candidacy and discrepancy theories. RESULTS: The operationalisation of the framework showed that satisfaction of the need to go out was first determined at the point of service access, affected by issues about navigation, adjudication, permeability, users' resistance to offers, users' appearance, and systems-level operating conditions, and, subsequently, at the point of service use, when factors related to service structure and care process determined (dis)satisfaction with service and, hence, further contributed to met or unmet need. CONCLUSION: The conceptual framework pinpoints causes of variations in satisfaction of care needs which can be addressed when designing interventions and service improvements. / We gratefully acknowledge financial support from the Health Foundation (grant number 1274233).

Yes / We interviewed people with dementia and carers from the IDEAL cohort to find out how the COVID-19 lockdown and continuing restrictions affected those living with dementia. Some people with dementia coped well, while others coped with difficulty or were only just coping. The additional stress of COVID-19 exacerbated pre-existing coping difficulties. For many, social isolation increased anxiety. Some felt that lack of activity or lack of social contact caused a decline in their abilities to manage everyday tasks. Confusion about COVID-19 rules or difficulty remembering what to do led to anxiety when leaving the house. People felt that members of the public might not understand their particular needs. While some carers felt they were coping well, others experienced stress when having to leave the home because the person with dementia might not be safe if left alone. Some experienced increased strain in the caring relationship compounded by an uncertainty about future availability of respite. Some were concerned about the complex health needs of the person with dementia alongside COVID-19 risk and lack of personalised information. Both people with dementia and carers talked about the importance of access to safe outdoor space. People were anxious about how others would react or behave towards them regarding keeping a distance if they went out. Being connected to friends, family and wider community or support groups was important to help combat the effects of isolation. People from BAME communities worried about their increased vulnerability to the virus. A lack of trust in Government guidance and in health care services added to their anxiety. However, some benefitted from strong community and faith group involvement. What might be helpful for people with dementia? • Reablement to help regain or maintain skills • Personalised health advice regarding managing COVID-19 risk and the opportunity to ask questions. • Identification of people with dementia who live alone and an assessment of their needs. What might be helpful for carers? • Needs assessment in regard to respite. • Novel forms of respite care that incorporate social distancing. What might be helpful for both carers and people with dementia? • Access to COVID-safe outdoor spaces. • Continuation and expansion of ‘just checking’ services. • Support to get online and use the internet. • Communication and information through non-digital means. • Community COVID-19 ‘dementia awareness’ initiatives. What might be helpful for people from Black and minority ethnic groups? • Addressing concerns about their increased risk of COVID-19. • Directing information and support through existing community and faith groups. / This report presents independent research funded by the National Institute for Health Research Policy Research Unit in Older People and Frailty.

This study explored healthcare utilization among the Transgender and Gender Non-Binary (TGNB) population of Florida using Geographic Information Systems (GIS) to visualize and analyze the spatial distribution of unmet healthcare needs. The aim was to provide a clear comparison of unmet healthcare needs across various regions, highlight areas with the highest and lowest levels of unmet needs, and understand the demographic factors influencing these disparities. Utilizing survey data from the NIH-funded U=CARE study, which involved TGNB participants aged 18-26 from diverse racial/ethnic and socioeconomic backgrounds, the data were cleaned, geocoded, and analyzed within ArcGIS. Geocoded survey responses were linked to Florida Department of Transportation (FDOT) district boundaries. Choropleth maps were created to represent the percentage of respondents in each geographic unit reporting unmet healthcare needs, with color gradation indicating the intensity of these needs. Regional variations were found, with Northeast Florida and Northwest Florida showing the highest levels of unmet healthcare needs despite having the lowest participant counts, while Central Florida, which had the highest number of participants, also reported a substantial percentage of unmet healthcare needs. A demographic analysis indicated that younger participants, those with lower education levels, and individuals from diverse racial and ethnic backgrounds were more likely to report unmet healthcare needs. Districts with lower socioeconomic status (SES) showed higher levels of unmet needs, underscoring the critical role of socioeconomic factors in healthcare access. This study identifies specific regions and demographic groups with significant unmet healthcare needs, informing targeted healthcare interventions and policies. By integrating spatial and demographic analysis, it provides a comprehensive understanding of healthcare disparities among TGNB young adults in Florida, contributing valuable insights for improving health outcomes across diverse populations and addressing the specific healthcare challenges faced by this community.

This thesis focuses on service utilisation among children with mild ID and their families, their needs for support and their experiences of support. Aims The overall aim of the thesis was to explore and describe service utilisation patterns among families of children with mild ID from a systems perspective. Methods A cross-sectional, descriptive and comparative quantitative design was used to describe the extent of service utilisation among 84 children with mild ID and their families (paper I and II). The types and number of services utilised were investigated in relation to the child’s age, gender and school setting. Data concerning the services utilised were collected from the organisational records of social services and paediatric habilitation units. In paper III, a descriptive questionnaire design was used to describe the support needs of families of 38 children with mild ID. A confirmatory design was used to examine the relation between family needs for support and (a) parental self-efficacy and (b) parents’ control over services. A confirmatory design was also used to examine the relation between parents’ experiences of the helpfulness of the support and (a) parental self-efficacy and (b) parents’ control over services. In paper IV a longitudinal, comparative and confirmatory design was used to investigate whether social service utilisation patterns differ over time when children with mild ID in self-contained classes are compared with those integrated into mainstream classes (n=405). Results In total, 60% of the families utilised paediatric habilitation services, and 40% of the families used disability-related services provided by social services. The most commonly utilised services were services concerned support outside of the home, such as respite care and services to improve children’s participation in society. Approximately 25% of the families utilised social problems-related services provided by social services. The most commonly utilised services concerned those to support parents in their parenting roles and financial assistance. In contrast to older children, younger children were more likely to utilise paediatric habilitation services. Older children utilised a higher number of disability-related service types provided by social services. Few differences were found between males and females. The majority of families did not utilise such services that are provided by social services. It was rare for families to use both disability-related services and those that address social problems during the same year. Commonly reported family needs concerned information about what services are available for their child, their child's impairment, how to respond to their child's behaviour and how to teach their child skills. Other common needs included access to parent support networks, to find suitable leisure activities for the child, and more alone time for parents. In contrast to families with mothers who did not participate in paid work, families with mothers who were employed expressed a lower requirement for support such as counselling, contact with other parents of children with impairments, more friends and more alone time for parents. Similar results werefound for families with mothers with higher levels of education. Parents with higher levels of perceived self-efficacy reported a lower need for information, as did also parents with higher levels of control over services. Parents with higher levels of control over services experienced the support as being more helpful. Children with mild ID who attended self-contained classes were more likely to utilise paediatric habilitation services than children integrated in mainstream classes. The same pattern was found for utilisation of disability-related services provided by social services. Integrated children who changed school setting to attend self-contained classes were more likely to begin to utilise disability-related services in comparison with those children who continued to be integrated. The former also had a higher likelihood of increasing the number of disability-related service types utilised. Conclusions In addition to disability-related problems, families of children with mild ID may also be at a higher risk of experiencing social problems when compared with the general population. Furthermore, very few families utilised both disability-related services and services addressing social problems. This implies that collaboration flaws exist between those professionals concerned with child welfare services and those concerned with disability-related services. A strong predictor of service utilisation was the type of school setting: children attending self-contained classes had a higher rate of service utilisation than those attending mainstream classes. This indicates that service systems outside of school are designed to collaborate with groups of pupils in special classes rather than individual children in mainstream classes. The strong need for information by families indicates that an ecological framework should be used to identify those factors that affect information availability and effectiveness. To increase parents’ perceived level of control over services, HSO professionals need to work in a capacity building manner with the explicit goal to enhance parental self-efficacy.

In the field of inclusive education and children in need of special education, the access to the general curriculum plays a significant role. Methods mentioned in the curriculum display the pedagogical vision within specific school systems and furthermore how teachers are expected to practice. Comparing curriculums from nations with different school systems can put national education systems in a wider perspective. Although the curriculums were studied out of their contexts, some interesting findings were ascertained. The study, performed with hermeneutic textual analysis and based on a comparison of the national curriculum of England, Finland, New Zeeland and Sweden, shows a difference in both frequency of methods mentioned, the way they are presented as well as what kind of methods each curriculum proposes. The New Zealand curriculum provides a demonstration of using inclusive education for all pupils while the Swedish and the Finish curriculums propose special methods when educating children being in special needs. The English curriculum also aims for inclusive education, but without the wide frequency of methods found in the New Zealand curriculum.

Lietuvos integracija į Europos Sąjungą, nuolatinė aplinkos kaita lemia naujus iššūkius švietimo sistemai, o kartu ir pagrindiniams švietimo sistemos dalyviams – pedagogams, nuo kurių pasirengimo dirbti komandoje priklauso jaunosios kartos, turinčios specialiųjų ugdymo(si) poreikių gebėjimai ir ateitis. Darbo tikslas – atskleisti pedagogų ir specialistų, sudarančių gerovės komisiją, komandinio darbo ugdant specialiųjų poreikių moksleivius pagrindinėje mokykloje perspektyvas. Darbo uždaviniai: 1) Teoriškai pagrįsti pedagogų komandinio darbo organizavimo ypatumus pagrindinėje mokykloje. 2) Aptarti specialiųjų poreikių vaikų ugdymą komandinio darbo kontekste. 3) Atskleisti pedagogų ir specialistų, sudarančių vaiko gerovės komisiją, požiūrį į komandinį darbą ugdant specialiųjų poreikių moksleivius pagrindinėje mokykloje. 4) Įvardinti komandinio darbo organizavimui taikomus komandinio darbo modelius ugdant specialiųjų poreikių moksleivius pagrindinėje mokykloje. Baigiamąjį magistro darbą sudaro trys skyriai. Pirmame darbo skyriuje yra nagrinėjami komandinio darbo ugdant specialiųjų poreikių turinčius vaikus pagrindinėje mokykloje teoriniai aspektai, aptariamas specialiųjų poreikių vaikų ugdymas komandinio darbo kontekste. Antroje darbo dalyje parengta komandinio darbo ugdant specialiųjų poreikių turinčius vaikus pagrindinėje mokykloje tyrimo metodika. Trečiame darbo skyriuje, remiantis teorine darbo dalimi ir parengta tyrimo metodologija atliktas komandinio darbo ugdant... [toliau žr. visą tekstą] / Lithuania 's integration into the European Union, a permanent change in the environment leads to new challenges in the education system , and thus the basic education system - the teachers, from a pre-work as a team depends on the young generation with special education (learning) skills needs and future. The aim - to expose teachers and professionals as well commission teamwork educating special needs students’ in the main school prospects. The tasks: 1 ) In theory, based on teachers' teamwork specific organization of basic school. 2 ) Discuss the education of children with special needs in the context of teamwork. 3 ) Reveal educators and professionals as well commission teamwork attitude educating special needs students’in the basic school. 4 ) Identify the organization applying teamwork models educating special needs students’ in the basic school. The thesis consists of three parts. The first chapter is the issue of teamwork educating children with special needs in the main school of theoretical aspects discussed in the education of children with special needs in the context of teamwork. The second part of the work developed teamwork educating children with special needs in the basic school methodology. The third part, based on the theoretical part of the work and developed the research methodology conducted teamwork educating children with special needs in the main school study of the results obtained suggest that educators and specialists sees a positive outlook , which... [to full text]