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Emergency Department (ED) presentations in older people are associated with a wide range of adverse events, which increase the risk of lengthy hospitalisation and poor outcomes. Pathfinder is an inter-organisational initiative delivered in partnership between Beaumont Hospital Occupational Therapy and Physiotherapy departments and the National Ambulance Service. Pathfinder responds to non-serious and non-life-threatening emergency medical service (EMS) calls. This study aims to demonstrate how Pathfinder can safely treat a proportion of older people at home by using alternative care pathways (ACPs), therefore avoiding unnecessary ED presentations. Once a decision has been reached to treat the person at home, the Pathfinder follow-up team delivers functional rehabilitation and case management in the persons’ home over the subsequent days.

This paper outlines the Pathfinder assessment, management and interventions in one clinical case example. Outcome measures include the level of patient satisfaction obtained via routine telephone feedback questionnaire and re-presentation to Beaumont Hospital within 30 days.

This paper illustrates through a case example the benefit of a collaborative multi-disciplinary rapid response team for non-serious and non-life-threatening EMS calls in older adults. The patient in this case example had no further EMS calls or ED presentations for 30 days after Pathfinder intervention and reported a high level of satisfaction with the service.

ED presentation was avoided through comprehensive multi-disciplinary assessment, including immediate access to intensive follow-up support in the person’s own home.

The Pathfinder service is improving access to ACPs for older people in the Beaumont Hospital catchment area. Pathfinder will now be spread nationally, with local adaptation, so that older people in other parts of Ireland will also benefit from this integrated model of care.

Patient feedback surveys confirm older adults want access to alternative care pathways.

The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.

The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

This paper uses data collected in a co-produced research study including peer researchers.

The rapid advancement of technology poses many social challenges including the emerging issue of technology-facilitated abuse (TFA) and violence. In Australia, women from culturally and linguistically diverse (CALD) backgrounds are found to be more vulnerable to domestic violence (DV) and abuse, including TFA. This chapter presents a snapshot of CALD women's technology-facilitated domestic abuse (TFDA) experiences in Melbourne through the eyes of a small group of DV practitioners. Findings show CALD women experience TFA similar to that of the mainstream, with tracking and monitoring through the use of smartphone and social media most common. Their migration and financial status, and language and digital literacy can increase their vulnerability to TFDA, making their experience more complicated. Appropriate digital services and resources together with face-to-face support services can be a way forward. Further research should focus on better understanding CALD women's perceptions of and responses to TFDA and explore ways to improve engagement with and use of community media channels/platforms.

Reflective practice (RP) is a key skill for developing one’s professional practice. It has, however, not been unanimously prioritised in public health (PH) competency and education frameworks. Reflection activities are often unstructured in higher education. There is also a dearth of literature on the RPs of undergraduate PH students. This study aims to explore in greater depth how RP helps undergraduate PH students explore their own learning in internships.

Reflection prompts were designed using the DEAL model. 124 written reflection entries from 32 students were collected and analysed thematically using a deductive-inductive approach. The conceptual framework of internship learning goals by Ash and Clayton (2009) was used to guide the deductive analysis.

Three themes were identified: initial engagement with reflective learning; gradual integration of reflective learning, and a transformative phase involving professional development, personal growth, civic learning, growth through struggle, being confronted with differences in expectations, and skill acquisition.

This study extends the limited evidence regarding RP in undergraduate non-medical PH education, and contributes toward informing the revision of undergraduate PH programmes, for example, by integrating structured reflection earlier in the curricula, and establishing/supporting mentorship programmes between institutions. The findings call for PH educators to be more intentional in creating opportunities to nurture RP among budding PH professionals.

Globally, urban planners and decision makers are pursuing place-based initiatives to develop and enhance urban infrastructure to optimise city performance, competitiveness and sustainability credentials. New discourses associated with big data, Building Information Modelling, SMART cities, green and biophilic thinking inform research, policy and practice agendas to varying extents. However, these discourses remain relatively isolated as much city planning is still pursued within traditional sectoral silos hindering integration. This research explores new conceptual ground at the Smart – Natural City interface within a safe interdisciplinary opportunity space. Using the city of Birmingham UK as a case study, a methodology was developed championing co-design, integration and social learning to develop a conceptual framework to navigate the challenges and opportunities at the Smart-Natural city interface. An innovation workshop and supplementary interviews drew upon the insights and experiences of 25 experts leading to the identification of five key spaces for the conceptualisation and delivery at the Smart-Natural city interface. At the core is the space for connectivity; surrounded by spaces for visioning, place-making, citizen-led participatorylearning and monitoring.The framework provides a starting point for improved discussions, understandings and negotiations to cover all components of this particular interface. Our results show the importance of using all spaces within shared narratives; moving towards ‘silver-green’ and living infrastructure and developing data in response to identified priorities. Whilst the need for vision has dominated traditional urban planning discourses we have identified the need for improved connectivity as a prerequisite. The use of all 5 characteristics collectively takes forward the literature on socio-ecological-technological relationships and heralds significant potential to inform and improve city governance frameworks, including the benefits of a transferable deliberative and co-design method that generates ownership with a real stake in the outcomes.