SUMMARY Background The burden of chronic disease in the USA necessitates a shift in medicine and medical education from disease treatment to health and wellness promotion. At the forefront of this shift is the field of lifestyle medicine – the evidence‐based use of lifestyle modification to prevent, treat and reverse disease. Health care providers, including physician assistants (PAs), can be the vehicle of behaviour change for patients, families and communities, and must receive adequate training to practice lifestyle medicine. Methods We describe a pilot lifestyle medicine curriculum implemented through a PA training programme run in the USA in the academic year 2016/2017. The curriculum included four taught modules on lifestyle medicine, two assessment activities and a survey of self‐perceived competency, measured before and after the programme. Results Forty students participated in the curriculum. Results showed a significant increase in self‐perceived competencies in seven of nine lifestyle medicine areas (p < 0.001). After the curriculum, all students were successfully able to provide a written lifestyle medicine prescription for a mock patient, with the most common prescription topics including nutrition‐related prescriptions (41%), followed by physical activity (26%), addressing substance use (10%), mental health or stresses (10%) and sleep (7%). Furthermore, on average students were able to correctly identify 70% of the desired recommendations for a mock patient. Conclusion Lifestyle medicine curricula can be successfully integrated into existing PA curricula, with demonstrated increases in self‐assessments of competency and practical skills.

PurposeThe purpose of this paper is to to describe development of a framework for use in the evaluation of the effectiveness of signage to assist people with dementia.Design/methodology/approachThe study consisted of two parts. Workshops held in both Sydney and Edinburgh using “world café” methodology with 28 knowledgeable participants produced a pool of statements. These were subsequently used in a three-round Delphi process administered to 38 participants in order to generate ideas and develop consensus content for a signage evaluation framework.FindingsThis process resulted in a framework consisting of Delphi statements which had a 70 per cent level of agreement and a series of prompt questions. Both intrinsic factors and wider environmental, extrinsic factors in signage for wayfinding were identified.Research limitations/implicationsLimitations of this study were the small number of participants, including only four people with dementia, and the unresolved problems inherent in designing signage that may simultaneously be universally relevant and readily understood, yet meets the idiosyncratic needs of each individual living with dementia.Originality/valueAs there is little prior work in this field concerning signage use by people with dementia, this framework provides an original preliminary tool that may be used in further research on evaluating signage effectiveness. In designing signage and testing its effectiveness, it was concluded that the direct involvement of people with dementia is essential.

No abstract

Purpose The purpose of this paper is to address the barrier to care experienced by LGBTQIA+ populations by binary language for gender, sexual orientation and relationship status. Design/methodology/approach The authors review the research that shows linguistic barriers are a significant obstacle to healthcare for LGBTQIA+ communities. The authors describe both a process and revisions for addressing language bias in psychiatric intake/research research materials as well as quantify its impact in an adult psychotherapy clinic in a public hospital. Findings Patients self-identified their gender, sexual orientation and relationship status in a variety of ways when not presented with binaries and/or pre-established response choices. In addition, the non-response rate to questions decreased and the authors received positive qualitative feedback. The authors also present the revisions to the intake/research materials. Practical implications Other healthcare settings/clinicians can revise language in order to remove significant barriers to treatment and in doing so, be welcoming, non-pathologizing and empowering for LGBTQIA+ consumers of mental health services (as well as for non-LGBTQIA+ consumers who are in non-traditional relationships). Social implications This work is one step in improving healthcare and the healthcare experience for LGBTQIA+ communities and for those in non-traditional relationships. Originality/value This work is set in a public safety-net hospital providing care for underserved and diverse populations. This paper describes the process of revising psychiatric materials to be more inclusive of the range of self-identity are: gender, sexual orientation and relationship status.

No abstract