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Background. Social and organisational changes in businesses have led to the appearance of "emergent risks" which affect workers but are less evident and hard to quantify such as psychosocial risks. Linked to psychosocial risks, issues such as work‐related stress and workplace violence are major challenges to occupational health and safety. This paper analyses the trends in the concerns expressed by wage‐earners in Spain regarding psychosocial factors that may affect them in the workplace. Methods. A causal analysis based on the application of binary logistic regression is presented, covering certain social and occupational characteristics of survey respondents and the psychosocial factors included in the Spanish National Surveys of Working Conditions for 2007 and for 2011‐2012. Binary logistic regression is a multivariate statistical tool that serves as a classification technique, identifying the variables that affect the probability of the event to be studied (dichotomous variable). This technique has the advantage that it does not require that the explanatory variables follow a normal distribution. The aim is to estimate the influence of the explanatory variables on the probability of the occurrence of the event under study, represented by the explained variable. Results. During the economic crisis of 2008, workers became more concerned about losing their jobs and about factors related to personnel cutbacks and decreases in investment in the prevention of occupational risks. Downsizing due to the crisis led to increased workloads for many of those still in work. Thus, in 2011, the likelihood of workers being concerned about working hours was greater, especially among respondents aged 25–34 and those working in commerce and transport. Workload was found to be a particular concern among respondents aged 25–34 and among workers in transport, communication, financial, professional, and administrative activities; health‐related activities; and industry. Conclusions. Policy should also be directed towards improving the structural aspects of psychosocial variations, in terms of work conditions, employment protection, and employment security to protect workers against income fluctuations as a result of job loss. [ABSTRACT FROM AUTHOR]

Aims. To synthesize the evidence on nurses' experiences of their caring role during the COVID‐19 pandemic and identify emerging concepts that have affected nurses within the caring role in relation to (a) their professional lives and (b) their personal lives. Background. The concept of caring is central to the science and art of nursing practice, and fulfilment of the caring role is fundamental to the profession. The COVID‐19 pandemic imposed unprecedented change globally transforming the caring role of the nurse. The WHO highlights that a well‐supported workforce is paramount to emergency preparedness; therefore, understanding the experiences of the nurse's caring role during the COVID‐19 crisis is paramount to practice in future healthcare crises. Methods. A scoping review. Data Sources. Studies published between January 2020 and November 2023 were identified from the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Coronavirus Database, PUBMED, PsycINFO, PsycArticles, Scopus, Web of Science, and SocINDEX. Reporting Method. The scoping review adhered to the Joanna Briggs Institute (JBI) Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Extension for Scoping Review (PRISMA‐ScR) checklist. Results. The search identified 1,347 studies, subsequent review of title and abstract, resulted in 117 full‐text papers for further eligibility screening, with a total of 52 studies being included in the scoping review. Findings were grouped thematically using the Braun and Clarke (2006) approach. The five distinctive themes that emerged were (a) emotional turmoil, (b) erosion of care, (c) relationships and solidarity, (d) expansion of role, and (e) professional growth. Conclusion. During the COVID‐19 pandemic, there was an evolutionary shift in the caring role of the nurse, on a trajectory from emotional turmoil to professional growth. The process followed a theoretical framework of transformative learning that could support nurses' capability and preparedness in their caring role for future inevitable extreme events and crisis in healthcare. Implications for Nursing Management. Mapping current knowledge of the unprecedented COVID‐19 crisis from a nurse's professional and personal perspective purposefully aims to highlight gaps for future research, education, and policy and is paramount to emergency preparedness and a well‐supported workforce in future healthcare crisis. [ABSTRACT FROM AUTHOR]

Parenting with a physical disability often brings with it a range of challenges. Occupational therapists are well positioned to support parents to address these challenges, yet occupational therapy research and practice around parenting is relatively scarce. This paper addresses the questions: (1) How should occupational therapists support parenting occupations for people with physical disability? (2) How do parents with physical disability experience occupational therapy? An anonymous survey of 62 parents, primarily mothers, with physical disability about their experiences with parenting challenges and occupational therapy was analysed using both quantitative and qualitative techniques. Parents experienced challenges in engaging in a range of parenting tasks with children over a range of age groups. Parents reported that support was often needed and indicated that occupational therapy could assist them directly with specific parenting goals as well as the more usual biomechanical goals that influence parenting. Yet less than half of participants who received occupational therapy services reported that parenting tasks were addressed, and only one‐fifth reported that their goals had been fully met. The data also indicated that the knowledge, skills, and attitudes of occupational therapists with regard to working with parents with disability can be improved. Findings suggest a need to better incorporate parenting occupations in standard occupational therapy training to increase occupational therapists' comfort and competence in working with clients on parenting issues. [ABSTRACT FROM AUTHOR]

Accurate segmentation of breast masses in mammogram images is essential for early cancer diagnosis and treatment planning. Several deep learning (DL) models have been proposed for whole mammogram segmentation and mass patch/crop segmentation. However, current DL models for breast mammogram mass segmentation face several limitations, including false positives (FPs), false negatives (FNs), and challenges with the end‐to‐end approach. This paper presents a novel two‐stage end‐to‐end cascaded breast mass segmentation framework that incorporates a saliency map of potential mass regions to guide the DL models for breast mass segmentation. The first‐stage segmentation model of the cascade framework is used to generate a saliency map to establish a coarse region of interest (ROI), effectively narrowing the focus to probable mass regions. The proposed presegmenter attention (PSA) blocks are introduced in the second‐stage segmentation model to enable dynamic adaptation to the most informative regions within the mammogram images based on the generated saliency map. Comparative analysis of the Attention U‐net model with and without the cascade framework is provided in terms of dice scores, precision, recall, FP rates (FPRs), and FN outcomes. Experimental results consistently demonstrate enhanced breast mass segmentation performance by the proposed cascade framework across all three datasets: INbreast, CSAW‐S, and DMID. The cascade framework shows superior segmentation performance by improving the dice score by about 6% for the INbreast dataset, 3% for the CSAW‐S dataset, and 2% for the DMID dataset. Similarly, the FN outcomes were reduced by 10% for the INbreast dataset, 19% for the CSAW‐S dataset, and 4% for the DMID dataset. Moreover, the proposed cascade framework's performance is validated with varying state‐of‐the‐art segmentation models such as DeepLabV3+ and Swin transformer U‐net. The presegmenter cascade framework has the potential to improve segmentation performance and mitigate FNs when integrated with any medical image segmentation framework, irrespective of the choice of the model. [ABSTRACT FROM AUTHOR]

Background: Negative leadership behaviour is very common and pervasive in nursing and healthcare, often leading to adverse effects such as nurses' silence, decreased job performance, and turnover. However, there is a lack of systematic reviews that summarize negative leadership types and nurses silencing behaviours. Aim: This systematic review examined the relationship between negative leadership behaviour and nurses' silence. Evaluation: We searched PubMed, Embase, the Cochrane Library, Web of Science, CNKI, VIP, and Wanfang databases from their inception until 30 April 2024 for articles examining the relationship between negative leadership and silent behaviour among nurses. The studies were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. The risk of bias in the included studies was assessed using the Newcastle–Ottawa Scale. Key Issues: After full‐text analysis, six papers were included in this systematic review. Four of the studies were conducted with nurses, and the remaining two were conducted with all medical staff including nurses. While most studies have shown that negative leadership causes nurses to become increasingly silent, others have shown that appropriate negative leadership behaviour instead reduces nurses' silence. Conclusions: Negative leadership behaviour can affect the silent behaviour of nurses. Implications for Nursing Management: Hospitals need to take the initiative to build a harmonious and safe working environment, correctly recognize and identify negative management behaviour, take appropriate and effective measures to enhance the positive leadership of nurse managers, and make an effort to prevent nursing staff's exposure to the negative management of direct leadership and mental health threats, which is a key point that hospital administrators and health policymakers tend to overlook. This is also effective for enhancing the leadership of hospital administrators. [ABSTRACT FROM AUTHOR]

The last three census data highlighted that UK Bangladeshi communities have the worst health outcomes. This includes a higher risk of type two diabetes and heart diseases; both are risk factors for developing vascular dementia. However, little is known about Bangladeshi community members' understandings of dementia, including cultural myths. This paper focuses on the cultural myths, superstitions, and stigma surrounding dementia in an English Bangladeshi community from the direct experiences of people living with dementia, their caregivers, and the views of dementia service providers/stakeholders. This qualitative research was undertaken with three distinct participant groups using semistructured interviews (n = 25), who were recruited from community settings. The first and second participant groups explored the experiences of people with dementia (n = 10) and their family caregivers (n = 10). The third group examined stakeholders'/service providers' views (n = 5). Interviews were recorded digitally and transcribed verbatim. Findings were reached using an interpretive approach, emphasising the sense people make in their own lives and experiences and how they frame and understand dementia. The study revealed that participants with dementia and their caregivers have "alternative" knowledge about dementia and do not necessarily understand dementia in a Westernised scientific/biomedical context. Misconceptions about dementia and belief in various myths and superstitions can lead people to go to spiritual healers or practice traditional remedies rather than to their GPs, delaying their dementia diagnosis. This paper concludes that there is a lack of awareness among the Bangladeshi participants and a need for targeted awareness about dementia to help dispel cultural myths and combat the stigma surrounding dementia within the Bangladeshi community. [ABSTRACT FROM AUTHOR]

Background. The involvement of women, as health influencers, has been instrumental in improving health outcomes and quality of life. In sub‐Saharan Africa, poor knowledge, attitudes, and beliefs about cancers have contributed to late detection and increased mortality. Although pharmacists have provided optimum pharmaceutical care in ensuring that prostate cancer (PCa) patients obtain maximum clinical benefits from pharmacotherapy, late detection has hindered pharmacotherapeutic outcomes. The application of the PCaKAB‐Gh tool to women has the potential to investigate their lapses in PCa knowledge, attitudes, and beliefs and further equip pharmacists and other healthcare professionals to design educational interventions. Ultimately, Ghanaian women will be well‐positioned to advise and motivate their men to screen for PCa. Method. Our pilot and psychometric studies recruited 400 and 500 participants from the Kumasi Central Market and the New Agogo Community Market, respectively. In this large population application of the PCaKAB‐Gh tool, 2000 women were simply randomly enrolled from these markets and data were collected using paper questionnaires with ethical approval. Data were entered into IBM SPSS (version 24) after cleaning and coding for analysis. The knowledge on signs and symptoms was scored and graded as "low" (≤2), "moderate" (3–5), and "high" (5–8), whilst the knowledge on causes and risk factors was stratified as "low" (≤1), "moderate" (2‐3), and "high" (4‐5). Pearson's correlation was conducted to investigate the relationship between women's educational status and knowledge, attitudes, and beliefs. Statistical significance was established as a p < 0.05. Results. Christians and Muslims accounted for about 70% and 24% of the participants, respectively, whilst over 50% of the participants were Akans. Over 50% and 30% of the 2000 participants had high and moderate knowledge about the signs and symptoms of PCa, respectively. Knowledge about the causes and risk factors was approximately 30% high and 50% moderate amongst the participants. Negative attitudes and beliefs outcomes were observed in about 25% and 55% of the participants. A p < 0.001 was achieved in Pearson's correlation between the educational level of respondents and knowledge on signs and symptoms (r = −0.102), knowledge on causes and risk factors (r = 0.111), attitudes (r = −0.122), and beliefs (r = 0.228). Conclusions. Our study established that market women had better knowledge on the signs and symptoms of PCa compared to the causes and risk factors. Their beliefs about PCa were worse compared to their attitudes. The development and administration of educational interventions, relying on the outcomes of this study, must involve markets, churches, and mosques as educational sites with special attention to addressing negative beliefs through a broader community‐based engagement. [ABSTRACT FROM AUTHOR]

Aim. To determine Senior Nurse Managers' perceptions of integration of Nurse Practitioner roles in Healthcare Organisations across Ireland and Australia. Background. Introduction of the Nurse Practitioner role in both countries is well established with national policies aimed at developing a critical mass in the health workforce. Current policy requires Senior Nurse Managers to be actively involved in the introduction of and oversight of the integration of Nurse Practitioners across healthcare settings. This is integral in the context of the success and sustainability of the services provided by the Nurse Practitioner. Methods. A quantitative, cross‐sectional cloud‐based survey of senior nurse managers across Ireland and Australia from April to September 2022. Results. Of 300 responses received, 122 were eligible for analysis. Of these, 77% expressed that there should be a specific role to support the integration of Nurse Practitioner roles at local level, and 61% recommended that this should occur at a national level, whilst 48% reported the absence of a standardised governance structure. Three reporting structures were identified: professional, clinical, and operational. Autonomous clinical decision making and prescribing were two Nurse Practitioner functions most identified. Fifty‐five percent reported having performance indicators for Nurse Practitioner roles, with 24% agreeing that performance indicators captured the quality of care provided. Thirty‐five percent of senior nurse managers indicated that there were agreed reporting timelines for performance indicators and a requirement for the provision of an annual report. Conclusion. Whilst some participants reported structure to guide and evaluate the work and value of Nurse Practitioners, the approach was inconsistent across organisations and countries. This paper demonstrates that integration is not broadly established across both countries. Implications for the Profession. The main findings were that Nurse Practitioners were misunderstood and the development of a structured framework to support the integration of Nurse Practitioners would provide long‐term benefits. [ABSTRACT FROM AUTHOR]

Background. A timely diagnosis of cancer is important for patient outcomes. The delay in the patient interval (time from symptom interpretation to seeking help) is often the longest throughout the cancer patient pathway. Factors extending this interval include vague symptom profiles increasing the difficulty of symptom appraisal and individual demographics influencing help‐seeking behaviours. An underexplored and potential source of delay in cancer diagnosis is associated with managing symptoms using self‐care activities prior to presentation to healthcare. Methods. This study aimed to characterise the use of self‐care activities in the context of managing nonspecific symptoms, prior to cancer diagnosis and their effect on the length of the patient interval. Eligible publications were identified using a rapid systematic review, and their qualitative self‐care data were extracted and analysed using thematic synthesis. Results. Forty‐five qualitative research papers between 2009 and 2024 were included in the final review. Self‐care was used as part of an iterative process, often resulting in delayed presentation to healthcare, if methods were effective in managing nonspecific symptoms. Across the literature, varying types of self‐care activities were reported across all cancers with nonspecific symptoms, including the use of over‐the‐counter or alternative medications, lifestyle changes, and watchful waiting. The individual's decision to self‐care was either prompted externally by a healthcare professional (HCP) (e.g., community pharmacists) or prompted by the individual depending on the availability of home remedies and medication. Patients used self‐care when there was a low perceived need to seek healthcare, to determine whether healthcare was required, or to avoid the use of healthcare. However, across the literature, there is limited evidence to understand the variation by cancer type, symptoms, and individual characteristics. Conclusions. The findings of this rapid review demonstrate that self‐care activities could hinder prompt help‐seeking and delay cancer diagnosis among people who are experiencing nonspecific cancer symptoms. However, more evidence is needed to understand which individual factors facilitate the adoption of self‐care behaviours over prompt help‐seeking for nonspecific cancer symptoms. [ABSTRACT FROM AUTHOR]

Purpose. This study aims to elucidate the gender gaps in the strategies for maintaining the social participation and interaction of older adults with people in a local community. Methods. The subjects were 130 older adults aged 65 years or older and independently living in their homes in Saitama, Saitama Prefecture, Japan. The authors conducted an anonymous questionnaire survey on paper and performed multiple regression analysis for men and women separately using the Lubben Social Network Scale-6 (LSNS-6) as the dependent variable. Results. Among the independent variables used for the analysis, those that significantly influenced LSNS-6 in men were social activities related to the daily life satisfaction of the elderly (SARDS). The independent variables that significantly influenced LSNS-6 in women were SARDS, sense of coherence-13 (SOC-13), and the number of family members living with the subjects. Discussion. Health promotion is not associated with interaction with people in men compared with women. [ABSTRACT FROM AUTHOR]

Background. The deterministic fiber tracking method has the advantage of high computational efficiency and good repeatability, making it suitable for the noninvasive estimation of brain structural connectivity in clinical fields. To address the issue of the current classical deterministic method tending to deviate in the tracking direction in the region of crossing fiber region, in this paper, we propose an adaptive correction-based deterministic white matter fiber tracking method, named FTACTD. Methods. The proposed FTACTD method can accurately track white matter fibers by adaptively adjusting the deflection direction strategy based on the tensor matrix and the input fiber direction of adjacent voxels. The degree of correction direction changes adaptively according to the shape of the diffusion tensor, mimicking the actual tracking deflection angle and direction. Furthermore, both forward and reverse tracking techniques are employed to track the entire fiber. The effectiveness of the proposed method is validated and quantified using both simulated and real brain datasets. Various indicators such as invalid bundles (IB), valid bundles (VB), invalid connections (IC), no connections (NC), and valid connections (VC) are utilized to assess the performance of the proposed method on simulated data and real diffusion-weighted imaging (DWI) data. Results. The experimental results of the simulated data show that the FTACTD method tracks outperform existing methods, achieving the highest number of VB with a total of 13 bundles. Additionally, it identifies the least number of incorrect fiber bundles, with only 32 bundles identified as wrong. Compared to the FACT method, the FTACTD method reduces the number of NC by 36.38%. In terms of VC, the FTACTD method surpasses even the best performing SD_Stream method among deterministic methods by 1.64%. Extensive in vivo experiments demonstrate the superiority of the proposed method in terms of tracking more accurate and complete fiber paths, resulting in improved continuity. Conclusion. The FTACTD method proposed in this study indicates superior tracking results and provides a methodological basis for the investigating, diagnosis, and treatment of brain disorders associated with white matter fiber deficits and abnormalities. [ABSTRACT FROM AUTHOR]

Background. Cancer diagnosis is a complex and multifaceted process that can be stressful and anxiety-provoking for patients. Evidence-based tools and information aids that can be used for guiding and supporting patients during cancer investigations and after diagnosis are limited. This paper presents a user-centred codesign project that aims to develop a cancer pathway support tool for patients, carers, and healthcare professionals. Method. A mixed-method codesign approach was used including prototype development (January–March 2022), three online codesign workshops (April–June 2022), one-to-one feedback, and beta testing informed by the standardised Theoretical Framework of Acceptability (TFA) questionnaire (July–October 2022). Nine individuals with lived experience of cancer contributed to the project and are referred to as codesigners. Results. The codesigners valued the potential importance of a tool that can be used by the patients and carers if they want specific information about cancer investigations, diagnosis, and treatment. The ability to select what they need as opposed to long leaflets and generating their own questions for the healthcare providers were highlighted as important aspects of improving patient care. The tool was collectively designed to provide clear definitions of the cancer care pathway and easily accessible links from trusted resources and includes practical information to minimise the burden that can be experienced from preparation for appointments and tests. Beta testing results with a small sample of potential users including patients, carers, and healthcare providers (n = 23) showed high acceptability of the guide (range = 7–35, mean = 28.52, and standard deviation = 3.88) based on the TFA questionnaire. Conclusion. A cancer pathway support tool called "Your Cancer Pathway Support Guide (YCPSG)" was developed as a result of an iterative codesign process aiming to improve patient experience and outcomes for people referred on a suspected cancer pathway or who have been diagnosed with cancer. The tool provides information and support in both digital and PDF formats. Further studies are needed to evaluate the potential impact of "Your Cancer Pathway Support Guide" on patient outcomes and experience and the wider system. [ABSTRACT FROM AUTHOR]

Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

Objective. The health benefits of medical care services for older adults have been well known. This study aims to identify trajectories of medical care accessibility and their impacts on Chinese older adults' psychological well-being to enrich findings on health outcomes of medical care accessibility. Methods. This study included 2660 participants aged 65 years and older from the 2005–2018 Chinese Longitudinal Healthy Longevity Survey, and this paper used the latent class growth model to analyze the heterogeneous trajectories of medical care accessibility among Chinese older adults. Ordinary least squares (OLS) regression was also used to explore whether the trajectories of medical care accessibility impact the psychological well-being of Chinese older adults and its heterogeneity among different subgroups of older adults. Results. Three distinct trajectories of medical care accessibility "maintaining high accessibility" (n = 2230, 84.1%), "medium to high accessibility" (n = 222, 8.10%), and "high to low accessibility" (n = 208, 7.80%) were identified, respectively. Regression results show that older adults maintaining high accessibility to medical care reported well psychological well-being. This result was particularly evident among older adults in urban and eastern areas. Discussion. Our findings highlight the importance of maintaining high accessibility to medical care and reducing inequalities in the accessibility to medical care for increasing psychological well-being of Chinese older adults. [ABSTRACT FROM AUTHOR]

Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

Social participation is positively related to mental health recovery and wellbeing, yet people with mental health problems are often socially isolated. This article investigates how social participation was incorporated into an Australian-integrated program that aimed to improve the wellbeing of people with chronic mental health needs. The data are from a longitudinal evaluation of the integrated program, including data linkage (5533 participants) and interviews (111). The paper uses concepts from the network perspective of social capital (bonding, bridging, linking, horizontal, and vertical) as lenses to re-examine the evaluation's findings about the consumers' social participation in life areas (social, leisure, and productive) facilitated by the program. This social capital perspective offers a lens to examine the breadth and intensity of participation experienced by the consumers taking part in the support program. The article adds to the literature about how service providers can improve social participation and therefore consumers' opportunities for recovery and wellbeing. The analyses found that the support increased people's social interaction and their capacity in the community. Their social interaction was mostly with other people in the service. Often their interactions in the community were only transactional. Few consumers participated in activities in productive life areas, and few of the activities promoted vertical social capital in social networks outside the service. The implications are that service providers need greater attention on facilitating a variety of social participation activities that can extend mental health consumers' horizontal and vertical social capital and so further contribute to their current and future recovery and wellbeing. [ABSTRACT FROM AUTHOR]