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Objective: To comparatively evaluate performances of tablet-based versus paper-based Venous Insufficiency Epidemiologic and Economic Study-Quality of Life/Symptom (VEINES-QOL/Sym) questionnaire. Methods: We prospectively evaluated 78 consecutive patients who completed tablet-based and paper-based VEINES-QOL/Sym questionnaires and compared their scores, completion time, data entry time, and ease of use. We used Student's t-test and Wilcoxon test for quantitative variables, Bland–Altman test and kappa coefficient for agreement between questionnaires and patients, respectively. Spearman's correlation coefficient was used to assess correlations. Results: Most participants (83.3%) found it easier to use the tablet device. Less time was needed to complete the tablet-based (median, 4.75; IQR, 3–7 min) than the paper-based (median, 8.3; IQR, 6.3–11.3 min) questionnaire (p <.001). Better educated patients took less time to complete paper-based (p =.003) and tablet-based (p =.001) questionnaires and considered the latter easier to use (p =.010). Conclusions: The tablet-based VEINES-QOL/Sym proved to be an easy-to-use and time-saving tool. [ABSTRACT FROM AUTHOR]

Aims: This study intended to explore the workplace bullying, self‐efficacy and emotional distress of the nursing staff and determine the predictors of nursing staff's emotional distress. Methods: Cross‐sectional and correlation designs were used, collecting data including socio‐demographic data, workplace bullying, self‐efficacy and emotional distress scales. Results: Results showed that the frequency of poor sleep quality in the recent 2 weeks, working in the intensive care centre or emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress in nursing staff. Conclusion: Nursing supervisors are advised to design suitable shift schemes to allow adequate time for nurses to maintain proper rest and develop a safety notification system to give bullied victims the assurance of safety. The design and implementation of the programs are encouraged to improve self‐efficacy among nurses by strengthening the training of social skills, improving employees' communication skills and their relationships with other employees. Summary statement: What is already known about this topic? Nursing workplace bullying can lead to health problems and patient safety problems.What this paper adds? This study provides information about workplace bullying, self‐efficacy and emotional distress in nurses.Poor sleep quality in the recent 2 weeks, working in the intensive care centre or the emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress among nurses.The implications of this paper for policy/practice/research/education Hospital managers should arrange education programs to improve nurses' self‐efficacy to avoid emotional distress.Suitable shift schemes should be designed for the nurses to maintain proper rest, and a safety notification system should be provided to the bullied victims for the assurance of safety. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Culture and leadership display various patterns of interrelationship across countries and regions. However, research is sparse for Slavic countries and especially for small countries like the Republic of North Macedonia. Therefore, this paper tries to explore the linkages between culture dimensions and preferred leader behavior in the country focusing on differences between the capital city of Skopje and the rest of the country. The study utilizes Values Survey Module and Leader Behavior Description Questionnaire XII on a sample of 259 employees. The results show statistically significant differences for one cultural dimension and most of the preferred leader behavior dimensions. There is a complex matrix of positive and negative correlations between the culture dimensions and preferred leader behavior with regional variations in the correlation matrix. Having in mind the small and convenient sample, more studies are needed to further explore such linkages. [ABSTRACT FROM AUTHOR]

Background: The Turkish and Syrian earthquake on February 6th 2023, was one of the deadliest earthquakes in the last decade. It affected approximately 26 million people and left at least 50.000 dead. In this paper, we analyzed the psychological impact and the relationship between mental health factors, earthquake-related experiences and stressors, and resources related to the earthquake, 4 months after the event. Methods: We conducted an analytical cross-sectional study, applying a survey to 320 adults (18–93 years old) in Adiyaman, Turkey. Post-traumatic stress disorder (PTSD) symptoms were assessed using the PC-PTSD, general psychiatric morbidity using the GHQ-12, together with questions focusing on suicidality, drug abuse, as well as experiences, related stressors and received support related to the earthquake. Results: We found a high prevalence of general mental health symptoms, and of PTSD. Fear of aftershocks and the loss of close family members were found to be risk factors for such symptoms. We didn't find significant differences in the GHQ or the PC-PTSD scores when considering ethnicity, religion or financial income. Conclusions: High levels of general mental health symptoms and PTSD symptoms were found 4 months after the earthquake and need to be addressed in all groups, independently from potential religious, social or ethnic backgrounds. The results indicate a large psychiatric and material burden on the entire sample and some priority needs. [ABSTRACT FROM AUTHOR]

Existing patellofemoral pain (PFP) literature has primarily been focused on quadriceps muscle volume, with limited attention given to the deep and superficial muscle volume of the lower limbs in individuals with unilateral and bilateral PFP. In this paper, we aim to fill this gap. To explore superficial and deep lower extremity muscle volume in women with unilateral or bilateral PFP compared with a normative database of pain-free women. Cross-sectional study. University imaging research center. Twenty women with PFP (10 unilateral and 10 bilateral) and 8 pain-free women from a normative database. We quantified lower extremity muscle volume via 3.0-T magnetic resonance imaging. Two separate 1-way analyses of variance were performed: (1) unilateral PFP (painful versus nonpainful limb) versus pain-free control groups and (2) bilateral PFP (more painful versus less painful limb) versus pain-free control groups. We observed no differences in age and body mass index across groups (P >.05). Compared with the pain-free group, the unilateral and bilateral PFP groups had bilaterally smaller volumes of the anterior (iliacus: P ≤.0004; d range, 2.12–2.65), medial (adductor brevis, adductor longus, gracilis, and pectineus: P ≤.02; d range, 1.25–2.48), posterior (obturator externus, obturator internus, and quadratus femoris: P <.05; d range, 1.17–4.82), and lateral (gluteus minimus: P ≤.03; d range, 1.16–2.09) hip muscles and knee extensors (rectus femoris: P ≤.003; d range, 1.67–2.16) and flexors (long and short head of the biceps femoris: P ≤.01, d range, 1.56–1.93). Women with unilateral and those with bilateral PFP displayed less volume of multiple superficial and deep muscles of the bilateral hips and knees than pain-free women. Interventions should bilaterally target lower limb muscles when treating PFP, and hypertrophy exercises for specific muscles should be explored to increase choices for intervention. [ABSTRACT FROM AUTHOR]

Why you should read this article: • UK care homes are an important example of a complex environment where research is essential but faces multiple challenges in terms of rigour and methodology • This paper offers a variety of important methodological strategies to identify and address challenges that could impact findings and the ability to carry out research • It highlights the importance of taking a critical stance with all elements of the research process and illustrates the need to identify and mitigate challenges when conducting research in complex environments. Background: The evidence base for hydration practice in care homes is underdeveloped. High-quality research is therefore needed to determine what practices support older people with dementia in drinking sufficient fluid. However, methodological developments are needed to be able to do this. Aim: To highlight the methodological issues researchers encountered during a feasibility cluster, randomised controlled trial of ThinkDrink, a hydration care guide for people with dementia living in UK care homes. Discussion: This is a challenging area because of the complexity of recruitment, participation and data collection in care homes. Researchers must pay extra attention to rigour and quality in the design of their studies. There may be multiple challenges, so various strategies may be required. Conclusion: It is important that researchers continue to reflect on rigorous approaches to develop evidence in a crucial area of care, despite these challenges. Implications for practice: Researchers working in complex environments face a variety of challenges to complete methodologically rigorous research. It is important for researchers to be critical of research processes and data, to mitigate and overcome these challenges. [ABSTRACT FROM AUTHOR]

Objective: This study explored the experiences, concerns and perceptions of hospital clinical staff returning to work after parental leave during the COVID-19 pandemic. Methods: An exploratory mixed-methods study was performed. Eligible staff employed at a large metropolitan tertiary health service in Melbourne, Australia, completed an ethics-approved anonymous online cross-sectional survey and/or participated in an interview between February and June 2021. Results: Ninety-six staff completed a survey and four participated in an interview. Staff reported both positive and negative aspects of being on parental leave during the COVID-19 pandemic including disappointment their leave had not gone as planned; feeling isolated from family and friends; wanting greater communication from their health service; appreciating the increased opportunities for them and their partner to be at home and bond with their baby; and concerns about returning to work such as limited knowledge of COVID-19 workplace policies and potentially infecting their baby and family. Conclusions: The COVID-19 pandemic had a unique impact on the parental leave and return to work experiences of hospital clinical staff. The findings suggest that staff would benefit from formal return to work policies and programs including regular contact with their manager while on parental leave and workplace reorientation on their return, especially during events such as a pandemic. What is known about the topic? Healthcare workers often experience additional challenges and stressors returning to work after parental leave compared to other workers. What does this paper add? The COVID-19 pandemic had a unique impact on the parental leave and return to work experiences of healthcare workers who reported positive and negative aspects including isolation, limited workplace communication and increased opportunities for bonding with their baby. What are the implications for practitioners? Appropriate organisational initiatives may alleviate staff distress and support their return to work and could include formal return to work programs, regular managerial contact and workplace reorientation. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Loneliness is common among young and middle‐aged stroke survivors. It not only hinders the recovery of their neurological and physical functions but also increases the risk of stroke recurrence, disability, and even death.Improving the mental health of young and middle‐aged stroke survivors is of utmost importance. However, previous research has not yet investigated the impact of interpersonal sensitivity and resilience on the relationship between stigma and feelings of loneliness. What the paper adds to existing knowledge?: This study confirms that stigma has a positive impact on loneliness among young and middle‐aged stroke survivors.Interpersonal sensitivity partially mediates the relationship between stigma and loneliness, and resilience plays a moderating role in the mediating mechanism. What are the implications for practice?: Mental health nurses can formulate nursing interventions to reduce loneliness of young and middle‐aged stroke survivors with the goals of improving stigma, reducing interpersonal sensitivity and cultivating resilience. Introduction: Previous studies have not explored the impact of interpersonal sensitivity and resilience on the relationship between stigma and loneliness. However, improving the resilience of young and middle‐aged stroke survivors and increasing their social participation is of great significance for reducing patients' loneliness of patients and promoting their physical and mental rehabilitation. Aims: To investigate the influence of stigma, interpersonal sensitivity and resilience on loneliness among young and middle‐aged stroke survivors. Methods: A cross‐sectional design was used to collect data. A total of 330 participants completed measures of stigma, resilience, interpersonal sensitivity and loneliness. The descriptive statistical approach, Pearson's correlation analysis and Hayes' PROCESS Macro Model 4 and 7 in regression analysis were used to analyse the available data. Results: The results revealed that young and middle‐aged stroke survivors' stigma, resilience, interpersonal sensitivity and loneliness were significantly correlated between every two variables, with coefficients ranging between −0.157 and 0.682. Interpersonal sensitivity played a partial mediating role in stigma and loneliness, accounting for 63.27% of the total effect; This process was moderated by resilience. Discussion: Stigma positively predicts participants' loneliness. As a mediating mechanism with moderating, interpersonal sensitivity and resilience further explain how stigma affects loneliness. Implications for Practice: Understanding this mechanism is of guiding significance to reduce loneliness of young and middle‐aged stroke patients and promote their physical and mental rehabilitation. [ABSTRACT FROM AUTHOR]

Background: In scientific inquiry learning, students often have difficulties conducting hypothetical reasoning with multiple intertwined variables. Concept maps have a potential to facilitate complex thinking and reasoning. However, there is little investigation into the content of student‐constructed concept maps and its association with inquiry task performance. Objectives: This study explored students' concept mapping style and its association with task performance in computer‐based inquiry learning. Methods: An exploratory study was conducted with 80 Grade 11 students, who collaboratively constructed concept maps in a free style to support inquiry learning with a virtual ecosystem. Student‐constructed concept maps was analysed by firstly identifying different types of propositions formed in the maps and then determining the style of each concept map based on the dominant type of propositions in the map. Finally, the association between the concept map style and inquiry task performance was explored. Results and Conclusions: Two major concept map styles were identified: (1) knowledge‐oriented concept maps (KCMs) mainly representing problem‐related subject knowledge as a set of concepts and their relationships, and (2) problem‐oriented concept maps (PCMs) mainly representing problem situation as a sequence of changes and their causal relationships. Compared with those constructing KCMs, the students constructing PCMs formed higher‐quality propositions in their maps and performed better in hypothesising, reasoning, and drawing conclusions in the inquiry task. Implications: Besides KCMs, students in inquiry learning can be encouraged to construct PCMs to foster effective thinking and reasoning; that is, constructing a concept map to represent the problem situation as a sequence of changes and the causal relationships between the changes. Lay Description: What is currently known about the subject matter: Concept maps (CMs) can facilitate complex thinking and reasoning in inquiry learning.There is little investigation into the content of student‐constructed CMs.It is unknown how CM content might associate with inquiry task performance. What this paper adds: Students constructed two major styles of CMs in computer‐based inquiry learning.The two styles of CMs are problem‐oriented and knowledge‐oriented CMs.Students constructing problem‐oriented CMs performed better in the inquiry task. Implications for practitioners: Analysing student‐constructed CMs helps understand student thinking in inquiry.Students are encouraged to build problem‐oriented CMs in inquiry learning. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that psychological needs frustration strongly influences adolescent depression. However, this influence's underlying mechanisms remain unknown, and related protective factors have not been identified. Based on an integration of basic psychological needs theory, the cognitive vulnerability model of depression, and findings regarding the link between psychological suzhi (a Chinese cultural construct that includes a hierarchical and integrated set of positive psychological qualities) and mental health, we assessed a structural equation model examining the mediating role of self-esteem and moderating role of psychological suzhi in the relationship between psychological needs frustration and depression. Participants were 1552 Chinese adolescents (Mage = 12.30, SD = 0.54, 49.10% male) who effectively completed paper-based questionnaires. The results indicated that psychological needs frustration significantly and positively predicted adolescent depression. Furthermore, the relationship between psychological needs frustration and depression was significantly mediated by self-esteem and significantly moderated by psychological suzhi; specifically, psychological suzhi buffered the association between psychological needs frustration and adolescents' depression. Additionally, we provide further evidence for the relationship between psychological needs frustration and depression, revealing the relevant underlying mechanisms and protective factors; these findings have practical relevance in the prevention and treatment of Chinese adolescents' depression. Highlights: Psychological needs frustration significantly and positively predicted adolescent depression. Self-esteem played a mediating role between psychological needs frustration and depression. Psychological suzhi played a moderating role in the association between psychological needs frustration and depression. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic. Design: Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders. Methods: Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust. Results: Participants continued to deliver a significant proportion of patient care inperson. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks. Conclusion: The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice. Impact: The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward. Reporting method: Standards for Reporting Qualitative Research (O'Brien et al., 2014). Patient or public contribution: This was a workforce study so there was no patient or public contribution. Implications for the profession and patient care: The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward. [ABSTRACT FROM AUTHOR]

Background: The potential of learning analytics dashboards in virtual reality simulation‐based training environments to influence occupational self‐efficacy via self‐reflection phase processes in the Chemical industry is still not fully understood. Learning analytics dashboards provide feedback on learner performance and offer points of comparison (i.e., comparison with one's own past performance or comparison with peer performance) to help learners make sense of their feedback. Objectives: We present a theoretical framework for describing learning analytics reference frames and investigate the impact of feedback delivered through dashboards with different reference frames on occupational self‐efficacy, while controlling for workplace self‐reflection. Methods: This experimental study engaged 42 chemical operator employees, aged between 18 and 55 years, each with at least one year of experience. We utilised a two‐group design to ask two research question each with three competing hypotheses related to changes in occupational self‐efficacy, employing Bayesian informative hypothesis evaluation. Results and Conclusions: Results for the primary research question suggest that dashboards with progress reference frames do not elicit greater change to self‐efficacy than those with social reference frames, however, they may elicit equal change. Furthermore, dashboards with social reference frames may elicit greater change to self‐efficacy than those with progress reference frames. Exploratory results found that dashboards with progress reference frames may elicit greater positive directional change than those with social reference frames and that they may elicit equal directional change. These findings contribute to the understanding of self‐efficacy beliefs within the Chemical industry, with potential impacts on skill development. The research may inform the design of targeted interventions and training programs to influence self‐efficacy. From a practical perspective, this research suggests that careful consideration is needed when choosing reference frames in learning analytics dashboards due to their potential consequences on the formation of learner self‐efficacy. Lay Description: What is already known about this topic?: Learning analytics dashboards often aim to stimulate self‐regulated learning by providing feedback.Feedback plays a crucial role in simulation‐based learning and learning analytics dashboards can be a valuable tool to deliver feedback and facilitate the learning process by providing learners with insights into their performance and progress.Previous research has highlighted the importance of reference frames as critical design features of learning analytics dashboards, as they assist learners in making sense of learning analytics feedback.Self‐efficacy is a powerful determine factor of workplace performance and is influenced by mastery experiences and social modelling information. What the paper adds?: A theoretical framework describes the mediating role self‐reflection phase processes of the self‐regulated learning cycle plays in the formation of occupational self‐efficacy.This paper introduces the concept of three learning analytics reference frame components which include the performance outcome component, point of comparison component and score delta component.The paper indicates that learning analytics dashboards designed with a progress reference frame does not elicit greater change to occupational self‐efficacy than the social reference frame.Exploratory results suggest dashboards with progress reference frames might produce greater positive directional change compared to social reference frames or elicit equal change. Implications for practice?: Learning analytics system designers who use reference frames to help learners make sense of their feedback should carefully consider which reference frames they use as these decisions likely have consequences on the formation of learner self‐efficacy beliefs.For LAD designers and stakeholders, recognising the absolute change and directional shift in self‐efficacy is crucial, as LAD designs significantly influence these dynamics and guide the tailoring of effective tools.In industries like the chemical sector, where overconfidence can result in severe consequences, understanding the nuance of self‐efficacy changes is especially pertinent. [ABSTRACT FROM AUTHOR]

Background: When parents bring their child to appointments and then adhere to agreed speech and language therapy (SLT) recommendations, there is the potential to increase the intensity of the intervention, support generalization and improve outcomes. In SLT, however, little is known about factors that may promote attendance or adherence. Studies in other clinical areas such in medicine, psychology and physiotherapy have identified risk factors for non‐attendance or non‐adherence that are multifactorial and variable dependent on, for example, population and intervention. Aims: To identify rates of non‐attendance and non‐adherence, and to identify parent or child factors associated with parent involvement in intervention for children under 5 years of age receiving SLT. Methods: Parents completed questionnaires at two time points assessing the domains of parents' beliefs (problem perceptions, self‐efficacy), personal circumstances (socio‐demographics, family functioning), treatment experience and child factors. Predictors of parent attendance and adherence were identified through multiple regression analyses. Non‐attendance rates were identified via local health records and non‐adherence ascertained using a specific parent‐reported measure within the treatment experience domain. Results: Participants (N = 199) were predominantly mothers, and were ethnically and socio‐economically diverse, speaking a wide range of languages. Their children presented with a range of speech, language communication needs (SLCN). The rate of non‐attendance was 25% and the main predictors of non‐attendance were maternal age, education level and two factors within the parent beliefs domain. This model explained 40% of the variance in attendance. The rate of non‐adherence in this cohort was 26% with parental rating of the importance of a recommendation and self‐efficacy beliefs predicting adherence; this explained 56% of the variance in adherence to SLT recommendations at home. Conclusions & Implications: Our research has provided preliminary evidence of the influence of parents' beliefs, personal circumstances and treatment experiences on their involvement in their child's therapy. Speech and language therapists should consider factors impacting attendance and adherence to treatment and explore parental perceptions of their child's SLCN before embarking on an intervention, a foundation for collaborative practice. A possible limitation of this study is that the levels of attrition in our sample led to generally high measured rates of participation, which should be considered in future studies. Future research should explore adherence in treatments with varying doses, with different types of SLCN or interventions and in different settings. WHAT THIS PAPER ADDS: What is already known on the subject: It is acknowledged that parent involvement in their child's therapy, such as attending and adhering to recommendations, is important but little is known about the rates of involvement and what factors may be associated with attendance and adherence in SLT. Qualitative research has explored parental involvement suggesting that beliefs about an intervention may be pertinent. Extensive research in other clinical areas suggest multiple and varied factors are influential and further exploration of particular populations and interventions is necessary. What this paper adds to the existing knowledge: This study identified rates of parental non‐attendance and non‐adherence in a cohort of predominantly mothers of children under the age of 5 years. It is the first study to measure parent adherence in SLT and identify factors that are associated parental adherence to SLT recommendations. It adds to the small body of SLT specific research in understanding risk factors for non‐attendance. What are the potential or actual clinical implications of this work?: This study highlights the need for a speech and language therapist to consider and explore parents' perspectives of their child's SLCN as a part of achieving collaboration with a parent in order to achieve the best outcomes. It provides a foundation for further systematic research into parent involvement with the ultimate aim of enhancing outcomes for children with SLCN. [ABSTRACT FROM AUTHOR]

Background: There is a lack of evidence relating to cognitive‐communication difficulties following traumatic brain injury (TBI) sustained in older adulthood. A prominent area in which post‐TBI cognitive‐communication difficulties manifest is at the level of social communication. An investigation of social communication focusing on comparison of those injured in older and younger adulthood is a practical starting point for age‐related cognitive‐communication outcome comparison. Aims: The overall objective of this study was to explore the social communication of individuals who sustained severe TBI in an early period of older adulthood (50–70 years) compared to younger adulthood (18–40 years), as informed by self and close other reports. Methods & Procedures: This exploratory controlled group comparison study involved analysis of self‐reported and close other reported La Trobe Communication Questionnaire data for 22 adults with severe TBI (11 older at injury; 11 younger at injury) and 22 control participants (11 older; 11 younger). TBI participants were matched for injury variables and participant groups were matched for sex, age and education. Outcomes & Results: The close others of the older and younger adults with TBI reported them to have significantly more frequent difficulty with social communication than the close others of age‐matched control groups. Older adults with TBI reported significantly more frequent difficulty with social communication than uninjured older adults. In contrast, younger adults with TBI and uninjured younger adults reported a similar frequency of difficulty with social communication. No age‐based difference in the frequency of social communication difficulty was evident when comparing the self or close other reports of older and younger adults with TBI. Awareness of social communication difficulty, as indexed by comparing self and close other perceptions, showed a different pattern across the TBI groups. The older TBI group rated themselves as having significantly less frequent social communication difficulty than was perceived by their close others. In contrast, no statistically significant difference was evident between the self and close other social communication ratings of the younger TBI group. Conclusions and Implications: Where possible clinicians need to work with close communication partners to understand the nature and degree of social communication difficulty following severe TBI. This may be especially important when working with people who sustain TBI in older adulthood if future research shows that this population have greater difficulty with self‐awareness of social communication difficulty. What this paper adds: What is already known on the subject: Cognitive‐communication difficulties are a common consequence of traumatic brain injury (TBI) that can have long‐term impact on everyday functioning. These challenges have primarily been investigated in individuals who sustained TBI in younger adulthood. What this paper adds to existing knowledge: Individuals who sustain severe TBI in early older adulthood have a higher frequency of reported social communication difficulty to non‐injured adults of a similar age, albeit they may underreport such difficulties potentially in the context of reduced self‐awareness. What are the potential or actual clinical implications of this work?: Social communication difficulty is an issue for people who sustain severe TBI in early older adulthood. However, a poorer overall social communication outcome in comparison to those injured in younger adulthood should not be assumed. Clinical service delivery for these challenges is most optimally delivered in a collaborative manner with the individual and their close others. Future research is required to investigate the identified trends from this study. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

There is an increased need for accessible psychosocial interventions that support both people with dementia and their spouses. Recent research demonstrates the benefits of music therapy and caregiver-delivered music therapy for this population. This paper contributes to the emerging evidence base on telehealth music therapy for people with dementia outside of a COVID-19 era when in-person services were available. This exploratory phenomenological study explores the experiences of two couples who attended a six-week telehealth music therapy programme via two detailed case examples. Online semi-structured interviews with each couple were conducted pre and post intervention and analysed using Interpretative Phenomenological Analysis. Three shared themes emerged from the data analysis including (1) social isolation and lack of confidence linked to dementia diagnosis is worsened in rural locations, (2) song singing and song writing enables us to revisit happy memories, and (3) telehealth delivery increases access due to geographical location. The findings are presented in a narrative case study format to provide rich detailed descriptions of the music therapy programme and to illuminate the experiences of the participants. In both examples, telehealth delivery expanded access to music therapy (which was otherwise unavailable) and stimulated reminiscence which in turn encouraged meaningful engagement between the couple. The delivery of music therapy via telehealth, alongside in-person delivery, has the potential to expand access to music therapy to those who may not have access to or are no longer able to attend community support services due to geographical location, increased cognitive decline or reduced mobility. The successful delivery of telehealth music therapy is dependent on several factors including digital literacy, access to appropriate technological devices, caregiver support and level of cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Nursing interventions in the post‐operative time period including psychological and emotional support, adverse event education, and instructions for follow‐up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post‐anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post‐operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform. Aims: This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated‐measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries. Methods & Materials: The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)‐approved study was a repeated‐measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice. Results: The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post‐operative Day 1. Fifty‐nine participants (78%) completed the surveys on post‐operative Day 14. Discussion: As the frequency of outpatient treatment increases, nurses conducting post‐operative research will need to collect the data outside of the hospital setting. Conclusion: Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non‐traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Self‐harm by ligature is common within inpatient mental healthcare settings and is a dangerous method of self‐harm. Most fatal and non‐fatal suicidal behaviours in inpatient settings are a result of ligature use.There is a lack of research which has explored the experiences of staff members who work within inpatient settings where patients may self‐harm by ligature. What the paper adds to existing knowledge: Key issues related to self‐harm by ligature reported by staff included (1) understaffing increasing risk of ligature incidents, (2) spreading of self‐harm by ligature within inpatient settings and (3) negative attitudes of staff related to patients who self‐harm by ligature.Working with self‐harm by ligature can have negative impacts on staff's personal (e.g. fear of blame) and professional lives (e.g. increased cautiousness). Many staff members currently feel underprepared by training related to working with self‐harm by ligature, and unsupported after responding to a ligature incident. What are the implications for practice: Training about self‐harm by ligature needs to be improved and be accessible for all inpatient mental healthcare staff. Training should be coproduced, and could include practical components, education on potential reasons for self‐harm, and acknowledgement of the emotional impact on staff.Support for staff members who respond to ligature incidents should be available for all staff members who respond to self‐harm by ligature incidents. Stigma associated with accessing support should be challenged, alongside blame cultures within the workplace. Introduction: Self‐harm by ligature is a common form of self‐harm within inpatient mental health services in England, where most suicides within inpatient settings involve hanging or suffocation. However, little research has examined the experiences of staff members working with this method of self‐harm. Aim: We explored the experiences of clinical staff who work with patients who self‐harm by ligature. Method: A staff survey was developed and disseminated to clinical staff working in inpatient settings in England. Quantitative data were analysed using descriptive statistics, and qualitative data using the framework approach. The study was STROBE checklist compliant. Results: 275 staff members participated. Challenges most frequently reported about working with self‐harm by ligature included understaffing (210, 76.6%), spreading of ligature incidents (198, 72.8%) and negative attitudes held by clinical staff towards such patients (185, 68.5%). Participants' responses indicated that this work could have significant impacts on their professional and personal lives. Staff often reported inadequate training and lack of preparedness, alongside insufficient support opportunities following ligature incidents. Discussion: Staff had a diverse range of professional and personal experiences and identified multiple challenges associated with working with patients who have self‐harmed by ligature. Implications for Practice: There is a need to improve accessibility, format and content of training and support for staff working within inpatient settings where patients may self‐harm by ligature. [ABSTRACT FROM AUTHOR]

Persuasive gamified systems are effective tools for motivating behaviour change using various persuasive strategies. In line with the reinforcement theory, some persuasive gamified systems employ reward and punishment in their design to achieve the intended behavioural outcome. Research has argued both in favour and against using these strategies in behaviour change applications due to mixed results with respect to their effectiveness. However, there is a lack knowledge about how interventions using these strategies could motivate or demotivate behaviours. Therefore, this paper explores the mechanism through which Reward and Punishment motivate or demotivate behaviours with respect to their strengths and weaknesses. The results of large-scale exploratory studies (N = 1768) uncover important strengths and weaknesses that could facilitate or hinder the effectiveness of Reward and Punishment at motivating behaviour change. These include their ability to engage users and make behaviour fun, reinforce commitments to goals, and reveal some consequences of bad behaviour. We also compared the perceived effectiveness of reward and punishment quantitatively. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Background: In response to the COVID-19 pandemic, the World Health Organization established a number of key recommendations such as educational activities especially within primary care practices (PCPs) which are a key component of this strategy. This paper aims to examine the educational activities of PCPs during COVID-19 pandemic and to identify the factors associated with these practices across 38 countries. Methods: A "Patient Education (PE)" score was created based on responses to six items from the self-reported questionnaire among PCPs (n = 3638) compiled by the PRICOV-19 study. Statistical analyses were performed on 3638 cases, with PCPs with missing PE score values were excluded. Results: The PE score features a mean of 2.55 (SD = 0.68) and a median of 2.50 (2.16 – 3.00), with a maximum of 4.00, and varies quite widely between countries. Among all PCPs characteristics, these factors significantly increase the PE score: the payment system type (with a capitation payment system or another system compared to the fee for service), the perception of average PCP with patients with chronic conditions and the perception of adequate governmental support. Conclusion: The model presented in this article is still incomplete and requires further investigation to identify other configuration elements favorable to educational activities. However, the results already highlight certain levers that will enable the development of this educational approach appropriate to primary care. [ABSTRACT FROM AUTHOR]

In programmes of assessment with both high and low-stakes assessments, the inclusion of open-ended long answer questions in the high-stakes examination can contribute to driving deeper learning among students. However, in larger institutions, this would generate a seemingly insurmountable marking workload. In this study, we use a focused ethnographic approach to explore how such a marking endeavour can be tackled efficiently and pragmatically. In marking parties, examiners come together to individually mark student papers. This study focuses on marking parties for two separate tasks assessing written clinical communication in medical school finals at Southampton, UK. Data collected included field notes from 21.3 h of marking parties, details of demographics and clinical and educational experience of examiners, examiners' written answers to an open-ended post-marking party questionnaire, an in-depth interview and details of the actual marks assigned during the marking parties. In a landscape of examiners who are busy clinicians and rarely interact with each other educationally, marking parties represent a spontaneous and sustainable community of practice, with functions extending beyond the mere marking of exams. These include benchmarking, learning, managing biases and exam development. Despite the intensity of the work, marking parties built camaraderie and were considered fun and motivating. [ABSTRACT FROM AUTHOR]

Objective: It is widely understood that a key means of improving health systems and patient outcomes is through research – accessing, understanding, generating and applying research evidence-based practice. To promote more targeted and strategic research in Allied Health practice, this study sought to establish the principles, areas and priorities for clinical research as perceived by Allied Health leaders in the South Australian public health system. Methods: The study used a mixed-methods design (full, sequential and equal model). Participants were recruited from the South Australian Department of Health and Wellbeing employment lists for Allied Health senior leaders. Consenting participants attended face-to-face focus groups; after an overview presentation, they discussed the principles for Allied Health research, followed by areas and priorities for research. Summaries of the responses were themed descriptively and circulated electronically so participants could confirm the research areas and ascribe priority ratings, clinical populations and services. Results: A total of 28 people attended the stakeholder forum (5 online); 20 responded to the second-round electronic summary. Nine principles of research action were agreed. Fourteen research areas were identified and prioritised. There was a relatively consistent prioritisation of measuring Allied Health value, Allied Health workforce, hospital avoidance and closing the gap for Aboriginal and Torres Strait Islander peoples health outcomes – whether the individuals were thinking about their own service or the state as a whole. Conclusions: Allied Health leadership identified key principles and priorities for research to improve service delivery and patient outcomes. These priorities should generate further discussion and interest for novice and experienced researchers and leaders and can be used to inform granting and project plans. What is known about the topic? Allied Health are well equipped to engage in research but have limited capacity. What does this paper add? We have identified key priorities and principles to inform Allied Health research activity. What are the implications for practitioners? Practitioners, funders and other stakeholders can develop these identified principles and priorities to direct research time and resources for the most impact on health outcomes. [ABSTRACT FROM AUTHOR]

Background: Haptic feedback has been shown to be an effective facilitator of the learning of scientific concepts in a series of studies. However, little is known about the underlying salient learning mechanisms, which are activated when learning from haptic feedback. Objectives: We investigate the learning mechanism in a higher chemistry education setting, in which the students learned about the abstract concept of potential energy in a quantum chemical context. Methods: In this work, we present a mixed‐methods problem‐solving prior to instruction (PS‐I) study with chemistry bachelor students. In an interactive quantum chemistry learning environment, the students explored the energetic profiles of nucleophilic substitution reactions and the corresponding activation barriers experienced as repulsion and attraction. We measured cognitive and affective mechanisms which have been shown to be activated in PS‐I designs, such as knowledge gap awareness, state curiosity, and positive affect as well as the learning outcome quantitatively and the learning trajectories qualitatively. Results and Conclusions: Planned contrasts revealed a small hindering effect of the haptic feedback on the learning outcome. Thematic analysis of the qualitative data lets us attribute this effect to the lack of scaffolding of the haptic feedback and the spontaneous atomic movements in the simulation, which may be interpreted as a visual representation of force in itself. This work highlights the importance of accurate mappings of the haptic feedback unto the target domain and further delivers insight into the prior conceptions of chemistry undergraduate students. Lay Description: What is already known about this topic: Haptic feedback can facilitate learning by grounding abstract concepts in sensory experiences.While previous studies have reported positive affective results, the cognitive results are ambiguous.Moreover, it was frequently reported that the learning of potential energy in a (quantum) chemical context is particularly difficult due to (i) the lack of grounding opportunities and (ii) the diverse previous conceptions. What this paper adds: A learning environment to interact with molecular systems in real‐time is proposed.The concept of activation energy is grounded in sensory experience of pushing and being pulled.The mixed‐methods design allows to explore cognitive and affective variables as well as the specific prior conceptions activated by the environment. Implications for practice and/or policy: We found a small negative effect of the haptic feedback on the learning outcome, potentially due to insufficient introduction of it to the students.The spontaneous movement of the atoms was identified as a more suitable external representation of the force.Future studies should investigate, if explicit introduction of the embodied metaphor can reverse this effect. [ABSTRACT FROM AUTHOR]

The development of a tool to track participation in activity-based therapy (ABT) for people with spinal cord injury or disease (SCI/D) was identified as a priority of the Canadian ABT Community of Practice. The objective of this study was to understand multi-stakeholder perspectives on tracking ABT participation across the continuum of care. Forty-eight individuals from six stakeholder groups (persons living with SCI/D; hospital therapists; community trainers; administrators; researchers; and funders, advocates and policy experts) were recruited to participate in focus group interviews. Participants were asked open-ended questions concerning the importance of and parameters around tracking ABT. Transcripts were analyzed using conventional content analysis. Themes reflected the Who, What, Where, When, Why and How of tracking ABT. Participants described the importance of involving hospital therapists, community trainers and individuals with SCI/D in tracking ABT to capture both subjective and objective parameters across the continuum of care and injury trajectory. Digital tracking tools were favoured, although paper-based versions were regarded as a necessity in some circumstances. Findings highlighted the importance of tracking ABT participation for individuals with SCI/D. The information may guide the development of ABT practice guidelines and support the implementation of ABT in Canada. Tracking the details of activity-based therapy (ABT) sessions and programs across the continuum of care and injury trajectory may provide important information to support the development of ABT practice guidelines and implementation strategies. Tracking objective and subjective parameters are needed to provide a comprehensive description of an ABT session and program. Clinicians and individuals with spinal cord injury or disease (SCI/D) should both be able to track ABT to accommodate all settings and types of data. Digital tracking tools, such as an app, may provide an accessible, versatile and efficient way of tracking ABT. [ABSTRACT FROM AUTHOR]

Introduced in the United Kingdom in 2012, Universal Credit (UC) is a welfare benefit that replaces six working-age 'legacy' benefits for out-of-work and low-income people. Designed with the aim of simplifying benefits and incentivising paid work, UC represents a deepening of conditionality in the British welfare state. Considering these developments, this paper quantitatively investigates the effect of UC on recipients' life satisfaction. Data from the United Kingdom Household Longitudinal Study is analysed, primarily using a fixed-effects regression approach. Results reveal a significantly negative effect of UC recipience on life satisfaction. Robustness checks and alternative model specifications, including difference-in-differences and inverse probability weighting, confirm this finding. Additionally, mediation models give credence to the idea that UC also negatively affects life satisfaction indirectly by increasing psychological distress. Heterogeneity tests indicate that UC has a less negative effect on single parents' life satisfaction compared to non-parents. Meanwhile, UC has a significantly more negative effect on the life satisfaction of people not in paid work (for reasons other than unemployment) than those in paid work. Discussion focuses on the potential effect of welfare conditionality specifically, and implications for future research and policy are explored. [ABSTRACT FROM AUTHOR]

Background Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. Methods In the VOICE community—a European healthcare centre cluster intending to address VBHC from theory to practice—information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. Results Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. Conclusions To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Vision impairments affect the ability to navigate environments and gain spatial perception of one's surroundings. Existing navigation aids typically provide close-range information, but not feedback on farther distances (i.e., beyond 5 m from the user). OBJECTIVE: To address this gap, the OptiBand, a custom assistive device, was previously designed with a stakeholder who is blind. The OptiBand uses Lidar sensing and haptic feedback to relay information on objects up to 15 m away. In this paper, we sought to evaluate the efficacy of the OptiBand with an in situ user study. METHODS: N = 9 participants (eight blind and one low-vision) used the OptiBand for a period of three months. Users periodically rated spatial perception workload and trust of their assistive navigation aids (at first as a baseline without the OptiBand, and then with the OptiBand). RESULTS: The OptiBand tended to yield lower workload requirements and similar trust levels compared to existing navigation aids. Interview data demonstrated the usefulness of the OptiBand in selected day-to-day tasks such as navigating outdoors and maintaining appropriate interpersonal spacing. CONCLUSIONS: This work provides evidence on benefits of and potential uses of assistive navigation aids like the OptiBand. Researchers interested in similar devices can benefit from our efforts. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]