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The anticipation, inclusion, responsiveness, and reflexivity (AIRR) framework (Stilgoe et al., 2013) is a novel framework that has helped those in science and technology fields shift their focus from products to the processes used to create those products. However, the framework has not been known to be applied to the development and implementation of data analytics in higher education. In a case study of creating an early-alert retention system at James Madison University, a working group of ~20 faculty, staff, and students creatively utilized the AIRR framework. The present study discusses how the AIRR framework was utilized to observe and enhance group processes, and the outcomes of those enhanced processes.

As increasing attention is focused on the experiences of people living with mild cognitive impairment (MCI), this paper reviews where we stand regarding evidence-based interventions. From simpler offers of information, psychoeducation, and ‘living well’ programmes, to more structured approaches that include cognitive stimulation, rehabilitation, and training, mindfulness, and mind-body exercise. Amongst studies of varying quality, there are notable trends emerging: evidence supports cognitive stimulation and combined mind-body programmes to improve neurocognitive function, yet there is still no clear picture regarding the efficacy of rehabilitation, cognitive training, or mindfulness-based approaches. Increasingly, it is multi-component interventions that are currently associated with more positive outcomes for cognitive health and wellbeing. However, it remains challenging to know what will work for whom when implementing these interventions in clinical practice.

Background The global COVID-19 pandemic has escalated the prevalence of mental illness in the community. While specialist mental health nurses have advanced training and skills in mental health care, supporting mental health is a key role for all nurses. As front-line health care professionals, primary health care (PHC) nurses need to be prepared and confident in managing mental health issues. Aim To critically analyse and synthesise international literature about the knowledge gaps and learning needs of PHC nurses in providing mental health care. Design and methods An integrative review. The quality of papers was assessed using the Mixed Methods Appraisal Tool. Data were extracted into a summary table and analysed using narrative analysis. Data sources CINAHL, Ovid MEDLINE, Web of Science and EBSCO electronic databases were searched between 1999 and 2019. Papers were included if they reported original research which explored mental health education/training of nurses working in PHC. Findings Of the 652 papers identified, 13 met the inclusion criteria. Four themes were identified: preparedness; addressing knowledge gaps, education programs, and facilitators and barriers. Discussion Despite increasing integration of physical and mental health management in PHC, there is limited evidence relating to knowledge gaps and skills development of PHC nurses or their preparedness to provide mental health care. Conclusion Findings from this review, together with the global increase in mental illness in communities arising from COVID-19, highlight the need for PHC nurses to identify their mental health learning needs and engage in education to prepare them to meet rising service demands.

Background: The “1-3-6-12-day rule” for starting direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation after acute ischemic stroke or transient ischemic attack recommends timings that may be later than used in clinical practice. We investigated more practical optimal timing of DOAC initiation according to stroke severity. Methods: The combined data of prospective registries in Japan, Stroke Acute Management with Urgent Risk-factor Assessment and Improvement-nonvalvular atrial fibrillation (September 2011 to March 2014) and RELAXED (February 2014 to April 2016) were used. Patients were divided into transient ischemic attack and 3 stroke subgroups by the National Institutes of Health Stroke Scale score: mild (0–7), moderate (8–15), and severe (≥16). The early treatment group was defined as patients starting DOACs earlier than the median initiation day in each subgroup. Outcomes included a composite of recurrent stroke or systemic embolism, ischemic stroke, and severe bleeding within 90 days. Six European prospective registries were used for validation. Results: In the 1797 derivation cohort patients, DOACs were started at median 2 days after transient ischemic attack and 3, 4, and 5 days after mild, moderate, and severe strokes, respectively. Stroke or systemic embolism was less common in Early Group (n=785)—initiating DOACS within 1, 2, 3, and 4 days, respectively—than Late Group (n=1012) (1.9% versus 3.9%; adjusted hazard ratio, 0.50 [95% CI, 0.27–0.89]), as was ischemic stroke (1.7% versus 3.2%, 0.54 [0.27–0.999]). Major bleeding was similarly common in the 2 groups (0.8% versus 1.0%). On validation, both ischemic stroke (2.4% versus 2.2%) and intracranial hemorrhage (0.2% versus 0.6%) were similarly common in Early (n=547) and Late (n=1483) Groups defined using derivation data. Conclusions: In Japanese and European populations, early DOAC initiation within 1, 2, 3, or 4 days according to stroke severity seemed to be feasible to decrease the risk of recurrent stroke or systemic embolism and no increase in major bleeding. These findings support ongoing randomized trials to better establish the optimal timing of DOAC initiation.

Mindfulness helps people focus on what is happening right now. It can help people to have good mental health.A group of researchers from the USA created a mindfulness-based therapy for people with intellectual disabilities, called Soles of the Feet.Soles of the Feet teaches people with intellectual disabilities to focus on the soles of their feet, instead of focusing on difficult thoughts and feelings.This paper thinks about how Soles of the Feet works for people with intellectual disabilities.

ObjectiveTo explore expert views on the potential value, and approaches to establishing and administering a tobacco control fund in the UK.DesignSemistructured interviews and follow-up discussion groups.SubjectsTwenty-four UK and international experts on tobacco control regulation, public health, economics or law from the academic, public, private and third sector.MethodsParticipants considered the relative merit of (1) general excise tax on retail tobacco sales; (2) ring-fenced hypothecation of excise taxes on retail tobacco sales; and (3) a direct levy on tobacco manufacturers. Preliminary synthesis of interview findings was deliberated on in two follow-up discussion groups to identify key considerations for policy design.ResultMost experts agreed that a ring-fenced tobacco control fund would be a valuable method of raising predictable and reliable funds from tobacco producers either using either companies’ sales volume or market share as a way to establish the proportion they should pay. Experts predominantly recommended that a fund in the UK should be administered by a government body with devolved nation input and with an independent advisory group. They typically indicated that funding should be allocated yearly with a distribution at local, regional and national levels to support smoking prevention and cessation rather than treatment activities with priority given to measures that tackle smoking-related inequalities.ConclusionThere was overwhelming agreement by experts on the need to establish a tobacco control fund to help meet the proposed government tobacco-free targets to reduce adult smoking prevalence to 5% by 2030 (England) and 2034 (Scotland).