Search

Abstract Background Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya. Methods This cross-sectional study included 260 school-aged children (age 9–17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children’s age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status. Results Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016). Conclusions A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet–malnutrition relationship in areas endemic for S. mansoni infection.

During the COVID-19 Pandemic, many companies around the world continued to implement and drive adherence to Lean principles. However, there are a number of key challenges each company would face when implementing Lean, one of those main challenges being workforce engagement. One way of measuring the engagement of Lean principles is by assessing adherence. In manufacturing organisations around the world, there are differing motivations, and these can be dependent on a number of aspects, such as culture and organisational structure. Therefore, it is imperative to understand employees' motivations in relation to the adherence to Lean principles. This 3-year study of Lean principles assesses the adherence in Jaguar Land Rover's (JLR) Powertrain Machining Facility. It also examines methods of instigating a new recognition process, developing an improved communication method, and creating digital solutions to training issues. The main achievement of the research is improving the adherence to the Lean principles, improving adherence to standardised working practices, and improving the utilisation of problem-solving and continuous improvement tools.

Abstract Background Diarrhoeal disease remains a significant cause of morbidity and mortality among the under-fives in many low- and middle-income countries. Changes to food safety practices and feeding methods around the weaning period, alongside improved nutrition, may significantly reduce the risk of disease and improve development for infants. We describe a protocol for a cluster randomised trial to evaluate the effectiveness of a multi-faceted community-based educational intervention that aims to improve food safety and hygiene behaviours and enhance child nutrition. Methods We describe a mixed-methods, parallel group, two-arm, superiority cluster randomised controlled trial with baseline measures. One hundred twenty clusters comprising small urban and rural communities will be recruited in equal numbers and randomly allocated in a 1:1 ratio to either treatment or control arms. The community intervention will be focussed around an ideal mother concept involving all community members during campaign days with dramatic arts and pledging, and follow-up home visits. Participants will be mother–child dyads (27 per cluster period) with children aged 6 to 36 months. Data collection will comprise a day of observation and interviews with each participating mother–child pair and will take place at baseline and 4 and 15 months post-intervention. The primary analysis will estimate the effectiveness of the intervention on changes to complementary-food safety and preparation behaviours, food and water contamination, and diarrhoea. Secondary outcomes include maternal autonomy, enteric infection, nutrition, child anthropometry, and development scores. A additional structural equation analysis will be conducted to examine the causal relationships between the different outcomes. Qualitative and health economic analyses including process evaluation will be done. Conclusions The trial will provide evidence on the effectiveness of community-based behavioural change interventions designed to reduce the burden of diarrhoeal disease in the under-fives and how effectiveness varies across different contexts. Trial registration ISRCTN14390796. Registration date December 13, 2021

Abstract Background Visceral obesity and insulin resistance contribute to developing cardiometabolic syndrome (MetS). We investigated the predictive abilities of lipid accumulation product (LAP), waist circumference‐triglyceride index (WTI), and triglyceride‐glucose (TyG) index for MetS screening among the general Ghanaian adults. Methods The final prospective analysis included 4740 healthy adults aged 30–90 years from three communities comprising Ejisu, Konongo, and Ashanti Akim Agogo in Ghana. Self‐structured questionnaire pretested was used to collect sociodemographic, anthropometric, and clinical data. Blood samples were taken after fasting to measure glucose and lipid levels. LAP, WTI, and TyG were calculated from standard equations. MetS was defined by the International Diabetes Federation criteria. Receiver operating characteristic (ROC) curves and multivariable logistic regression were utilized to evaluate the potential of the three indices in identifying MetS. Results Of the 4740 participants, 39.7% had MetS. MetS was more common in females (50.3%) than in males (22.2%). Overall, LAP ≥ 27.52 yielded as the best index for MetS with the highest area under the ROC curve (AUC) (0.866). At cut‐off LAP point of ≥23.87 in males and ≥33.32 in females, an AUC of 0.951 and 0.790 was identified in MetS prediction, respectively. LAP was an independent risk measure of MetS for both males (45.6‐fold) and females (3.7‐fold) whereas TyG was an independent risk measure for females (3.7‐fold) only. Conclusions MetS is increasing among the general adult population. LAP and TyG are important sex‐specific risk measures to screen for MetS among the general adult population in our cohort.

Within the eukaryotic cell, the actin cytoskeleton is a crucial structural framework that maintains cellular form, regulates cell movement and division, and facilitates the internal transportation of proteins and organelles. External cues induce alterations in the actin cytoskeleton primarily through the activation of Rho GTPases, which then bind to a diverse array of effector proteins to promote the local assembly or disassembly of actin. We have harnessed the extensively studied functions of RhoA in the dynamics of the actin cytoskeleton to craft a practical series for Stage 2 Biology students. This series not only imparts essential tissue culture laboratory skills but also reinforces them through repetition. These activities are presented in a scenario designed for students to explore the function of a hypothetical RhoA family member. Students produce slides from transfected cells, undertake fluorescence microscopy, process the images using ImageJ, and compile their findings in a comprehensive scientific report. The composition of the report requires independent acquisition of new knowledge and synoptic learning. According to student feedback, this early experience greatly aids in solidifying and honing the skills required to report on more extensive and intricate research projects, such as capstone projects.

This paper examines the impact of process mapping on the management of change in an academic library in a UK higher education institution. Book ordering has been highlighted by a group of subject librarians as being time-consuming and inefficient, detracting from their ability to respond to new challenges and opportunities. An action research approach is used to bring the subject librarians together to draw book ordering process maps, identify on the maps where perceived problem areas lie and discuss potential solutions. Analysis of the empirical data suggests that process maps used in an action learning setting are impactful in terms of demonstrating readiness for change, showing where change is needed and creating a vision for change. The value of investigating the impact of process mapping through the lenses of different change models is discussed and the applicability of this approach to other professional services settings in higher education is explored.

While interdisciplinarity has been promoted in universities for decades, research suggests that untenured faculty struggle to receive recognition for their interdisciplinary research. Informed by the microfoundations of institutional theory and discursive legitimation, we examine how members of academic departments participate in the legitimation and reproduction of tenure and promotion norms in relation to disciplinary and interdisciplinary research in a prestigious private university. Our analysis draws on 59 interviews with department chairs, directors of interdisciplinary centers, and disciplinary and interdisciplinary untenured faculty in the STEM fields, the social sciences, and the humanities. Our findings reveal three mechanisms and processes through which tenure and promotion norms become legitimated and reproduced in academic departments: 1) institutional micro-practices concerned with evaluation and gatekeeping, 2) discursive legitimation of the expulsion of interdisciplinarity at the pre-tenure stage, and 3) scholarly positioning through discursive boundary strategies directed at rationalizing the expulsion of interdisciplinarity or the expansion of existing tenure and promotion norms. Taken together, these findings advance our understanding of the tensions between the promotion of interdisciplinary research in higher education institutions, reproduction of the disciplinary order in academic departments, and interdisciplinary early-career scholars' career advancement.

This article explores the extent to which students of different ethnicities, (dis)abilities, sexes, POLAR groups, and academic abilities undertake Year in Industry (YINI) placements and realise post-placement academic improvements, in comparison with non-YINI students. The benefits of work placements on student employability and graduate prospects are well-documented but less is known about which student groups gain access to placements. The study analyses secondary data relating to the sex, ethnicity, disability, POLAR group, grades, and degree classifications of 31,159 undergraduates graduating from a UK Russell Group university between 2016 and 2023, representing the largest study of its kind to date. The study found that students completing YINI programmes are significantly more likely to achieve first class (70.1% YINI, 28.5% non-YINI) and good degrees (97.7% YINI, 83.6% non-YINI). Importantly, the study found that YINI completion narrows awarding gaps found in the non-YINI population in relation to sex, disability, ethnicity, and POLAR group. The potential gains are greatest for male students, students with disabilities, Asian, Black and mixed ethnicity students, and students from low POLAR groups. However, access to placements is not proportionately distributed. Female students, students with disabilities, students from all ethnic minority groups and those of unknown ethnicity, and students from low POLAR groups are under-represented within the YINI population, suggesting placement access gaps in relation to sex, disability, ethnicity, and POLAR group. The paper concludes with strategies to encourage YINI participation amongst diverse student groups and calls for further research into lived experiences of YINI and non-YINI students.

The purpose of this article is to share the examination of inclusivity as a paradigm for fostering authenticity and agency (Moore, 2017) among teacher candidates. This framing challenges the notion of inclusion as a tool of meritocracy used to manage learners through expectations that uphold monolingualism, decenter racial histories, and rely on rigid behavior plans. In this work, the authors interrogate the impact inclusion as assimilation has on English learners' authentic ways of knowing and being. Thus, they present a conceptualization of spaces of difference (Agbenyaga & Klibthong, 2012) within the context of an Inclusive Early Childhood Teacher Education (IECTE) program and the objectives of the Preparing Inclusive Early Childhood Educators (PIECE) project. With its rigorous coursework, clinical experiences, multi-tiered mentorship, and practice-based professional development, the PIECE project aims to develop inclusive early childhood educators at the preservice and in-service levels. Infused throughout the PIECE project is an emphasis on cultivating the knowledge and skills needed to provide high-quality instruction that improves educational outcomes for English learners (ELs). Frameworks of transformative theory and intersectionality perspectives provided the authors with a grounding for the work within the PIECE project community of learners (i.e., teacher candidates, teacher educators, and school district partners). This article summarizes critical concepts of inclusivity centered in the PIECE project work. These concepts include (1) understanding oneself to look beyond; (2) disrupting notions of normalcy and naturalized language; and (3) reconceptualizing inclusivity as a social justice act.

Over the last decade or so, the rate of growth of academic publications involving discussion of 'citizen science' and 'community science', and similar variants, has risen exponentially. These fluid terms, with no fixed definition, cover a continuum of public participation within a range of scientific activities. It is, therefore, apposite and timely to examine the evolving typologies of citizen science and community science and to ask how particular disciplinary actors are shaping content and usage. Do certain approaches to citizen science and community science activity remain siloed within specific disciplines or do some approaches resonate more widely? In this study, we use mixed methods--bibliometric and textual analysis--to chart the changing academic interpretations of this scientific activity over time. We then ask what these analyses mean for the future direction of academic research into citizen science and community science. The results suggest that, while certain disciplinary-based interpretations have been particularly influential in the past, a more epistemically mixed array of academic interests than was previously evident are currently determining expectations of what citizen science and community science should look like and what they can be expected to deliver.

Abstract Background There are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n = 100) and 8-months’ follow-up (n = 81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Methods Multiple-pass 24-h dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake. Results Complete data were collected at baseline (n = 100) and 8-months’ follow-up (n = 81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z = -4.01, p

Abstract Background The United Kingdom population is ageing and becoming increasingly diverse; thus, it is vital to develop and implement interventions supporting this population shift. Social networks (SN) significantly impact health outcomes in later life, however relatively little is known about SN of community-dwelling ethnically diverse older adults. This study aimed to: 1) profile SN and changes in SN in this population over 8 months; 2) examine associations between SN, dietary intake, nutritional status, and physical function. Methods SN were assessed using the Wenger Practitioner Assessment of Network Type. Energy and nutrient intakes were measured using multiple-pass 24-h recalls. The Mini Nutritional Assessment-Short Form (MNA-SF) assessed nutritional status. Physical function was measured using the Short Physical Performance Battery (SPPB) and handgrip strength. Data were collected at baseline and 8-months. Correlation and regression analyses examined relationships between SN, physical function, nutrient intake and nutritional status. Semi-structured interviews were conducted at baseline (n = 92) and follow-up (n = 81) to identify potential influences of SN. Interviews were transcribed verbatim and analysed using directed content analysis. Results Quantitative data were obtained from 100 participants at baseline and 81 at follow-up. Mean (SD) age was 70.8 (8.1) years (59% male), comprising African/Caribbean (60%), South Asian (34%), and other ethnicities (6%). Five SN typologies were identified under two broad areas: integrated-SN consisting of locally integrated (44%) and wider community (8%); and non-integrated-SN consisting of family dependent (25%), local self-contained (17%), and private restricted (6%). At follow-up, 37% remained in non-integrated networks, 19% transitioned to non-integrated networks, 11% transitioned to, and 33% remained in, integrated networks. Participants within integrated networks at baseline had higher SPPB scores at follow-up. Compared to the private restricted, local self-contained SN significantly predicted zinc, riboflavin and vitamin B6 intakes. Participants remaining in, or transitioning to, non-integrated networks had low MNA-SF scores. Qualitative findings indicate that participants with reductions in SN perceived it as causing poorer physical function and eating behaviours. Conclusion In the present study, integrated SN were associated with higher physical function and nutritional status at 8-month’s follow-up. These results can inform the design of interventions to improve social networks, physical function and healthy nutrition within this population.

We examine the coseismic influence of the 5 July 2019, MW7.1 Ridgecrest and the 24 June 2020 MW5.8 Owens Lake earthquakes on rockfall distributions in two undisturbed high-altitude areas of the southern Sierra Nevada Mountains, California, USA. These events occurred within the geologically recent (2), the significantly lower magnitude Owens Lake event produced nearly twice as many (102) mappable rockslides as the significantly stronger Ridgecrest event (58), a difference likely due to slope oversteepening in the formerly glaciated area. Significant seismic amplification by topography and reactivation of preexisting failures was apparent for both areas. Inclusion of these factors may improve failure predictions and rockfall probability estimation.

Interprofessional education (IPE) is essential to prepare healthcare students to work collaboratively once they enter the mental health workforce. However, there is limited research exploring IPE for students in a mental health service context. This study aimed to explore stakeholder experiences of a work-integrated learning (WIL) placement model with embedded IPE opportunities for clinical psychology and occupational therapy students in a youth mental health service in Australia. Students (n=9), staff (n=12) and clients (n=10) involved in the model participated in semi-structured interviews. A template thematic analysis derived five themes from the data: placement model valuable for all stakeholders, students' interprofessional learning, the role of the clinical educators, contrasting expectations of students' workload, and challenges of piloting new models of care. The findings from this research highlight the value and challenges of WIL placements featuring IPE in mental health settings, providing useful future directions to organizations hoping to implement similar models.

Preparing students enrolled in healthcare programs for industry is paramount. While providing administrative and clinical education is essential, students must understand the health literacy levels of the population they serve and work diligently to ensure the population understands and comprehends the health information. Adults with low or limited health literacy levels need help understanding health information and making informed decisions. Research shows that improvements in health literacy result in decreased ER visits, medication errors, increased patient satisfaction, and better health outcomes. Health literacy is an issue throughout the world. This reflection seeks to provide a narrative comparing health literacy concerns in the United States and Spain. The objective is to shed light on the need for all colleges and universities to teach students about health literacy and how to determine patients' health literacy levels. Increasing students' understanding can improve the comprehension and awareness of patients and the population that they serve, thus leading to more appropriate health decisions and outcomes.

Although assessment of student learning remains a thorny area for co-creation in education, a growing number of researchers and practitioners advocate and enact partnership in formative and summative assessment as part of equity work. In this case study, we join these efforts in reflecting on students' and our own experiences of the midterm conversation that we use as a key formative assessment structure and process across three co-facilitated courses. The midterm conversation--a partnership among students and instructors as co-teachers--is embedded in course design and curriculum with the goal of advancing, informing, and sustaining our pedagogical commitments. This case illustrates how we practice assessment as dialogue and as emergent understanding. This practice is based on an expectation of diverse learning goals and outcomes and on trust in students' capacities to direct their learning with reference to their own interests and standards for their work.

This paper aims to further explore the impact of need and culture as they relate to orientation, training, development, and administrative policies on regional university adjunct faculty. The use of adjunct faculty has risen considerably over recent years making their university experience more relevant in today's higher education climate. Adjunct faculty express the desire for orientation, training, and professional development. In addition, adjunct faculty find administrative policies extremely isolating in nature as they struggle to develop more meaningful relationships with other faculty, administrators, and students. While adjunct faculty have vast industry experience, they often lack extensive experience in higher education. Considering that adjunct faculty have such a tremendous impact on college students, how they feel about their higher education experience is of great concern. Adjunct faculty effectiveness suffers when they do not receive adequate orientation, training, and development. When adjunct faculty are isolated from the university due to the structure of administrative policy, they become less committed to the overarching goals of the organization and thus less committed to students.

In this study, we aimed to determine the role of parental praise and child affect in the neural processes underlying parent-child interactions, utilizing functional near-infrared spectroscopy (fNIRS) hyperscanning. We characterized the dynamic changes in interpersonal neural synchrony (INS) between parents and children (4-6 years old, n = 40 dyads) during a cognitively challenging task. We then examined how changes in parent-child INS are influenced by parental feedback and child affect. Parent-child INS showed a quadratic change over time, indicating a decelerated decline during the interaction period. The relationship of parental praise, in the form of positive feedback, to change in INS was contingent upon the child's positive affect during the task. The highest levels of INS were observed when praise was present and child affect was positive. The left temporo-parietal regions of the child and the right dorsolateral prefrontal and right temporo-parietal regions of the parent demonstrated the strongest INS. The dynamic change in INS during the interaction was associated with children's independent performance on a standardized test of visuospatial processing. This research, leveraging fNIRS hyperscanning, elucidates the neural dynamics underlying the interaction between parent praise and child positive affect, thereby contributing to our broader understanding of parent-child dynamics.

Anxiety is commonly experienced by autistic people and impacts on quality of life and social participation. New anxiety interventions are required to effectively meet the needs of autistic people. Personalised Anxiety Treatment-Autism (PAT-A©) is a bespoke, modular approach to treating anxiety in up to 12 sessions. This study explored the feasibility and acceptability of delivering PAT-A© in the UK National Health Service (NHS). A single-blind randomised controlled trial design. Thirty-four autistic adults were recruited via clinical services and randomised to receive either PAT-A© or enhanced treatment as usual (CCSP). Outcome assessments relating to anxiety, quality of life and related constructs were completed at baseline, immediately post intervention; and at 3 and 12 months. Seventy-one percent of the PAT-A© group and 65% of the CCSP met diagnostic threshold for at least three anxiety disorders. Retention was good across both groups, with 82% (N = 14/17) completing the full course of PAT-A© and 71% (N = 12/17) attending both psychoeducational sessions in CCSP. 94% in PAT-A© and 82% in CCSP completed some follow up assessment 3 months post-intervention. Thematic analysis of interview data revealed that many participants valued the personalised approach, developed transferable skills and experienced positive changes to their anxiety. Participants were willing to be recruited and randomised, PAT-A© was feasible to deliver in the NHS and the trial methods and materials were acceptable. Our findings indicate that a fully powered clinical and cost-effectiveness trial of PAT-A© is warranted.

Sustained motivation for Daily Mile participation at higher physical activity intensities may contribute to the attainment of children's daily moderate-to-vigorous physical activity (MVPA) targets and long-term health benefits. However, individual variability exists in the amount of MVPA accumulated by children during the Daily Mile. The current study explored children's motivation for participating in the Daily Mile at MVPA intensity, using a theory of planned behaviour framework. Twenty-five children (mean age = 10.07 ± 0.60 years) from the Northwest of England were recruited to the study; 52% were female and 88% were White. Participants completed a questionnaire, with an open-ended response format, probing behavioural, control, and normative beliefs for participation in the Daily Mile at MVPA intensity. Template analysis was conducted independently by two researchers to identify main themes and subthemes. Findings showed that children possessed a range of behavioural, control, and normative beliefs about MVPA participation during the Daily Mile. Prominent behavioural beliefs included fitness enhancement, implications for concentration and learning, positive affective states, and pain and discomfort. Key control beliefs included weather, space and health restrictions, and distractions from peers. Finally, peers and parents were salient normative beliefs. Children possessed a range of modal beliefs in relation to MVPA participation during the Daily Mile. Implications of the findings, and methods for practitioners seeking to maximise the contribution of the Daily Mile to children's daily MVPA targets are discussed.

Objective: This paper describes several automation tools and software that can be considered during evidence synthesis projects and provides guidance for their integration in the conduct of scoping reviews. Study Design and Setting: The guidance presented in this work is adapted from the results of a scoping review and consultations with the JBI Scoping Review Methodology group. Results: This paper describes several reliable, validated automation tools and software that can be used to enhance the conduct of scoping reviews. Developments in the automation of systematic reviews, and more recently scoping reviews, are continuously evolving. We detail several helpful tools in order of the key steps recommended by the JBI's methodological guidance for undertaking scoping reviews including team establishment, protocol development, searching, de-duplication, screening titles and abstracts, data extraction, data charting, and report writing. While we include several reliable tools and software that can be used for the automation of scoping reviews, there are some limitations to the tools mentioned. For example, some are available in English only and their lack of integration with other tools results in limited interoperability. Conclusion: This paper highlighted several useful automation tools and software programs to use in undertaking each step of a scoping review. This guidance has the potential to inform collaborative efforts aiming at the development of evidence informed, integrated automation tools and software packages for enhancing the conduct of high-quality scoping reviews.

Mobile learning has gained significant recognition for its beneficial effects on learning across various dimensions. Nonetheless, ensuring consistent learner acceptance of mobile learning remains a critical factor to address. This meta-analysis study is the first comprehensive examination of critical antecedents impacting learners' perceived usefulness and perceived ease of use of mobile learning within the Technology Acceptance Model. This study undertook a comprehensive analysis of prior research conducted in both English and Chinese languages during the last 22 years. The aim was to build the Integrated Mobile Learning Acceptance Model utilizing a one-stage meta-analysis structural equation model. Five major antecedents of perceived usefulness and perceived ease of use were identified, and the moderating effects of education level, region, and culture were revealed. The resulting model provides a cohesive framework for understanding the factors that influence learners' intention to use mobile learning across various contexts. At the same time, the results of the study contribute to the advancement of theory in mobile learning acceptance and have practical implications for the design and evaluation of mobile learning.

Embedding musicians' occupational health training in music education curricula is widely recommended due to the well-documented high prevalence of performance-related health problems (PRHPs) among musicians across their lifespan. A scoping review was conducted to examine the range of evidence from implementations of musicians' health education programs, regarding the maintenance of hearing, musculoskeletal, psychological, and vocal health, as well as injury prevention strategies to minimize the risk of PRHP. Eligible sources of evidence included published and unpublished studies reporting occupational health education programs (which may have incorporated information on physical or psychological health, exercise, or somatic movement training) implemented with pre-tertiary and tertiary music students and teachers. Studies reporting stand-alone psychological health education were excluded. Key characteristics from included studies were extracted and charted. Data charts outline commonalities across the reported results, including physical, psychological, educational, and behavioral change outcome measures. Out of 46 records included for data extraction, 35 reported programs with tertiary-aged music students, seven reported programs with pre-tertiary-aged music students, two reported programs with music teachers, and two reported systematic reviews. Reported benefits from this research with both pre-tertiary and tertiary music students suggest that musicians' health education and injury prevention strategies reduce self-reported playing-related pain and music performance anxiety. However, future implementation studies need to address identified challenges such as effective behavior change and the enablers and barriers to the long-term adoption of strategies for optimal music performance and health outcomes. This review highlights the need for further research into designing and embedding musicians' health education into all music training settings, including more implementations with pre-tertiary music students, as well as training to support the professional development needs of instrumental and vocal teachers.

Responses to the COVID-19 pandemic globally disrupted lives and contributed to the exacerbation of pre-existing inequalities. Women in research were also affected. The prominent role that women played in professional and personal care duties had a detrimental effect on their research outputs, potentially hindering their career progression. Moreover, the challenges faced by women academics during the pandemic, including job loss, increased mental health issues, and the intersection of gender with other socio-demographic traits exacerbated existing gender disparities within academia. By systematically scoping the qualitative literature on the experiences of women researchers during the pandemic, this study sought to explore how women experienced and reacted to the challenges generated by the COVID-19 pandemic. A qualitative meta synthesis of the included studies revealed three themes: gendered professional expectations, colliding identities and coping strategies. These themes show how gendered roles such as teaching and professional care work, associated with the hierarchical and gendered division of tasks both at home and in the workplace, made women feel unsupported and alienated as relevant agents in the academic context. The study reveals the importance of pastoral care, teaching and service work as the essential backbone of the academic infrastructure, especially in times of crises. It also exposes how productivity-focused researcher assessment criteria, rewarding mainly individual results and unrewarding of care and service work, can be viewed as perpetuating structural inequalities based on gender, parenting situations, contractual situations and background. In conclusion, this study exposes the need to proactively address the gendered practices and implicit biases which reproduce inequalities within academia and highlights how paying attention to the experiences and needs of women researchers is essential for improving the resilience and crises preparedness of academic the system.

Objectives: Community sites, including schools, are important settings for interventions to promote children and young people's mental health and wellbeing. A central provision to support mental health in the UK is school- and community-based counselling services. However, the evidence-base for school counselling services is limited by weak evaluation designs, lack of understanding of different counselling approaches in use, and a failure to conceptualise counselling services as part of a wider complex system. To address the last point, this article takes a complex system-focused perspective to explore how a 'system disruption', that is counselling service implementation, can be optimised in the Welsh education system. Design: The approach used in this study is a mixed-method qualitative design. Setting: Participants were recruited from school and community settings. They included children and young people, parents, carers, school staff, counsellors and stakeholders from health and education. Method: Consultations, key system stakeholder interviews and school case studies were conducted. All stakeholders were asked about their experiences of local authority-funded school- and community-based counselling services in Wales. Interview and consultation data were analysed using a thematic analysis approach. Results: Data converged into three main themes focusing on the specifics of counselling sessions, counselling services as part of universal mental health provision and a whole education system approach. These three themes are brought together into a complex systems-focused model of an optimised school- and community-based counselling service. Conclusion: The model offers an opportunity to address issues with current counselling services in Wales and improve outcomes and sustainability by increasing the likelihood they will become embedded in the whole education system.

The notions of indigenous knowledge and cultural philosophies are becoming ubiquitous in many social inquiries, and evaluation is no exception. Nonetheless, the pursuit to embed relevant indigenous philosophies in contemporary evaluation has yet to succeed. In this article, we discuss indigenous relational philosophies, approaches, and practices as they relate to evaluation. Using qualitative research approaches, we interviewed 43 Indigenous development leaders and other local representatives in three local government areas in Ghana. Utilizing evidence synthesis approaches through a triangulation process, we conclude that indigenous knowledge and other cultural ethos were distinct in community-based development evaluation processes. There was an elusive intersection between indigenous and contemporary evaluation paradigms. Indigenous evaluation has principles such as community spirit, mutual trust, self-organization, relational patterns or networks, "ubuntu" ideals, consensus building, and collective action that can complement contemporary evaluation for the effective and efficient evaluation of community development programs and social policies. We identify key indigenous elements and other indigenous relational assessment patterns to aid in the design of an indigenously driven relational evaluation framework. The evaluative competencies embedded in indigenous philosophies are vast, thus, a call for future research is proposed.

Digital technologies and the instructional contexts in which they are embedded can increase students' access to meaningful learning opportunities. Although there is a tradition of designing and integrating digital tools in secondary-grades project-based science instruction to enhance learners' access to disciplinary learning, the elementary grades have received less attention. This has left classroom teachers with limited guidance for leveraging affordances of digital tools in project-based learning (PBL) with younger learners. In this article, we describe the design and integration of digital tools in Multiple Literacies in Project-based Learning, a recent elementary-grade project-based science curriculum that integrates literacy and mathematics. We use the principles of Universal Design for Learning to characterize the affordances of these digital tools, with attention to how the interplay of the tools and the PBL environment in which they were embedded enhanced access to learning opportunities for all students.

Youth with attention problems are at increased risk for school disengagement (Booster et al., JAD 16:179-189, 2012; DuPaul & Langberg, in: Barkley (ed), Attention-deficit/hyperactivity disorder: A handbook for diagnosis and treatment, Guilford, New York, 2014), which portends risk for poor outcomes (Bond et al., JAH 40:357.e9-357, 2007; Carter et al., JA 30:51-62, 2007; Fredricks et al., RER 74:59-109, 2004). Interventions that target school engagement may benefit from peer delivery because peers are widely available in schools and potentially more credible than adults. In this study, a peer-supported school-based school engagement intervention for middle school students with attention problems, Together Engaging and Achieving Meaningfully (TEAM) was developed with educators and students. In initial development (Study One), community development team meetings with partners (N = 9 school staff and students) were conducted. Thematic analysis was used to identify themes used to refine TEAM. In Study Two, a single-case pilot with one student with attention problems and one peer coach was conducted. Measures of fidelity, attendance, acceptability, and satisfaction were collected. Results were used to refine TEAM. Then in pilot implementation (Study Three), a non-randomized pilot was conducted with 10 fifth- through seventh-grade students with attention problems (n = 6 in the intervention group) and six eighth-grade coaches. Measures of fidelity, attendance, acceptability, satisfaction, and clinician-required time for implementation were collected. Cohen's d mean difference effect sizes were calculated between and within groups over implementation. Feedback from partners highlighted barriers and aspects that were acceptable and feasible. Results from implementation suggested high attendance, high coach fidelity with revised implementation support, and low clinician-required time. Lessons learned and avenues for future development and research are discussed.

This study compared parenting across four non-Western cultures to test cross-cultural commonality and specificity principles in three aspects: measurement properties, parenting normativeness, and their associations with child outcomes. Both mothers and fathers (N = 1509 dyads) with preschool-aged children (M = 5.00 years; 48% girls) from urban areas of four countries (Malaysia, N = 372; China, N = 441; Turkey, N = 402; and Japan, N = 294) reported on four parenting constructs (authoritative, authoritarian, group harmony socialization, and intrusive control) and their sub-dimensions using modified culturally relevant measures. Teachers reported on children's internalizing, externalizing, and prosocial behaviors. The commonality principle was supported by two sets of findings: (1) full measurement invariance was established for most parenting constructs and sub-dimensions, except that intrusive control only reached partial scalar invariance, and (2) no variations were found in associations between parenting and any child outcomes across cultures or parent gender at the construct level for all four parenting constructs and at the sub-dimensional level for authoritarian and intrusive control sub-dimensions. The specificity principle was supported by the other two sets of findings: (1) cross-cultural differences in parenting normativeness did not follow the pattern of economic development but yielded culture-specific patterns, and (2) at the sub-dimensional level, the authoritative parenting and group harmony socialization sub-dimensions were differently associated with child outcomes across cultures and/or parent gender. The findings suggested that examining specific dimensions rather than broad parenting constructs is necessary to reflect cultural specificities and nuances. Our study provided a culturally-invariant instrument and a three-step guide for future parenting research to examine cross-cultural commonalities/specificities.

Due to its haptic and interactive nature, virtual anatomy provides an opportunity for small-group learning, enabling students to develop their group work skills before they graduate. However, there is currently little practical guidance supported by pedagogic principles detailing how to incorporate it into curricula. Anatomy educators at the University of Plymouth conducted action research aiming to capture students' overall perceptions of the virtual anatomy platform Anatomage. Questioning the benefits and challenges students face while interacting with Anatomage prompted the creation of evidence-based interventions to be later evaluated. Although a plethora of themes were identified, this report specifically examines those relating to group work. Thematic analysis of initial focus group data found group size and group dynamics impacted students' experience with the platform. Following the implementation of interventions to resolve these issues, a questionnaire and second series of focus groups were conducted to determine whether they were successful. Additional subthemes found from these data included facilitation, social pressure, peer learning and working with friends. This study contributed to the improvement of small group learning and integration of virtual anatomy into curricula based on student and staff feedback. As such, these data support the development of effective group working skills which are fundamental for healthcare professionals and widely recognized by regulators such as the General Medical Council and Health and Care Professions Council. In this report, the authors provide practical advice informed by pedagogy and principles from management and psychology to provide a multidisciplinary perspective.

Children and adolescents (henceforth "children") with both attention-deficit/hyperactivity disorder (ADHD) and anxiety experience greater difficulties than children with either alone, though qualitative methodologies are yet to be used to understand the challenges this population experiences. We aimed to explore parent-reported daily impacts of co-occurring anxiety in children with ADHD (ages 8-13 years). Participants were enrolled in an Australian trial evaluating an adapted anxiety intervention and were eligible if their child met diagnostic criteria for ADHD plus separation, social, and/or generalized anxiety disorder. A baseline measure of life impacts associated with child anxiety captured situations parents reported were difficult, due to their child's anxiety. Reflexive thematic analysis of free-text responses (N = 203) facilitated new insights via inductively generating key themes. Three overarching themes highlighted (1) child difficulties with everyday situations and processes due to their anxiety; (2) the nature of the child's anxiety being pervasive and unrelenting; and (3) the strain placed on the child's family system. This study enhances understanding of daily impacts associated with co-occurring anxiety and ADHD and may contribute to an improved understanding of support needs. Results reiterate the need to identify co-occurring difficulties in children with ADHD and support both children and their families.

We examined the prevalence of self-reported motivations and barriers to helping intoxicated peers among emerging adults (N = 377; M[subscript age] = 18.64; 75% women, 88% White) attending a Southeastern university and whether motivations and barriers differed by age, gender, race, and class standing. Respondents aged 19-24 were more likely to endorse the motivation item "Because it was your "turn" to be the helper/designated driver (DD) that night" than eighteen-year-olds. Race differences were also reported for the motivation item, "Because the person was your friend", where White participants were more likely to endorse this item than non-White participants. Men also reported more Burden/Hassles-related barriers than did women.

Background: This study investigated differences in the clinical and demographic characteristics of individuals with intellectual disabilities delayed in assessment and treatment hospitals versus individuals who were not delayed. The study further investigated the clinical outcomes of the individuals whose discharge from the hospital was delayed. Method: This was a cohort study using secondary data collected from patient records. Variables included age, ethnicity, levels of deprivation, areas of origin, diagnoses, and the provision of a care and treatment review. A comparison was made between individuals who became delayed despite being clinically ready for discharge and those who were discharged on time. Findings: Individuals with severe intellectual disabilities were more likely to experience delayed discharge from hospital (p = 0.001). Similarly, people who were admitted to hospitals away from their home areas were also more likely to experience delayed discharge (p < 0.001). There were no significant differences between the delayed and nondelayed groups for other factors such as age, deprivation or ethnicity. Individuals who experienced a delay in discharge did not experience an increased rate of adverse incidents compared to the period of active treatment and clinical improvements were maintained during the period of delay. There were low rates of completion of care and treatment reviews before admission, although people who were delayed were more likely to have received a review during admission (78.8% vs. 27.1%). Conclusion: It is important for clinicians and service development leads to be aware that people who are admitted away from their home area and people with severe intellectual disabilities may be at higher risk of experiencing significantly delayed discharge from the hospital. More broadly, many people remained in hospital for a substantial length of time after being assessed as clinically ready for discharge. Due to the low rates of completion before admission, the expansion of community-based care and treatment reviews should also be explored. While people did not suffer increased rates of adverse incidents during their extended stay, their liberty was still restricted, hence there should be a focus on effective community provision. The current model of relying on the willingness of independent providers to support the care of complex individuals requires significant reform.

Background: This study determined awareness and occupational exposures to needlestick injuries (NSIs) and its associated risk factors among healthcare workers (HCWs) in the Kumasi Metropolis, Ghana. Materials and Methods: A descriptive cross-sectional study was conducted among a total of 540 HCWs from three selected tertiary hospitals in the Kumasi Metropolis, Ghana. Data were collected using a structured questionnaire and analyzed. Results: All the study participants were aware of NSI and NSI-associated hepatitis B virus (HBV), hepatitis C virus, or human immunodeficiency virus (HIV) acquisition. Most of them (63.6%) were trained on the safety use of sharps devices and the majority of them preferred safety-engineered devices (79.8%). A greater proportion of the participants has had HBV vaccination (85.9%). The prevalence of NSIs was approximately 47%. NSIs were highly ranked to occur at patient's bedside (28.5%) and clinical laboratories (24.6%). Handling of needles/sharp objects before usage (27.7%) and during usage (34.0%) ranked the second and first cause of NSIs among health workers, respectively. Compared with those with less than 5 years working experience, having worked at the health facility between 5 and 10 years (prevalence rate ration [PRR] = 2.07 [1.39–3.11], p = 0.0004), 11–15 years (PRR = 4.32 [2.14–8.73], p < 0.0001), and >15 years (PRR = 5.73 [2.40–13.70], p < 0.0001) were associated with increased events of NSI. Conclusion: Despite the high awareness of NSIs and its perceived risk of infection acquisition, the prevalence of NSIs was high among HCWs. There is, therefore, the need for employers to enforce the universal precaution practices, provide regular training and education, and ensure adherence of HCWs to safety precaution of needle usage disease.