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Purpose: Determining whether patients’ unrealistic expectations of chemotherapy as a cure were associated with their perception of the disclosure of incurability. Methods: This prospective study included consecutive patients with pretreated non-small cell lung cancer from four study sites. Patients and their oncologists were asked whether they perceived the disclosure of cancer incurability. Patients were also asked if they thought that chemotherapy was curative. We followed up on whether the deceased patients received specialized palliative care 14 months after their last enrollment. Multiple regression analyses were conducted to examine the association between the expectation of chemotherapy as a cure and patient/oncologist-reported perceptions of the disclosure of incurability. Results: We analyzed 200 patients, 77 (38.5%) of whom had unrealistic expectations of a cure. Based on patients’ perceptions, incurability was disclosed to 138 (69.0%) patients, and based on their oncologists’ perceptions, incurability was disclosed to 185 (92.5%) patients (patient/oncologist agreements, κ = 0.19). Patients without a perception of the oncologist’s disclosure of incurability—regardless of their oncologist’s perception—were more likely to have unrealistic expectations of a cure than patients for whom both patient and oncologist perceptions were present. Patients who had unrealistic expectations of chemotherapy as a cure were shown to be significantly less likely to have received specialized palliative care, after adjusting for covariates (adjusted OR, 0.45; 95% CI, 0.23–0.91; p =.027). Conclusion: Oncologists’ disclosure of incurability was not fully recognized by patients, and expectations of chemotherapy as a cure were associated with patients’ perception of the disclosure of incurability. [ABSTRACT FROM AUTHOR]

Aim: To present the development, implementation and evaluation of a theoretically grounded novel virtual dissemination evaluation (VDE) framework. Background: Care of intensive care unit patients requires access to the most up‐to‐date knowledge and best practices. To address this challenge, we present the development, implementation and evaluation of a theoretically grounded novel VDE framework. This framework is applied to a dissemination strategy, NeoECHO, in neonatal intensive care units. Evidence‐based virtual education is implemented to prevent, detect and treat necrotizing enterocolitis in neonates. Design: Research Methodology: Discussion Paper—Methodology. Methods: The virtual dissemination evaluation framework is a sequential combination of Integration of Integrated‐Promoting Action on Research Implementation in Health Services and Moore's Expanded Outcomes frameworks. The framework's conceptual determinants, virtual facilitators and implementation evaluations were operationalized in the NeoECHO dissemination strategy and evaluated for feasibility. The virtual dissemination evaluation framework was conceptually mapped, and operational activities were examined including theoretical constructs drawing on insights of nursing theorists, especially Fawcett's criteria (2005) for frameworks with practical application (significance, internal consistency, parsimony, testability and design fit). The NeoECHO strategy was evaluated for virtual dissemination evaluation adherence, operationalization and feasibility of implementation evaluation. Results: The virtual dissemination evaluation framework meets the criteria for a practical application and demonstrates feasibility for adherence and operationalization consistency. The implementation evaluation was usable in the virtual dissemination of best practices for neonatal care for necrotizing enterocolitis and healthcare providers were actively engaged in using NeoECHO as an implementation strategy. Conclusion: This examination of the foundational aspects of the framework underscores the rigour required for generalization of practical application. Effective virtual dissemination of evidence‐based practices to hospital units requires structured delivery and evaluation, enabling engaged healthcare providers to actualize education rapidly. The virtual dissemination evaluation frameworks' potential for narrowing the evidence‐based practice gap in neonatal care showcases its wider significance and applicability. Implications: Care of neonates in NICUs requires a multidisciplinary approach and necessitates access to the most up‐to‐date knowledge and best practices. More than traditional dissemination methods are required to bridge the implementation gap. Impact: The effective use of the VDE framework can enhance the design, implementation and evaluation of knowledge dissemination, ultimately elevating neonatal care quality. Clinical Relevance: This paper introduces the VDE framework, a sequential combination of the iPARIHS and Moore's EO frameworks—as a methodological tool for designing, implementing and evaluating a neonatal strategy (NeoECHO) for virtual dissemination of education in NICUs. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

In this qualitative study, we explored Portuguese adolescents' perceptions of diet, sustainability, and health through six focus group discussions (FGDs). Fifty-five adolescents (10–18 years) participated. FGDs focused on sustainability in food choices and its health impact, with our primary interest in their perceptions. Results showed a limited comprehension of "sustainable/sustainability," especially among younger participants. Those aware of sustainability recognized its diverse aspects, including health, economic, and ecological domains. Some adolescents recognized the link between health and sustainability in their diets, emphasizing the need for food literacy. These findings emphasize the importance of public health and sustainable policies among Portuguese adolescents. [ABSTRACT FROM AUTHOR]

AbstractDespite the increasing emphasis on social studies in Early Childhood Education, there has been a serious paucity of empirical studies on how culturally and linguistically diverse children develop their emergent understanding on their identities and citizenships in different racial and cultural surroundings. The main purpose of this article is to explore the intersections of bilingualism, early literacy practices, and social studies education by examining bilingual children’s conversations about dual citizenships and ethnic identities during read-aloud sessions. The data were collected by video/audio recordings, open-ended interviews, and children’s artifacts over a period of four months. The findings suggest the potential of bilingual discussions about dual citizenship as a means to help young bilinguals develop their emergent understandings of their rights and responsibilities as young dual citizens. [ABSTRACT FROM AUTHOR]

This qualitative case study investigated L2 readers' semester-long experiences with web-based pre-class peer discussions (WPPD). Data were collected from a university L2 reading course and included field notes on 21 students' web-based learning activities and in-class learning activities, interviews with these students, and their reflections. Through a qualitative analysis of these data sources, the study revealed that the L2 readers felt that the WPPD created an engaging peer-learning platform for their pre-class learning. The students also felt that their WPPD, buttressed by their instructor's in-class assistance, gradually facilitated their pre-class navigation of a new text, as exemplified by their questions and answers about the deep meaning of the text. The study concludes that despite the L2 readers' individual differences regarding their need for teacher assistance, they perceived WPPD as useful for their pre-learning activities motivating them to engage in peer learning and develop subject knowledge, especially in L2 contexts, where understanding the deep meaning of L2 texts at the content level is emphasized. [ABSTRACT FROM AUTHOR]

Background: In the Indian context, published systematic research on the opinions of mental health professionals and other stakeholders (patients and caregivers) regarding the different adverse effects of electroconvulsive therapy (ECT) is not available. This type of study allows for an in-depth exploration of complex phenomena, such as the perspectives of mental health professionals, which can provide a rich understanding of their experiences regarding ECT and also helps to understand the views of mental health professionals regarding the adverse effects of ECT during the post-ECT recovery period and its management. Conversely, the perception of patients and caregivers regarding the adverse effects of ECT can provide a more comprehensive understanding of the treatment and its impact on the patients who receive it. Purpose: To explore the understanding of participants about the various adverse effects following ECT and their perception of managing different adverse effects of ECT during the post-ECT recovery period. Methods: A qualitative approach using focus group discussion (FGD) was used. A convenience sampling technique was followed for selecting the participants. FGDs were conducted with stakeholders including mental health professionals, patients, and caregivers. Five FGDs were conducted with psychiatry residents, nursing officers from the ECT suite, and different psychiatry wards at NIMHANS. Four FGDs were held separately for patients receiving ECT and their caregivers, admitted to various psychiatry wards at NIMHANS. A total of 28 mental health professionals, 20 patients, and 20 caregivers participated. The number of participants for FGDs was decided based on data saturation. The FGDs, lasting 30--40 minutes each, occurred between October 2022 and December 2022. The FGDs were audio-recorded with prior permission from the participants. All the participants were informed about the study. Written informed consent was obtained. All FGDs were transcribed. Thematic analysis was done using Atlas. ti software. Results: The broad categories identified were adverse events associated with ECT during the ECT procedure, adverse events associated with ECT after the ECT procedure, prevalence of different adverse effects according to mental health professionals, effects of adverse effects on the continuity of ECT, and difficulties encountered by mental health professionals throughout the management. Other broad categories were found after conducting FGDs with caregivers and patients, which were patients' experience as per the caregivers over the course of ECT, caregivers' and patients' willingness to continue ECT, unfavorable impacts of ECT experienced by the patients immediately after ECT sessions, and, later till the end of that day, suggestions of the caregivers and patients to improvise the management of ECT-related adverse effects and management of adverse effects by the treating team. Conclusion: The findings will develop a standard operating procedure that may help nursing officers monitor and identify the adverse effects immediately after ECT and minimize the complications during the post-ECT recovery period. [ABSTRACT FROM AUTHOR]

Despite the established need for sexuality and relationship programming for autistic adults, there are extremely limited curricula for this population. This pilot study used an evidence-based sexuality and relationship education program for autistic adolescents (Tackling Teenage Training) as the basis for an adult-focused virtual psychoeducational group. Qualitative feedback, quantitative ratings of the programming, and behavioral surveys from participants were collected. Nine participants completed the program, and corresponding pre and post measures. Highly rated topics, for example gender identity and online dating, were consistent with previous research on what autistic adults want from a sexuality and relationship education program. Future programming should incorporate increased attention to themes and topics highlighted by participants, and should utilize the teaching tools (e.g., role play, peer discussions) identified as useful by the participants. [ABSTRACT FROM AUTHOR]

Most online media consumption is not driven by a desire to seek out news and politics. However, the public may still encounter politics because it arises organically in communities devoted to non-political subjects. This study examines the potential of popular reality television online discussion forums to serve as online third spaces and stimulate political discussion due to the natural connections that audiences make between the cast members and "real life" in reality-based programming. Based on a quantitative analysis of political comments made to reality television subreddits and a survey of visitors to a popular subreddit focused on The Bachelor television show, the findings not only demonstrate the ability of entertainment-focused online communities to expose a broad segment of the public to political talk, but also point to the obstacles in promoting political discussion that is simultaneously enjoyable, informative, and tolerant of diverse viewpoints. [ABSTRACT FROM AUTHOR]

Some questions, such as the definition or name of certain feeds, the need for hay imports, new edition of Quality Standard of Fishmeal for Feed, fish and shrimp feed high protein, ideal feed, conditions under which feed products play their intended role, the order in which each component of a diet is supplied, the "direct supply theory" of dietary nutrients was put forward, in feed industry and feed science literature are listed in this paper. Regarding the above questions, the thinking and discussion are done for reference of colleagues in the industry. [ABSTRACT FROM AUTHOR]

Background: Deaths of people with intellectual disabilities are often unplanned for and poorly managed. Little is known about how to involve people with intellectual disabilities in end-of-life care planning. Aim: To explore the perspectives of people with intellectual disabilities, families, health and social care professionals and policy makers on end-of-life care planning within intellectual disability services. Design: A total of 11 focus groups and 1 semi-structured interview were analysed using qualitative framework and matrix analysis. The analysis was conducted inclusively with co-researchers with intellectual disabilities. Setting/participants: A total of 60 participants (14 people with intellectual disabilities, 9 family carers, 21 intellectual disability professionals, 8 healthcare professionals and 8 policy makers) from the UK. Results: There were differences in how end-of-life care planning was understood by stakeholder groups, covering four areas: funeral planning, illness planning, planning for living and talking about dying. This impacted when end-of-life care planning should happen and with whom. Participants agreed that end-of-life care planning was important, and most wanted to be involved, but in practice discussions were postponed. Barriers included issues with understanding, how or when to initiate the topic and a reluctance to talk about dying. Conclusions: To develop effective interventions and resources aiding end-of-life care planning with people with intellectual disabilities, clarity is needed around what is being planned for, with whom and when. Research and development are needed into supporting intellectual disability staff in end-of-life care planning conversations. Collaboration between intellectual disability staff and palliative care services may facilitate timely end-of-life care planning and thus optimal palliative end-of-life care. [ABSTRACT FROM AUTHOR]

Examining the impact of maternal borderline personality disorder (BPD) on parent-child interactions could elucidate pathways of intergenerational risk and inform intervention. The current study used an expanded version of the Observing Mediational Interactions to investigate (a) associations between maternal BPD symptom severity and mediational parenting behaviors during conflict discussions with clinically referred early adolescent offspring (N = 56, age = 10-15, 54% female) and their mothers, and (b) the potential moderating role of early adolescent BPD symptom severity in those associations. Consistent with hypotheses, mothers with higher levels of BPD symptom severity engaged in fewer positive emotional/attachment-based behaviors and more negative (i.e., invalidating, controlling, coercive, or insensitive) parenting behaviors. Only parent-reported, but not self-reported, adolescent BPD severity moderated these associations; maternal BPD severity was significantly associated only with negative parenting in dyads with low-to-moderate levels of parent-reported adolescent BPD severity. We discuss implications including targeting attachment-based and negative parenting behaviors in intervention. [ABSTRACT FROM AUTHOR]

To better understand what makes cost-of-care communication between oncologists and cancer patients more or less successful, we conducted in-depth interviews with 32 oncologists (22 male, 10 female) who were board-certified in medical, surgical, or radiation oncology. Through qualitative descriptive analysis by four coders, we found that oncologists used six broad strategies to discuss cost with patients: open discussion, avoidance, reassurance, warning, outsourcing, and educating. We also found that oncologists invoked certain meanings of cost conversations: cost conversations as holistic care, coercion, a matter of timing, risking patient suspicions, advocacy, unwanted distraction, transparency, bad news delivery, problem-solving, pointless, informed decision making, or irrelevant. These meanings appeared to be linked to oncologists enacting certain strategies (e.g., oncologists who invoked cost conversations as holistic care tended to enact open discussion, those who saw cost conversations as risky tended to use avoidance). Theoretically, our results suggest that the invoked meaning of a difficult conversation may be a key explanatory mechanism for differentiating high-quality from low-quality communication in cost conversations. Practically, our findings suggest that oncologists should consider how well the invoked meaning of the cost conversation is serving their own and their patients' goals. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges ICU (Intensive care unit) clinicians face in conducting end-of-life care conversations, highlighting barriers such as system issues, variability in conversation quality, goal misalignment, and clinician moral distress.

The article focuses on the importance of documenting patient goals and preferences in medical records to ensure continuity of care and alignment with patient preferences, highlighting the role of nurses and social workers in facilitating these discussions.

Background: Community health agents (CHAs) provide basic health services and increase health care access thereby improving health outcomes for peri-urban regions in Peru. Few studies analyze the effect that becoming a CHA has on women's interpersonal interactions. We aim to explore the impact CHAs may have on gender and social norms through their roles as trusted leaders in male-dominated communities. Methods: We conducted six 90-minute group discussions with CHAs working in Huancayo and Trujillo, Peru. We designed the discussions to extract data about family and community norms that changed as a result of working as a CHA. Results: A total of 53 female CHAs participated in six discussion groups. CHAs reported shifting family support (a change in how their family supported them in their role as a CHA), gaining status within their family (feeling more valued for their knowledge and experience), and shifting family gender roles (men and boys taking on more household responsibilities) as a result of their work. CHAs also reported a change in community norms and felt they were more valued and respected within their communities as women leaders. Conclusions: Working as a CHA creates an opportunity to enact social change through altering family dynamics and community perceptions. Moreover, empowering women to become CHAs not only generates tangible benefits in community health, but can help create social change that ultimately improves the lives of women and realize their human rights. [ABSTRACT FROM AUTHOR]

Background In collaboration with six European public health agencies as part of the PANDEM-2 consortium, we have developed and validated a self-assessment tool that captures the workforce capacities and capabilities needed at the institutional level within National Public Health Institutes (NPHIs) to deal with public health emergencies. Methods The work carried out in this study included (i) a review of existing tools for workforce assessment, (ii) focus group discussions and interviews to map the experiences and needs of NPHI's, (iii) the development of a tool for NPHI's to assess their workforce capacity and capabilities in public health emergency preparedness (PHEP) and (iv) refinement of the assessment tool via a Delphi study. Results Capacity markers were identified to assess the workforce required for PHEP functions and the availability of surge capacity during a public health emergency. The tool also enables NPHIs to analyze gaps in PHEP staff competencies. The assessment scores can assist NPHI pandemic preparedness by identifying and prioritizing training and recruitment needs. Conclusions In line with EU Regulation 2022/2371 on serious cross-border threats to health, article 11 Training of healthcare staff and public health staff, Member States (MS) are tasked with assessing current workforce capacity and capability gaps. The PANDEM-2 workforce self-assessment tool aligns with this requirement and will support effective planning and development to strengthen the public health workforce capacity in EU MS. [ABSTRACT FROM AUTHOR]

Background: Deep discussions play an important role in students' online learning. However, researchers have largely focused on engaging students in deep discussions in online asynchronous forums. Few studies have investigated how to promote deep discussion via mobile instant messaging (MIM). Objectives: In this study, we applied learning analytical tools (i.e., KBdeX and word clouds) to enhance students' shared epistemic agency and thereby support their deep discussions in MIM. Methods: Forty Chinese college students participated in this study and reflected on their MIM engagement by participating in the learning analytics (LA)‐augmented meta‐discourse sessions. The study used multiple data analysis methods, including content analysis, statistical analysis, epistemic network analysis and lag sequential analysis. Results: We found that LA engaged students in deep discussions and shared epistemic agency‐related discourse, such as creating shared understanding, creating knowledge objects, and projective and regulative processes. In particular, word clouds engaged students in more complete shared epistemic agency discourse trajectory which started from creating awareness of unknowns, then progressed to setting projective plans and sharing information, and ultimately, creating shared understanding. Moreover, our analysis indicated that epistemic agency discourse moves of creating shared understanding led students to a high level of deep discussion. Implications: This study contributes to research by extending the 'comparison paradigm', which focuses on comparing (a)synchronous forums with MIM, to a 'design paradigm', which mobilises design features from (a)synchronous forums to MIM and using learning analytical tools to engage students in deep online discussions by promoting their epistemic agency. Lay Description: What is known in this subject matter: Supporting students' online deep discussions is important.Prior studies have shown multiple technological and pedagogical strategies to support deep discussions in (a)synchronous discussion forums, but few studies in mobile instant messaging (MIM).MIM is a quasi‐synchronous tool. It is difficult to transform the traditional external scaffolds (i.e., scripts or teachers' facilitation) which promote deep discussions from (a)synchronous forums to MIM. What this paper adds to this: We constructed a design framework which used learning analytical tools‐augmented meta‐discourse to engage students in shared epistemic agency discourse moves to promote their deep discussion in MIM.We conducted multiple types of analyses (content analysis, statistical analysis, epistemic network analysis and lag sequential analysis) on students' WeChat message (a major MIM in China).Results indicated both learning analytical tools helped engage students in shared epistemic agency discourse moves, such as creating shared understanding, creating knowledge objects, projective and regulative, thus, to promote students' deep discussions. Word cloud especially engaged students in more complete shared epistemic agency discourse trajectory. Moreover, analysis results indicated that shared epistemic agency discourse moves of creating shared understanding would lead students to a high level of deep discussions. Implications of study findings for practitioners: Our study provides a feasible way to educational practitioners who want to promote students' deep discussions in their online learning course (both fully online and flipped classroom mode).Knowledge Building Discourse Explorer (KBDeX presents the original analysis results of students' written messages in discussion forums as socio‐cognitive networks.) could be implemented in the classroom. The objective is to encourage students to understand the importance of connecting with peers' ideas in a one‐session implementation period.If time allows, teachers could use word cloud and meta‐discourse to engage students in socio‐metacognitive conversations in class to promote their shared epistemic agency discourse in online discussions. [ABSTRACT FROM AUTHOR]

Background: Online collaboration tools have been identified as potentially effective means for enhancing student learning, motivation, and engagement in science education. However, their effectiveness in improving science education outcomes among middle school students remains uncertain. Objectives: The study aimed to investigate the impact of online collaboration tools on science education outcomes among middle school students, focusing on learning achievement, engagement, and motivation. Methods: A quasi‐experimental design with a pretest‐posttest control group was used in this study. A total of 60 eighth‐grade middle school students were involved in the study, with both the experimental and control groups comprising 30 students each. The experimental group incorporated the use of digital collaboration platforms, including Asana, Slack, and Team Viewer, as instrumental components of group project execution and discussion in their science lessons. Conversely, the control group adhered to the current educational approach in Turkey, characterized by the employment of an inquiry‐based learning strategy in their science instruction. Data was collected over eight weeks using a science achievement test, engagement scale, and science motivation scale. Results: The experimental group demonstrated significantly higher post‐test scores compared to the control group, suggesting that online collaboration tools positively impacted science education outcomes. Additionally, survey data indicated high levels of engagement and motivation among the experimental group students when using the online collaboration tools. Conclusions: The findings support the notion that online collaboration tools can effectively enhance learning, motivation, and engagement in science education among middle school students. These results have significant implications for educators, educational institutions, policymakers, and curriculum developers. Further research is needed to examine the potential of these tools in various educational contexts and with different student populations. This will help broaden the understanding of how online collaboration tools can be integrated into diverse learning environments, potentially benefiting a larger number of students and further improving science education outcomes. Lay Description: What is already known about this topic: Technology's role, particularly online collaboration tools, in enriching science education is undebatable (Donkin & Rasmussen, 2021; Rahmawati et al., 2022). Such tools have been theorized to bolster student learning outcomes, motivation, and engagement (Donnelly et al., 2013; Ekici, 2017; Khazanchi & Khazanchi, 2019). Yet, the empirical evidence validating their efficacy in science educational settings remains sparse. What this paper adds: This research delves into the influence of online collaboration tools on science learning outcomes among middle school learners. Data indicates that employing these digital tools substantially elevates student performance, as gauged by a science achievement test. Furthermore, students navigating through these online collaborative platforms recorded elevated levels of both engagement and motivation. The primary effectiveness of online collaboration tools stems from their ability to foster specific behaviours, such as increased communication frequency and structured task management, which can amplify learning and group collaboration through their facilitated structured interactions. Implications for practice and/or policy: This study's conclusions offer pivotal insights for educators, academic institutions, policy framers, and curriculum architects. Online collaborative platforms exhibit promise in amplifying student outcomes and engagement within the realm of science education. It is imperative to broaden this research scope to discern the tools' potential across varied educational environments and diverse student demographics. There is a compelling case for stakeholders, especially educators and policymakers, to contemplate incorporating these online tools into science pedagogy, aiming to magnify student learning experiences and engagement levels. [ABSTRACT FROM AUTHOR]

Supportive housing programs such as the Community Homes for Opportunity (CHO) that provide combined formal (off-site healthcare providers) and informal (on-site supports are effective in reducing erratic housing and homelessness. This study explored the views of the Community Mental Health Agency staff on their experiences with the CHO and related changes for further improvement of the program. We applied focused ethnographic techniques to recruit 47 agency staff from 28 group homes in Southwestern Ontario, Canada. Focus group discussions were conducted at two-time points (baseline–spring 2018 and post-implementation – winter 2019). Data analysis guided by Leininger's ethnographic qualitative analysis techniques produced three main themes and 11 subthemes themes. The main themes include facilitators of CHO, challenges to the CHO implementation, and strategies for improving the CHO program. Overall, supportive housing models have been found to constitute an effective pathway to reducing precarious housing and ending chronic homelessness for those in need while enhancing their social integration. [ABSTRACT FROM AUTHOR]

At present, the field of political psychology lacks an effective framework to conceptually organize the findings from the voluminous literature assessing whether interpersonal political interaction makes democracy better or worse. Historically, the scholarship examining various styles of interactions has remained siloed; scholars have not designed their studies to facilitate comparisons across different styles, so the accumulation of knowledge about one style often fails to influence how knowledge is accumulated about other styles. Moreover, the approaches used to study interpersonal political interaction bundle together constituent facets of discussion in a way that makes it difficult to unpack the relationship between the structural features and attitudinal outcomes of that interaction. In this review, I seek to develop a conceptual framework with two goals: (1) to encourage research design that intentionally examines why and how particular features of interpersonal interactions are linked to particular kinds of attitudinal outcomes, regardless of the style of interaction and (2) to facilitate communication between academic researchers and practitioners in order to strengthen the theory‐to‐practice pipeline for interpersonal political interaction research. [ABSTRACT FROM AUTHOR]

The memory conformity effect occurs when people witness a given incident (e.g. a crime) then talk to each other about it, and the statement of one person affects the memory account of the other person with respect to this incident. The aim of this article is to improve the quality of witness testimony by verifying the effectiveness of three methods that aim to reduce memory conformity effect: (1) an extended warning against misinformation; (2) a method based on information about memory functioning and its fallibility and (3) a method consisting in motivating participants to resist influence and demonstrating their individual vulnerability to it. In the presented experiment, the innovative MORI technique was used to study the memory conformity effect. This technique allows a pair of participants to sit beside each other, look at the same screen and see a different version of the same criminal event. In the next stages, the subjects are asked to answer a series of questions about different details, thereby introducing mutual misinformation; then, the participants perform an individual memory test. In the experimental conditions, this test was preceded by one of the three tested methods in each group, with the aim of determining their effectiveness in reducing memory conformity. It turns out that the implementation of an extended warning against misinformation eliminated the memory conformity effect, while the application of two other methods led to a reduction (but not complete elimination) of the studied phenomenon. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Physicians often feel they are not equipped to serve the lesbian, gay, bisexual, and queer (LGBTQ) community, but integrating education that incorporates LGBTQ content and perspective into an already-condensed medical school curriculum is challenging. We developed a preclinical active learning module on assisted reproductive technologies (ART) in LGBTQ care, integrating clinical and basic science content with patient perspective. METHODS: We created a module that combined a case-based small group discussion with a patient panel. We developed a case for discussion in collaboration with a female cis-gender same-sex couple who conceived through ART. A patient panel with the same couple followed the discussion. All first-year medical students attended both parts of the module. Prior to participation, students learned reproductive endocrinology and genetics concepts through lectures. After the module, students voluntarily completed an anonymous survey to evaluate self-perceived changes in familiarity and confidence with LGBTQ patients and satisfaction with the module. RESULTS: Of the 126 students who attended, 72 (57%) completed the survey. Of these, 69 (95.8%) felt the module gave them better perspectives on LGBTQ patient experiences, and 66 to 69 (92-96%) agreed the small group discussion achieved its learning objectives on LGBTQ health barriers and the application of ART. Students valued the patient panel (84.7%) and cited a better understanding of reproductive barriers for LGBTQ patients as its most valuable point. CONCLUSION: A preclerkship module combining a case-based small group discussion and patient panel on ART delivered in the context of a real-life LGBTQ patient experience provided an opportunity for the students to integrate basic science and clinical science knowledge to reflect on the healthcare needs of this patient population. Creating the case in collaboration with the same-sex couple and having them present their own experience provided an authentic perspective to students on reproductive healthcare issues and how they impact members of the LGBTQ community. [ABSTRACT FROM AUTHOR]

This study reports the preliminary efficacy of an innovative school‐based, technology‐enhanced social–emotional learning program called “mindfulness‐based collaborative social reasoning” (MBCSR) for middle school students. MBCSR was developed by an interdisciplinary team of educational psychologists, mindfulness researchers, computer scientists, and health experts. We integrated the strengths of contemplative approaches, collaborative small group discussions, learning technology, and multidimensional assessments of students' social–emotional outcomes. Using a quasi‐experimental design, the study was implemented in four sixth‐grade English language arts classrooms (2 experimental and 2 business‐as‐usual control; N = 74) in a public middle school in the Midwest of the United States. It was co‐implemented by researchers and teachers, with sessions occurring for 45 minutes, once per week, for 8 weeks. The MBCSR group showed greater self‐efficacy for using Upa‐yoga and mindful breathing to regulate their emotions and behaviors (ηp2$$ {\eta}_p^2 $$ = .13), and lower externalizing (ηp2$$ {\eta}_p^2 $$ = .07) and bullying behaviors (ηp2$$ {\eta}_p^2 $$ = .09) at the posttest compared to the control group, after controlling for baseline differences. Students in the experimental group overall showed positive and relaxed emotional and physiological states during the sessions. There were no significant differences between the two groups in mindfulness, emotional regulation, and social skills. This program sets an example for integrating social–emotional learning and academic learning into students' daily content instruction. [ABSTRACT FROM AUTHOR]

The article critically examines the phenomenon of cyberlibertarianism, which encompasses various digital advocacy causes such as open source software, internet freedom, and encryption, highlighting the lack of nuanced discussions and the opaque relationship between these digital issues and broader political contexts. It argues that cyberlibertarianism often presents absolutist views without addressing the complexities and contradictions within them.

Through a conversation analytic approach, we investigate the emergence of accounts provided by autistic children in small-group discussions. Nine Finnish children (7–10 years old) attending school with special support participated in a five-month-duration pedagogical practice purposefully designed to enhance children's participation in groups. We analyzed videos of sharing circles where children discussed their ideas and interests. Our data show three different account structures, which created different modes of children's participation and gradually changed how they positioned themselves in the group. Results show how accounts can create different focuses of attention; reveal children's reflections on what is relevant to them, and how to promote the exchange of ideas within a small group. Implications for the development of educational practices are discussed. [ABSTRACT FROM AUTHOR]

Exposome research is put forward as a major tool for solving the nature‐versus‐nurture debate because the exposome is said to represent "the nature of nurture." Against this influential idea, we argue that the adoption of the nature‐versus‐nurture debate into the exposome research program is a mistake that needs to be undone to allow for a proper bioethical assessment of exposome research. We first argue that this adoption is originally based on an equivocation between the traditional nature‐versus‐nurture debate and a debate about disease prediction/etiology. Second, due to this mistake, exposome research is pushed to adopt a limited conception of agential control that is harmful to one's thinking about the good that exposome research can do for human health and wellbeing. To fully excise the nature‐versus‐nurture debate from exposome research, we argue that exposome researchers and bioethicists need to think about the exposome afresh from the perspective of actionability. We define the concept of actionability and related concepts and show how these can be used to analyze the ethical aspects of the exposome. In particular, we focus on refuting the popular "gun analogy" in exposome research, returning results to study participants and risk‐taking in the context of a well‐lived life. [ABSTRACT FROM AUTHOR]

Aims The aims of this study were to evaluate: (i) the short- and long-term effects of the internet-based cognitive behaviour (iCBT) programme on symptoms of distress and fear disorder in cardiovascular disease (CVD) patients, and (ii) the association between changes in depression and changes in symptoms of distress and fear disorder from baseline to 12-month follow-up. Methods and results Secondary analysis of data collected in a randomized controlled study evaluating the effects on depression of an iCBT programme compared to an online discussion forum (ODF) in CVD patients (n = 144). Data were collected at baseline, at post-intervention (9 weeks), and at 6- and 12-month follow-ups. The results showed that symptoms of distress disorder were statistically significantly more reduced in the iCBT group than in the ODF group. For symptoms of the fear disorder, no differences were found except for avoidance, which showed a statistically significant reduction in the iCBT group. The long-term analysis in the iCBT group showed that CAQ total score and fear decreased from baseline to 6- and 12-month follow-ups, respectively. Avoidance and attention both decreased statistically significantly from baseline to post-intervention, but not between post-intervention and 12-month follow-up. Conclusion The results suggest that the iCBT programme targeted depression in CVD patients successfully reduced symptoms of distress disorder and to a lesser extent symptoms of fear disorder. Change in depression was more strongly associated with a change in distress than a change in fear disorder. Registration ClinicalTrials.gov: NCT02778074 [ABSTRACT FROM AUTHOR]

The U.S. Preventive Services Task Force recommends screening women to identify individuals eligible for genetic counseling based on a priori hereditary breast and ovarian cancer syndrome (HBOC) risk (i.e., risk assessment). However, risk assessment has not been widely integrated into primary care. This qualitative study explored young women's views on implementing routine HBOC risk assessment with a focus on equity and patient-centeredness. We conducted group discussions with young women (aged 21–40 years) receiving care in an integrated health care system. Discussion groups occurred in two phases and used a modified deliberative approach that included a didactic component and prioritized developing consensus. Twenty women participated in one of three initial small group discussions (phase one). All 20 were invited to participate in a subsequent large group discussion (phase two), and 15 of them attended. Key themes and recommendations were as follows. Risk assessment should be accessible, contextualized, and destigmatized to encourage participation and reduce anxiety, particularly for women who do not know their family history. Providers conducting risk assessments must be equipped to address women's informational needs, relieve emotionality, and plan next steps after positive screens. Finally, to minimize differential screening uptake, health care systems must prioritize equity in program design and contribute to external educational and outreach efforts. Young women see pragmatic opportunities for health systems to optimize HBOC screening implementation. [ABSTRACT FROM AUTHOR]

Computer-supported collaborative learning (CSCL) seeks to improve students' learning with the support of technology. Although CSCL facilitates an enriching environment for cooperation, CSCL activities might be affected by asymmetrical participation. Group awareness tools have proven to enhance learners' interactions, balancing the levels of participation and increasing the learning outcomes. This study investigates the effect of a group awareness tool (GAT) on participation within synchronous CSCL activities in the context of extracurricular activities. We designed a quasi-experimental within-subject study (GAT exposure and control condition) and tested an ad hoc GAT in a web-based CSCL platform with high school students (N = 140). The measured variables included the effect of the GAT on students' participation and the quality of discussion. A complementary analysis evaluated students' perceptions of the tool. Results revealed that the implementation of a GAT encourages students to take part in CSCL discussions without explicitly hindering its quality. Even so, the balance of participation was not significantly affected. Students further reported that they found the GAT useful to regulate collaboration. The results from the study provide further knowledge of the functioning of group awareness tools in secondary education and share an insight into how students perceive them. [ABSTRACT FROM AUTHOR]

Background: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non‐specialist settings. Objective: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management. Methods: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium. Results: Within the physical axis (Axis 1), the self‐report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10‐section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint‐related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra‐brief 11 item assessment. Conclusion: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non‐specialist general dental practice. [ABSTRACT FROM AUTHOR]

The vision behind the Next Generation Science Standards (NGSS) is that all students engage in explaining phenomena and designing solutions with three-dimensional learning. Authentic sensemaking involves opportunities for learners to share, analyze, and critique ideas in collaborative groups. However, it can be challenging to structure classroom discourse so that all students actively participate. This article outlines the success of two teachers using Group Learning Routines (GLR), or peer-to-peer discussion protocols, to support diverse learners. The routines are embedded in the New Visions for Public Schools Biology Curriculum which is open source and storyline-based. The unit described here engages students in an exploration of the mismatch between how our bodies and our environments function. Embedded routines structure student talk throughout a learning sequence culminating in class consensus discussion, in which students collaboratively decide on a class-wide explanation of the phenomenon. Resources, such as rubrics, descriptions of the routines, and example student work are provided to support classroom implementation. [ABSTRACT FROM AUTHOR]

Peer-based interventions are increasingly used for delivering mental health services to help people with an illness re-examine their situation and accept their illness as part of their life story. The role of the peer supporter in these interventions, known as experts-by-experience (EbE), is situated between mutual peer support and semi-professional service delivery, and they face the challenge of balancing an asymmetric, professional relationship with a reciprocal, mutuality-based, equal relationship. This article investigates how EbEs tackle this challenge when responding to clients' stories about their personal, distressing experiences in peer-based groups in psychiatric services. The results show how the EbEs responded to their clients' experience-sharing with two types of turns of talk. In the first response type, the EbEs highlighted reciprocal experience-sharing, nudging the clients toward accepting their illness. This invoked mutual affiliation and more problem-talk from the clients. In the second response type, the EbEs compromised reciprocal experience-sharing and advised clients on how to accept their illness in their everyday lives. This was considered less affiliative in relation to the client's problem description, and the sequence was brought to a close. Both response types involved epistemic asymmetries that needed to be managed in the interaction. Based on our analysis, semi-professional, experience-based expertise involves constant epistemic tensions, as the participants struggle to retain the mutual orientation toward peer-based experience-sharing and affiliation. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles within the issue, including a roundtable on Eric Lott's book "Love and Theft: Blackface Minstrelsy & the American Working Class," the trial of fugitive enslaved woman Lucy Bagby and a collection of book reviews.

The article presents the highlights of the roundtable discussion about the book "The Black Civil War Soldier: A Visual History of Conflict and Citizenship" by Deborah Willis. Topics include a visual history of conflict and citizenship, the revolution of photography, and art history. Among the participants are Cheryl Finley, Sarah Elizabeth Lewis, and Deborah Willis.

Background: In Colombia, health care for people with trans life experiences is characterised by countless barriers to health services and care. Commonly, trans people have experienced stigma and discrimination among health professionals, a lack of services and professionals specialized to guarantee affirmative processes from non-hegemonic gender perspectives, and there exists a marked pathologization and medicalization of services. Therefore, it is necessary to provide affirmative health services to improve health and well-being from the recognition of their needs and experiences. The article describes life narratives about health care for the gender transitions of trans women in Colombia. Methods: A qualitative narrative study was conducted with 139 trans women in seven cities in Colombia. In-depth interviews and discussion groups were conducted between June 2019 and March 2020. Data were analyzed using thematic analysis and the Atlas Ti cloud program. National and international ethical guidelines were followed in the development of the research. Results: This research provided an overview of the health experiences of Colombian trans women. They reported their experiences of pathologizing approaches to transgender healthcare, stigma, discrimination, and barriers to accessing preventive, specialized, and regular healthcare services. For this reason, they opted for self-medicated gender transition processes and self-management of health care. An important aspect to consider within healthcare is that not all women want binary gender transition processes. Conclusion: Participants felt that in Colombia there is a lack of affirmative health care for transgender women and that there are many limitations to care related to the gender transition processes. This exposes them to more situations that violate their rights and influences their lack of confidence and their search for professional health care. In Colombia, it is important to develop strategies for education, information, and communication, as well as a handbook for health workers on specialized healthcare for trans women. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsCollegial conversations are important for sustainable learning to last beyond a course. Research on collegial conversations and peer learning in the workplace during psychiatric residency courses remains sparse, however. In this study, the aim was to explore residents’ opportunities for collegial conversations during and after national courses in psychiatry.Residents in psychiatry completed an online survey including questions on opportunities for collegial conversations in their workplaces. Logistic regression was used for multivariate analysis and thematic content analysis was used for the open-ended answers where a theoretical framework of communities of practice was employed for the interpretation of the findings.The survey was completed by 112 residents out of 725 (15,4%). The participants reported few structured forums for collegial discussion. The results of multivariate analysis suggest that more women than men feel it is advantageous to attend courses with others from the same workplace or from the same group of residents, described here as a team. The analysis of qualitative data identified how opportunities for collegial conversations differ across contexts and the type of values that are attached to team participation in residency courses.This study highlights the importance of collegial conversations as a way to sustain the learning from residency courses into the workplace. By learning about residents’ perceptions of collegial conversations during and after courses, teachers and directors may be more able to support residents’ lifelong learning and professional development. [ABSTRACT FROM AUTHOR]

Background: Simien Mountain National Park is a world heritage site with spectacular landscapes and rich in floral diversity. Exploring the plethora of conventional wisdom regarding therapeutic flora for sustainable use and drug development is a timely endeavor. Thus, the present study was aimed at investigating therapeutic plant uses and conservation practices by the local communities dwelling in the vicinity of the Park. Methods: Eighty randomly selected general informants and 20 purposefully selected key informants were used to collect the traditional lore from 10 purposefully selected kebeles that border the Park. Data were collected using face-to-face interviews, guided field walks, group discussions and market surveys. Descriptive statistics were used to analyze the basic information collected from the informants. An independent sample t test was computed to compare the knowledge variations among different informant groups. Clustering and ranking techniques were employed to validate traditional wisdom of informants. Results: Significant differences in traditional wisdom (P < 0.05) were observed only between general and key informants. Hundred thirteen therapeutic plant species belonging to 56 families were recorded. Asteraceae was the most species-rich family (10%). The majority of therapeutic species were collected from the wild (77%). Herbs and roots were the most preferred habit (47%) and plant parts (37%) for remedy preparation, respectively. Pounding was the most common preparation method (50.1%). The most frequently practiced route of administration was the oral route (48.1%). The highest Informant Consensus Factor (ICF) value (84%) was recorded for respiratory and febrile illnesses. Rumex nepalensis was the most preferred for the treatment of wounds, and Olea europaea subsp cuspidata was the first-ranked multipurpose plant. Conclusion: The Park is rich in therapeutic species serving as a refuge for many endemic and endangered species associated with the local community rich medicinal traditional lore. Erosion of therapeutic plants, verbal transfer of the traditional wisdom and young generation negligence in acquiring traditional lore led to the deterioration of the long tradition of using therapeutic plants for health care. Endangered multipurpose therapeutic plants like Echinops kebericho should get conservation priority. Therapeutic plants with the highest ICF and fidelity level could be candidates for drug development. [ABSTRACT FROM AUTHOR]

We use survey data collected in 2021 in four countries (Canada, France, the United Kingdom, and the United States) to examine the role of extraversion and open-mindedness in predicting discussion on Facebook. We focus on discussions with people holding different views about politics and COVID-19. Using a preregistered analysis plan, we find extraversion predicts participation in heterogeneous discussions on Facebook; this finding is replicated across four countries and two topics of discussion. Openness does not have a significant role in engagement in heterogeneous discussions. This research sheds light on the role of platform algorithms in generating echo chambers. [ABSTRACT FROM AUTHOR]

Aim and background: Despite the vast heterogeneity of teaching methods, there remains a dilemma on what works best for teaching medical students. Flipped classroom teaching is a learner-oriented active teaching-learning methodology with a focus on inculcating different aspects of knowledge attainment in learners including application, analysis, evaluation, and synthesis of knowledge. This study aimed to assess the acceptability of the flipped classroom model for teaching undergraduate medical students. Materials and methods: This was a mixed method qualitative analysis conducted over 3 months utilizing anonymized prevalidated questionnaire for learners and focused group discussion (FGD) for facilitators. A total of 50 students were enrolled for the flipped classroom sessions and feedback was taken with a combination of open and closed-ended questions. Focused group discussion was carried out to discuss the merits and constraints of the teaching methodology. Results were compiled as frequency distribution and the qualitative data was analyzed using pre-formed codes to identify recurring themes and opinions. Results: The majority of students found flipped classrooms to be more interactive and easier to comprehend in comparison with traditional teaching methods. About 72% of students experienced higher confidence levels after the subject was taken up as a flipped classroom. Conclusion: Flipped classroom teaching is acceptable and finds high satisfaction levels amongst medical students. It involves an investment of extra time and energy by the facilitators, especially initially. Clinical significance: This pilot project helps to understand the need for innovating and integrating various teaching techniques for better academic outcomes as well as student satisfaction and promotes further research with a higher sample size to fortify these active teaching methods in the world of education. [ABSTRACT FROM AUTHOR]

The article focuses on the development and implementation of a book discussion group in a consumer health library, aiming to promote health literacy and engagement with patients, healthcare providers and community members. Topics include the planning process; book selection aligned with health themes and observances; the transition from virtual to in-person discussions; and also highlighting increased participation and positive feedback from attendees.

Digital media use can connect citizens across geographic boundaries into coordinated action by distributing political information, enabling the formation of groups, and facilitating political talk. These activities can lead to political consumerism, which is an important and popular form of political participation that translates across geographic borders. This article uses original survey data (n = 9284) to examine the relationship between digital media use and political consumerism in the United States, United Kingdom, and France. Talking politics online, joining social groups on social media, and searching online for political information increase participation in political consumerism. However, the strength of these positive correlations differs by age, country, and mode of political consumerism. Joining social groups on social media has a much larger effect size on buycotting compared to boycotting. The findings imply that social groups are more salient in the mobilization process for buycotting campaigns compared to boycotting campaigns. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, and diverse sexual orientation minorities are disproportionately represented in the prevalence of adverse health conditions, even in Canada, suggested as one of the more progressive countries when it comes to social acceptance and human rights protections. This highlights the inclusion of sexual orientation identity as a point of consideration when providers interact with patients and to consider facilitating sexual orientation identity disclosure when accessing health care. This study explored factors associated with different facets of sexual orientation disclosure to primary care providers. A cross-sectional survey of sexual orientation minority participants, 16 years or older, living, working, or residing in Waterloo Region was distributed (n = 437). Modified Poisson regression methods modelled (a) comfort sharing sexual orientation with their regular primary care provider (RPCP), (b) disclosure of sexual orientation to their RPCP, and (c) talking to their RPCP about health issues related to their sexual orientation. Increasing outness within one's social network was consistently significant across all three outcomes of comfort, disclosure, and talking about health issues related to sexual orientation. Self-esteem was also identified as salient in comfort and when talking to providers. The authors also observed significant associations between sexual orientation identity and relationship status variables. Findings highlight important factors to consider in discussing and disclosing sexual orientation identity and associated health issues with health care providers. Implications for practice include training new health care providers and providing opportunities for continued education for established providers to ensure appropriate care is provided based on sexual orientation. [ABSTRACT FROM AUTHOR]

Background: Managing medications for Alzheimer's disease and related dementias is challenging for caregivers. Information about caregivers' strategies to manage these challenges is needed to inform intervention development. Objective: This study aimed to understand caregivers' medication management experiences by analyzing online community discussions. Methods: Posts were extracted from the ALZConnected® Forum using keywords "medication" and "drug" via web scraping. The researchers applied thematic analysis. Results: Four major themes emerged: (1) role transition of medication management responsibilities, (2) caregivers' uncertainty about medication purpose and values, (3) conflicts between the care recipients and caregivers, and (4) difficulty accessing and affording medications. Conclusions: The experiences shared on a non-moderated, unstructured online forum indicate that medication management is challenging and overwhelming for caregivers of people living with Alzheimer's disease and related dementias. Since this is a progressive disease with various stages and changing needs, caregivers' strategies vary and are often limited by available resources and support. Health care providers should offer training and support for caregivers to navigate the transfer of medication management responsibilities and changing care needs as the disease progresses. [ABSTRACT FROM AUTHOR]

This paper opens a critical conversation about the ethics of international bioethics conferencing and proposes principles that commit to being anti-discriminatory, global, and inclusive. We launch this conversation in the Section, Case Study, with a case example involving the International Association of Bioethics' (IAB's) selection of Qatar to host the 2024 World Congress of Bioethics. IAB's choice of Qatar sparked controversy. We believe it also may reveal deeper issues of Islamophobia in bioethics. The Section, Principles for International Bioethics Conferencing, sets forth and defends proposed principles for international bioethics conferencing. The Section, Applying Principles to Site Selection applies the proposed principles to the case example. The Section, Applying Principles Beyond Site Selection addresses other applications of the proposed principles. The Section, Objections responds to objections. We close (in the Section, Conclusion) by calling for a wider discussion of our proposed principles. One-Sentence Capsule Summary: How should bioethicists navigate the ethics of global bioethics conferencing? [ABSTRACT FROM AUTHOR]

Idiopathic Interstitial Pneumonias (IIPs) are a heterogeneous group of the broader category of Interstitial Lung Diseases (ILDs), pathologically characterized by the distortion of lung parenchyma by interstitial inflammation and/or fibrosis. The American Thoracic Society (ATS)/European Respiratory Society (ERS) international multidisciplinary consensus classification of the IIPs was published in 2002 and then updated in 2013, with the authors emphasizing the need for a multidisciplinary approach to the diagnosis of IIPs. The histological evaluation of IIPs is challenging, and different types of IIPs are classically associated with specific histopathological patterns. However, morphological overlaps can be observed, and the same histopathological features can be seen in totally different clinical settings. Therefore, the pathologist's aim is to recognize the pathologic–morphologic pattern of disease in this clinical setting, and only after multi-disciplinary evaluation, if there is concordance between clinical and radiological findings, a definitive diagnosis of specific IIP can be established, allowing the optimal clinical–therapeutic management of the patient. [ABSTRACT FROM AUTHOR]

Aims: Investigated the experiences of Māori (the Indigenous peoples of Aotearoa, New Zealand) patients and whānau (extended family network) engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. Design: A qualitative Māori-centred research design using a Thought Space Wānanga (learning through in-depth group discussion, deliberation and consideration) approach. Methods: Two wānanga were conducted between May 2022 and June 2022, with 13 Māori patients who had been acutely hospitalized within the past 12 months and their whānau members. The first wānanga utilized storytelling and journey mapping to collect data. The second wānanga refined the initial themes. Wānanga were audiorecorded and then inductively coded and developed into themes. Results: Thirteen patients and whānau attended the first wānanga, while 10 patients and whānau participated in the second wānanga). Four themes were developed: (1) Whakawhanaungatanga (establishing connections and relationships), (2) Whakamana (uplifting the status and esteem of Māori), (3) Whakawhitiwhiti kōrero (the importance of communicating, discussing and deliberating) and (4) Kotahitanga (working together with purpose) all provide insights into the importance of effectively engaging and connecting with Māori patients and whānau when acutely hospitalized. Conclusions: The experiences and priorities of Māori patients and whānau affirm the international literature, suggesting that Indigenous relational concepts are critical to building relationships, connections and trust. Despite existing healthcare models for working with Indigenous peoples, their poor application contributes to sub-optimal healthcare experiences at all points of their healthcare journey. A relational mode of practice focused on engagement and forming connections better meets the needs of Indigenous peoples engaging with inpatient health services. Implications for the profession and/or patient care: Despite the existence of Indigenous models of care, Indigenous peoples consistently report a lack of engagement and connection when accessing inpatient health services. Without establishing relationships, applying models of care is challenging. Impact (Addressing): • What problem did the study address? Internationally, healthcare systems are consistently ill-equipped to deliver culturally safe care for Indigenous and marginalized peoples, evident in ongoing health inequities. Like other reports of Indigenous experiences of health services, Māori express dissatisfaction with care delivery in an acute inpatient setting. This study investigated Māori patients and whānau experiences engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. • What were the main findings? Māori patients and whānau recounted negative experiences with healthcare professionals lacking effective relationships and trust. Satisfaction occurred when engagement with health care professionals resembled Indigenous cultural rituals of encounter that considered their holistic, collective and dynamic worldviews. Previous models of relational care, while helpful, are not Indigenous and so do not address their needs, such as engagement as a mode of practice (how) to achieve this. • Where and on whom will the research have an impact? This research impacts Indigenous peoples' health outcomes, particularly Māori, and nurses and clinicians working and interacting within acute inpatient and other hospital settings. Indigenous research methods support co-constructing knowledge for translation into practical outcomes through transformational practices, policies and theory development. Reporting method: We used the Consolidated Criteria for Strengthening the Reporting of Health Research Involving Indigenous Peoples (CONSIDER) statement (see File S2—CONSIDER Checklist) and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (see File S3—COREQ Checklist). [ABSTRACT FROM AUTHOR]

Discussing disease progression is a core task in palliative care. This is especially important when there are indications that a patient considers their death as less imminent than the clinical team does. This article examines a communicative action that palliative medicine doctors use to address such discrepancies in knowledge and understanding of the patient's prognosis: inviting the patient to talk about the contents of a conversation they had with another healthcare practitioner. The study used conversation analysis to examine five consultations in which this action was identified. These were part of a larger data set of 37 consultations recorded in a large UK hospice and involving patients with palliative care needs, sometimes accompanied by family or friends, and palliative medicine doctors. Findings are that the action of inviting the patient to talk about a previous conversation creates an opportunity for patients to articulate what they know and understand about their disease progression – but without requiring them to do so. Discussing such sensitive matters is thus made a matter of 'opting in' (rather than 'opting out'). Doctors thereby avoid being interactionally accountable for directly initiating a potentially distressing topic. The article shows how the task of discussing disease progression and end of life is intertwined with the delicate management of patients' displayed states of awareness regarding their disease progression. The study thus has practical implications by documenting ways in which clinicians can help patients realign their expectations about such delicate matters. [ABSTRACT FROM AUTHOR]