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This article describes the perceptions and experiences of collaboration between teachers of physical education (n = 3) and special educators (n = 3) on teaching pupils with disabilities. Using a qualitative approach, the study seeks to establish the nature and extent of collaboration among these teachers and to identify the benefits and barriers to implementation. Semistructured interviews were used as the main data source. Data were collected from teachers working in the public school system in the southern part of Finland. The findings indicate that while teachers are mostly aware of the value of collaboration, its implementation varies immensely among the different schools. While the special educators in this study see themselves mainly responsible for supporting pupils with disabilities, the physical education teachers showed a strong commitment to the subject matter of their teaching. Participants also reported several challenges relating to time constraints, a lack of classroom support, and a shared vision of inclusive teaching. [ABSTRACT FROM AUTHOR]

In 2016, the Bloomberg Philanthropies Data for Health initiative assisted the Philippine Statistical Authority in implementing Iris, an automated coding software program that enables medical death certificates to be coded according to international standards. Iris was implemented to improve the quality, timeliness, and consistency of coded data as part of broader activities to strengthen the country's civil registration and vital statistics system. This study was conducted as part of the routine implementation of Iris to ensure that automatically coded cause of death data was of sufficient quality to be released and disseminated as national mortality statistics. Data from medical death certificates coded with Iris between 2017 and 2019 were analysed and evaluated for apparent errors and inconsistencies, and trends were examined for plausibility. Cause-specific mortality distributions were calculated for each of the 3 years and compared for consistency, and annual numeric and percentage changes were calculated and compared for all age groups. The typology, reasons, and proportions of records that could not be coded (Iris 'rejects') were also studied. Overall, the study found that the Philippine Statistical Authority successfully operates Iris. The cause-specific mortality fractions for the 20 leading causes of death showed reassuring stability after the introduction of Iris, and the type and proportion of rejects were similar to international experience. Broadly, this study demonstrates how an automated coding system can improve the accuracy and timeliness of cause of death data—providing critical country experiences to help build the evidence base on the topic. [ABSTRACT FROM AUTHOR]

Public health measures (PHMs) implemented during the COVID-19 pandemic introduced sudden changes to adolescents' everyday routines and required adolescents to repeatedly adapt their routines at a critical developmental stage. While meant to protect physical health, the PHMs destabilized mental health. Using a youth-engaged approach and interpretive description, this study explored adolescents' perspectives on their mental health in relation to the COVID-19 pandemic-related PHMs in Canada from March 2020 to the time of data collection in March 2022. Four Youth Research Collaborators contributed an adolescent lens to informing study activities, and a total of 33 high-school aged adolescents ages 14 to 19 completed individual interviews. Findings suggest an overarching concept of a "timeline" through which adolescents described their experiences. Most adolescents described their mental health as worsening during the initial lockdown, although some adolescents experienced positive mental health outcomes. Several adolescents felt their mental health had not recovered after the PHMs were fully lifted. This study contributes young Canadians' unique voices to the literature on the pandemic-related PHMs and adolescent mental health. It is essential that the impacts of the pandemic on adolescent mental health continue to be a focus of research and programming to better understand and address its ongoing effects. [ABSTRACT FROM AUTHOR]

Purpose: This study explores the underutilized pedagogical approach of incorporating lived experiences of parents with children possessing diverse hearing profiles and their family characteristics into the audiology curriculum for students. The aim was to investigate the impact of integrating such experiences into the classroom as an andragogical learning experience through the qualitative analysis of written student reflections. Method: Twelve (N = 12) third-year female audiology students enrolled in a pediatric auditory (re)habilitation course attended a parent panel presentation during their regularly scheduled face-to-face class. Five parents of children with diverse hearing differences and diverse technology, communication, and educational choices participated on the panel as guest speakers via the Zoom platform. Students completed written reflections based on Rolfe's reflective framework. Written reflections were downloaded from Canvas and de-identified prior to uploading to NVivo software for coding, utilizing an inductive grounded theory coding strategy coupled with content analysis. Findings: This study underscores the effectiveness of written reflections as an effective andragogical learning model. Through reflective practice, students gained a deeper understanding of their experiences, values, and learning journeys, enhancing their competency in pediatric audiology and auditory (re)habilitation. Students articulated previous knowledge and learning experiences, utilized newfound insights from exposure to the parent panel of shared lived experiences, and connected this knowledge with future clinical applications. Conclusions: Key findings underscore the effectiveness of reflective practice as an andragogical learning model, facilitating the integration of prior experiences with new knowledge. Moreover, it aids the transition of the professional journey from the familiar to the unfamiliar, demonstrating the impact of combining real-world lived experiences to reinforce and highlight classroom topics. Additionally, reflective practice enhances professional efficacy by valuing patient/parent perspectives regarding clinical care and aligning with evidence-based principles. [ABSTRACT FROM AUTHOR]

The article discusses a 2024 study on the attitudes of patients 65 years and older on the use of routine clinical data in making treatment decisions. Results show participants' interest in such data and in how drugs work for them, and their concerns on confounders like populations' similarity of conditions with them, and on common minor side effects. Also noted are participants' common view that their physicians determine the evidence's applicability to them, and recommend a medication.

Objective: To illuminate child healthcare nurses' experiences of communication with 4‐year‐old children during their visit to the child healthcare center. Design: A qualitative method, using data collected from individual interviews. Sample: Fifteen semistructured interviews with nurses working in a child healthcare center. Measurements: The results were analyzed using reflexive thematic analysis. Results: The analysis resulted in three themes and eight subthemes: Adapting to the child in the conversation, based on the subthemes Preparing for the visit, Listening in and observing, and Creating a welcoming environment; Combining strategies for the conversation, based on the subthemes Engaging the child, Using visual tools, and Parental involvement; and Challenges due to language barriers, based on the subthemes Using an interpreter and Parent acts as interpreter. Conclusion: Child healthcare nurses focus on the child when communicating and strive to create joy and a welcoming environment. The communication strategies employed during the visit include engaging the child directly, involving parents in the conversation, and balancing the parental involvement. Communication challenges related to language barriers are addressed, particularly during interpreter‐assisted conversations. The study indicates a need for tailored strategies, collaboration, and sensitivity to ensure a child‐centered approach. [ABSTRACT FROM AUTHOR]

Semi-supervised classification has gained widespread popularity because of their superior ability to handle unlabeled samples in practical problems. This paper has presented a novel estimation error-ranked LSSVM method with double Mahalanobis-kernel which is used for semi-supervised classification. The main point is to construct two Mahalanobis distances in Hilbert space to form double Mahalanobis-kernel by considering the relationship between the characteristics of two sorts of samples, so as to reduce the influence of non-informational dimensions. Furthermore, the implementation of the proposed method is required to solve the label security problem of unlabeled samples. The unlabeled sample with the minimum evaluated error is selected for labeling, which effectively ensures the accuracy of the unlabeled sample labeling. This method not only considers the similarity of sample features, but also focuses on the security of unlabeled samples. And based on the experimental results of four artificial data sets and several UCI data sets, it verifies the effectiveness of the semi-supervised method with double Mahalanobis-kernel. Especially considering the experimental results of five disease diagnosis data sets, it demonstrates the potential of the proposed semi-supervised classification method in medical diagnosis. [ABSTRACT FROM AUTHOR]

Background: Previous research identifies organisational culture as one of a number of factors associated with the quality of life outcomes of group home residents' with intellectual and developmental disabilities. This study aims to elaborate on the dimensions of group home culture in settings in England. Method: Participant observations and semi‐structured interviews with staff were carried out in two group homes. Field‐notes, interview notes and transcripts were analysed using inductive thematic analysis by a researcher naïve to the project and the previous literature. Initial coding was re‐examined after sensitisation to theorised models in previous literature to identify the most parsimonious fit. The two settings were rated and compared using a five‐point Likert scale for each of the dimensions. Results: The findings describe group home culture across seven dimensions. There were mixed ratings across the different dimensions reflecting inconsistencies in culture that were reflected in staff practice. The challenge in assigning a global rating of culture in group homes, which includes interactions across multiple staff and multiple residents over time, was highlighted. Conclusion: The development of an observational measure of culture is highlighted as potentially helpful in understanding and responding to culture in services for individuals with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

Aim: To understand the experiences of Filipino internationally educated nurses (FIENs) on their recognition and credentialing pathway in the recruitment process in Finland. Background: The nursing shortage in Finland results in the recruitment of internationally educated nurses (IENs) such as those from the Philippines. In the context of migration, IENs experience a rigorous process to become qualified nurses in the destination country. Methods: A thematic analysis of the secondary data from qualitative interviews was conducted. Ten FIENs (n = 10) were recruited from university hospitals in Finland through purposeful and snowball sampling. The study adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. Results: Three main themes were identified. First, pre‐migration victories and predicaments described the experiences of FIENs during the recruitment process and the pathway to acquiring a Registered Nurse qualification. Second, ambiguous integration implied integrating into the workplace while working on the top‐up education programme as a prerequisite to nursing registration. Lastly, migration uncertainty discussed the interest among FIENs to continue practising as Registered Nurses (RNs) in Finland. Conclusions: Pre‐migration orientation and workplace integration experiences influenced FIENs' choice to practise as RNs in Finland. The licensure pathway for FIENs required collaboration from various stakeholders in Finnish society. It is recommended to structure the system for the recognition and qualification process of IENs by creating a national model in line with international standards and requirements in collaboration with higher education institutions. Implication for nursing policy: Recognition of previous education and clinical experience can facilitate the transition to becoming an RN for IENs, but the lack of a clear education model and recognition of foreign nursing qualifications leads to deskilling and hinders IENs from practising. Policies prioritising education and integration into the local healthcare system can facilitate the integration and professional growth of IENs, enabling them to contribute significantly to the healthcare system. [ABSTRACT FROM AUTHOR]

Objectives: In 2019, the Council of State and Territorial Epidemiologists ratified a multitiered standardized surveillance case definition (SSCD) for neonatal abstinence syndrome (NAS) to minimize variability in definitions across states. This evaluation of the tier 1 NAS SSCD aimed to identify common challenges and opportunities for enhancement to support consistent implementation of the definition. Methods: This mixed-methods analysis consisted of 3 virtual focus groups in March 2021 with site principal investigators, medical record abstractors, and data analysts (1 focus group each) from 4 jurisdictions piloting the tier 1 NAS SSCD. We analyzed focus group transcripts to create a codebook. We collected written reports in February 2022 from the 4 jurisdictions, conducted thematic analysis of focus group transcripts and written reports to identify themes, and collected surveillance data on infants identified with NAS born from January 2020 through December 2021 from the pilot sites. We analyzed surveillance data to further inform identified themes. We examined agreement among tier 1 classifications assigned independently by each pilot site and the Centers for Disease Control and Prevention to cases of NAS. Results: Three major themes emerged in the data: challenges abstracting data on withdrawal signs from the medical record, difficulty determining the time frame of prenatal substance exposure, and challenges assigning case classifications. In a comparison of tier 1 classifications assigned by the Centers for Disease Control and Prevention and the sites, 82.1% of cases in the dataset were concordant. Conclusions: We identified several opportunities to modify the SSCD to promote consistency and ease implementation across jurisdictions. Promoting consistent implementation supports comparability of NAS incidence estimates across jurisdictions, evaluation of prevention efforts, and allocation of resources to support families. [ABSTRACT FROM AUTHOR]

Research on romantic conflict has persuasively documented that the way partners communicate with one another during disagreements is a driving factor in predicting how they perceive the conflicts in their relationships. The current research added to this literature by differentiating couples who resolve conflicts more, versus less, successfully. Specifically, the current work examined how couples' behavioral trajectories across the course of conflict related to their perceptions of conflict resolution. To this end, we coded warmth and dominance behaviors exhibited by 173 couple members (346 individuals) over the course of an eight-minute conflict discussion. We examined how participants', and their partners', perceptions of conflict resolution were related to their interpersonal behaviors. In line with predictions, less average interpersonal warmth was associated with worse perceptions of resolution, and declining warmth over time was also associated with worse perceptions of resolution. Dominance behaviors were not associated with conflict resolution perceptions. [ABSTRACT FROM AUTHOR]

BACKGROUND AND PURPOSE Although the prevalence of dissociative disorders (DDs) is up to 10 percent of the general population, psychiatric-mental health (PMH) registered nurses lack education on how to care for individuals diagnosed with these disorders. METHOD Sixty-two PMH nurse educators completed an anonymous online survey about their perceptions of teaching DDs to nursing students. Braun and Clarke’s six-phase framework was used to conduct an inductive, reflexive thematic analysis of the data. RESULTS Three primary themes were identified: lack of resources, differing opinions on the value of teaching DDs, and stigma. CONCLUSION Though roughly 75 percent of participants reported that they teach DDs to their nursing students, they endorsed concerning misperceptions about the diagnoses. By failing to properly educate future PMH RNs about DDs, individuals with DDs are at risk of receiving inadequate and inappropriate nursing care and experiencing poor outcomes. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus, cardiovascular disease and chronic obstructive pulmonary disease contribute significantly to societal and individual impact globally. High‐quality management of these long‐term health conditions is important to prevent deterioration of health, although potentially more complex for patients with intellectual disabilities in residential care. Disease management in this context particularly benefits from complete and accurate recording of disease management. Without complete records, long‐term health conditions are more difficult to track due to the level of uncertainty regarding which clinical examinations have and have not been performed. This study therefore aims to examine the recording routines of quality indicators for disease monitoring for chronically ill patients with intellectual disabilities in Dutch residential care. Methods: This retrospective study utilised medical record data from a large Dutch long‐term care provider. We assessed the occurrence of cardiovascular disease (ICPC‐2 codes K74, K75, K76, K89 and K90), type 2 diabetes mellitus (T90, T90.02) and/or COPD (R91, R95). For adults with intellectual disabilities and long‐term condition, we analysed data entries in an 18‐month period (between July 2020 and December 2021). Observed consultation rates were calculated and presented in median with interquartile range and contrasted against the baseline number of consultations in primary care. Information on recorded quality indicators was presented in frequencies and percentages. Findings: Of the three long‐term conditions investigated, the most common was type 2 diabetes mellitus (8.6%; n = 287), followed by cardiovascular disease (5.8%; n = 195) and COPD (3.0%; n = 101). Of those who received management for their long‐term condition from their contracted GP, patients with type 2 diabetes mellitus, cardiovascular disease, or COPD had fewer consultations in 2021 than the Dutch baseline. Discussion of lifestyle was often not recorded. Disease monitoring quality indicators were recorded more often but at a lower frequency than expected. Conclusions: Because of the infrequent recording of quality indicators, recording of management of long‐term conditions for patients with intellectual disabilities in long‐term care appears suboptimal. Although this may not directly harm individual patients, it may jeopardise the quality of management of long‐term conditions, as suboptimal recording limits opportunities for evaluation and improvement. Within a broader trend towards data‐driven work methods in healthcare, recording of quality indicators requires attention from practice, research and policy. We should watch over long‐term diseases to help people stay healthy. We run tests, like checking blood pressure. The results are written in their medical records. These tests are like quality checks.We wanted to see if and how these quality checks were used, mostly for people with a learning disability living in care homes who also have heart disease, diabetes, or lung problems.We looked at their medical papers to see if these checks were there. We also looked at how often they saw the doctor.We found that chronically ill people with a learning disability went to the doctor quite often. But not as often as we expected. Also, the checks were not always written down. The talks about their lifestyle with the doctors were not noted very often.This can impact how well doctors care for the health issues of people with learning disability. [ABSTRACT FROM AUTHOR]

Attendance at type 2 diabetes self-management interventions is associated with improved outcomes. However, difficulties maintaining self-management behaviours attenuate long-term impact. This review aimed to identify and synthesise qualitative research on barriers and enablers to maintaining type 2 diabetes self-management behaviours after attending a self-management intervention. Eight electronic databases were searched to identify relevant peer-reviewed and grey literature studies. Data were synthesised using the best-fit framework synthesis approach guided by the themes and constructs identified by Kwasnicka et al. (2016) on their review of theoretical explanations for behaviour change maintenance. Study methodological limitations and confidence in findings were assessed using an adapted version of the Critical Appraisal Skills Programme (CASP) tool and the GRADE-CERQual approach respectively. Eleven articles reporting on 10 studies were included. Twenty-eight barriers and enablers were coded to the a priori themes. Barriers were commonly coded to the themes self-regulation, resources, and environmental and social influences. Enablers were commonly coded to the themes habits and maintenance motives. Methodological limitations of included studies varied, leading to moderate or low confidence in most findings. Interventions may improve behavioural maintenance by providing post-intervention support, promoting positive behaviour change motives, self-regulation, habit formation, and facilitating access to resources and support. [ABSTRACT FROM AUTHOR]

Purpose To explore factors influencing career goals and goal attainment for pharmacy learners (eg, students, residents, fellows) who identify as part of the Black, Indigenous, and People of Color (BIPOC) community. Methods In late 2021 and early 2022, US-based pharmacy learners were invited to participate in two focus groups. In the first focus group, participants were asked to reflect on career goal influences, barriers, and facilitators. In the second focus group, participants were asked to provide suggestions for educational institution and healthcare organization improvement to support career goal attainment for learners in the BIPOC community. Focus group transcripts were coded using both deductive and inductive coding and thematic analysis. Results Fifteen learners were included in the first focus group, and 10 learners were included in the second. The most common career goal motivators were self-efficacy factors. Barriers and facilitators were often closely related. The most common barriers were financial, lack of representation, and lack of support. Common facilitators included mentorship and informal networking opportunities. Participants suggested multiple strategies for educational institutions and healthcare organizations to support BIPOC learner success, including genuine investment, representation, financial support, improved access to professional development opportunities, partnering with other professional organizations, and prioritizing diversity, equity, and inclusion (DEI) initiatives. Conclusion Institutions should prioritize effective, positive mentoring relationships and exposure to BIPOC professionals. Training programs and associations should consider improving financial support and lowering the cost of involvement to reduce barriers. All stakeholders should prioritize DEI in their organizational culture to promote career advancement of BIPOC learners and professionals. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To (i) determine the prevalence of delirium and identify delirium subtypes in surgical and non‐surgical patients aged ≥65 years, (ii) determine whether certain precipitating factors affect the prevalence of delirium and (iii) review patients' medical records for description of delirium symptoms and the presence of International Classification of Diseases (ICD‐10) coding for delirium in discharge summaries. Methodological Design and Justifications: Despite being a robust predictor of morbidity and mortality in older adults, delirium might be inadequately recognised and under‐reported in patients' medical records and discharge summaries. A point prevalence study (24‐h) of patients ≥65 years from surgical and non‐surgical wards was therefore conducted in a tertiary university hospital. Ethical Issues and Approval: The study was approved by the Data Protection Officer at the university hospital (2018/3454). Research Methods, Instruments and/or Interventions: Patients were assessed for delirium with 4AT and delirium subtypes with the Delirium Motor Subtype Scale. Information about room transfers, need and use of sensory aids and medical equipment was collected onsite. Patients' medical records were reviewed for description of delirium symptoms and of ICD‐10 codes. Results: Overall, 123 patients were screened (52% female). Delirium was identified in 27% of them. Prevalence was associated with advanced age (≥85 years). The uncharacterised delirium subtype was most common (36%), followed by hypoactive (30%), hyperactive (24%) and mixed (9%). There were significant associations between positive screening tests and the need and use of sensory aids. Delirium symptoms were described in 58% of the patients who tested positive for delirium and the ICD‐10 code for delirium was registered in 12% of these patients' discharge summaries. Conclusions: The high prevalence of delirium and limited use of discharge codes highlight the need to improve the identification of delirium in hospital settings and at discharge. Increased awareness and detection of delirium in hospital settings are vital to improve patient care. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) is a complex problem characterized by frequent hospitalizations and high 30-day readmission rates. Researchers studying HF readmission report that patients and clinicians have different perspectives on readmission and preventability when unadjusted for disease severity. Objective: The aim of this study was to gather patient, caregiver, nurse, and physician subjective reason(s) for 30-day HF readmission and perceptions of preventability with contextual factors to evaluate differences. Methods: A convergent, parallel, mixed-methods design was used with interviews and chart reviews to evaluate contextual factors from the current and index hospital stay. Adults readmitted within 30 days of a previous inpatient stay with a coded HF diagnosis were enrolled and interviewed, followed by interviews with associated caregivers, attending physicians, and assigned nurses. Results: Interviews were conducted with patients (n = 44), caregivers (n = 6), physicians (n = 24), and nurses (n = 44). Readmissions were emergent/urgent (95%) and occurred within 14.9 days (SD, 8.1; 2-28 days) on average after discharge. Index stay coding revealed that most patients (73%) had a high severity of illness (73%) and risk of mortality (68%). Heart failure stage was inconsistently documented. Patients reported acute symptomatic reasons, with only 32% describing readmission as preventable. Physicians reported diagnostic reasons, 38% of which were preventable. Nurses reported behavioral reasons, with 59% being preventable. Patient/clinician agreement on readmission reason was low(30%). Conclusions: Patient/clinician perspectives on readmission varied among the patients with complex HF. Care planning based on HF stage and other contextual factors is needed to ensure a shared understanding of disease severity and a tailored symptom management approach to prevent readmission. [ABSTRACT FROM AUTHOR]

As artificial intelligence (AI) applications become more pervasive, it is critical to understand how knowledge workers with different levels and types of experience can team with AI for productivity gains. We focus on the influence of two major types of human work experience (narrow experience based on the specific task volume and broad experience based on seniority) on the human-AI team dynamics. We developed an AI solution for medical chart coding in a publicly traded company and conducted a field study among the knowledge workers. Based on a detailed analysis performed at the medical chart level, we find evidence that AI benefits workers with greater task-based experience, but senior workers gain less from AI than their junior colleagues. Further investigation reveals that the relatively lower productivity lift from AI is not a result of seniority per se but lower trust in AI, likely triggered by the senior workers' broader job responsibilities. This study provides new empirical insights into the differential roles of worker experience in the collaborative dynamics between AI and knowledge workers, which have important societal and business implications. This paper was accepted by Kartik Hosanagar, information systems. Funding: This work was supported by Inovalon [Sponsor of the Health Insights AI Laboratory]. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2021.00588. [ABSTRACT FROM AUTHOR]

Background Exercise Referral Schemes (ERS) are designed so health professionals can refer certain patients to a supervised programme of physical activity. However, evaluations have questioned the effectiveness of these schemes/programmes. The aim of this study was to systematically review the provision of ERS in England and analyse related promotional material. Methods Content analysis methods were used to analyse scheme websites and promotional material. A coding scheme was used to analyse the data, which included information on the programme's aims, inclusion criteria, type of activities, accessibility and cost. Results The study identified 625 sites offering ERS across 168 geographic areas. Findings highlighted a lack of clarity in what constitutes a scheme. Over a third of schemes did not explicitly state their aims, but of those that did, the focus was mainly on notions of physical and mental health benefits. Conclusions This study is the first to review the scope and offer of ERS in the UK by examining promotional material and highlights issues around the stated aims of ERS. More clarity on aims is needed in the material that promotes the schemes and most likely within the schemes themselves. Such improvements could make a difference when considering engagement with delivery stakeholders and potential participants. [ABSTRACT FROM AUTHOR]

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Background: Healthcare triage policies are vital for allocating limited resources fairly and equitably. Despite extensive studies of healthcare equity, consensus on the applied definition of equity in triage remains elusive. This study aimed to investigate how the principles of equity are operationalised in Australian hospital physiotherapy triage tools to guide resource distribution. Methods: A retrospective, qualitative content analysis of 13 triage policies from 10 hospitals across Australia was conducted. Triage policies from both inpatient and outpatient settings were sourced. Data were coded deductively using the five discrete domains of the multi-faceted operational definition of health equity posited by Lane et al. (2017): 1) point of equalisation in the health service supply/access/outcome chain, 2) need or potential to benefit, 3) groupings of equalisation, 4) caveats to equalisation, 5) close enough is good enough. Descriptive summative statistics were used to analyse and present the frequency of reported equity domains. Results: Within the included triage tools, four out of five domains of equity were evident in the included documents to guide decision making. Allocation based on perceived patient need and overall health outcomes were the central guiding principles across both inpatient and outpatient settings. Equal provision of service relative to patient need and reducing wait times were also prioritised. However, explicit inclusion of certain equity domains such as discrimination, ensuring equal capability to be healthy and other patient factors was limited. Conclusions: Physiotherapy triage policies consider various domains of equity to guide resource allocation decisions. Policymakers and service providers can use the insights gained from this study to review the application and operationalisation of equity principles within their healthcare systems through mechanisms such as patient triage tools. [ABSTRACT FROM AUTHOR]

Aims and Objectives: We sought to gain an understanding of the patient experience during their hospital stay for COVID‐19, and the impact of COVID‐19 on quality of life post discharge. Background: Symptoms of COVID‐19 include a persistent cough, dyspnoea and fatigue. Individuals with comorbidities such as cardiovascular disease have a higher risk of contracting COVID‐19 and approximately 20% of those diagnosed with COVID‐19 are admitted to hospital. Following discharge from hospital, 40% of patients report a worsened quality of life and up to 87% of those discharged from hospital have experienced 'long COVID'. Design: A qualitative design was used to understand patient experience of hospitalisation following a diagnosis of COVID‐19, and their experiences following discharge from hospital. Methods: Ten patients with a previous diagnosis of COVID‐19 took part in semi‐structured interviews regarding their experiences of hospitalisation and the impact on quality of life post‐discharge. Results: The results identified three key themes from the interviews: communication and the inpatient experience, symptoms following discharge and regaining independence. Patients discussed their experience of hospitalisation and how this continued to impact their emotional well‐being post‐discharge. However, patients appeared to push themselves physically to improve their health, despite continued COVID‐19 symptoms. Conclusion: Patients hospitalised following a diagnosis of COVID‐19 experienced psychological distress during their hospital stay, as well as 3‐months post‐discharge. We suggest the use of psychosocial interventions to support patients post‐discharge. Relevance to Clinical Practice: The results of this study provide a greater understanding of the patient experience during their hospital stay, which can support nursing staff practice. Additionally, the study provides in depth knowledge of personal experiences of patients diagnosed with COVID‐19 and the impact following hospital discharge. Patient or Public Contribution: Patient's took part in semi‐structured interviews via telephone to support the aims and objectives of this study. [ABSTRACT FROM AUTHOR]

Background: Administrative healthcare databases, such as Medicare, are increasingly used to identify groups at risk of a crash. However, they only contain information on crash-related injuries, not all crashes. If the driver characteristics associated with crash and crash-related injury differ, conflating the two may result in ineffective or imprecise policy interventions. Methods: We linked 10 years (2008–2017) of Medicare claims to New Jersey police crash reports to compare the demographics, clinical diagnoses, and prescription drug dispensings for crash-involved drivers ≥ 68 years with a police-reported crash to those with a claim for a crash-related injury. We calculated standardized mean differences to compare characteristics between groups. Results: Crash-involved drivers with a Medicare claim for an injury were more likely than those with a police-reported crash to be female (62.4% vs. 51.8%, standardized mean difference [SMD] = 0.30), had more clinical diagnoses including Alzheimer's disease and related dementias (13.0% vs. 9.2%, SMD = 0.20) and rheumatoid arthritis/osteoarthritis (69.5% vs 61.4%, SMD = 0.20), and a higher rate of dispensing for opioids (33.8% vs 27.6%, SMD = 0.18) and antiepileptics (12.9% vs 9.6%, SMD = 0.14) prior to the crash. Despite documented inconsistencies in coding practices, findings were robust when restricted to claims indicating the injured party was the driver or was left unspecified. Conclusions: To identify effective mechanisms for reducing morbidity and mortality from crashes, researchers should consider augmenting administrative datasets with information from police crash reports, and vice versa. When those data are not available, we caution researchers and policymakers against the tendency to conflate crash and crash-related injury when interpreting their findings. [ABSTRACT FROM AUTHOR]

Accurate diagnosis of white blood cells from cytopathological images is a crucial step in evaluating leukaemia. In recent years, image classification methods based on fully convolutional networks have drawn extensive attention and achieved competitive performance in medical image classification. In this paper, we propose a white blood cell classification network called ResNeXt-CC for cytopathological images. First, we transform cytopathological images from the RGB color space to the HSV color space so as to precisely extract the texture features, color changes and other details of white blood cells. Second, since cell classification primarily relies on distinguishing local characteristics, we design a cross-layer deep-feature fusion module to enhance our ability to extract discriminative information. Third, the efficient attention mechanism based on the ECANet module is used to promote the feature extraction capability of cell details. Finally, we combine the modified softmax loss function and the central loss function to train the network, thereby effectively addressing the problem of class imbalance and improving the network performance. The experimental results on the C-NMC 2019 dataset show that our proposed method manifests obvious advantages over the existing classification methods, including ResNet-50, Inception-V3, Densenet121, VGG16, Cross ViT, Token-to-Token ViT, Deep ViT, and simple ViT about 5.5–20.43% accuracy, 3.6–23.56% F1-score, 3.5–25.71% AUROC and 8.1–36.98% specificity, respectively. [ABSTRACT FROM AUTHOR]

Aims This study aimed to identify barriers and facilitators to implementing alcohol screening and brief interventions (SBI) in cardiology services. Methods and results This was a qualitative study. Individual, semi-structured interviews were conducted with 24 clinical cardiology staff (doctors, nurses, and assistant nurses) of varying experience levels and from various clinical settings (high-dependency unit, ward, and outpatient clinic), in three regions of Sweden. Reflexive thematic analysis was used, with deductive coding applying the Capability, Opportunity, Motivation (COM-B) theoretical framework. A total of 41 barriers and facilitators were identified, including 12 related to capability, 9 to opportunity, and 20 to motivation. Four themes were developed: (i) uncharted territory, where clinicians expressed a need to address alcohol use but lacked knowledge and a roadmap for implementing SBI; (ii) cardiology as a cardiovascular specialty, where tasks were prioritized according to established roles; (iii) alcohol stigma, where alcohol was reported to be a sensitive topic that staff avoid discussing with patients; and (iv) window of opportunity, where staff expressed potential for implementing SBI in routine cardiology care. Conclusion Findings suggest that opportunities exist for early identification and follow-up of hazardous alcohol use within routine cardiology care. Several barriers, including low knowledge, stigma, a lack of ownership, and a greater focus on other risk factors, must be addressed prior to the implementation of SBI in cardiology. To meet current clinical guidelines, there is a need to increase awareness and to improve pathways to addiction care. In addition, there may be a need for clinicians dedicated to alcohol interventions within cardiology services. Registration OSF (osf.io/hx3ts). [ABSTRACT FROM AUTHOR]

Aboriginal and Torres Strait Islander women are key members of the community who have specific roles within their families that may result in lower levels of physical activity (PA) undertaken. Clearly identifying barriers for women to engage with PA, and exploring culturally based activities (i.e. Traditional Indigenous Games), may help to improve long-term health benefits. Subsequently, the aim of this study was to identify the barriers and facilitators for Aboriginal and Torres Strait Islander women engaging in PA, and their interest in participating in Traditional Indigenous Games. Seventeen Aboriginal and Torres Strait Islander women (34.3 ± 10.2 years) participated in focus groups. Through thematic analysis, participants experienced a range of common barriers such as lack of time due to family commitments, limited finances, ageing and poor physical and/or mental health. Common facilitators were also identified such as fun, access and improving mental and/or physical health. Importantly, unique themes were identified for Aboriginal and Torres Strait Islander women including barriers (e.g. racism, shame) and facilitators (e.g. culture, interactions with other Aboriginal and Torres Strait Islander women) that influenced PA participation. Notably, Traditional Indigenous Games were considered as an appealing PA mode to engage with their culture, experience nostalgia and be around other Aboriginal and Torres Strait Islander women. These key findings will guide future PA programs including Traditional Indigenous Games to improve health outcomes of Aboriginal and Torres Strait Islander women, vital members of the community. [ABSTRACT FROM AUTHOR]

Background: Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context of medical decisions of adults. Objective: The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods: A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results: 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual's relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers' dominant voice hampers the demonstration of relational autonomy. Conclusions: Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual's values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual's values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. [ABSTRACT FROM AUTHOR]

Rescue workers (policemen, firefighters, emergency medical staff, etc.) experience intense stress due to rescuing and helping victims of accidents, terrorist attacks, violent crimes, and natural disasters. Overexposure and ineffective coping with such stressful events may lead to developing Post‐Traumatic Stress Disorder (PTSD). Meta‐regression procedures were applied to examine moderators such as the sample sex composition, age, working experience, occupation, country, or type of PTSD evaluation. The 9.8% PTSD prevalence found here was virtually the same compared with earlier findings from 10 years ago. There was a large heterogeneity, however, associated with geographical location and the instrument used to evaluate PTSD. The main findings revealed that rescue workers are a high‐risk group with increased levels of Post‐traumatic Stress Disorder (PTSD). Moreover, PTSD prevalence could depend on a great extent on geographical and cultural factors, and on the type of PTSD evaluation. [ABSTRACT FROM AUTHOR]

Background: For more than a decade, the Patient-Centered Medical Home model has been a guiding vision for the modernization of primary care systems. In Canada, Ontario's Family Health Teams (FHTs) were designed in the mid-2000s with the medical home model in mind. These primary care clinics aim to provide accessible, comprehensive, and person-centered primary care services to communities across Ontario. Their services typically include mental health care for people experiencing common mental disorders, such as depression and anxiety disorders. It remains unclear, however, whether the mental health care delivered within FHTs is consistent with person-centered care approaches. In the current study, we aimed to explore the perspectives of FHT providers on the care delivered to people with common mental disorders to determine whether, and to what extent, they believed this care was person-centered. Methods: We conducted a qualitative grounded theory study involving interviews with 65 health professionals and administrators from 18 FHTs across Ontario. Transcripts were coded using a three-step process of initial, focused, and axial coding that mixed inductive and deductive approaches informed by sensitizing concepts on person-centeredness. Results: Practices and challenges associated with the delivery of mental health care in a person-centered way were captured by several themes regrouped into five domains: (1) patient as unique person, (2) patient-provider relationship, (3) sharing power and responsibility, (4) connecting to family and community, and (5) creating person-centered care environments. FHT providers perceived that they delivered person-centered care by delivering mental health care that was responsive, flexible, and consistent with biopsychosocial approaches. They emphasized the importance of creating long-lasting relationships with patients grounded in empathy and trust. Their challenges included being able to ensure continuity of care, adequately prioritizing patients' mental health issues, and meaningfully engaging patients and families as partners in care. Conclusions: Our findings suggest that FHT providers have adopted a range of person-centered practices for people with common mental disorders. However, greater attention to practices such as shared decision making, supporting self-management, and involving families in care would strengthen person-centeredness and bring teams closer to the Patient-Centered Medical Home vision. [ABSTRACT FROM AUTHOR]

To describe and analyze how Extension nutrition educators in one state system transitioned from primarily face-to-face to virtual nutrition education programming. This exploratory case study gathered data through nutrition educator interviews, virtual program delivery guides, and nutrition educators' program impact statements. Southeastern State Extension system in late 2022. The sample included 15 participant interviews, multiple virtual program delivery guides, and 43 program impact summaries. The use of Cultural Historical Activity Theory as a framework to explore educators' learning process with virtual program delivery and how this learning influenced community nutrition program delivery choices. Qualitative data was analyzed with ATLAS.ti using a priori coding. Two key findings emerged from the data: educators were more likely to deliver programs in a virtual setting when the programs aligned with their values and skills, and educators preferred flexible program curricula and delivery guides because it allowed them to address their community's specific needs. Educators plan to continue to deliver certain community nutrition programs virtually. Future research is needed to explore additional perspectives on virtual delivery, such as program participants and state program managers. [ABSTRACT FROM AUTHOR]

Purpose: Return to work after maternity leave represents a radical change in women's lives. This paper aims to present a new metaphor categorization system based on two studies, which could assist working mothers in expressing the nuances of their experience when returning to work after maternity leave. Methods: We carried out the analysis of the metaphors according to the method for thematic analysis, through a multistep, iterative coding process. To ensure the researchers encode the data similarly, inter-coder reliability was achieved through the judges' agreement method. The level of agreement between the two judges was measured by Cohen's kappa. Results: In Study 1, we established a system comprising ten metaphor categories (namely, Natural event and/or element, Challenge and destination, Movement and/or action, Fresh start, Fight, Game and hobby, Animal, Alternate reality, Means of transport, Hostile place). In Study 2, we recognized the same metaphor categories observed in Study 1, except "Means of transport", even with data sourced from a distinct participant group, an indicator of credibility in terms of inter-coder reliability. Conclusion: Findings highlight the usefulness of this new metaphor categorization system (named Meta4Moms@Work—Metaphors system for Moms back to Work) to facilitate a more straightforward elicitation of the meanings employed by working mothers to depict their return to work after maternity leave. Leveraging these insights, researchers/practitioners can develop and execute primary and secondary interventions aimed to enhance working mothers' work-life balance, well-being, and mental health. [ABSTRACT FROM AUTHOR]

Given recent congressional interest in codifying price transparency regulations, it is important to understand the extent to which newly available price transparency data capture true underlying procedure-level prices. To that end, we compared the prices for maternity services negotiated between a large payer and 26 hospitals in Mississippi across 2 separate price transparency data sources: payer and hospital. The degree of file overlap is low, with only 16.3% of hospital-billing code observations appearing in both data sources. However, for the observations that overlap, pricing concordance is high: Corresponding prices have a correlation coefficient of 0.975, 77.4% match to the penny, and 84.4% are within 10%. Exact price matching rates are greater than 90% for 3 of the 4 service lines included in this study. Taken together, these results suggest that although administrative misalignment exists between payers and hospitals, there is a measure of signal amid the price transparency noise. [ABSTRACT FROM AUTHOR]

The article proposes a framework that pediatric educators may use for behaviorally based assessment of learner professionalism. It describes factors to consider in assessing professionalism in medical trainees, including educators' biases and experiences that may affect the way they perceive learner behaviors. It explains the PROFESSIONAL framework that outlines the core elements of medical professionalism to be assessed, including descriptions and examples of narrative comments.

High‐risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re‐traumatisation of young people and deteriorating therapeutic relationships. Trauma‐informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma‐informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma‐informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma‐informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma‐informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma‐informed practice is crucial to recovery‐focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people. [ABSTRACT FROM AUTHOR]

Eating disorders are complex mental health conditions exacerbated by high mortality rates. International and national guidelines recommend family involvement in the treatment process, recognising the family as an important source of support to young people. Research suggests fathers engage less in the process compared to mothers. In studies exploring parental perspectives, most samples consisted of mothers, with fathers minimally represented. Few studies explore family involvement from the perspective of fathers. This study aimed to explore the experiences of fathers regarding their involvement in the treatment process. Qualitative descriptive methods were used, involving focus group interviews of seven fathers. Interviews were assisted by a semi‐structured interview guide. A qualitative content analysis approach was used to analyse the data regarding paternal experiences of engagement in the treatment process. Fathers understood the importance of the whole family working together but viewed mothers as taking a more central role in the treatment process, with fathers more at the periphery. Gender emerged as an influencing factor in paternal involvement, with mothers primarily taking on responsibility for the child with the eating disorder and fathers providing secondary support. Healthcare providers need to be aware of the contribution of gendered roles within the family system and consider this when working with families within the treatment process. Consequently, mental health nurses have an important role in encouraging fathers to become actively involved in the treatment process. [ABSTRACT FROM AUTHOR]

Qualitative research is a relatively new approach for conducting studies in health disciplines. The value of this research approach is to explore peoples' experiences and gain a deeper understanding of the meaning of their experiences. Qualitative inquiries answer research questions about what, why and how by implementing various research designs such as qualitative descriptive, qualitative case study, ethnological, phenomenology, or grounded theory designs. Purposive and snowball sampling methods are commonly used to recruit participants followed by personal interviews or focus group discussions to collect data. Data analysis requires several coding procedures performed by the researcher or an alternative is using a coding software program. Preparing a manuscript for dissemination of the results can be challenging, although achievable. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your understanding of ‘elderspeak’ and the use of terms of endearment with older adults • To recognise that acceptance or rejection of the use of terms of endearment may be a matter of opinion • To enhance your practice by considering and acknowledging each individual’s communication preferences. Background: ‘Elderspeak’ has been defined as a form of communication overaccommodation used with older adults that typically involves inappropriate simplified speech. One aspect of elderspeak is the use of terms of endearment such as ‘honey’, sweetie’ and ‘dear’. There is disagreement regarding the use of terms of endearment with older adults, with differing views on whether it is beneficial or harmful. Aim: To explore the perceptions of older adults residing in an assisted living facility on the use of terms of endearment by healthcare staff. Method: This qualitative study used a descriptive phenomenological design. Semi-structured interviews were undertaken with 15 older adults regarding their perceptions of the use of terms of endearment. The data were analysed to identify themes. Findings: Two themes emerged from the interview data: ‘it’s a matter of opinion’ and ‘context matters’. Not all older adults viewed terms of endearment negatively; some liked them, others were neutral and some viewed them as childish or disrespectful. Conclusion: Perceptions regarding the use of terms of endearment appear to differ among older adults. Therefore, the use of such terms should be individualised based on the preferences of the older adult. [ABSTRACT FROM AUTHOR]

Aim: To identify insights for supporting people at risk of suicide in the community based on primary healthcare workers' experiences. Design: Qualitative descriptive design. Methods: Semi‐structured interviews were conducted with fifteen primary healthcare workers employed by Japanese municipalities between August and October 2019. The data were subjected to qualitative descriptive analysis. Results: The analysis revealed eleven subthemes, clustered under the following three themes: (1) fostering 'opportunities for discovery' for people at risk of suicide by encompassing strategies such as increasing access to services and promoting a holistic understanding of the life cycle; (2) fostering 'meaningful connections' by searching for channels to reach the heart and taking approaches from different objectives; and (3) engaging in 'risk management', by understanding and coping with real‐life struggles and implementing timely crisis intervention. Conclusion: Not only direct care targeting suicide prevention but also holistic care that includes atypical perspectives such as 'approaches from different objectives' may provide important insights for supporting people with suicide risk. Implications for Practice: Beyond the limitations of existing suicide risk screening methods, this study highlights the importance of a holistic approach that sees people at risk of suicide in the context of their daily lives and aims to alleviate the difficulties in their lives that have brought them to the point of considering suicide. Impact: By describing support focused on the difficulties that people at risk of suicide face in their daily lives, this study identified insights for supporting people at risk of suicide in communities where screening and intervention are difficult. These findings will contribute to the relief of people at risk of suicide by stimulating suicide prevention measures in primary healthcare settings. Reporting Method: This study complied with the COREQ guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The self-reference effect (SRE) is a memory advantage produced by encoding information in a self-relevant manner. The "evaluative" SRE arises when people engage in explicit self-evaluation/reflection to process to-be-remembered items, while the "incidental" SRE occurs when self-referential information (e.g., one's own name) is co-presented with to-be-remembered items but is irrelevant to a given task. Using a divided-attention paradigm, the present study examined potential differences in the attentional requirements of the evaluative and incidental SREs. During encoding, personality-trait words were presented simultaneously with the participant's own or a celebrity's name. The participants' task was either to evaluate whether each word described themselves/the celebrity (evaluative encoding) or to indicate the location of each word (incidental encoding), in the presence or absence of a secondary task. A subsequent recognition test with a remember/know procedure showed better overall recognition and enhanced episodic recollection for words presented with one's own name vs. another name, with this SRE being larger in the evaluative than incidental encoding condition. Critically, divided attention at encoding attenuated the magnitudes of both evaluative and incidental SREs to a comparable degree in overall recognition and episodic recollection. These findings suggest that both the evaluative and incidental SREs are resource-demanding, effortful mnemonic benefits. [ABSTRACT FROM AUTHOR]

Narrative identity – how individuals narrate their lived and remembered past – is usually assessed via independent rater coding, but new methods relying on self-report have been introduced. To test the assumption that different methods assess aspects of the same underlying construct, studies measuring similar components of narrative identity with different methods are needed. However, such studies are surprisingly rare. To begin to fill this gap, the present study compared the narrative variables, temporal coherence, causal coherence, and thematic coherence, measured via rater coding of participants' self-generated narratives of the remembered past and via subscales of the self-report measure Awareness of Narrative Identity Questionnaire (ANIQ). The results showed that the ANIQ subscales did not correlate significantly with their corresponding rater-coded dimension, and that the ANIQ subscales were generally unrelated to the other rater-coded dimensions. Furthermore, an exploratory factor analysis demonstrated that the ANIQ subscales loaded together on a factor that did not include any rater-coded variables. The findings suggest that the narrative variables share little empirical overlap when assessed via the ANIQ and rater coding of self-generated narratives. [ABSTRACT FROM AUTHOR]

Introduction The problem of transcoding is recurrent when researchers wish to link occupational data from cohorts to Job-Exposure Matrices (JEMs) which were not set up in the same classifications. The Occupational Asthma-specific JEM (OAsJEM) is a JEM developed for assessing exposure to agents known at risk for asthma for jobs coded with ISCO88 occupation classification. To apply the OAsJEM in the CONSTANCES cohort, in which jobs and industries were coded with French PCS2003 and NAF2008 classifications respectively, we developed a crosswalk to convert jobs from PCS2003 into ISCO88 classification. Methods This work was carried out by 2 skilled coders and 1 novice coder who have worked independently by using different tools and transcoding strategies defined a priori. Consensus meetings were organized with skilled coders to define the final crosswalk. This work was elaborated in 2 steps: (i) for 38 ISCO88 codes classified as potentially exposed to cleaning and disinfection products by the OAsJEM, and (ii) for all jobs from the ISCO88 classification. A comparison between the 3 initial coder's crosswalk proposals and the final crosswalk was made for the 38 ISCO codes in step (i). Results The final crosswalk provided 998 matches between the 482 4-digit PCS2003 codes, 308 4-digit ISCO88 codes, and 31 3-digit ISCO88 codes. Information regarding the NAF2008 industry classification was also used in some cases to improve the final crosswalk. For the selected 38 ISCO88 codes, the final crosswalk provided 110 combinations, but the number of proposed ISCO88–PCS2003 couples by each of the 3 coders varied greatly from 68 to 153. In addition, an important variability between the 3 coders were observed among the number of common combinations between the initial coder's proposals and the final crosswalk (from 47% to 78%). Discussion We have developed a crosswalk specifically for an application of the OAsJEM in population-based surveys using the PCS2003 occupation classification. The development of this crosswalk is of great interest for the use of OAsJEM on the data of the CONSTANCES cohort and on any other survey with occupational data coded according to the French classifications. This OAsJEM crosswalk could be used by other teams to evaluate occupational exposures known to be at risk of asthma from occupational calendars coded with French classifications. [ABSTRACT FROM AUTHOR]

Background: Online interaction in blended learning is leveraged through social presence and convergence. However, little systematic work currently exists on how researchers have explored these challenges in higher education institutions and no studies have synthesised these challenges. Objectives: The purpose of this study is to give a novel overview of social presence and convergence to improve online interaction in blended learning in higher education. The findings will be synthesised into blended learning design principles. Method: Two systematic literature reviews, one on each challenge, were carried out through the Web of Science databases and consulting cited sources in review articles. Accordingly, 28 distinct studies were selected through the guidelines of the PRISMA statement, using predefined selection criteria. Results and Conclusions: The results show that social presence in blended learning is mostly evoked through course design, introductory f2f meetings, collaborative activities, prompt online feedback, the teacher's presence, and planned facilitation. To establish convergence, it is recommended to make basic theory available online through video clips, web‐lectures, articles, followed by simple online assignments or self‐study to increase understanding, thereby creating opportunities for deep learning during face‐to‐face through discussions and collaborative activities. Implications: This paper adds to the theory on blended learning and instructional design in higher education, and further offers an elaborate set of design principles for educational practice. Future research on instructional design may investigate in particular how a target group or student factors, are affected by the blended learning environment in order to tailor designs for a specific target group. Lay Description: What is known?: Online interaction is pivotal in blended learningOnline interaction is leveraged through social presence and convergenceSocial presence prevents the online student from feeling lonelyConvergence entails deciding the best‐suited delivery mode: online or face‐to‐face What this paper adds: A novel overview and critical analysis of social presence in blended learningA novel overview and critical analysis of convergence in blended learningA synthesis of the findings on social presence and convergenceExtraction of the findings into blended learning design principles Implications for practitioners: The teacher's presence through design and accessibility fosters students' social presencePlacing concepts online leaves room for deep learning during face‐to‐faceCollaborative activities evoke social presence and facilitate deep learningBlended learning designs should be further tailored for the target group [ABSTRACT FROM AUTHOR]

Background: A resurgence in teaching coding in primary school classrooms has led to a pedagogical swing towards using physical computing and coding to develop students' use of algorithms, computational thinking, and problem‐solving skills. Two obstacles impede the optimal development of these objectives: the availability of a suitable pedagogy and an instructional sequencing model for primary school teachers to effectively present coding and computational thinking concepts and skills to students in alignment with their developmental stage. Objective: This study aims to address both obstacles by introducing the 3C Model, a newly developed instructional sequence grounded in established pedagogies and designed to effectively teach coding and computational thinking skills to primary school students based on their developmental stage. Methods: The qualitative study employed two data sources to triangulate findings, using: (1) semi‐structured interviews and thematic analysis to investigate 11 primary school students' perceptions of their learning experiences with the 3C Model, and (2) researcher observations along with reflections of the students' developed and demonstrated learning through the method of knowing‐in‐action, reflection‐in‐action, and reflection‐on‐action. Results and Conclusions: The findings of this study fill a gap in the existing literature by demonstrating that the pedagogical and sequential approach embedded in the 3C Model not only enhanced students' engagement levels but also resulted in improved curriculum learning outcomes. The 3C Model provides teachers with a coherent and age‐appropriate instructional structure. It uses physical computing devices and digital coding platforms to introduce coding concepts, furthering the development of computational thinking skills in primary school students beyond mere procedural and rote learning. Implications: The study holds important implications for practical applications, as it addresses an absence in the literature of an established pedagogy and instructional sequencing model for effectively teaching coding and computational thinking concepts and skills to primary school students. Drawing on established pedagogical and developmental learning theories, the 3C Model provides primary school teachers with an engaging, age‐appropriate instructional method that avoids decontextualised teaching and surface‐based learning. Instead, it encourages collaborative student work and contextualised learning, steering away from isolated and generic approaches. Lay Description: What is currently known about this topic: Teaching coding and computational thinking concepts and skills is complex due to their abstract nature.Teaching resources such as work samples, curriculum connections and tools are available to primary school teachers.There is no consensus on the most effective methods to teach these abstract concepts and skills.Primary school teachers default to applying general teaching strategies due to the lack of an age‐appropriate, specific activity sequencing model to use during coding instruction. What does this paper add: The study fills the existing gap by presenting a newly conceptualised instructional model, which considers the students' developmental stage of learning and pedagogical best practices.The study trialled the 3C Model with primary school students in a classroom setting.The study found that employing the pedagogical approach of the 3C Model increased students' engagement levels and resulted in enhanced curriculum learning outcomes. Implications for practitioners: Without an age‐appropriate instructional sequencing model students may not be grasping the underlying concepts.Simply focusing on the code without emphasising concepts such as decomposition and algorithmic thinking will result in shallow learning.Key considerations in using the 3C Model are ensuring that conceptual development occurs using physical computing devices and language students are familiar with prior to introducing coding language and its symbolic representations.Primary school teachers should consider incorporating physical interactive digital devices, physical movement, staged language development and subsequent coding procedures within the context of an engaging and authentic problem. This approach enables students to effectively grasp and represent coding and computational thinking concepts and skills, surpassing mere procedural and rote learning. [ABSTRACT FROM AUTHOR]

Background: With the growing integration of technology in education, the adoption of blended learning (b‐learning) has gained attention. B‐learning combines traditional classroom teaching with online components, holding potential to enhance student outcomes and educational efficiency. Yet, current research predominantly concentrates on higher education institutions in urban areas, creating a void in understanding its impact on K‐12 education, particularly in rural settings. Objectives: This qualitative study aims to propose recommendations for successful implementation of blended learning in rural K‐12 areas by addressing the key stakeholders influencing its adoption and identifying the main factors affecting its success. Methods: We performed a content analysis of grey literature documents detailing the implementation of b‐learning in K‐12 education. Additionally, interviews with crucial stakeholders such as teachers, principals, and experts in rural schools in South America provide insights into the challenges and prospects of b‐learning adoption in these contexts. Results and Conclusions: The study identifies pivotal stakeholders for effective b‐learning implementation, outlining their roles and addressing challenges inherent in rural settings. Recommendations for enhancing b‐learning's implementation in developing countries are also proposed. The research underscores the significance of involving diverse stakeholders such as governmental bodies, school leaders, educators, students, and families to ensure a holistic and efficient approach to blended learning. Lay Description: What is currently known about this topic: Blended Learning Definition and Benefits: Blended learning combines face‐to‐face and online instruction, enhancing student engagement and personalization by providing diverse learning pathways.Growth in K‐12 Implementation: Blended learning gained traction in K‐12 education, boosting academic outcomes, driven by recognition of learner diversity and potential in meeting students' needs.Contextual Challenges: Implementation challenges arise in low‐income households and rural areas, including limited access to technology and internet connectivity, impacting student engagement and success. What does this paper add: Focusing on Rural Dynamics: This study helps to fill a gap by investigating blended learning in rural K‐12 settings, spotlighting key players and success drivers in these unique contexts.Recommendations from Various Sources: By combining interviews and grey literature, this research generates comprehensive, practical recommendations grounded in both empirical insights and real‐world perspectives.Insights into Rural Hurdles: This paper extends the discussion on blended learning by addressing specific rural barriers, proposing family involvement, private sector partnerships for training, and tailored pedagogical strategies. Implications for practice or policy: Leadership and Collaboration: Effective school leadership and collaboration with local governments are pivotal for fruitful blended learning implementation, ensuring defined roles, responsibility, and accountability.Adaptable Curriculum Design: An adaptable, centralized curriculum aligns with recommendations, fostering efficient tracking of student progress and enabling customized learning.Engagement‐Centric Pedagogies: Recommendations spotlight interactive, student‐centered teaching methods, tailored to diverse student needs, nurturing active participation and elevated learning outcomes. [ABSTRACT FROM AUTHOR]

Clinical psychological science is long overdue to incorporate antiracism and social justice as core principles. To evaluate the current state of clinical science training programs' public-facing statements on antiracism and diversity, equity, inclusion, and justice (ADEIJ), we formed a workgroup under the guidance of the Academy of Psychological Clinical Science (APCS) Task Force to Center Racial and Social Justice in Clinical Science. Our workgroup evaluated the public-facing web materials of 78 APCS doctoral and internship programs. Following existing frameworks that have conceptualized the development of multicultural organizations, we evaluated the degree to which materials mentioned inclusivity, acknowledged inequities, and reported planned and enacted actions to promote ADEIJ. We examined rationales for engaging in this work, differentiating between moral and instrumental rationales. Results showed not all programs had ADEIJ statements, but a coding scheme can reliably assess existing statements. While all programs mentioned inclusivity and most acknowledged inequities, some had subtle or implicit exclusionary language, and a minority described concrete actions. Current efforts within our field may represent more symbolic than identity or structural change. Our findings inform recommendations for improving the efforts of training programs. Public Significance Statement: A coding scheme can reliably assess how clearly public-facing statements communicate a program's commitment to diversity, equity, inclusion, justice, or antiracist values. The programs assessed showed more indications of symbolic change than identity or structural change, perhaps reflecting a lack of knowledge about how to enact structural change and/or limited willingness to reflect on our field's contributions to historical and current inequities. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore the experiences of individuals with chronic kidney disease (CKD) undergoing haemodialysis and their caregivers, focusing on the disease's impact and the treatment process. Background: In Sri Lanka, CKD is a growing health concern, particularly affecting farming communities and contributing to the strain on the biomedical healthcare system. Despite increasing awareness of CKD's physical implications, its psychosocial impact remains underexplored. This study seeks to fill this gap, aiming to inform culturally sensitive interventions and improve the healthcare system's responsiveness to the unique needs of Sinhala Buddhist individuals with CKD and their caregivers. Design: An exploratory qualitative study. Method: Semistructured interviews were conducted with 10 individuals undergoing haemodialysis and 5 caregivers at a dialysis unit. The interviews were audio‐recorded, transcribed and analysed using conventional qualitative content analysis. Findings: The analysis revealed three interrelated main themes: (1) impact on standard of living (quality of life), (2) coping strategies and (3) medical experience, with a notable influence of traditional beliefs and practices. Conclusion: The findings highlight the need for a holistic approach to CKD management that integrates physical, emotional, psychological and social aspects, considering the significant role of traditional influences. Further research is essential to develop effective interventions that can enhance the quality of life for CKD. Patient or Public Contribution: The lived experiences of Sinhala Buddhist individuals with CKD and their caregivers served as a cornerstone, providing profound insights into the impact of the condition on their lives. Throughout the study, these participants played an instrumental role in refining the research's cultural sensitivity and relevance. Their engagement extended beyond the data collection phase to encompass feedback sessions, where they actively shared their perspectives. This ongoing collaboration ensured the study's depth and applicability to real‐world experiences. By actively involving those directly affected by CKD, this collaborative approach safeguards that the study remains rooted in their voices and addresses their unique needs. Reporting Method: This study adhered to relevant EQUATOR guidelines (the COREQ checklist). Trial Registration: This study is not a clinical trial, and thus, registration is not applicable. [ABSTRACT FROM AUTHOR]

Mothers of autistic children encounter numerous daily challenges that can affect their adaptation. While many studies have documented the impact on mothers of having an autistic child and factors contributing to their adaptation and their experiences of motherhood, few have examined how mothers of autistic children perceive their overall adaptation. We investigated with a qualitative design how mothers of autistic children perceive stressors, facilitators (resources, coping strategies, and contexts), and outcomes of adaptation in various life domains. Participants included 17 mothers of autistic children ranging from 2 to 8 years old. Mothers participated in a phone interview about their perception of their successes, challenges, and adaptation as mothers of their children. A thematic analysis was conducted on interview transcripts using inductive and deductive coding. A cross-case analysis was subsequently used to identify themes and subthemes. Results highlight the complexity of the maternal adaptation process in the context of autism, which starts before the child's diagnosis. Stressors, facilitators, and outcomes were described as overlapping in the psychological, social, professional, marital, and parental life domains. The accumulation of stressors was identified as mothers of autistic children's main source of stress and almost impossible to reduce. Participants explained having difficulties accessing effective facilitators. While outcomes of adaptation vary across mothers and life domains, indicators of distress were identified for all participants. Implications are discussed regarding how service providers and society could better support mothers of autistic children by considering their complex reality and by providing more resources and information. Highlights: Mothers of young autistic children participated in semi-structured interviews about their adaptation process. The adaptation process starts before the child's diagnosis. Stressors, facilitators, and outcomes overlap between life domains. The accumulation of stressors is identified as the main source of mothers' stress and is almost impossible to reduce. Outcomes of adaptation vary across mothers and life domains, yet all mothers mention at least one indicator of distress. Service providers should focus on offering more resources to mothers to promote better access to effective facilitators. [ABSTRACT FROM AUTHOR]

Objectives: The Three Delays model is a well‐established global public health framework for the utilization of obstetric services where each delay represents a series of factors affecting utilization: (1) Delay #1—Deciding to seek care, (2) Delay #2—Reaching an appropriate facility and (3) Delay #3—Receiving adequate care. The aim of this qualitative study was to explore the application of the Three Delays model to dental service utilization and describe factors attributed to delayed utilization within this framework. Methods: This study utilized a framework analysis, underpinned by the Three Delays model, to examine delays in dental care utilization. A criterion purposive sample of English‐speaking adults (18+ years) in Massachusetts and Florida, USA with limited dental care access was recruited. Data were collected via semi‐structured interviews conducted in two phases: 17 individual interviews, followed by interviews with a subset of five participants over 3 months (a total of 18 interviews). The analysis involved inductive thematic coding and systematic organization within the framework. Results: Major themes and subthemes were constructed from the participants' narratives, identified and categorized as factors in the Three Delays framework. Each of the delays was interrelated to the other two, and Delay #1 was the most common delay based on the participants' interviews. The themes and subthemes contributing to one or more delays included interpersonal communication, prior dental experience, financial considerations, childcare costs, social connection, technology literacy, time constraints, competing priorities, stressors such as eviction and immigration status and microaggressions including racism and stigma. Conclusion: The Three Delays model was applicable to the study of dental care utilization and factors that impact the decision to seek dental care, reaching an appropriate dental facility and receiving adequate dental care in this study context. [ABSTRACT FROM AUTHOR]

Background and Objectives Gerontologists have yet to explore the types of questions individuals have about later life. Analyzing questions offers a unique perspective on how individuals make sense of age-related issues. Specifically, questions require people to articulate specific inquiries or doubts, thus providing an unfiltered glimpse into the public's concerns and priorities vis-à-vis aging. We conduct a content analysis of questions posted on Quora that pertain to later life. Research Design and Methods We compiled 2,950 questions posted across four topics on Quora: "Aging," "Senior Citizens," "Elders" and "Older People." After applying our exclusion criteria, 658 questions were left for content analysis. These questions received more than 250 million views. Both deductive and inductive approaches guided the qualitative analysis. Results Five themes emerged from the analysis. The biggest theme (30%; N  = 195) dealt with 'Practical Concerns' (Theme 1). The next biggest theme (29%; N  = 191) was about "Health and Well-Being" (Theme 2). Theme 3 was about the 'Prolongation of Youth' (16%; N  = 110) and Theme 4 was about the 'Science of Aging' (15%; N  = 97). Theme 5 covered 'Existential Concerns' (10%; N  = 65). Discussion and Implications There is a need to address concerns that the public has about aging, particularly those involving practical issues and health. Growing old is unavoidable and with the population aging at a rapid pace, assuaging such concerns is of paramount importance. By doing so, individuals can approach the aging process with greater clarity and an elevated sense of empowerment. [ABSTRACT FROM AUTHOR]

Aims: One half of Norwegians die in nursing homes, where death certificates (DCs) are completed by two types of physicians: in-house physicians or physicians on call. The aims of this study were to examine differences in the quality of DCs due to type of physician and to uncover possible implications of errors for the public statistics. Methods: DCs from the year 2013 from nursing homes in the catchment area of Akershus University Hospital were examined with regard to logical deficiencies, garbage code diagnoses and type of certifying physician. In one third of cases, the registered causes of death were compared to information in the medical records. Results: A total of 873 DCs from 24 nursing homes were evaluated. Physicians on call certified 46% of all deaths. Logical deficiencies were found in 34% of all DCs and were more common in DCs from physicians on call. Garbage code diagnoses were used in every third DC, with 'sudden death' or 'cause of death unknown' preferred by physicians on call and 'unspecified pneumonia' preferred by in-house physicians. Comparisons against medical records uncovered missing information in 49% and 35% of DCs from physicians on call and in-house physicians, respectively. A dementia diagnosis was frequently overlooked by both physician types. Garbage code diagnoses were more common in DCs with missing information from medical records. Conclusions: Error rates in DCs in nursing homes in Norway are high. The results raise concerns about the validity of public cause of death statistics. [ABSTRACT FROM AUTHOR]