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Kaizen initiatives are core organisational mechanisms in lean healthcare projects. Although they show specific peculiarities (e.g. a narrow goal and an accelerated timeframe), they can vary in the way they are planned and executed. This study investigates what types of configurations of kaizen initiatives (profiled as gestalts of specific characteristics) can exist in healthcare, if they differ for social and technical outcomes, and for their application context (here considered in terms of work area routineness and team composition). The study is based on data from 362 participants to 105 kaizen initiatives implemented in two public hospitals in Italy. It identifies three clusters (i.e. 'hard practices-oriented', 'soft practices-oriented' and 'full-lean adherent' kaizen initiatives) characterised by different social and technical outcomes. The original contribution to the lean healthcare literature is twofold: first, the simultaneous focus on performance improvement (technical outcome) and modification of operators' mindset (social outcome); second, the adoption of a configurational approach to understand how gestalts of many variables explain the dynamics that lead to social and technical outcomes. No significant differences were found among clusters in terms of work area routineness and team composition, which also opens interesting directions for future research. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the emergence of social entrepreneurial intentions (SEIs) of youngsters at the base of the pyramid (BoP). A small but growing literature is emerging at the intersection of social entrepreneurship (SE) and BoP perspectives. However, little is known about the emergence of SEI in this context. Drawing on a qualitative approach, our findings highlight perceived self-efficacy, self-fulfilment and reciprocity as important drivers of SEIs of youngsters at the BoP. At a practical level, our study also highlights how social support could aid to develop individuals' perceptions of their own capabilities and help them to project themselves as social entrepreneurs. [ABSTRACT FROM AUTHOR]

Effective governance is crucial for the success of conservation projects aimed at protecting wildlife populations and supporting human well‐being. However, few large‐scale, comprehensive syntheses have been conducted on the effects of different environmental governance types on conservation outcomes (i.e., biological and ecological effectiveness or effects of conservation on human well‐being), and clarity on the quantity and quality of evidence remains dispersed and ambiguous. We attempted a systematic map of the evidence on the effectiveness of different governance types to meet desired conservation outcomes in Africa, Asia, and Latin America. However, early in this effort, we observed a general lack of empirical research on the links between governance and conservation outcomes. To fill observed data gaps in the evidence base, we tried triangulating governance data from alternative sources (Protected Planet database) and pooling evidence from research conducted within the same conservation areas. Limited data were contained in the Protected Planet database, and governance types in conservation areas and landscapes were complex, making it difficult to use these approaches to assign governance types to conservation areas. To illustrate our observations from the failed systematic map attempt, we prepared a rapid evidence map that outlines a subset of the evidence base of articles linking governance types and governance principles with conservation outcomes. Only 3.2% (34 of 1067) of the articles we screened directly related conservation outcomes to governance type, and even fewer related governance principles to conservation outcomes. Based on our findings, we recommend improving the evidence base by supporting empirical research and increasing the availability and quality of governance data in freely accessible databases. These recommendations are critical for enhancing understanding of the role of governance in conservation projects and improving conservation outcomes. [ABSTRACT FROM AUTHOR]

Anxiety is a common co-occurring condition for autistic students; however, little is known about how anxiety may affect their social or academic outcomes in an educational setting. Furthermore, the perspectives of students themselves have rarely been included in the literature. Using Q-sort method, 45 autistic participants aged 7 to 17 years identified the outcomes they perceived were most impacted by their anxiety in the educational setting. The three outcomes most highly rated as being impacted by anxiety overall were academic outcomes. Using by-person factor analysis, six distinct factors, or 'viewpoints', were identified. These viewpoints reflect different combinations of outcomes affected by anxiety, including missing school or activities, reduced interactions with friends, reduced classroom communication and finding it harder to complete schoolwork. This study adds to the literature by using Q-sort method to enable autistic children and adolescents to report the impacts of their anxiety. Anxiety has additional impacts on the social and academic outcomes of autistic students, highlighting the need for increased awareness and training for parents and professionals, an individualised approach to student support and further research regarding the relationship between anxiety and academic outcomes. Many autistic students experience anxiety, but there is little research that explores how anxiety might affect autistic students in the school environment. In this study, 45 autistic students, aged 7 to 17 years, completed an online sorting activity to tell us how anxiety impacts them at school. The students were given 21 statements about possible social and academic effects of anxiety (for example, 'When I'm worried it's hard to start my schoolwork' or 'When I'm worried I talk less to my friends or other students'), and sorted them based on how much they agreed each statement was true for them. The three statements most highly rated as being impacted by anxiety were difficulties related to schoolwork. By comparing the information provided by students, six smaller groups of students were identified who sorted the statements in a similar order. These groups show that anxiety affects different autistic students in different ways, including missing school or activities, communicating less with friends and teachers and finding it harder to complete schoolwork. This online sorting activity enabled autistic students themselves to report how anxiety affects them at school. The results suggest that it is important to provide individualised support for autistic students who experience anxiety at school, to reduce the impact of their anxiety on their participation, communication and interactions, and schoolwork. Further research about the effects of anxiety on the academic outcomes of autistic students is also needed. [ABSTRACT FROM AUTHOR]

Introduction: Transitioning to adulthood often involves achieving independence from the parental home. We assessed whether the likelihood of leaving the parental home, cohabitation, and marriage was similar between patients who experienced a hematologic malignancy at a young age and their peers. Methods: We identified 11,575 patients diagnosed with a hematologic malignancy under the age of 20 years between 1971 and 2011 in Denmark, Finland, and Sweden, 57,727 country‐, age‐, and sex‐matched population comparisons and 11,803 sibling comparisons and obtained annual information on family and marital status by linking to the statistical institute databases. Hazard ratios (HR) for leaving the parental home, cohabitation and marriage were estimated using Cox proportional hazards modeling. Results: Young adults with a history of a hematologic malignancy were slightly less likely to leave the parental home (HR 0.89; 95% confidence interval [CI] 0.86–0.92; HR 0.87 [95% CI 0.82–0.92]), cohabit with a nonmarital partner (HR 0.83 [95%CI 0.78–0.87]; HR 0.84 [95% CI 0.77–0.92]) and be married (HR 0.87 [95% CI 0.82–0.91]; HR 0.86 [95% CI 0.79–0.93]), compared with population comparisons and siblings, respectively. Conclusions: Our findings provide reassurance that young adults with a history of a hematologic malignancy show only a slight decrease in their likelihood of gaining independence from their childhood family and forming close interpersonal relationships compared to peers. While most patients are coping well in the long term, integrating structured psychosocial support into long‐term follow‐up is recommended to facilitate a timely and adequate transition into adulthood. [ABSTRACT FROM AUTHOR]

This article is devoted to researching the complex interactions between a society’s efforts to approach best practices of social inclusion and gender equality implementation in policy development processes and the ability of such a society to maintain its commitment to liberal and human-centered values in political life. Using the methods of stylized facts and comparative politics, we ground the applicability of the two-stage model of acquiring the institutional capacity to implement the principles of gender equality and social inclusion in the activities of the authorities. The first stage of this model involves the ability to accumulate additional costs to take into account and meet the special needs of vulnerable and discriminated-against groups in the process of policy development and implementation. The second stage entails the ability to achieve the efficiency of such expenditures in order to extract social outcomes through the reduction in the number of marginalized groups and the expansion of participation in the functioning of civil society institutions, ensuring the broad representation of all socio-demographic strata of the population. The stylized facts collected in this article may be the first (and are certainly not comprehensive) evidence that Ukraine is at the stage of forming the capability within society to benefit from the implementation of the principles of gender equality and social inclusion, both at the nationwide level and the level of individual organizations.

Aim Design Methods Results Conclusion Impact Reporting Method Patient or Public Contribution To explore the experiences and support needs of parents in the first 6 months after paediatric critical care.Longitudinal qualitative design.Sequential semi‐structured qualitative interviews were conducted with a sample of 28 parents in succession at 1 month and at 6 months (n = 22) after their child's discharge from paediatric critical care using purposive sampling. Data were analysed using the adapted five‐stage framework analysis.Data were developed into eight synthesized themes, three domains and an overarching theme: Regaining Normalcy. Families of children requiring medical treatment at 6 months showed signs of adaption to daily care routines. The two domains were Parental Emotional Health and Parental Social Health. Parental Transitional Health, a third domain, was added to the Post Intensive Care Syndrome‐paediatric framework. Parents were forward‐looking and discussed emotional health, relating to current caregiving issues. Emotional attention was related to present challenges and concerns about current health and possible readmission to the hospital. In terms of Parental Social Health, families isolated themselves for infection control while remaining connected with families using chat applications. Parents were selective to whom they allowed access to their lives. The impact of parental transitional health was evident and emphasized the daily challenges associated with integration back to home life. Flexible work arrangements allowed working parents to support caregiving needs in the first 6 months after discharge.In the first 6 months after paediatric critical illness, most families reported having moved past the experiences while having provoking memories of the admission period. Parents viewed the point of normalcy as child returned to school or when all medications were discontinued. Extension of transitional support can facilitate discharge experiences between paediatric critical care and normalcy. The findings highlight the importance of understanding the medium‐ and longer‐term impact of paediatric critical care. What problem did the study address? ○Limited understanding of long‐term parental experiences and support needs after PICU discharge. What were the main findings? ○Most families regained normalcy when child returns to school or when medications were discontinued. Some families continued to show signs of adaptations at 6 months after PICU discharge. Where and on whom did the research have an impact? ○The research has an impact on improving the understanding of long‐term parental experiences and support needs after PICU discharge, informing clinical practice, guiding policy development and shaping parental support programs. What problem did the study address? ○Limited understanding of long‐term parental experiences and support needs after PICU discharge. Limited understanding of long‐term parental experiences and support needs after PICU discharge.What were the main findings? ○Most families regained normalcy when child returns to school or when medications were discontinued. Some families continued to show signs of adaptations at 6 months after PICU discharge. Most families regained normalcy when child returns to school or when medications were discontinued. Some families continued to show signs of adaptations at 6 months after PICU discharge.Where and on whom did the research have an impact? ○The research has an impact on improving the understanding of long‐term parental experiences and support needs after PICU discharge, informing clinical practice, guiding policy development and shaping parental support programs. The research has an impact on improving the understanding of long‐term parental experiences and support needs after PICU discharge, informing clinical practice, guiding policy development and shaping parental support programs.We reported this study using the COREQ guidelines.Prior to confirming the interview guide, three parents of critically ill children actively participated by reviewing and providing feedback on its content. They provided suggestions to refine the wording and ensure clarity to enhance the participants' understanding. By including the perspectives of these parents, we aimed to improve the overall quality and relevance of the interview guide. [ABSTRACT FROM AUTHOR]

This article is devoted to researching the complex interactions between a society’s efforts to approach best practices of social inclusion and gender equality implementation in policy development processes and the ability of such a society to maintain its commitment to liberal and human-centered values in political life. Using the methods of stylized facts and comparative politics, we ground the applicability of the two-stage model of acquiring the institutional capacity to implement the principles of gender equality and social inclusion in the activities of the authorities. The first stage of this model involves the ability to accumulate additional costs to take into account and meet the special needs of vulnerable and discriminated-against groups in the process of policy development and implementation. The second stage entails the ability to achieve the efficiency of such expenditures in order to extract social outcomes through the reduction in the number of marginalized groups and the expansion of participation in the functioning of civil society institutions, ensuring the broad representation of all socio-demographic strata of the population. The stylized facts collected in this article may be the first (and are certainly not comprehensive) evidence that Ukraine is at the stage of forming the capability within society to benefit from the implementation of the principles of gender equality and social inclusion, both at the nationwide level and the level of individual organizations. [ABSTRACT FROM AUTHOR]

The subject matter of the research was to determine whether Serbian teachers encouraged the development of social competences in their students adequately and sufficiently as regards social outcomes. The hypotheses postulated were the following: ethics, empathy and loyalty are expected to be desirable character traits of importance in the development of students' social competences; teachers are expected to develop prosocial behaviour and communication skills among their students; teachers are expected to initiate and stimulate team work with the purpose of developing prosocial behaviour among their students; teachers are expected to initiate discussions and debates with the purpose of developing their students' communication skills; teachers are expected to be exemplary models in developing altruism and empathy among their students. The sample was comprised of 555 primary and secondary school teachers in Serbia. The results showed that: Ethics, empathy and loyalty are seen to be desirable character traits of importance in the development of students' social competences. Moreover, the findings proved that teachers were expected to develop prosocial behaviour and communication skills among their students, as well as to initiate and stimulate team work with the purpose of developing prosocial behaviour among their students. [ABSTRACT FROM AUTHOR]

Abstract Background Hearing loss can have a negative impact on individuals’ health and engagement with social activities. Integrated approaches that tackle barriers and social outcomes could mitigate some of these effects for cochlear implants (CI) users. This review aims to synthesise the evidence of the impact of a CI on adults’ health service utilisation and social outcomes. Methods Five databases (MEDLINE, Scopus, ERIC, CINAHL and PsychINFO) were searched from 1st January 2000 to 16 January 2023 and May 2023. Articles that reported on health service utilisation or social outcomes post-CI in adults aged ≥ 18 years were included. Health service utilisation includes hospital admissions, emergency department (ED) presentations, general practitioner (GP) visits, CI revision surgery and pharmaceutical use. Social outcomes include education, autonomy, social participation, training, disability, social housing, social welfare benefits, occupation, employment, income level, anxiety, depression, quality of life (QoL), communication and cognition. Searched articles were screened in two stages ̶̶̶ by going through the title and abstract then full text. Information extracted from the included studies was narratively synthesised. Results There were 44 studies included in this review, with 20 (45.5%) cohort studies, 18 (40.9%) cross-sectional and six (13.6%) qualitative studies. Nine studies (20.5%) reported on health service utilisation and 35 (79.5%) on social outcomes. Five out of nine studies showed benefits of CI in improving adults’ health service utilisation including reduced use of prescription medication, reduced number of surgical and audiological visits. Most of the studies 27 (77.1%) revealed improvements for at least one social outcome, such as work or employment 18 (85.7%), social participation 14 (93.3%), autonomy 8 (88.9%), education (all nine studies), perceived hearing disability (five out of six studies) and income (all three studies) post-CI. None of the included studies had a low risk of bias. Conclusions This review identified beneficial impacts of CI in improving adults’ health service utilisation and social outcomes. Improvement in hearing enhanced social interactions and working lives. There is a need for large scale, well-designed epidemiological studies examining health and social outcomes post-CI.

Funding for homelessness services in Australia has traditionally been based on short-term contracts centred on specific outputs, rather than outcomes. However, social work research has suggested that lengthier projects with individualised responses are needed, and longer-term funding is required to align with this need. Consequently, social impact bonds (SIBs), a new method of funding programs for longer time periods, have emerged, shifting the focus away from crisis management and towards prevention by assessing service usage and savings associated with a reduction in service usage. This approach relies heavily on funding from the private sector and is conditional on services meeting specific outcomes within a time frame. It is important for social workers to understand this new funding model and its implications for social policy, as well as to critically understand its alignments with social work values and purpose. This article has reviewed literature on the outcomes of homelessness interventions and how these outcomes may inform SIB investment in future. IMPLICATIONS SIB funding has the capacity to facilitate longer term programs. SIB funding has the potential to address the largely individualised presentation and support requirements for people experiencing homelessness. Social workers need to understand SIB structures and their potential to leverage sustainable longer-term funding, but also understand tensions such as how SIBs contribute to the movement of social welfare funding towards a more neoliberalist model. [ABSTRACT FROM AUTHOR]

Narcissistic individuals have a strong desire for attracting short-term mates, being influential in groups, and attaining prestige and material wealth. Past research suggests that narcissistic individuals are also quite successful in attaining these outcomes and these effects are due to narcissists' grandiose self-image and admiration-seeking tendency (i.e., admiration component of narcissism). In the current research, we investigated whether the effects of narcissistic admiration are moderated by specific qualities that are helpful for attaining the respective outcomes. Specifically, we tested whether physical attractiveness moderates the effect of narcissistic admiration on short-term mate appeal, whether intelligence and socio-emotional abilities moderate the effect on social influence, and whether intelligence moderates the effects on occupational prestige and material wealth. Analyzing data from a speed-dating study (Study 1, N = 397), a round-robin laboratory study (Study 2, N = 256), and a panel study representative of the German population (Study 3, N = 1,477), we found that narcissistic admiration and the respective qualities predicted the outcomes, but in most cases, their interactions were non-significant. There was one exception: Narcissistic admiration interacted with verbal intelligence in the sense that the effects of narcissistic admiration on occupational prestige and material wealth were more positive, the higher verbal intelligence was. [ABSTRACT FROM AUTHOR]

PEERS® for Preschoolers (P4P) is a social skills group program for young autistic children and their caregivers, which provides everyday tools for interacting and communicating with others. Twenty-two caregiver-child dyads participated and completed pre-treatment, post-treatment, and follow-up measures (4–16 weeks after). Using single-subject analyses to examine social skills, 60% demonstrated post-treatment improvement, and 53.85% demonstrated follow-up improvement. Regarding a secondary outcome of behavioral difficulties, 33.33% demonstrated post-treatment reduction, and 7.69% demonstrated follow-up reduction. Using regressions, autistic traits predicted outcomes; fewer social communication difficulties predicted both greater social skills and fewer behavioral difficulties at post-treatment, while fewer repetitive behaviors predicted fewer post-treatment and follow-up behavioral difficulties. These results preliminarily demonstrate the benefits of P4P and how autistic traits may impact P4P outcomes. [ABSTRACT FROM AUTHOR]

This study demonstrates how to access social value from profit-oriented public–private partnership. The author examines social impact bonds (SIBs) as a tool for financing public–private investments. Using the database of worldwide SIB-financed projects, this study develops an incentive-compatible mechanism of profit write-off for social purposes (e.g. medical services for uninsured constituencies). It presents the feasibility space of this mechanism given entrepreneur, institutional boundaries. The mechanism resurfaces public–private partnerships as a vehicle where profitability and social goals can be met. [ABSTRACT FROM AUTHOR]

This article considers the impact of improved sanitation beyond physical well-being. Based on the experiences of women from three community-based organisations (CBOs) in the rural Philippines, this article expands on documented non-health related outcomes of health, safety and security, cleaner surroundings, and ownership, to also include those linked to household income, livelihood, and CBOs. Drawing from the participatory and qualitative methods of Photovoice and Most Significant Change, semi-structured interviews and individual photo conversations were conducted among 13 CBO leaders and 50 sanitation project participants, respectively. Findings suggest that CBOs enable improved sanitation, and such improvements include a personal and communal change in the form of reformed sanitation and hygiene practices, enhanced independence, privacy, and security, and improved ability to reclaim spaces for personal and public use, cultivation, and economic stimulation. Findings also underscore the idea that people may be more likely to adopt and sustain improved sanitation efforts if they are made aware of the additional non-physical health advantages of doing so. HIGHLIGHTS Community-led sanitation initiatives are effective and sustainable.; The social and economic outcomes of sanitation interventions enhance well-being.; Practitioners can improve the adaptability and sustainability of sanitation interventions by emphasising the non-physical health outcomes during awareness-raising activities.; This study utilises participatory qualitative methods that enable participants' creativity.;

IntroductionLiterature on parental experiences after childhood critical illness has limited representation from diverse ethnic backgrounds. Parents from global ethnic majority groups have reported worst psychological outcomes and required more social support after childhood critical illness.AimTo explore the experiences of Chinese, Malay, and Indian parents in the first six months after Pediatric Intensive Care Unit (PICU) discharge of their child in Singapore.MethodsSequential semi-structured qualitative interviews were conducted to collect data from a convenience sample of 28 parents at one month (n = 28) and at six months (n = 22) after their child's discharge from a multidisciplinary PICU. Framework Analysis was adopted as the qualitative analysis strategy. The PICS-p framework was applied a priori in the Framework Analysis.FindingsThree interdependent domains and seven themes framed the 28 accounts in which ethnically diverse parents reported psychological stressors (PICS-p: emotional health), support received (PICS-p: social health) and practical challenges (transitional health) in the first six months after childhood critical illness. In the emotional health domain, parents were affected by different stressors and had different priorities over their child's survivorship. Only Indian parents reported experiences of stress symptoms, at six months post discharge. Malay parents sought solace from their religion more than Chinese and Indian parents. In the social health domain, parents reported various sources and degree of support received. Familial supports were strong across all groups, while community support was more prominent in Malay as compared to Chinese and Indian parents. A third domain, transitional health, was introduced to capture the difficulties parents faced during the transition from PICU survival to home. Parents from non-Chinese families were more likely to report financial challenges and more involvement of spouses after discharge. Complementary medicine or commercial health products were utilized by Chinese and Malay families.ConclusionThese findings reveal preferred strategies that parents from a global ethnic employ to address the emotional, social and transitional health impacts of their child's critical illness. Future care delivery may consider tailored care plans, communication strategies, and emotional support in PICUs that address the unique ethnic needs of parents during the critical six-months post their child's illness.

Objective: Developmental disruption contributes to poor psychosocial outcomes among adolescents and young adults (AYAs) with cancer, though indicators of AYAs' developmental status are not well understood. In this study, we describe perceived adult status as a novel developmental indicator and examine its associations with social milestones achievements and health‐related quality of life (HRQoL). Methods: For this secondary analysis, AYAs with cancer were recruited using a 2 (on/off treatment) × 2 [emerging adults (EAs) 18–25 years‐old, young adults (YAs) 26–39 years‐old] stratified sampling design through an online research panel. Surveys assessed perceived adult status (i.e., self‐perception of the extent to which one has reached adulthood), social milestones (marital, child‐rearing, employment, educational status), demographic and treatment characteristics, and HRQoL. Generalized linear models tested associations between perceived adult status, social milestones, and HRQoL. Results: AYAs (N = 383; Mage = 27.2, SD = 6.0) were majority male (56%) and treated with radiation without chemotherapy (37%). Most EAs (60%) perceived they had reached adulthood in some ways; most YAs (65%) perceived they had reached adulthood. EAs who perceived they had reached adulthood were more likely to be married, raising a child, and working than EAs who did not perceive they had reached adulthood. Among EAs, lower perceived adult status was associated with lower HRQoL when accounting for social milestones. Among YAs, perceived adult status was not associated with social milestones and neither perceived adult status nor social milestones were associated with HRQoL. Conclusions: Perceived adult status may be a useful developmental indicator for EAs with cancer. Findings highlight unique developmental needs of EAs and utility of patient perspectives for understanding developmental outcomes. [ABSTRACT FROM AUTHOR]

Friendships contribute to positive social outcomes such as the promotion of prosocial behaviors and social well-being and can lead to an overall healthy quality of life. Despite the importance of friendships, little is known about how individuals without disabilities develop and maintain friendships with individuals with intellectual and developmental disabilities. Using a phenomenological research design, the current study explored the lived experiences of 17 adults without disabilities who discussed the development and maintenance of their friendship with an individual with intellectual and developmental disabilities. Semi-structured interviews were conducted and subsequently collaborative, open coding was used to identify codes and themes across participants. Three main themes emerged related to 1) factors that facilitated friendship development; 2) factors that contributed to friendship maintenance; and 3) impacts of the friendship for both individuals with and without intellectual and developmental disabilities. Implications of the results are discussed as well as future directions for research. [ABSTRACT FROM AUTHOR]

Background: Hearing loss can have a negative impact on individuals' health and engagement with social activities. Integrated approaches that tackle barriers and social outcomes could mitigate some of these effects for cochlear implants (CI) users. This review aims to synthesise the evidence of the impact of a CI on adults' health service utilisation and social outcomes. Methods: Five databases (MEDLINE, Scopus, ERIC, CINAHL and PsychINFO) were searched from 1st January 2000 to 16 January 2023 and May 2023. Articles that reported on health service utilisation or social outcomes post-CI in adults aged ≥ 18 years were included. Health service utilisation includes hospital admissions, emergency department (ED) presentations, general practitioner (GP) visits, CI revision surgery and pharmaceutical use. Social outcomes include education, autonomy, social participation, training, disability, social housing, social welfare benefits, occupation, employment, income level, anxiety, depression, quality of life (QoL), communication and cognition. Searched articles were screened in two stages ̶̶̶ by going through the title and abstract then full text. Information extracted from the included studies was narratively synthesised. Results: There were 44 studies included in this review, with 20 (45.5%) cohort studies, 18 (40.9%) cross-sectional and six (13.6%) qualitative studies. Nine studies (20.5%) reported on health service utilisation and 35 (79.5%) on social outcomes. Five out of nine studies showed benefits of CI in improving adults' health service utilisation including reduced use of prescription medication, reduced number of surgical and audiological visits. Most of the studies 27 (77.1%) revealed improvements for at least one social outcome, such as work or employment 18 (85.7%), social participation 14 (93.3%), autonomy 8 (88.9%), education (all nine studies), perceived hearing disability (five out of six studies) and income (all three studies) post-CI. None of the included studies had a low risk of bias. Conclusions: This review identified beneficial impacts of CI in improving adults' health service utilisation and social outcomes. Improvement in hearing enhanced social interactions and working lives. There is a need for large scale, well-designed epidemiological studies examining health and social outcomes post-CI. [ABSTRACT FROM AUTHOR]

To synthesize knowledge about social participation interventions targeting relational outcomes for young people with physical and developmental disabilities. An umbrella review with a narrative synthesis was conducted to integrate findings of review articles examining social participation interventions targeting relational outcomes (e.g., peer interaction and friendships). Six databases were searched to identify reviews published between 2010 and 2021. Five reviews were identified, examining participation interventions, social/community integration interventions, recreational sport programs, online peer mentorship programs, and augmentative and alternative communication interventions to promote social interaction with peers. Interventions associated with improvements in relational outcomes included group-based programs, programs involving personalized goals, arts-based programs, and multi-component social communication interventions. Recommendations for future research included better description of interventions to identify active ingredients and key mechanisms, measurement of participants' experiences, and the need for interventions to be aligned with the nature of the outcomes examined. Preliminary intervention principles are proposed to guide the design of social participation interventions: individualizing, contextualizing, and immersion in social settings. There are multiple pathways by which to influence the relational outcomes of young people with disabilities. There are implications for the design of social participation interventions based on an ecological/experiential and relational perspective. Improvements in relational outcomes are associated with participation in group-based programs, programs involving personalized goals, arts-based programs, and multi-component social communication interventions. Three evidence-informed principles can help guide the design of social participation interventions: (1) personalizing, (2) contextualizing, and (3) immersion in social settings. Greater attention to aligning the nature of intervention with desired outcomes is needed to more effectively measure and promote relational outcomes. [ABSTRACT FROM AUTHOR]

Background: Diabetes burden manifests in social outcomes, with Kenya having the second highest global mortality rate (88.4%), attributable to the inadequacies of mitigation measures. Despite diabetes being manageable, there are concerns about client compliance with biomedical healthcare-seeking behaviour (HSB), which is scientifically recommended, with cases of shifting, combining HSB, or defaulting. This study sought to determine the social outcomes of alternative HSB among persons living with diabetes in Rongo Sub-County. Methods: This study adopted the Health Belief Model and a convergent mixed-method approach with a descriptive-exploratory design. Yamane’s formula was used to sample 257 respondents from a target population of 718 persons living with diabetes in Rongo Sub-County using proportionate and simple random sampling. Six healthcare workers from the purposively sampled health facilities were interviewed. Questionnaires and interview schedules were tested to obtain a validity and reliability index of .83 and .87 respectively. Results: Pearson’s correlation revealed a statistically significant and strong positive relationship between social outcomes and alternative HSB (.60, p =.00). The thematically analysed data revealed that perceptions, experiences, and beliefs influenced alternative HSB, thus impacting social outcomes. Conclusion: This study concluded that there is a strong positive relationship between social outcomes and seeking ethno-medicine (alternative HSB) among persons living with diabetes in the study area. Therefore, there is a need for a well-outlined framework for collaboration between biomedical and alternative healthcare practitioners. [ABSTRACT FROM AUTHOR]

Highlights: − Standardised questionnaires are used to measure the outcomes of citizenship education. − A prerequisite for cross-group comparisons based on these questionnaires is an assessment of measurement invariance. − This study used data from 6035 students from 87 Dutch primary schools to examine the measurement invariance of citizenship knowledge, attitude, and skill across sex, socioeconomic position and migration background. − The measurement invariance was sufficient in most cases. − Periodic assessment of measurement invariance in instruments measuring citizenship competences is important due to the dynamic nature of the construct. Purpose: Standardised questionnaires are used to measure the outcomes of citizenship education. These outcomes are often compared across groups to document different outcomes, for example, between boys and girls. A prerequisite for cross-group comparisons is an assessment of measurement invariance. Methodology: This study used data from 6035 students from 87 Dutch primary schools to examine the measurement invariance of the Citizenship Competences Questionnaire (Ten Dam et al., 2011). Dutch schools use this questionnaire to gain insight into students’ citizenship knowledge, attitudes, and skills. Measurement invariance was assessed across sex, socioeconomic position, and migration background. Findings: Measurement invariance was sufficient in most cases, allowing for cross-group comparisons of associations between latent constructs and their indicators, and in some cases, for cross-group comparisons of the latent means. We conclude by emphasising that periodic assessment of measurement invariance in instruments measuring citizenship competences is important due to the dynamic nature of the construct. [ABSTRACT FROM AUTHOR]

The study aims to assess and analyze the social outcomes of the COVID-19 pandemic. The study uses the discourse of comprehensive literature review to identify the outcomes, Interpretive Structural Modeling (ISM) for developing a structural model and Matrices' Impacts Cruise's Multiplication Appliquée a UN Classement (MICMAC) for analysis, classification of societal outcomes, and corroboration of results of ISM. Data from fifteen experts was collected through a survey questionnaire. As a result of the literature review, a list of sixteen outcomes was generated and verified by a panel of experts. Results of ISM revealed that the outcomes, namely, "emotional instability," "mental health self-harm," loneliness reduced recreational activities, obesity, and "increased screen time" come at the top of the model; therefore, they are less vital outcomes, whereas the most significant outcome which is at the bottom of the model is "employment instability"; hence it has a major impact on the society. The remaining outcomes fall in the middle of the model, so they have a moderate-severe impact. Results of MICMAC validate the findings of ISM. Overall findings of the study reveal that "employment instability" is the crucial social outcome of the COVID-19 pandemic. It is an original attempt based on real-time data, which is helpful for society at large, researchers, the international community, and policymakers because this study provides a lot of new information about the phenomenon. The study includes understanding society at large, policymakers, and researchers by illustrating the complex relations and simplifying the connections among a wide range of social outcomes of COVID-19. [ABSTRACT FROM AUTHOR]

Social communication deficits have been robustly documented in schizophrenia spectrum disorders. Historically, attempts to lessen this dysfunction have focused almost exclusively on modifying the person with schizophrenia's own behaviors and cognition. However, social communication is inherently dyadic, and this approach leaves unaddressed the role of the neurotypical interlocutor in communication breakdown. In this position piece, we review psycholinguistic theories and research in order to propose a more comprehensive and equitable understanding of the social dysfunction that people with schizophrenia experience. We do so by drawing attention to the manner in which neurotypical individuals may drive communication failure in schizophrenia. Stigma is proposed to be a major component of this phenomenon. In addition to an overview of our theoretical framework, we provide a research agenda to test the hypotheses this framework has produced. We hope this piece can inform future research directions within psycholinguistics. [ABSTRACT FROM AUTHOR]

In this journal Ikkos examines the work of the American sociologist Owen Whooley, who argues that US psychiatry has gone through five paradigm shifts without defining the object of its own expertise. We look at the substance of Whooley's methods and assumptions and offer our observations on Ikkos's argument and conclusions.

For sport for development practitioners, a theory of change document is a critical first step to map how program inputs yield the desired program outcomes. Yet, in our experience, this document is rarely created in practice. Accordingly, this study makes use of the case of an award-winning sport for development charity that expanded their operations from India to London to illustrate the pejorative implications resulting from failing to create a theory of change. A mixed-methods, quasi-experimental approach was utilized to understand program mechanisms, program processes, and how these influenced the aggregate participant experience. The quantitative analyses yielded no significant effects. Triangulating the qualitative data revealed that personal, social, health, and economic education was a competing product to the program. The limited effects are attributed to a failure to identify and attempt to assuage a local social problem. In addition, alignments with stakeholder expectations, program context, and legal requirements were also derailing. A discussion of the results, implications, and recommendations for establishing and implementing a theory of change are provided. [ABSTRACT FROM AUTHOR]

Highlights: • Standardised questionnaires are used to measure the outcomes of citizenship education. • A prerequisite for cross-group comparisons based on these questionnaires is an assessment of measurement invariance. • This study used data from 6035 students from 87 Dutch primary schools to examine the measurement invariance of citizenship knowledge, attitude, and skill across sex, socioeconomic position and migration background. • The measurement invariance was sufficient in most cases. • Periodic assessment of measurement invariance in instruments measuring citizenship competences is important due to the dynamic nature of the construct. Purpose: Standardised questionnaires are used to measure the outcomes of citizenship education. These outcomes are often compared across groups to document different outcomes, for example, between boys and girls. A prerequisite for cross-group comparisons is an assessment of measurement invariance. Methodology: This study used data from 6035 students from 87 Dutch primary schools to examine the measurement invariance of the Citizenship Competences Questionnaire (Ten Dam et al., 2011). Dutch schools use this questionnaire to gain insight into students’ citizenship knowledge, attitudes, and skills. Measurement invariance was assessed across sex, socioeconomic position, and migration background. Findings: Measurement invariance was sufficient in most cases, allowing for cross-group comparisons of associations between latent constructs and their indicators, and in some cases, for cross-group comparisons of the latent means. We conclude by emphasising that periodic assessment of measurement invariance in instruments measuring citizenship competences is important due to the dynamic nature of the construct.

Background: Diabetes burden manifests in social outcomes, with Kenya having the second highest global mortality rate (88.4%), attributable to the inadequacies of mitigation measures. Despite diabetes being manageable, there are concerns about client compliance with biomedical healthcare-seeking behaviour (HSB), which is scientifically recommended, with cases of shifting, combining HSB, or defaulting. This study sought to determine the social outcomes of alternative HSB among persons living with diabetes in Rongo Sub-County. Methods: This study adopted the Health Belief Model and a convergent mixedmethod approach with a descriptive-exploratory design. Yamane’s formula was used to sample 257 respondents from a target population of 718 persons living with diabetes in Rongo Sub-County using proportionate and simple random sampling. Six healthcare workers from the purposively sampled health facilities were interviewed. Questionnaires and interview schedules were tested to obtain a validity and reliability index of .83 and .87 respectively. Results: Pearson’s correlation revealed a statistically significant and strong positive relationship between social outcomes and alternative HSB (.60, p =.00). The thematically analysed data revealed that perceptions, experiences, and beliefs influenced alternative HSB, thus impacting social outcomes. Conclusion: This study concluded that there is a strong positive relationship between social outcomes and seeking ethno-medicine (alternative HSB) among persons living with diabetes in the study area. Therefore, there is a need for a well-outlined framework for collaboration between biomedical and alternative healthcare practitioners.

Background: Reports of increasing presentations of new cases of acute psychosis both locally, nationally and internationally during the COVID-19 pandemic, warranted further investigation. International case reports almost exclusively reported only clinical outcome (e.g. remission of psychotic symptoms), and fail to report on social precipitants or social outcomes. This is a common omission when investigating new psychosis cases such as acute and transient psychotic disorder (ATPD). In order to assess social impacts and outcomes, we conducted a rapid review of recent evidence. Aims: To conduct a rapid review of the recent evidence of social outcomes on new cases of psychosis emerging during the COVID-19 pandemic. Method: Four databases (Medline, Embase, Psychinfo and Cochrane COVID-19) were searched for ATPD, psychosis and social outcomes in adults aged 18+. Duplicates were removed. There were no language limitations. Results: There were 24 papers consisting of 18 original data research papers and 6 reviews. Additionally, 33 papers/letters, reporting on 60 individual cases of psychosis emerging during the COVID-19 pandemic. These two sets of papers were reviewed separately. Many original data research papers and reviews were sub optimal in their quality, with 44% online surveys, with the remainder being routinely collected data. Conclusion: There is a consensus that clinical outcomes of ATPD and other brief psychotic disorders (BPD) are good in the short term. The focus only on symptomatic clinical presentation and outcomes, leaves a gap in our understanding regarding social stressors and longer term social outcomes. ATPD and BPD often may not come to the attention of Early Intervention in Psychosis services, and if they do, are discharged following symptomatic remission. Without an understanding of the social stress factors and social outcomes, opportunities may be missed to prevent increased social disability and future relapse with these presentations. [ABSTRACT FROM AUTHOR]

Online video social interaction is now commonplace following rapid technological advances and the Covid-19 pandemic. Whether computer mediated communication (CMC) fundamentally changes nonverbal behaviour and social responses from others is unknown. Here, we conducted a repeated measures experimental study (N = 66) comparing three types of dyadic social interactions: in person, online video call (with self-view) and online video call (no self-view). Facial videos were analysed using automated facial movement tracking (based on the Facial Action Coding System: FACS). Independent raters made first impression judgements across all conditions (N = 198). Overall, people were more facially expressive in person compared to CMC, but there were significant individual differences across participants. Agreeableness was associated with a particular increase in expressivity in person compared to online, while extroversion was associated with greater expressivity in online video calls, but only when self-view was visible. Older adults were most impacted by CMC and showed the greatest reduction in facial expressivity online compared to in person. The first impressions of observers did not differ as a function of CMC. These results suggest that CMC does alter facial expressivity during social interaction, but that there is an important interplay with individual differences. • People are more facially expressive during in-person vs computer mediated video communication. • There is a great deal of individual variation in facial expressivity. • Social outcomes are similar for in-person and CMC interactions. • Personality types respond differentially to computer mediated communication. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review was to investigate the learning, social, and psychological outcomes of students with moderate, severe, and complex disabilities (MSCD) in inclusive settings. The review discusses barriers to conducting rigorous research in this field. Whilst an initial literature search located 1,338 records, only 18 were finally included due to the eligibility criteria. Studies were placed in categories based on the topics investigated. Regarding learning outcomes of students with MSCD, findings were moderately in favour of school inclusion for both academic achievement and adaptive skills. Regarding social outcomes, results showed that inclusive settings offer more access to instructional time and peer interaction, although they reported marginalisation during class activities and social isolation within the peer group. Finally, in terms of psychological outcomes, inclusive settings appeared to reduce the frequency of challenging behaviours. The paper also addresses conceptual barriers regarding the definition of inclusion and its consequences on research and practice as well as research design barriers resulting from the quality of research in this field. Based on review results, this paper outlines epistemological propositions for developing standards of quality for both research and practice in the field. [ABSTRACT FROM AUTHOR]

To examine whether the level of genetic risk in psychiatric disorders impacts the social functioning of affected individuals, we examine the relationship between genetic risk factors for major depression (MD), anxiety disorders (AD), bipolar disorder (BD), non-affective psychosis (NAP), alcohol use disorder (AUD), and drug use disorder (DUD) in disordered individuals and five adverse social outcomes: unemployment, residence in areas of social deprivation, social welfare, early retirement, and divorce. We examine all cases with registration for these disorders from 1995 to 2015 in individuals born in Sweden. Genetic risk was assessed by the family genetic risk score (FGRS) and statistical estimates by Cox proportional hazard models. High genetic risk was significantly and modestly associated with poorer social outcomes in 23 of 30 analyses. Overall, genetic risk for MD, AD, AUD, and DUD impacted social functioning more strongly in affected individuals than did genetic risk for BD and NAP. Social welfare had the strongest associations with genetic risk, and residence in areas of high deprivation had the weakest. In individuals suffering from psychiatric and substance use disorders, high levels of genetic risk impact not only clinical features but also diverse measures of social functioning., (© 2024 The Author(s). American Journal of Medical Genetics Part B: Neuropsychiatric Genetics published by Wiley Periodicals LLC.)

Loneliness is associated with poor mental and social outcomes globally. The literature suggests an association between loneliness and personal characteristics, place of residence, and leisure activities. However, the current literature has produced inconsistent findings and has focused largely on older adults. This study is one of the first to examine the differences, relationships, and predictors of loneliness in an adult population, and the roles of personal characteristics, place of residence, leisure activities, mental health, and social outcomes. A cross-sectional online survey was undertaken. A sample of 155 adults responded, with a mean age of 34.5 years (SD = 13.2), and with 54.1% identifying as female. An analysis revealed experiences of loneliness across the sample. In addition, age was moderately associated with loneliness, while psychological distress, depressive symptoms, and social networks were significantly associated with loneliness. Depressive symptoms were a positive predictor for loneliness, and social networks were a negative predictor for loneliness. This study has confirmed findings from previous research and provided new information on loneliness, which can guide future research and interventions to prevent or support people who suffer from loneliness. [ABSTRACT FROM AUTHOR]

Abstract Background Major disruptions imposed on medical education by the COVID-19 pandemic and the rapid shift to online teaching in medical programs, necessitated need for evaluation of this format. In this study we directly compared knowledge outcomes, social outcomes, and wellbeing of first year student small group teaching in either face to face (f2f) or online format. Methods At the end of the first course of our medical program, students were invited to participate in an online questionnaire with 10 quantitative items and 1 qualitative item. These were analysed using Factor Analysis Pattern Matrix and linear regression to group items and assess relatedness. Qualitative responses were thematized using Qualtrics software (Qualtrics, Provo, UT, USA). Summative assessment results were compared, both between current cohorts to historical cohorts. Results From a cohort of 298 students there was a 77% response rate. Overall, there were no differences in knowledge gains, either between groups or when compared to historical cohorts. Questionnaire items fell reliably into groups that related to either learning outcomes, social outcomes, or wellbeing. Independent T tests showed that format for teaching (online versus f2f) had an impact on social outcomes but no direct impact on learning outcomes. Linear regression revealed that the social outcomes have a direct impact on wellbeing and almost the double the impact on learning outcomes than mode of learning i.e.. F2f or online (β = .448 and β = .232 respectively). Conclusion In this study, we were able to show with statistical strength that social outcomes for students such as engaging with peers and facilitator, contributing to the group, and making friends have a direct impact on wellbeing and indirectly impact learning outcomes (such as motivation, satisfaction, integration of knowledge). In a rapidly changing educational landscape, in our opinion, it is vital that these aspects are a focus of design and delivery of medical education. The data from this study supports the notion that activity design and the expertise of the teacher in facilitating the small group activities, has greater impact than the mode of educational delivery itself on students’ learning processes.

Social benefits of water, sanitation and hygiene (WASH) interventions are less documented compared to health benefits such as the reduction of diarrheal diseases. Although most decisions in WASH investments are based on potential health outcomes, interventions may also lead to social benefits, such as income generation, increased school enrollment, improved levels of dignity, self-esteem and civic pride, which can have a significant value both personally and to the wider community. This qualitative case study was used to assess the perceived social outcomes of purposively selected stakeholders from a WASH intervention study in Malawi. In-depth Interviews (n = 10), focus group discussions (n = 4) and key informants interviews (n = 10) were conducted with caregivers (male and female), community leaders, traditional leaders and community coordinators. Thematic analysis identified eight social outcomes: formation and strengthening of relationships (n = 32), becoming role models to community members (n = 23), women empowerment (n = 20), time-saving (n = 17), change of status (n = 12), receiving awards (n = 12), reduced medical costs (n = 11) and obtaining new skills (n = 7). Social capital among caregivers was also found to be high. No negative outcomes from the intervention were reported. WASH interventions have multiple, important, but difficult to quantify social benefits which should be measured, reported and considered in WASH investment decision-making. HIGHLIGHTS Cluster-based and community-led WASH interventions can lead to positive social impacts, particularly for primary caregivers.; Social benefits included improved relationships, role modeling, female empowerment, increased household funds, and skills development.; WASH and other development programs should consider and evaluate the social impact of interventions routinely.;

Can Autonomous Vehicles (AVs) contribute to a balanced distribution of accessibility? Despite optimism regarding technological advancements in transport, social outcomes from AVs are highly uncertain, dependent on unknowns including technology and transport mode. We aim to critically consider how different AVs' future situations influence accessibility, grounded on continuous debates on the socio-spatial implications of transport development. Referring to the two key uncertain factors, we deliberated spatial changes that could be induced by AVs, and reflect how such changes might influence accessibility and equity. Our research indicated that high automation and strong shared mobility together can enhance accessibility for all if shared autonomous vehicles are affordable and available for disadvantaged areas. High automation without shared mobility can have negative impacts in inner cities, due to increasing congestion and limited opportunities for effective land development. With limited automation and strong shared mobility, we may see better distribution of accessibility across a wider area, owing to advanced public transport and mobility hub development. We posit that, despite high expectations, the socio-spatial consequences of AVs are far from certain and critical conditions necessary for accessibility for all in varied mobility futures should be carefully considered. • Socio-spatial effects of AVs are uncertain, being dependent on unknowns. • Automation and sharing mobility can contribute to greater accessibility for all. • Automation and non-sharing mobility negatively affect advantaged areas. • Affordability and availability of shared AVs is a critical element for equity. • Critical conditions for accessibility equity of AVs should be considered. [ABSTRACT FROM AUTHOR]

Background: The neurobiology underlying ASD is largely unknown but altered neural excitability/inhibitory ratios have been reported. Memantine is an N-methyl-D-aspartate (NMDA) glutamatergic antagonist studied for the treatment of core ASD symptoms, with mixed results. We examined whether glutamatergic levels were associated with and predicted response to memantine in an exploratory pilot study. Methods: Ten adult participants with ASD underwent proton magnetic resonance spectroscopy (1H-MRS) imaging at baseline and behavioral assessments before and after 12-weeks of open-label memantine. Post-treatment scores on Clinical Global Impressions-Improvement (CGI-I) for social interaction were the primary outcome measure, and scores on the Social Responsiveness Scale (SRS) were included as a secondary outcome. LCModel was used to quantify the concentrations of Point RESolved Spectroscopy-detected glutamate+glutamine (Glx) (and other neurometabolites, i.e., N-acetylaspartate, NAA; creatine+phosphocreatine, Cr+PCr, and myo-inositol, Ins), within the left dorsolateral prefrontal cortex (LDLPFC) and right (R) posterolateral cerebellum. SPM was used to perform brain tissue segmentation within the spectroscopic voxels. CGI-I scores post-treatment were used to classify the participants into two groups, responders (scores 1-3; n = 5) and non-responders (scores 4-7, or withdrew due to increase behaviors; n = 5). Independent samples t-tests, partial correlations and linear hierarchical regression models (SPSS) were used to determine between-group differences in neurometabolite concentrations and associations between neurometabolites and behavioral scores. Results: Responders and non-responders did not significantly differ in Glx levels in any region of interest, but differed in NAA levels in LDLPFC (higher in responders vs. non-responders). Although changes in CGI-I social scores were not correlated with Glx in any region of interest, the linear hierarchical regression did reveal that Glx and Ins levels in LDLPFC were predictors of post-treatment CGI-I social scores. Changes in SRS scores were correlated with baseline Cr+PCr levels in the LDLPFC. Discussion: Our pilot data suggest that baseline Glx, a marker of glutamatergic neurotransmission, did not directly predict response to memantine for social outcomes in adults with ASD. However, interactions between Glx and the neurometabolite associated with glial integrity (Ins) may help predict treatment response. Further, those with highest baseline NAA, a putative neuronal marker, and Cr+pCr, a brain energy metabolism marker, were the best responders. These preliminary results may explain some of the mixed results reported in previous memantine trials in ASD. Future studies will need to examine these results in a larger sample. [ABSTRACT FROM AUTHOR]

A rich body of scientific research suggests a positive relationship between education and social and political engagement. Active social engagement is important for incarcerated individuals if they are to successfully reintegrate into communities and desist from further involvement in crime. While a plethora of research has focused on the importance of correctional education, the extent of association between other forms of human capital such as cognitive skills and adult lifelong learning is unclear. The current study utilized data from the U.S. PIAAC Prison Study (2014) to explore the relationship between educational attainment, adult cognitive skill proficiency, lifelong learning, and social outcomes among incarcerated individuals. At least one of the three types of human capital variables included was found to be positively and significantly related to the three social outcomes of political efficacy, interpersonal trust, and health perception, even after controlling for the other two human capital variables and a number of demographics, demonstrating that each has its own, distinct contribution to social outcomes. Policy implications regarding these findings are discussed. [ABSTRACT FROM AUTHOR]

Background Context: In the acute postinjury setting, the prognostic value of sensory sparing among motor complete spinal injury patients has been well demonstrated. However, once final AIS grade is achieved 1 year postinjury, the value of sensory sparing alone has not been elucidated. We hypothesized that sensory sparing would lead to better outcomes in AIS B over AIS A patients at long-term, postrecovery follow-up.Purpose: To evaluate for differences in medical, Physical and Social outcomes between AIS A and B patients at least 1 year postinjury.Study Design: Retrospective Cohort.Patient Sample: Adults over the age of 18 with AIS A or B spinal cord injury sustained between January 1, 1995 and September 13, 2019. Data Collected from the Spinal Cord Injury Model Systems Database.Outcome Measures: Self-reported Measures: PHQ-9 score; SCI-QOL Resilience Short Form score; VAS pain score; Life Satisfaction Score; Self-reported depression and sleep disturbances. Physiologic Measures: Body Mass Index, Diabetes Mellitus, Hypertension, Hyperlipidemia, Mortality, Incidence of Pressure Sores. Functional Measures: Bowel and Bladder Management; Illicit Substance use; Level of Education; Marital Status; Rehospitalization Rate.Methods: Patient data from the Spinal Cord Injury Model Systems Database were extracted for patients with a final, recovered American Spinal Injury Association Impairment Scale (AIS) grade of A or B at 1-year postinjury. Variables related to physical, mental and social functioning were compared between the two groups.Results: A total of 2,562 AIS A and 675 AIS B patient met inclusion criteria. Occurrence of pressure ulcers was 7% less in AIS B versus A (34.5% vs. 41.9%, p=.003). There were no statistical differences between groups in pain, bowel or bladder accidents, urinary tract infections, or the level of assistance for bowel or bladder management. There was no statistical difference for PHQ-9 depression scores, SCI-QOL Resilience Scores, rates of suicidality or sleep disturbance. There was no difference for illicit drug or alcohol abuse, life satisfaction scores, perceived health, and marriage or divorce rates.Conclusions: Except for a 7% reduction in pressure ulcer occurrence, there is no apparent long-term outcome advantage for motor complete spinal cord injury patients with AIS B sensory sparing over AIS A sensory complete. All other physical function domains were not different, nor were mental and social outcomes. [ABSTRACT FROM AUTHOR]

Extending Freeman and Alkin's review of the literature, this systematic literature review examines the social and academic outcomes of students with extensive support needs (ESN) taught in general education settings compared with those taught in segregated settings. Six comparison design studies were analyzed for contextual factors of educational environments, participants' characteristics, and outcomes related to social or academic attainment. Results indicate access to the general education classroom with same-age peers is associated with greater academic and social outcomes for students with ESN. There remains a need for improved reporting of participant support needs and demographic information (e.g., SES, nonbinary genders, and race and ethnicity), and a need for improved reporting of potential mediating factors (e.g., contextual factors and personnel) across settings. Detailed implications for future research are provided, particularly as they relate to providing high-quality instruction for students with ESN. [ABSTRACT FROM AUTHOR]

[Display omitted] • Singapore kept its stale policy while targeting a zero-waste Circular Economy plan. • In 2019, Shanghai enhanced household waste segregation and recycling at the source. • Differences were assessed in strategy, environmental, economic and social perspectives. • New policies and digitalisation improved waste management in Shanghai in 2019. • Digitalisation, market reshaping and COVID-19 triggered challenges and opportunities. Due to rapid economic development and urbanisation, emerging megacities with dense populations have witnessed a significant increase in waste generation. Megacities face challenges in developing sustainable waste management systems. Considerable heterogeneity exists across megacities in management strategies. The two selected emerging megacities, Singapore (a city-state) and Shanghai, have similar developmental characteristics, but their waste management modes differ strikingly. This study assessed the two modes in terms of management strategies, environmental effects, economic costs, and social outcomes. Environmental footprint analysis and cost quantification were employed for the assessment based on public data. The research results would permit a deeper understanding of the long-term sustainability of each mode while considering the feasibility of implementation across different contexts. It was found that the waste management system in Singapore had a relatively lower environmental impact than Shanghai before Shanghai's new waste segregation and recycling policy in 2019. However, when the effect of fossil fuel substitution is taken into account, the environmental burden in Shanghai can be lowered more substantially than the one in Singapore. Although Shanghai had more economic burden for the waste segregation at source, it tended to implement the circular economy principles (e.g., reduce, reuse, and recycling) better and improve its sense of community significantly. Based on the practical experiences from the two representative megacities, suggestions for better waste management practices were provided for Singapore, Shanghai, and other emerging megacities with similar circumstances. In addition, challenges and opportunities related to household waste segregation and recycling were identified to guide future practices in emerging megacities. [ABSTRACT FROM AUTHOR]

Mental and physical health problems are common during early fatherhood. The current study aimed to assess a broad range of mental, physical and social outcomes for fathers of young children (aged 0–4 years) participating in a pilot evaluation of 'Working Out Dads' (WOD). These results were complemented by a nested qualitative study capturing the perceived outcomes for fathers. The sample consisted of 53 fathers who completed pre-, post- and 3-month follow-up measures. There were significant reductions in psychological distress, depression, anxiety and stress from pre- to post-intervention, which were maintained at 3-month follow-up. There were significant improvements in perceived vitality levels across all time points, and improvements in general physical health, social support and parenting self-efficacy from pre- to the 3-month follow-up. The nested qualitative results revealed that fathers and their partners perceived positive changes to paternal health, social support, parenting and the couple relationship. These findings contribute to the evidence-base for interventions targeting fathers' health in the early years of their children's lives. The current findings will be used to inform further development of WOD. [ABSTRACT FROM AUTHOR]

BackgroundThe neurobiology underlying ASD is largely unknown but altered neural excitability/inhibitory ratios have been reported. Memantine is an N-methyl-D-aspartate (NMDA) glutamatergic antagonist studied for the treatment of core ASD symptoms, with mixed results. We examined whether glutamatergic levels were associated with and predicted response to memantine in an exploratory pilot study.MethodsTen adult participants with ASD underwent proton magnetic resonance spectroscopy (1H-MRS) imaging at baseline and behavioral assessments before and after 12-weeks of open-label memantine. Post-treatment scores on Clinical Global Impressions–Improvement (CGI-I) for social interaction were the primary outcome measure, and scores on the Social Responsiveness Scale (SRS) were included as a secondary outcome. LCModel was used to quantify the concentrations of Point RESolved Spectroscopy-detected glutamate+glutamine (Glx) (and other neurometabolites, i.e., N-acetylaspartate, NAA; creatine+phosphocreatine, Cr+PCr, and myo-inositol, Ins), within the left dorsolateral prefrontal cortex (LDLPFC) and right (R) posterolateral cerebellum. SPM was used to perform brain tissue segmentation within the spectroscopic voxels. CGI-I scores post-treatment were used to classify the participants into two groups, responders (scores 1–3; n = 5) and non-responders (scores 4–7, or withdrew due to increase behaviors; n = 5). Independent samples t-tests, partial correlations and linear hierarchical regression models (SPSS) were used to determine between-group differences in neurometabolite concentrations and associations between neurometabolites and behavioral scores.ResultsResponders and non-responders did not significantly differ in Glx levels in any region of interest, but differed in NAA levels in LDLPFC (higher in responders vs. non-responders). Although changes in CGI-I social scores were not correlated with Glx in any region of interest, the linear hierarchical regression did reveal that Glx and Ins levels in LDLPFC were predictors of post-treatment CGI-I social scores. Changes in SRS scores were correlated with baseline Cr+PCr levels in the LDLPFC.DiscussionOur pilot data suggest that baseline Glx, a marker of glutamatergic neurotransmission, did not directly predict response to memantine for social outcomes in adults with ASD. However, interactions between Glx and the neurometabolite associated with glial integrity (Ins) may help predict treatment response. Further, those with highest baseline NAA, a putative neuronal marker, and Cr+pCr, a brain energy metabolism marker, were the best responders. These preliminary results may explain some of the mixed results reported in previous memantine trials in ASD. Future studies will need to examine these results in a larger sample.

In this journal Ikkos examines the work of the American sociologist Owen Whooley, who argues that US psychiatry has gone through five paradigm shifts without defining the object of its own expertise. We look at the substance of Whooley's methods and assumptions and offer our observations on Ikkos's argument and conclusions. [ABSTRACT FROM AUTHOR]