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Resilience is an important attribute of incident management teams (IMTs) for managing disasters. Previous research on resilience of IMTs has focused on comparing work-as-imagined (WAI) and work-as-done (WAD) but predominantly used narrative analyses which limited comparisons between IMTs. This paper presents a novel Interaction Episode Analysis (IEA) method to identify the IMT's WAI and WAD episodes by analyzing dynamic interactions that occur between different roles that carry out information management tasks. Observations and audio--visual recordings of two high-fidelity IMT exercises were conducted to capture WAD episodes, and semi-structured interviews with experts elicited corresponding WAI episodes. Quantitative analyses using five interaction-based measures were conducted to detect differences of the WAD episodes between two IMTs. Next, qualitative analyses were focused on identifying reasons why such differences have occurred by comparing the gaps between WAI and WAD episodes. Some of the reasons for WAI-WAD gaps included the non-occurrence of critical interactions that were expected and occurrence of unexpected interactions between IMT members. This paper also identifies cases of preparatory, proactive, and reactive performance adjustment that characterizes IMT resilience. The IEA method shows promise for investigating how and why the gaps between WAI and WAD in IMTs occur. With the identification of these gaps, future research can be conducted to reconcile the gaps between WAI and WAD episodes, and thus enhance resilience of IMTs in future disasters. [ABSTRACT FROM AUTHOR]

Persuasive gamified systems are effective tools for motivating behaviour change using various persuasive strategies. In line with the reinforcement theory, some persuasive gamified systems employ reward and punishment in their design to achieve the intended behavioural outcome. Research has argued both in favour and against using these strategies in behaviour change applications due to mixed results with respect to their effectiveness. However, there is a lack knowledge about how interventions using these strategies could motivate or demotivate behaviours. Therefore, this paper explores the mechanism through which Reward and Punishment motivate or demotivate behaviours with respect to their strengths and weaknesses. The results of large-scale exploratory studies (N = 1768) uncover important strengths and weaknesses that could facilitate or hinder the effectiveness of Reward and Punishment at motivating behaviour change. These include their ability to engage users and make behaviour fun, reinforce commitments to goals, and reveal some consequences of bad behaviour. We also compared the perceived effectiveness of reward and punishment quantitatively. [ABSTRACT FROM AUTHOR]

Previous research has suggested that older trans and gender non-conforming (TGNC) people may face particular challenges related to stigma, social exclusion and discrimination in later life. However, direct data on social support and needs in older TGNC population both internationally and within the UK is limited due to the small, dispersed nature of this population, and the absence of specific data collection on aging TGNC populations. During the UK COVID-19 lockdown in summer 2020, older people and those with long-term health conditions were advised to adopt particular precautions. This study aimed to explore older TGNC people's social support networks, key concerns and unmet needs during the COVID-19 'lockdown'. A UK cross-sectional survey of LGBT + people aged 60+ (n = 375) was undertaken during the lockdown. This paper analyses responses from the subset (n = 38) of TGNC participants. The majority of TGNC respondents described diverse social networks, often centered around friends and non-kin social networks, although partners and adult children were also significant for some. In most cases, those with existing strong networks continued to maintain social connections during lockdown, albeit with some regrets about loss of activities and face-to-face connection. However, a minority of respondents had experienced greater challenges prior to lockdown, and may have been at increased vulnerability during the pandemic, for example indicating that they had no-one to call on for practical support in an emergency. When asked about unmet needs and challenges, social isolation was repeatedly raised as the most frequent concern. Several respondents also mentioned issues specifically affecting TGNC communities, including access to gender affirming care and a perceived rise in social intolerance. Health and social care providers should be aware of the diversity of support networks within TGNC communities. There may also be benefits in community sector interventions to help older TGNC build and maintain strong social networks. [ABSTRACT FROM AUTHOR]

A growing body of conceptual evidence over the last decade has increased our understanding of parents' experiences of having an infant with complex congenital heart disease. These concepts include parents' feelings of uncertainty, fear, excitement, and mastery. However, little is known about parents' experiences, confidence, and knowledge acquisition during transition from hospital to home with their infant after the first stage of complex cardiac surgery. A theoretical framework to assess, plan and implement child and family centered care would assist children's cardiac nurses responsible for parental education, discharge planning and coordination. To explore parents' experiences of the transition from hospital to home with their infant, following the first stage of cardiac surgery. A prospective mixed methods longitudinal design. Semi-structured interviews were undertaken, including administration of the Maternal Confidence Questionnaire at four timepoints: before discharge following stage one cardiac surgery (T0), 2 weeks' post discharge (T1), 8 weeks' post discharge (T2) and after stage two surgery (T3). Qualitative data were thematically analyzed. Descriptive statistics were used to characterize the sample and non-parametric repeated measures analysis of variance was used to analyze changes over time in maternal confidence scores. Sixteen parents of 12 infants participated. Four "patterns of transition experience" emerged, the fourth "Mastery", is discussed in this paper. Mastery can be contextualized in terms of the parents' journeys of knowledge construction, gaining confidence and reflection. Learning was dynamic and transformational, but successful learning and acquisition of knowledge was also dependent upon the parents' ability to absorb, integrate and adjust at any given time. Confidence at T0 was significantly lower than at T1 (p =.011), T2 (p =.018) and T3 (p =.012). There were no significant differences between scores at T1, T2 and T3. Liminality, as a concept, described the between and betwixt time that parents experienced as they were preparing for discharge from hospital; excitement to be going home balanced with the fear of being alone and confidence in looking after their fragile infant. Parents of infants with complex congenital heart disease obtain knowledge, confidence, and mastery dependent upon their transition experience and their personal journey through pre-liminal, liminal, and post-liminal phases of discharge from hospital to home. A conceptual framework "Parenting through Transitions – hospital to home" emerged that could assist in structuring assessment of parents' knowledge and support needs within a coordinated discharge process. Identifying individualized support would promote adaptation and adjustment during transition from the pre to post liminal phase, following their infant's first stage of complex cardiac surgery. Parents learning was dynamic and transformational, learning opportunities overlapped transitional phases of their infant's journey, but successful learning and acquisition of knowledge was also dependent upon the parents' ability to absorb, integrate and adjust at any given time. The transition from hospital to home and traversing the physical boundary of leaving the hospital for the first time with their infant (liminal phase), was loaded with emotionally traumatic experiences that could not be separated from the transition that was being explored within this study. Adjusting to the new situation, developing confidence over time, and becoming comfortable as they mastered new skills, demonstrated that some of these parents could pass through that liminal space to mastery of a new normal (post-liminal phase), which encompassed competence, integration, and comfort. [ABSTRACT FROM AUTHOR]

Republican politicians unabashedly condemn the use of critical race theory (CRT) as a pedagogical framework for educators. While most Democrats have quickly come to the defense of CRT, even they are socialized through White supremacist practices. Connecting CRT to the theory of impression management, this paper reveals how Minnesota politicians (both Republicans and Democrats) and government officials used Twitter during a pivotal time in U.S. history—the murder of George Floyd. Examining these theories in relation to the faces of whiteness, we reveal how language of support by government officials and Republican and Democrat politicians may perpetuate White supremacy in overt and camouflaged ways. [ABSTRACT FROM AUTHOR]

Following the spread of COVID-19, the Rhode Island Department of Health delivered its first virtual World Diabetes Day (RIWDD) event. Evaluations exploring advantages and disadvantages of delivering public health events virtually are generally lacking. The aims of the present paper were to evaluate the reach, feasibility, and effectiveness of delivering RIWDD virtually. Quantitative methods were used to: (1) estimate and compare the target population to RIWDD's event reach; and (2) evaluate whether diabetes knowledge increased amongst attendees. Qualitative methods assessed event facilitators' perceptions of the strengths, limitations, and challenges of using a virtual format to inform planning and implementation of future RIWDD events. Results revealed segments of RI's population disproportionately affected by diabetes, including men, persons of color, and older adults were underrepresented at the event. The event was not associated with increases in diabetes knowledge; however, attendees possessed high diabetes knowledge overall. Facilitators identified several important factors associated with virtual delivery in the context of COVID-19. Considerations for delivering virtual events are discussed. A key takeaway of this evaluation is the critical need for cultural competency as a guiding framework for professional practice when delivering events virtually. [ABSTRACT FROM AUTHOR]

The paper examines the multi-dimensional nature of Internet Addiction (IA) and its influence on Well-Being (WB) amongst a representative sample of 320 young urban Indian internet users. Nine hypotheses are proposed through a conceptual model to assess the multi-dimensional nature of IA and its relationship with WB. Partial Least Squares – Structure Equation Modelling (PLS-SEM) was conducted to assess the hypothesised relationships. Of the proposed nine hypotheses, seven were accepted. The result indicated IA as a four-dimensional construct – Internet Control Disorder (ICD), Internet Craving (IC), Internet Obsession (IO), and Addictive Behaviour (AB). The findings supported that ICD positively and significantly influences IC. IC and AB both have a significant impact on IO. ICD and IC have a significant impact on the individual's AB. ICD and IO significantly influence WB. With respect to the dimensions IC, AB, and IO, the model is successful in explaining around 26%, 45%, and 33% of the variation. IA as a multi-dimensional phenomenon and its relationship with WB in a young-demographic nation like India has immense academic and societal value. The study provides critical actionable insights for users, educators, health counsellors, parents, and policymakers regarding interventions for controlling internet addiction. [ABSTRACT FROM AUTHOR]

Purpose: The "Joint Resources – Sedentary Behavior Study" (JR-SB) revealed significant behavioral and cardio-metabolic effects of reducing daily sedentary behavior replaced by light-intensity physical activity in patients with rheumatoid arthritis. This study explores the participant perception and experiences of the intervention and impact on the participants' health, family and physical activity behavior. Materials and Methods: A mixed-methods study design, including quantitative and qualitative data, was applied. Quantitative data were collected post-intervention using a questionnaire (n = 69) evaluating experiences of participation in the intervention. By maximum variation sampling, 18 participants were recruited to three focus group interviews with discussions of intervention elements. Data from the two sub-studies were collected and analyzed separately, although integrated at the interpretation and reporting level. Results: Based on four overarching themes, results indicated participant satisfaction with the individually tailored, behavioral approach and the focus on light-intensity physical activity rather than higher intensities. Study participation had an additional positive impact on the behaviors of family and social relations. Conversely, the family motivated the participants to achieve their physical activity goals. Conclusions: The study results support the use of individually tailored and behavioral approaches to reduce sedentary behavior, increase light-intensity physical activity and improve physical abilities in patients with rheumatoid arthritis. This paper presents positive participant perception and motivation for an individually tailored, behavioural intervention that aimed to reduce sedentary behaviour replaced by light-intensity physical activity in patients with rheumatoid arthritis. The results indicate that especially the focus on light-intensity physical activity, a consistent focus on the individual's everyday life and continuous support from health professionals motivated the participants to reduce their daily sedentary behaviour – also in the long term. Involvement of participants' family members seems to have influence on their own physical activity behavior as well as on the participants' motivation for changing physical activity behavior. Together with earlier evidence, the results underpin the use of behavioural strategies to support patients with rheumatoid arthritis in achieving their physical activity goals and in improving the abilities needed to manage their everyday lives. [ABSTRACT FROM AUTHOR]

In pregnancy, the attachment relationship between a mother and her baby begins to develop and women are more motivated and willing to make changes to become more engaged and responsive mothers and have better relationships with their children. A transgenerational framework has proposed that dysfunctional relationship patterns are often repeated across generations and this has broadened the understanding of early difficulties in parenting. Despite this there has been little research specifically examining high-risk perinatal women and how their interactions with their infants are related to attachment or relational outcomes. This pilot study aims to evaluate, and to explore the acceptability and feasibility, of participating in the Supporting Transitions, Attachment and Relationships (STAR Mums) program, a psychodynamic attachment-based group intervention, for pregnant women with risk factors for attachment difficulties. The STAR Mums program aims to intervene during pregnancy to assist women with risk factors in the transition to parenthood with the desired outcome to improve the quality of mother-infant emotional interactions, regulation and the attachment relationship. This is a mixed-methods design study incorporating both qualitative and quantitative assessments of five groups of five first-time mothers over a 12-month period. This paper outlines the STAR Mums intervention and protocol for assessing acceptability and feasibility. The STAR Mums program takes a preventative approach and supports early intervention for parents at risk of attachment difficulties with their infants. The results of this study will inform revisions to the current treatment manual and a larger-scale program evaluation to further examine the efficacy of this intervention. [ABSTRACT FROM AUTHOR]

Up to two-thirds of South African adolescent mothers drop out of school, which increases their HIV risk and other poor health outcomes. Despite variability in adolescent mothers' schooling trajectories, we have a limited understanding of their re-enrollment in school following the life-changing circumstance of childbirth. In this paper, we draw on qualitative interviews (n = 16) and quantitative surveys (n = 109) with adolescent mothers (aged 14–19) who had recently given birth to describe how access to individual and social resources contributes to their resilience following childbirth and thus affects their ability to re-enroll in school. Nearly all the adolescent mothers in our study expressed a desire to return to school, and most of their families also emotionally supported adolescent mothers in these goals. Despite mothers' high hopes and familial emotional support, only half of the adolescent mothers re-enrolled in the first six months following childbirth. Adolescent mothers' re-entry trajectories were strongly affected by institutional support and by family members' provision of instrumental support. To a lesser extent, support from partners and peers also played a role in re-enrollment. Multilevel interventions to maximise resilience following the onset of early motherhood may facilitate return to school and positively influence adolescent mothers' health and well-being. [ABSTRACT FROM AUTHOR]

This article proposes a methodology for systematically assessing the cost of journal subscriptions. The authors of the paper (hereafter "the researchers") established ratios comparing the list costs of journal articles as advertised by publishers against the cost per article of journal articles available in aggregated collections in library databases (hereafter "aggregating databases"). The researchers propose that the ratios can be used by libraries wishing to apply a standard methodology for assessing journal packages containing full-text articles. The study may be helpful for those librarians who seek to supplement qualitative information and other quantitative data, such as usage statistics, in order to demonstrate the library's rationale for providing journal access either by purchasing articles directly from a publisher as needed or by continuing to subscribe to an aggregating database. The aggregating databases reviewed in this study included representative aggregating databases commonly associated with the following fields of study: Social Sciences, Humanities, and Health Sciences; however, the methodology described in this article could be applied to other disciplines as well. The results of the study indicated that the ratios for Mean Cost/Package Subscription Price (MC/PSP), Median Cost/Package Subscription Price (MED/PSP) could be used in evaluating journal collections. The researchers suggest that future studies should be conducted to assess resource sharing and the availability of open access resource versions of articles as possible contributing factors to the purchase decisions associated with scholarly journal articles. [ABSTRACT FROM AUTHOR]

The optimization of the human-centeredness of technological innovations – policy digitalization - has exceedingly proliferated in most policy sectors. Yet, a few studies exist on the implications of digital policy tools in realizing social protection policies for older people, particularly in Africa. This paper discusses this issue. It examines data on the 'digital capabilities' of older persons and how digital technologies impact their usage and access to social safety net programs in Kenya, where digital policy tools like mHealth and e-Payment platforms are used to realize them. The data collection involved interviews with 81 respondents between 65-90 years of age (individuals targeted by social safety net programs and Social Protection officers). Findings show a need for more robust and policy target-sensitive efforts and budget allocation to overcome policy digitalization challenges, especially those arising from structural governance inequalities or older people's capability deficits that underpin digital transformation pathways for different policy targets. Most older people in rural areas have negative attitudes and low user digital capabilities toward digital services. This is partly due to a range of challenges from infrastructural deficiencies, low access to internet resources to inadequate policy communication around digital tools. However, higher digital capabilities of policy targets and positive societal attitudes toward digital platforms could improve effective 'public policy digitalization' with more targeted investments and user-sensitive designs in place. [ABSTRACT FROM AUTHOR]

There is scant information on the instructions provided by health workers to patients diagnosed with tuberculosis and the implications these instructions have for sexual and reproductive health and rights and tuberculosis control in Bangladesh. This paper aims to draw attention to tuberculosis control guidelines and information dissemination practices that may need to be adapted to the living situations of those with tuberculosis. Data collection took place in the Monohardi and Narsingdi Sadar sub-districts in Narsingdi and the Mirpur slum in Dhaka, Bangladesh, between December 2015 and March 2016. We present findings from an analysis of four significant documents, 45 in-depth interviews (of current and former tuberculosis patients, their family members, and health workers), and two focus group discussions with health workers. The findings show that the official guidelines and policies hardly address sexual health or rights. During the treatment period, patients received mixed and inconsistent instructions from health workers on sexual intercourse, contraception, pregnancy, and living arrangements. The messages were interpreted differently based on who delivered and received them, and different instructions were provided to women and men. The instructions were not specific to the living situations of patients and therefore led to implementation challenges. Future interventions should ensure correct and consistent messaging, and policies should be adapted to the sexual needs of those infected with the disease. [ABSTRACT FROM AUTHOR]

There has been little research on the challenges facing special education teachers (SETs), since the COVID-19 pandemic. This study aimed to identify SETs predictors for stress and barriers to teaching effectiveness. Using a mixed methods cross-sectional design we sampled six public sector special needs institutes. A total of 205 quantitative surveys and 21 qualitative interviews were collected, respectively. Logistic bivariate regression results revealed seven factors predicting higher stress in SETs and qualitative themes further shed light on barriers to teacher efficacy. We conclude with key recommendations for the Special Education Sector and support for SETs, with implications for other developing regions. Abbreviations: SET: special edcation teachers; SSN: students with special needs [ABSTRACT FROM AUTHOR]

As the efficacy of low vision service provision is facilitated by clients' access to and proper use of low vision devices, the objective of this study was to evaluate an outpatient clinic-based low vision device lending library program and the functional and psychosocial impact that device use had upon clients. Twenty individuals borrowed portable video magnifiers during the study period. Line items from the Revised-Self-Report Assessment of Functional Visual Performance and the Reading Behavior Inventory were analyzed before and after device loan at two months. The Psychosocial Impact of Assistive Devices Scale-10 and a semi-structured interview were also completed at two months. Reported improvements in reading performance and satisfaction levels on the Reading Behavior Inventory were significant (p<.001). The Revised-Self-Report Assessment of Functional Visual Performance indicated improved independence in reading medications, bills and labels. Higher scores in happiness, independence, sense of control and adaptability on the Psychosocial Impact of Assistive Devices Scale-10 indicated device retention at two months. Qualitative themes included improved independence, time needed to acclimate to the device, personal appraisal impacting motivation and challenges specific to low vision. This article provides occupational therapists a model to facilitate access, person-device fit and successful use of low vision devices to promote therapy outcomes. [ABSTRACT FROM AUTHOR]

To understand the nature of mental health discussions in audiological rehabilitation, specifically, the types of conversations, when and how they are initiated, and the participant factors associated with discussing mental health. A cross-sectional descriptive survey including quantitative (multiple choice) and qualitative (free-text) questions regarding mental health discussions between audiologists and clients. A convenience sample of 118 Australian audiologists working in adult audiological rehabilitation. The majority of participants (95.8%) reported having engaged in discussions with clients about mental illness and health at some point throughout their career. The frequency of these discussions varied across participants: 7% rarely discuss, 50% discuss occasionally, 30% discuss with about half their clients and 13% have discussions with most clients. Many participants (85.6%) reported that clients would initiate these conversations, most often via disclosing the impacts of hearing loss on clients' lives. Most audiologists will encounter clients with mental health concerns, and many will engage in conversations about psychological symptoms, therefore, training audiologists to recognise and address verbal and non-verbal cues regarding mental health may help to promote person-centred care and potentially improve outcomes. [ABSTRACT FROM AUTHOR]

Interprofessional (IP) education is essential for healthcare professionals to prepare them for future IP collaboration. IP training wards (ITWs) have been established for work-based IP education. Short-term effects of ITW placements have been published but long-term results are scarce. There are no reports on ITWs in paediatrics. We established the Interprofessional Training Ward in Paediatrics (IPAPAED) for paediatric nursing trainees and medical students. The aim of the study is to evaluate both short- and long-term outcomes regarding IP competencies of IPAPAED participants. The study was designed as a prospective, non-randomized trial, using a mixed-methods design. The Interprofessional Socialization and Valuing Scale (ISVS-9A/B) and the Interprofessional Collaboration Scale (ICS) were used for quantitative evaluation, qualitative data were gathered from structured group discussions and free-text comments. Data were collected from 68 IPAPAED participants, before and after the rotation, and 6–34 months later. Results: IPAPAED participants showed increased global scores in the ISVS 9 A/B and rated their communication competencies and their accommodation in IP teams better (ICS). Improvements in communication competency and accommodation persisted at 6–34 months. Conclusions: IP learning and working on IPAPAED had positive short-term effects on interprofessional competencies. Some of these effects persisted on a long-term. [ABSTRACT FROM AUTHOR]

Orgasm coercion occurs when someone pressures a partner to orgasm by implying that not orgasming will have negative consequences. But what happens when the coerced partner refuses to go along with orgasm coercion? And how do perpetrators of orgasm coercion react? In the current study, we analysed 100 participants' (cisgender women, n = 66; cisgender men, n = 24; gender/sex minorities, n = 10) descriptions of refusing orgasm coercion during their most recent orgasm coercion encounter. We assessed how participants expressed refusals, perpetrators reacted to these refusals, and perpetrator reactions connected to relationship and psychological outcomes. Results showed that participants used a variety of refusal strategies that were positively- or negatively-valenced. Some perpetrators (31%) reacted in positive, understanding ways. However, most perpetrators (61%) reacted negatively or with more coercion when confronted. Of note, results suggested that whether perpetrators responded in positive vs. negative ways did not depend on participants' refusal strategies. We also found that positive perpetrator reactions were associated with positive relationship outcomes, but participants reported high negative psychological outcomes regardless of perpetrators' reactions. Findings support that perpetrators of orgasm coercion are not necessarily invested in partners' positive experiences and that orgasm coercion cannot be resolved through better communication. [ABSTRACT FROM AUTHOR]

With an official HIV infection rate of 18.5%, approximately one in five South Africans are HIV positive. Despite this prevalence, stigma and discrimination associated with being HIV positive is widespread. HIV-related stigma emanates from the fact that HIV is associated with risky behaviors such as drug use, sexual promiscuity, homosexuality and transactional sex. Participants were recruited through announcements in classrooms and during community meetings. Participants were selected if they knew someone who was discriminated against HIV as a result of being affected by HIV. The status of the participants was irrelevant. Seven focus group sessions were conducted with 62 participants. The results show that stigma is seen as a result of lack of HIV knowledge, with participants from rural areas showing more knowledge regarding HIV transmission and care as compared to urban participants. Most participants agreed that disclosure leads to more voluntary HIV testing, obtaining treatment and preventing further transmission of HIV. The results of this study provide indications that stigma can be mitigated by increasing knowledge of HIV prevention, targeted information campaigns in urban areas, and encouraging discussion about stigma and discrimination against the disease. Programmes should apply the Theory of Planned Behavior for the development of such interventions, take culture, creed, and other social affiliation into consideration. [ABSTRACT FROM AUTHOR]

Assistive technology (AT) is a highly effective intervention to address the capability gap for people living with deafblindness. The My AT Outcomes Framework (MyATOF) is a novel Australian framework founded upon AT process principles and outcomes research. It guides stakeholders to articulate AT use according to 6 dimensions. MyATOF was developed as a data collection and knowledge translation tool. The use case of AT by people with deafblindness in Southern Africa was investigated in this study to determine the applicability of MyATOF dimensions to (a) people with deafblindness and (b) low- and middle-income countries. Two online surveys, using the Delphi methodology, were undertaken with key stakeholders including people with deafblindness, family members, researchers, service providers, educators and advocates. An expert panel of 17 completed Phase 1, with 14 completing Phase 2. The WHO 5 Ps AT systems thinking model was used in data analysis. Respondents affirmed the validity of the dimensions of MyATOF for people with deafblindness in four Southern African countries. In-country barriers and constraints were identified as significantly impacting the capacity of AT users with deafblindness, to realize positive outcomes. The MyATOF dimensions show promise in their use with persons with deafblindness in Southern Africa, though further research is needed. The impact of assistive technology and related supports can be evaluated across a number of dimensions including human rights, costs incurred and saved, consumer experience, and service delivery satisfaction. These dimensions of impact resonate across the two continents investigated to date, with contextual factors being considered. Variables influencing access to assistive technology across contexts can be understood through the WHO GATE five P's systems thinking model. Few tools place data capture and outcomes measurement in the hands of assistive technology users, but indications are that this is of value to consumers. [ABSTRACT FROM AUTHOR]

Yolŋu, Aboriginal people from Arnhem Land, Australia are at risk of Machado-Joseph disease, with progressive loss of speech. Yolŋu are interested in developing augmentative and alternative communication (AAC) systems in their own languages. This research aimed to develop a culturally responsive process to explore and create a core vocabulary word list for Yolŋu adults living with the disease for inclusion in AAC system prototypes. A list of 243 Yolŋu words and morphemes was created. In this highly collaborative, mixed methods, participatory action research, Balanda (the Yolŋu word for non-Aboriginal people) and Yolŋu researchers conducted cycles of transcription and analysis of a language sample, with oral group discussions to identify which words to include, omit, or add, based on Yolŋu perceptions of the structure and use of their languages. A Yolŋu metaphor, Gulaka-buma ("Harvesting yams"), was identified by Yolŋu researchers to represent and share the research process and findings. Three key themes were identified that summarize the main cultural and linguistic considerations related to changes made to the core vocabulary. Study findings emphasized the role of language as an expression of culture and identity for Indigenous peoples and the importance of considering cultural and linguistic factors in selecting vocabulary for AAC systems. [ABSTRACT FROM AUTHOR]

To determine the knowledge and confidence of physiotherapists in managing knee osteoarthritis (OA) and patellofemoral pain (PFP); and explore their learning behaviors and preferences related to the management of these knee conditions. One hundred and sixteen Australian and Canadian Physiotherapists were recruited via social media, e-mail, and an online course. Part 1: Quantitative involved an online survey evaluating knowledge of evidence and confidence in providing treatments for knee OA and PFP. Part 2: Qualitative involved semi-structured interviews with 13 participants exploring current practice and learning needs, that were analyzed using an initial framework structured on interview questions, followed by inductive approach to identify additional themes. Awareness regarding evidence supporting exercise for knee OA and PFP was good (89–96%), and qualitative themes indicated physiotherapists emphasized exercise-therapy and education. Perceived value of passive treatments and surgery varied. Preference for face-to-face workshops to address learning needs, alongside describing time and cost barriers to access them, emerged from qualitative findings. Online learning formats were viewed as convenient, but not as effective as face-to-face learning. Knowledge and confidence related to interventions for knee OA and PFP of Australian and Canadian physiotherapist participants broadly aligns with guidelines. Knowledge translation strategies focused on face-to-face workshops, supported by online education may help to bridge evidence-to-practice gaps. [ABSTRACT FROM AUTHOR]

With the Peace Agreement between Fuerzas Armadas Revolucionarias de Colombia (FARC), Colombia promised healthcare to 13,000 'reincorporating' FARC ex-combatants. Shortages of healthcare workers in reincorporation camps means this promise is in danger of going unfulfilled. More information is needed to determine incentives, disincentives, and recruitment of healthcare providers to address this shortage. Semi-structured interviews were conducted with healthcare providers across FARC reincorporation camps, and a multidisciplinary team conducted analysis in NVivo12 using a team-based coding method. Twenty-four healthcare professionals from 15 camps participated, of which 75% were female. Incentives to work with FARC included improved clinical skills, professional advancement, increased comfort with FARC, and contributing to the peace process. Disincentives included poor living conditions, lack of support, biases, familial commitments, and sacrificing career opportunities. Three-fourths of the sample recommended working with FARC, and 92% reported a shortage of healthcare workers. Recruitment strategies included improved resources and specialised career development for healthcare workers, facilitating interactions between FARC and healthcare professionals outside clinical scenarios, and integrating medicine for vulnerable populations into health education. This study shows the impact that working with FARC ex-combatants can have on healthcare providers and tangible suggestions for increasing provider participation to address the healthcare worker shortage. [ABSTRACT FROM AUTHOR]

Reducing stigma is key to improving the wellbeing of people with albinism in Tanzania. This study aimed to obtain more insight into the effects of two radio interventions with regard to albinism-related stigma: a radio drama and a radio interview. Assessment of the radio interventions was based on two attitude measurement instruments (The Albinism Explanatory Model Interview Catalogue Community Stigma Scale and the Albinism Social Distance Scale), an entertainment scale, and two informal (group) interviews. In total, 111 community members participated in the assessment prior to the radio drama, and 65 after. In the case of the radio interview, 123 community members participated in the assessment prior to the radio show, and 77 after. Following the radio drama, a significant reduction was found in terms of community stigma, and a reduction in social distance was found after both interventions. The entertainment score for both interventions was high, but significantly higher for the radio drama. The respondents indicated that they had gained more understanding of albinism as a result of the interventions, and were positive about this type of education. The current study shows that a radio show in which the listener interacts with someone with albinism can contribute to a reduction in stigma, and demonstrates that different types of radio intervention can have different outcomes. Reducing discrimination is key to improving the wellbeing of people with albinism in Tanzania. This research investigated the use of radio shows to change attitudes towards people with albinism within the community; two types of radio show were tested: a radio drama and a radio interview. Through the shows the respondents got into contact with someone with albinism. The shows were valued by the community members as an attractive means of education. The shows proved to be effective in terms of improving peoples' knowledge about, and attitude towards people with albinism. People enjoyed the radio drama more than the radio interview. The radio drama was also more effective than the radio interview in improving peoples' attitudes towards people with albinism. This research offers recommendations for organisations that are working to raise awareness with regard to albinism. [ABSTRACT FROM AUTHOR]

Entertainment programming in the United States has long addressed major public health issues. In the present study, we used a culture-centric approach to systematically investigate the role of television storylines in facilitating health-related conversations on social media. In particular, we examined Twitter conversations about sexual and police-involved trauma prompted by portrayals on the fictional television drama Queen Sugar. Guided by the culture-centric model of narratives in health promotion, we classified the tweets (N = 1,671) into four main thematic categories: identification, social proliferation, emotions, and intentions. The analysis also revealed several subthemes, including identification with characters and cultural elements, expressions of pain and joy, information seeking and sharing, and the need to address intergenerational trauma and promote intergenerational conversations. The data suggests that Twitter may provide a vehicle for engaging in difficult conversations. We discuss the theoretical and practical implications of the study for mental health communication with Black Americans. [ABSTRACT FROM AUTHOR]

Speech assessment methods used in clinical practice are varied and mainly perceptual and motor. Reliable assessment of speech disorders is essential for the tailoring of the patient's treatment plan. To describe current clinical practices and identify the shortcomings and needs reported by French-speaking clinicians regarding the assessment of speech disorders in adult patients. Data were collected using an online questionnaire for French-speaking speech and language pathologists (SLPs) in Belgium, France, Switzerland, Luxembourg, and Maghreb. Forty-nine questions were grouped into six domains: participant data, educational and occupational background, experience with speech disorders, patient population, tools and tasks for speech assessment, and possible lacks regarding the current assessment of speech disorders. Responses from 119 clinicians were included in the analyses. SLPs generally use "à la carte" assessment with a large variety of tasks and speech samples. About one quarter of them do not use existing assessment batteries. Those who do mostly use them partially. Pseudo-words are rarely used and are absent from standardized batteries, in contrast to the major use of words and sentences. Perceptual evaluation largely prevails (mainly overall ratings of speech "intelligibility", "severity," and "comprehensibility" and percent-correct phonemes), whereas the recording equipment for acoustic measures is not standardized and only scarcely described by the SLPs. The most commonly used questionnaire to assess the functional impact of the speech disorder is the Voice Handicap Index; one quarter of the SLPs does not use any questionnaire. Overall, the available tools are considered only moderately satisfactory. The main reported shortcomings are a lack of objectivity and reproducibility of speech measures; exhaustiveness and consideration of specific speech parameters (prosody, speech rate, and nasality); practicality of the assessment tools. This study highlights a lack of standardization of the speech assessment in French-speaking adults and the need to offer new reliable tools for an optimized, accurate speech assessment. The automation of these tools would allow for rapid, reproducible, and accurate measures. [ABSTRACT FROM AUTHOR]

Surveillance is ubiquitous. It is well known that the presence of other people (in-person or remote, actual or perceived) increases performance on simple tasks and decreases performance in complex tasks (Zajonc 1965). But little is known about these phenomena in the context of video games, with recent advances finding that they do not necessarily extend to games (Emmerich and Masuch 2018). In Experiment 1 (N=1489; No Observation vs. Researcher Observing), we find that participants observed by a researcher played significantly longer, and performed significantly better, across three video games. Moreover, we find some support that participants observed by a researcher score higher on player experience and intrinsic motivation. In Experiment 2 (N=843; Researcher Observing vs. Professor Observing), we seek to understand whether different roles differing in their perceived evaluativeness would influence the effects of observation. We find that participants observed by a professor had, at times, significantly lower performance, player experience, intrinsic motivation, playing time, and higher anxiety. In Experiment 3 (N=1358; No Observation vs. Researcher Observing), we further validate Experiment 1 by extending our results to three additional game genres. Here, we provide the largest study on observation in video games to date. The study is also the first to show that observer type can significantly influence player outcomes. [ABSTRACT FROM AUTHOR]

This study bridges understandings of character strengths, based on McGrath and Walker's four-factor analysis of VIA-Youth, and a key text in current Chinese moral education: The Code for Primary and Secondary Schools. We utilise two research methods, textual analysis and survey questionnaires, to garner data theoretically and empirically. Our research has three aims. First, through analysing 'the Code' from a VIA-Youth perspective, we identify 30 implicit character strengths, of which 11 are nominally in common with VIA-Youth. Second, we fit all the 30 strengths into the four-factor model through textual analysis. Third, we test the model by factor-analysing student self-report surveys based on the Code. Our analysis reveals that one of the six extracted factors matches the adaptation of the four-factor model while the remaining five present a mix of virtue categories. Moreover, the nine clusters that constitute the Code present a high resemblance with the structuration of the components' matrix. [ABSTRACT FROM AUTHOR]

To explore multi-professional teamwork in relation to the physical environment in three newly built or renovated stroke units. An observational study was undertaken. The participants were all staff members of a multi-professional team working in the reviewed stroke units. The data were collected using behavioural mapping and semi-structured observations, and they were analysed by content analysis and descriptive statistics. Out of all the observations in the behavioural mapping, very few were of two or more members from the team together with a patient. None of the included stroke units had a co-location for all the members of the multi-professional team. Three main categories emerged from the analysis of the interviews: (i) the hub of the unit; (ii) the division of places; and (iii) power imbalance. All the categories reflected the teamwork in relation to parts of the physical environment. The design of the physical environment is important for multi-professional teamwork. Emphasis must be placed on better understanding the impact of the physical environment and on incorporating the evidence related to multi-professional teamwork during the design of stroke units. Understanding the link between the physical environment and effective teamwork can lead to more tailored and supportive design solutions. The design of the physical environment should be considered as a vital part of effective teamwork in stroke units. The physical environment should include shared workstations, allowing team members to meet and communicate face to face. [ABSTRACT FROM AUTHOR]

Objective/Participants The American College Health Association (ACHA) found that 65.4% of Ontario (Canada) students feel overwhelming anxiety and 89.5% of students feel overwhelmed by all of their obligations. Thus, this study assessed the current state of full-time undergraduate (UGS) and graduate students' (GS) mental health and resilience. Methods A total of 598-796 UGS and GS completed three questionnaires (BRS, MHI, and SF-36) and a demographic questionnaire, which were distributed campus-wide. Focus groups/individual interviews (n = 30) explored students' mental health- and resilience-related experiences. Results/Conclusions Quantitatively, participants produced normal levels of resilience on the BRS, below-the-norm levels of anxiety on the MHI, and above-the-norm levels of physical functioning, but below-the-norm levels of six mental-health-related constructs on the SF-36. Qualitatively, GS and UGS felt physical activity (PA) benefited their mental health and resilience, and voiced the need for more counselors. Overall, participants' mental health and resilience were similar to the population. [ABSTRACT FROM AUTHOR]

Numerous quality-improvement projects including healthcare professional training are conducted globally every year, but there is a gap between the knowledge obtained in the training and its implementation in practice and policy. A quality-improvement programme was conducted in eastern Democratic Republic of Congo (DRC) to reduce maternal and neonatal mortality and morbidity. This study explores the implementation process, mechanisms of impact, and outcomes of a training intervention addressing labour and birth management and involving healthcare providers in an urban health zone in eastern part of DRC. In 2019, master trainers were educated and in turn trained facilitators from seven participating healthcare facilities, which received the necessary equipment. Data comprised statistics on maternal and neonatal birth outcomes for the years before and after the training intervention, and focus group discussions (n = 18); and interviews (n = 2) with healthcare professionals, at the end of (n = 52) and after the training intervention (n = 59), respectively. The analysis was guided by a process evaluation framework, using descriptive statistics and content analysis. The three-pillar training intervention using a low-dose, high-frequency approach was successfully implemented in terms of fidelity, dose, adaptation, and reach. Several improved care routines were established, including improved planning, teamwork, and self-reflection skills, as well as improved awareness of the influence of the care environment, of having a respectful encounter, and of allowing a companion to be present with the birthing woman. The proportions of emergency caesareans decreased and of vaginal births increased without an increase in maternal and neonatal complications. The findings of this study are encouraging and provide learnings for other healthcare facilities in DRC as well as other low-income countries. When designing similar training interventions, it is crucial to consider contextual factors such as incentives and to measure more salutogenic outcomes. [ABSTRACT FROM AUTHOR]

The aim of the current study was to examine the social representation (SR) of hearing aids in people with hearing loss (PHL) in India, the Republic of Korea (ROK), the United Kingdom (UK), and the United States of America (US). The study used a cross-sectional survey design. The data collected by using a free association task were analysed qualitatively (i.e. content analysis) and quantitatively (i.e. chi-square analysis, similarities analysis, prototypical analysis). 424 participants with hearing loss The most commonly reported categories across all countries were "beneficial," "cost and time," and "appearance and design." Approximately 50% of the associations reported were negative. There were variations in terms of the categories that were predominant in the SR of each country. "Others actions and attitude" category was predominantly reported by PHL in India. "Disturbance" and "dissatisfaction" of hearing aids and the "repairs and maintenance of hearing aids" categories were mainly reported from the ROK and the US, respectively. The current results highlight the main aspects that PHL report spontaneously when they think about hearing aids. The findings will help to further inform public health campaigns and will contribute to develop culturally appropriate media materials regarding hearing aids. [ABSTRACT FROM AUTHOR]

To explore the publicised opinions of consumers actively participating in online hearing aid reviews. A retrospective design examining data generated from an online consumer review website (). Qualitative data (open text responses) were analysed using the open source automated topic modelling software IRaMuTeQ () to identify themes. Outputs were compared with quantitative data from the consumer reviews (short response questions exploring hearing aid performance and benefit, and some meta-data such as hearing aid brand and years of hearing aid ownership). 1378 online consumer hearing aid reviews. Six clusters within two domains were identified. The domain Device Acquisition included three clusters: Finding the right provider, device and price-point; Selecting a hearing aid to suit the hearing loss; Attaining physical fit and device management skills. The domain Device Use included three clusters: Smartphone streaming to hearing aids; Hearing aid adjustment using smartphone; and Hearing in noise. Although online hearing aid consumers indicate positive performance on multiple-choice questions relating to hearing aid performance and benefit, their online reviews describe a number of barriers limiting their success. Hearing healthcare clinicians must employ a personalised approach to audiological rehabilitation to ensure individual clients' needs are met. [ABSTRACT FROM AUTHOR]

Background: Australian Nursing and Midwifery Accreditation Council prescribes midwifery accreditation standards that support students' development in Aboriginal and Torres Strait Islander Health and cultural safety to be deemed practice ready. However, the impact of training programmes are not widely explored. Aim: This study aimed to assess the impact of a mandatory 8-week online subject focussed on the development of culturally safe practices among midwifery students. Methods: The Ganngaleh nga Yagaleh cultural safety assessment tool was used to collect online quantitative data from post graduate midwifery students at the commencement and completion of an online subject. Results: Through a purposive sample (n = 10) participant perceptions of culturally safe practices remained relatively unchanged, except for three items of the Ganngaleh nga Yagaleh cultural safety assessment tool. Discussion: Findings demonstrate that when post graduate midwifery students are exposed to Aboriginal and Torres Strait Islander perspectives of Australia's colonial history it impacts their sense of optimism, personal values and beliefs about the healthcare they will provide to Aboriginal and Torres Strait Islander peoples. However, midwifery students who self-identified as Aboriginal and/or Torres Strait Islander people, reported a decline in optimism when imagining a healthcare system free of racism. Conclusion: The subject did not impact on cultural safety scores. This may be due to prior learning of student midwives. Educators should consider building on prior knowledge in post graduate midwifery to ensure the content is contextualised to midwifery. [ABSTRACT FROM AUTHOR]

The social work Grand Challenge to Promote Smart Decarceration's aim is to address the high rates of incarceration in the United States. Purpose: Yet very little is known about criminal justice practitioners in the U.S. Method: In this exploratory study. Practitioners in correctional facilities (n = 38), responded to an online survey asking them about their perceptions of the services they provide and to identify their professional needs working within these settings. Results: Findings include the need for people who are incarcerated to have access to treatment for substance use, behavioral/mental health, and trauma-related issues. In addition, they reported the need for service coordination with agencies based in their home communities. Furthermore, the participants reported that they need more training and support on these topics in order to provide effective services to their clients. Discussion: Implications for practice, research, and policy are discussed, including strategies to address all levels of primary, secondary, and tertiary prevention. [ABSTRACT FROM AUTHOR]