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Background: The WHO definition of palliative care includes bereavement support as integral to palliative care, yet a previous survey of bereavement support in palliative care in Europe has shown a range of service responses to loss. A rigorous approach to agreeing and implementing a palliative care bereavement framework was required. Aim: The aim of this study was to develop consensus on best-practice recommendations for bereavement care principles, structures, processes and delivery based on current practice and evidence. Design: In accordance with Guidance on Conducting and Reporting Delphi Studies, a consensus-building five-round Delphi technique was performed. A scoping review of research literature informed drafting of 54 statements by the EAPC Bereavement Task Force. Evaluation of the statements was performed by an expert panel using a 5-point Likert scale. ⩾80% agreement were defined as essential items and 75%–79% agreement were defined as desirable items. Items with a consensus rating <75% were revised during the process. Setting/participants: The Delphi study was carried out by an expert panel among membership organisations of the European Association for Palliative Care. Results: In total, 376 email requests to complete Delphi questionnaire were distributed with a response rate of 23% (n = 87) and a follow-up response-rate of 79% (n = 69). Of the initial 54 statements in six dimensions, 52 statements were endorsed with 26 essential statements and 26 desirable statements. Conclusions: The six dimensions and 52 statements agreed through this Delphi study clarify a coherent direction for development of bereavement services in palliative care in Europe. [ABSTRACT FROM AUTHOR]

Informed by existing gaps in the research of elder abuse and neglect (EAN) outcomes and very limited knowledge from Central-European cultural contexts, this paper analyzes the link between domestic-based EAN and three measures of well-being, namely subjective loneliness, sense of control over one's life, and a broader outlook on life. To do this, we used recently (2022) collected EAN survey fielded among home-dwelling residents of the Czech Republic aged 65 +. The results show that there is a clear relationship between EAN and these selected outcomes. Controlling for several sets of potential modifying or confounding factors further indicates that this relationship is substantial and direct, rather than weak and indirect. Among controls, only variables related to disadvantage (health, income, dependency, history of abuse) partly account for the link between EAN and its outcomes due to their relation to both heightened risk of EAN and lower well-being. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Background: The implementation science literature acknowledges a need for engagement of key stakeholders when designing, delivering and evaluating implementation work. To date, the literature reports minimal or focused stakeholder engagement, where stakeholders are engaged in either barrier identification and/or barrier prioritisation. This paper begins to answer calls from the literature for the development of tools and guidance to support comprehensive stakeholder engagement in implementation research and practice. The paper describes the systematic development of the Implementation‐STakeholder Engagement Model (I‐STEM) in the context of an international, large‐scale empirical implementation study (ImpleMentAll) aimed at evaluating the effectiveness of a tailored implementation toolkit. The I‐STEM is a sensitising tool that defines key considerations and activities for undertaking stakeholder engagement activities across an implementation process. Methods: In‐depth, semistructured interviews and observations were conducted with implementers who were tailoring implementation strategies to integrate and embed internet‐based cognitive behavioural therapy (iCBT) services in 12 routine mental health care organisations in nine countries in Europe and Australia. The analytical process was informed by principles of first‐ and third‐generation Grounded Theory, including constant comparative method. Results: We conducted 55 interviews and observed 19 implementation‐related activities (e.g., team meetings and technical support calls). The final outcome of our analysis is expressed in an initial version of the I‐STEM, consisting of five interrelated concepts: engagement objectives, stakeholder mapping, engagement approaches, engagement qualities and engagement outcomes. Engagement objectives are goals that implementers plan to achieve by working with stakeholders in the implementation process. Stakeholder mapping involves identifying a range of organisations, groups or people who may be instrumental in achieving the engagement objectives. Engagement approaches define the type of work that is undertaken with stakeholders to achieve the engagement objectives. Engagement qualities define the logistics of the engagement approach. Lastly, every engagement activity may result in a range of engagement outcomes. Conclusion: The I‐STEM represents potential avenues for substantial stakeholder engagement activity across key phases of an implementation process. It provides a conceptual model for the planning, delivery, evaluation and reporting of stakeholder engagement activities. The I‐STEM is nonprescriptive and highlights the importance of a flexible, iterative approach to stakeholder engagement. It is developmental and will require application and validation across a range of implementation activities. Patient or Public Contribution: Patient contribution to ImpleMentAll trial was facilitated by GAMIAN‐Europe at all stages—from grant development to dissemination. GAMIAN‐Europe brings together a wide variety of patient representation organisations (local, regional and national) from almost all European countries. GAMIAN‐Europe was involved in pilot testing the ItFits‐toolkit and provided their views on the various aspects, including stakeholder engagement. Patients were also represented in the external advisory board providing support and advice on the design, conduct and interpretation of the wider project, including the development of the ItFits‐toolkit. Trial registration: ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018. [ABSTRACT FROM AUTHOR]

Background: Economic burden studies can provide insights into the drivers leading to increasing healthcare costs. It can also provide a more holistic view of how diseases impact the welfare of patients and their families. Having concrete estimates of the economic burden across multiple diseases can help policymakers determine which diseases are economically more burdensome. This study aimed to review and summarise comprehensively economic burden studies across multiple diseases in the Nordic countries between 2000 and 2020. Methods: According to the 2020 PRISMA statement, a systematic literature review was conducted in PubMed, CINAHL, Academic Search Premier and Global Health databases using key terms related to the economic burden of any disease in Denmark, Finland, Greenland, Iceland, Norway and Sweden. Grey literature was also reviewed. Results: A total of 10,050 potential titles and abstracts were identified and screened, and 254 full-text papers that met the inclusion criteria were evaluated by two independent reviewers. Of these, 119 articles were included in a qualitative synthesis. Twenty-nine had clearly defined comparison groups, thus able to attribute the costs to the disease. Large variations concerning methodology and cost components were noted. Across diseases, the economic burden ranged from EUR 1668 per patient annually for chronic obstructive pulmonary disease to EUR 93,041 for multiple sclerosis. However, estimates varied widely, even within each disease. Conclusions: Our review highlights the need for more comparable economic burden studies. Future studies should focus on applying robust methodology and homogeneous cost-reporting methods to inform policymakers about which diseases are economically more burdensome. [ABSTRACT FROM AUTHOR]

Background Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. Methods In the VOICE community—a European healthcare centre cluster intending to address VBHC from theory to practice—information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. Results Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. Conclusions To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions. [ABSTRACT FROM AUTHOR]

Aim: To report the results of a mapping exercise by the European Federation of Nurses on current advanced practice nursing frameworks and developments across Europe. Design: Online, cross‐sectional, questionnaire study. Methods: An online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. The questionnaire solicited input on 60 items concerning key features of advanced practice nursing, intending to map existing developments and better understand the current state of advanced practice nursing in Europe. Data analysis used descriptive statistics, including counts and percentages, tabulation; open‐text responses were handled with thematic synthesis techniques. Results: The definition, sense‐making and operationalization of advanced practice nursing vary across Europe. Important variations were noted in the definition and requirements of advanced practice nursing, resulting in different views on the competencies and scope of practice associated with this role. Importantly, the level of education and training required to qualify and practice as an advanced practice nurse varies across European countries. Furthermore, only 11 countries reported the existence of a national legislation establishing minimum educational requirements. Conclusion: Significant variation exists in how countries define advanced practice nursing and how it is regulated at academic and practice levels. More research is needed to clarify whether this variation results from designing models of advanced practice nursing that work in different contexts; and what impact a standardized regulatory framework could have to grow the volume of advanced practice nurses across Europe. Impact: The current paper exposes the lack of clarity on the development and implementation of advanced practice nursing across Europe. We found significant variation in the definition, recognition, regulation and education of advanced practice nurses. Our data are essential to policymakers, professional associations and employers to ensure a coordinated and systematic effort in the consistency and ongoing development of advanced practice nurses across Europe. Patient or Public Contribution: No patient or public contribution applied; the participants were national nurses' associations. [ABSTRACT FROM AUTHOR]

Background: Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S) questionnaire. A large POSHA–S database has collected responses from over 20 000 people from 49 countries. Aims: The aim of this study was to use the POSHA‐S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents' sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents' children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents). Methods & Procedures: Data used in this study were extracted from selected, relevant studies that administered the POSHA–S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen's d was calculated to determine effect sizes. Outcomes & Results: Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA–S database. Effect sizes were small for all comparisons. Conclusions & Implications: The effect of geographic region and culture may predict sex‐based differences among mothers' and fathers' attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents' attitudes toward stuttering. What this paper adds: What is already known on this subject: The research clearly indicates that attitudes toward stuttering vary according to geographical region. Less clear is whether mothers and fathers from geographically diverse backgrounds hold different attitudes toward stuttering and the extent to which parental status (being a parent, parent of a child who stutters or nonparent) affects attitudes toward stuttering. What this study adds: This study's findings confirm that geographical differences do influence attitudes toward stuttering. Male parents and nonparents tend to have equal or more positive attitudes toward stuttering in Middle Eastern samples, whereas non‐Middle Eastern female parents and nonparents tend to show hold more positive attitudes. What are the clinical implications of this work?: In addition to being culturally sensitive when working with parents of children who stutter, clinicians should also consider that mothers and fathers may have some differences in attitudes and behaviours toward their child's stuttering. These differences should be considered when designing treatment plans. It should also be noted that, despite statistical significance, the effect sizes in this study were low, suggesting that further research as well as close collaboration with parents of children who stutter is warranted. [ABSTRACT FROM AUTHOR]

Background: Cesarean birth (CB) rates have increased over recent years with concerns over differences between these rates in migrant communities compared with the rates among women in their receiving country. This review aimed at summarizing the available literature regarding the incidence of CB among migrants in Europe. Methods: A systematic search of four electronic databases was carried out, including CINAHL, MEDLINE, Scopus, and Maternity and Infant Care. Identified studies were screened and their quality assessed. Meta‐analysis was undertaken using Rev Man 5.4 where sufficient data were available. Otherwise, data were synthesized narratively. Results: From the 435 records identified in searches, 21 papers were included. Analysis shows that overall CB rates were significantly lower for Syrian refugee women compared with women in their receiving country (Turkey) and higher for Iranian migrants than women in their host country. Emergency CB rates were significantly higher for migrant women from "Sub Saharan Africa" and the "South East Asia, Asia and Pacific" region than rates in the receiving country. Statistical significance was not found between other populations. Conclusions: This review highlights differences between CB rates in certain migrant groups in comparison with women native to their host country, which merits further investigation for potential explanations. We also identified a need to standardize definitions and population groupings to enable more meaningful analysis. This review also highlights a substantial lack of data on CB rates between different population groups that could negatively impact the provision of care. [ABSTRACT FROM AUTHOR]

Aims: To perform temporal validation of a risk prediction model for breast cancer‐related lymphoedema in the European population. Design: Temporal validation of a previously developed prediction model using a new retrospective cohort of women who had undergone axillary lymph node dissection between June 2018 and June 2020. Methods: We reviewed clinical records to identify women who did and did not develop lymphoedema within 2 years of surgery and to gather data regarding the variables included in the prediction model. The model was calibrated by calculating Spearman's correlation between observed and expected cases. Its accuracy in discriminating between patients who did versus did not develop lymphoedema was assessed by calculating the area under the receiver operating characteristic curve (AUC). Results: The validation cohort comprised 154 women, 41 of whom developed lymphoedema within 2 years of surgery. The value of Spearman's coefficient indicated a strong correlation between observed and expected cases. Sensitivity of the model was higher than in the derivation cohort, as was the value of the AUC. Conclusion: The model shows a good capacity to discriminate women at risk of lymphoedema and may therefore help in developing improved care pathways for individual patients. Implications for the Profession and/or Patient Care: Identifying risk factors for lymphoedema secondary to breast cancer treatment is vital given its impact on women's physical and emotional well‐being. Impact: What problem did the study address? Risk of BCRL. What were the main findings? The prediction model has a good capacity to discriminate women at risk of lymphoedema. Where and on whom will the research have an impact? In clinical practice with women at risk of BCRL. Reporting Method: STROBE checklist. What Does this Paper Contribute to the Wider Global Clinical Community?: It presents a validated risk prediction model for BCRL. No Patient or Public Contribution: There was no patient or public contribution in the conduct of this study. [ABSTRACT FROM AUTHOR]

Simple Summary: Patients with advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor gene (EGFR) Exon 20 insertion mutations (Exon20ins) used to have poor outcomes after the failure of platinum-based therapies. Amivantamab, a drug that targets two proteins involved in NSCLC (EGFR/MET), was developed and studied in the CHRYSALIS clinical trial. This paper summarizes an analysis comparing outcomes for amivantamab from CHRYSALIS to the outcomes for a mix of treatments that were used in real-world clinical practice (real-world physician's choice [RWPC]). RWPC data were collected from hospitals across Europe in the CATERPILLAR real-world evidence (RWE) study. The outcomes of 114 patients from CHRYSALIS were compared to 55 lines of treatment (LOTs) from CATERPILLAR-RWE, accounting for differences in patient characteristics between the two populations. Overall, the results show that amivantamab was at least twice as good as RWPC for platinum pre-treated patients in terms of tumor response and survival rates. Patients with advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor gene (EGFR) Exon 20 insertions (Exon20ins) at the second line and beyond (2L+) have an unmet need for new treatment. Amivantamab, a bispecific EGFR- and MET-targeted antibody, demonstrated efficacy in this setting in the phase 1b, open-label CHRYSALIS trial (NCT02609776). The primary objective was to compare the efficacy of amivantamab to the choices made by real-world physicians (RWPC) using an external control cohort from the real-world evidence (RWE) chart review study, CATERPILLAR-RWE. Adjustment was conducted to address differences in prognostic variables between cohorts using inverse probability weighting (IPW) and covariate adjustments based on multivariable regression. In total, 114 patients from CHRYSALIS were compared for 55 lines of therapy from CATERPILLAR-RWE. Baseline characteristics were comparable between the amivantamab and IPW-weighted RWPC cohorts. For amivantamab versus RWPC using IPW adjustment, the response rate ratio for the overall response was 2.14 (p = 0.0181), and the progression-free survival (PFS), time-to-next-treatment (TTNT) and overall survival (OS) hazard ratios (HRs) were 0.42 (p < 0.0001), 0.47 (p = 0.0063) and 0.48 (p = 0.0207), respectively. These analyses provide evidence of clinical and statistical benefits across multiple outcomes and adjustment methods, of amivantamab in platinum pre-treated patients with advanced NSCLC harboring EGFR Exon20ins. These results confirm earlier comparisons versus pooled national registry data. [ABSTRACT FROM AUTHOR]

Objectives Research among older adults reveals that the loss of core network members is a risk factor for loneliness. Still, it is not clear whether all such losses induce similar levels of loneliness, particularly as network members are distributed at varied geographic distances. Neither is it clear whether tie addition—the other ubiquitous aspect of network turnover in later life—offsets the loneliness that arises from different network loss scenarios. Methods This paper scrutinized core network losses across multiple relationship–distance scenarios. We used the fourth and sixth waves of data from the Survey of Health, Ageing, and Retirement in Europe and estimated fixed-effect models. Results The loss of a child from a core network increases feelings of loneliness across variant distances, especially when not complemented by additional connections. Losing relatives or nonkin core connections in proximity (within 1 km and 5 km radius, respectively) is also associated with increased loneliness, yet such effects are also largely mitigated by the addition of new core network members. Discussion The relationship between core network member losses and loneliness can significantly differ based on the nature of the lost connection and its geographic distance. Active rebalancing of one's core network following losses and proactive network expansion can serve as pivotal strategies to prevent loneliness for the aging population. [ABSTRACT FROM AUTHOR]

Objectives. To review the prevalence of loneliness (during/after COVID-19) in older people. Design. Scoping review using Medline and PsycInfo for worldwide prevalence estimates (white published literature search) and Google for prevalence data inside the Euregio Meuse-Rhine (grey literature). Setting. Worldwide prevalence estimates and a focus on the Euregio Meuse-Rhine. Participants. Papers published between 2016 and 2022 and a mean age of minimum of 65 years. Measurements. Prevalence estimates for older people. Results. The white literature search yielded 37 articles. Before the onset of the COVID-19 pandemic, loneliness estimates were the highest in Nigeria (46%) and the lowest in Australia (5%) (mean prevalence was 25.6%). Loneliness was reported to be higher in specific populations, for example, people living in specific communities such as senior housing communities or with impairments, than in the general population, with a mean prevalence estimate of 47.8%. During COVID-19, the prevalence of loneliness was higher than that before the pandemic: we observed a mean prevalence of 39.4%, in comparison to 25.6 before COVID-19. The grey literature search showed that, compared to Belgium and the Netherlands (13.5% and 36.5%, respectively), loneliness estimates were the lowest in Germany, with a mean prevalence of 7.7%. Conclusion. Large international differences in the prevalence of loneliness were observed between countries and populations studied. Several hypotheses could explain such differences, including sociocultural or historical-political characteristics. Without surprise, the pandemic and associated measures were linked to a higher level of loneliness. Furthermore, recommendations for addressing loneliness, including interventions, are discussed. [ABSTRACT FROM AUTHOR]

Background: Learning Analytics (LA) is an emerging field concerned with measuring, collecting, and analysing data about learners and their contexts to gain insights into learning processes. As the technology of Learning Analytics is evolving, many systems are being implemented. In this context, it is essential to understand stakeholders' expectations of LA across Higher Education Institutions (HEIs) for large‐scale implementations that take their needs into account. Objectives: This study aims to contribute to knowledge about individual LA expectations of European higher education students. It may facilitate the strategy of stakeholder buy‐in, the transfer of LA insights across HEIs, and the development of international best practices and guidelines. Methods: To this end, the study employs a 'Student Expectations of Learning Analytics Questionnaire' (SELAQ) survey of 417 students at the Goethe University Frankfurt (Germany) Based on this data, Multiple Linear Regressions are applied to determine how these students position themselves compared to students from Madrid (Spain), Edinburgh (United Kingdom) and the Netherlands, where SELAQ had already been implemented at HEIs. Results and Conclusions: The results show that students' expectations at Goethe University Frankfurt are rather homogeneous regarding 'LA Ethics and Privacy' and 'LA Service Features'. Furthermore, we found that European students generally show a consistent pattern of expectations of LA with a high degree of similarity across the HEIs examined. European HEIs face challenges more similar than anticipated. The HEI experience with implementing LA can be more easily transferred to other HEIs, suggesting standardized LA rather than tailor‐made solutions designed from scratch. Lay Description: What is currently known about this topic: Implementing Learning Analytics is a promising but challenging task.SELAQ is a questionnaire that can be used to determine students' expectations of Learning Analytics.Several institutions in Europe applied SELAQ to implement Learning Analytics that meet the needs of their students. What this paper adds to this: This study applies SELAQ for the first time at a German university and compares the results to studies from the UK, Spain, and the Netherlands.The participating students at the German university show relatively homogeneous expectations of Learning Analytics.The expectations towards Learning Analytics of students across Europe are comparable. The implications of study findings for practitioners: Learning Analytics systems should be shared across institutions rather than being implemented separately as tailored solutions.More standardized or modular Learning Analytics systems are reasonable. [ABSTRACT FROM AUTHOR]

Rapid technological change – the digitalization and automation of work – is challenging contemporary welfare states. Most of the existing research, however, focuses on its effect on labor market outcomes, such as employment or wage levels. In contrast, this paper studies the implications of technological change for welfare state attitudes and preferences. Compared to previous work on this topic, this paper adopts a much broader perspective regarding different kinds of social policy. Using data from the European Social Survey, we find that individual automation risk is positively associated with support for redistribution, but negatively with support for social investment policies (partly depending on the specific measure of automation risk that is used), while there is no statistically significant association with support for basic income. We also find a moderating effect of the overall size of the welfare state on the micro-level association between risk and preferences. [ABSTRACT FROM AUTHOR]

This paper investigates changes over the period 2005 to 2014 in material deprivation dynamics of social risk groups in 11 European countries covering a range of welfare regimes. The period covered experienced dramatic economic change, encompassing periods of boom, the Great Recession and early recovery. Social risk groups are defined as groups which differ in the challenges that they face in converting resources into desired outcomes. The comparative element of the paper allows us to assess whether certain welfare regimes were better at protecting more vulnerable groups. Results, based on the longitudinal component of the European Union Statistics on Income and Living Conditions and on analysis of deprivation dynamics between pairs of years, showed large inequality between groups in the risk of persistent deprivation – with lone parents and people with disability most at risk in all countries. Variation across welfare regimes was restricted to the contrast between the liberal and the remaining regimes. Countries belonging to the former regime (UK and Ireland) were distinctive in showing the largest social risk gap in persistent deprivation and were the only ones which experienced substantial polarisation between groups with the Great Recession. [ABSTRACT FROM AUTHOR]

Aims and objectives: To review the literature on family caregivers' experiences of providing care for a family member from an ethnic minority group living with dementia within the European context. Background: Due to labour migration during the late 1960s and early 1970s, many European countries are now encountering an increasing number of older people from diverse ethnic minority groups who have been diagnosed with dementia. Although family care is predominantly used as a care pathway among families with immigrant backgrounds, little is known about family caregivers' experiences of providing care for a family member with dementia. Design: A systematic review of qualitative literature. Methods: Eight databases (CINAHL, EMBASE, MEDLINE, PsychINFO, SCOPUS, Social Care Online, SocIndex and Epistemonikos) were searched for original, peer‐reviewed papers, published in English between 2010 and 2021. The literature review was conducted and reported in accordance with PRISMA 2020 checklist for reporting systematic reviews. Results: After identifying, screening and assessing articles for eligibility, 14 articles were critically appraised using the standardised assessment tool Mixed methods Appraisal Tool (MMAT, version 2018) and included in the review. The data synthesis process identified four themes across the qualitative studies: controversies and challenges; a lack of health literacy; barriers to seeking support from the healthcare or social services; and models of care. Conclusions: Most of the family caregivers highlighted the value of being able to care for a family member living with dementia. However, the findings also reveal that they experience controversies and challenges due to their lack of dementia health literacy and perceived barriers to seeking healthcare support. Relevance to clinical practice: The findings from the current review can inform healthcare and social services in relation to implementing models of care that facilitate and complement family caregivers' role in caring for family members living with dementia from minority ethnic groups. [ABSTRACT FROM AUTHOR]

Background: Formative assessments are vital for supporting learning and performance but are also considered to increase the workload of teachers. As self‐assessments in higher education are increasingly facilitated via digital learning environments allowing to offer direct feedback and tracking students' digital learning behaviour these constraints might be reduced. Yet, learning analytics do not make sufficient use of data on assessments. Aims: This exploratory case study uses learning analytics methods for investigating students' engagement with self‐assessments and how this relates to performance in the final exam and self‐reported self‐testing strategies. Materials & Methods: The research study has been conducted at a European university in a twelve‐weeks course of a Bachelor's program in Economic and Business Education including nenroll = 159 participants. During the semester, students were offered nine self‐assessments each including three to eight tasks plus one mid‐term and one exam‐preparation self‐assessment including all prior self‐assessments tasks. The self‐assessment interaction data for each student included: the results of the last self‐assessment attempt, the number of processed self‐assessment tasks, and the time spent on the last self‐assessment attempt, the total self‐assessment attempts, and the first as well as last access of each self‐assessment. Data analytics included unsupervised machine learning and process mining approaches. Results: Findings indicate that students use the self‐assessments predominantly before summative assessments. Two distinct clusters based on engagement with self‐assessments could be identified and engagement was positively related to performance in the final exam. The findings from learning analytics data were also indicated by students' self‐reported use of self‐testing strategies. Discussion: With the help of multiple data from self‐reports, formal exams, and a learning analytics system, the findings provided multiple perspectives on the use of self‐assessments and their relationships with course performance. These findings call for applying assessment analytics and related frameworks in learning analytics as well as providing learners with related adaptive feedback. Conclusion: Future research might investigate different (self‐report) variables for clustering, other student cohorts or self‐assessment forms. Lay Description: What is already known about this topic: Formative assessments are vital for supporting learning and performance.Learning analytics do not make sufficient use of data on assessments. What this paper adds: Students use the self‐assessments predominantly prior to summative assessments.Engagement with self‐assessments was positively related to performance in the final exam. Implications for practice and/or policy: Findings call for applying assessment analytics and implementing related learning analytics frameworks for supporting learning processes and performance.Pedagogically oriented assessment analytics may provide multiple benefits for learners, teachers, schools, and other involved stakeholders. [ABSTRACT FROM AUTHOR]

This paper investigates different uses of the Journal Impact Factor (JIF) in national journal rankings and discusses the merits of supplementing metrics with expert assessment. Our focus is national journal rankings used as evidence to support decisions about the distribution of institutional funding or career advancement. The seven countries under comparison are China, Denmark, Finland, Italy, Norway, Poland, and Turkey—and the region of Flanders in Belgium. With the exception of Italy, top‐tier journals used in national rankings include those classified at the highest level, or according to tier, or points implemented. A total of 3,565 (75.8%) out of 4,701 unique top‐tier journals were identified as having a JIF, with 55.7% belonging to the first Journal Impact Factor quartile. Journal rankings in China, Flanders, Poland, and Turkey classify journals with a JIF as being top‐tier, but only when they are in the first quartile of the Average Journal Impact Factor Percentile. Journal rankings that result from expert assessment in Denmark, Finland, and Norway regularly classify journals as top‐tier outside the first quartile, particularly in the social sciences and humanities. We conclude that experts, when tasked with metric‐informed journal rankings, take into account quality dimensions that are not covered by JIFs. [ABSTRACT FROM AUTHOR]

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Despite the strong evidence of prevention as a prime defence against the disease, the majority of cancer research investment continues to be made in basic science and clinical translational research. Little quantitative data is available to guide decisions on the choice of research priorities or the allocation of research resources. The primary aim of the mapping of the European cancer prevention research landscape presented in this paper is to provide the evidence-base to inform future investments in cancer research. Using bibliometric data to identify funders that are active in prevention research in Europe and in the world, we have identified that 14% of cancer research papers had a focus on prevention research and those were funded by 16% of all the European cancer research funders. An important finding of our study is the lack of research on primary prevention with primary prevention funders accounting for 25% of European cancer prevention funders, meaning that less than 4% of all European cancer research funders identified show an interest in primary prevention. An additional analysis revealed that 7% of European cancer prevention research papers are categorised as implementation projects, meaning that only 1% of all cancer research publications are implementation research in cancer prevention. This paper highlights that the narrow focus on biology and treatment in Europe needs to be widened to include such areas as primary prevention and secondary prevention and a larger concentration on implementation research. These data can help support a more policy-focused cancer research agenda for individual European governments and charitable and philanthropic organisations and stimulate joining efforts across Europe to create a more systematic and structured approach to cancer prevention. • 14% of European cancer research papers have a focus on prevention research. • Only 7% of those papers are categorised as implementation research. • 16% of all European cancer research funders show an interest in prevention research. • Less than 4% of them show an interest in primary prevention. • These data can help support more policy-focused cancer research agenda. [ABSTRACT FROM AUTHOR]

The paper aims to identify and describe the European evidence on opportunities and barriers to access and utilization of palliative care among non- western migrants. A systematic review in accordance with PRISMA guidelines was conducted in June 2020, searching Medline, CINAHL, PsychINFO and EMBASE databases. PROSPERO# CRD42020193651. Studies included empirical research published between 2011 and 2020. Search words were, for example, ethnic groups and palliative care. Thematic analysis was used to analyze data. Twenty nine qualitative and six quantitative studies were included. Four main themes were identified: communication and language; knowledge and awareness; patient preferences, cultural and religious issues; and lack of resources at different levels of palliative care service provision. Migrants' access to palliative care is impeded at system, community and individual levels, yet, recommendations are mostly at the individual level. Closer attention is required to these different levels when designing future palliative interventions for migrants. [ABSTRACT FROM AUTHOR]

Background: The cultural and language diversity across many European countries presents a range of challenges and opportunities for speech and language therapists and other practitioners working with children with developmental language disorders (DLD) and their families. Objective: The aim of this study was to explore practitioners' perceptions of cultural and linguistic differences in response to children with DLD across different countries. Methods: A survey was developed by practitioners and researchers working with children with DLD across Europe and beyond as part of the work of Cost Action IS1406. Data from 1,358 practitioners from 8 European countries – Ireland, UK, Bulgaria, Poland, Croatia, Spain, Norway and Sweden – and 2 neighbour countries – Turkey and Lebanon – were included in the present analyses, which address two groups of questions. The first focuses on practitioners' perceptions of the way that parents think about cultural differences and their relationship to language development in their children. The second concerns the extent to which practitioners consider themselves to have the skills to work with children from other cultures and using different languages. Results/Conclusions: Most countries present a similar profile with intermediate results about their perception of cultural issues, but Lebanon and Turkey are the group with the most positive responses. In terms of bilingual issues most practitioners indicated that they only worked in their country's primary language. The only country where this was not the case was Lebanon. Professionals from Spain and Lebanon form a subgroup in terms of their confidence to work with different cultural/language groups. The paper highlights both the universal importance of cultural and linguistic competence in managing young children's needs and indicates that in most cases professionals do not think they have the necessary expertise to work with cultural and linguistic diversity. [ABSTRACT FROM AUTHOR]

Introduction: Several forces are contributing to an increase in the number of people living with and surviving colorectal cancer (CRC). However, due to the lack of available data, little is known about the implications of these forces. In recent years, the use of administrative records to inform research has been increasing. The aim of this paper is to investigate the potential contribution that administrative data could have on the health economic research of CRC. Methods: To achieve this aim, we conducted a systematic review of the health economic CRC literature published in the United Kingdom and Europe within the last decade (2009–2019). Results: Thirty‐seven relevant studies were identified and divided into economic evaluations, cost of illness studies and cost consequence analyses. Conclusions: The use of administrative data, including cancer registry, screening and hospital records, within the health economic research of CRC is commonplace. However, we found that this data often come from regional databases, which reduces the generalisability of results. Further, administrative data appear less able to contribute towards understanding the wider and indirect costs associated with the disease. We explore several ways in which various sources of administrative data could enhance future research in this area. [ABSTRACT FROM AUTHOR]

Dual or multiple earnership has been considered an important factor to prevent in-work poverty. The aim of this paper is to quantify the impact of second earnership on the risk of in-work poverty and the role of the tax-benefit system in moderating this risk. Our analysis refers to 2014 and employs EUROMOD, the tax-benefit microsimulation model for the European Union and the United Kingdom. In order to assess the role of second earners in preventing in-work poverty we simulate a counterfactual scenario where second earners become unemployed. Our results show that the effect of net replacement rates (i.e. the ratio of household income before and after the transition of second earners to unemployment) on the probability of in-work poverty is negative and statistically significant, but in relative terms it appears to be small compared to the effects of individual labour market characteristics, such as low pay and part-time employment. [ABSTRACT FROM AUTHOR]

This paper examines the effect of spectators on women's football games. COVID-19 and related restrictions provide a unique opportunity with an adequate sample size to test the effect of lockdown on sports activities. Studies have recently exploited this opportunity for men's football to better understand the potential causes of home advantage and, more specifically, assess the psychological consequences when matches are played without supporters. Despite the increased scientific interest, there was only one paper that focused on women's football. Therefore, we aim to contribute to this research field by considering matches from four major European women's football leagues. The findings suggest that for three of these leagues, lockdown has a statistically significant effect on the sanctioned yellow cards by either reducing the number of yellow cards sanctioned to the away teams or increasing the number of yellow cards sanctioned to the home teams. Nonetheless, lockdown does not affect any final match outcomes; therefore, it does not significantly affect the magnitude of home advantage for women's games. • Referreing activities and home advantage of women's football for pre- and post-COVID-19 periods are investigated. • Lockdown does not affect the magnitude of home advantage for women's football. • Sanctioned yellow cards are significantly affected by lockdown in line with the literature for men's football. [ABSTRACT FROM AUTHOR]

• 107 correlates were investigated among 62,500 participants aged 50 years and over. • Machine learning techniques were used to identify the correlates of quality of life. • Physical health and subjective life circumstances were important correlates. Previous research has documented the role of different categories of psychosocial factors (i.e., sociodemographic factors, personality, subjective life circumstances, activity, physical health, and childhood circumstances) in predicting subjective well-being and quality of life among older adults. No previous study has simultaneously modeled a large number of these psychosocial factors using a well-powered sample and machine learning algorithms to predict quality of life, happiness, and life satisfaction among older adults. The aim of this paper was to investigate the correlates of quality of life, happiness, and life satisfaction among European adults older than 50 years using machine learning techniques. Data drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 7 were used. Participants were 62,500 persons aged 50 years and over living in 26 Continental EU Member States, Switzerland, and Israel. Multiple machine learning regression approaches were used. The algorithms captured 53%, 33%, and 18% of the variance of quality of life, life satisfaction, and happiness, respectively. The most important categories of correlates of quality of life and life satisfaction were physical health and subjective life circumstances. Sociodemographic factors (mostly country of residence) and psychological variables were the most important categories of correlates of happiness. This study highlights subjective poverty, self-perceived health, country of residence, subjective survival probability, and personality factors (especially neuroticism) as important correlates of quality of life, happiness, and life satisfaction. These findings provide evidence-based recommendations for practice and/or policy implications. [ABSTRACT FROM AUTHOR]