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Introduction. This review describes standardized ergonomics assessment based on pen-and-paper observational methods for assessing ergonomics risk factors. Objective. The three main objectives are to analyze published pen-and-paper observational methods, to extract and understand the risk levels of each method and to identify their associated health effects. Methodology. The authors searched scientific databases and the Internet for materials from 1970 to 2013 using the following keywords: ergo, posture, method, observational, postural angle, health effects, pain and diseases. Postural assessments of upper arms, lower arms, wrists, neck, back and legs in six pen-and-paper-based observational methods are highlighted, extracted in groups and linked with associated adverse health effects. Results. The literature reviewed showed strengths and limitations of published pen-and-paper-based observational methods in determining the work activities, risk levels and related postural angles to adverse health effects. This provided a better understanding of unsafe work postures and how to improve these postures. Conclusion. Many pen-and-paper-based observational methods have been developed. However, there are still many limitations of these methods. There is, therefore, a need to develop a new pen-and-paper-based observational method for assessing postural problems. [ABSTRACT FROM AUTHOR]

To compare resources required to provide paper-based versus videoed instructions for home exercises in rehabilitation. An observational cohort study included twenty-two allied health professionals (physiotherapists [n = 13], occupational therapists [n = 6] and speech pathologists [n = 3]), providing exercise instructions for n = 110 patients within a community rehabilitation program of a large metropolitan health service. Home exercise instructions were provided to patients with various health conditions. Patients chose between receiving paper-based home exercise instructions, or using their own smart technology to video their home exercises. The primary outcome measure was cost from a health service perspective, based on health professional time, paper used, and printing. A total of 128 initial home exercise instructions were provided to 110 patients, with 36 patients reviewed at least once. Each initial exercise instruction provided using electronic devices saved 5.5 min (95% CI 0.5 to 10.5) with a cost saving of Australian dollar $4.70 (95% CI −8.89 to −0.52) compared with paper-based instructions. There were no significant cost differences (MD $1.16 95% CI −3.87 to 6.18) between modes for exercise review. Home exercise instructions provided on electronic devices cost less than paper-based instructions when patients are using their own smart devices. Costs are minimised when home exercise instructions are provided using the video function of the patient's own electronic devices compared with paper-based instructions. Since patient outcomes appear to be similar with instructions provided in electronic or paper-based mode, exercise instructions in community rehabilitation should be provided using the video function of electronic devices where these are available. [ABSTRACT FROM AUTHOR]

The Cumberland Ankle Instability Tool is a common patient reported outcome used to assess those with Chronic Ankle Instability. However, paper versions of the Cumberland Ankle Instability Tool have only been assessed for reliability purposes. The purpose of this study was to assess the agreement and reliability of a digital version of the Cumberland Ankle Instability Tool-Digital. Sixty-eight participants with a history of ankle sprain(s) were recruited to participate in this study. Participants completed a paper version of the Cumberland Ankle Instability Tool and a digital version then returned one week later and completed them again. Intraclass correlation coefficients (ICC) and Kappa coefficients were used to determine the agreement between the paper and digital versions as well as test-retest reliability between the two time periods. The digital version showed excellent reliability (ICC = 0.93, 95% CI: 0.89–0.96) with the paper version. The test-retest reliability between testing sessions was considered good (ICC = 0.86, 95% CI: 0.77–0.92). A majority of individual items on the digital version demonstrated substantial agreement (κ = 0.60–0.81) with the paper version. A digital version of the Cumberland Ankle Instability Tool demonstrated good to excellent psychometric properties. Clinicians who utilize a digital version as part of an electronic medical record system can utilize them confidently to accurately assess patients with Chronic Ankle Instability. Future studies may want to consider assessing a digital version with expanded clinical and research populations. The digital version of the Cumberland Ankle Instability Tool demonstrated adequate psychometric properties. The digital version of the Cumberland Ankle Instability Tool can be considered a reliable instrument for the assessment of Chronic Ankle Instability. A digital version of the Cumberland Ankle Instability Tool can provide automated scoring and quick administration for clinicians in a rehabilitation setting. [ABSTRACT FROM AUTHOR]

The prevalence of impaired foot function and floating toes of 91 baseball players with disabled throwing shoulder or elbow were retrospectively investigated. Foot function was evaluated by foot "rock paper scissors" and floating toes were confirmed if none of the toes made contact with the mat in standing posture. The prevalence of impaired foot function and floating toes and the relationship between between them were determined. Abnormal foot function was observed in 83 players (91%); of those, 73 players (88%) also had floating toes, and the prevalence was statistically significant compared to those without it (12%) (P < 0.001). Floating toes were observed in 74 players (81%); of those, 73 players (99%) had impaired foot function, and the prevalence was also statistically significant compared to those without them (59%) (P < 0.001). Baseball players with disabled throwing shoulder or elbow have high rates of impaired foot function and floating toes. [ABSTRACT FROM AUTHOR]

Hospital to home transfers for older people require effective communication, coordination and collaboration across multiple service settings. Rural Nursing Theory and the Beyond Periphery model explain why this is particularly difficult in rural areas, but there are few examples of how rural services respond. This paper presents a case study of the district of Tärnaby in the inland north of Sweden. Data are drawn from interviews with health and care staff in Tärnaby, observations, and experiences of the researchers. Data were analyzed thematically, with four main themes emerging – role clarity, communication, geography, and understanding of the rural context. Responses to challenges included increasing opportunities for communication between service providers and improving documentation. The paper concludes that informal "workarounds" run the risk of further disconnecting rural service settings from "the city". Rather, the aim needs to be to improve contextual understanding through formally incorporating "the rural" in service design. [ABSTRACT FROM AUTHOR]

This paper compares two strikingly different uses of water. The first by an adolescent young man on the autistic spectrum, in an art psychotherapy session; the second, by an ordinary developing toddler, observed at home. It uses insights gleaned from psychoanalytic infant observation to illuminate the seemingly enigmatic behaviours found in clinical practice. In doing so, it delineates the centrality of joint visual attention in the development of symbol formation. Understanding is advanced by making evident that water may be used to either enable or inhibit this process. As such, it argues that the phenomenon of liquidity be given greater consideration. Further, it critically champions for the inclusion of infant observation in art psychotherapy training. [ABSTRACT FROM AUTHOR]

Health care systems around the globe are currently orienting themselves towards 'personalized medicine', a medical care regime aimed at individualizing prevention, diagnosis, and treatment of disease through proliferating amounts and sources of data, including genetic information. In Denmark, national health policies on personalized medicine focus on harnessing the potentials of genomic science and technology to bring knowledge about patient-specific genetic variation into clinical application. A major hope is to improve public health and prevent common diseases by integrating genomic information in health care, yet to act preventively, a temporal path has to be established defining what kind of knowledge to create and to act upon, and when. This paper explores the temporal orderings of medical knowledge in two different areas: health policy and clinical practice. Examining policy papers on personalized medicine issued by Danish governmental and research institutions, and, comparing them with contemporary practices of using genetic information in preventive cardiac health care, we demonstrate that genetic knowledge-making is ordered around two different conceptual views of time: namely the sequential order and the speed with which such knowledge is produced. We argue that the visions of knowledge-making and early intervention through genomic science and technology as conveyed in policy papers on personalized medicine, challenge preexisting practices and understandings of what constitutes timely prevention and actionable knowledge within clinical care. We close the article discussing how prevention through genomics amplifies the significance of the clinical space for public health as a site for sense-making and translation of controversial genetic knowledge. [ABSTRACT FROM AUTHOR]

Despite the apparent centrality of supervision to the effectiveness of social work practice, this topic remains largely under researched. The majority of studies to date have relied on self-reporting mechanisms to understand 'what happens' in supervision, with few accessing supervision directly, and none, to the writer's knowledge, attempting to analyse the impact of unconscious processes. This paper aims to contribute to this gap in the knowledge base by analysing the conscious and unconscious processes at play in two cohorts of systemic group supervision held in UK children's services, and how such processes, alongside the leadership styles of the supervisors, impacted on the nature of supervision practice. A psychoanalytically informed research methodology is employed to study the group supervision sessions, and the subsequent data analysed through a thematic analysis. This paper employs Bion's model of thought outlined in Learning from Experience to explore how each group developed its own unique ability to think in light of its capacity to contain anxiety. Implications for the nature of reflective practice in the supervision, and social work practice more broadly, are then discussed. [ABSTRACT FROM AUTHOR]

This paper explores isomorphic patterns in social work group supervision and social work practice through the lens of the psychoanalytical concept of parallel process and Bion's theory of learning from experience. Empirical data from group supervision sessions are presented, and a link is theorised between sessions characterised by high levels of anxiety and the presence of parallel process, whereby 'unthought' anxiety provoking phenomena described in social workers' practice appear to be repeated in supervision. Implications for supervision practice and social work more broadly are then discussed. [ABSTRACT FROM AUTHOR]

Common depictions of buying and selling illicit drugs online centre on how drug market actors engage in dark web drug cryptomarkets, but the supply of illicit drugs also takes place in 'plain site' on the surface web. Drawing on netnographic observations and qualitative interviews with hard-to-reach buyers and vendors (n = 20), this paper explores LeafedOut, a specific, popular surface web platform, that provides a conduit for local cannabis exchanges. We found that the platform enabled easy access and supply at the local level but increased some specific risks to those involved. Actors neutralised the perceived risks of drug supply over this surface web platform through the broader societal normalisation of cannabis use/supply, adopting encrypted messaging applications to cover 'digital traces', and developing various methods to establish trust with an exchange partner (e.g. review systems, sending selfies with drug paraphernalia, selectively choosing meet-up locations). This paper expands our understanding of the growing number of online illicit drug markets by shifting attention from dark web cryptomarkets to the much more widely accessed surface/clear web. Theoretical implications for the study of trust and risk in online illicit drug market exchanges are also considered. [ABSTRACT FROM AUTHOR]

Executive functions have both direct and indirect effects on reading comprehension. Previous studies have shown that people with hearing loss (HL) perform poorly on executive functions and reading comprehension tasks. This scoping review explored the current state of the literature relating executive function and reading comprehension in children and adolescents with cochlear implants. Searches were carried out in five databases to identify empirical studies related to executive functions, reading comprehension, and children and/or adolescents with cochlear implants. All results were analysed by peer-reviewers. A systematic search only found four studies in the field. We carried out our narrative review of these papers, with a focus on the mediating role of oral language on the relationship between executive functions and reading comprehension. [ABSTRACT FROM AUTHOR]

Substance use disorder is a growing health problem all over the world. The coexistence of substance misuse, affective temperaments, and emotion dysregulation has not been studied sufficiently. The present study aimed to evaluate the role of affective temperaments and emotion dysregulation on substance use disorder. The Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder study was designed observational. This paper presents only the baseline assessments of the patient and control groups. One-year remission rates of the patients' group will be reported elsewhere after 1-year follow-up. Sixty-seven patients with opioid use disorder and 68 healthy controls enrolled. All participants were administered to The Structured Clinical Interview for DSM-5, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire, Difficulties in Emotion Regulation Scale, Beck Anxiety Inventory, and Beck Depression Inventory. Patients with opioid use disorder had higher scores from all temperamental scales and showed higher difficulties on emotion regulation than the control group. Even controlling the confounding effects of anxiety and depression levels, dysthymic and anxious temperament scores were found correlated with the emotion dysregulation score in the patient group. The emotional traits (i.e., affective temperaments) and emotion regulation abilities play a crucial role in substance use disorder. While managing substance use disorder, being aware of affective temperament characteristics and/or interventions to improve emotion regulation skills may be helpful. [ABSTRACT FROM AUTHOR]

Rejecting the association between aging and asexuality that persists in the UK's cultural representation of the female aging body, this paper reveals the importance of sensuality and maintaining physical agency to older women. It pays attention to the phenomena of participating in recreational burlesque classes to counter and negotiate potentially negative representations. Through in-depth interviews and researcher-as-participant observation, the paper explores the transformative possibilities mediated through participating in theatrically glamorized performance classes and the processes thereby initiated. The author examines the potential of burlesque to offer improvements to wellbeing and healthier self-perceptions for aging women experiencing marginalization through social invisibility. [ABSTRACT FROM AUTHOR]

Children who use augmentative and alternative communication (AAC) are multimodal communicators. However, in classroom interactions involving children and staff, achieving mutual understanding and accomplishing task-oriented goals by attending to the child's unaided AAC can be challenging. This study draws on excerpts of video recordings of interactions in a classroom for 6–9-year-old children who used AAC to explore how three child participants used the range of multimodal resources available to them – vocal, movement-based, and gestural, technological, temporal – to shape (and to some degree, co-control) classroom interactions. Our research was concerned with examining achievements and problems in establishing a sense of common ground and the realization of child agency. Through detailed multimodal analysis, this paper renders visible different types of practices rejecting a request for clarification, drawing new parties into a conversation, disrupting whole-class teacher talk-through which the children in the study voiced themselves in persuasive ways. It concludes by suggesting that multimodal accounts paint a more nuanced picture of children's resourcefulness and conversational asymmetry that highlights children's agency amidst material, semiotic, and institutional constraints. [ABSTRACT FROM AUTHOR]

This paper aims to examine the spatial attributes in the hospital ward environment and their impact on medical students' learning and experience of the clinical workplace. An ethnographic study was conducted in a Scottish teaching hospital, combining observations and interviews over a period of 10 months. Two teaching wards served as the field-sites where approximately 120 h of non-participant observations took place sequentially. In addition, 34 individual interviews were conducted with identified key informants that included medical students, junior doctors, postgraduate trainees, consultant supervisors, ward nurses and hospital pharmacist. A combination of Actor-network Theory (ANT) and Social cognitive theory (SCT) was applied to analyse data pertaining to spatial attributes and their relevance to clinical teaching and learning. Analysis of the observational and interview data led to generation of the following themes: spatial attributes in the clinical workplace can enable or constrain teaching and learning opportunities, inadequate spaces impact students' and junior doctors' sense of value, short clinical rotations influence a sense of ownership of doctors' spaces, and contested nature of space in the clinical environment. Several illustrations of the field-sites help to contextualise the themes and aid in understanding the participants' experiences and perceptions. Our findings suggest a complex entanglement of space with medical students learning and wellbeing in the clinical workplace. Provision of suitable spaces needs to be a core consideration to realise the full potential of work-based learning in medicine. [ABSTRACT FROM AUTHOR]

This study's goal was to inform the selection of the most frequently used words to serve as a reference for core vocabulary selection for Hebrew-speaking children who require AAC. The paper describes the vocabulary used by 12 Hebrew-speaking preschool children with typical development in two different conditions: peer talk, and peer talk with adult mediation. Language samples were audio-recorded, transcribed, and analyzed using the CHILDES (Child Language Data Exchange System) tools to identify the most frequently used words. The top 200 lexemes (all variations of a single word) in the peer talk and adult-mediated peer talk conditions accounted for 87.15% (n = 5008 tokens) and 86.4% (n = 5331 tokens) of the total tokens produced in each language sample (n = 5746, n = 6168), respectively. A substantially overlapping vocabulary of 337 lexemes accounted for up to 87% (n = 10411) of the tokens produced in the composite list (n = 11914). The results indicate that a relatively small set of words represent a large proportion of the words used by the preschoolers across two different conditions. General versus language-specific implications for core vocabulary selection for children in need of AAC devices are discussed. [ABSTRACT FROM AUTHOR]

Social work is often described as a helping profession. Yet in the context of child protection services, the kind of 'help' on offer is not always welcome. Relatively few parents or children request the assistance of child protection services, and child protection investigations are often highly stressful. Workers and family members may have different ideas about the nature of the family's problems, and the type of support they need. So, how do child protection social workers think they are helping children and their families? In this paper, we report an analysis of audio-recordings of supervision case discussions, through which we explore what social workers talk about when they talk about helping families. In some cases, workers did not know how they were helping, or even if they were. Other times, workers said they were helping by developing positive relationships, addressing parental behaviour change, coordinating with other services, and fulfilling their statutory duties. We reflect on these findings in relation to the nature of 'help' in child protection services, practice epistemologies and Hasenfeld's typologies of power. [ABSTRACT FROM AUTHOR]

This discussion paper provides an introduction and overview of Ethnography as a qualitative research methodology and outlines its usefulness in understanding the experiences of patients and service users during their healthcare journey. Ethnographic research provides an insight into the group being studied. In this paper that author suggests that ethnography can provide an insight into the behaviours, thoughts and feelings of a patient group. Research methods used in ethnographic research have been outlined and discussed along with some of the possible methodological and ethical issues that might occur when carrying out an ethnographic study with a group of patients. This paper discusses some of the potential results of an ethnographic study with patients and how ethnographic research can be used to study the experiences of patients. the author draws together some lessons that can be learnt and some possible applications of ethnographic research in healthcare settings with patients. Implications for rehabilitation are also proposed. Ethnography is a simple and effective qualitative research methodology for studying groups of people with a common enterprise or experience, ethnography studies the culture, behaviours and norms of the group. Ethnography is a useful research methodology to understand the experiences of patients and service users during their healthcare journey. It can provide information about what it is like to have a particular medical condition or diagnosis and the norms and behaviours of patients with this condition. Ethnographic data allows the patient's voice to be heard. Data from ethnographic studies of patient groups can be used for service improvement within health and social care. [ABSTRACT FROM AUTHOR]

Purpose:To explore the usefulness of conventional tests for assessing spatial neglect and contrast these tests with daily challenges encountered by patients after discharge from rehabilitation to home. Methods:A mixed method prospective study of 15 patients with neglect after a right hemisphere stroke, <1 month after discharge to home. Data were obtained from: (1) Catherine Bergego Scale (CBS), (2) star cancellation and figure copying and (3) observations and interviews. Qualitative data were analysed with content analysis and quantitative data with non-parametric statistics. The data were presented in a ‘mixing matrix’ and integrated by ‘following threads’. Finally, a synthesis was written into a vignette. Results:The CBS significantly underestimated fluctuations and did not capture important items of neglect. The star cancellation and figure copying did not identify neglect in mildly affected participants. Left starting point in the star cancellation and a characteristic process of drawing in figure copying were observed in all participants. Conclusion:Traditional numerical interpretations of paper-pencil tests inadequately confirmed mild neglect. Starting points of the star cancellation and observation of drawing should be incorporated into screening procedures. Assessment strategies need improvement to identify patients with subtle forms of neglect.Implications for RehabilitationFindings demonstrate that identification of spatial neglect and the way symptoms of neglect impact on daily life functioning of stroke patients must be carefully pursued by health-care professionals working in stroke rehabilitation.Areas that should receive professional attention in the rehabilitation process include: preparing patients and their family for fluctuations related to neglect in the patient’s own home, locating issues that might impact safety, and identifying unique factors that either enhance or diminish neglect within each patient’s daily life context.The results of this study could be used to develop more wide-ranging assessment strategies to assist health-care professionals in identifying neglect after hospital discharge, for instance by expanding existing ecological assessment tools and including qualitative evaluation of test performance in paper-pencil tests, such as the star cancellation and figure copying. [ABSTRACT FROM PUBLISHER]

Drawing on participant observation and interviews in two yoga studios in the highly socially stratified city of Marseille, France, this paper explores the understandings of yoga as a health practice that emerge at the intersections between yoga styles and their social contexts of consumption. Its insights emerge from the comparison of three modern yoga styles that were developed for Western English-speaking cultural contexts – Iyengar, Bikram and Forrest – and which differ in form but also in the chronology of their emergence on the global yoga market and that of their reception in France. These three yoga styles are also branded through contrasting mythologies of transformational healing, and the aim of this paper is to explore how a brand conceptualization of yoga as a health practice relates to or resonates with the embodied experiences of practitioners, and to the socio-cultural contexts in which practitioners and their practices are embedded. The paper contributes a new case study to the global yoga scholarship and to a poorly studied French yoga scene, but more importantly, it cross-examines the discourses through which a yoga style is branded, the way it is transmitted, and the social context and social positioning of the individuals who practice it. Combining perspectives on the body, narrative and rituals, it identifies how yoga healing is construed in relation to gender, ethnicity and class and the points of consensus and dissent that emerge from the encounters between French social bodies and exogenous yoga styles. [ABSTRACT FROM AUTHOR]

This paper explores the decision-making processes involved in giving physiotherapy students responsibility on clinical placement and the impact on their developing professional autonomy. The qualitative study, using semi-structured interviews, involved physiotherapy students and clinical educators (CEs) from two higher education institutions, one in Australia, and the other in the United Kingdom (UK). Findings led to the development of a heuristic framework of 'graduated supervision,' a process of progressively less direct observation and monitoring of students as clinical proficiency improved. By focusing on the measured exposure of students to increasing complexity and inverse levels of supervision, the framework captures tacit practices, and consistent, yet varied facilitation strategies adopted across specialties, and evident in clinical education settings in both countries. The framework formalizes, for the first time, assumptions and expectations previously unacknowledged. Factors identified as affecting students' progress toward autonomy include the student/CE relationship, the development of mutual trust through ongoing dialogue, and the importance of formal discussions at the commencement of a clinical placement to establish learning goals, preferred supervision styles and learner responsibilities. Insights have significance for the CE community, and students who at times have to second-guess what is required of them and how they might excel on clinical placement. [ABSTRACT FROM AUTHOR]

As the duration of diabetes progresses, various disease related complications might occur in patients. The main goal of this paper is to compare acoustic and aerodynamic measures of patients with type 2 diabetes mellitus (T2DM) with a control group of healthy subjects. A total of 91 subjects, 51 individuals with type 2 diabetes mellitus (DM group) and 40 healthy volunteers (HV group) were participated in the study. Maximum phonation time (MPT) was captured for assessing phonatory mechanics. Acoustic voice parameters, including mean fundamental frequency (mean fo), jitter local (Jlocal), jitter absolute (Jabs), shimmer local (Slocal), shimmer decibel (SdB), and harmonics to noise ratio (HNR) were detected using the Praat software program. Only for Jabs, statically significant difference was found between the groups. There were no statically significant differences between any voice parameters of HV versus those with the duration of diabetes ≥10 years and the HbA1c level ≥7%. However, statically significant differences for MPT and Slocal were found between patients with neuropathy versus HV. In addition, a comparison between patients with voice complaint versus HV showed significant differences for Slocal and SdB. The findings of the present study do not provide strong evidence about the possible effect of DM on the human voice. However, diabetic neuropathy is considered to be a factor affecting the voice parameters in the target population. The physicians should pay attention to the acoustic and aerodynamic voice parameters in patients with diabetes, particularly in those with neuropathy or voice complaints. [ABSTRACT FROM AUTHOR]

PhenomenonCadavers have long played an important and complex role in medical education. While research on cadaver-based simulation has largely focused on exploring student attitudes and reactions or measuring improvements in procedural performance, the ethical, philosophical, and experiential aspects of teaching and learning with cadavers are rarely discussed. In this paper, we shed new light on the fascinating philosophical moves in which people engage each and every time they find themselves face to face with a cadaver. ApproachOver a two-year period (2018/19–2019/20), we applied ethnographic methods (137 hours of observation, 24 interviews, and the analysis of 22 documents) to shadow the educational cadaver through the practical stages involved in cadaver-based simulation: 1. cadaver preparation, 2. cadaver-based skill practice with physicians and residents, and 3. interment and memorial services. We used Deleuze and Guattari's concepts of becoming and acts of creation to trace the ontological "lifecycle" of an educational cadaver as embedded within everyday work practices. FindingsWe delineated six sub-phases of the lifecycle, through which the cadaver transformed ontologically from person to donor, body, cadaver, educational cadaver, teacher, and loved one/legacy. These shifts involved a network of bureaucratic, technical, educational, and humanistic practices that shaped the way the cadaver was perceived and acted upon at different moments in the lifecycle. By highlighting, at each phase, 1) the ontological transitions of the cadaver, itself, and 2) the practices, events, settings, and people involved in each of these transitions, we explored questions of "being" as it related to the ontological ambiguity of the cadaver: its conceptualization as both person and tool, simultaneously representing life and death. InsightsEngaging deeply with the philosophical questions of cadaver-based simulation (CBS) helped us conceptualize the lifecycle as a series of meaningful and purposeful acts of becoming. Following the cadaver from program entry to interment allowed us to contemplate how its ontological ambiguity shapes every aspect of cadaver-based simulation. We found that in discussions of fidelity in medical simulation, beyond both the physical and functional, it is possible to conceive of a third type: ontological. The humanness of the cadaver makes CBS a unique, irreplaceable, and inherently philosophical, practice. [ABSTRACT FROM AUTHOR]

Changes in life expectancy (LE) across metropolitan areas in the United States have been associated with substantial differential reductions in fine particulate matter (aerodynamic diameter <2.5 μm; PM2.5) air pollution that occurred during the 1980s and 1990s. It has been suggested that a single influential observation was largely responsible for the statistically significant LE-PM2.5associations. In this paper, the role of influential observations is further explored. Stable and statistically significant LE-PM2.5associations are observed in analyses that control for available socioeconomic, demographic, and proxy smoking variables and that use robust regression procedures that are relatively resistant to influential observations. These associations are not dependent upon the inclusion or exclusion of any single observation. [ABSTRACT FROM AUTHOR]

The past two decades have seen an increasing role for the UK community and voluntary sector (CVS) in health promotion in disadvantaged areas, largely based on assumptions on the part of funders that CVS providers are better able to engage ‘hard-to-reach’ population groups in services than statutory providers. However, there is limited empirical research exploring CVS provider practices in this field. Using ethnographic data, this paper examines the experiences of a network of CVS providers seeking to engage residents in health-promoting community services in a disadvantaged region in the North of England. The paper shows how CVS providers engaged in apparently contradictory practices, fluctuating between an empathically informed response to complex resident circumstances and (in the context of meeting externally set targets) behavioural lifestyle approaches to health promotion. Drawing on concepts from figurational sociology, the paper explains how lifestyle drift occurs in health promotion as a result of the complex web of relations (with funders, commissioners and residents) in which CVS providers are embedded. Despite the fact that research has revealed the impact of targets on the work of the CVS before, this paper demonstrates more specifically the way in which monitoring processes within CVS contracts can draw providers into the neoliberal lifestyle discourse so prevalent in health promotion. [ABSTRACT FROM PUBLISHER]

Research has been and will continue to be important to the music therapy profession, as evidenced by the number of studies examining the evolution of research in the field. Despite its seeming importance, no recent studies have investigated the extent to which music therapists find research relevant to practice and very few studies have examined this topic outside of the United States. The purposes of this study were to (a) examine the extent to which music therapists around the world view research as relevant to clinical practice and (b) among those who read research, identify which sections from scientific papers are read. This nonexperimental study involved an online survey of music therapists from 51 countries. Of the 1586 initially responding to the participant invitation, 1272 music therapists completed the survey (a completion rate of 80%). Findings suggest that music therapists find research to be relevant to clinical practice and perceptions differ as a function of educational attainment and occupational role. Results also evidenced similar educational and occupational differences with regard to reading scientific papers. These findings parallel those from earlier studies indicating those with higher educational attainment and working in academic/research-related positions tend to find research more relevant. These findings are important because they suggest there may be a disconnection between the extant research and the end consumer, the clinician. [ABSTRACT FROM PUBLISHER]

Limb salvage surgery is a surgical procedure for tumour resection in bone and soft-tissue cancers. Guidelines aim to preserve as much function and tissue of the limb as possible. Surgical outcome data is routinely available as part of surgical reporting processes. What is less known are important non-oncological outcomes throughout recovery from both clinical and patient perspectives. The objective of this review was to explore non-oncological outcomes in patients diagnosed with sarcoma around the knee following limb salvage surgery. A scoping review methodology was used, and results analysed using CASP checklists. Thirteen studies were included and following appraisal and synthesis, three themes emerged as providing important measures intrinsic to successful patient recovery: (1) physical function, (2) quality of life and, (3) gait and knee goniometry. Specifically, patients develop range of motion complications that alter gait patterns and patients often limit their post-operative participation in sport and leisure activities. This study has shown the importance of exploring confounding factors, adopting a holistic view of patient recovery beyond surgical outcomes, proposing evidence-based guidance to support and inform healthcare providers with clinical decision-making. This review highlights the paucity and lack of quality of research available, emphasising how under-represented this population is in the research literature. Patients having undergone LSS often have limited participation in sport and leisure activities. Patients can develop range of motion complications, such as flexion contracture or extension lag, which may affect the pattern of gait. Clinical consideration should be given to walking ability and gait patterns during the rehabilitation phase to prevent poor functional outcomes during recovery. Variation of treatment protocols, outcome measurement and rehabilitative care has been identified as important in predicting the outcomes in recovery from LSS procedures. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses various reports published within the issue including one by Ian Hacking on Philosophy of Mathematics, one by Jan-Willem Romeijin on the role and nature of experiments and observation in science, and one by Marion Vorms on the status of theories and the metaphysics of science.

The article discusses various topics published within the issue including one on the significance of observational method in learning, and another on the abbreviated version of an interview with author Gianna Polacco Williams.

Purpose: In this paper, we critically investigate the implementation of person-centered care with the purpose of advancing philosophical debates regarding the overarching aims and delivery of rehabilitation. While general agreement exists regarding person centered care's core principles, how practitioners reconcile the implementation of these principles with competing practice demands remains an open question. Materials and methods: For the paper, we drew on post-qualitative methods to engage in a process of "diffractive" analysis wherein we analyzed the micro-doings of person-centered care in everyday rehabilitation work. Working from our team members' diverse experiences, traditions, and epistemological commitments, we engaged with data from nine "care events" generated in previous research to interrogate the multiple forces that co-produce care practices. Results: We map our analyses under three categories: scripts mediate practice, securing compliance through "benevolent manipulations", and care(ful) tinkering. In the latter, we explore the notion of tinkering as a useful concept for approaching person centered care. Uncertainty, humility, and doubt in one's expertise are inherent to tinkering, which involves a continual questioning of what to do, what is best, and what is person centered care within each moment of care. The paper concludes with a discussion of the implications for rehabilitation and person-centered care. Determinations of what constitutes good, better, or best rehabilitation practices are inevitably questions of ethics. Person-centered care is promoted as good practice in rehabilitation because it provides a framework for attending to the personhood of all engaged in clinical encounters. Post-critical analyses suggest that multiple interacting forces, conditions, assumptions, and actions intersect in shaping each rehabilitation encounter such that what constitutes good care or person-centered care cannot be determined in advance. "Tinkering" is a potentially useful approach that involves a continual questioning of what to do, what is best, and what is person-centered care within each moment of care. [ABSTRACT FROM AUTHOR]

Though there is growing enthusiasm for computational research methods in the field of communication, research using computational methods is not yet integrated into mainstream communication research. This paper promotes such integration by highlighting niche for computational research within communication – the specialized roles it can play in symbiosis with researchers using other methods in the field. This paper articulates this niche via the computational communication researcher's specific comparative advantages for testing existing communication theory and generating novel communication theoretic ideas. It then proposes four recommendations for performing and evaluating computational communication research to facilitate meeting these objectives. [ABSTRACT FROM AUTHOR]

The aim of this integrative literature review was to identify high quality empirical research and theoretical literature on the sources of meaning in life and people's beliefs regarding the meaning of life. This will inform current mental health clinical practice and research by providing a synthesis of empirical and theoretical literature. Failure to address meaninglessness or the existential crisis can lead to psychopathologies such as depression, anxiety, addiction, aggression, hopelessness, apathy, lower levels of well-being, physical illness, and suicide. Integrative literature reviews incorporate empirical research and theoretical literature. The inclusion criteria were primary research and theoretical papers and books by prominent theorists. Thirty-nine items underwent the critical appraisal process. Thirty-two papers or books were included. Overwhelmingly the results revealed that relationships, particularly relationships with family, are cited as the most important source of meaning in people's lives in all cultures and age groups. There was no consensus identified to answer the meaning of life question. These results and future research will allow mental health clinicians to help patients deepen their understanding of themselves, identify where they find meaning and understand their beliefs about meaning of life, contributing to a reduction in symptomatology and meaninglessness, and an increase in happiness, life satisfaction, positive affect, better coping, psychosocial health and well-being, and more meaningfulness in life. [ABSTRACT FROM PUBLISHER]

Changing and challenging social norms is essential to preventing gendered violence, and education is widely regarded as a key means through which this can happen. Whilst good-quality research exploring the outcomes of such educational interventions exists, very little is known about what actually happens inside educational spaces aiming to instigate change. This gap limits understandings of how and why change does (or does not) happen. This paper aims to address this by providing an opportunity to peer into a ‘space for change’. To do this, observational data are analysed from a non-formal education programme aiming to empower girls to be free from violence in Kenya. Three moments are explored which illustrate ‘empowerment’, ‘subversion’ and ‘resistance’. The paper also explores the often hidden stories of the facilitators, showing that who teaches can be as important as the curriculum used in determining what happens inside educational spaces for change. [ABSTRACT FROM PUBLISHER]

We investigated the correlations and agreement between cognitive assessments made using a computerised (CogState™, six domains) and a standard pen-and-paper battery (five domains) in PWH and lifestyle-similar HIV-negative individuals. Demographically adjusted domain and global T-scores were obtained and used to define cognitive impairment according to the multivariate normative comparison (MNC) criteria. Correlations between T-scores and the agreement between the classifications of cognitive impairment obtained from the two batteries were assessed using the Spearman's rank correlation and Cohen's κ, respectively. The correlation between global T-scores from the two batteries was 0.52 (95% CI 0.44–0.60) in PWH and 0.45 (0.29–0.59) in controls (p = 0.38 for their difference). Correlations were generally stronger between domains within the same battery than between those from different batteries. The agreement between the two batteries in classifying individuals as cognitively impaired or not impaired was fair in PWH (κ = 0.24) and poor in HIV-negative individuals (κ = −0.02). The moderate correlation between overall cognitive function and the modest agreement between binary classifications of cognitive impairment obtained from two different batteries indicate the two batteries may assess slightly different components of cognition. [ABSTRACT FROM AUTHOR]

Pain disorders affect a large number of individuals throughout the world and are costly. Although randomized clinical trials assess the efficacy (i.e., how well treatments work in controlled settings) of pain pharmacotherapy, clinical trials do not assess effectiveness (i.e., how well treatments work in real-world settings). The number of observational studies that use real-world data to assess the effectiveness of medications is increasing rapidly in many disease areas. It is important for clinicians to understand how real-world data may be used to assess the effectiveness of medications. This paper aims to review the current body of literature assessing the effectiveness of pain pharmacotherapy using medical records. To do this, a literature search was conducted to identify papers published between January 2013 and September 2015 that examined the effectiveness of pain pharmacotherapy using electronic medical records. The search found only three papers meeting these criteria, which were described, reviewed, and critiqued in this paper. Electronic medical records are an underutilized source of data to assess pain outcomes in real-world settings. Although there are many methodological challenges in using these data, there is also great opportunity to impact clinical practice and explore the real-world effectiveness of pharmacotherapy used in pain management. [ABSTRACT FROM AUTHOR]

Child Sexual Abuse (CSA) has been linked to a wide variety of adverse psychological and behavioral outcomes. This paper describes girls' sexual development in the inner city based on qualitative material from a long-term ethnographic (observational) study. For many inner-city girls, early and then continued experiences of being compelled to have sex were found to be part of a pathway leading to independent sexuality that often involved prostitution, teen pregnancy, early motherhood, school dropout, limited involvement with jobs, drug abuse, multiple children by different fathers and single-parent families. Quotes from respondents illustrate the mechanics of this process and how it is sustained by the deprivations of structural disadvantage, prevailing subcultural norms, violence and illicit drug use. [ABSTRACT FROM AUTHOR]

Paliperidone palmitate (PP), a long‐acting intramuscular formulation of paliperidone, has been marketed in Europe within the last 10 years and provides an important treatment option for patients with schizophrenia. Our aim was to describe PP-related adverse drug reactions (ADRs) leading to death or life-threatening events, specifying their main clinical and pharmacological characteristics. This observational study was a retrospective review of PP-related ADRs in the French pharmacovigilance database between January 1, 2013, and December 31, 2019. Out of 473 PP-related ADRs, we identified 13 deaths and 14 life-threatening events. ADRs were primarily cardiorespiratory (n = 17; 63%). Other symptoms observed were mainly metabolic (n = 4), digestive (n = 4), and neurological (n = 4). Cardiorespiratory symptoms were generally observed within first 6 months after initiation of treatment (11 out of 17 cases), unlike metabolic disorders (all 4 cases 12–21 months after initiation). Cardiac arrests and sudden unexpected deaths occurred 10–14 days after the last PP once-monthly injection (23 cases) or 11–24 days after the last PP three-monthly injection (remaining 4 cases). No PP blood concentration assays were performed for these patients. In this study, PP-related ADRs leading to death or life-threatening events mainly presented with cardiorespiratory symptoms and tended to occur in the first 6 months after the initiation of treatment and within postadministration periods aligned with peak plasma PP concentrations. The hypothesis of supratherapeutic drug concentrations following intramuscular PP injection must be raised. PP-related ADRs leading to death or life-threatening events mainly presented with cardiorespiratory symptoms. Cardiac arrests and sudden unexpected deaths following initiation of PP treatment could be due to supratherapeutic drug concentrations. This study highlights the need to monitor blood concentrations of PP. Adverse reactions to paliperidone palmitate can lead to death or life-threatening events. It is hypothesized that cardiac arrests and sudden unexpected deaths following initiation of paliperidone palmitate treatment could be due to supratherapeutic drug concentrations. This paper proposes the need to monitor blood concentrations of paliperidone palmitate in future studies. [ABSTRACT FROM AUTHOR]

This is the abstract that was submitted online with the paper: Despite the fact that many survivors of human trafficking have experienced complex trauma, there are no established interventions designed to specifically address these impacts. Leaders in the field of complex trauma have advocated for the need for somatic approaches to intervention. This paper presents STARS Experiential Group treatment, the first structured bodybased group intervention that has been designed to address complex trauma in survivors of human trafficking. Three pilot groups were run in residential settings with adolescent and adult survivors of sex trafficking. Two adaptations were utilized, with one focusing on application of expressive arts modalities and the other incorporating theater games. Qualitative results, using thematic analysis, identified several themes related to challenges and potential benefits of these groups. Potential benefits of the STARS groups were found in the areas of Interpersonal Relationships, Regulation, and Self/ Identity, with fourteen sub-themes further describing positive impacts. Challenges within these areas are explored, to inform the development of group interventions for trafficking survivors. The results of this paper suggest that experiential, somatically-oriented group treatment shows promise as an important element of holistic intervention with trafficking survivors [ABSTRACT FROM AUTHOR]

This paper primarily examines the perspectives of dying persons in Germany, in terms of if and when the dying feels lonely during their final weeks. The author contrasts emic perceptions with public discourses in regards to the non-dying ones possibly neglecting or tabooing the terminally ill. Secondly, the paper explores how and where the dying persons included in the study want to pass away. The dying individuals involved did not feel tabooed or ignored by non-dying persons. Dying at home did not necessarily remain the preferred option compared to dying at institutions. The author collected data between 2013 and 2015 in Western Germany, using long-term participant observation and interviews with individuals diagnosed as terminally ill. [ABSTRACT FROM AUTHOR]

This paper is an ethnography of a four-year, multi-disciplinary adolescent sexual and reproductive health intervention in Bolivia, Nicaragua and Ecuador. An important goal of the intervention – and of the larger global field of adolescent sexual and reproductive health – is to create more open parent-to-teen communication. This paper analyzes the project's efforts to foster such communication and how social actors variously interpreted, responded to, and repurposed the intervention's language and practices. While the intervention emphasized the goal of ‘open communication,’ its participants more often used the term ‘confianza’ (trust). This norm was defined in ways that might – or might not – include revealing information about sexual activity. Questioning public health assumptions about parent–teen communication on sex, in and of itself, is key to healthy sexual behavior, the paper explores a pragmatics of communication on sex that includes silence, implied expectations, gendered conflicts, and temporally delayed knowledge. [ABSTRACT FROM AUTHOR]

This paper addresses the working practices of a mobile mental health outreach team in a large French city, one that ‘targets’ homeless people with severe psychiatric disorders who are considered ‘hard to reach’ by the public health authorities and medical services. Analysis of the team's work – where acts of curing and caring are closely tied – reveals the importance of moving beyond a polarized vision ofcureandcare. The paper departs from much of the literature on the medicalization of social problems by arguing that medicalization is not only a means of social control, but has ethical value as well. In examining the practices of frontline health workers, it aims to show that integrating the methods and theoretical approaches of social work in medical practice is necessary to address the specific problems of homeless people, to enable health professionals to pursue medical cures, and to challenge the shortcomings of public policy. [ABSTRACT FROM AUTHOR]

This paper examines the biopolitics of HIV and labour migration from Pakistan (a country classified by UNAIDS as at ‘high risk’ of a generalised epidemic) to the countries of the Gulf Cooperation Council (GCC). The remittances by the labour migrants in the Gulf are an invaluable source of foreign exchange for Pakistan and a large number of households are entirely dependent upon them. At the same time, the National AIDS Control Programme regards Gulf migrants as a key risk factor for an HIV epidemic. The majority of HIV positive people in clinics comprise Gulf returnee migrants and their family members. This paper suggests that in the process of migrating, prospective migrants are subjected to structural violence that increases their HIV vulnerabilities. In this process, they are subjected to regimes of medical inspection, reduced to their certifiable labour power, inscribed with nationalist ideologies identifying HIV as a disease that strikes ‘the other’, and exposed to exploitation that increases their vulnerabilities. After migration, they are made to undergo compulsory periodic medical examinations in the GCC and, if found to be HIV positive, they are forcibly deported without papers, proper diagnosis or healthcare – only to return as ‘failed subjects’. Taking a disaggregated view of the state, the paper argues that, in order to be effective, debates on structural violence and the HIV epidemic must make explicit the role of the state in producing migrants’ vulnerabilities. [ABSTRACT FROM PUBLISHER]

HIV/AIDS is a major driver of livelihood insecurity. The AIDS epidemic, through the death or disability of economically productive adults, destabilises and erodes the social networks which sustain the livelihoods of vulnerable households. This paper draws upon research with home-based care workers and family members of 14 households directly affected by HIV/AIDS in the rural district of Nkomazi, South Africa. Through a social capital framework this study reveals the fragile linkages between households and broader kin networks demonstrating the (in)ability of the households to adapt and manage the economic and social impact of the epidemic. The chronic financial burden of the epidemic on poor households compounded by HIV/AIDS-related stigma undermines kinship ties resulting in the extended family becoming more conditional, temporary and at times destructive. The extended family cannot be romanticised as a ‘safety net’ and instead needs to be problematised for its complexities, limitations and constraints while ensuring sufficient external support is provided to sustain the care and support provided by the family and local community. [ABSTRACT FROM PUBLISHER]

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In emergencies, such as the COVID-19 pandemic, there is an increased need for contact with emergency medical services (EMS), and call volume might surpass capacity. The Copenhagen EMS operates two telephone line the 1-1-2 emergency number and the 1813 medical helpline. A separate coronavirus support track was implemented on the 1813 medical helpline and a web-based self-triage (web triage) system was created to reduce non-emergency call volume. The aim of this paper is to present call volume and the two measures implemented to handle the increased call volume to the Copenhagen EMS. This is a cross sectional observational study. Call volume and queue time is presented in the first month of the COVID-19 pandemic (27th of February 2020 to 27th of march) and compared to the equivalent month from the year before (2019). Descriptive statistics are conducted on call volumes and queue times and spearman's rank correlation test are performed to test correlation between web triage and call volume. Total EMS call volume increase by 23.3% between 2019 and 2020 (92.670 vs. 114,250). The 1-1-2 emergency line total call volume increase by 4.4% (8,4942 vs. 8,870) and the 1813 medical helpline increased by 25.1% (84.176 vs. 105.380). The coronavirus support track handled 21,063 calls. The 1813 medical helpline queue time was a mean of 02 minutes and 23 seconds (CI: 2.22-2.25) in 2019 and 12 minutes and 2 seconds (CI 11:55-12:09) in 2020 (P < 0.001). The web triage was used 10,894 times. No correlation between call volume and web triage usage was seen. In the first month of the ongoing COVID-19 pandemic a significant increase in call volume was observed in the 1813 medical helpline compared to 2019. A large number of calls were handled by the additional coronavirus track and diverted away from the regular tracks of the 1813 medical helpline. This likely contributed to mitigating increased call volumes and queue times. The web triage was widely used but no significant correlation was seen with 1813 medical helpline call volume. Other EMS organizations can learn from this to enhance capacity in a future epidemics. [ABSTRACT FROM AUTHOR]

Concise and effective business English communication underpins successful organisations. During the 4th Industrial Revolution (4IR) much of the working day is spent in some form of communication, usually e-mails. This paper examines the effectiveness of English communication between integral parts of a business operation during the 4IR. A mixed methods approach utilising a non-experimental design was used to investigate effective business communication using e-mails in English in a medium sized organisation in South Africa. A questionnaire consisting of 10 Likert type scale questions and 5 open ended questions was used. Purposive sampling was utilised as the population was small (150 employees, final sample 55) thus results cannot be generalised. Certain barriers to communication were identified which were considered important. For instance, many staff members were second language English speakers and often misunderstand e-mails. As a result, they reported that they felt frustrated in their working life and were demotivated. It was concluded that many e-mails were challenging to staff and needed to be written in everyday English not business language. The authors recommended that workshops and initial training in business language skills when people enter the organisation should be undertaken. Human Resources could also audit the use of appropriate English. [ABSTRACT FROM AUTHOR]

Purpose:This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). Methods and results:An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. Conclusions:TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings.Implications for RehabilitationTriangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners.TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support.TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals. [ABSTRACT FROM PUBLISHER]

The Open Science (OS) movement promises nothing less than a revolution in the availability of scientific knowledge around the globe. By removing barriers to online data and encouraging publication in Open Access formats and Open Data archives, OS seeks to expand the role, reach and value of research. The promises of OS imply a set of expectations about what different publics hope to gain from research, how accountability and participation can be enhanced, and what makes science public in the first place. This paper presents empirical material from fieldwork undertaken in (bio)chemistry laboratories in Kenya and South Africa to examine the extent to which these ideals can be realized in a sub-Saharan context. To analyse the challenges African researchers face in making use of freely available data, we draw from Amartya Sen’s Capabilities Approach. His theorisations of ‘conversion factors’ helps to understand how seemingly minor economic and social contingencies can hamper the production and (re-)use of online data. In contrast to initiatives that seek to make more data available, we suggest the need to facilitate a more egalitarian engagement with online data resources. [ABSTRACT FROM PUBLISHER]

A growing ageing population and an increasing reliance on information and communication technologies (ICT) to conduct activities associated with daily living means that addressing how older people learn to use ICT is timely and important. By drawing on a four-year ethnographical study with 420 older people in two different environments, this paper shows that they adopt three strategies to become successful ICT learners, while at the same time dealing with the effects of age-related changes in fluid memory: (a) linking learning to real-life needs, (b) learning collaboratively and informally, and (c) adopting appropriate memory aids. This paper also addresses the question of how valid these results will be when today's ICT-literate adult people grow older. The longitudinal aspect of the data gathered shows that older people become confident ICT learners over time, that the learning strategies and cognitive-related difficulties are mostly time-persistent, and that their life experience is always important in learning transfer. Implications for providing older people with a more integrated approach to ICT learning are discussed. [ABSTRACT FROM PUBLISHER]

The large number of international medical graduates (IMGs) working in Australia, and many other countries around the world, has received significant attention from the media, governments and academia. These institutions utilise a number of classificatory schemes in order to categorise IMGs. Such classification is often stigmatising, yet goes largely unquestioned. In this paper I show that the 'official naming' of IMGs in Australia, as well as the naming of IMGs by staff in hospitals, is historically, politically and socially produced. Following Bourdieu's call to also study how the classified classify, the paper goes on to examine ways in which IMGs name and categorise each other, drawing on ethnographic research. I argue that IMGs use classification themselves, strategically, in order to modify their marginalised position within the 'social space' of the hospital. The article questions taken-for-granted assumptions about classified groups such as IMGs and leaves an opening for change. [ABSTRACT FROM AUTHOR]