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The paper provides an overview of the global research on graduate education. The study applied a combination of a bibliometric and social network analysis methods to bibliographic data from Thompson Reuters' Web of Science. More specifically, a keyword search approach was used to retrieve 2,454 articles on graduate education from 1996 until 2020. The set was processed with the VantagePoint software. The paper reports the findings in the form of lists of top scholars, research centres, and countries contributing to research on graduate education. The findings include similar lists of the key funding agencies, contributing disciplines and publication venues, as well as maps representing collaborative activity in the field between institutions, and countries. Finally, the frequency of utilisation of groups of author-supplied keywords is analysed to determine the basic thematic structure of the research on the topic. The originality of the paper consists in the fact that it represents the first attempt to map the landscape of research on graduate education using bibliographic data. It can be used to supplement the results of literature reviews on the topic, which apply a more in-depth content analysis-based approaches to a limited number of papers to determine the thematic structure of the field.

The purpose of this article is to explore the development of the knowledge base on middle leadership in schools. Since the seminal reviews conducted by Bennett a contemporary scan only of the scholarly literature on middle leaders/leadership in schools has not been undertaken. Consequently, this article looks at outputs relating to this topic by examining research papers indexed in the Web of Science and in SCOPUS between 2003 and 2017. The prime purpose of this review is to offer some reflections on the development of the empirical base on middle leadership in schools since 2003 and to highlight some of the implications for future research. The article concludes that middle leadership in schools remains an ongoing focus of research inquiry in a growing number of countries but suggests that the knowledge base would benefit from more sophisticated empirical studies and greater theoretical analysis.

Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

This paper draws on findings from a European project, 'Rights through Alliances: Innovating and Networking Both Within Homes And Schools' (RAINBOW-HAS), conducted in 2013-15. It built collaboration between six EU countries to analyse and improve the rights of children and youth regarding sexual orientation and gender identity in educational settings. The main focus of discussion derives from a secondary discourse analysis following thematic analyses of the qualitative interviews undertaken with a range of different families, schools and community associations across these European countries, which provide a snapshot of contemporary practice. We discuss the relative silence of social work in challenging homophobic and transphobic bullying, given their potential in promoting family and young people's engagement. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since the mid-1990 s, Prevention through Design (PtD) has become increasingly prevalent in the built environment. The acceptance of PtD has largely been due to the removal or reduction of risks during the execution phase of construction projects. European States have had the added impetus of national legislation. OBJECTIVE: This paper analyzes the influence of European Union Directive 92/57/EEC on occupational safety and health injury prevention in the project design phase. METHODS: Qualitative methods comprised individual semi-structured interviews and focus groups with a panel of experts. Sixty individuals from construction and related professions (architects, engineers, constructors, developers, and other construction experts) answered 17 key questions to establish national perceptions of the effectiveness of Directive 92/57/EEC in Spain and the United Kingdom (UK). RESULTS: The implementation of PtD in the project design phase in the UK is clearer since the regulations explicitly state the obligations of project designers as well as those of the coordinator. Interviews with Spanish experts show that, in Spain, the prevention culture is less frequently realized. CONCLUSIONS: The most significant differences between the European Directive and national regulations which influence PtD are linked to the Health and Safety Coordinator, and Health and Safety documents. [ABSTRACT FROM AUTHOR]

Objective: Local wound infections are a major challenge for patients and health professionals. Various diagnostic and therapeutic options are available. However, a generally accepted standard is still lacking in Europe. The aim was to develop an easy-to-use clinical score for the early detection of local wound infections, as a basis for decisionmaking on antiseptic therapy or decolonisation. Method: An interdisciplinary and interprofessional panel of experts from seven European countries was brought together to discuss the various aspects of diagnosing local wound infections. Results: The result was the adoption of the Therapeutic Index for Local Infections (TILI) score, developed in Germany by Initiative Chronische Wunden e.V., specifically for health professionals not specialised in wound care. Available in six European languages, the TILI score could also be adapted for different European countries, depending on their specific national healthcare requirements. The six clinical criteria for local wound infection are erythema to surrounding skin; heat; oedema, induration or swelling; spontaneous pain or pressure pain; stalled wound healing; and increase and/or change in colour or smell of exudate. Meeting all criteria indicates that antiseptic wound therapy could be started. Regardless of these unspecific clinical signs, there are also health conditions for the clinical situation which are a direct indication for antimicrobial wound therapy. These include the presence of wound pathogens, such as meticillin-resistant Staphylococcus aureus, septic surgical wound or the presence of free pus. Conclusion: The development of the new internationally adapted TILI score, which could also be used by any caregiver in daily practice to diagnose local infections in acute and hard-to-heal wounds, is the result of expert consensus. However, the score system has to be validated through a clinical evaluation. This is to be performed in expert centres throughout Europe. Declaration of interest: JD has received research support, lecture fees and travel-cost reimbursements from 4M, Coloplast, Convatec, Draco, Engelhardt, Paul Hartmann, KCI, Lohmann&Rauscher, Mölnlycke, SastoMed and Urgo. RL has received research support, lecture fees and travel-cost reimbursements from Mölnlycke and Urgo. AK has received research support, lecture fees and travel-cost reimbursements from 3M, B. Braun Melsungen, Bode/Paul Hartmann, Ethicon, Lohmann&Rauscher, Mundipharma, Oculus, SastoMed Schülke&Mayr, SERAG-WIESSNER and Urgo. JVS has received research support, lecture fees and travel-cost reimbursements from Mundipharma, Histocell, Quesper and Urgo. This work was supported by an unlimited grant from Urgo Medical. The views expressed are those of the authors and do not necessarily reflect those of Urgo Medical. The company had no direct influence on the content of this paper. [ABSTRACT FROM AUTHOR]

Introduction: Educators require focused training to foster the development of intercultural competence in nurses. Training programs for educators need to be based on a comprehensive profile with a focus on intercultural learning. This study aims to define and validate a profile of the Intercultural Nursing Educator (INE). Method: The Delphi method was used with an iterative, multi-stage process to transform opinions into group consensus. A total of 46 European, African, and American experts from the nursing and intercultural field participated. Inclusion criteria required English at a level of B2, expertise in the field of intercultural competence, experience in teaching intercultural competence in the nursing context, and publications focused on intercultural topics. Results: The INE profile was developed and all 126 competencies were validated. Discussion and conclusion: The profile is freely available on the project website and provides the basis for curricula, training programs and assessment of the required competences. [ABSTRACT FROM AUTHOR]

O'BRIEN T and ACKROYD S. Nursing Inquiry 2012; 19: 39-50 Understanding the recruitment and retention of overseas nurses: realist case study research in National Health Service Hospitals in the UK This paper illustrates one of the possible applications of critical realist ideas to the analysis of health services, in the use of comparative case study research design, to elucidate the causal social processes underlying events. In the research reported here, a comparative research design was used as a basis for improving our understanding of the processes involved in the assimilation of overseas nurses (OSN) into the salient long-term workforce of the National Health Service (NHS) hospitals in the UK. The work brought to light the salient experiences of overseas nurses during their initial work in the NHS hospitals, and these were used as a basis for developing an account of the general mechanisms typically underlying the recruitment and assimilation at work. The authors conclude that successful assimilation is often hindered by the presence of occupational closure mechanisms, by which home nurses effectively excluded recruits from participation and promotion; these mechanisms, which articulate with everyday racism, threaten successful assimilation for obvious reasons. If the treatment recruits receive does not lead to withdrawal, it is because they typically have very strong economic motives to continue despite unfavourable and sometimes inhumane treatment. Thus, the research offered substantial reasons why recruitment policies should be reviewed by policy-makers. [ABSTRACT FROM AUTHOR]

Background: People experiencing homelessness (PEH) are known to be at higher risk of adverse health outcomes and premature mortality when compared to the housed population and often face significant barriers when attempting to access health services. This study aimed to better understand the specific health care needs of PEH and the barriers and facilitators associated with their timely and equitable access to health services in the European context. Methods: We conducted an exploratory cross-national qualitative study involving people with lived experience of homelessness and health and social care professionals in Austria, Greece, Spain, and the UK. A total of 69 semi-structured interviews comprising 15 social care professionals, 19 health care professionals, and 35 PEH were completed, transcribed, and analysed thematically. Results: Findings were organised into three overarching themes relating to the research question: (a) Health care needs of PEH, (b) Barriers to health care access, and (c) Facilitators to health care access. Overall, the general health of PEH was depicted as extremely poor, and mainstream health services were portrayed as ill-equipped to respond to the needs of this population. Adopting tailored approaches to care, especially involving trusted professionals in the delivery of care, was identified as a key strategy for overcoming existing barriers. Conclusions: The results of this study indicate there to be a high degree of consistency in the health care needs of PEH and the barriers and facilitators associated with their access to health care across the various European settings. Homelessness in itself is recognized to represent an essential social determinant of health, with PEH at risk of unequal access to health services. Changes are thus required to facilitate PEH's access to mainstream primary care. This can also be further complemented by investment in 'in-reach' services and other tailored and person-centred forms of health care. Trial registration: This study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687. [ABSTRACT FROM AUTHOR]

Scholarly interest in the experience of dehumanization, the perception that one is being dehumanized, has increased significantly in recent years, yet the construct lacks a validated measurement. The purpose of this research is therefore to develop and validate a theoretically grounded experience of dehumanization measurement (EDHM) using item response theory. Evidence from five studies using data collected from participants in the United Kingdom (N = 2082) and Spain (N = 1427), shows that (a) a unidimensional structure replicates and fits well; (b) the measurement demonstrates high precision and reliability across a broad range of the latent trait; (c) the measurement demonstrates evidence for nomological and discriminant validity with constructs in the experience of dehumanization nomological network; (d) the measurement is invariant across gender and cultures; (e) the measurement demonstrates incremental validity in the prediction of important outcomes over and above conceptually overlapping constructs and prior measurements. Overall, our findings suggest the EDHM is a psychometrically sound measurement that can advance research relating to the experience of dehumanization. [ABSTRACT FROM AUTHOR]

Background: Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long‐term conditions such as Parkinson's disease. Objective: This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. Methods: A mixed‐methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta‐ethnography approach was used to analyse and synthesize cross‐national findings. Results: A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. Conclusions: Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. Patient or Public Contribution: Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of the study was to compare advanced practice in epilepsy nurses in Spain and United Kingdom, identifying differences in the domains of standard advanced practice. Background: Europe has recently faced the challenge of providing high‐quality care for patients with epilepsy, a disease that generates many health demands. In some countries, such as the United Kingdom, advanced practice nursing is well established and could serve as a guide for implantation in countries where it is still in development, as is the case of Spain. Design: A multicentre cross‐sectional descriptive cohort study compared differences in the roles of advanced practice nurses in Spain and the United Kingdom. Methods: The Advanced Practice Role Delineation Tool and its validated Spanish version were administered using an online questionnaire in a cohort of advanced practice epilepsy nurses in both countries. A convenience sample was recruited between January to December 2019. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: Most United Kingdom nurses in our sample came from community environments, in contrast to Spanish nurses who worked in hospital. All domains analysed in the survey had significantly higher scores in the United Kingdom than in the Spanish cohort, especially in the research and leadership domains. Conclusions: The advanced practice role in Spain is underdeveloped compared with the United Kingdom. Differences in the settings of advanced roles in epilepsy nurses may be explained by greater community practice in the United Kingdom and differences in organisational and health systems. Relevance to clinical practice: Our study showed the need to implement specific policies to develop advance practice nurse roles in Spain to improve the quality of care of patients with epilepsy. [ABSTRACT FROM AUTHOR]

The question of how migrants’ language use affects their ethnic identity has received considerable attention in the literature. There is, however, little understanding of how this relationship manifests or is negotiated in interethnic families. This article presents an in-depth exploration of Spanish mothers’ experiences of Spanish- and English-language interactions with their English-born children. Semistructured interviews were conducted with Spanish mothers living in Britain in interethnic partnerships and transcripts were subjected to interpretative phenomenological analysis. Analysis reveals a process of identity change where participants’ shifting ethnic identifications with host and heritage culture is intimately related to their language use with their children. Pivotal to this process is the participants’ need to maintain their “Spanish mother” identity, a desire that can only be fulfilled by transferring their heritage language to their children and speaking it with them. Findings reveal how this dynamic affects perception of family roles, relationship quality, and psychological well-being. [ABSTRACT FROM AUTHOR]

Background: The Seven Countries Study in the 1960s showed very low mortality from coronary heart disease (CHD) in Japan, which was attributed to very low levels of total cholesterol. Studies of migrant Japanese to the USA in the 1970s documented increase in CHD rates, thus CHD mortality in Japan was expected to increase as their lifestyle became Westernized, yet CHD mortality has continued to decline since 1970. This study describes trends in CHD mortality and its risk factors since 1980 in Japan, contrasting those in other selected developed countries.Methods: We selected Australia, Canada, France, Japan, Spain, Sweden, the UK and the USA. CHD mortality between 1980 and 2007 was obtained from WHO Statistical Information System. National data on traditional risk factors during the same period were obtained from literature and national surveys.Results: Age-adjusted CHD mortality continuously declined between 1980 and 2007 in all these countries. The decline was accompanied by a constant fall in total cholesterol except Japan where total cholesterol continuously rose. In the birth cohort of individuals currently aged 50-69 years, levels of total cholesterol have been higher in Japan than in the USA, yet CHD mortality in Japan remained the lowest: >67% lower in men and > 75% lower in women compared with the USA. The direction and magnitude of changes in other risk factors were generally similar between Japan and the other countries.Conclusions: Decline in CHD mortality despite a continuous rise in total cholesterol is unique. The observation may suggest some protective factors unique to Japanese. [ABSTRACT FROM AUTHOR]

The article focuses on the investigation on the use of cane among blind and partially sighted people with late onset visual impairment considering their experiences and attitudes across countries. The semi-structured interview was carried out as part of the main method of gathering data. The several factors considered in data gathering which includes psychological and related barriers, safety, and adaption and acceptance of the cane use.

Varicella-zoster virus (VZV) is the causative agent of both varicella (chickenpox) and herpes zoster (HZ) (shingles). After varicella infection, the virus remains dormant in the host's dorsal ganglia and can reactivate due to waning cell-mediated immunity, causing HZ. Exposure of varicella-immune persons to VZV may boost the host's immune response, resulting in a protective effect against HZ. In this study, we used mathematical models of VZV transmission and HZ development to test the biological hypothesis of “progressive immunity,” originally proposed by Hope-Simpson (Proc R Soc Med. 1965;58:9–20), that cell-mediated protection against HZ increases after each episode of exposure to VZV. Predictions from a model incorporating such a hypothesis were compared with those of other concurrent models proposed for explaining HZ epidemiology. The progressive immunity model fits significantly better the age profile of HZ incidence for Finland (years 2000–2006), Italy (2003–2005), Spain (1997–2004), and the United Kingdom (1991–1992), suggesting that this mechanism may be critical in shaping HZ patterns. The model thus validated is an alternative to VZV models currently used to evaluate the impact of mass immunization programs for varicella and therefore extends the range of tools available to assist policy-makers with the present decision paralysis on the introduction of vaccination. [ABSTRACT FROM PUBLISHER]

This observational, prospective study was undertaken to estimate the burden of rotavirus (RV) gastroenteritis (GE) leading to general practitioner (GP)/family paediatrician (FP) visits among children aged <5 years in Czech Republic, Germany, Italy, Poland, Spain and the UK. Children aged <5 years presenting with acute GE provided stool samples for rapid RV testing. RV+ samples were confirmed and typed by RT-PCR. Demographic and clinical data were collected for all RVGE episodes. Transmission patterns among other household children aged <5 years were also assessed. From November 2005 to May 2007, excluding data from the UK, 497/3,813 (13.0%) children aged <5 years presenting with acute GE to GP/FP and tested were RV+ by PCR. Most RVGE cases (69.1%) occurred in children aged <2 years, occurred between December and May (93.1%) and were moderate or severe by Vesikari score (92.9%). RV strain distribution varied between countries: G9P[8] was the most common type in Poland (54/76) and Spain (172/196), G1P[8] was predominant in the Czech Republic (56/64) and Italy (46/107), and G4P[8] and G1P[8] both prevailed in Germany (17/54 and 13/54, respectively). A total of 24/122 (19.7%) children aged <5 years resident in the same household as a PCR+ study participant also developed RVGE. Conclusion. This multinational epidemiological study in Europe shows that RV is easily transmitted among household children, with RVGE burden highest among children aged <2 years accessing primary healthcare for acute GE. [ABSTRACT FROM AUTHOR]