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The prevalence of plagiarism, cheating, and other acts of academic dishonesty may be as high as 80% in populations of high school and post-secondary students. Various educational interventions have been developed and implemented in an effort to educate students about academic integrity and to prevent academic misconduct. We reviewed the peer-reviewed research literature describing face-to-face workshops, e-learning tutorials, or blended approaches for promoting academic integrity and the effectiveness of these approaches. In general, the educational interventions were described as effective in terms of satisfaction with the intervention, and changes in students' attitudes and knowledge of academic integrity. Few studies provided evidence that the educational interventions changed student behaviour or outcomes outside the context of the intervention. Future research should explore how participation in educational interventions to promote academic integrity are linked to long-term student outcomes, such as graduate school admission, alumni career success, service to society, and personal stability.

Traditional approaches to system management are not suited to highly uncertain conditions. Hard system approaches with a top‐down management approach are often used to manage well‐defined systems that are not easily able to cope with uncertainty. Soft system approaches of the with bottom‐up or participative style may cause a lack of conformance to industry standards. Few studies have investigated these approaches within the context of COVID‐19 pandemic. Therefore, this paper aims to use the philosophy of Total Systems Intervention to investigate the applicability of an integrated management approach to cope with the uncertainty of COVID‐19. Three different countries from Europe, Oceania and Asia are selected as typical case studies to clarify the strengths and weaknesses of differing management approaches. The case studies demonstrate that using an integrated management approach can potentially assist decision‐makers to deal with crises and conclusively reveal the superiority of the integrated approach, independent of cultural milieu. [ABSTRACT FROM AUTHOR]

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

Background: Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.Methods: This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.Results: The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.Conclusions: Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking. [ABSTRACT FROM AUTHOR]

Background: Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.Methods: This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.Results: The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.Conclusions: Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking. [ABSTRACT FROM AUTHOR]

The aim of this study is to identify the most prolific countries in the field of special education and to discuss the widespread impact of their papers by taking into account the country's h-index. Through a bibliometric analysis, the data were collected in the Web of Science Core Collection category "Education, Special" in the Social Science Citation Index during 2011-2020. The 25 most prolific countries in the field of special education were determined in terms of paper productivity, and it was seen that the leading country was undisputedly the USA (54.42%). Meanwhile, a strong positive correlation was found between the h-index and the number of papers published by the countries (r=0.864). On the other hand, when the ranking in terms of the number of papers was reconfigured by the h-index, it was relatively changed. The possible reasons for this change for the countries with the most changing rankings were discussed by considering some definitive criteria such as the journal quartiles, the percentage of international and domestic, and the percentage of open access papers. This study reports a positive correlation between the quality and quantity in the field of special education for the publications of countries. It has been shown that where the positive correlation deviates, then especially, the journal quartiles, the percentage of international collaboration and the percentage of open access papers have a significant effect. The bibliometric findings may be useful to enrich the discussion about the widespread impact of papers and debate whether the use of h-index is acceptable for cross-national comparisons.

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This specially themed ""Getting of Wisdom," Learning in Later Life" Edition of the "Australian Journal of Adult Learning" ("AJAL") is not so much concerned with the issue of ageing itself, but more about quality of life regardless of age. It is about taking, but also giving back as best as possible at any age. This special issue is a result of the one week "The Getting of Wisdom Exchange", a collaboration between around 100 adult education practitioners and researchers from ten countries from Australia, New Zealand, Asia and Europe. In this issue, papers are presented from Sweden, Ireland, Aotearoa/New Zealand, Australia, Slovenia, Poland, Germany, Portugal and the United Kingdom. Papers cover different topics and open questions about various issues in older people's learning.

In this study, the variables having impact on the student motivation have been analyzed based on the articles, conference papers, master's theses and doctoral dissertations published in the years 2000-2017. A total of 165 research papers were selected for the research material and the data were collected through qualitative research techniques through document review and content analysis. According to the research results, the most important factors affecting student motivation are the fields of teacher, teachers' classroom management skills and their teaching methods. In this research, factors having less influence on the student motivation are parental communication, student characteristics and study fields. In addition, relational search type was used more than others, mostly students were selected as the study group and most researches were conducted in USA and Turkey.

This article maps the scientific production and the contents associated with the sustainable development goals and their integration with universities during the past 21 years. Although many of the topics related to sustainable development goals (SDGs) have been addressed in different studies for decades, it is since 2015 onwards that they gained greater prominence due to the inclusion of higher education as an important actor in the fulfillment of the 2030 agenda and the United Nations SDGs. For the purpose of this paper, a bibliometric analysis of 871 papers, 535 documents in Scopus, and 336 in Web of Science (WoS) from 1998 to 2019 was performed, and the Bibliometrix analysis tool was used. The objective of this mapping is to answer the following research question: Is the integration of the Sustainable Development Goals and Universities a field of study? An analysis of the network of collaborators and trend topics in Scopus and WoS allows us to identify the concurrence and relationships of some keywords, such as sustainable development, sustainability and planning, and some background words, such as humans and global health. In another analysis, the word "higher education" is related to change. This article suggests that the integration of the Sustainable Development Goals in Universities is becoming a field of study under exploration, with a peak of production in 2016 and that has remained stable in the last three years, but thanks to the leading role assigned to Universities, intellectual production should increase in the following years.

Using data from the Program for the International Assessment of Adult Competencies, this paper compares the earnings premium and employment share of jobs in Science, Technology, Engineering and Mathematics (STEM) across 11 member countries of the Organisation for Economic Co-operation and Development. The results reveal that the STEM wage premium is higher in the United States than in any of the other comparison countries, despite the fact that the U.S. has a larger share of workers in STEM jobs. We also find evidence that the premium varies significantly across STEM sub-fields and education levels, and that the premium tends to be higher in countries with lower unionization rates, less employment protection, or a larger share of employment in the public sector.

This paper elaborates on a number of key criticisms of Mezirow's transformative learning theory as well as providing arguments that validate it. Our paper exemplifies how Mezirow's theory can help adult educators and prospective school teachers understand that social structures and belief systems can influence student learning, that learners make meaning of their experiences in various ways which influence the sort of value systems they develop and that disorienting dilemmas often challenge the validity of one's values and the assumptions that underpin them. It exemplifies how Mezirow's theory can be put into practice in Adult and Higher Education via three case studies undertaken by the authors in different places, at different times and with different sets of learners. These include mature aged women returning to study, PhDs at a Swedish Engineering University, and domestic and international students studying at an Australian regional university. The case studies make use of a values survey, interviews and subsequent focus groups. Data from the survey and interviews are analysed and used to argue that transformative learning (Mezirow, 1991) can be practiced, to good effect, in university staff development and teacher education courses.

While ChatGPT has recently become very popular, AI has a long history and philosophy. This paper intends to explore the promises and pitfalls of the Generative Pre-trained Transformer (GPT) AI and potentially future technologies by adopting a speculative methodology. Speculative future narratives with a specific focus on educational contexts are provided in an attempt to identify emerging themes and discuss their implications for education in the 21st century. Affordances of (using) AI in Education (AIEd) and possible adverse effects are identified and discussed which emerge from the narratives. It is argued that now is the best of times to define human vs AI contribution to education because AI can accomplish more and more educational activities that used to be the prerogative of human educators. Therefore, it is imperative to rethink the respective roles of technology and human educators in education with a future-oriented mindset.

The study of variables related to the use of ICT in the classroom is a topic of interest that has been frequently researched. In this paper, after examining the importance of teacher training in explaining the use of ICT in the classroom, we focused on analysing the weight of variables related to teaching practices and the organisational context of schools, which are variables that are less frequently addressed in the literature. To do so, a secondary analysis was carried out using data provided by the Teaching and Learning International Study (TALIS 2018). Specifically, we worked with a sample of 3,918 principals and 64,899 teachers from a total of 3921 schools in 21 countries. A multilevel binary regression model with random intercept, fixed coefficients and a two-level structure with teachers at level 1 and schools at level 2 was used. The results indicate that the presence of ICT in the classroom is associated with self-efficacy in teaching and the cognitive activation of students and with the organisational aspects of the school, which are scarcely addressed by the existing literature on this topic of interest, such as school climate, educational innovation and cooperation among teachers. Based on these results, we reflect on possible ways to promote the use of ICT in the classroom.

Volumetric prefabricated building construction is growing in most developed countries; for example, in Sweden the market share of prefabricated building systems in the housing industry was more than 80%. However, in Australia only approximately 3–4% of new building constructions are prefabricated buildings in a year. A major hindrance to the growth of prefab construction in Australia is that systems are developed under commercial and confidential conditions. There are limited publicly-available research and case studies for certifiers, regulators, engineers and academia to provide independent information on the performance, advantages and disadvantages of prefabricated building systems. Independent designers and structural engineers are relying on the strength of the structural and non-structural element, as well as the connections of the prefabricated building systems. This strength is estimated from the "commercial-in-confidence" test of individual components by manufactures, and it might result in undesired outcomes in design. This paper provides an overview of available literature on structural performance, benefits, constraints and challenges of prefabricated building systems. This paper also highlights the research needed on the prefabricated building systems such as full-scale tests, numerical modelling, hybrid simulations, case studies and social and economic assessments. Being supported by sound academic research will increase the market demand for prefabricated building systems in Australia as well as in other countries. [ABSTRACT FROM AUTHOR]

The death literacy index (DLI) was developed in Australia to measure death literacy, a set of experience-based knowledge needed to understand and act on end-of-life (EOL) care options but has not yet been validated outside its original context. The aim of this study was to develop a culturally adapted Swedish-language version of the DLI, the DLI-S, and assess sources of evidence for its validity in a Swedish context. The study involved a multi-step process of translation and cultural adaptation and two validation phases: examining first content and response process validity through expert review (n = 10) and cognitive interviews (n = 10); and second, internal structure validity of DLI-S data collected from an online cross-sectional survey (n = 503). The psychometric evaluation involved analysis of descriptive statistics on item and scale-level, internal consistency and test-retest reliability, and confirmatory factor analysis. During translation and adaptation, changes were made to adjust items to the Swedish context. Additional adjustments were made following findings from the expert review and cognitive interviews. The content validity index exceeded recommended thresholds (S-CVIAve = 0.926). The psychometric evaluation provided support for DLI-S' validity. The hypothesized six-factor model showed good fit (χ2 = 1107.631 p<0.001, CFI = 0.993, TLI = 0.993, RMSEA = 0.064, SRMR = 0.054). High internal consistency reliability was demonstrated for the overall scale (Cronbach's α = 0.94) and each sub-scale (α 0.81–0.92). Test-retest reliability was acceptable, ICC ranging between 0.66–0.85. Through a comprehensive assessment of several sources of evidence, we show that the DLI-S demonstrates satisfactory validity and acceptability to measure death literacy in the Swedish context. There are, however, indications that the sub-scales measuring community capacity perform worse in comparison to other sca and may function differently in Sweden than in the original context. The DLI-S has potential to contribute to research on community-based EOL interventions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Global software engineering education (GSEE) is aimed at providing software engineering (SE) students with knowledge, skills, and understanding of working in globally distributed arrangements so they can be prepared for the global SE (GSE) paradigm. It is important to understand the challenges involved in GSEE for improving the quality and experience of educators and students. This paper reports the findings of an empirical study on the socio-cultural aspects of GSEE. A case study was conducted involving 14 participants from ten different universities in eight countries. The data was analyzed using grounded theory's open coding procedure. The key contributions of this paper are the identification and description of seven dimensions of socio-cultural distance that caused several significant challenges in the courses: 1) language differences; 2) concept of time; 3) attitude toward grades; 4) assumptions about national culture; 5) differences in autonomy; 6) influence of the course lecturer; and 7) work habits. Recommendations from this paper that are expected to benefit GSEE educators and students include: cross-cultural orientation of students prior to the course; use of various strategies to support better comprehension of different English accents (e.g., speaking slowly, replaying recorded video messages, and text chatting); and educators familiarizing themselves and their students with the relevant GSE and GSEE literature.

This article reports on a study analysing changes in the use of digital technologies and working from home during the COVID-19 crisis and the impact of these changes on the wellbeing of five female university lecturers from Australia and Sweden. Applying collaborative autoethnographical methods, this study employed Weick's sensemaking framework to explore how the academics made sense of these sudden changes. The Positive emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA) wellbeing framework was also employed to explore the effect of these changes on the academics' wellbeing. Findings from the reflective narratives show that after the initial experiences of stress, each university lecturer was able to adapt and navigate the online teaching environment during the pandemic. However, the time constraints in preparing and adapting to online teaching, and working from home, were experienced by some of the university lecturers as highly stressful and isolating which impacted their sense of wellbeing. Even so, working from home was recognized as a positive experience, providing time for research, hobbies, and time with family. This study addresses a gap in current knowledge by examining the impact of the sudden transition to online teaching and learning had on academic wellbeing as conceptualised through the PERMA framework. In addition, by applying Weick's sensemaking framework, this study provides a unique perspective around how academics made sense of the sudden switch to online teaching and learning during COVID-19. [ABSTRACT FROM AUTHOR]

Seamless learning has a significance that has been increasing in recent years, and an increasing number of studies on the subject in the literature draws attention. This study aimed to examine the research on seamless learning between 1996 and 2020 with the bibliometric analysis method. The Scopus database was used in the collection of the data. After various screening processes, a total of 389 publications were included in the analysis. Descriptive analysis and bibliometric analysis were used in the analysis of the data. The distribution of publications by years, types of publications, sources, and languages were analyzed in the research. Additionally, visual maps were created with analyses of co-author, cocitation, and co-word. At the end of the study, it was seen that there has been an increase in the number of publications from the past to the present, articles and papers were predominant, and that most of the studies were carried out in English. As a result of bibliometric analysis, it was concluded that the most efficient countries in seamless learning were the United Kingdom, the United States, and Singapore. Also, it has been determined that the National Institute of Education, Center for International Education and Exchange, and Kyushu University institutions are dominant. The most frequently mentioned authors cited in studies in many different fields are M. Sharples, L.-H. Wong, and H. Ogata. According to the co-word analysis, the keywords seamless learning, mobile learning, ubiquitous learning, and mobile-assisted language learning stand out in the field of seamless learning.

Background: Implementing effective antenatal care models is a key global policy goal. However, the mechanisms of action of these multi-faceted models that would allow widespread implementation are seldom examined and poorly understood. In existing care model analyses there is little distinction between what is done, how it is done, and who does it. A new evidence-informed quality maternal and newborn care (QMNC) framework identifies key characteristics of quality care. This offers the opportunity to identify systematically the characteristics of care delivery that may be generalizable across contexts, thereby enhancing implementation. Our objective was to map the characteristics of antenatal care models tested in Randomised Controlled Trials (RCTs) to a new evidence-based framework for quality maternal and newborn care; thus facilitating the identification of characteristics of effective care.Methods: A systematic review of RCTs of midwifery-led antenatal care models. Mapping and evaluation of these models' characteristics to the QMNC framework using data extraction and scoring forms derived from the five framework components. Paired team members independently extracted data and conducted quality assessment using the QMNC framework and standard RCT criteria.Results: From 13,050 citations initially retrieved we identified 17 RCTs of midwifery-led antenatal care models from Australia (7), the UK (4), China (2), and Sweden, Ireland, Mexico and Canada (1 each). QMNC framework scores ranged from 9 to 25 (possible range 0-32), with most models reporting fewer than half the characteristics associated with quality maternity care. Description of care model characteristics was lacking in many studies, but was better reported for the intervention arms. Organisation of care was the best-described component. Underlying values and philosophy of care were poorly reported.Conclusions: The QMNC framework facilitates assessment of the characteristics of antenatal care models. It is vital to understand all the characteristics of multi-faceted interventions such as care models; not only what is done but why it is done, by whom, and how this differed from the standard care package. By applying the QMNC framework we have established a foundation for future reports of intervention studies so that the characteristics of individual models can be evaluated, and the impact of any differences appraised. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effects of a person‐centred and thriving‐promoting intervention on nursing home residents´ experiences of thriving and person‐centredness of the environment, and to evaluate if the effects varied between female and male residents. Design: A multi‐centre, non‐equivalent controlled group before‐after intervention design. Methods: Six nursing homes in Australia, Norway and Sweden were allocated to either intervention or control group. The intervention comprised a staff educational programme. A survey using proxy‐ratings by staff was administered before (T0), immediately after (T1) and six months after (T2) the intervention. The sample varied between 205 and 292 residents. Linear regression models were used to explore effects. Results: Statistically significant effects were found on experiences of thriving and person‐centredness of the environment. These effects were significant for male residents but not for female residents. The results emphasize the importance of individually tailored social and recreational activities. [ABSTRACT FROM AUTHOR]

Student learning outcomes assessment examines whether programs cover the material stated in their learning goals, whether students are learning the material, and the impact on student retention, graduation, post-graduation outcomes, and institutional accreditation, with the aim of providing faculty with data that can be used to help programs evolve or improve. While there is a plethora of research regarding effective methods of assessment used in the United States, little has been written regarding cross-national comparisons of assessment methodologies. This paper examines the current state of assessment in several nations and regions, and draws parallels in practices across countries. A literature search using the term "outcomes assessment" yielded 228 articles, of which, only 35 described practices outside the United States. Generally, searches on the terms "outcomes assessment" and "global" tend to return studies of outcomes assessment of teaching about global issues as it is practiced in the United States, rather than results about outcomes assessment practices used in other countries.

Education is the core of the factors that improved people for a better lifestyle and increases the level of society' development. Quality education is one of the most vital goals of Sustainable Development Goals (SDGs) due to actualizing these factors. Using relational network data envelopment analysis (DEA), which have three interrelated substages, this current paper computes the educational economy efficiency of the Organisation for Economic Co-operation and Development (OECD) countries bearing in mind the characteristics related to SDGs. The contribution of our study is the use of a novel approach to computing the educational economy efficiency using relational network DEA with GAMS. Even though some interesting differences reveal in the efficiency of the countries, the findings show that countries with high-efficiency scores are clustered around countries like Latvia, Slovenia, and Korea.

Historically, there are inconsistencies in the calculation of whole-grain intake, particularly through use of highly variable whole-grain food definitions. The current study aimed to determine the impact of using a whole-grain food definition on whole-grain intake estimation in Australian and Swedish national cohorts and investigate impacts on apparent associations with CVD risk factors. This utilised the Australian National Nutrition and Physical Activity Survey 2011–2012, the Swedish Riksmaten adults 2010–2011 and relevant food composition databases. Whole-grain intakes and associations with CVD risk factors were determined based on consumption of foods complying with the Healthgrain definition (≥30 % whole grain (dry weight), more whole than refined grain and meeting accepted standards for 'healthy foods' based on local regulations) and compared with absolute whole-grain intake. Compliance of whole-grain containing foods with the Healthgrain definition was low in both Sweden (twenty-nine of 155 foods) and Australia (214 of 609 foods). Significant mean differences of up to 24·6 g/10 MJ per d of whole-grain intake were highlighted using Swedish data. Despite these large differences, application of a whole-grain food definition altered very few associations with CVD risk factors, specifically, changes with body weight and blood glucose associations in Australian adults where a whole-grain food definition was applied, and some anthropometric measures in Swedish data where a high percentage of whole-grain content was included. Use of whole-grain food definitions appears to have limited impact on measuring whole-grain health benefits but may have greater relevance in public health messaging. [ABSTRACT FROM AUTHOR]

Literature on the support of the First Year Experience (FYE) in institutions of Higher Education provides a range of modelled approaches. However, we argue that institutions still need to selectively plan which approach/es and attendant strategies are best suited to their particular contexts and institutional policy and practice frameworks and how their FYE is to be presented for their particular student cohort. This paper compares different ways of supporting students in their first year in two contrasting universities. The first case study focuses on a first year course at Stockholm University (SU), Sweden, a large, metropolitan, single campus institution, while the second investigates a strategy for supporting first year students using a community of practice at a satellite campus of the University of the Sunshine Coast (USC), a small regional university in South-East Queensland, Australia. The research contrasts a formal, first generation support approach versus a fourth generation support approach which seeks to involve a wider range of stakeholders in supporting first year students. The research findings draw conclusions about how effective the interventions were for the students and provide clear illustrations that selective planning in considering the institution's strategic priorities and human, physical, and resource contexts was instrumental in providing a distinctive experience which complemented the institute and the student cohort.

The use of sunscreens is recommended to limit the impact of sun exposure on the skin. The objective of this study was to examine the relationship between sunscreen sales and melanoma in 4 different countries with diverse sunscreen regulations. Data from publicly available databases were examined for Sweden, England, Australia, and the USA from 1999 to 2018. The association between incidence of melanoma and sunscreen sales was estimated using a generalized estimating equation, and modelling was used to predict melanoma cases. Incidence of melanoma was positively associated with sunscreen sales in England, Australia, and the USA, and negatively associated with sunscreen sales in Sweden. Growth rates in melanoma cases of 0.42%, 16.7%, 19.1% and 12.2% were predicted for Sweden, England, Australia, and the USA, respectively. The differences observed between England, Australia, and the USA, on the one hand, and Sweden, on the other hand, are consistent with the adoption of strong regulations requiring the use of ultraviolet A blocking agents in sunscreens. [ABSTRACT FROM AUTHOR]

In this paper, we explore the improvisations made in examination practices in higher education during the pandemic of 2020. Drawing on STS, we start from the theoretical assumption that examinations constitute an obligatory passage point in universities and colleges: a sacred point which students need to pass if they want to gain recognized qualifications. We base our analysis of higher education examinations on cases from six countries around the world: Australia, Belgium, Chile, India, Sweden and the UK. We use the analytical heuristic of choreography to follow the movements, tensions and resistance of the 'emergency examinations' as well as the re-orderings of actors and stages that have inevitably occurred. In our analytical stories we see the interplay between the maintenance of fixed and sacred aspects of examinations and the fluidity of improvisations aimed at meeting threats of spreading COVID-19. These measures have forced the complex network of examinations both to reinforce some conventional actors and to assemble new actors and stages, thus creating radically new choreographies. Although higher education teaching and didactics are being framed as a playground for pedagogical innovation with digital technologies, it is clear from our data that not all educational activities can be so easily replicated.

Background: Breastfeeding in public continues to be contentious with qualitative evidence confirming that women face many challenges. It is therefore important to gain understanding of not only the challenges but also what women perceive is helpful to breastfeed in public. Methods: A cross-sectional study was conducted with women living in Australia, Ireland or Sweden currently breastfeeding or having breastfed within the previous 2 years. Our objective was to explore and compare what women do when faced with having to breastfeed in the presence of someone they are uncomfortable with and what women think is helpful and challenging when considering whether to breastfeed in public. Data were collected in 2018 from an online survey over a 4 week period in each country. Content analysis revealed data similarity and theme names and definitions were negotiated until consensus was reached. How often each theme was cited was counted to report frequencies. Helpful and challenging aspects were also ranked by women to allow international comparison. Results: Ten themes emerged around women facing someone they were uncomfortable to breastfeed in the presence of with the most frequently cited being: 'made the effort to be discreet'; 'moved to a private location'; 'turned away' and 'just got on with breastfeeding'. Nine themes captured challenges to breastfeed in public with the following ranked in the top five across countries: 'unwanted attention'; 'no comfortable place to sit'; 'environment not suitable'; 'awkward audience' and 'not wearing appropriate clothing'. Nine themes revealed what was helpful to breastfeed in public with the top five: 'supportive network'; 'quiet private suitable environment'; 'comfortable seating'; 'understanding and acceptance of others' and 'seeing other mothers' breastfeed'. Conclusions: When breastfeeding in public women are challenged by shared concerns around unwanted attention, coping with an awkward audience and unsuitable environments. Women want to feel comfortable when breastfeeding in a public space. How women respond to situations where they are uncomfortable is counterproductive to what they share would be helpful, namely seeing other mothers breastfeed. Themes reveal issues beyond the control of the individual and highlight how the support required by breastfeeding women is a public health responsibility. [ABSTRACT FROM AUTHOR]

Background: Data from the Programme for the International Assessment of Adult Competencies (PIAAC) revealed that countries systematically differ in their respondents' literacy, numeracy, and problem solving in technology-rich environments skills; skill levels also vary by gender, age, level of education or migration background. Similarly, systematic differences have been documented with respect to adults' participation in education, which can be considered as a means to develop and maintain skills. From a psychological perspective, motivation to learn is considered a key factor associated with both skill development and participation in (further) education. In order to account for motivation when analyzing PIAAC data, four items from the PIAAC background questionnaire were recently compiled into a motivation-to-learn scale. This scale has been found to be invariant (i.e., showing full weak and partial strong measurement invariance) across 21 countries. Methods: This paper presents further analyses using multiple-group graded response models to scrutinize the validity of the motivation-to-learn scale for group comparisons. Results: Results indicate at least partial strong measurement invariance across gender, age groups, level of education, and migration background in most countries under study (all CFI > 0.95, all RMSEA < 0.08). Thus, the scale is suitable for comparing both means and associations across these groups. Conclusions:Results are discussed in light of country characteristics, challenges of measurement invariance testing, and potential future research using PIAAC data.

Background: Cancer survival in the UK and Denmark are lower when compared with similar countries with late diagnosis a possible cause. We aimed to study the relationship between barriers to attending a primary care physician (GP) and anticipated time to help seeking (ATHS) with four cancer symptoms in six countries. Methods: A population-based survey measuring cancer awareness and beliefs conducted within the International Cancer Benchmarking Partnership in Australia, Canada, Denmark, Norway, Sweden and UK. Data were collected on perceived barriers to GP consultation (including embarrassment, worry about wasting the doctors' time, fear about what the doctor might find and being too busy) and ATHS for persistent cough, abdominal swelling, rectal bleeding and breast changes. Relationships between perceived barriers and ATHS were investigated using multivariable analysis. Results: Among 19079 respondents, higher perceived barrier scores were associated with longer ATHS intervals for all symptoms studied (P<0.01) responders with the highest barrier scores (>10.84) had between two and three times the odds of longer ATHS. ATHS was low in Australia for all symptoms and highest in Denmark for abdominal bloating. Conclusions: Perceived barriers to help-seeking have a role in delaying GP presentation. Early diagnosis campaigns should address emotional and practical barriers that reduce early presentation with potential cancer symptoms. [ABSTRACT FROM AUTHOR]

When investigating the association between brain tumors and use of mobile telephones, accurate data on tumor position are essential, due to the highly localized absorption of energy in the human brain from the radio-frequency fields emitted. We used a point process model to investigate this association using information that included tumor localization data from the INTERPHONE Study (Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the United Kingdom). Our main analysis included 792 regular mobile phone users diagnosed with a glioma between 2000 and 2004. Similar to earlier results, we found a statistically significant association between the intracranial distribution of gliomas and the self-reported location of the phone. When we accounted for the preferred side of the head not being exclusively used for all mobile phone calls, the results were similar. The association was independent of the cumulative call time and cumulative number of calls. However, our model used reported side of mobile phone use, which is potentially influenced by recall bias. The point process method provides an alternative to previously used epidemiologic research designs when one is including localization in the investigation of brain tumors and mobile phone use. [ABSTRACT FROM AUTHOR]

Ample evidence indicates that a person's human capital is important for success on the labor market in terms of both wages and employment prospects. However, unlike the efforts to identify the impact of school attainment on labor-market outcomes, the literature on returns to cognitive skills has not yet provided convincing evidence that the estimated returns can be causally interpreted. Using the PIAAC Survey of Adult Skills, this paper explores several approaches that aim to address potential threats to causal identification of returns to skills, in terms of both higher wages and better employment chances. We address measurement error by exploiting the fact that PIAAC measures skills in several domains. Furthermore, we estimate instrumental-variable models that use skill variation stemming from school attainment and parental education to circumvent reverse causation. Results show a strikingly similar pattern across the diverse set of countries in our sample. In fact, the instrumental-variable estimates are consistently larger than those found in standard least-squares estimations. The same is true in two "natural experiments," one of which exploits variation in skills from changes in compulsory-schooling laws across U.S. states. The other one identifies technologically induced variation in broadband Internet availability that gives rise to variation in ICT skills across German municipalities. Together, the results suggest that least-squares estimates may provide a lower bound of the true returns to skills in the labor market.

Background: Educational qualifications and literacy skills are highly related. This is not surprising as it is one aim of educational systems to equip individuals with competencies necessary to take part in society. Because of this relationship educational qualifications are often used as a proxy for "human capital". However, from a theoretical perspective, there are many reasons why this relationship is not perfect, and to some degree this is due to third variables. Thus, we want to explore the net relationship between educational attainment (harmonized according to the International Standard Classification of Education, ISCED) and literacy skills, and how much skills vary within education levels across countries. Methods: We use data from 21 countries from the Programme for the International Assessment of Adult Competencies 2012. This paper compares the literacy skills of adults who achieved different levels of educational attainment across countries. Given the high degree of educational differentiation in most countries, we do this using a more differentiated educational attainment variable than what is commonly used. In our analyses we firstly adjust for factors that are likely to affect access to education and the acquisition of educational qualifications and literacy skills, such as parental education and language and migration background. In a second step, we also take into account factors affecting skill development after initial formal education, such as occupation and skill use at home. Results: We firstly find a high degree of heterogeneity of skills across countries for equivalent education categories. Secondly, we find skill similarities for equivalent education categories classified at different broad education levels, sometimes even breaking the hierarchical order of 'higher education entails higher competencies'. Conclusion: We conclude that ISCED levels cannot be taken as a cross-nationally comparable proxy for human capital in terms of literacy skills, and that education has to be harmonized in a substantively more meaningful way in future adult literacy surveys.

Background: General Practitioners (GPs) are responsible for primary prescribing decisions in most settings. Elderly patients living in Advanced Care Facilities (ACFs) often have significant co-morbidities to consider when selecting an appropriate drug therapy. Careful assessment is required when considering appropriate medication use in frail older patients as they have multiple diseases and thus multiple medication. Many physicians seem reluctant to discontinue other physicians' prescriptions, resulting in further polypharmacy. Therefore it is relevant to ascertain and synthesise the GP views from multiple settings to understand the processes that might promote appropriate deprescribing medications in the elderly. The aims of this study were to 1) compare and contrast behavioural factors influencing the deprescribing practices of GPs providing care for ACF residents in two separate countries, 2) review health policy and ACF systems in each setting for their potential impact on the prescribing of medications for an older person in residential care of the elderly, and 3) based on these findings, provide recommendations for future ACF deprescribing initiatives. Methods: A review and critical synthesis of qualitative data from two interview studies of knowledge, attitudes, and behavioural practices held by GPs towards medication management and deprescribing for residents of ACFs in Australia and Sweden was conducted. A review of policies and health care infrastructure was also carried out to describe the system of residential aged care in the both countries. Results: Our study has identified that deprescribing by GPs in ACFs is a complex process and that there are numerous barriers to medication reduction for aged care residents in both countries, both with similarities and differences. The factors affecting deprescribing behaviour were identified and divided into: intentions, skills and abilities and environmental factors. Conclusions: In this study we show that the GPs' behaviour of deprescribing in two different countries is much dependent on the larger health care system. There is a need for more education to both GPs and ACF staff as well as better cooperation between the different health care systems and appropriate monetary incentives for elderly care to achieve better conditions for deprescribing practice. [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]

Background: The present study aims to illuminate the meaning of working in a person-centred way as experienced by staff in nursing homes. Insights into what working in a person-centred way mean for nursing home staff may contribute to a more comprehensive understanding of what gives staff satisfaction in their work and support further development of person-centred care approach in nursing homes. Methods: Interviews with 29 health care personnel who had participated in a one-year intervention focusing on person-centred care and thriving in three nursing homes in Australia, Norway and Sweden were performed, and a phenomenological-hermeneutical method was used to explore staffs' lived experiences of working in a person-centred way in nursing homes. Results: For nursing home staff, working in a person-centred way meant that they were able to meet individual resident's needs and expressed preferences in close family-like relationships, understanding the residents' rhythms and preferences as the basis of the daily work plans and being able to do 'the little extra' for residents. Also, working in a person-centred way meant meeting shared goals by working towards a collective practice in collaborative teams. As a whole, the staffs' lived experiences of working in a person-centred way in nursing homes was interpreted to mean thriving at work as a psychological state in which individuals experience both a sense of vitality and learning. Conclusions: Working in a person-centred way means staff thriving at work in nursing homes. The results further indicate that delivering care by only focusing on routines and practical tasks and not on residents' preferences and well-being would inhibit thriving among nursing staff, leading to the potential for dissatisfaction with work. [ABSTRACT FROM AUTHOR]

Background: Despite significant investments to support primary care internationally, income-based inequities in access to quality health care are present in many high-income countries. This study aims to determine whether low- and middle-income groups are more likely to report poor quality of primary care (PC) than high-income groups cross-nationally. Methods: The 2011 Commonwealth Fund Telephone Survey of Sicker Adults is a cross-sectional study across eleven countries. Respondents were recruited from randomly selected households. We used data from surveys conducted in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. We identified all questions relating to primary care performance, and categorized these into five dimensions: 1) access to care, 2) coordination 3) patient-centered care, and 4) technical quality of care. We used logistic regression with low and middle-income as the comparison groups and high-income as the referent. Results: Fourteen thousand two hundred sixty-two respondents provided income data. Countries varied considerably in their extent of income disparity. Overall, 24.7% were categorized as low- and 13.9% as high-income. The odds of reporting poor access to care were higher for low- and middle-income than high-income respondents in Canada, New Zealand and the US. Similar results were found for Sweden and Norway on coordination; the opposite trend favoring the low- and middle-income groups was found in New Zealand, United Kingdom, and the United States. The odds of reporting poor patient-centered care were higher for low-income than high-income respondents in the Netherlands, Norway, and the US; in Australia, this was true for low- and middle-income respondents. On technical quality of care, the odds of reporting poor care were higher for the low- and middle-income comparisons in Canada and Norway; in Germany, the odds were higher for low-income respondents only. The odds of reporting poor technical quality of care were higher for high-income than low-income respondents in the Netherlands. Conclusion: Inequities in quality PC for low and middle income groups exist on at least one dimension in all countries, including some that in theory provide universal access. More research is needed to fully understand equity in the PC sector. [ABSTRACT FROM AUTHOR]

Background: Disparities in access to primary care (PC) have been demonstrated within and between health systems. However, few studies have assessed the factors associated with multiple barriers to access occurring along the care-seeking process in different healthcare systems. Methods: In this secondary analysis of the 2016 Commonwealth Fund International Health Policy Survey of Adults, access was represented through participant responses to questions relating to access barriers either before or after reaching the PC practice in 11 countries (Australia, Canada, France, Germany, Norway, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and United States). The number of respondents in each country ranged from 1000 to 7000 and the response rates ranged from 11% to 47%. We used multivariable logistic regression models within each of eleven countries to identify disparities in response to the access barriers by age, sex, immigrant status, income and the presence of chronic conditions. Results: Overall, one in five adults (21%) experienced multiple barriers before reaching PC practices. After reaching care, an average of 16% of adults had two or more barriers. There was a sixfold difference between nations in the experience of these barriers to access. Vulnerable groups experiencing multiple barriers were relatively consistent across countries. People with lower income were more likely to experience multiple barriers, particularly before reaching primary care practices. Respondents with mental health problems and those born outside the country displayed substantial vulnerability in terms of barriers after reaching care. Conclusion: A greater understanding of the multiple barriers to access to PC across the stages of the care-seeking process may help to inform planning and performance monitoring of disparities in access. Variation across countries may reveal organisational and system drivers of access, and inform efforts to improve access to PC for vulnerable groups. The cumulative nature of these barriers remains to be assessed. [ABSTRACT FROM AUTHOR]