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Although the Paralympic Games have been around for over 60 years, women remain underrepresented in almost all aspects of the Paralympic Movement. It has been suggested that a way to increase women's involvement is through the implementation of mixed-gender events. On paper, this approach makes sense. However, when it comes to the implementation of mixed-gender opportunities for women, it is less clear how effective these events are in increasing participation by women in Para sport. Through document analysis and interviews with athletes and organizers of mixed-gender Paralympic sport, we explore the various strategies that four mixed-gender sports have used to address the issue of gender parity. Using critical feminist theories, we illustrate how larger social, political, and cultural ideas about gender influence women's experiences within these events and discuss the potential of using mixed-gender initiatives to address gender parity within the Paralympic Movement. [ABSTRACT FROM AUTHOR]

Aims: Inpatient falls among older adults are a relentless problem, and extant inpatient fall prevention research and interventions lack the older adults' perspectives and experiences of their own fall risk in the hospital. Theory‐guided research is essential in nursing, and the purpose of this paper was to describe the process of developing a theoretical framework for a phenomenological nursing study exploring older adults' lived experiences of being at risk for falling in the hospital. Method: Based on philosophical nursing underpinnings, the Health Belief Model (HBM) was selected as the theoretical model. The limitations of the model led to expansion of the model with established concepts associated with accidental falls among older adults. Results: The HBM was selected as the guiding model due to its ability to capture a broad range of perceptions of a health threat. The HBM was expanded with the concepts of embarrassment, independence, fear of falling, dignity and positivity effect. The addition of these concepts made the theoretical framework more applicable to age‐related developmental behaviours of older adult and more applicable to nursing research. Conclusion: The Expanded HBM theoretical framework may guide future nursing research to develop fall prevention interventions to decrease fall rates among hospitalized older adults. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: Patients' death or adverse events appear to be associated with poor healthcare decision‐making. This might be due to an inability to have an adequate representation of the problem or of the connections among problem‐related elements. Changing how a problem is formulated can reduce biases in clinical reasoning. The purpose of this article is to explore the possible contributions of psychoneuroendocrinoimmunology (PNEI) and psychology of reasoning and decision‐making (PRDM) to support a new nursing theoretical frame. Design: Discursive paper. Method: This article discusses the main assumptions about nursing and nurses' ability to face patient's problems, suggesting a new approach that integrates knowledge from PNEI and PRDM. While PNEI explains the complexity of systems, highlighting the importance of systems connections in affecting health, PRDM underlines the importance of the informative context in creating a mental representation of the problem. Furthermore, PRDM suggests the need to pay attention to information that is not immediately explicit and its connections. Conclusion: Nursing recognizes the patient–nurse relationship as the axiom that governs care. The integration of PNEI and PRDM in nursing theoretics allows the expansion of the axiom by providing essential elements to read a new type of relationship: the relationship among information. PNEI explains the relationships between biological systems and the psyche and between the whole individual and the environment; PRDM provides tools for the nurse's analytical thinking system to correctly process information and its connections. Impact on Nursing Practice: A theoretical renewal is mandatory to improve nursing reasoning and nursing priority identification. Integrating PNEI and PRDM into nursing theoretics will modify the way professionals approach patients, reducing cognitive biases and medical errors. No Patient or Public Contribution: There was no patient or public involvement in the design or writing of this discursive article. [ABSTRACT FROM AUTHOR]

This study investigates the views of contemporary Muslim jurists about withdrawing treatment of the terminally ill. Its aim is threefold. Firstly, it analyses jurists' views concerning core themes within the process of withdrawing treatment. Secondly, it provides insight into fatwas about withdrawing treatment. Thirdly, it compares these views with current medical standards in Europe and the Atlantic world on withdrawing treatment. The data consisted of six papers by Muslim jurists presented at the conference of the Islamic Fiqh Council in 2015. We conducted a directed content analysis (DCA) through a predetermined framework and compiled an overview of all previous fatwas referred to in the papers, which are also analysed. The results show that the general consensus is that if health cannot be restored, treatment may be withdrawn at the request of the patient and/or his family or on the initiative of the doctor. The accompanying fatwa emphasizes the importance of life-prolonging treatment if this does not harm the patient. It becomes apparent in the fatwa that the doctor has the monopoly in decision-making, which is inconsistent with current medical standards in Europe. Managing disclosure in view of the importance of maintaining the hope of Muslim patients may challenge the doctor's obligation to share a diagnosis with them. [ABSTRACT FROM AUTHOR]

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Aim: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a ‘Dialogue’ with the patients, which has four components: ‘Establishing family involvement’, ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’, with the primary goal being ‘Enhancement of the health experience’. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. Design: Discursive paper. Methods: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. Results: The nursing practice framework highlights capacities and possibilities that lie in the nurse–patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component ‘Assisting living with the disease’ was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’. The primary goal remains unchanged: enhancing the ‘Health experience’. Conclusion: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. Implications for the Profession and/or Patient Care: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. [ABSTRACT FROM AUTHOR]

Value co‐creation as a research topic has been a critical proposition of interest to a wide range of disciplines. In recent years, the field of cultural heritage has also developed a range of information practices to promote different forms of value co‐creation. While the body of literature has begun to accumulate, we still lack a comprehensive understanding of conceptual foundations and how value co‐creation is implemented in cultural heritage information practices. This paper conducted a hermeneutic literature review to understand and conceptualize the core aspects of value co‐creation in various cultural heritage information works. In particular, this paper provides a research mapping of the genres of co‐creation in cultural heritage information practices, the actors, and the roles played by the stakeholders. Further, this review provides an overview of the dominant value co‐creation models in the cultural heritage field. It distills the drivers of value co‐creation and the core value consequences that arise from a process perspective. Finally, this paper puts forward a thematic, theoretical, and methodological agenda for future work based on these findings. The review contributes to the literature by proposing an integrated conceptual framework that summarizes the core elements of value co‐creation in cultural heritage information practices. The framework also serves as a call for action, providing a general understanding of the conceptual foundation for future research. [ABSTRACT FROM AUTHOR]

mHealth applications (apps) are tools that can enhance research by efficiently collecting and storing large amounts of data. However, data collection alone does not lead to change. Innovation and practice change occur through utilisation of evidence. The volume of data collected raises questions regarding utilisation of data by nurses and midwives, and how data from mHealth apps can be used to improve person-centred practice. There is limited empirical evidence and a lack of direction from global health authorities to guide nurses and midwives in this area. To describe strategies for nurses and midwives that could enhance the effective use of data generated by mHealth apps to inform person-centred practice. The purpose of this paper is to stimulate reflection and generate actions for data utilisation when using mHealth apps in nursing research and practice. This discussion paper has been informed by current evidence, the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, and research experience as part of doctoral study. Before engaging in data collection using mHealth apps, nurses and midwives would benefit from considering the nature of the evidence collected, available technological infrastructure, and staff skill levels. When collecting data and interpreting results, use of a team approach supported by engaged leadership and external facilitation is invaluable. This provides support to operate apps, and more importantly use the data collected to inform person-centred practice. This paper addresses the limited available evidence to guide nurses and midwives when using mHealth apps to collect and use data to inform practice change. It highlights the need for appropriate technology, external facilitative support, engaged leadership, and a team approach to collect meaningful evidence using mHealth apps. Clinicians, leaders, and researchers can apply the strategies provided to enhance the use of mHealth apps and ensure translation of evidence into practice. [ABSTRACT FROM AUTHOR]

Covid-19, the disease caused by severe acute respiratory syndrome coronavirus 2 is recognised as one of the most challenging global events of the twenty-first Century. The detrimental impact of the pandemic resulted in high rates of infection, morbidity, and mortality, with health-care workers firmly positioned on the frontline of this unparalleled international crisis. An emerging literature detailing the impact of COVID-19 on health-care practitioners identifies high levels of depression, anxiety, and distress. Accordingly, there are calls for the implementation of effective interventions to tackle the impending spectre of psychological morbidities and staff burnout. While it is important to explore new approaches, it is also valuable to examine how existing strategies, such as reflective practice, can be repurposed to specifically address practitioner well-being. This requires a reimagining of reflective practice and a reimagining of the reflective practice contexts in which reflective activity occurs. This paper presents The Reflective Practice Integrative Framework, which illustrates how reflective practice can be used to address the complex aims of supporting effective patient care, while also facilitating practitioner well-being. The Reflective Organisational Learning Framework is also presented which can be used to develop effective reflective practice environments through single, double, and/or triple loop learning. [ABSTRACT FROM AUTHOR]

This paper discusses the relationship between spiritual and emotional intelligence and eternal happiness, from an Islamic perspective. In Islam, achieving spiritual intelligence first requires a close relationship with God—established, for example, through consistent purification of the soul, repentance, acts of worship, performing good deeds and avoiding evil. Through such action, the light of God—which comes with Divine guidance and the knowledge of truth—touches the hearts of believers, causing them to experience pure contentedness. This study takes a qualitative approach, using the NVivo text analysis tool to analyse texts from 43 references, comprising 31 journal articles and 12 books or chapters. The three most frequently used words were 'Islamic', 'spiritual' and 'happiness', while 'intelligence' was the fourteenth most-used. This finding highlights the fear of God due to the love of God as the highest obedience, as it is the purest and sincerest degree of worship (i.e. for God's sake completely). Spiritual intelligence trains the soul from its prone-to-evil state to become more angelic or serene, thereby increasing emotional intelligence. This will be reflected in a believer's attitude, emotion and behaviours aligning with the conduct commended in Islam, to whom God promises an afterlife of eternal happiness in Heaven. This paper draws on the Qur'an and Sunnah as well as prominent Islamic scholarship to support the Islamic concepts discussed, enriching our understanding and perspective on the Islamic concept of spiritual and emotional intelligence and its role in attaining eternal happiness in Islam. This study also highlights several key concepts pivotal to Islamic spiritual and emotional intelligence as pre-requisites for obtaining eternal happiness, therefore advancing current knowledge on the subject. [ABSTRACT FROM AUTHOR]

The Nominal Group Technique is a method used to explore issues, generate ideas, and reach consensus on a topic. The Nominal Group Technique includes individual and group work and is designed to ensure participants have the same opportunity to engage and provide their opinions. While the technique has been used for around six decades to assist groups, in industry, and government organizations to examine issues and make decisions, this technique has received limited attention in nursing research, particularly in mental health. This discussion paper describes the use of a modified Nominal Group Technique for a study designed to determine a nursing decision‐making framework for a state‐wide forensic mental health service. Modifications were made to the traditional technique, to enable participants to make an informed and collective decision about a suitable framework for the novice to expert nurses, across secure inpatient, prison, and community forensic mental health settings. The Nominal Group Technique generated rich data and offered a structured approach to the process. We argue that the Nominal Group Technique offers an exciting and interactive method for nursing research and can increase opportunity for minority group members to participate. This technique also offers a time efficient way to engage busy clinical nurses to participate in research, with the advantage of members knowing the decision on the day of the group. Consideration, however, needs to be given to the duration and effect on participant concentration, and if not actively managed by facilitators, the possible emergence of group dynamics affecting individuals' decisions. [ABSTRACT FROM AUTHOR]

Aim: To describe and discuss clinical strategies for nurses working in partnership with substitute decision‐makers for people living with advanced dementia. Background: By providing person‐centred care to patients living with advanced dementia, nurses are positioned to work in partnership with substitute decision‐makers who make healthcare decisions related to advanced care. Because the experience of being substitute decision‐makers is complex and stressful, nurses need skillsets for working in partnership with substitute decision‐makers. Design: In this discursive paper, an innovative framework for working in partnership with substitute decision‐makers is proposed. Method: Evidence‐based findings from a systematic review provided five domain foci for the partnership framework. In each domain, two clinical strategies were discursively proposed. Clinical strategies were hypothesised from research findings and insights from the authors' nursing experiences. Then, topical literature was searched, and findings were used to support the discursively argued strategies. Discussion: To deal with complexities and reduce stress for substitute decision‐makers, an innovative Nurse–Substitute Decision‐Maker Partnership Framework for use in the context of advanced dementia is proposed and discussed. The partnership framework consists of five domains: Building trust, Exploring emotions, Translating quality of life, Encouraging proactivity and Negotiating families. Within these domains, ten strategies to support the practices of clinical nurses to work in partnership with substitute decision‐makers are discussed. Relevance to Clinical Practice: In the framework, the ten clinical nursing strategies are designed to provide targeted care to substitute decision‐makers in areas that are known to cause complexity and stress to them. The Nurse–Substitute Decision‐Maker Partnership Framework has been designed to improve nurse–substitute decision‐maker partnerships and reduce the stress experienced by substitute decision‐makers as they work through the complexities associated with advanced dementia. [ABSTRACT FROM AUTHOR]

Within dual diagnosis treatment, principles of recovery are increasingly acknowledged. Nevertheless, recovery-oriented rehabilitation often becomes an abstract concept, leaving professionals in various dilemmas. This article examines competing representations of recovery-oriented rehabilitation across Danish dual diagnosis treatment policy and practice from a post-structural, analytical perspective inspired by governmentality and problematization studies. The empirical foundation consists of a qualitative ethnographic study including conducting and examining 12 national policies relevant to contemporary Danish dual diagnosis treatment practice and 23 interviews with health/welfare professionals employed at a Danish in-patient, dual diagnosis rehabilitation unit. The analysis points to a complexity between three sets of competing representations reflected in 1) the conceptual relationship between rehabilitation and recovery , 2) perceptions of knowledge based on experience or evidence , and 3) ideals of optimization and emancipation. Finally, the article discusses convergences between the competing and, at times, conflictual ideals, attempting to explain the conceptual fluffiness , discrepancies, and dilemmas experienced by professionals in dual diagnosis treatment within broader epistemological and ideological debates in social sciences and humanities. • Recovery is a key, however ambiguous, principle in dual diagnosis treatment. • Different, competing representations of recovery-oriented rehabilitation exist. • The recovery concept reflects epistemological and ideological discrepancies. • A conceptual framework for understanding dilemmas in dual diagnosis care practices. [ABSTRACT FROM AUTHOR]

Background: Inpatient nursing documentation facilitates multi‐disciplinary team care and tracking of patient progress. In both high‐ and low‐ and middle‐income settings, it is largely paper‐based and may be used as a template for electronic medical records. However, there is limited evidence on how they have been developed. Objective: To synthesise evidence on how paper‐based nursing records have been developed and implemented in inpatient settings to support documentation of nursing care. Design: A scoping review guided by the Arksey and O'Malley framework and reported using PRISMA‐ScR guidelines. Eligibility criteria: We included studies that described the process of designing paper‐based inpatient records and excluded those focussing on electronic records. Included studies were published in English up to October 2019. Sources of evidence: PubMed, CINAHL, Web of Science and Cochrane supplemented by free‐text searches on Google Scholar and snowballing the reference sections of included papers. Results: 12 studies met the eligibility criteria. We extracted data on study characteristics, the development process and outcomes related to documentation of inpatient care. Studies reviewed followed a process of problem identification, literature review, chart (re)design, piloting, implementation and evaluation but varied in their execution of each step. All studies except one reported a positive change in inpatient documentation or the adoption of charts amid various challenges. Conclusions: The approaches used seemed to work for each of the studies but could be strengthened by following a systematic process. Human‐centred Design provides a clear process that prioritises the healthcare professional's needs and their context to deliver a usable product. Problems with the chart could be addressed during the design phase rather than during implementation, thereby promoting chart ownership and uptake since users are involved throughout the design. This will translate to better documentation of inpatient care thus facilitating better patient tracking, improved team communication and better patient outcomes. Relevance to clinical practice: Paper‐based charts should be designed in a systematic and clear process that considers patient's and healthcare professional's needs contributing to improved uptake of charts and therefore better documentation. [ABSTRACT FROM AUTHOR]

Purpose: The paper examines three English research papers on self-neglect, from 1957, 1966 and 1975, discussing them in the context of more recent thinking and the statutory framework in England. Design/methodology/approach: In reviewing the three research papers, developments and points of continuity in the field of self-neglect were identified and are discussed in this paper. Findings: In light of the findings of the three articles, the present paper traces some of the classificatory refinements in this field that have taken place since the papers were published, notably in respect of hoarding and severe domestic squalor. Some of the difficulties in making judgements about behaviour thought to breach societal norms are described, and the challenges practitioners face in intervening in cases, particularly where the person concerned is refusing assistance, are examined. Originality/value: By drawing on the historical research context, the paper contributes to our current understanding of the field of self-neglect. [ABSTRACT FROM AUTHOR]

Sociologists have shown that moral understandings of market exchanges can differ between historical periods and institutional settings, but they have paid less attention to how producers' moral frameworks vary depending on their unequal positions within both markets and institutions. We use interviews and ethnographic observations to examine the vibrant market of research shops selling academic work to students around two of Uganda's top universities. We identify three groups of researchers—Knowledge Producers, Entrepreneurs, and Educators—who construct different professional identities and moral justifications of their trade, and who orient their market action accordingly. We demonstrate that these identities and moral frameworks reflect an interplay between the institutional contexts and the social class positions that researchers occupy within this illicit market. Knowledge Producers and Entrepreneurs both experienced a sense of "fit" with their respective institutional cultures, but the former now see their work as compromising ideals of research, whereas the latter capitalize on what they view as a broken system. Educators, disadvantaged at both institutions, articulate a framework countering the dominant institutional cultures and sympathetic to underperforming students. This approach illuminates how institutional contexts and individual class positions within them influence producers' moral frameworks, leading to differentiation of the market. [ABSTRACT FROM AUTHOR]

Background: This position paper highlights the opportunistic integral role of the pharmacist across the patient pathway utilizing cardiovascular care as an example. The paper aims to highlight the potential roles that pharmacists worldwide can have (or already have) to provide efficient patient care in the context of interprofessional collaboration. Methods: It results from a literature review and experts seeking advice to identify existing interventions and potential innovative interventions. We developed a conceptual framework highlighting seven critical phases in the patient pathway and for each of those listed some of the initiatives identified by our experts worldwide. Results: Existing pharmacists' interventions in each of these phases have been identified globally. Various examples in the area of prevention and self‐management were found to exist for long; the contribution for early detection and subsequently to timely diagnosis were also quite clear; integration of care was perhaps one of the areas needing greater development, although interventions in secondary care were also quite common. Tertiary care and end of life interventions were found to often be left for other healthcare professionals. Conclusion: On the basis of the findings, we can argue that much has been done but globally consider that pharmacists are still an untapped resource potentially useful for improved patient care. [ABSTRACT FROM AUTHOR]

Purpose: Children's perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation. Method: The present paper illustrates children's experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework. Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation. Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children's own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings. [ABSTRACT FROM AUTHOR]

Summary: The International Osteoporosis Foundation (IOF) Capture the Fracture® Campaign with the Fragility Fracture Network (FFN) and National Osteoporosis Foundation (NOF) has developed eleven patient-level key performance indicators (KPIs) for fracture liaison services (FLSs) to guide quality improvement. Introduction: Fracture Liaison Services (FLSs) are recommended worldwide to reduce fracture risk after a sentinel fracture. Given not every FLS is automatically effective, the IOF Capture the Fracture working group has developed and implemented the Best Practice Framework to assess the organisational components of an FLS. We have now developed a complimentary KPI set that extends this assessment of performance to the patient level. Methods: The Capture the Fracture working group in collaboration with the Fragility Fracture Network Secondary Fragility Fracture Special Interest Group and National Osteoporosis Foundation adapted existing metrics from the UK-based Fracture Liaison Service Database Audit to develop a patient-level KPI set for FLSs. Results: Eleven KPIs were selected. The proportion of patients: with non-spinal fractures; with spine fractures (detected clinically and radiologically); assessed for fracture risk within 12 weeks of sentinel fracture; having DXA assessment within 12 weeks of sentinel fracture; having falls risk assessment; recommended anti-osteoporosis medication; commenced of strength and balance exercise intervention within 16 weeks of sentinel fracture; monitored within 16 weeks of sentinel fracture; started anti-osteoporosis medication within 16 weeks of sentinel fracture; prescribed anti-osteoporosis medication 52 weeks after sentinel fracture. The final KPI measures data completeness for each of the other KPIs. For these indicators, levels of achievement were set at the < 50%, 50–80% and > 80% levels except for treatment recommendation where a level of 50% was used. Conclusion: This KPI set compliments the existing Best Practice Framework to support FLSs to examine their own performance using patient-level data. By using this KPI set for local quality improvement cycles, FLSs will be able to efficiently realise the full potential of secondary fracture prevention and improved clinical outcomes for their local populations. [ABSTRACT FROM AUTHOR]

This study discusses the importance of the DSpace open-source software that supports numerous digital libraries and repositories around the world. With the release of DSpace version 7, a natural question that arises is whether the new version offers enough new functionalities to motivate system administrators to upgrade. This paper briefly describes the most important changes, including new features and bug fixes, included in DSpace 7.4 and prior minor versions. The next parts of this paper explore our estimate that there are several thousand DSpace-based systems globally that will likely have to be upgraded in the near future. The main reason for this need is that older versions of DSpace (including 5.x) have reached the end of their developer support period or are reaching it in mid-2023. Based on our own upgrade experience, we propose suggestions and recommendations on migrating from the previous DSpace 6.3-based environment to the new one in a case study that concludes this article. [ABSTRACT FROM AUTHOR]

Aim: To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence‐based practices, from the perspectives of potential programme participants and deliverers. Design: A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China. Methods: We conducted individual semi‐structured interviews with unit‐level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability. Results: After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi‐modal training activities such as group work, experience‐sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID‐19 pandemic, and support from senior organizational leadership. Conclusions: The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success. Impact: The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a behaviour many counselling psychologists encounter in practice, and the way clinician's respond can have an important impact on the individual's experience of recovery. The person-centred NSSI recovery framework incorporates the voices of lived experience in understanding the multi-faceted nature of recovery. Objectives: This paper outlines important considerations for how the recovery framework can guide clinicians with respect to both therapeutic stance and intervention targets in order to support clients in navigating their experience of NSSI and recovery. Implications: Clinicians should adopt a strengths-based approach and foster self-efficacy and self-compassion with persons with lived experience. This paper provides specific recommendations for counselling psychologists and their clients, including encouraging clinicians to avoid making assumptions about the causes, meanings, and outcomes of self-injury, and to be cognizant of the non-linear nature of the recovery process. [ABSTRACT FROM AUTHOR]

This commentary brings together thoughts on the papers in this special issue and integrates research on adolescent development, resilence, and positive youth experiences that promote character development. We apply the Protective and Compensatory Experieces (PACEs) framework to the papers in the special issue. We also discuss future directions for research and interventions promoting positive youth development and characters strengths. [ABSTRACT FROM AUTHOR]

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF–LPF frameworks and suggestions to increase the transformative power of future studies. [ABSTRACT FROM AUTHOR]

New Orleans is no stranger to trauma. The Crescent City has a vast history of environmental calamities and oppression. Yet, New Orleans is renowned for its "joie de vivre"—or "love of life." Specifically, this community is known for its unique practice of second-line parades. Researchers have noted the healing power of second-line processions, but none have analyzed the practice and psychology of this ritual through a trauma-informed lens. The aim of this conceptual paper is to begin the conversation, rather than deliver hard fast conclusions, on the potential therapeutic function of second-line parades in response to grief. Relevant literature is presented to illustrate second-line parades, trauma theory, and to provide evidence that the therapeutic effects of second-lining may, in part, be explained by trauma theory. This paper concludes with remarks on conceptualizing the second-line funeral as a sophisticated trauma-informed approach to grief and a note for future research. [ABSTRACT FROM AUTHOR]

Background: Cultural competence is considered one of the criteria for high‐quality nursing care. Aim: This study aimed to analyse cultural competence in nursing. Methods: This study was performed using the hybrid concept analysis approach in three phases. In the theoretical phase, literature was reviewed by searching Persian and English language databases, and 94 articles were included. In the second or fieldwork phase, 11 semi‐structured interviews were conducted with purposefully selected nurses. The results of both theoretical and fieldwork phases were analysed using conventional content analysis, and in the final analysis phase, the results of the previous phases were triangulated. Results: The attributes of cultural competence were obtained in the theoretical phase in six and the fieldwork phase in three categories. In the final phase, the categories obtained in both previous phases were triangulated: cultural competence in nursing is a continuous, developmental, flexible, extensive and complex process that is patient‐ and justice‐oriented and emerges through learning and skills acquisition, including cultural knowledge, attitudes and practices. Conclusion: Managers and planners of nursing education can use the results of this study to educate nursing students and nurses and evaluate outcomes as one of the criteria for quality care. Summary statement: What is already known about this topic? There is a concern in nursing that the profession needs a unified definition of cultural competence.What this paper adds? This study showed that cultural competence in nursing is a continuous, developmental, complex, and extensive process that is patient‐ and justice‐orientated and emerges through learning and skills acquisition, including cultural knowledge, attitudes, and practices.The implications of this paper: The findings help identify and present the definition of cultural competence in nursing and be used in the training of nursing students and the continuous education of nurses. [ABSTRACT FROM AUTHOR]

Objectives: To explore the rate of NUPs and associated factors in the PED of the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain) using Andersen's Behavioural Model. Methods: We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain). Results: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions: The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice: Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method: This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team. [ABSTRACT FROM AUTHOR]

Introduction: Implementing occupation‐based practice in low‐resourced settings can be challenging especially when working with children with HIV/Aids whose daily occupation of play is often affected by their health condition and other contextual factors such as poverty or stigma. Aim: The aim of this paper is to obtain consensus from experts on the content and application of a play‐based intervention for children with HIV/Aids living in a low‐resourced setting. Methods: A Delphi study involving two rounds using an online survey format was conducted with experts from the field of child development, play and/or HIV/Aids. Consensus agreement was reached when at least 70% of Delphi experts rated each item at 3 or higher on a 5‐point Likert scale. Consumer and Community Involvement: This paper is part of a multi‐stage study that involved input and feedback from families of children who were born HIV/Aids, occupational therapists working with families of children with HIV/Aids, and input from local and international experts working with people with HIV/Aids. Results: Thirty‐seven experts completed the first round, and 35 completed the second round of the study. Consensus was achieved on the application of the Cooper's Model of Children's Play, techniques to be used and the structure of the intervention. Experts also agreed on the inclusion of a pre‐intervention workshop as part of the play‐based intervention. Discussion and conclusion: The consensus on the content and application of a play‐based intervention framework through a process of gaining expert perspectives provides confidence that the intervention planned to promote play for children with HIV/Aids living in low‐resourced settings is likely to be effective. Key Points for Occupational Therapy: Occupation‐based practice is challenging when working with children with HIV/Aids in low‐resourced settings.Consensus was achieved on the play‐based intervention's theoretical model, techniques to be used, and the structure.Consensus from experts provides confidence that the intervention planned is likely to be effective. [ABSTRACT FROM AUTHOR]

Background: AI can positively influence teaching by offering support for classroom management, creating inclusive learning environments, enhancing digital skills, personalizing teaching methods, and strengthening teacher‐student relationships. Objectives: This quantitative research study investigates the opportunities, difficulties, and consequences of incorporating AI into teacher education. Methods: Data were collected through structured questionnaires from 202 college students and 68 staff members. The analysis was conducted using SPSS software. Results: The study provides a novel contribution by its thorough investigation of the diverse effects of AI on teacher education. It offers beneficial perspectives on the possible benefits and challenges, illuminating the far‐reaching changes that AI could bring to the terrain of learning and instruction and teaching methods in the time yet to come. The research sought to assess the effect of AI adoption in teacher education across five main dimensions: (i) its influence on teaching support and classroom management, (ii) its role in creating inclusive and accessible learning environments, (iii) its contribution to improving teachers' digital literacy and computer skills, and enhancing access to digital teaching resources, (iv) its positive influence on identifying students' learning styles and facilitating the adoption of diverse teaching methods, and (v) its role in strengthening teacher‐student relationships through improved interactions. Conclusion: The findings elucidate the promising opportunities that AI presents in the field of teacher education, along with the obstacles that require resolution for the effective fusion of AI educational settings. Lay Description: What is currently known about this topic?: AI has the potential to enhance various aspects of teaching, including classroom management and personalizing teaching methods.Incorporating AI into education has garnered significant interest due to its perceived benefits in improving learning outcomes. What does this paper add?: This paper provides a comprehensive investigation into the effects of AI adoption in teacher education, highlighting both the opportunities and challenges associated with its implementation.It offers insights into how AI can influence different dimensions of teaching, such as classroom management, learning environment inclusivity, and teacher‐student relationships. Implications for practice/or policy: The findings of this study underscore the importance of integrating AI into teacher education programs to leverage its potential benefits in enhancing teaching practices.Policymakers and educators should consider the implications of AI adoption in education and develop strategies to address challenges while maximizing the advantages of AI technologies in teaching and learning. [ABSTRACT FROM AUTHOR]

Background: Instructional videos constitute a pivotal component in flipped learning. Despite their significance, there is a dearth of research specifically dedicated to instructional videos within the context of flipped classrooms. This paucity has led to an empirical void in verifying the efficacy of instructional videos in flipped learning environments. Objectives: The present study endeavours to contribute to the extant literature on flipped pedagogical practices by providing empirical evidence regarding the effectiveness of instructional videos in flipped learning environments. Methods: This study employs a convergent mixed‐methods design. Forty‐five instructional videos in three subtypes were administered in two classes over a 15‐week semester. Data, both quantitative (log data from the learning management system) and qualitative (from focus group discussions at two time points), were concurrently collected from a flipped class (n = 25) and a blended class (n = 28) with the aim of gauging student engagement and learning outcomes in the flipped class and understanding video‐viewing features typical of the flipped class. Results: Both datasets corroborated that participants in the flipped class outperformed their counterparts in the blended class in terms of video‐watching, peer interaction, knowledge retention, and transfer skills. Conclusions: The instructional videos within the flipped classroom setting serve to enhance student engagement in the learning process and improve learning outcomes. The efficacy of these instructional videos in flipped learning can be further augmented through strategic approaches in both their design and implementation. Lay Description: What is currently known about this topic: The flipping pedagogy is conducive to learning.Videos play a crucial role in flipped learning.Videos prepared students for classroom activities.However, engaging students with pre‐class videos presents a challenge. What this paper adds: This paper furnishes direct empirical evidence supporting the effectiveness of instructional videos in flipped learning.It uncovers factors affecting student engagement with videos in flipped learning.It offers insights into the design and implementation of videos in flipped learning. Implications for practice: Considering facilitating conditions and affective factors when creating videos.Acknowledging learner characteristics when designing videos.Utilizing instructional strategies when implementing videos. [ABSTRACT FROM AUTHOR]

Background: Both socially regulated learning and cognitive quality are important factors affecting collaborative knowledge building, but the current research lacks a joint quantified evaluation method that combines these two aspects. Objectives: Based on the existing framework, we proposed a joint evaluation method for regulated learning and cognitive quality in collaborative knowledge building, and further extracted the evaluation indicators. Methods: This study involved 74 learners enrolled in a course named 'the Application of Modern Educational Technology' as the subject of study, and made a case analysis with this method. Results and Conclusions: First, the indicators of this joint evaluation method could complement the indicators of traditional frequency statistics methods and facilitate an analysis of regulated learning and cognitive quality in collaborative knowledge building. Second, the group with a higher proportion of high‐level cognitive quality and socially shared regulation in collaborative knowledge building achieved better final scores. Finally, four types of groups were obtained through clustering: excellent, risky, mixed group, and highly collaborative group. This study introduced a joint evaluation method for regulated learning and cognitive quality in collaborative knowledge building and provides suggestions for future research. Lay Description: What is currently known about this topic?: Online collaborative knowledge building is increasingly important.Regulated learning and cognitive quality are considered very important for successful collaborative learning.Without quantitative methods, it is difficult to assess regulated learning and cognitive quality during collaborative knowledge building in a timely manner. What does this paper add?: This paper provided a joint evaluation method of regulated learning and cognitive quality (JERC) for online collaborative knowledge building.A case study was conducted to identify JERC's usefulness. Using descriptive statistics and visualization, it was determined that indicators of JERC can not only capture the state of cognitive quality and regulated learning status, but also elucidate the nature of that status (i.e., comprehensive, dynamic, cyclical).Through clustering analysis, four distinct groups were identified, each exhibiting different characteristics and moving patterns of regulated learning and cognitive quality over time. These patterns indicate that the quality of cognitive and regulatory learning cannot be determined solely by behavioural frequency. Moreover, an excessive proportion of individual regulation cannot predict better learning performance. Implications for practice: A computable representation model of regulated learning and cognitive quality was constructed to support automated perception and intervention in regulated learning and cognitive processing.With JERC, it is possible for researchers to capture, process, analyse and predict dynamic data to examine online collaborative knowledge building combined with shared physiological arousal events.The results of JERC can be used by researchers to develop advanced techniques, such as AI deep learning, for designing adaptive supports that can foster students' online collaborative knowledge building. [ABSTRACT FROM AUTHOR]

This paper delves into the creative methodology adopted whilst engaging in a research study with five families whose young children (aged between 8 and 10 years old) were excluded from school due to social, emotional and mental health difficulties. The complex needs surrounding these families often lead to them being labelled as hard-to-reach and therefore challenging to engage in research. This paper will explore these challenges, the ethical dilemmas that emerged, the constant observation throughout, the reflexivity and flexibility required by the researchers and the relationships forged. Using various creative methods as part of the Mosaic approach both the children and their parents were able to play a part in the meaning-making process throughout the research journey. The culmination of the research study took place in the format of a multi-family group session which provided a safe space for an intergenerational encounter allowing for the children's and parent's authentic voices to continue to be heard. [ABSTRACT FROM AUTHOR]

Introduction: To contribute to addressing diagnostic health inequalities in the United Kingdom, this review aimed to investigate determinants of diagnostic service use amongst people experiencing high deprivation in the United Kingdom. Methods: A systematic review was conducted using three databases (EBSCO, Web of Science and SCOPUS) to search studies pertaining to diagnostic service use amongst people experiencing high deprivation. Search terms related to diagnostics, barriers and facilitators to access and deprivation. Articles were included if they discussed facilitators and/or barriers to diagnostic service access, contained participants' direct perspectives and focussed on individuals experiencing high deprivation in the United Kingdom. Articles were excluded if the full text was unretrievable, only abstracts were available, the research did not focus on adults experiencing high deprivation in the United Kingdom, those not including participants' direct perspectives (e.g., quantitative studies) and papers unavailable in English. Results: Of 14,717 initial papers, 18 were included in the final review. Determinants were grouped into three themes (Beliefs and Behaviours, Emotional and Psychological Factors and Practical Factors), made up of 15 sub‐themes. These were mapped to a conceptual model, which illustrates that Beliefs and Behaviours interact with Emotional and Psychological Factors to influence Motivation to access diagnostic services. Motivation then influences and is influenced by Practical Factors, resulting in a Decision to Access or Not. This decision influences Beliefs and Behaviours and/or Emotional and Psychological Factors such that the cycle begins again. Conclusion: Decision‐making regarding diagnostic service use for people experiencing high deprivation in the United Kingdom is complex. The conceptual model illustrates this complexity, as well as the mediative, interactive and iterative nature of the process. The model should be applied in policy and practice to enable understanding of the factors influencing access to diagnostic services and to design interventions that address identified determinants. Patient or Public Contribution: Consulting lived experience experts was imperative in understanding whether and how the existing literature captures the lived experience of those experiencing high deprivation in South England. The model was presented to lived experience experts, who corroborated findings, highlighted significant factors for them and introduced issues that were not identified in the review. [ABSTRACT FROM AUTHOR]

Emotionally-based school avoidance (EBSA) is an important driver of persistent school absenteeism and may have worsened in the context of COVID-19. This paper describes the development of a brief parent-focused psychosocial intervention with the goal to address the lack of accessible early interventions for EBSA. The developmental process used a person-based approach with two phases. In Phase 1, qualitative data were collected about intervention preferences and priorities from N = 10 parents and N = 7 practitioners in a series of co-design workshops. Phase 2 refined an intervention blueprint based on iterative consultations with N = 4 parents and N = 3 practitioners. Framework analysis was used to organise findings around key intervention parameters, including relevant mechanisms, content, and delivery methods needed to provide effective, acceptable and feasible support for families affected by EBSA. The resulting blueprint incorporates three online modules to be delivered over three weeks with each module consisting of psychoeducational videos, self-completed learning tasks and a corresponding coaching session. Respective module content includes: (i) self-care strategies to increase parent wellbeing and self-efficacy; (ii) parenting strategies to change behavioural patterns that maintain child distress and avoidance of school; and (iii) strategic communication strategies to increase the quality of home-school relationships. The blueprint has been developed into a full prototype for a forthcoming feasibility study. Plain language summary: Since the onset of the Covid-19 pandemic, there has been a noticeable increase in children missing school. One significant contributor to this rise in absences is Emotionally-Based School Avoidance (EBSA). EBSA refers to a situation where a child stays home from school due to feelings of anxiety and distress about attending. Accessing timely support for children with EBSA can be difficult due to lengthy waiting lists for child and adolescent mental health services. This paper outlines the creation of a new, brief psychosocial intervention aimed at helping parents support their child experiencing EBSA. The development process involved two phases. In the first phase, we collaborated with 10 parents and 7 practitioners to gather ideas about the kind of support families require, what should be included in the intervention, and how to make it practical for families to use. Based on these discussions, we formulated a plan for the new intervention. The second phase refined this plan of the intervention to ensure its suitability for families. The intervention is called ISAAC: Intervention for School Anxiety and Absenteeism in Children. ISAAC consists of three online modules to be completed by parents over a three-week period. Each module includes videos, reflection activities and homework tasks which help the parent learn a new skill or try a different way of responding to their child's anxiety about attending school. Parents are also supported by a coach. The first module encourages parents to take care of their own wellbeing and manage stress. The second module helps parents to learn new ways to respond to their child's distress related to school attendance, while the third module provides guidance on effective communication with the child's school. The next step for this intervention is to see whether it is agreeable to parents and practical to deliver in the real-world. [ABSTRACT FROM AUTHOR]

This paper examines moral dilemmas faced by family caregivers of older adults who employ live-in migrant care workers. Being both a family caregiver as well as an employer of a live-in migrant care worker often puts family members at a crossroad, where moral decisions must be made. Lacking a formal role, family members do not have a professional code of ethics or other clear rules that can guide their actions, and their choices are rooted in cultural, community, familial, and personal values. This paper discusses moral dilemmas that result from family caregivers' dual commitment, to the wellbeing of their older sick relative who is the recipient of care, and to the wellbeing of the live-in care worker whom they employ. The paper uses relational ethics as a theoretical framework to discuss three cases that involve complex moral decision making in real life. [ABSTRACT FROM AUTHOR]

Commitment to culturally sensitive practice is an ethical obligation that requires knowledge and skills specific to the practice context. Research shows that incorporating religion and spirituality into mental health practice is central to working effectively with Muslim communities. Practitioners need to consider the unique positionality and intersectionality when promoting mental health among Muslim women living in Western countries. This paper explores the trauma-informed, counseling approach and the integration of spirituality and religion when working with Muslim women living in Western Australia. Using the critical reflection approach, the research focuses on the concept of guilt about mental health and summarizes the main points considered in the counseling framework such as the centrality of spirituality and religion in perceiving guilt. The paper presents some practical strategies to incorporate cultural, religious, and spiritual concepts into the counseling relationship. [ABSTRACT FROM AUTHOR]

This paper reports on how service providers and academic researchers partnered to support the journey of a primary prevention organization in western Canada as they reviewed their programming against an evidence-based practice (EBP) framework. The process allows the organization to increase their EBP culture by encouraging staff understanding and uptake of their nine family support programs. It also informs service users and other stakeholders of the evidentiary status of different kinds of support services. In this way, the families become more informed and engaged partners who might easily evaluate the respective risks and benefits of the various applications. As part of the process, an evidence-based framework used a common language to assess the efficacy of the respective nine programs. All nine programs are now mapped into the EBP framework. This review allows staff to become more intentional and informed about the EBPs they employ to support vulnerable families and to use this knowledge to better inform the families with whom they work. This paper and the process the agency followed can be a model for other organizations who serve families experiencing short-term housing crisis, provide infant nursery care, and other support services for families with young children. [ABSTRACT FROM AUTHOR]

Aim: To present the development, implementation and evaluation of a theoretically grounded novel virtual dissemination evaluation (VDE) framework. Background: Care of intensive care unit patients requires access to the most up‐to‐date knowledge and best practices. To address this challenge, we present the development, implementation and evaluation of a theoretically grounded novel VDE framework. This framework is applied to a dissemination strategy, NeoECHO, in neonatal intensive care units. Evidence‐based virtual education is implemented to prevent, detect and treat necrotizing enterocolitis in neonates. Design: Research Methodology: Discussion Paper—Methodology. Methods: The virtual dissemination evaluation framework is a sequential combination of Integration of Integrated‐Promoting Action on Research Implementation in Health Services and Moore's Expanded Outcomes frameworks. The framework's conceptual determinants, virtual facilitators and implementation evaluations were operationalized in the NeoECHO dissemination strategy and evaluated for feasibility. The virtual dissemination evaluation framework was conceptually mapped, and operational activities were examined including theoretical constructs drawing on insights of nursing theorists, especially Fawcett's criteria (2005) for frameworks with practical application (significance, internal consistency, parsimony, testability and design fit). The NeoECHO strategy was evaluated for virtual dissemination evaluation adherence, operationalization and feasibility of implementation evaluation. Results: The virtual dissemination evaluation framework meets the criteria for a practical application and demonstrates feasibility for adherence and operationalization consistency. The implementation evaluation was usable in the virtual dissemination of best practices for neonatal care for necrotizing enterocolitis and healthcare providers were actively engaged in using NeoECHO as an implementation strategy. Conclusion: This examination of the foundational aspects of the framework underscores the rigour required for generalization of practical application. Effective virtual dissemination of evidence‐based practices to hospital units requires structured delivery and evaluation, enabling engaged healthcare providers to actualize education rapidly. The virtual dissemination evaluation frameworks' potential for narrowing the evidence‐based practice gap in neonatal care showcases its wider significance and applicability. Implications: Care of neonates in NICUs requires a multidisciplinary approach and necessitates access to the most up‐to‐date knowledge and best practices. More than traditional dissemination methods are required to bridge the implementation gap. Impact: The effective use of the VDE framework can enhance the design, implementation and evaluation of knowledge dissemination, ultimately elevating neonatal care quality. Clinical Relevance: This paper introduces the VDE framework, a sequential combination of the iPARIHS and Moore's EO frameworks—as a methodological tool for designing, implementing and evaluating a neonatal strategy (NeoECHO) for virtual dissemination of education in NICUs. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

In Yogācāra epistemology, the term prapañca refers to various dimensions of the cognitive process in aspects ranging from consciousness, language formation, the conceptualization of subject–object duality, mental defilements, and ignorance. Given that the Laṅkāvatāra Sūtra conveys the richness of early tenets for both the Yogācāra and Madhyamaka traditions, an investigation of the meaning and discourse context of prapañca is a necessity. This paper conducts a contextual examination of the word prapañca, primarily addressing (1) a range of meanings, (2) possible characteristics, (3) conditions and consequences, especially the associations with the conceptualization (vikalpa) process, and (4) the significance of the elimination of prapañca that the corresponding dialogue implies. This paper finds that prapañca is associated with dualistic conceptualization and the evolution of consciousness within saṃsāra. It shows some qualities of the beginningless conceptual structure of saṃsāric conditioned negativity and is related to language formation. As the discourse in Laṅka adduces it as the root of suffering, liberation from it is a prerequisite for reaching enlightenment and achieving the state of Buddhahood. [ABSTRACT FROM AUTHOR]

Background: Maintenance of speech outcomes following speech‐language therapy (SLT) in Parkinson's disease (PD) is an unmet expectation of people with PD (PWPD) and poorly defined in SLT practice. PD Check‐In, a model for supported self‐managed maintenance of speech following Lee Silverman Voice Treatment (LSVT) LOUD was investigated. Aims: To investigate the impact of the semi‐structured component of PD Check‐In on the adoption of self‐management concepts and behaviours and the identification of facilitators, barriers and strategies for speech maintenance by PWPD over 24 months post‐treatment. Methods and procedure: Following LSVT LOUD, 16 PWPD participated in individual PD Check‐In semi‐structured discussions with a SLT at 6 and 12 weeks, and 6, 12 and 24 months post treatment. A two‐stage qualitative content analysis was applied: directed content analysis using categories from the theoretical framework of PD Check‐In followed by inductive content analysis to identify subcategories. Outcomes and results: Statements from PWPD indicated adoption of seven concepts of self‐management across participants and across time. Six concepts from the theoretical framework of PD Check‐In (partnerships, self‐reflection, maintenance barriers and facilitators, revision of LSVT LOUD skill, goal setting and maintenance strategies), and one new category, participation, emerged from the analysis. Self‐reflection, maintenance facilitators and barriers and participation were most prevalent in discussions. PWPD identified facilitators, barriers and strategies for maintenance across time points. Conclusions and implications: Statements from PWPD indicated a positive impact of SLT‐supported self‐management of speech using self‐tailored strategies for sustainable maintenance according to their individual circumstances and needs. WHAT THIS PAPER ADDS: What is already known on this subject: People with Parkinson's disease (PWPD) have expressed their need for speech‐language therapy (SLT) services that are accessible for the duration of the condition and responsive to their expectation of maintaining speech following treatment. Outcomes for maintenance of the treatment effect following Lee Silverman Voice Treatment (LSVT) LOUD are variable. What this paper adds to existing knowledge: This study presents the outcomes of five PD Check‐In interventions delivered in semi‐structured discussions between PWPD and a SLT over 24 months following LSVT LOUD for the development of self‐management skills and behaviours. PWPD adopted self‐management positively using self‐tailored strategies for sustainable maintenance according to their individual circumstances and needs. What are the potential or actual clinical implications of this work?: PWPD responded positively to the individual development of self‐management skills and behaviours over time. Individuality and flexible responsivity are features of PD Check‐In which resonate with PWPD and speak to SLT supported self‐managed maintenance of speech as a long‐term model for PD. [ABSTRACT FROM AUTHOR]

Background: Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent‐based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent‐based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20‐week period. Participants received one of two interventions: (1) Standard Care – indirect group PBI – (PBI) (2) Enhanced Care: indirect group enhanced PBI – (EPBI). Both standardised and non‐standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure – Speech & Language Therapy (PAM‐SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well‐being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. Outcomes and Results: One hundred fifty‐five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur‐Bates Communicative Development Inventories Sentence Length, from pre‐intervention to post‐intervention and 6 months post‐intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval –0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents. WHAT THIS PAPER ADDS: What is already known on the subject: Speech, language and communication needs (SLCN) have a knock‐on effect on emotional well‐being, school readiness, literacy and school attainment, putting children at increased risk of long‐term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge: Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work?: This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends. Methods: We conducted multiple, art‐informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships. Results: The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends. Conclusion: There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art‐informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children. WHAT THIS PAPER ADDS: What is already known on the subject: Children with Language Disorder (LD) are at risk of peer relationship difficulties. Studies to date are based on sociometrics and adult reports. Only a few studies employ participatory approaches to research with children, directly engaging children with LD when exploring their friendships What this paper adds: This paper directly asks children with LD about their understanding of friendship and strategies for making friends.Physical proximity and play are important to children.s understanding of friendship especially in recognising good and bad friends. This indicates potential reasons for children with LD being susceptible to false friendsAdditionally, children with LD do not perceive language and communication as a barrier to making friends. What are the potential or actual clinical implications of this work?: Concepts around friendship and good/bad friends should be routinely assessed and targeted (if appropriate) in interventions. The study highlights the need to continue discussing practices around sharing diagnoses with children with LD. [ABSTRACT FROM AUTHOR]

Background: The role of participatory health research (PHR) is increasingly acknowledged by funding bodies, researchers and civil society globally; however, it continues to be under‐represented in the speech and language therapy (SLT) research literature. This collaborative research approach is associated with the increased application of research evidence, and the generation of positive impacts in practice, policy, health systems and society. Aims: To increase researchers' and other participatory partners' understanding of PHR, and to demonstrate its applicability to research in the SLT field. Methods & Procedures: This aim is achieved through a discussion on PHR, its principles, benefits and challenges, and the evaluation of its impact. A recently developed evaluation framework to support the implementation of best engagement practices is examined, and recommendations for how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. Main contribution: This paper serves as an important conversation on the value of PHR to SLT research, and presents guidance to support its increased implementation in this research field. Conclusions & Implications: Conclusions & Implications: PHR remains an under‐represented research approach in the SLT literature, despite increasing evidence demonstrating its effectiveness and value. It offers a potential solution to the research–practice gap, and challenges the ongoing research hierarchies by democrating the process of knowledge production. WHAT THIS PAPER ADDS: What is already known on this subject: PHR is increasingly attracting the attention of funders, researchers and decision‐makers due to a growing body of evidence in support of this collaborative research approach. Despite its potential to bridge the research–practice gap, PHR remains significantly under‐represented in the SLT research literature. What this paper adds to the existing knowledge: This paper discusses the principles, benefits, challenges and impact evaluation of PHR. A recently developed evaluation framework for supporting the implementation of best engagement practices is examined. A demonstration of how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. What are the potential or actual clinical implications of this work?: Speech and language therapists play a key role in PHR, as co‐researchers contributing essential context‐based knowledge. It is therefore imperative that they understand the principles and practices of this approach in order to maximize their input in future participatory partnerships. [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess and compare the quality of paper-based and electronic- based health records. The comparison examined three criteria: content, documentation process and structure. Background: Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. Methods: A retrospective, descriptive, comparative design was used to address the study’s purposes. A convenient number of patients’ records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Results: Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses’ knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Conclusion: Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Relevance to clinical practice: Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients’ outcomes. [ABSTRACT FROM AUTHOR]

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) software that analyzes medical images is becoming increasingly prevalent. Unlike earlier generations of AI software, which relied on expert knowledge to identify imaging features, machine learning approaches automatically learn to recognize these features. However, the promise of accurate personalized medicine can only be fulfilled with access to large quantities of medical data from patients. This data could be used for purposes such as predicting disease, diagnosis, treatment optimization, and prognostication. Radiology is positioned to lead development and implementation of AI algorithms and to manage the associated ethical and legal challenges. This white paper from the Canadian Association of Radiologists provides a framework for study of the legal and ethical issues related to AI in medical imaging, related to patient data (privacy, confidentiality, ownership, and sharing); algorithms (levels of autonomy, liability, and jurisprudence); practice (best practices and current legal framework); and finally, opportunities in AI from the perspective of a universal health care system. [ABSTRACT FROM AUTHOR]

Background: The Pontifical Academy for Life (PAV) is an academic institution of the Holy See (Vatican), which aims to develop and promote Catholic teachings on questions of biomedical ethics. Palliative care (PC) experts from around the world professing different faiths were invited by the PAV to develop strategic recommendations for the global development of PC ("PAL-LIFE group"). Design: Thirteen experts in PC advocacy participated in an online Delphi process. In four iterative rounds, participants were asked to identify the most significant stakeholder groups and then propose for each, strategic recommendations to advance PC. Each round incorporated the feedback from previous rounds until consensus was achieved on the most important recommendations. In a last step, the ad hoc group was asked to rank the stakeholders' groups by order of importance on a 13-point scale and to propose suggestions for implementation. A cluster analysis provided a classification of the stakeholders in different levels of importance for PC development. Results: Thirteen stakeholder groups and 43 recommendations resulted from the first round, and, of those, 13 recommendations were chosen as the most important (1 for each stakeholder group). Five groups had higher scores. The recommendation chosen for these top 5 groups were as follows: (1) Policy makers: Ensure universal access to PC; (2) Academia: Offer mandatory PC courses to undergraduates; (3) Healthcare workers: PC professionals should receive adequate certification; (4) Hospitals and healthcare centers: Every healthcare center should ensure access to PC medicines; and (5) PC associations: National Associations should be effective advocates and work with their governments in the process of implementing international policy framework. A recommendation for each of the remaining eight groups is also presented. Discussion: This white paper represents a position statement of the PAV developed through a consensus process in regard to advocacy strategies for the advancement of PC in the world. [ABSTRACT FROM AUTHOR]

The paper attempts to contextualize the significance of the work of unpaid female family helpers' (UPFFH) for women empowerment. Additionally, it brings into light the subjective feelings and perceptions of unpaid family helpers. The current research is based on primary data collected through a self-structured questionnaire from 200 females aged 15+ years who were helping in the household income generation without getting paid. A cross-sectional survey was conducted among UPFFHs residing in district Lahore, Pakistan. The participants were selected using a simple random sampling technique. The analysis of UPFFHs empowerment was performed by employing a percentage distribution approach based on four levels of participation in decision making. The research puts emphasis on the impact of excessive, unequal, and unpaid work on women and further argues for social rational of recognizing the work through empowering women in decision-making process at their personal, household, and community level. The findings of the study indicates that the young UPFFHs are less empowered as they face the greatest familial and community pressure when it comes to making their life decisions. However, the paper further documents their aspiration to attain economic independence which would then bring change in gender perceptions and their overall social standing. The paper concludes by highlighting the problems associated with "unpaid work" and why it must be addressed, especially if the country has to fully realize the valued goal of women empowerment and gender equality. [ABSTRACT FROM AUTHOR]

Young people's sexual and reproductive health (SRH) continues to be a major challenge in low and middle-income countries, with implications for public health now and in the future. Fortunately there is a growing array of evidence-based interventions, and commitments from governments, development partners and donors, to support programmes that aim to improve young people's SRH. However, in some situations, the technical assistance that governments feel that they need to strengthen and implement national policies and strategies, to move from words to action, is not available. The WHO Adolescent and Youth Sexual and Reproductive Health and Rights (AYSRHR) Technical Assistance (TA) Coordination Mechanism was initiated to help fill this technical assistance gap; to respond to TA requests from ministries of health in ways that are timely, efficient, effective and contribute to strengthening capacity. This paper describes the process of developing the Technical Assistance Coordination Mechanism (TA Mechanism) and the outcomes, experiences and lessons learned after three years of working. It triangulates the findings from a preliminary review of the literature and discussions with selected key informants; the outcomes from a series of structured review meetings; and the documented processes and results of the technical assistance provided to countries. The lessons learned focus on three aspects of the TA Mechanism. How it was conceptualized and designed: through listening to people who provide and receive AYSRHR TA and by reviewing and synthesizing past experiences of TA provision. What the TA Mechanism has achieved: a standardized process for TA provision, at different stages for a range of AYSRHR issues in ten countries in three geographic regions. And what worked well and what did not: which common challenges was the TA Mechanism able to address and which ones persisted despite efforts to avoid or resolve them. The paper ends with the implications of the lessons learned for future action. [ABSTRACT FROM AUTHOR]

Over the past decade, healthcare systems have started to establish control centres to manage patient flow, with a view to removing delays and increasing the quality of care. Such centres—here dubbed Healthcare Capacity Command/Coordination Centres (HCCCs)—are a challenge to design and operate. Broad-ranging surveys of HCCCs have been lacking, and design for their human users is only starting to be addressed. In this review we identified 73 papers describing different kinds of HCCCs, classifying them according to whether they describe virtual or physical control centres, the kinds of situations they handle, and the different levels of Rasmussen's [1] risk management framework that they integrate. Most of the papers (71%) describe physical HCCCs established as control centres, whereas 29% of the papers describe virtual HCCCs staffed by stakeholders in separate locations. Principal functions of the HCCCs described are categorised as business as usual (BAU) (48%), surge management (15%), emergency response (18%), and mass casualty management (19%). The organisation layers that the HCCCs incorporate are classified according to the risk management framework; HCCCs managing BAU involve lower levels of the framework, whereas HCCCs handling the more emergent functions involve all levels. Major challenges confronting HCCCs include the dissemination of information about healthcare system status, and the management of perspectives and goals from different parts of the healthcare system. HCCCs that take the form of physical control centres are just starting to be analysed using human factors principles that will make staff more effective and productive at managing patient flow. [ABSTRACT FROM AUTHOR]