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Artificial Intelligence (AI) carries the potential for unprecedented disruption in radiology, with possible positive and negative consequences. The integration of AI in radiology holds the potential to revolutionize healthcare practices by advancing diagnosis, quantification, and management of multiple medical conditions. Nevertheless, the ever‑growing availability of AI tools in radiology highlights an increasing need to critically evaluate claims for its utility and to differentiate safe product offerings from potentially harmful, or fundamentally unhelpful ones. This multi‑society paper, presenting the views of Radiology Societies in the USA, Canada, Europe, Australia, and New Zealand, defines the potential practical problems and ethical issues surrounding the incorporation of AI into radiological practice. In addition to delineating the main points of concern that developers, regulators, and purchasers of AI tools should consider prior to their introduction into clinical practice, this statement also suggests methods to monitor their stability and safety in clinical use, and their suitability for possible autonomous function. This statement is intended to serve as a useful summary of the practical issues which should be considered by all parties involved in the development of radiology AI resources, and their implementation as clinical tools. [ABSTRACT FROM AUTHOR]

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

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

The analysis of international and collaborative publication trends in prominent behavior‐analytic journals has been a topic of interest for behavioral researchers. This paper focuses on publication trends from 1997 through 2020 in three prominent journals: Journal of the Experimental Analysis of Behavior (JEAB), Journal of Applied Behavior Analysis (JABA), and Perspectives on Behavior Science (PBS). The variable of interest was the percentage of articles published per geographical category—Australasia/East Asia, Europe, Latin America, Middle East, North America, and Africa. The results showed that 79, 96, and 87% of the published articles in JEAB, JABA, and PBS, respectively, were conducted by researchers with a North American affiliation. Furthermore, 12, 4, and 4% of the articles in JEAB, JABA, and PBS, respectively, were coauthored by at least two researchers from different geographical categories. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: ●Expert by Experience participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goal.●Involving mental health Experts by Experience in the education of nursing students demonstrates positive attitudinal change. What the paper adds to existing knowledge: ●The paper presents perspectives from Experts by Experience about the unique knowledge and expertise they derive from their lived experience of mental distress and mental health service use. As a result, they can make a unique and essential contribution to mental health nursing education. They utilize this knowledge to create an interactive learning environment and encourage critical thinking.●The international focus of this research enriches understandings about how Experts by Experience might be perceived in a broader range of countries. What are the implications for practice: ●Mental health policy articulates the importance of service user involvement in all aspects of mental health service delivery. This goal will not be fully achieved without nurses having positive attitudes towards experts by experience as colleagues.●Positive attitudes are more likely to develop when nurses understand and value the contribution experts by experience bring by virtue of their unique knowledge and expertise. This paper provides some important insights to achieving this end. Introduction: Embedding lived experience in mental health nursing education is increasing, with research findings suggesting the impact is positive. To date, research has primarily targeted the perspectives of nursing students and academics from the health professions. Aim: To enhance understanding of the unique knowledge and expertise experts by experience contribute to mental health nursing education. Methods: Qualitative exploratory research methods were employed. In‐depth individual interviews were conducted with experts by experience who delivered a coproduced learning module to nursing students in Europe and Australia. Results: Participants described their unique and essential contribution to mental health nursing education under four main themes: critical thinking, beyond textbooks; interactive and open communication; understanding personal recovery; and mental health is health. Conclusions: These findings present an understanding of the unique knowledge and expertise Experts by Experience contribute to mental health education not previously addressed in the literature. Appreciating and respecting this, unique contribute is necessary as Expert by Experience contributions continue to develop. Implications for Practice: Mental health services purport to value service user involvement. Identifying and respecting and valuing the unique contribution they bring to services is essential. Without this understanding, tokenistic involvement may become a major barrier. [ABSTRACT FROM AUTHOR]

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

This paper qualitative examines a holistic framework for teaching in the digital era. The examination is based on teachers' perspectives of their career, that is, what core features can be said to characterise teacher's practice, across contexts, cultures and subjects. Semi-structured interviews of expert teachers, specifically from Australia, Europe and the Latin-America, are the main data source. The design process sought to examine teachers' approaches to their professional definition and their agency to enact this, against a theoretically validated framework. Results indicated the emergence of three defining categories based on the validation and synthesis of the relationships between six elements in the theoretical model. [ABSTRACT FROM AUTHOR]

In many long-enduring coastal cultures, there are stories – sometimes mythologized – about times when pieces of land became separated from mainlands by submergence, a process that created islands where none existed before. Using examples from northwest Europe and Australia, this paper argues that many such stories recall times, often millennia ago, when sea level in the aftermath of the Last Glaciation (last ice age) was rising and transforming coastal landscapes and their human uses in exactly the ways these stories describe. The possibility that these may have arisen from eyewitness accounts of these transformative processes, hitherto thought to be understandable only by scientific (palaeoenvironmental) reconstructions, should encourage more systematic investigations of such stories by scientists. It also suggests that science has traditionally underestimated the capacity of oral (pre-literate) cultures to acquire, encode and sustain their observations of memorable events with a high degree of replication fidelity. [ABSTRACT FROM AUTHOR]

Online platforms can support health and educational professionals in their daily work; however, it is challenging to keep online platforms sustainable. This paper aims to indicate the most important factors of platform sustainability from the perspective of professionals involved in online platforms. Further, it aims to understand how these factors operate. A mixed methods study was carried out among professionals from Europe, Australia, the USA and Canada. In the first phase, the importance of 54 factors from the literature was assessed with a questionnaire among 17 professionals. The relative importance of the factors and the consensus regarding this importance were calculated using median scores and interquartile deviations. In total, 19 factors were selected representing general characteristics, characteristics related to the platform, communication, visitor and context. In the second phase, insight was gained regarding the experiences with those factors through 12 individual Skype interviews. The most frequently mentioned important factors of platform sustainability were (i) having sufficient time, resources and expertise, (ii) user friendliness and (iii) creating a sense of belonging. Platforms should use a planned approach to address a combination of factors directly from platform development. Gaining long-term resources is challenging and should be considered from the start of a project by building partnerships. To promote user friendliness, platforms should be simple, have a clear set-up and provide high-quality tools. Finally, establishing a sense of belonging could be supported by branding and face-to-face networking activities. For all aspects, involving visitors and stakeholders is essential. [ABSTRACT FROM AUTHOR]

Purpose: The analysis of data collected from user interactions with educational and information technology has attracted much attention as a promising approach to advancing our understanding of the learning process. This promise motivated the emergence of the field of learning analytics and supported the education sector in moving toward data-informed strategic decision making. Yet, progress to date in embedding such data-informed processes has been limited. The purpose of this paper is to address a commonly posed question asked by educators, managers, administrators and researchers seeking to implement learning analytics – how do we start institutional adoption of learning analytics? Design/methodology/approach: A narrative review is performed to synthesize the existing literature on learning analytics adoption in higher education. The synthesis is based on the established models for the adoption of business analytics and finding two projects performed in Australia and Europe to develop and evaluate approaches to adoption of learning analytics in higher education. Findings: The paper first defines learning analytics and touches on lessons learned from some well-known case studies. The paper then reviews the current state of institutional adoption of learning analytics by examining evidence produced in several studies conducted worldwide. The paper next outlines an approach to learning analytics adoption that could aid system-wide institutional transformation. The approach also highlights critical challenges that require close attention in order for learning analytics to make a long-term impact on research and practice of learning and teaching. Originality/value: The paper proposed approach that can be used by senior leaders, practitioners and researchers interested in adoption of learning analytics in higher education. The proposed approach highlights the importance of the socio-technical nature of learning analytics and complexities pertinent to innovation adoption in higher education institutions. [ABSTRACT FROM AUTHOR]

Food value chain businesses form alliances with horizontal and/or vertical partners to take collective action to either overcome or ameliorate chain failure, or to take advantage of new opportunities available due to innovations in products or processes. The desired outcomes from the collective action would no t be possible to achieve if these businesses acted independently. While such alliances and collaborations may take many forms, depending on the degree of commitment, the kind of governance and infrastructure linkages, they can often be thought of as "clubs" for the purpose of economic analysis. Several different types of clubs can be identified, thus the path to collective action chosen by clubs may vary according to existing capabilities and the scope for collaboration, particularly in relation to the potential for value-creating innovation. The result of the collective action is the provision of a chain good or service, which usually leads to greater and more valuable chain coordination. By collectively identifying, funding and acting to capture positive externalities associated with innovation, businesses in many parts of a food value chain can widen opportunities to increase whole-of-chain surplus as well as private profits. In this paper five mini-case studies are presented to demonstrate the breadth of past collective actions undertaken by businesses in food value chains, two in Europe and three in Australia. These are the Euro Pool System, and Global Standards certification in Europe and globally, as well as Meat Standards Australia, an Australian beef organic producer alliance (OBE Organic®), and the supply of food to households during Covid-19 lockdown in Australia. Each case study yields insights into the rationale of how businesses in different food value chains in different countries have acted as a club to use their joint resources to internalise positive innovation and coordination externalities. [ABSTRACT FROM AUTHOR]

Issues: Drug consumptions rooms (DCR) and supervised injecting facilities (SIF) are expanding internationally. Previous reviews have not systematically addressed evaluation methodologies.Approach: Results from systematic searches of scientific databases in English until June 2017 were coded for paper type, country and year of publication. For evaluation papers, study outcome, methodology/study design and main indicators of DCR/SIF 'exposure' were recorded.Key Findings: Two hundred and nineteen eligible peer-reviewed papers were published since 1999: the majority from Canada (n = 117 papers), Europe (n = 36) and Australia (n = 32). Fifty-six papers reported evaluation outcomes. Ecological study designs (n = 10) were used to assess the impact on overdose, public nuisance and crime; modelling techniques (n = 6) estimated impact on blood-borne diseases, overdose deaths and costs. Papers using individual-level data included four prospective cohorts (n = 28), cross-sectional surveys (n = 7) and service records (n = 5). Individual-level data were used to assess safer injecting practice, uptake into health and social services and all the other above outcomes except for impact on crime and costs. Four different indicators of DCR/SIF attendance were used to measure service 'exposure'.Implications: Research around DCRs/SIFs has used ecological, modelling, cross-sectional and cohort study designs. Further research could involve systematic inclusion of a control group of people who are eligible but do not access SIFs, validation of self-reported proportion of injections at SIFs or a stepped-wedge or a cluster trial comparing localities.Conclusions: Methodologies appropriate for DCR/SIF evaluation have been established and can be readily replicated from the existing literature. Research on operational aspects, implementation and transferability is also warranted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Consumer participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goalInvolving mental health "Experts by Experience" in the education of nursing students demonstrates positive attitudinal change What this paper adds to existing knowledge?: More detailed understanding of nursing students' experiences and perspectives about being taught mental health nursing by "Experts by Experience"An international focus, extending understandings about how Experts by Experience might be perceived in a broader range of countries What are the implications for practice?: Positive attitudes towards people labelled with mental illness are essential for quality nursing practiceNurses have an important leadership role in facilitating consumer participation within health services. It is critical that their attitudes are professional and optimistic. Introduction: Consumer participation is central to mental health policy. Negative attitudes of health professionals are barriers to realizing policy goals. Evidence suggests consumers (Experts by Experience) can influence positive attitudes in nursing students. Research in this area to date is limited and primarily from Australia and New Zealand. Aim: To enhance understanding of nursing students' perspectives and experiences of being taught mental health by an Expert by Experience. Method: A qualitative exploratory approach was used. Focus groups were conducted with nursing students from seven universities in Australia and Europe. Data were analysed thematically. Results: Student participants described how exposure to Experts by Experience challenged their views and attitudes and provided a mechanism for reflection, critique and change. The main theme "changing mindset" includes two subthemes: exposing stereotypes and reflection. Discussion: This unique international study demonstrates the capacity for Experts by Experience to contribute to positive attitudinal change towards mental illness in nursing students. This changed mindset must occur for policy goals to be realized. Implications for practice: Nurses in all areas of practice will work with people labelled with mental illness and experiencing mental distress. Overcoming stereotypes and adopting more positive attitudes is essential to deliver quality mental health care. [ABSTRACT FROM AUTHOR]

Over the past two decades, research has emphasised a shift from city government to urban governance. Such a shift brings about its very own challenges, namely governance gaps, uncertain configurations in governance and a limited capacity to act. In this paper, we argue that the concurrent rise of strategy documents in city administration addresses these challenges. Our central claim is that strategy documents can be understood as a distinct discursive device through which local governments enact aspired governance configurations. We illustrate our argument empirically using two prominent examples that, while showing similar features and characteristics, are anchored in different administrative traditions and institutional frameworks: the city administrations of Sydney, Australia, and Vienna, Austria. The contribution of the paper is to show how strategy documents enact governance configurations along four core dimensions: the setting in space and time, the definition of the public, the framing of the res publica and legitimacy issues. Moreover, our comparative analysis of Sydney and Vienna gives evidence of differences in governance configurations enacted through strategy documents. [ABSTRACT FROM AUTHOR]

Background: Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies.Methods: This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS.Results: Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive.Conclusions: This study contributes new knowledge that can inform the initiation and maintenance of primary care patient navigation programs that link patients with CBHSS. It also provides directions for future research. [ABSTRACT FROM AUTHOR]

This paper deals with public service obligation, a form of state aid that applies to air services. The paper first provides general information on the European legislation applying to this form of state aid, and elaborates the legal framework and general principles. The second part is dedicated to a comparison of a similar subsidizing programme in the USA and Australia. An examination of current imposed public service obligation routes in Europe is provided in the following section. The coefficients defining the number of imposed PSO routes per various geo-economic variables have been defined. [ABSTRACT FROM AUTHOR]

• This paper provides a global review of literature relating to the evaluation of national policy addressing work-related psychosocial issues and psychological health. • Results show the literature is scarce in countries outside of Europe. • Methodological approaches and reviewed and future recommendations are provided. • The findings and implications from the existing policy evaluation literature are summarised and areas for future research presented. This paper presents a critical appraisal of the international literature in relation to national work health and safety (WHS) policy evaluation for the management of psychosocial hazards and risks and the protection of work-related psychological health. We reviewed policy evaluation publications from the last 20 years (i.e. between 2001 and 2021). In total, 26 publications were identified and analysed based on: the origin of the research, participants involved, data collection strategies and the data analysis techniques. As an additional component of this review we also synthesised the key findings and implications derived from current policy evaluation efforts. Results support the need for more international research beyond Europe and Australia, and data collection from a more diverse pool of participants (e.g. workers, inspectors, regulators). Understanding the current body of knowledge provides a valuable resource for guiding the future development of informed and high-quality evaluation research and practice, as well as sharing knowledge across countries with the goal to improve psychosocial work conditions globally. The value of this paper is that it provides a clear overview of the current research status, in addition to suggestions for progressing future policy evaluation. [ABSTRACT FROM AUTHOR]

The ultraviolet radiation index (UVI) was adopted internationally to raise awareness about and encourage the public to protect their skin from skin cancer. The current paper is a systematic review of over 20 years of research investigating awareness, comprehension, use, and impact of the UVI. Thirty-one studies were included from the USA, Canada, Europe, Australia, New Zealand, and elsewhere. Awareness of the UVI varies by country, with samples from some countries demonstrating high awareness. However, comprehension and use of the UVI to inform sun safety behaviors are typically much lower. In fact, greater UVI awareness has sometimes been associated with riskier UV-related behaviors such as intentional tanning. Fewer studies have evaluated interventions, and their results have been mixed. In summary, more research is needed to determine how to help the public understand and use the UVI for effective skin protection. This review offers suggestions for future use of and research with the UVI. [ABSTRACT FROM AUTHOR]

Purpose: Signs of Safety (SoS) is a strengths-based approach to child protection casework that has been widely adopted in countries across the world. The purpose of this paper is to report on a study that aimed to synthesise the many evaluations of SoS that have been conducted to assess their strengths and limitations. The intention is to identify the aspects which should be explored further and those that remain unexamined to inform future evaluations. Design/methodology/approach: The study collated and then examined many of the evaluations that are in the public domain as well as some of those that were conducted within agencies and have not been made publicly available. Findings: At the present time (early 2019), the evidence base for SoS is limited. Independent, robust research needs to be undertaken over time to build on the studies that have been conducted. New research must be designed to fill gaps and be capable of producing the evidence required and it must address its own limitations. Originality/value: This study is the most comprehensive contemporary review of the evaluations of SoS that have been conducted to the best of the authors' knowledge. [ABSTRACT FROM AUTHOR]

Background: To date, little is known about the characteristics of highly cited studies in hand surgery compared with other orthopaedic subspecialties. We aimed to assess the position of hand surgery within the orthopedic surgery literature. Methods: We conducted a bibliographic analysis using the Web of Science database to review 1,568 articles published between January 2012 and December 2012 in 4 relevant general orthopedic and 2 hand surgery journals. We used the number of citations within 3 years of publication to measure the impact of each paper. To analyze prognostic factors using logistic regression analysis, we extracted data on orthopedic subspecialty, published journal, location of authorship, and type of study for all articles. For clinical studies, we also recorded details on study design and sample size. Results: Of eligible hand surgery articles (n = 307), the majority (62%) were case reports/series. Only 19% were comparative studies, comprising a significantly smaller proportion of comparative studies from other subspecialties in general orthopedic journals. Systematic reviews/meta-analyses generated a significantly higher number of average citations, whereas educational reviews were consistently cited less frequently than other study types (14.9 and 6.1 average citations, respectively). Being published in the Journal of Bone and Joint Surgery, American volume, having authorship in North America or Europe and Australia, focusing on subspecialties like hip & knee, sports, or shoulder, utilizing a comparative or randomized clinical trial study design, and having a larger sample size increased the odds of receiving more citations. Conclusions: Clinical studies related to hand surgery published in general orthopedic journals are most often of lower quality study design. Having a larger sample size or using a comparative study or randomized clinical trial design can improve the quality of study and may ultimately increase the impact factor of hand surgery journals. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of the Paediatric International Nursing Study was to explore the utility of key performance indicators in developing person-centred practice across a range of services provided to sick children. The objective addressed in this paper was evaluating the use of these indicators to benchmark services internationally. Background This study builds on primary research, which produced indicators that were considered novel both in terms of their positive orientation and use in generating data that privileges the patient voice. This study extends this research through wider testing on an international platform within paediatrics. Design The overall methodological approach was a realistic evaluation used to evaluate the implementation of the key performance indicators, which combined an integrated development and evaluation methodology. Methods The study involved children's wards/hospitals in Australia (six sites across three states) and Europe (seven sites across four countries). Qualitative and quantitative methods were used during the implementation process, however, this paper reports the quantitative data only, which used survey, observations and documentary review. Results The findings demonstrate the quality of care being delivered to children and their families across different international sites. The benchmarking does, however, highlight some differences between paediatric and general hospitals, and between the different key performance indicators across all the sites. Conclusions The findings support the use of the key performance indicators as a novel method to benchmark services internationally. Whilst the data collected across 20 paediatric sites suggest services are more similar than different, benchmarking illuminates variations that encourage a critical dialogue about what works and why. Relevance to clinical practice The transferability of the key performance indicators and measurement framework across different settings has significant implications for practice. The findings offer an approach to benchmarking and celebrating the successes within practice, while learning from partners across the globe in further developing person-centred cultures. [ABSTRACT FROM AUTHOR]

Background: There is significant interest in comparing countries on many different indicators of social problems and policies. Cross-national comparisons of drug prevalence and policies are often hampered by differences in the approach used to reach respondents and the methods used to obtain information in national surveys. The paper explores how much these differences could affect cross-country comparisons.Methods: This study reports prevalence of drug use according to the most recent national household survey and then adjusts estimates as if all national surveys used the same methodology. The analysis focuses on European countries for which the European Monitoring Centre for Drugs and Drug Addiction reports data, the United States, Canada, and Australia. Adjustment factors are based on US data.Findings: Adjusting for modality differences appears likely to modestly affect the rankings of countries by prevalence, but to an extent that could be important for comparisons. For example, general population surveys suggest that the US had some of the highest cannabis and cocaine prevalence rates circa 2012, but this is partially driven by the use of a modality known to produce higher prevalence estimates. This analysis shows that country rankings are partly an artifact of the mode of interview used in national general population surveys.Conclusions: Our preliminary efforts suggest that cross-national prevalence comparisons, policy analyses and, other projects such as estimating the global burden of disease could be improved by adjusting estimates from drug use surveys for differences in modality. Research is needed to create more authoritative adjustment factors. [ABSTRACT FROM AUTHOR]

Background and aims Prohibitions on producing, distributing and selling cannabis are loosening in various jurisdictions around the world. This paper describes the diversification of cannabis supply laws and discusses the challenges to and opportunities for learning from these changes. Methods We document changes in cannabis supply laws that de jure legalized cannabis production for medical and/or non-medical purposes (excluding industrial hemp) in Australasia, Europe, North America and South America. We also highlight challenges to evaluating these legal changes based on our experiences studying cannabis laws and policies in the United States. Findings As of August 2016, two countries have passed laws to legalize large-scale cannabis production for non-medical purposes at the national (Uruguay) or subnational level (four US states). At least nine other countries legally allow (or will soon allow) cannabis to be supplied for medicinal purposes. Most of the changes in cannabis supply laws have occurred since 2010. The data available in most countries are inadequate for rigorously evaluating the changes in cannabis supply laws. Conclusion The evidence base for assessing changes in cannabis supply laws remains weak. Efforts should focus upon collecting information about quantities consumed and market transactions as well as validating self-report surveys. [ABSTRACT FROM AUTHOR]

The vulnerability of deafblind people is considered axiomatic; they are seen not only as a vulnerable group but also as one of the most vulnerable. This paper aims to synthesise existing knowledge to determine what is known about such vulnerability. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. An approach based on a 'hierarchy of evidence' would have reduced the amount of literature reviewed significantly, to the point where synthesis would not be possible. Included material was appraised and an interpretative rather than aggregative approach to synthesis adopted. Drawing on principles of critical interpretive synthesis, rather than being a determiner of whether material should be included or excluded, a critique of the literature is offered within the synthesis. Twenty-eight references were identified for inclusion, originating from the UK, USA, Australia, Continental Europe and the Nordic Countries. No empirical studies specifically examining the experience of vulnerability of deafblind people were found. However, deafblind people describe feelings of vulnerability in studies exploring their experiences more generally, and in personal accounts of living with the impairment. Literature produced by practitioners and specialist organisations also explores the topic. Deafblind people are identified as a population 'at risk' of various adverse outcomes, particularly when compared to the non-deafblind majority, and deafblind people describe being and feeling vulnerable in various situations. The literature largely relates to negative outcomes and includes significantly less exploration of positive risk taking, coping capacity and resilience. Deafblind people do not appear to describe themselves as being vulnerable as a permanent state, suggesting a need for greater exploration of the experience among all sections of this heterogeneous population, with consideration of the concepts of resilience and coping capacity. [ABSTRACT FROM AUTHOR]

Purpose: Different health state utility (HSU) instruments produce different utilities for the same individuals, thereby compromising the intended comparability of economic evaluations of health care interventions. When developing crosswalks, previous studies have indicated nonlinear relationships. This paper inquires into the degree of nonlinearity across the four most widely used HSU-instruments and proposes exchange rates that differ depending on the severity levels of the health state utility scale.Methods: Overall, 7933 respondents from six countries, 1760 in a non-diagnosed healthy group and 6173 in seven disease groups, reported their health states using four different instruments: EQ-5D-5L, SF-6D, HUI-3 and 15D. Quantile regressions investigate the degree of nonlinear relationships between these instruments. To compare the instruments across different disease severities, we split the health state utility scale into utility intervals with 0.2 successive decrements in utility starting from perfect health at 1.00. Exchange rates (ERs) are calculated as the mean utility difference between two utility intervals on one HSU-instrument divided by the difference in mean utility on another HSU-instrument.Results: Quantile regressions reveal significant nonlinear relationships across all four HSU-instruments. The degrees of nonlinearities differ, with a maximum degree of difference in the coefficients along the health state utility scale of 3.34 when SF-6D is regressed on EQ-5D. At the lower end of the health state utility scale, the exchange rate from SF-6D to EQ-5D is 2.11, whilst at the upper end it is 0.38.Conclusion: Comparisons at different utility levels illustrate the fallacy of using linear functions as crosswalks between HSU-instruments. The existence of nonlinear relationships between different HSU-instruments suggests that level-specific exchange rates should be used when converting a change in utility on the instrument used, onto a corresponding utility change had another instrument been used. Accounting for nonlinearities will increase the validity of the comparison for decision makers when faced with a choice between interventions whose calculations of QALY gains have been based on different HSU-instruments. [ABSTRACT FROM AUTHOR]

Anaerobic digestion (AD) of biomass has become a common technology used in many European nations and is receiving increased attention in other nations. The chief attraction of AD is it generates renewable energy. Yet it also manages and treats organic waste, recycles key nutrients to soil, and can create local jobs; making AD an attractive technology to governments. In this paper we review the role government policy has played in promoting AD use and driving its growth in five developed nations studied; Australia, Denmark, Germany, the UK and USA. These nations were chosen for review as they provide a breadth of AD use with the number of AD plants in the aforementioned nations totaling 78, 114, 9545, 265, and 1497. This review looks to demonstrate and discuss policy mechanisms introduced by each nation that has helped drive AD use, and identify areas where policy can help overcome enduring challenges that face the AD industry. Focused discussion is given to waste management, climate change and energy security policies, and to financial incentives made available to AD installations. Analysis shows that the impact of performance based incentives targeted at small-medium capacity AD plants, less than 500 kW, have a significant positive correlation with the growth of AD use in the UK and Germany. The relatively new AD industry faces a number of barriers, which are also discussed, but with the help of supportive government policy for the technology, that considers the wide-ranging benefits of AD across government portfolios; investors will be more likely to show interest in the developing AD industry. [ABSTRACT FROM AUTHOR]

The International Psycho-oncology Society (IPOS) has just celebrated its 30th anniversary. The growth of psychosocial oncology has been exponential, and this relatively new field is becoming a core service that focuses on prevention, reducing the burden of cancer, and enhancing the quality of life from time of diagnosis, through treatment, survivorship, and palliative care. Looking back over the past 30 years, we see that cancer care globally has evolved to a new and higher standard. Today, 'cancer care for the whole patient' is being accomplished with an evidence-based model that addresses psychosocial needs and integrates psycho-oncology into the treatment and care of patients. The President's Plenary Session in Lisbon, Portugal, highlighted the IPOS Mission of promoting global excellence in psychosocial care of people affected by cancer through our research, public policy, advocacy, and education. The internationally endorsed IPOS Standard of Quality Cancer Care, for example, clearly states the necessity of integrating the psychosocial domain into routine care, and that distress should be measured as the sixth vital sign after temperature, blood pressure, pulse, respiratory rate, and pain. The plenary paper also discussed the global progress being made in Europe, North America, and Australia in providing quality cancer care for the whole patient. Collaborative partnerships between IPOS and organizations such as the European Partnership Action Against Cancer and the World Health Organization are essential in building capacity for the delivery of high-quality psycho-oncology services in the future. [ABSTRACT FROM AUTHOR]

Background: Health care organizations need to be responsive to the needs of increasingly diverse patient populations. We compared the contents of six publicly available approaches to organizational responsiveness to diversity. The central questions addressed in this paper are: what are the most consistently recommended issues for health care organizations to address in order to be responsive to the needs of diverse groups that differ from the majority population? How much consensus is there between various approaches?Methods: We purposively sampled six approaches from the US, Australia and Europe and used qualitative textual analysis to categorize the content of each approach into domains (conceptually distinct topic areas) and, within each domain, into dimensions (operationalizations). The resulting classification framework was used for comparative analysis of the content of the six approaches.Results: We identified seven domains that were represented in most or all approaches: organizational commitment, empirical evidence on inequalities and needs, a competent and diverse workforce, ensuring access for all users, ensuring responsiveness in care provision, fostering patient and community participation, and actively promoting responsiveness. Variations in the operationalization of these domains related to different scopes, contexts and types of diversity. For example, approaches that focus on ethnic diversity mostly provide recommendations to handle cultural and language differences; approaches that take an intersectional approach and broaden their target population to vulnerable groups in a more general sense also pay attention to factors such as socio-economic status and gender.Conclusions: Despite differences in labeling, there is a broad consensus about what health care organizations need to do in order to be responsive to patient diversity. This opens the way to full scale implementation of organizational responsiveness in healthcare and structured evaluation of its effectiveness in improving patient outcomes. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth. [ABSTRACT FROM AUTHOR]

Catchment/floodplain sediment geochemical datasets from three continental-scale geochemical projects in Australia (AU), China (CH) and Europe (EU) were studied by comparing sample media, sample preparation, elements determined, analytical methods, detection limits and proportions of reportable values, and certified reference materials used. Twenty six elements (Ba, Ce, Co, Cr, Cu, Mo, Nb, Ni, Pb, Rb, Sr, Th, V, Y, Zn, Zr, Al 2 O 3 , CaO, K 2 O, MgO, MnO, Na 2 O, P 2 O 5 , SiO 2 , Fe 2 O 3 (total), TiO 2 ) were considered comparable among the 35 determined by all three projects, according to the criteria for global comparability of elements proposed in this paper. The median concentrations of all elements (except Co, Y, Zr, SiO 2 and TiO 2 ) in the three datasets increase in the following order: AU < EU ≤ CH, and the median CH/EU ratios for all elements range from 0.98 to 1.94, while the median CH/AU and EU/AU ratios for elements, such as CaO, Na 2 O, MgO and Zn are generally greater than 2 (and up to 7), which could be explained partly by protracted weathering in Australia, and partly by the smaller grain size fraction analysed of the CH dataset (< 1 mm) compared to AU and EU (< 2 mm). In conclusion, a unified sample medium should be collected and unified sample preparation techniques should be followed. Key elements related to mineral resources and the environment should be determined and international or exchanged internal standard materials inserted in new national or global geochemical mapping projects in order to generate globally comparable datasets for establishing global geochemical baselines. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals (HCPs) provide an important point of contact through which people who use performance and image enhancing drugs (PIEDs) could access reliable information, advice, and interventions on a range of PIEDs, their use and related harms. However, HCPs often report difficulties engaging and building rapport with people who use PIEDs, and research suggests that they often lack specialist knowledge on these substances. Providing credible evidence-based resources to support HCPs is thus important. However, educational materials in this area are generally absent and the ones that exist have not been assessed for their utility in the HCP workforce. This paper examines the acceptability and usability of a PIED e-learning module (the Dopinglinkki e-module) targeted at HCPs in three EU Member States and Australia.Methods: A standardised two stage, mixed methodology was implemented. Stage 1 involved HCPs completing the e-module and completing an online survey (N = 77). Stage 2 involved conducting individual structured interviews with a subset of survey respondents (N = 37). Normalisation Process Theory and the Theoretical Framework of Acceptability were used as conceptual lenses.Findings: The e-module provided information that was perceived as useful for HCPs' current and future practice. However, several individual, organisational and societal level barriers were reported as preventing the e-module becoming an accepted and normalised aspect of the HCP workforce, including the need for up to date evidence, the time-consuming nature of completing the e-module, lack of organisational support, the use of over-complex language, and the module's potential to reinforce the stigmatisation of PIEDs.Conclusion: Providing credible evidence-based resources to support HCPs' knowledge development is important. Evidence-based and theory informed interventions are needed to equip HCPs with knowledge that can aid culturally sensitive interactions and effective engagement with people who use PIEDs. Reflecting on our study findings, it is important that the development of interventions should include the voices of both HCP and those using PIEDs, and that careful consideration is given to the various factors that may act as a barrier to effective implementation. [ABSTRACT FROM AUTHOR]

Brassica napus is cultivated largely as a winter or semi‐winter form in Europe and Asia, respectively, whereas spring‐sown rape types are more adapted to the climatic conditions in Canada, northern Europe, and Australia. This plant, the third most important oil crop in the world after maize and oil palm, has had a unique history among those crops that have been targets of breeding and genetic modification. Although agronomy and genetic manipulations of B. napus plants to create seed with substantially no erucic acid content in the seed oil and meal largely free from aliphatic glucosinolates were major breakthroughs, opportunities for further advances in the reduction of antinutritive compounds/enhancement of bioactive compounds, in oil and meal health safety and quality, as well as in agronomic performance and pest resistance, are still greater today than they have ever been. Understanding and application of genetic control for key agronomic traits in B. napus, such as seed oil composition and concentration as well as their environmental interactions, are the main targets, which will underpin the development of the crop for cultivation in an extensive range of environments. It is also needed to improve phytochemical content through traditional breeding programs or through bioengineering of the phenylpropanoid pathway, leading to desirable secondary metabolite accumulation. This paper is a review of modifications (in the field of biotechnology, agronomy, and processing) that have been applied to improve the nutritional value of B. napus L. Practical Applications: This paper has value for people starting their scientific work in the field related to the B. napus biotechnology and nutritional value of vegetable oils. In addition, it is a current compedium of knowledge for people working professionally in the oil industry. Moreover, this article is a cross‐section of the current achievements of genetic engineering in improving the composition of rapeseed and indicates key publications on this subject. Brassica napus L., the third most important oil crop in the world after maize and oil palm, has a unique history among those crops that are targets of breeding and genetic modification. Effective tools of processing, biotechnology, and agronomy are essential to produce rapeseed oil with a high amount of bioactive compounds and continue to be employed in strengthening the product versatility. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) remain a major challenge in the 21st century. High-income countries (HICs) populations are ethnically and culturally diverse due to international migration. Evidence suggests that NCDs rates differ between migrants and the host populations in HICs. This paper presents a review of NCDs burden among migrant groups in HICs in Europe, North America and Australia with a major focus on cardiovascular diseases (CVDs), cancer and diabetes.Methods: We performed a narrative review consisting of scholarly papers published between 1960 until 2018.Results: CVD risk differs by country of origin, country of destination and duration of residence. For example, stroke is more common in sub-Sahara African and South-Asian migrants, but lower in North African and Chinese migrants. Chinese migrants, however, have a higher risk of haemorrhagic stroke despite the lower rate of overall stroke. Coronary heart disease (CHD) is more common in South-Asian migrants, but less common in sub-Saharan and north African migrants although the lower risk of CHD in these population is waning. Diabetes risk is higher in all migrants and migrants seem to develop diabetes at an earlier age than the host populations. Migrants in general have lower rates of overall cancer morbidity and mortality than the host populations in Europe. However, migrants have a higher infectious disease-related cancers than the host populations in Europe. In North America, the picture is more complex. Data from cross-national comparisons indicate that migration-related lifestyle changes associated with the lifestyle of the host population in the country of settlement may influence NCDs risk among migrants in a very significant way.Conclusion: With exception of diabetes, which is consistently higher in all migrant groups than in the host populations, the burden of NCDs among migrants seems to depend on the migrant group, country of settlement and NCD type. This suggests that more work is needed to disentangle the key migration-related lifestyle changes and contextual factors that may be driving the differential risk of NCDs among migrants in order to assist prevention and clinical management of NCDs in these populations. [ABSTRACT FROM AUTHOR]

Floodplains are some of the most ecologically important and human‐impacted habitats throughout the world. Large efforts are underway in North America, Europe, Australia, and elsewhere to restore floodplain habitats, not only to increase fish and aquatic biota but to restore ecological diversity. As the scale, number, and complexity of floodplain restoration projects has increased, so has the need for rigorous monitoring and evaluation to demonstrate effectiveness and guide future floodplain restoration efforts. Moreover, technological advances in remote sensing, genetics, and fish marking have been evolving rapidly and there is need to update guidance on the best methods for monitoring physical and biological response to floodplain restoration. A comprehensive review of the restoration literature located 180 papers that specifically examined the effectiveness of various floodplain restoration techniques. The various methods that were historically and currently used to evaluate the physical (channel and floodplain morphology, sediment, flow, water quality [temperature and nutrients]) and biological (fish, invertebrates, and aquatic and riparian plants) effectiveness of floodplain restoration were reviewed and used to provide recommendations for future monitoring. For each major physical and biological monitoring method, we discuss their importance, how they have historically been used to evaluate floodplain restoration, newer methodologies, and limitations or advantages of different methodologies and approaches. We then discuss monitoring the effectiveness of small (<2 km in main channel length) and large (>2 km of main channel length) floodplain projects, with recommendations for various study designs, parameters, and monitoring methodologies. This article is categorized under:Water and Life > Conservation, Management, and AwarenessWater and Life > Methods [ABSTRACT FROM AUTHOR]