Search

Aim: To describe the co‐designing process of an online support programme with and for informal carers of people with heart failure. Design: A co‐design process built on core concepts and ideas embedded in co‐design methodology. Data sources: Our co‐design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme. Outcomes: The co‐design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal. Conclusion: Co‐design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process. Relevance to clinical practice: Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person‐centred care and provides a valuable learning opportunity for those involved. Furthermore, a co‐designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self‐care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel. Reporting methods: Consolidated criteria for reporting qualitative research (COREQ). Patient or public contribution: Both informal carers and content creators were involved in developing the support programme. [ABSTRACT FROM AUTHOR]

The Lidcombe Program was developed in the 1980s for children who stutter. This program relies on the efficacy of caregivers in managing their child's stutter within everyday environments, including rating the severity of their child's stuttering on a daily basis. The aim of this pilot project was to compare the traditional paper-based severity rating (SR) system to a newly developed online SR system and, in the context of one regional community health service, report on the outcomes of novel components such as the daily reminder text message. A descriptive comparative analysis was utilised to assess the opinions of participants on the two SR systems by using an online questionnaire. All participants (n = 7) preferred the online SR system compared to the paper-based SR system and in particular found the feature of an evening daily SMS text message to be useful in reminding them to rate their child's stuttering severity. This small pilot study demonstrated that adding a relatively small initiative to an established program can have a considerable impact on the monitoring of adherence to therapy in a small community health care service. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper was to examine variables associated with food insecurity among community college caregivers during the COVID-19 pandemic. Methods: We used data from a multi-institutional survey of 15,051 caregivers enrolled at 130 community colleges in 42 states in fall 2020. We used a logistic regression to examine whether demographic, academic, caregiving-related, financial, or COVID-19-related variables were associated with caregivers' food insecurity. Results: Over half (52%) of community college caregivers experienced food insecurity. Transgender caregivers, first-generation caregivers, and caregivers who were divorced or single, had multiple disabilities, were previously in foster care, and had a family that experienced trouble making ends meet growing up had significantly (p < 0.05) higher probabilities of experiencing food insecurity. Community college caregivers who used childcare and those with at least one child up to 12 years old also had increased probabilities of experiencing food insecurity. Moreover, caregivers who felt childcare was not affordable and believed that they did not earn enough money to make employment worthwhile after paying for childcare expenses had higher probabilities of experiencing food insecurity, as did those who experienced housing insecurity and used Pell grants, student loans, and support from friends or family to pay for college. Losing a job, experiencing cuts to work hours or wages, employment as a frontline worker, and contracting COVID were associated with higher probabilities of food insecurity. Contributions: Community college caregivers experienced high rates of food insecurity during the pandemic and some caregivers were at greater risk of exacerbated probabilities of food insecurity. We advocate for targeted interventions, wraparound services, and increased advocacy for legislation to support student caregivers.

Aims and Objectives: To explore organisation‐wide experiences of person‐centred care and risk assessment practices using existing healthcare organisation documentation. Background: There is increasing emphasis on multidimensional risk assessments during hospital admission. However, little is known about how nurses use multidimensional assessment documentation in clinical practice to address preventable harms and optimise person‐centred care. Design: A qualitative descriptive study reported according to COREQ. Methods: Metropolitan tertiary hospital and rehabilitation hospital servicing a population of 550,000. A sample of 111 participants (12 patients, 4 family members/carers, 94 nurses and 1 allied health professional) from a range of wards/clinical locations. Semi‐structured interviews and focus groups were conducted at two time points. The audio recording was transcribed, and an inductive thematic analysis was used to provide insight from multiple perspectives. Results: Three main themes emerged: (1) 'What works well in practice' included: efficiency in the structure of the documentation; the Introduction, Situation, Background Assessment, Recommendation (ISBAR) framework and prompting for clinical decision‐making were valued by nurses; and direct patient care is always prioritised. (2) 'What does not work well in practice': obtaining the patient's signature on daily care plans; multidisciplinary (MDT) involvement; duplication of paperwork and person‐centred goals are not well‐captured in care plan documentation. (3) 'Experience of care'; satisfaction of person‐centred care; communication in the MDT was important, but sometimes insufficient; patients had variable involvement in their daily care plan; and inadequate integration of care between MDT team which negatively impacted patients. Conclusions: Efficient and streamlined documentation systems should herald feedback from nurses to address their clinical workflow needs and can support, and capture, their decision‐making that enables partnership with patients to improve the individualisation of care provision. Relevance to clinical practice: The integration of effective MDT involvement in clinical documentation was problematic and resulted in unmet supportive care from the patient's perspective. [ABSTRACT FROM AUTHOR]

The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (M[subscript age] = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha = 0.93) and test-retest (ICC = 0.95) reliability. Scores were normally distributed and sensitive to age (r = - 0.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = - 0.35), and challenging behaviors (r = 0.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children.

Background: Australian research indicates that post-parental care transitions are rarely planned and primarily occur following a crisis for a primary carer. This paper examines disability staff perceptions of transitions for people with intellectual disability and their ageing carers in rural South Australia. Method: A focus group interview model was used, with a semi-structured interview guide initiating group discussions. A thematic analysis methodological approach was selected to analyse the data. Results: This paper reports on the theme of Service Delivery, which has three sub-themes of Availability; Distance; and Individual Access. The key findings are presented and supported by the use of exemplar quotes. Conclusions: This research indicates a poor intersection of general and specialist services is inhibiting post-parental transitional care for rural people. Simply allocating money to the individual does not resolve the issues, and the interface between different services needs to be better considered at government level.

Making sensitive pedagogic relationships in the nursery is a deeply human activity evoking joy and satisfaction, but stress and uncertainty too. From an international perspective, strong local reflective spaces are required if early childhood provision is to be culturally and context responsive, counter-balancing globalising pressure to standardise provision. Further, nursery practitioners are entitled to a formal space where their subjective experience of the work, its demands and dilemma, can be expressed and understood. This paper is about 'Work Discussion' (WD) as such a reflective space. Professional reflection is now included in early years policy frameworks internationally for the reasons above. WD, distinctive in including explicit attention to emotion in pedagogy, is one model of a reflective space. This paper arises from a longitudinal evaluation of WD in nursery funded by the Froebel Trust. The methodology of the evaluation and the positive findings of impact for children have already been published. The aim of this paper is to theorise WD, drawing on the work of Wilfried Bion, a psychoanalyst and theorist of thinking in groups. Empirical data if offered to illustrate the explanatory power of Bion's theory including what may be discussed openly and what is avoided in pedagogic reflection.

To date, there is a lack of suitable assessment tools specifically for the looked after child population. Such assessments, often completed by foster carers, help to provide an overview of a child's presenting level of emotional and behavioural need, and are evidential in offering a pathway to further provision and services for young people in care. This study explores perspectives of foster carers working at one UK-based independent fostering agency, Five Rivers Child Care (FRCC). The twofold study, conducted in 2017, involved understanding foster carers' perceptions both of routine assessments and subsequent feedback procedures; activities which are mandatory to facilitate foster carers' understanding of the wellbeing needs of the young people within their care. In Study 1, an online quantitative survey established foster carers' (n = 42) experiences of assessment and intervention, over a six-month timeframe. Study 2, conducted with a subsample of carers (n = 6) used telephone interviews to provide additional qualitative insight. The findings of both studies were consistent, highlighting the need for enhanced relevance of assessments, active involvement in the assessment process, more knowledge of the process; greater support with assessments; and further opportunity to self-reflect. The paper reflects on how the findings resulted in developments within the FRCC assessment process in 2018, including adaptations and additions to its protocol, with the aims of improving outcomes for children in care services, increasing collaboration and support, and enhancing reflection and practice. These findings have allowed for assessments to be tailored or changed, with carers being far more involved and informed of the process, resulting in improved practice and enhanced learning about this population. Furthermore, this study has wider implications beyond FRCC: the extracted themes are likely to be highly pertinent and applicable across similar populations, with assessment protocols enhancing understanding about the expectations and challenges that might emerge within this population.

In this paper, we analyse mechanisms of exclusion in Norwegian daycare facilities for children ("Skolefritidsordning -- SFOs), which provide after-school care. Such mechanisms are analysed and discussed as unanticipated consequences of reform policy initiatives or simply as accepted trade-offs left to the SFO staff's discretion. The data are taken from a reanalysis of a national evaluation of Norwegian SFOs. The results show several examples of new exclusion mechanisms occurring as old inequalities are addressed through social policy reforms. Examples from case studies are used to highlight and discuss the staff's reactions and actions when faced with dilemmas of meeting demands from the system while taking care of demands from the children.

This paper contributes to the scarce literature on factors affecting EdTech use in households. These factors were considered through exploratory mixed-methods analyses of cross-sectional data on Kenyan girls and caregivers, captured during the COVID-19 pandemic. Quantitative analysis of the child dataset (n = 544) suggested the importance of both structural factors--such as technology hardware availability--and non-structural factors--including caregiver permission. Findings were supported by a thematic analysis of interview data from girls' caregivers (n = 58), which emphasised the role they play in girls' use of EdTech. Interviews also highlighted numerous caregiver concerns with EdTech, related to the relevance and rigour of educational content, the possibility of children accessing age-inappropriate material and child health (especially eyesight). Policy makers could alleviate these concerns by providing guidance on EdTech use and clearly signalling their approval of verified initiatives.

Communication is a vital social phenomenon; therefore, its study must be related to theories of social structure, social behavior, and human interaction. Successful communication is substantially crucial for better social life in all contexts. Unfortunately, the process of communication in medical settings and healthcare is challenging, especially when communicating with patients who are affected by cognitive communicative disorders including people with Autism Spectrum Disorders. This paper aims to address the difficulties and the different encumbrances related to autism and communication in the Algerian context. It attempts to evaluate the effectiveness of communication interventions in children with ASD, and look for reliable methods to help families promote their children's communication abilities. The current research is a case study of a six-year-old child with ASD, in addition to the participants involved; his caregivers, parents, escorts, and the speech therapist. The study shows that the child suffers from language impairments that are typical of autistic children's verbal repertoire: lexical, grammatical, morphological, and syntactic impairments that lead to a failure in the communicative task. The analysis of the data indicates that patients with ASD suffer also from different extra-linguistic problems which can be diminished through successful social interaction and effective therapeutic interventions.

Aim: To map existing evidence and identify gaps in the literature concerning psychosocial impacts of being nil by mouth (NBM) as an adult. Design: A scoping review of the literature was undertaken using JBI guidance. A protocol was registered on the Open Science Framework (osf.io/43g9y). Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for Scoping Reviews (PRISMA‐ScR). Methods: A comprehensive search of six databases (CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS and Web of Science) was performed for studies published up to February 2023, with no restriction to study type. A scope of the grey literature was also undertaken. Two authors independently assessed eligibility and extracted data. Descriptive statistical analysis and narrative synthesis were used, and patient and public involvement included in funding discussions. Results: A total of 23 papers were included in the review, consisting of 14 primary studies (7 qualitative and 7 quantitative) and 9 grey literature. Both global psychological distress and distress specific to being NBM (thirst, missing food and drink) were reported. Caregivers also experience distress from their family member being NBM. Furthermore, social impacts were reported for both patient and caregiver, primarily social isolation and subsequent low mood. Conclusion: Furthermore, research is needed to understand the prevalence of this population, how best to measure psychosocial impacts and to explore whether (and how) psychosocial impacts change over time. Advancement in this area would enable better service development to optimize care for this patient group. What is known about this topic?: Eating and drinking provides more than nutrition and hydration.A wide range of conditions can lead to recommendations for no longer eating and drinking (nil by mouth).Being nil by mouth (NBM) for short periods such as pre‐operative fasting causes distress; however, little is understood about impact on longer‐term abstinence from eating and drinking. What this paper adds?: Psychosocial consequences of being nil by mouth (NBM)have been investigated by both quantitative and qualitative studies.Being NBM impacts both patients and caregivers in various psychosocial aspects, including distress and social isolation.Several gaps remain, however, regarding ways to measure psychosocial impact of being NBM. [ABSTRACT FROM AUTHOR]

The research protocol described aims to examine and establish the health outcomes of children and young people living in Out-of-Home Care (OOHC) in Perth, Western Australia (WA) from the perspective of the care recipients and service providers. A Study Advisory Panel (SAP) will be established comprised of Aboriginal Elders (because of the over-representation of Aboriginal children in OOHC), health professionals and other relevant stakeholders to help co-design all phases of the study. Mixed methods will be used in data collection and analysis. In the quantitative phase, it is proposed to collect retrospective data from three WA Department of Communities (DOC) districts. The data proposed to be collected includes: the number of children who received initial and annual health assessments, the health needs identified, and interventions put in place to address these needs. The qualitative phase will consist of interviews with service recipients (young people who have exited OOHC and Carers), health service providers (Community Health Nurses, School Nurses, General Practitioners and Paediatricians) and OOHC Case Workers. The research will provide an overview of the current health needs of children and young people in OOHC in WA and the perspectives of these young people, their Carers and service providers on current processes for accessing healthcare. It is anticipated that the study will provide valuable evidence for quality improvement in health service delivery to better meet the health needs of children and young people in OOHC. [ABSTRACT FROM AUTHOR]

Sustainable Development Goal Target 4.2.1 is monitored by determining the proportion of children aged 24 to 59 months who are developmentally on track in the domains of health, learning, and psychosocial well-being. UNICEF has developed a caregiver report measure, the Early Childhood Development Index 2030 (ECDI2030), to measure progress towards this target. This paper examines whether a newly developed tool, the Early Childhood Development Assessment Scale--Direct Assessment (ECDAS-DA) can add value to the measurement of Target Indicator 4.2.1 by complementing UNICEF's ECDI2030, and explores the psychometric properties of the ECDAS-DA. A total of 956 children (476 girls) aged 3 to 5 years from Bangladesh, China, India and Myanmar were administered the ECDAS-DA in individual sessions. Caregivers provided responses to a survey based on UNICEF's ECDI2030. Confirmatory Factor Analyses indicated that learning, health, and psychosocial well-being domains of the ECDAS-DA were three component parts of one underlying construct of early child development. Significant correlations between the ECDAS-DA and the caregiver-reported ECDI2030 survey were found in the learning and health domains but findings were mixed for the psychosocial well-being domain. Multiple measures of early development could be important in measuring SDG Target 4.2.1 and the ECDAS-DA has the potential to complement UNICEF's ECDI2030.

Inclusive education is enshrined in law and supported by the literature as best practice in education. Inclusive education has been shown to provide better academic, social and behavioural outcomes for children with disabilities than segregated learning environments. In the Northern Territory, Australia, however, the dual system of mainstream and special education persists and so too does segregation and exclusion. The Northern Territory education strategy commits to strengthening inclusion and empowering families in educational decision-making by listening to their voices. In this paper, we highlight some of these voices, examining the experiences and perspectives of caregivers of children with disabilities as they participate in education in the Northern Territory. Caregivers' experiences were coded into categories of inclusion and exclusion. Those that were not clearly inclusion nor exclusion were identified and the theme of non-inclusion was created. Non-inclusion was analysed thematically and is discussed as a nebulous space that exists for caregivers, presenting significant challenges that threaten their child's inclusion at school as they navigate this dual system. If Australian education systems are to provide genuine inclusive education, we need to understand the experiences of caregivers better so we can remediate the issues creating non-inclusion for children with disabilities and caregivers.

COVID-19 poses serious challenges to the health and safety of childcare providers, and these challenges were particularly acute in early 2022 during the first Omicron wave when vaccines were not available for children. Childcare providers work in environments where the recommended methods to minimize COVID-19 infection were often not possible to implement: children could not wear masks for extended periods and were not able to maintain physical distance. Under these pressures, Canada's already-fragile childcare sector was strained, caregivers struggled, and existing deficiencies were exacerbated. As part of a larger quality assurance and improvement project examining the impacts of the pandemic on childcare in the Canadian prairie province of Manitoba, this paper reports on qualitative findings to make public health and policy recommendations for the childcare sector. Data were voluntarily provided by a sample of childcare providers between January 6-13, 2022. A thematic analysis of open-text responses was performed, finding: an urgent need for health and safety resources; a need for sustained support and guidelines; and an absence of value and respect. We also identified an emergent theme of gratitude, which was reflected by an overwhelming number of thanks to the project team for listening to the voices of childcare providers. We draw on our qualitative analysis to propose measures to improve public health and safety, funding, and infrastructure, as well as to underscore the importance of systematic data collection and evaluation to protect and support the essential childcare workforce through the COVID-19 pandemic and into the future.

Professional development for sustainability in early childhood care and education (ECCE) has been perceived by experts as education that supports the workforce to acquire the right skills, attitudes, and knowledge that resonate through their practices to the benefit of the sector. Professional development for sustainability is aimed at providing quality and continuing development to the ECCE workforce to equip them with the relevant skills to perform their duties for the benefit of the children and society. This paper discusses practitioners' (n=211) professional development needs from a sustainability perspective and the impacts of some demographic features. The data were gathered through semi-structured interviews and questionnaire. The study found that practitioners' professional development was germane to the sustainability of the ECCE sector. The study further found that practitioners' perceptions of their professional development needs were independent of their marital status and age. Practitioners suggested that the transformation of communities depended on the sustainable provisioning of ECCE by a highly trained workforce.

Despite a focus on successful transitions to school, transition to School Aged Care (SAC) has largely been overlooked. This paper shares insights into transition programs provided for children commencing in SAC, at or close to their transition to school. Educators working in SAC programs in Victoria, Australia, participated in an online survey exploring their practices, beliefs, and understandings regarding children's transition into SAC in their Foundation year of school. Findings highlighted that whilst transition to SAC should be considered an integral component of a child's broader transition to school program, very few SAC programs are formally included in the process. Findings also showed that the programs that do offer transition to SAC programs for children commencing their Foundation year of school tend to design and implement these externally to the broader transition-to-school process. Furthermore, SAC educators share a strong consensus that clear integration of transitions into SAC and school should occur.

In 2012, the Austin Independent School District reported that over 60 percent of its students identified as Hispanic. However, the number of theatrical offerings for children including Latino stories or Latino/a characters on Austin stages is staggeringly disproportionate to the number of Latino children living in the community. "Mariachi Girl" is a new bilingual Spanish/English musical for child audiences. This paper articulates and analyzes research findings from surveys collected from children, teachers, and care givers who saw the production. The paper introduces the term culturally responsive artistry and offers new perspectives and suggestions on how arts institutions and theater educators can form lasting relationships with minority communities.

Background: Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and services to enhance independence. People with disability are required to develop a plan with the National Disability Insurance Agency (NDIA), the government department responsible for managing the NDIS. This scoping review aims to ascertain the level of research into people's experience of the NDIS planning process in these geographic areas. Methodology: Research publication databases were searched using a specific search string to identify research about people with disability and their families/carer's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications focused on Aboriginal and Torres Strait Islander people were additionally appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications' contents was undertaken to ascertain people with disabilities and carers experience of the NDIS planning process. Results: Ten (N = 10) research papers were found that met the inclusion criteria. Two papers were policy reviews and reported on the improvements of the NDIS planning process since its conception. The analysis found the research archive focused on five themes: (1) healthcare workforce and NDIA staff; (2) NDIS package holders and carers lack of awareness of the NDIS; (3) cultural/socio‐economic barriers; (4) travel funding; and (5) emotional burden of the NDIS planning process. Conclusion: There are limited papers available that explore people's experiences of the NDIS planning process in regional, rural and remote regions of Australia. This systematic review illuminates the difficulties, barriers and concerns of people with disability and their carers about the planning process. [ABSTRACT FROM AUTHOR]

Focussing on the experiences and perceptions of parents and volunteer caregivers of children with disabilities, this paper reports on a study that explored the provision of early childhood development and inclusive education for children with disabilities in rural Malawi. Drawing on a community-based participatory research (CBPR) design, ten local community researchers and two Malawian researchers collaborated to interview forty caregivers and parents of children with disabilities attending ten Community Based Care Centres (CBCCS) in Southern Malawi. Findings are reported through four key themes: experiences of disability, inclusion, learning and developmental progress; factors influencing non-enrolment and absenteeism; barriers to learning and progress; and accountability and support channels. Five key components were highlighted: (1) relevance of peer interactions for learning outcomes and wellbeing; (2) the importance of the CBCC as (a model for) a safe space against discrimination; (3) relevance of quality education and pre-school teacher training; (4) necessity of material support to decrease absenteeism; and (5) the need for greater community and state support for children with disabilities. The implications of the study's findings are discussed, including the importance and relevance of considering the perspectives of community based actors in program and policy design.

Family caregivers of people with dementia can find the impairments in their relative's ability to communicate an enormous challenge. Peer facilitated educational interventions are a potentially efficient and effective way to address these complex communication issues. This paper examines the processes required to support the development of peer educators and the impact this has had on facilitators and course attendees. Semi-structured interviews with six participants who facilitated Empowered Conversations (EC) a communication skills educational program for caregivers of people with dementia and 28 participants who attended the program. A qualitative thematic analysis approach identified emergent themes within the data. Three broad findings are reported: first the support that is needed for peer facilitators; second, the impact of the course reported by facilitators and course attendees; and third, suggestions for improvements. The content of the EC program is strong and the reflective cycle encouraged via support mechanisms prior to, during and following the delivery of sessions is effective for supporting facilitators. When upscaling the program it was important to enhance the support structures for new peer facilitators. Introducing a support session focusing on examples of logistical issues experienced and how these could be addressed would be a useful addition to the support mechanisms already devised. Attendees reported positively on participation in the course, particularly valuing the input from facilitators with experience of caregiving. Suggested improvements related to better information about the course and a settling in period, with some specific individual suggestions for content relating to their personal experiences.

This paper explores the affordances of using video-based research to capture a multiplicity of events, along with multimodal representations when producing data related to adult-child book readings. In doing this we answer two questions: (1) why more than one event is needed when seeking a comprehensive collection of information for the purpose of analysis; and (2) why one mode of data production alone (e.g. audio recordings or note taking) is insufficient to record practice or interviews when richness is of priority. This research used three videoed events to produce data. These included videoing: (1) caregiver-child interactions during four shared book reading sessions, (2) interviews with caregivers immediately following each of the reading sessions and (3) video-stimulated discussions with caregivers within two months of the final shared book reading. In this paper, I contribute to discussions that highlight the affordances of using video-based research as a means of capturing the multimodal elements of an experience, which can contribute to the analysis and interpretation of data. I expand on this, however, to suggest that when coupled with a multiplicity of events, video-based research can be a means of pursuing richness via a method that has been criticized for its narrow subjectivity.

The significance of practitioners' emotions in nursery interactions is evident in vivid accounts from widely different socio-cultural contexts. Work Discussion (WD) is a model of professional reflection distinctive in its attention to emotion in work interactions. Psychoanalytic conceptions, particularly the notion of the defended subject, underpin WD. Enabling participants in WD to discuss subjective work experience in an open way is thus subtle and sensitive. Research has not addressed how the impact of different models of professional reflection may be evaluated. Can WD, with its explicit attention to the emotions evoked at work, strengthen practitioners' engagement with children and families? This paper critically discusses the complex methodological issues in evaluating the impact of WD on nursery practitioners, children and parents in the nursery. The challenge is to combine the intense subjectivity of WD with an evaluation that is rigorous and objective. Later papers will illustrate data analysis and report findings.

Background: Liver disease is an increasing cause of morbidity and mortality in the United Kingdom and can be challenging to live with in the advanced stages. There has been little research exploring the healthcare experiences of UK individuals with decompensated disease when the liver cannot carry out its functions properly. A PhD research project was developed with people who have liver disease to explore care experiences in decompensated advanced liver disease. Public involvement (PI) is an essential aspect of meaningful health research, and this paper reports on the progression of our PI approach in this ongoing study. Objective: To embed PI throughout the research project to ensure that the study is meaningful to individuals with liver disease and the people who support them. Methods: The research adopts a Constructivist Grounded Theory methodology to develop a theory of care experience. Various PI approaches were considered in developing the PI strategy for this qualitative study. Initially, Embedded consultation was the preferred model, which has evolved to include aspects of collaboration and coproduction. A PI group was set up to oversee the project through the national public engagement website VOICE, and reflections on PI from three members of the group are included in this paper to illuminate the PI process. Results: Six individuals with liver disease and three carers from across the United Kingdom are part of an ongoing PI group. Their role includes commenting on the findings of the systematic literature review for this project and contributing to decisions about recruitment, data collection and data analysis. Additionally, they had a direct impact on changing the focus of the research. The PI group will continue involvement until the completion of the project. Conclusion: Successfully embedding PI into doctoral research, as demonstrated in this project, requires commitment, planning and dedication to reciprocal working for the benefit of PI contributors as well as the research. This approach could be adopted by other postgraduate researchers. Patient or Public Contribution: This project is overseen by the PI group, whose contribution is described throughout, including reflections from three PI group members. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide a literature review on what is known about unpaid family carers who are at risk of or have experienced abuse from the people they provide care for and relevant policy/legal and practice responses for affected family carers. Design/methodology/approach: A literature search was carried out to locate literature relating to unpaid family carers who are at risk of or have experienced abuse from the people they provide care for. This also incorporated grey literature, including policy guidance and law, to determine the existing knowledge base, gaps in practice and areas that might require further research. Findings: The findings suggest that although carer harm is serious, it is under-researched. In addition, the unique needs of unpaid family carers who are at risk of or have experienced abuse, violence and harm from the people they provide care for are subsumed in safeguarding policy/law processes and practice under the auspices of the protection of "adults at risk" rather than the protection of "carers at risk". Research limitations/implications: It is important that those who support unpaid family carers who are at risk of abuse and harm know about their unique safeguarding needs and concerns to offer appropriate support. It is also apparent that policy and law need to address the gap in provision relating to the unique safeguarding concerns involving the abuse of unpaid family carers by the people they provide care for. This paper is based on this literature review and not on other types of research. Originality/value: The paper provides insights into what is known about the abuse of unpaid family carers by the people they provide care for, and the policy/legal and practice responses to affected unpaid family carers. It contributes to the body of knowledge on carer abuse and safeguarding carers from abuse and harm. [ABSTRACT FROM AUTHOR]

This paper provides an exploratory discussion surrounding the views and experiences of women and men who work/train in the early years (0-8 years) by bringing together select findings from two independent doctoral research projects. In an effort to weave together the voices of females and males working/training in the early years sector, this paper focuses its attention on the different ways in which their working roles are constructed and the possible ways in which this leads to the imposition of gender roles upon professionals in the 0-8 workforce in England.

An enterprise imaging (EI) strategy is an organized plan to optimize the electronic health record (EHR) so that healthcare providers have intuitive and immediate access to all patient clinical images and their associated documentation, regardless of source. We describe ten steps recommended to achieve the goal of implementing EI for an institution. The first step is to define and access all images used for medical decision-making. Next, demonstrate how EI is a powerful strategy for enhancing patient and caregiver experience, improving population health, and reducing cost. Then, it is recommended that one must understand the specialties and their clinical workflow challenges as related to imaging. Step four is to create a strategy to improve quality of care and patient safety with EI. Step five demonstrates how EI can reduce costs. Then, show how EI can help enhance the patient experience. Step seven suggests how EI can enhance the work life of caregivers and step eight describes how to develop EI governance. Step nine describes the plan to implement an EI project, and finally, step 10, to understand cybersecurity from a patient safety perspective and to protect images from accidental and malicious intrusion. [ABSTRACT FROM AUTHOR]

Introduction: People with a borderline personality disorder (BPD) diagnosis or symptoms may experience emotional crises which necessitate use of the emergency department (ED). No existing reviews focus specifically on experiences of consumersa, carersb and clinicians in relation to ED presentations by people diagnosed with BPD. Aim/Question: The aim of this study was to synthesise knowledge on consumer, carer and clinician experiences of BPD in the ED. Method: An integrative review methodology was chosen as it best captures the complexity of varied perspectives and emergent phenomena from diverse literature sources. EMBASE, CINAHL, PsycInfo and Medline were searched for papers published before 16 February 2022. Results: Nine papers met the inclusion criteria (five qualitative, one quantitative, one mixed methods and two letters to the editor). Key themes were barriers to timely and adequate care, and stigmatising attitudes and practices towards people diagnosed with BPD. Negative attitudes were perceived to perpetuate harmful outcomes and further ED visits. Discussion: Predominantly negative ED experiences were expressed by clinicians, consumers and carers. Further work is needed in ED models of care and staff education to improve the experience of care for consumers, carers and clinicians alike. Implications for Practice: Opportunities for change will exist through co‐designed innovation, education, advocacy and leadership. [ABSTRACT FROM AUTHOR]

Purpose: As populations are ageing and the global average life expectancy is rising, the provision of care for older people is an increasingly salient issue. This paper aims to focus on family-provided care for older immigrants, examining how older immigrants and care providers experience and construct family caregiving. Design/methodology/approach: Based on interviews with care recipients, family care providers, municipal staff and representatives for migrant organisations in Sweden, this study presents a typology of family caregiving for older immigrants. Findings: The authors found three caregiving types, namely, solely family-provided care and a combination of family care and public care (predominantly one or the other). The decision to select family-provided or publicly-funded care depends on personal and institutional factors. Originality/value: The paper makes three empirical contributions to the literature on care provision for older immigrants. Firstly, this study provides insights into the structural and personal factors that shape care-giving arrangements for older immigrants. Secondly, this study examines the perspectives of care recipients and care providers on family-provided care. Care expectations differ between both groups and sometimes result in intergenerational disagreement. Thirdly, in terms of institutional support, this study finds that the Swedish state's notion of individual needs does not match the needs of immigrant elderly and their caregivers. The paper places the care types in a broader discussion about eldercare provision in the Swedish welfare state, which has experienced a decline in publicly funded care services and an increase in family caregiving in the past 30 years. In addition, it addresses questions of dignified ageing from a minority perspective. [ABSTRACT FROM AUTHOR]

Intellectual disability (ID) is an emerging field of research in Nigeria. This review seeks to identify what has been published in order to describe the evidence and to identify the major gaps in knowledge and practice. A systematic search of five databases and an African disability journal yielded 15 papers that reported on empirical studies related to people with ID in Nigeria. Fifteen studies across the databases and journal searched met the inclusion criteria. The participants included adults and children with ID and their families. Twelve of the papers employed quantitative methods, two were qualitative and one was a mixed methods study. There is a paucity of empirical research on people with ID in Nigeria, thus emphasising the need for more primary research about people with ID living in Nigeria. Nigeria is estimated to have the largest population of people with disabilities in Africa; however, this review found limited empirical work regarding their lives, prevalence and care. This limited evidence hinders the understanding of the challenges people with an intellectual disability face and potentially inhibit the creation of policy-oriented solutions to their plights in a globalised world. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate critical independent living skills for adults with intellectual and developmental disabilities who live in the community and common reasons individuals lose their residential placement. Participants included residential specialists from 26 states who worked at small group homes and supported apartments. A paper-based survey was mailed to 1000 randomly selected residential specialists using a proportional stratified sampling procedure; 280 completed surveys were used for data analysis. Descriptive statistics, chi square analyses, and a content analysis procedure were used to analyze the findings. The majority of residential specialists rated 13 skills as critical. Significant differences in perceptions of critical skills emerged based on type of residence (i.e., group home, supported apartment). The most common reasons reported for losing a residential placement were behavior concerns and medical issues.

The use of telehealth technologies to provide clinical services to families of children with autism and other developmental disabilities is a rapidly growing area of research. In particular, remote training of caregivers via video conferencing appears to be a promising approach for disseminating behavior-analytic interventions (Neely et al. in "J Dev Phys Disabil" 29:849-874, 2017. 10.1007/s10882-017-9550-4; Tomlinson et al. in "J Behav Educ" 27:172-222, 2018. 10.1007/s10864-018-9292-0). Although remote training offers a number of advantages, it brings a variety of challenges that are unique to this modality. The field would benefit from information on problems that practitioners may encounter when providing these services and how to train caregivers effectively. In this paper, we report on the experiences of 18 practitioners who provided caregiver training via telehealth from four different sites across a 4-year period. We describe a variety of technical and clinical issues that arose during service delivery, suggest strategies for preventing and remediating problems, and include case descriptions and data to illustrate our experiences. This information may help prepare practitioners to deliver telehealth services and guide further research in this area.

Early childhood and primary educators' and carers' education and support in identifying and responding appropriately to children displaying problematic sexual behaviours has fallen behind the demands currently arising in care and education sites in Australia. This is a key finding of research examining professional educators' and carers' experiences of problematic sexual behaviours in their workplaces, their understanding of problematic sexual behaviours, and their source of training in this area. This paper reports on the professional development, workplace and community support for educators and affected children, which educators and carers wanted to have implemented to more adequately respond to their professional needs and the needs of affected children and their families. The research was conducted using an online survey in 2016 and involved 107 respondents from government, independent and Catholic primary schools, preschools and care organisations.

Educators in Early Childhood Education and Care (ECEC) have experienced changes in policies, accountability and curriculum. Concerns arise for educators regarding rapid staff turnover, pressure of expectations, and burnout. Although increased research has examined teacher resilience, less has focused on the perspectives of ECEC educators and what helps them continue in their work and maintain wellbeing. We examine perceptions of Australian early childhood educators about the challenges they face and the personal and contextual resources they harness to cope and demonstrate professional resilience. An ecological framework is used to understand educators' experiences and perspectives of macro-, micro- and personal-system level challenges and resources. Fourteen leaders and educators were interviewed, with data coded deductively to identify personal and contextual challenges and resources at each system level. Inductive coding revealed key themes relating to each system. Findings showed that the educators experienced several macro-system level challenges. In the micro-system, relationships acted both as challenges and supports. In the personal-system, the focus was on resources as individuals used a variety of specific strategies to maintain physical and mental wellbeing. The paper concludes with implications for the ECEC sector relating to the different system levels.

Background: Evidence suggests that parents with intellectual disabilities can be "good enough" parents with appropriate support that focuses on the whole family. This paper brings together theories of vulnerability with an ethics of care approach to reflect on challenges for practitioners in supporting parents, drawing upon data from a study carried out in Scotland. Method: An online survey was administered to practitioners in three settings, and follow-up interviews were carried out with key informants. Results: Pockets of good practice existed but a number of barriers to supporting families remained. These related to a lack of accessible information, difficulties in identifying and engaging with families at an early stage and poor joint working across agencies. Conclusion: The study concludes by arguing that practitioners' constructions of families as "vulnerable" reflects negatively on their perceived capacity to parent, creating further barriers in accessing appropriate support and reducing expectations of success.

Purpose: The purpose of this paper is to explore how home reading practices can impact what teachers assume to be the optimum practice in preparing students for school may not be supported by the local culture. In Kuwait, I have heard teachers repeatedly complain that students do not read at home or seem to value reading. Kuwaiti adults relate that they rarely engage in reading for pleasure. Students here are challenged with learning English, but also seem to take a greater amount of time to understand the use of reading in their lives and learning. These factors led me to consider that what teachers assume to be the optimum practice in preparing students for school may not be supported by the local culture. Design/methodology/approach: In this case study, five nannies were interviewed focusing on participants' reading practices in their homes of origin and those practiced with Kuwaiti children. Observational notes were taken to record nonverbal communication. Data were analyzed to uncover references to home reading practices such as storytelling, recreational reading and verbal interaction based on the reading. References were color coded and a database was constructed of references the nannies made to reading practices both in their homes of origin and in the Kuwaiti homes in which they work. The references to reading practices were then categorized according to activities reported. Findings: As a result, it was found that the nannies perceived the purpose of reading to be for education only, storytelling is used for different purposes in different cultures, print material were rarely found in the homes of the nannies due to lack of economic means, and the fathers of most of the nannies were critical in their reading development. Research limitations/implications: Further exploration of the home reading practices of the Kuwaitis is needed to fully support the effective inclusion of their cultural reading traditions into school practice. Parent and student surveys, parent interviews and possibly home visits would assist researchers in more fully defining home reading practices. Partnering with Arabic-speaking or Kuwaiti teachers would benefit researchers in being able to efficiently translate for the interviews and then discuss their observations, giving the researchers a more nuanced perspective of the findings. Originality/value: This paper offers an original view on a particular aspect of international education, namely, reading habits, and discusses the promotion of multicultural reading instruction in a more culturally responsive manner.

High health literacy (HL) is important to optimise health outcomes, particularly for older people (who are substantial consumers of health services) and their adult caregivers. The aim of this systematic review was to evaluate measurement properties of HL instruments tested with these population groups. Six databases (MEDLINE (OVID); CINAHL; EMBASE (OVID); PsycInfo; Scopus; Cochrane Library) were searched for studies evaluating eight measurement properties of HL tools administered to older people or their caregivers. Only studies evaluating multi-domain self-report HL tools were included in analyses, using the COSMIN methodology. From 4261 unique papers located, 11 met inclusion criteria; six reported measurement properties of three HL self-report tools administered to older people (HLQ, eHEALS, and HeLMS) so are reported in this review, none involved caregiver samples. The HLQ and HeLMS were rated "moderate," and eHEALS "low" for tool development. The HLQ, examined in four included studies, had the highest ratings and quality of evidence across the three measurement properties investigated in included papers. The HLQ was the most highly rated self-report HL tool of just three tested with older people. Further studies evaluating measurement properties of self-report HL tools used with older people and/or their caregivers are needed. Health literacy is important to optimise health outcomes of interventions for older people and their adult caregivers. Few studies have evaluated measurement properties of self-report / multi-domain health literacy tools for this population. The Health Literacy Questionnaire (HLQ) had the highest ratings and quality of evidence across the three measurement properties investigated in included studies, and is recommended for use in rehabilitation settings. [ABSTRACT FROM AUTHOR]

Background: Shared decision-making is a key element of person-centred care and promoted as the favoured model in preference-sensitive decision-making. Limitations to implementation have been observed, and barriers and limitations, both generally and in the palliative setting, have been highlighted. More knowledge about the process of shared decision-making in palliative cancer care would assist in addressing these limitations. Aim: To identify and synthesise qualitative data on how people with cancer, informal carers and healthcare professionals experience and perceive shared decision-making in palliative cancer care. Design: A systematic review and metasynthesis of qualitative studies. We analysed data using inductive thematic analysis. Data sources: We searched five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL and Scopus) from inception until June 2023, supplemented by backward searches. Results: We identified and included 23 studies, reported in 26 papers. Our analysis produced four analytical themes; (1) Overwhelming situation of 'no choice', (2) Processes vary depending on the timings and nature of the decisions involved, (3) Patient-physician dyad is central to decision-making, with surrounding support and (4) Level of involvement depends on interactions between individuals and systems. Conclusion: Shared decision-making in palliative cancer care is a complex process of many decisions in a challenging, multifaceted and evolving situation where equipoise and choice are limited. Implications for practice: Implementing shared decision-making in clinical practice requires (1) clarifying conceptual confusion, (2) including members of the interprofessional team in the shared decision-making process and (3) adapting the approach to the ambiguous, existential situations which arise in palliative cancer care. [ABSTRACT FROM AUTHOR]

Introduction: We conducted a systematic review of qualitative evidence to improve understanding of the processes and outcomes of redress and reconciliation following a life‐changing event from the perspectives of individuals experiencing the event and their families. Methods: We searched six bibliographic databases for primary qualitative evidence exploring the views of individuals who have experienced a life‐changing event, and/or their family or carers, of redress or reconciliation processes. This was supplemented with targeted database searches, forward and backward citation chasing and searches of Google Scholar and relevant websites. Title and abstract and full‐text screening were undertaken independently by two reviewers. Data extraction and quality appraisal were conducted by one reviewer and checked by a second. We used a best‐fit framework synthesis approach, drawing upon procedural and restorative justice concepts. Findings: Fifty‐three studies (61 papers) were eligible for inclusion. Forty‐one studies (47 papers) were included in the synthesis, from which we identified four themes. Three themes 'Transparency', 'Person‐centered' and 'Trustworthy' represent the procedural elements required to support a fair and objective process. The fourth, 'Restorative justice' encapsulates how a fair process feels to those who have experienced a life‐changing event. This theme highlights the importance of an empathic relationship between the different parties involved in the redress‐reconciliation process and the significance of being able to engage in meaningful action. Conclusion: Our findings highlight the procedural aspects and context of redress‐reconciliation processes required to ensure that the process and outcomes are experienced as fair. These criteria may be applied to the processes used to investigate both recent and historical patient safety events. Public Contribution: One member of the public affiliated with the Exeter Policy Research Programme Evidence Review Facility helped develop the review protocol. Two people with experience of medically life‐changing events provided insight which corroborated our findings and identified important limitations of the evidence included in this review. [ABSTRACT FROM AUTHOR]

Background: Foster parents experience multiple challenges; however, managing problematic child behaviors can be especially difficult. Given the ecological nature of challenges associated with fostering, it is imperative that researchers identify means for combatting foster parent stress and factors that may contribute to placement disruption. Objective: The purpose of this paper is to examine the importance of social support for foster parents, in regards to confidence and satisfaction, as well as perceived challenges with fostering. Additionally, social support was evaluated as a moderator between reported child behaviors and foster parents' confidence and satisfaction with fostering. Method: This study included 155 licensed foster caregivers across the United States. Participants completed standardized measures (i.e., child behaviors, satisfaction and challenges as a foster parent, social support) through an online survey after being recruited via social media. Variables were analyzed through simple and hierarchal linear regressions. Results: Findings indicate that social support significantly predicted confidence and satisfaction as a foster parent; intensity of child behaviors is negatively associated with confidence as a foster parent and positively associated with an overall perception of challenges related to fostering; and social support moderates the relationship between perceived problem with child behaviors and perceived challenging aspects of fostering. Conclusion: This study indicates social support may be a protective factor for foster parents in regards to child behaviors and challenges associated with fostering. Social support is linked to variables that directly influence placement stability.

Smooth transitions through the early years of education are recognised as pivotal to later personal and academic success. However, for children considered outside the mainstream, these transitions can provide extra challenge for them, their families and educators. This paper reveals the findings of two qualitative studies investigating early years' transitions. The first study focused on the transition of children with disabilities into early childhood education and care (ECEC) centres; the second explored transition to school for emergent bilingual children. These studies highlight 'strengths-based' perspectives (Perry, Dockett, & Petriwskyj, 2013), wherein participants are understood as experts in their own lives bringing strengths as well as challenges to the new context. Despite the differences in participants, timing and methods, key themes were evident across the studies: parent perceptions of transition; educator attitudes; and home/centre or home/school relationships. These themes are significant to all educational transitions for children considered outside the mainstream.