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Introduction: Entrustable professional activities (EPAs), discrete profession‐specific tasks requiring integration of multiple competencies, are increasingly used to help define and inform curricula of specialty training programmes. Although guidelines exist to help guide the developmental process, deciding what logic to use to draft a preliminary EPA framework poses a crucial but often difficult first step. The logic of an EPA framework can be defined as the perspective used by its developers to break down the practice of a profession into units of professional work. This study aimed to map dominant logics and their rationales across postgraduate medical education and fellowship programmes. Methods: A scoping review using systematic searches within five electronic databases (Medline, Embase, Google Scholar, Scopus and Web of Science) was performed. Dominant logics of included papers were identified using inductive coding and iterative analysis. Results: In total, 42 studies were included. Most studies were conducted in the United States (n = 22; 52%), Canada (n = 6; 14%) and the Netherlands (n = 4; 10%). Across the reported range of specialties, family medicine (n = 4; 10%), internal medicine (n = 4; 10%), paediatrics (n = 3; 7%) and psychiatry (n = 3; 7%) were the most common. Three dominant logics could be identified, namely, 'service provision', 'procedures' and/or 'disease or patient categories'. The majority of papers (n = 37; 88%) used two or more logics when developing EPA frameworks (median = 3, range = 1–4). Disease or patient groups and service provision were the most common logics used (39% and 37%, respectively). Conclusions: Most programmes used a combination of logics when trying to capture the essential tasks of a profession in EPAs. For each of the three dominant logics, the authors arrived at a definition and identified benefits, limitations and examples. These findings may potentially inform best practice guidelines for EPA development. This study mapped the 3 dominant logics used in development of EPA‐frameworks. For each, a definition is provided with examples, benefits and limitations. [ABSTRACT FROM AUTHOR]

Background: Adequate housing is a basic human right. The many millions of people experiencing homelessness (PEH) have a lower life expectancy and more physical and mental health problems. Practical and effective interventions to provide appropriate housing are a public health priority. Objectives: To summarise the best available evidence relating to the components of case‐management interventions for PEH via a mixed methods review that explored both the effectiveness of interventions and factors that may influence its impact. Search Methods: We searched 10 bibliographic databases from 1990 to March 2021. We also included studies from Campbell Collaboration Evidence and Gap Maps and searched 28 web sites. Reference lists of included papers and systematic reviews were examined and experts contacted for additional studies. Selection Criteria: We included all randomised and non‐randomised study designs exploring case management interventions where a comparison group was used. The primary outcome of interest was homelessness. Secondary outcomes included health, wellbeing, employment and costs. We also included all studies where data were collected on views and experiences that may impact on implementation. Data Collection and Analysis: We assessed risk of bias using tools developed by the Campbell Collaboration. We conducted meta‐analyses of the intervention studies where possible and carried out a framework synthesis of a set of implementation studies identified by purposive sampling to represent the most 'rich' and 'thick' data. Main Results: We included 64 intervention studies and 41 implementation studies. The evidence base was dominated by studies from the USA and Canada. Participants were largely (though not exclusively) people who were literally homeless, that is, living on the streets or in shelters, and who had additional support needs. Many studies were assessed as having a medium or high risk of bias. However, there was some consistency in outcomes across studies that improved confidence in the main findings. Case Management and Housing Outcomes: Case management of any description was superior to usual care for homelessness outcomes (standardised mean difference [SMD] = −0.51 [95% confidence interval [CI]: −0.71, −0.30]; p < 0.01). For studies included in the meta‐analyses, Housing First had the largest observed impact, followed by Assertive Community Treatment, Critical Time Intervention and Intensive Case Management. The only statistically significant difference was between Housing First and Intensive Case Management (SMD = −0.6 [–1.1, −0.1]; p = 0.03) at ≥12 months. There was not enough evidence to compare the above approaches with standard case management within the meta‐analyses. A narrative comparison across all studies was inconclusive, though suggestive of a trend in favour of more intensive approaches. Case Management and Mental Health Outcomes: The overall evidence suggested that case management of any description was not more or less effective compared to usual care for an individual's mental health (SMD = 0.02 [−0.15, 0.18]; p = 0.817). Case Management and Other Outcomes: Based on meta‐analyses, case management was superior to usual care for capability and wellbeing outcomes up to 1 year (an improvement of around one‐third of an SMD; p < 0.01) but was not statistically significantly different for substance use outcomes, physical health, and employment. Case Management Components: For homelessness outcomes, there was a non‐significant trend for benefits to be greater in the medium term (≤3 years) compared to long term (>3 years) (SMD = −0.64 [−1.04, −0.24] vs. −0.27 [−0.53, 0]; p = 0.16) and for in‐person meetings in comparison to mixed (in‐person and remote) approaches (SMD = −0.73 [−1.25,−0.21]) versus −0.26 [−0.5,−0.02]; p = 0.13). There was no evidence from meta‐analyses to suggest that an individual case manager led to better outcomes then a team, and interventions with no dedicated case manager may have better outcomes than those with a named case manager (SMD = −0.36 [−0.55, −0.18] vs. −1.00 [−2.00, 0.00]; p = 0.02). There was not enough evidence from meta‐analysis to assess whether the case manager should have a professional qualification, or if frequency of contact, case manager availability or conditionality (barriers due to conditions attached to service provision) influenced outcomes. However, the main theme from implementation studies concerned barriers where conditions were attached to services. Characteristics of Persons Experiencing Homelessness: No conclusions could be drawn from meta‐analysis other than a trend for greater reductions in homelessness for persons with high complexity of need (two or more support needs in addition to homelessness) as compared to those with medium complexity of need (one additional support need); effect sizes were SMD = −0.61 [−0.91, −0.31] versus −0.36 [−0.68, −0.05]; p = 0.3. The Broader Context of Delivery of Case Management Programmes: Other major themes from the implementation studies included the importance of interagency partnership; provision for non‐housing support and training needs of PEH (such as independent living skills), intensive community support following the move to new housing; emotional support and training needs of case managers; and an emphasis on housing safety, security and choice. Cost Effectiveness: The 12 studies with cost data provided contrasting results and no clear conclusions. Some case management costs may be largely off‐set by reductions in the use of other services. Cost estimates from three North American studies were $45–52 for each additional day housed. Authors' Conclusions: Case management interventions improve housing outcomes for PEH with one or more additional support needs, with more intense interventions leading to greater benefits. Those with greater support needs may gain greater benefit. There is also evidence for improvements to capabilities and wellbeing. Current approaches do not appear to lead to mental health benefits. In terms of case management components, there is evidence in support of a team approach and in‐person meetings and, from the implementation evidence, that conditions associated with service provision should be minimised. The approach within Housing First could explain the finding that overall benefits may be greater than for other types of case management. Four of its principles were identified as key themes within the implementation studies: No conditionality, offer choice, provide an individualised approach and support community building. Recommendations for further research include an expansion of the research base outside North America and further exploration of case management components and intervention cost‐effectiveness. [ABSTRACT FROM AUTHOR]

Job insecurity is a widespread workplace stressor that has been extensively investigated using quantitative approaches. With the use of a critical organisational psychology framework, we conducted a meta‐synthesis of 20 qualitative studies to investigate the experience of job insecurity among vulnerable employee groups (i.e., women and immigrants). The qualitative meta‐synthesis results suggest that there are meaningful differences. Specifically, whereas women were more concerned with and exposed to deteriorating working conditions, men experienced job insecurity as a threat to their identity. Among immigrants, the experience of job insecurity is viewed as largely intersecting with the legal system, impacting their ability to remain in their country and making them feel powerless. Thematic evidence also emerged regarding individual actions that participants use to attain security in contrast to corporate strategies that enhance job insecurity. We contribute to the critical organisational psychology literature by discussing how these results test common academic theories and neoliberal assumptions pervasive within the job insecurity literature: We highlight how organisations manufacture job insecurity, question the existence of harmonious social exchanges, discuss the use of job insecurity as a form of worker control, consider the role of the legal context in aiding worker exploitation and argue for an intersectional view of job insecurity. [ABSTRACT FROM AUTHOR]

Introduction: This integrative review aimed to understand the impact of nursing on the health outcomes of people with opioid use disorder (OUD). Methods: Whittemore and Knafl's (2005) integrative review methodology guided the review process. The authors searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and OVID databases for peer‐reviewed, English language articles describing nursing care for people receiving medications for OUD. The literature search followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. Results: A total of 773 articles were identified through the database searches after duplicates were removed; 15 articles met inclusion criteria and were included in the final review from the United States, Canada, Ireland, England, and the Netherlands. Two themes emerged: (1) The effect of nurse‐led care on patient outcomes and (2) Nursing roles and the environment of care. Studies emphasized the aspects of nursing care that promote patient‐centeredness and patient satisfaction. Conclusions: The importance of the registered nurse in providing quality care for people receiving medications for OUD is clear from the literature reviewed. The studies in the review highlighted important aspects of the registered nurses' role in affecting outcomes for people receiving medications for OUD including communication and care coordination. Clinical relevance: This review highlights the need for role delineation and further development of nurse‐sensitive indicators in the OUD treatment setting. [ABSTRACT FROM AUTHOR]

Background: Examining the emerging body of evidence investigating what drives physiotherapist's clinical decisions in the management of low back pain can guide future research into identifying barriers and facilitators of their adherence to evidence recommended interventions. Objective: To establish the body of evidence regarding factors that improve or hinder physiotherapists' adherence to high‐value interventions on the management of non‐specific low back pain. Design: Scoping review. Methods: We conducted a Scoping review by searching MEDLINE, CINAHL, and SPORTDiscus databases on 13 February 2021. Two reviewers independently screened the retrieved literature and selected articles for inclusion. We included quantitative research that investigated an association between physiotherapists' personal characteristics or setting related characteristics with their clinical management of patients with non‐specific low back pain. Results: Twelve studies reported in 13 publications were included. The majority of the studies were conducted in high‐income countries including, the United States, Canada and UK. Twenty‐six factors were investigated as potentially influencing physiotherapists' adherence to high value interventions in low back pain management. The most commonly examined physiotherapists' attributes were educational qualification that is postgraduate or certification course (58%, N = 7 studies), years of experience (41%, N = 5 studies), and beliefs and attitude about low back pain (41%, N = 5 studies). Work setting (N = 4) and workload (N = 3) were frequently investigated setting related factors. Conclusion: Currently, there is limited evidence available to understand determinants controlling practice behaviours of physiotherapists' management of nonspecific low back pain. Future researches conceptualized within contemporary theories of clinician behaviour change and models of knowledge translation are needed. [ABSTRACT FROM AUTHOR]