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Decision prediction based on neurophysiological signals is of great application value in many real‐life situations, especially in human–AI collaboration or counteraction. Single‐trial analysis of electroencephalogram (EEG) signals is a very valuable step in the development of an online decision‐prediction system. However, previous EEG‐based decision‐prediction methods focused mainly on averaged EEG signals of all decision‐making trials to predict an individual's general decision tendency (e.g., risk seeking or aversion) over a period rather than on a specific decision response in a single trial. In the present study, we used a rock–paper–scissors game, which is a common multichoice decision‐making task, to explore how to predict participants' single‐trial choice with EEG signals. Forty participants, comprising 20 females and 20 males, played the game with a computer player for 330 trials. Considering that the decision‐making process of this game involves multiple brain regions and neural networks, we proposed a new algorithm named common spatial pattern‐attractor metagene (CSP‐AM) to extract CSP features from different frequency bands of EEG signals that occurred during decision making. The results showed that a multilayer perceptron classifier achieved an accuracy significantly exceeding the chance level among 88.57% (31 of 35) of participants, verifying the classification ability of CSP features in multichoice decision‐making prediction. We believe that the CSP‐AM algorithm could be used in the development of proactive AI systems. [ABSTRACT FROM AUTHOR]

Reviews have long been recognized as among the most important forms of scientific communication. The rapid growth of the primary literature has further increased the need for reviews to distill and interpret the literature. This review on Reviews and Reviewing: Approaches to Research Synthesis encompasses the evolution of the review literature, taxonomy of review literature, uses and users of reviews, the process of preparing reviews, assessment of review quality and impact, the impact of information technology on the preparation of reviews, and research opportunities for information science related to reviews and reviewing. In addition to providing a synthesis of prior research, this review seeks to identify gaps in the published research and to suggest possible future research directions. [ABSTRACT FROM AUTHOR]

Improved global access to novel age‐appropriate formulations for paediatric subsets, either of new chemical entities or existing drugs, is a priority to ensure that medicines meet the needs of these patients. However, despite regulatory incentives, the introduction to the market of paediatric formulations still lags behind adult products. This is mainly caused by additional complexities associated with the development of acceptable age‐appropriate paediatric medicines. This position paper recommends the use of a paediatric Quality Target Product Profile as an efficient tool to facilitate early planning and decision making across all teams involved in paediatric formulation development during the children‐centric formulation design for new chemical entities, or to repurpose/reformulate off‐patent drugs. Essential key attributes of a paediatric formulation are suggested and described. Moreover, greater collaboration between formulation experts and clinical colleagues, including healthcare professionals, is advocated to lead to safe and effective, age‐appropriate medicinal products. Acceptability testing should be a secondary endpoint in paediatric clinical trials to ensure postmarketing adherence is not compromised by a lack of acceptability. Not knowing the indications and the related age groups and potential dosing regimens early enough is still a major hurdle for efficient paediatric formulation development; however, the proposed paediatric Quality Target Product Profile could be a valuable collaborative tool for planning and decision making to expedite paediatric product development, particularly for those with limited experience in developing a paediatric product. [ABSTRACT FROM AUTHOR]

Dispersal is crucial for both individual fitness and spatiotemporal population dynamics. In sexual organisms, females and males have different reproductive strategies and therefore have different reproductive demands (i.e., reproductive resources and mating partners, respectively), which leads to differences in dispersal decision making between sexes. Although many studies have described sexual differences in dispersal behavior, little is known about the consequences for spatiotemporal population dynamics because metapopulation theory has considered only either nonrandom dispersal in asexual systems or random dispersal in sexual systems. To fill the knowledge gap, we propose a modeling framework that incorporates nonrandom and sex‐specific dispersal into metapopulation theory. It allows us to ask how female‐biased (e.g., in mammals) or male‐biased (e.g., in birds) dispersal can influence persistence of sexual organisms. [ABSTRACT FROM AUTHOR]

Summary: Critical appraisal skills enabling assessment of the validity and importance of evidence are essential for clinicians to make informed decisions regarding what new information should be incorporated into their clinical practice. This review highlights key points to consider in a critical review concentrating on common study designs used in the equine literature. [ABSTRACT FROM AUTHOR]

Introduction: The real‐world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why? Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes. The outcome (i.e. desired outcome) was a PED. Mechanisms were a substantial focus of the analysis and informed the core findings. To define a final corpus of 52 included papers, the authors searched four databases, screened all results from those searches and performed a full‐text review of a subset of screened papers. Data extraction focused on developing context–mechanism–outcome configurations from the papers, which were used to create a theory for how PEDM leads to PEDs. Results: PEDM is often driven by default (non‐deliberate) decision making rather than a deliberate process of deciding whether a trainee should be entrusted or not. When defaulting, some E/CCCs find red flags that sometimes lead to being more deliberate with decision making. E/CCCs that seek to be deliberate describe PEDM that can be effortful (when data are insufficient or incongruent) or effortless (when data are robust and tell a congruent story about a trainee). Both information about trainee trustworthiness and the sufficiency of data about trainee performance influence PEDM. Several moderators influence what is considered to be sufficient data, how trustworthiness data are viewed and how PEDM is carried out. These include perceived consequences and associated risks, E/CCC member trust propensity, E/CCC member personal knowledge of and experience with trainees and E/CCC structures and processes. Discussion: PEDM is rarely deliberate but should be. Data about trainee trustworthiness are foundational to making PEDs. Bias, equity and fairness are nearly absent from the papers in this synthesis, and future efforts must seek to advance understanding and practice regarding the roles of bias, equity and fairness in PEDM. Entrustment decisions made by committees are rarely deliberate, but should be. These authors provide practical advice, based in the literature, for improvement. [ABSTRACT FROM AUTHOR]

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]

This paper presents research into communication pathways between young people and political decision‐makers. The aim of the study was to give young people a platform to challenge how they are perceived in urban public space. Using innovative creative mapping methods, a group of teenagers shared insights into their everyday experiences of their urban neighbourhood with elected political representatives. This paper argues that the perception of young people within the political establishment inhibits engagement and change, but that the participation process is an important step towards reframing perceptions and affecting change. [ABSTRACT FROM AUTHOR]

The simplest example of non-transitive competition is the game rock-paper-scissors (RPS), which exhibits characteristic cyclic strategy replacement: paper beats rock, which in turn beats scissors, which in turn beats paper. In addition to its familiar use in understanding human decision-making, rock-paper-scissors is also played in many biological systems. Among other reasons, this is important because it potentially provides a mechanism whereby species- or strain coexistence can occur in the face of intense competition. Kerr et al. (2002, Nature 418: 171-174) use complementary experiments and simulations to show that RPS-playing toxic, resistant, and susceptible E. coli bacteria can coexist when interactions between the strains are spatially explicit. This raises the question of whether limited interactions associated with space are sufficient to allow strain coexistence, or whether space per se is crucial. I approach this question by extending the Kerr et al. model to include different (aspatial) population network structures with the same degree distributions as corresponding spatial lattice models. I show that the coexistence that occurs for some parameter combinations when simulated bacterial strains compete on lattices is absent when they compete on random regular graphs. Further, considering small-world networks of intermediate 'quenched randomness' between lattices and random regular graphs, I show that only small deviations from pure spatial interactions are sufficient to prevent strain coexistence. These results emphasize the explicit role of space, rather than merely limited interactions, as being decisive in allowing the coexistence of toxic, resistant, and susceptible strains in this model system. [ABSTRACT FROM AUTHOR]

Abstract: In order to prevent tunnel vision, and ultimately miscarriages of justice, police, prosecutors, and judges must remain open to alternative scenarios in which the suspect is in fact innocent. However, it is not evident from the literature that people are sufficiently aware of how alternative scenarios should be employed in the decision‐making process. In the present research, participants read a case vignette and formed an impression of the suspect's guilt. Some participants were made familiar with an alternative scenario. Others were not only presented with an alternative scenario but were also instructed to score (with pen and paper) the extent to which every piece of evidence fitted in the primary and the alternative scenario. Findings suggest that this pen‐and‐paper task helped to reduce tunnel vision. [ABSTRACT FROM AUTHOR]

The study discusses a new approach to parental agency in pediatric palliative care based on an active form of caregiving. It also explores the possibility of a positive conceptualization of parental agency in its relational context. The paper begins with an illustrative case study based on a clinical situation. This is followed by an analysis of various aspects of parental agency based on empirical studies that disclose the insufficiencies of the traditional approach to parental agency. In the next step, parental agency is analyzed from a reality‐based perspective as an activity focused on relationships and the cognitive capacity of parents vis‐a‐vis their seriously ill children. The paper also considers the importance of the cultural and social contexts in which parental agency and decision‐making take place. This agency is addressed not as individualistic in form, and nor is it exercised in terms of fixed choices. Rather, the focus is on its dynamic and future‐oriented aspects. Consequently, parental agency should be comprehended not only as a form of proxy agency representing the child's best interests but also as a complex decision‐making process in which the parents learn from their child how to become good, compassionate caregivers and at the same time good parents. [ABSTRACT FROM AUTHOR]

Background: Collaborations between patient organisations (POs) and the pharmaceutical industry can help identify and address the unmet needs of people living with a disease. In Alzheimer's disease (AD), the scale and complexity of the current unmet needs call for a broad and cross‐sectoral collaboration, including people living with Alzheimer's (PLWA), their care partners and the wider research community. Objective: This study aimed to describe learnings from the Finding Alzheimer's Solutions Together (F.A.S.T.) Council, a collaboration between POs and Roche, convened to better understand the unmet needs of PLWA and their care partners. Results: 1. Learnings from the collaboration, including clarifying objectives and members' expectations upfront, and establishing a set of guiding values and engagement principles. 2. Insights and recommendations for improving care in AD, including a wide range of unmet needs and potential solutions, systematically captured throughout the PLWA journey. These have resulted in several published reports and other outcomes, including (1) 'Portraits of care', highlighting the role of care partners, and the impact of coronavirus disease 2019 on care; (2) Clinical trial guidebook, recommending how PLWA and care partner experience can be incorporated into trial design; (3) 'Commitments Catalogue', highlighting progress by governmental organisations in achieving their commitments; and (4) a report to guide policy on improving diversity, equity and inclusion in clinical trials. Conclusions: Close collaboration between POs and the pharmaceutical industry in AD can enable effective research, in which PLWA and care partners are engaged as 'experts through experience' to help identify key unmet needs and co‐create solutions with the wider AD research community. This paper and the work undertaken by the F.A.S.T. Council may act as a blueprint for meaningful collaboration between POs and the pharmaceutical industry. Patient or Public Contribution: The paper reports the collaboration between POs, the F.A.S.T. Council and Roche to progress towards a future in which PLWA can live fulfilling lives with their disease managed well. Clinical Trial Registration: Not applicable. [ABSTRACT FROM AUTHOR]

Previous research demonstrates that businesses that are Indigenous‐owned are far more likely to employ Indigenous people than non‐Indigenous‐owned businesses (Hunter, 2015). The majority of the literature on Indigenous employment uses a deficit discourse, describing factors that prevent or exclude Indigenous people from non‐Indigenous‐owned organisations. There is markedly less literature using a strength‐based approach, detailing how Indigenous‐owned businesses create workplaces without barriers to Indigenous employment. Through 32 semistructured interviews with Indigenous business owners, managers, and Indigenous employees of Indigenous‐owned businesses, this paper provides insights into how participants' businesses create workplaces that are more supportive of, and conducive to, Indigenous employment. This paper finds that Indigenous approaches to governance inform an organisational level of cultural competence, which creates tailored and specific practices that support better Indigenous employment outcomes. This resonates with the concept of Indigenous ways of "knowing, being, and doing," and how this framework encompasses participants' approaches to business operations. In the light of increasing public and private policy commitments to improve Indigenous employment outcomes, it is imperative that the Indigenous business sector's best practice inform said policies, given its successes. However, inherent in these findings are broader discussions into more systemic and societal issues that go beyond workplace policy. [ABSTRACT FROM AUTHOR]

Background: Achieving universal health coverage (UHC) in the context of limited resources will require prioritising the most vulnerable and ensuring health policies and services are responsive to their needs. One way of addressing this is through the engagement of marginalised voices in the priority setting process. Public engagement approaches that enable group level deliberation as well as individual level preference capturing might be valuable in this regard, but there are limited examples of their practical application, and gaps in understanding their outcomes, especially with rural populations. Objective: To address this gap, we implemented a modified priority setting tool (Choosing All Together—CHAT) that enables individuals and groups to make trade‐offs to demonstrate the type of health services packages that may be acceptable to a rural population. The paper presents the findings from the individual choices as compared to the group choices, as well as the differences among the individual choices using this tool. Methods: Participants worked in groups and as individuals to allocate stickers representing the available budget to different health topics and interventions using the CHAT tool. The allocations were recorded at each stage of the study. We calculated the median and interquartile range across study participants for the topic totals. To examine differences in individual choices, we performed Wilcoxon rank sum tests. Results: The results show that individual interests were mostly aligned with societal ones, and there were no statistically significant differences between the individual and group choices. However, there were some statistically significant differences between individual priorities based on demographic characteristics like age. Discussion: The study demonstrates that giving individuals greater control and agency in designing health services packages can increase their participation in the priority setting process, align individual and community priorities, and potentially enhance the legitimacy and acceptability of priority setting. Methods that enable group level deliberation and individual level priority setting may be necessary to reconcile plurality. The paper also highlights the importance of capturing the details of public engagement processes and transparently reporting on these details to ensure valuable outcomes. Public Contribution: The facilitator of the CHAT groups was a member from the community and underwent training from the research team. The fieldworkers were also from the community and were trained and paid to capture the data. The participants were all members of the rural community‐ the study represents their priorities. [ABSTRACT FROM AUTHOR]

Although the implementation of person‐centred care (PCC) has gained momentum in healthcare systems, it is not always obvious why it is an important objective in clinical settings and educational institutions that train future healthcare professionals. Various conceptions about PCC have flourished, such as that it only works in certain healthcare contexts, it is the same as the patient making all their own healthcare decisions, it is too demanding for most patients, the word 'patient' may no longer be used, the care provided is already person‐centred, and that there is simply not enough time and resources to achieve it. This viewpoint paper aims to problematize these conceptions and may be used for didactical and reflective exercises that support the transition towards more person‐centred healthcare. Patient or Public Contribution: The Person Council for patients and carers at the University of Gothenburg provided focus group input on and validated the occurrence of the conceptions discussed in the present paper. The person council consists of a group of persons with many years of personal experiences of health care, either as patients and/or relatives/carers. One member of the person council who is also a designer and artist created the illustration for the article. [ABSTRACT FROM AUTHOR]

Background: The role of patient participation and representation during crises, such as the COVID‐19 pandemic, has been under‐researched. Existing studies paint a pessimistic picture of patient representation during the pandemic. However, there are indications that patient representatives have adapted to the new situation and can contribute to the resilience of healthcare systems. This paper aims to further explore the potential contribution of patient representatives for healthcare system resilience during the COVID‐19 pandemic. Methods: The study used a qualitative approach. We conducted a thematic analysis on the following data: interviews with client council members (n = 32) and representatives from patient organizations (n = 6) and focus groups (n = 2) to investigate patient representation on both the national policy level and organizational level in the Netherlands. Results: We identified the crisis discourse, the dependent position, the diversity of patient perspectives and the layered decision‐making structure as themes that help to understand what made patient representation in pandemic times a struggle for national and local patient representatives. The analysis of the subjects these representatives put forward during decision‐making shows that their input can play an important role in broadening discussions, challenging decisions, and suggesting alternatives during a crisis. We identified several strategies (e.g., collaborating with other actors, proactively putting subjects on the policy agenda, finding new ways of contacting their 'constituency') used by the patient representatives studied to exert influence despite the difficulties encountered. Conclusions: The struggle for patient representation during pandemic decision‐making is a missed opportunity for resilient healthcare systems as these representatives can play a role in opening up discussions and putting different perspectives to the fore. Moreover, the adaptive strategies used by representatives to influence decision‐making offer lessons for future representation activities. However, adaptations to the crisis decision‐making structure are also needed to enable patient representatives to play their role. Patient Contribution: We conducted interviews with patient representatives and discussed our preliminary findings with patient representatives during the focus groups. Zorgbelang, a patient organization supporting client councils and enabling and organizing patient participation for organizations and municipalities, was partner in this research and contributed to the interview guide, conducting interviews and focus groups. Additionally, the analysis made by the first author was discussed and refined multiple times with the partners of Zorgbelang and one of them co‐authored this paper. [ABSTRACT FROM AUTHOR]

Background: A person‐centred approach in the context of health services delivery implies a biopsychosocial model focusing on all factors that influence the person's health and functioning. Those wishing to monitor change should consider this perspective when they develop and use guidelines to stimulate active consideration of the person's needs, preferences and participation in goal setting, intervention selection and the use of appropriate outcome measures. Objective: To develop a position paper that promotes a person‐centred approach in guideline development and implementation. Design, setting and participants: We used three narrative discussion formats to collect data for achieving consensus: a nominal group technique for the Allied Health Steering Group, an Internet discussion board and a workshop at the annual G‐I‐N conference. We analysed the data for relevant themes to draft recommendations. Results: We built the position paper on the values of the biopsychosocial model. Four key themes for enhancing a person‐centred approach in clinical guidelines emerged: (i) use a joint definition of health‐related quality of life as an essential component of intervention goals, (ii) incorporate the International Classification of Functioning, Disability and Health (ICF) as a framework for considering all domains related to health, (iii) adopt a shared decision‐making method, and (iv) incorporate patient‐reported health outcome measures. The position statement includes 14 recommendations for guideline developers, implementers and users. Conclusion: This position paper describes essential elements for incorporating a person‐centred approach in clinical guidelines. The consensus process provided information about barriers and facilitators that might help us develop strategies for implementing person‐centred care. [ABSTRACT FROM AUTHOR]

With the continuous growth of electricity demand, the safe and stable operation of distribution lines is crucial for power transportation. Unmanned aerial vehicle (UAV) inspection has been widely used for the maintenance and repair of distribution lines. Due to the limitations of computational power and endurance, it is difficult for UAVs to independently complete data processing. Combined with mobile edge computing (MEC), this paper proposes a computing offloading strategy based on multi‐agent reinforcement learning and double‐layer offloading mechanism, which can further utilize the computing power of non‐task devices and edge servers. Firstly, three‐layer system architecture, named MEC‐U‐NTDC (MEC‐UAV‐Non‐task Device Cloud), is built. Secondly, double‐layer offloading mechanism is designed to comprehensively utilize the computing power of edge servers and neighbouring non‐task devices. Finally, a multi‐agent algorithm DLMQMIX is proposed to minimize the total cost for UAV inspection. Simulation experiments show that the proposed algorithm can effectively solve the task offloading problem of UAV‐aided distribution line inspection, and compared with algorithms such as PSO, GA, and QMIX, it performs better in terms of average delay, system cost, and load balancing, achieving a smaller total system cost. [ABSTRACT FROM AUTHOR]

ABSTRACT In clinical trials with time‐to‐event data, the evaluation of treatment efficacy can be a long and complex process, especially when considering long‐term primary endpoints. Using surrogate endpoints to correlate the primary endpoint has become a common practice to accelerate decision‐making. Moreover, the ethical need to minimize sample size and the practical need to optimize available resources have encouraged the scientific community to develop methodologies that leverage historical data. Relying on the general theory of group sequential design and using a Bayesian framework, the methodology described in this paper exploits a documented historical relationship between a clinical “final” endpoint and a surrogate endpoint to build an informative prior for the primary endpoint, using surrogate data from an early interim analysis of the clinical trial. The predictive probability of success of the trial is then used to define a futility‐stopping rule. The methodology demonstrates substantial enhancements in trial operating characteristics when there is a good agreement between current and historical data. Furthermore, incorporating a robust approach that combines the surrogate prior with a vague component mitigates the impact of the minor prior‐data conflicts while maintaining acceptable performance even in the presence of significant prior‐data conflicts. The proposed methodology was applied to design a Phase III clinical trial in metastatic colorectal cancer, with overall survival as the primary endpoint and progression‐free survival as the surrogate endpoint. [ABSTRACT FROM AUTHOR]

The present study aims to explore the forms paternalistic communication can take in doctor–patient interactions and how they should be considered from a normative perspective. In contemporary philosophical debate, the problem with paternalism is often perceived as either undermining autonomy (the autonomy problem) or the paternalist viewing their judgment as superior (the superiority problem). In either case, paternalism is problematized mainly in a general, theoretical sense. In contrast, this paper investigates specific doctor–patient encounters, revealing distinct types of paternalistic communication. For this study, I reviewed videorecorded encounters from a Norwegian hospital to detect paternalism—specifically, doctors overriding patients' expressed preferences, presumably to benefit or protect the patients. I identified variations in paternalistic communication styles—termed paternalist modes—which I categorized into four types: the fighter, the advocate, the sympathizer, and the fisher. Drawing on these findings, I aim to nuance the debate on paternalism. Specifically, I argue that each paternalist mode carries its own normative implications and that the autonomy and the superiority problems manifest differently across the modes. Furthermore, by illustrating paternalism in communication through real‐life cases, I aim to reach a more comprehensive understanding of what we mean by paternalistic doctors. [ABSTRACT FROM AUTHOR]

Background: Understanding the factors that contribute to diagnostic errors is critical if we are to correct or prevent them. Some scholars influenced by the default interventionist dual‐process theory of cognition (dual‐process theory) emphasise a narrow focus on individual clinician's faulty reasoning as a significant contributor. In this paper, we examine the validity of claims that dual process theory is a key to error reduction. Methods: We examined the relationship between a clinical experience (staff and resident physicians) and viewing time on accuracy for categorising chest X‐rays (CXRs) and electrocardiograms (ECGs). In two studies, participants categorised images as normal or abnormal, presented at viewing times of 175, 250, 500 and 1000 ms, to encourage System 1 processing. Study 2 extended viewing times to 1, 5, 10 and 20 s to allow time for System 2 processing and a diagnosis. Descriptives and repeated measures analysis of variance were used to analyse the proportion of true and false positive rates (TP and FP) as well as correct diagnoses. Results: In Study 1, physicians were able to detect abnormal CXRs (0.78) and ECGs (0.67) with relatively high accuracy. The effect of experience was found for ECGs only, as staff physicians (0.71, 95% CI = 0.66–0.75) had higher ECG TP than resident physicians (0.63, 95% CI = 0.58–0.68) in Study 1, and staff had lower ECG FP (0.10, 95% CI = 0.03–0.18) than resident physicians (0.27, 95% CI = 0.20–0.33) in Study 2. In other comparisons, experience was equivocal for ECG FPs and CXR TPs and FPs. In Study 2, overall diagnostic accuracy was similar for both ECGs and CXRs, (0.74). There were small interactions between experience and time for TP in ECGs and FP in CXRs, which are discussed further in the discussion and offer insights into the relationship between processing and experience. Conclusion: Overall, our findings raise concerns about the practical application of models that link processing type to diagnostic error, or to specific diagnostic error reduction strategies. Recommendations to employ self‐directed strategies to slow down, take a diagnostic time out, or reflect, are reported as not being reliable means for reducing diagnostic error; in fact, these strategies may increase error. [ABSTRACT FROM AUTHOR]

Despite progress in computer automated solutions, constitutional isomer verification by NMR using one‐ and two‐dimensional data sets is still, in the main, a manual, user‐intensive activity that is challenging for a number of reasons. These include the problem of simultaneously keeping track of the information from a number of separate NMR experiments and the difficulty of another researcher subsequently verifying the assignments made without having to independently repeat the whole analysis. This paper describes a graphical interactive approach that overcomes some of these problems. By using concepts used to visualise graph networks, we have been able to represent the NMR data in a manner that highlights directly the link between the different NMR experiments and the molecule of interest. Furthermore, by making the graph networks interactive, a user can easily validate and correct the assignment and understand the decisions made in arriving at the solution. We have developed a usable proof‐of‐concept computer program, 'simpleNMR', written in Python to illustrate the ideas and approach. [ABSTRACT FROM AUTHOR]

Background: The introduction of the National Disability Insurance Scheme (NDIS) in Australia in 2013 promised significant improvements in the lives of adults with intellectual disabilities. Although the scheme enables support, there are challenges associated with establishing eligibility and administering funds. This scoping review explored perceived barriers and enablers to effectively utilising the NDIS for adults with intellectual disabilities and their families. Method: A scoping review of the empirical literature on the NDIS and intellectual disabilities included nine studies in this review. These papers were subjected to thematic analysis and the findings were presented as a narrative synthesis. Results: The key themes identified were: (1) Limited understanding of the NDIS process; (2) Language use and capacity assumptions; (3) Unrealistic goals and progress, and difficulty utilising plans; (4) Expectations of families and associated workloads; (5) Opening up opportunities not previously available; (6) Knowledgeable planners who actively seek to involve adults and their families. Conclusion: Although qualitative studies demonstrate that adults with an intellectual disability and their families are largely satisfied with the increased opportunities the NDIS has afforded them, there are various areas in which accessibility to services can be improved. In order for the NDIS to continue to improve, the results from this scoping review underline the need for adults with an intellectual disability and their support systems to have their voices heard and be utilised. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to develop a model to explain why and how some expatriate managers engage in misbehavior in host countries, a notoriously elusive phenomenon in the academe. Integrating social cognitive and fraud triangle theories, we conceptualize this phenomenon as an externally driven, cognitive decision‐making process. Specifically, we theorize that discrepancies between both home and host country environments and expatriate managerial and parent‐company performance expectations and on the ground realities that expatriates face trigger expatriate managerial cognitive self‐regulatory dynamics. Consequently, extrinsic reputation and intrinsic self‐esteem threats provide motivation for managers to learn vicariously from the host social environment about the effectiveness of misbehavior for achieving their goals. Expatriate self‐efficacy and the propensity to morally disengage moderate this process. Parent company controls also impact the influence of vicarious learning on expatriate managers' development of motivation, justification, and opportunities for misbehavior. Our model contributes to the misbehavior and expatriate literatures and extends social cognitive and fraud triangle theories. [ABSTRACT FROM AUTHOR]

This paper argues that there are two importantly distinct normative relations that can be referred to using phrases like ‘X is obligated to Y,’ ‘Y has a right against X,’ or ‘X wronged Y.’ When we say that I am obligated to you not to read your diary, one thing we might mean is that I am subject to a deontological constraint against reading your diary that gives me a non‐instrumental, agent‐relative reason not to do so, and which you are typically in a unique position to waive with consent. I call this first relation the constraint relation. A second thing we might mean is that you are in a position to fittingly hold me personally accountable for reading your diary by demanding that I not read your diary, resenting me if I do so without excuse, and deciding whether to forgive me for this afterwards. I call this second relation the accountability relation. Though these two kinds of directed obligation often coincide, I argue that they are extensionally dissociable and play different normative roles. We cannot provide an adequate theory of ‘obligation to’ until we recognize that this phrase denotes not one relation, but two. [ABSTRACT FROM AUTHOR]

Article 12 of the United Nations Convention on the Rights of Persons with Disabilities has been instrumental in driving the development of the concept and practice of supported decision making. An important feature has been the development of "supported decision making pilots." This paper identifies, describes and analyses pilot programmes providing support for decision making for people with cognitive disabilities in Australia and internationally between 2016 and 2021. It finds that challenges included providing support for socially isolated people and adequately resourcing those programmes. However, most pilots reported positive outcomes for decision makers, adding to the evidence base for claims to be made about the positive impact of supported decision making on the lives of people with disabilities. The pilots demonstrate that, internationally, there is an emerging set of programmes that seek to promote supported decision making incrementally through developing focussed community awareness and practice. While still small‐scale, time‐limited and experimental, with different levels of rigour in practice and evaluation, they provide some foundation and a preliminary evidence base for larger interventions and reforms in the future. [ABSTRACT FROM AUTHOR]

Background: Informal care features high on the policy agenda of many countries to deal with workforce shortages. As a consequence, care provision increasingly takes place in the care triad of care recipients, informal caregivers and care professionals. How collaboration between care partners takes shape depends on how the different partners perceive this collaboration. This paper aims to investigate the relative importance of the different aspects of collaboration from the perspectives of care recipients, informal caregivers and care professionals in the context of the care for older persons in The Netherlands. Methods: Using Q‐methodology, 32 participants ranked 28 statements that reflect different aspects of collaboration in the care triad and explained their ranking during a follow‐up interview. Participants comprised 9 older persons, 10 informal caregivers and 13 care professionals. Data were analysed using by‐person factor analysis to identify common patterns in the rankings of the statements. Emerging patterns were interpreted and described as views on collaboration using aggregated rankings and qualitative data from the interviews. Results: Five distinct views on collaboration were found: (1) Emphasizing warm collaboration, (2) trusting care professional's expertise, (3) open and compassionate care professionals, (4) responsive decision‐making by autonomous care professionals and (5) prioritizing care recipient's and informal caregiver's interests. Care recipients and/or informal caregivers were associated with views 1, 3 and, 5, whereas care professionals were associated with all five views. Conclusions: Our study highlights the importance of recognizing the potential diversity of views between and within different partner groups in care triads. Governmental and organizational policy makers, as well as healthcare professionals who aim to increase or support the involvement of informal caregivers, should take this heterogeneity into consideration. Patient or Public Contribution: An advisory board of older persons (care recipients and informal caregivers) was involved in the recruitment of the participants, the formulation of the statements and the reflection on the findings of the study and potential implications. [ABSTRACT FROM AUTHOR]

Backgroud: Despite the advancements in the rights of persons with disabilities in Western countries, the motherhood of women with intellectual disabilities remains scarcely visible. The approval of the Convention on the Rights of Persons with Disabilities (2006) and its subsequent ratification by the Spanish Government (2008) recalls the obligation to fulfil the rights of persons with disabilities to found a family (art. 23) and to choose who they want to live with (art. 19). While the importance of this legislation is undeniable, the personal experiences of women with intellectual disabilities still demand effective changes. Methods: This article reports the results of a study entitled Subjectivities and motherhood in women with intellectual disabilities. Reflections in dialogue through an inclusive research project. In this study, we delved into the stories of 13 women, aged between 24 and 72, to learn about their motherhood experiences (before, during and after making the decision of being mothers) and to identify the barriers and supports encountered. Methods for data collection included individual semi‐structured interviews, discussion groups and other narrative and visual resources (images and biograms). Findings: This study explores in depth the obstacles identified by the participating mothers, which have been organised around six themes: (1) information and guidance on sexuality and family planning, (2) assistance of health services, (3) employment and housing situation, (4) child custody, (5) raising children, and (6) informal support. The participants encountered difficulties in all the above fields related to contextual factors. In other words, these barriers do not derive from individual issues centred on their disability, but from factors that often do not depend on mothers with intellectual disabilities, such as deprivation of socio‐educational opportunities. Conclusions: Our results show the nuanced ways in which these mothers were immersed in a social system that questions them as 'good mothers' and violates their rights. As we discussed, the participants' desires and decisions to engage and/or continue with motherhood constitute an exercise of resistance to this system. Accessible summary: People with intellectual disabilities have the right to start a family and to choose who they want to live with.These rights need the support of society and institutions to be effective.This paper deals with interviews and discussion groups with thirteen women with intellectual disabilities.Women with intellectual disabilities shared their experiences of motherhood.The participating women and academic researchers found some of the barriers mothers with intellectual disabilities encountered.Women with intellectual disabilities defend their desire and ability to become mothers. [ABSTRACT FROM AUTHOR]

Policy PointsFaced with urgent threats to human health and well‐being such as climate change, calls among the academic community are getting louder to contribute more effectively to the implementation of the evidence generated by our research into public policy.As interest in knowledge translation (KT) surges, so have a number of anxieties about the field's shortcomings. Our paper is motivated by a call in the literature to render useful advice for those beginning in KT on how to advance impact at a policy level.By integrating knowledge from fields such as political science, moral psychology, and marketing, we suggest that thinking and acting like marketers, lobbyists, movements, and political scientists would help us advance on the quest to bridge the chasm between evidence and policy. [ABSTRACT FROM AUTHOR]

Medical and health sciences librarians who are involved in evidence synthesis projects will know that systematic reviews are intensely rigorous, requiring research teams to devote significant resources to the methodological process. As expert searchers, librarians are often identified as personnel to conduct the database searching portion and/or are approached as experts in the methodology to guide research teams through the lifecycle of the project. This research method has surged in popularity at our campus and demand for librarian participation is unsustainable. As a response to this, the library created self‐directed learning objects in the form of roadmap to assist researchers in learning about the knowledge synthesis methodology in an expedient, self‐directed manner. This paper will discuss the creation, implementation and feedback around our educational offering: Systematic & Scoping Reviews: Your Roadmap to Conducting an Evidence Synthesis. [ABSTRACT FROM AUTHOR]

Community health workers are responsible for finding, processing, and transferring health information to communities with limited access to health‐related resources, including farmworkers. This paper is the culmination of an undergraduate student research project to explore the learning processes and preferences of farmworker‐serving community health workers in the USA. The project was designed for students from farmworker or agricultural backgrounds at two North Carolina universities and was supported by a North Carolina Department of Health and Human Services workforce development grant. Semi‐structured interviews were conducted, in person and virtually, with a convenience sample of 17 current and former community health workers. The interview data were analysed thematically and identified a preference for a combination of learning styles, with visual and hands‐on learning being the most preferred. Community health workers also identified the importance of learning preferences in relation to their responsibilities as health educators. This study provides librarians, along with public health and medical professionals, with useful information about learning preferences to inform the creation of new and varied learning materials for community health workers. [ABSTRACT FROM AUTHOR]

In unmanned aerial vehicle ad‐hoc network (UANET), the node speed of unmanned aerial vehicles (UAVs) may reach up to 400 km/h. The fast or slow movement of UAV nodes leads to different speeds of topology change of the nodes. Traditional optimized link state routing (OLSR) protocol cannot adaptively adjust the routing update period when the network topology changes, which may lead to the nodes calculating incorrect routing tables. This increases the average end‐to‐end delay and packet loss rate for packet transmission. To enhance the adaptability of OLSR routing protocol to network topology changes, this paper proposes a multi‐agent independent deep deterministic policy gradient‐OLSR (MA‐IDDPG‐OLSR) routing protocol based on distributed multi‐agent reinforcement learning. The protocol deploys DDPG algorithm on each UAV node, and each UAV node adaptively adjusts the Hello and TC message sending intervals, according to the one‐hop neighbouring nodes as well as its own state. Simulation results show that the proposed protocol is able to improve the throughput and reduce the packet loss rate as compared to traditional AODV, GRP, OLSR, and distributed multiple‐agent independent proximal policy optimization‐OLSR (MA‐IPPO‐OLSR), distributed multiple‐agent independent twin delayed deep deterministic policy gradient‐OLSR (MA‐ITD3‐OLSR) routing protocols. Since MA‐IDDPG‐OLSR relies only on local information, there is a minor performance degradation in MA‐IDDPG‐OLSR compared to centralized single‐agent DQN‐OLSR routing protocol. But it is more suitable to a completely distributed UAV network without a centralized node. [ABSTRACT FROM AUTHOR]

In 2020, after George Floyd's murder and with the mobilisation of Black Lives Matter activism, many UK institutions announced social media pledges to tackle racism. The cultural sector promised honest conversations about race, racism and whiteness and offered hope for social justice. However, not long after claims of imminent change on the part of cultural organisations, it went quiet. Conversations about race, racism and whiteness, once again, were not a priority. Rightly, young activists question the performative nature of cultural institutions expressing anti‐racist commitment and social justice values. Drawing upon the experiences of museum education, engagement and activism, the key question addressed in this paper by the author and members of the Our Shared Cultural Heritage Young Collective is: How do young people understand and experience the processes of engaging in education and activism in what they perceive to be overwhelmingly white middle‐class cultural institutions? The authors argue that museums can be useful, relevant and interesting to young people if museum staff actively seek to learn from them through participatory action research. The authors share some highlights, challenges and complexities of our 'youth‐led' work in the heritage sector, in the hope that museums and galleries, as well as other arts and cultural organisations, might learn and benefit from our experiences and knowledge of young people's activism in the heritage sector. [ABSTRACT FROM AUTHOR]

Divergences and controversies are inevitable in the discussion of freedoms and rights, especially in the matter of reproduction. The Chinese first social egg freezing lawsuit raises the question: is the freedom to freeze eggs for social reasons justified because it is an instance of reproductive rights? This paper accepts social egg freezing as desirable reproductive freedom, but following Harel's approach and considering two theories of rights, the choice and interest theories of rights, we argue that social egg freezing is not a reproductive right because one cannot justify a right or an instance of rights via merely describing the function of those instances that have been justified as right, that is, the choice theory lacks justifying normativity. Since reserving fertility and a suspension from reproduction do not serve reproductive ends per se, the sufficient reason for demanding social egg freezing as a right should be found in other ends rather than in right‐to‐reproduce, that is, the interest theory denies the demand as a right‐to‐reproduce. Permitting it on any grounds without guaranteeing adequate and accessible resources, especially in light of cross‐border reproductive care, raises serious questions about reproductive equality and violates the idea of reproductive rights. Therefore, any ground for social egg freezing should be weighed against whether more pressing reproductive needs, specifically those that are justified as rights, have been met. It would be social progress to shoulder these burdens for the vulnerable and then allow social egg freezing—if right‐to‐reproduce were not the only privilege of the few. [ABSTRACT FROM AUTHOR]

Multiple‐choice questions (MCQs) are the most popular type of items used in knowledge‐based assessments in undergraduate and postgraduate healthcare education. MCQs allow assessment of candidates' knowledge on a broad range of knowledge‐based learning outcomes in a single assessment. Single‐best‐answer (SBA) MCQs are the most versatile and commonly used format. Although writing MCQs may seem straight‐forward, producing decent‐quality MCQs is challenging and warrants a range of quality checks before an item is deemed suitable for inclusion in an assessment. Like all assessments, MCQ‐based examinations must be aligned with the learning outcomes and learning opportunities provided to the students. This paper provides evidence‐based guidance on the effective use of MCQs in student assessments, not only to make decisions regarding student progression but also to build an academic environment that promotes assessment as a driver for learning. Practical tips are provided to the readers to produce authentic MCQ items, along with appropriate pre‐ and post‐assessment reviews, the use of standard setting and psychometric evaluation of assessments based on MCQs. Institutions need to develop an academic culture that fosters transparency, openness, equality and inclusivity. In line with contemporary educational principles, teamwork amongst teaching faculty, administrators and students is essential to establish effective learning and assessment practices. [ABSTRACT FROM AUTHOR]

Background: Cheating during medical training is a delicate subject matter with varying opinions on the prevalence, causes and gravity of cheating during training. Proposed framework: In this article, the authors suggest that the decision to cheat is best viewed as the product of a person‐by‐situation interaction rather than indicating inherent dishonesty and/or extrinsic motivation in those who participate in cheating. This framework can explain why individuals who would typically default to honesty may participate in cheating if there is perceived justification for cheating and where situational variables, such as ease of cheating, rewards for cheating and perceived risk associated with cheating, make the decision to cheat appear rational. Discussion: They discuss why the impression that there is a culture of cheating can provide perceived justification for medical trainees to cheat if they have the opportunity. They then describe how aspects of medical training and assessment may enable or hinder cheating by trainees. Consistent with the person‐by‐situation interaction framework, they contend that our response to cheating should include interventions directed at both the person who cheated and situational variables that enabled cheating. Recognising that some forms of cheating may be widespread, difficult to detect and contentious (such as the creation and use of exam reconstructs), their proposal for dealing with suspected and pervasive cheating is to identify and target enabling variables such that the decision to cheat becomes less rational. Their hope is that in so doing, we can gradually nudge trainees and the culture of medical training towards honesty. Why do students cheat? The literature reviewed in this Cross‐cutting Edge paper suggests cheating should be viewed as the product of a person‐by‐situation interaction rather than dishonesty and/or extrinsic motivation. [ABSTRACT FROM AUTHOR]

Analysing data from educational tests allows governments to make decisions for improving the quality of life of individuals in a society. One of the key responsibilities of statisticians is to develop models that provide decision‐makers with pertinent information about the latent process that educational tests seek to represent. Mixtures of t$$ t $$ factor analysers (MtFA) have emerged as a powerful device for model‐based clustering and classification of high‐dimensional data containing one or several groups of observations with fatter tails or anomalous outliers. This paper considers an extension of MtFA for robust clustering of censored data, referred to as the MtFAC model, by incorporating external covariates. The enhanced flexibility of including covariates in MtFAC enables cluster‐specific multivariate regression analysis of dependent variables with censored responses arising from upper and/or lower detection limits of experimental equipment. An alternating expectation conditional maximization (AECM) algorithm is developed for maximum likelihood estimation of the proposed model. Two simulation experiments are conducted to examine the effectiveness of the techniques presented. Furthermore, the proposed methodology is applied to Peruvian data from the 2007 Early Grade Reading Assessment, and the results obtained from the analysis provide new insights regarding the reading skills of Peruvian students. [ABSTRACT FROM AUTHOR]

With this paper, we walk out some central ideas about posthumanisms and the ways in which nursing is already deeply entangled with them. At the same time, we point to ways in which nursing might benefit from further entanglement with other ideas emerging from posthumanisms. We first offer up a brief history of posthumanisms, following multiple roots to several points of formation. We then turn to key flavors of posthuman thought to differentiate between them and clarify our collective understanding and use of the terms. This includes considerations of the threads of transhumanism, critical posthumanism, feminist new materialism, and the speculative, affirmative ethics that arise from critical posthumanism and feminist new materialism. These ideas are fruitful for nursing, and already in action in many cases, which is the matter we occupy ourselves with in the final third of the paper. We consider the ways nursing is already posthuman—sometimes even critically so—and the speculative worldbuilding of nursing as praxis. We conclude with visions for a critical posthumanist nursing that attends to humans and other/more/nonhumans, situated and material and embodied and connected, in relation. [ABSTRACT FROM AUTHOR]

Background: As delays or disorders in early language and communication are the most prevalent symptom in children with disabilities, early screening is crucial to promote prevention, early diagnosis, and intervention. However, to the best of our knowledge, no screening tool is available for the joint assessment of early language and social communication skills in European Portuguese (EP)‐learning children, which is critical for screening, monitoring and enrolment in appropriate early intervention services. Aims: (1) To adapt and validate the EP version of the Communication and Symbolic Behaviour Scales Developmental Profile™ (CSBS DP™) Infant–Toddler Checklist, a parental report for the screening of early language and social communication skills. (2) To conduct a cross‐cultural comparison between the EP adaptation and the original US version. Methods & Procedures: A total of 611 EP‐learning children (ages 6–24 months) were assessed on the CSBS DP Infant–Toddler Checklist. Normative data, psychometric characteristics (i.e., internal consistency and test–retest reliability), and cross‐cultural comparison between the EP and the original version were explored. Outcomes & Results: Internal consistency ranged from good to excellent and the test–retest reliability was excellent. The performance of the EP and US samples matched on almost all scores. However, EP children performed significantly better than their American peers in the Social compositive at 22 months and in the Symbolic composite at 20 months. No further differences were found. Conclusions & Implications: These findings showed that the EP CSBS DP Infant–Toddler Checklist seems to be a reliable screening tool of communicative and symbolic behaviours for EP‐learning children, which can be particularly relevant for decision‐making in clinical practice. WHAT THIS PAPER ADDS: What is already known on the subject: Early communication skills are known to be related to later language outcomes. Thus, screening tools for the early identification of children at risk for language and communication impairments, which may lead to monitoring and early intervention, have the potential to promote better outcomes. However, to the best of our knowledge, no screening tool is available for the assessment of early communication abilities in EP‐learning children. What this paper adds to existing knowledge: This study adapted and validated the EP CSBS DP Infant–Toddler Checklist, the first published parental report checklist for the assessment of early communication skills in EP. It described the psychometric characteristics of the adapted checklist, summarized the newly available normative data for EP‐learning infants and toddlers, and compared the performance of EP‐learning children with the original standardization sample reported for American English. The results demonstrated that this tool is a reliable instrument for the early screening of language, communicative and symbolic behaviours for EP‐learning children between 6 and 24 months of age. What are the potential or actual clinical implications of this work?: Given that early screening is crucial to promote prevention, early diagnosis and intervention, the availability of this tool is particularly relevant for children monitoring and their enrolment in appropriate early intervention services, helping decision‐making in clinical practice, in line with current guidelines regarding early monitoring and intervention to promote and support better outcomes. Thus, the tool and related normative data will be useful for paediatricians, family doctors, primary healthcare providers, developmental psychologists and speech–language therapists, among other professionals in the healthcare and educational fields, concerned with speech, language, and communication development and impairments. [ABSTRACT FROM AUTHOR]

This paper depicts a Covid science case, that of the AstraZeneca Vaxzevria vaccine, with specific focus on what happened in Italy. Given that we believe acknowledging the role of non‐evidential factors in medicine is an important insight into the recent philosophy of science, we illustrate how in the case of Vaxzevria, the interplay between facts, values (both epistemic and non‐epistemic) and cognitive biases may have possibly led to different institutional decisions based on the same evidence. The structure of the paper is as follows. First, we provide a glossary of the relevant terms involved, that is to say, epistemic values, non‐epistemic values and cognitive biases. Second, we sketch a timeline of Vaxzevria's approvals and suspensions by relevant institutional healthcare authorities with special focus on Italy and the Italian Medicines Agency. Then we show the interplay between the evidence base, epistemic as well as non‐epistemic values and cognitive biases using a narrative review of political decisions along with newspaper and social media content pertaining to Vaxzevria. We briefly compare Italy with other European countries to show that different political decisions were made on the basis of the same evidence. [ABSTRACT FROM AUTHOR]

Background: To reduce their decisional uncertainty, health policy decision‐makers rely more often on experts or their intuition than on evidence‐based knowledge, especially in times of urgency. However, this practice is unacceptable from an evidence‐based medicine (EbM) perspective. Therefore, in fast‐changing and complex situations, we need an approach that delivers recommendations that serve decision‐makers' needs for urgent, sound and uncertainty‐reducing decisions based on the principles of EbM. Aims: The aim of this paper is to propose an approach that serves this need by enriching EbM with theory. Materials and Methods: We call this the EbM+theory approach, which integrates empirical and theoretical evidence in a context‐sensitive way to reduce intervention and implementation uncertainty. Results: Within this framework, we propose two distinct roadmaps to decrease intervention and implementation uncertainty: one for simple and the other for complex interventions. As part of the roadmap, we present a three‐step approach: applying theory (step 1), conducting mechanistic studies (EbM+; step 2) and conducting experiments (EbM; step 3). Discussion: This paper is a plea for integrating empirical and theoretical knowledge by combining EbM, EbM+ and theoretical knowledge in a common procedural framework that allows flexibility even in dynamic times. A further aim is to stimulate a discussion on using theories in health sciences, health policy, and implementation. Conclusion: The main implications are that scientists and health politicians – the two main target groups of this paper—should receive more training in theoretical thinking; moreover, regulatory agencies like NICE may think about the usefulness of integrating elements of the EbM+theory approach into their considerations. [ABSTRACT FROM AUTHOR]

Background: Normal physiologic birth has been shown to result in optimal maternal–infant outcomes, but the concept of physiologic birth is continually evolving. Midwives play an important role in advocating for normal physiologic birth; however, their perceptions of what this approach entails have not been systematically appraised. Objective: In this qualitative review, we aimed to examine midwives' perceived meanings of "normal physiologic birth" and to describe their experiences facilitating such births. Methods: Five electronic databases were searched, and 26 qualitative papers were included, representing a total of 433 midwives from different backgrounds (i.e., independent, home‐based, community‐based, and hospital‐based). Eligible papers were assessed for quality, and then data were coded and synthesized thematically. Results: Four highly connected themes were generated: (1) the midwife: fundamental beliefs; (2) the woman: empowerment and advocacy; (3) the environment: ambience and culture; and (4) the team: need for institutional support and recognition. The fundamental beliefs of midwives, such as their perceived role and definition of normal physiologic birth and their self‐confidence, influence practice styles and contribute to personal and professional development. Midwives often advocate for a person‐centered approach that encouraged women's and other birthing person's autonomy and involvement in shared decision‐making. The midwife–client relationship is also central. Most importantly, a conducive birthing environment and an inclusive workplace culture that encourages interprofessional support, collaboration, and recognizes midwifery practices were identified as crucial in providing optimal conditions for the facilitation of physiologic birth. Conclusions: This review provides healthcare policymakers and institutions fresh impetus to evaluate and revise as needed current workplace policies to be more inclusive and supportive of midwifery practices and physiologic birth. [ABSTRACT FROM AUTHOR]

Inclinometer probes are devices that can be used to measure deformations within earthwork slopes. This paper demonstrates a novel application of Bayesian techniques to real‐world inclinometer data, providing both anomaly detection and forecasting. Specifically, this paper details an analysis of data collected from across the entire UK rail network. Inclinometers are a standard tool of geotechnical site monitoring. Data from these instruments is often used in risk analysis and decision‐making. However, discerning anomalous data points and forecasting future behaviour from inclinometer data requires significant 'engineering judgement' (subjective appraisal). This is because the observational data is derived from complex physical phenomena and contains complex spatio‐temporal correlations. Additionally, the practical demands of data collected from remote sites over several years tends to introduce systematic errors. These issues make the interpretation of inclinometer data challenging. Practitioners have effectively two goals when processing monitoring data. The first is to identify any anomalous or dangerous movements, and the second is to predict potential future adverse scenarios by forecasting. In this paper we apply Uncertainty Quantification (UQ) techniques by implementing a Bayesian approach to anomaly detection and forecasting for inclinometer data. Subsequently, both costs and risks may be minimised by quantifying and evaluating the appropriate uncertainties. This framework may then act as an enabler for enhanced decision making and risk analysis. We show that inclinometer data can be described by a latent autocorrelated Markov process derived from measurements. This can be used as the transition model of a non‐linear Bayesian filter. This allows for the prediction of system states. This learnt latent model also allows for the detection of anomalies: observations that are far from their expected value may be considered to have 'high surprisal', that is they have a high information content relative to the model encoding represented by the learnt latent model. We successfully apply the forecasting and anomaly detection techniques to a large real‐world data set in a computationally efficient manner. Although this paper studies inclinometers in particular, the techniques are broadly applicable to all areas of engineering UQ and Structural Health Monitoring (SHM). [ABSTRACT FROM AUTHOR]

When dealing with problems with more than two objectives, sophisticated multi‐objective optimization algorithms might be needed. Pareto optimization, which is based on the concept of dominated and non‐dominated solutions, is the most widely utilized method when comparing solutions within a multi‐objective setting. However, in the context of optimization, where three or more objectives are involved, the effectiveness of Pareto dominance approaches to drive the solutions to convergence is significantly compromised as more and more solutions tend to be non‐dominated by each other. This in turn reduces the selection pressure, especially for algorithms that rely on evolving a population of solutions such as evolutionary algorithms, particle swarm optimization, differential evolution, etc. The size of the non‐dominated set of trade‐off solutions can be quite large, rendering the decision‐making process difficult if not impossible. The size of the non‐dominated solution set increases exponentially with an increase in the number of objectives. This paper aims to expand a framework for coping with many/multi‐objective and multidisciplinary optimization problems through the introduction of a min‐max metric that behaves like a median measure that can locate the center of a data set. We compare this metric to the Chebyshev norm L_∞ metric that behaves like a mean measure in locating the center of a data set. The median metric is introduced in this paper for the first time, and unlike the mean metric is independent of the data normalization method. These metrics advocate balanced, natural, and minimum compromise solutions about all objectives. We also demonstrate and compare the behavior of the two metrics for a Tradespace case study involving more than 1200 CubeSat design alternatives identifying a manageable set of potential solutions for decision‐makers. [ABSTRACT FROM AUTHOR]

The institution of liability serves to mitigate the lack of care in almost all areas, whether private or business. However, we have not yet found such an institution in political decision-making. Surprisingly, the literature has not discussed a specific institution that subjects political actors who fail to exercise due diligence in their decision-making regarding personal liability. Hence, this paper aims to fill this gap and derive the necessity of internalizing the negative effects resulting from the imperfections of the market for political services in general and the democratic process, particularly by a liability rule. To design the new institution, we draw on the findings of corporate governance, combining economic thinking in incentives and legal knowledge expressed in the law of the corporation. In this respect, this paper is the first to make a concrete proposal for political liability accompanied by a political judgment rule. However, it is important to emphasize that the aim is not to punish a wrong decision but to provide strong incentives to prevent it ex ante. Political liability must be understood as a process-oriented institution that considers uncertainty and decision-making complexities. By proposing and analyzing this new institution, this work contributes to a broader discussion of incentive structures in the political process of modern democracies and shows how the political sphere can learn from the corporate world. [ABSTRACT FROM AUTHOR]

Projective mapping has recently attracted a lot of attention and the main sensory data acquisition software packages have developed interfaces to collect projective mapping data. However, the comparison between paper- and computer-based projective mapping has never been reported. The objectives of this research were to (1) compare the consensus maps and panelists' performances for paper- and computer-based projective mapping and (2) analyze the panelists' strategies while performing either tasks. In the first part of the study, 32 panelists were asked to perform both paper- and computer-based projective mapping on eight beer samples. In a second part of the study, 10 panelists were asked to repeat the tasks while 'thinking aloud' their strategy. There was no significant difference in panelists' performance as assessed by the people performance index between the paper and computer tasks. The consensus maps obtained were similar with respect to sample groupings, RV coefficients and variation explained by the first two dimensions. Individual panelists adopted similar strategies on paper and computer, but strategies differed greatly between panelists. Practical Applications The results reported here will help panel leaders in making informed decisions with respect to support choice when designing projective mapping tests. Additionally, an insight into the diversity of panelists' mapping strategies is provided which may inform further research and discussion into the most appropriate instructions given to panelists and/or type of panel used. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Despite extensive evidence on the value of patient decision support interventions ( DESIs), there is no consensus on optimal DESI formats. Assessing clinicians' perceptions about DESI formats can help facilitate their adoption. The aim of this study was to assess clinicians' perceptions of DESIs formats and potential use in practice. Methods Semi-structured qualitative interviews were conducted with doctors from diverse practice areas (internal medicine, OB/ GYN, surgery, medical oncology, emergency medicine) and elicited perceptions toward patient DESIs formats (digital vs. paper) and timing of administration. Questions also elicited beliefs underlying attitudes, perceived social norms and self-efficacy for using DESIs and the feasibility of doing so. Data analysis was conducted using a thematic analysis approach. Results Participants identified strengths of both more comprehensive digital and shorter paper-based tools and thought they could complement each other. Participants consistently expressed the advantages of using DESIs outside the consultation to supplement clinical discussions about cancer decisions given the amount of information to discuss during these emotion-laden conversations. Participants felt that patients with older age and lower socio-economic status were more likely to use a paper-based compared with a digital DESI. Participants also noted challenges related to reliable resources such as computers and Internet in the practice setting, which would be necessary for implementing the digital DESIs on site. Conclusions Clinicians' perceptions and opinions about value of DESIs can vary widely across doctor, patient and clinic characteristics. A one-size-fits-all approach to implementation might not be feasible, suggesting that flexible approaches to providing decision support for patients are needed to drive broader adoption. [ABSTRACT FROM AUTHOR]

Background: Florida International University Herbert Wertheim College of Medicine (FIU‐HWCOM) participated in the AAMC Core Entrustable Professional Activities (EPA) implementation pilot. Entrustment decision processes based on data from workplace‐based assessments (WBAs) were piloted. Outcomes illustrated challenges including variability across EPAs with regards to learner level alignment and feasibility of data collection in the form of WBAs. In addition, students reported discomfort requesting WBA completion by preceptors and dissatisfaction with associated feedback. Approach: To guide future directions, we conducted a survey of third‐year students to better understand their experience with and perceptions of WBAs used to evaluate EPAs at FIU‐HWCOM. Evaluation: Survey response was 96% (n = 107/112). Most (84%) reported that WBAs were not valuable to their development and that preceptors often did not complete WBAs in a timely fashion. Many (47%) reported not receiving verbal feedback. Most students (78%) used language in written responses demonstrating confusion between the EPAs and the WBAs used to assess them. Implications: The use of WBAs to assess EPAs did not have its intended impact at FIU‐HWCOM. For future classes, WBA forms will consist of paper cards with questions directly assessing performance of skills aligned with EPAs 1, 5 and 6 only. To continue to promote feedback, students will be required to collect WBAs on all clerkships, but the number of required WBAs will be less than prior and no entrustment decisions will be made. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is an extremely contagious illness caused by Mycobacterium tuberculosis. Chest tuberculosis classification is conducted based on a deep convolutional neural network architecture. In this research, a pre‐trained network is utilized to demonstrate the advantage of using the oversampling technique on the classification of TB and compare results with recent research that used the same dataset. Therefore, the dataset consists of 3500 uninfected TB cases and 700 infected with TB. This paper circumvents the imbalance by using the oversampling technique in X‐ray TB images to be fed into several pre‐trained networks for TB classification. The oversampling technique is crucial in enhancing the performance of TB classification compared with other pre‐trained models reported here. Inceptionv3 shows a promising result compared to other pre‐trained models; it achieves 99.94% accuracy, 99.88% precision, 100% recall, and 99.94% F1‐Score. [ABSTRACT FROM AUTHOR]

The origins of marginalization in nursing and the health sector in Ghana can be traced to colonialism and how a colonial era laid a solid foundation for inequities and entrenched disparities, as well as the subsequent normalization of marginalizing acts, in the health sector, particularly for women. Drawing upon varied literature over a 60‐year period and perspectives from feminist theory, this paper considers the lasting impact of Ghanaian women's historical position during the colonial era and within the patriarchal system that ensued. Through this process, it becomes possible to shed light on the crucial role that colonialism has played in women's experiences, perspectives, and health‐seeking behaviors, and the manner in which it has created a healthcare sector that marginalizes women's health. Although women possess valuable knowledge which should be an asset to consider when providing healthcare services, marginalization of that knowledge has become normalized across society and the healthcare system. There is an urgent need to disrupt and challenge this normalization, and to advocate empowerment and recognition of women's valuable knowledge and experiences, providing women a voice in health decision‐making discourses and in the research processes by which we understand and develop healthcare. Through this, healthcare in Ghana could become more empowering, inclusive, and responsive to the unique experiences and needs of Ghanaian women. By understanding something of the historical origins of women's health marginalization within colonialism, nurses can begin to appreciate women's knowledge and integrate it into healthcare strategies that are more gender‐sensitive and equitable. [ABSTRACT FROM AUTHOR]