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To what extent is the destiny of a scientific paper shaped by the cocitation network in which it is involved? What are the social contexts that can explain these structuring? Using bibliometric data, interviews with researchers, and social network analysis, this article proposes a typology based on egocentric cocitation networks that displays a quadruple structuring (before and after publication): polarization, clusterization, atomization, and attrition. It shows that the academic capital of the authors and the intellectual resources of their research are key factors of these destinies, as are the social relations between the authors concerned. The circumstances of the publishing are also correlated with the structuring of the egocentric cocitation networks, showing how socially embedded they are. Finally, the article discusses the contribution of these original networks to the analyze of scientific production and its dynamics. [ABSTRACT FROM AUTHOR]

Aim: To explore the health beliefs of clinical and academic nurses from Japan, Australia and China regarding wearing paper masks to protect themselves and others, and to identify differences in participants' health beliefs regarding masks. Background: The correct use of face masks and consensus among health professionals across the globe is essential for containing pandemics, and nurses need to act according to policy to protect themselves, educate the public and preserve resources for frontline health workers. Paper masks are worn by health professionals and the general public to avoid the transmission of respiratory infections, such as COVID‐19, but there appear to be differences in health beliefs of nurses within and between countries regarding these. Methods: This qualitative descriptive study used content analysis with a framework approach. Findings: There were major differences in nurse participants' beliefs between and within countries, including how nurses use paper masks and their understanding of their efficacy. In addition, there were cultural differences in the way that nurses use masks in their daily lives and nursing practice contexts. Conclusion: Nurses from different working environments, countries and areas of practice hold a variety of health beliefs about mask wearing at the personal and professional level. Implications for nursing policy and health policy: The COVID‐19 pandemic has sparked much discussion about the critical importance of masks for the safety of health professionals, and there has been considerable discussion and disagreement about health policies regarding mask use by the general public. Improper use of masks may have a role in creating mask shortages or transmitting infections. An evidence‐based global policy on mask use for respiratory illnesses for health professionals, including nurses, and the general public needs to be adopted and supported by a wide‐reaching education campaign. [ABSTRACT FROM AUTHOR]

Background: A practical test that measures the information and communication technology (ICT) skills students need for effectively using ICT in primary education has yet to be developed (Oh et al., 2021). This paper reports on the development, validation, and reliability of a test measuring primary school students' ICT skills required for effectively using ICT (the ECC‐ICT test). Objectives: Based on existing literature, three ICT use domains were identified for effectively using ICT: Effective, collaborative, and creativeuse of ICT. For these three domains, 24 corresponding teaching objectives were identified from a widely used digital literacy framework. Thirty‐four test items cover these teaching objectives in an online test. Methods: A mixed‐method approach was used for the ECC‐ICT test. Four pilot rounds (n=25) implemented qualitative interviews for cognitive validity and refining the test items, followed by a qualitative usability study(n=6). Confirmatory factor analysis and ANOVA provided quantitative insight into the large‐scale test administration(n=575). Results and Conclusions: Composite reliability of our conceptual 3‐factor confirmatory model showed that the test reliably measured primary school effective use of ICT (ω = 0.82), collaborative use of ICT (ω = 0.80) and creative use of ICT (ω = 0.64). Convergent validity (ranging from 0.41 to 0.46) was acceptable. Internal consistency (ranging from 0.84 to 0.91) and discriminant validity (HTMT values below 0.90) are good. ANOVA results show that mean test scores are higher for students in higher grade levels (p < 0.001). The post hoc Bonferroni results show that most grade‐by‐grade comparisons are significant (p < 0.001). Lay Description: What is already known about this topic: Information and communication technology (ICT) skills are finding their way into national curriculums as teachers implement more digital learning environments.Teachers currently do not have a measurement instrument for the ICT skills primary education students need to learn in a personalised way. What this paper adds: This paper gives teachers a test that reliably measures the effective, collaborative, and creative ICT skills required for primary school students to learn using ICT.To our knowledge, this test is the first of its kind.Al materials to reproduce the test are available digitally for teachers. The implications of study findings for practitioners: For policy, this test can be used to check if a student is ready to use ICT in a self‐regulated setting.With this test, teachers can assess and support students' growth on the effective, collaborative, and creative ICT skills required for primary school students using ICT. [ABSTRACT FROM AUTHOR]

This paper calls for greater attention to the interpersonal aspects of youth activism through a sociological and Black feminist exploration of peer relationships within youth political engagement. Drawing on a multi‐method qualitative research, the work foregrounds the perspectives and experiences of Black girls and girls of colour involved in an anti‐racist Scottish youth work charity. I argue that community and friendship ties cultivated participants' activism. Moreover, participants sought to enact social change by undertaking activist educational practices with their peers. This paper demonstrates how studying young people's peer relationships can engender a better understanding of youth activism and support it. [ABSTRACT FROM AUTHOR]

Background: Meaningful, varied, joyful conversation is an important therapy target for adults with language or cognitive–communication disorders following acquired brain injury (ABI). However, the complexity of daily communication is often reduced to component parts within intervention programmes, with mixed evidence of generalization to everyday conversation. Interventions targeting co‐construction of communication within a dyad offer a structured way in which to retain and treat elements of everyday conversation for individuals and their communication partner (CP). Such interventions exist but they are variably labelled, target different ABI populations and have not been synthesized. Aims: To identify the nature, scope and effects of intervention studies targeting co‐constructed communication in adults with ABI. Method: This systematic review was completed using PRISMA Guidelines. Six databases (MEDLINE, Embase, CINAHL, Scopus, LLBA, PsychInfo) were searched and 1210 studies were screened. Data were extracted and studies were rated for methodological quality and completeness of reporting. Outcome measures and effects of treatment were collated through descriptive synthesis. Main Contribution: This review highlights an emerging evidence base in relation to an intervention approach that targets everyday communication. Co‐constructed communication interventions have been reported by 13 studies, from a total of 206 participants with post‐stroke aphasia, traumatic brain injury and progressive language impairments. These interventions take a range of formats, including referential communication tasks, retell/recount therapies and communication training programmes. Methodological quality evaluation indicated mostly low‐level study designs. Heterogeneity was identified in primary outcome measures, with 28 unique primary outcome measures reported across studies. Most studies demonstrated change in task‐specific or broad communication outcome measures. Conclusions: Co‐constructed communication interventions may offer clinicians a systematic, protocolized, replicable way to target everyday communication for adults with ABI. More high‐quality, experimental designs with complete reporting and psychometrically sound outcome measures are needed to strengthen the evidence base. What This Paper Adds: What is already known on this subject: Everyday conversation is an important therapy target for adults with ABI, but there is mixed evidence of therapy gains generalizing to everyday life. Many interventions reduce conversation to component parts such as naming or sentence construction. A different approach is needed to capture the social, dyadic, interactive and multifaceted nature of conversation. We propose the term 'co‐constructed communication interventions' as a therapy genre targeting semi‐structured dialogue. These interventions retain elements of everyday conversation (such as multimodal communication and situating tasks within dyads), combined with experimental elements (where stimuli prompt interactions and responses can be scored against normative data). What this paper adds to existing knowledge: This review proposes and describes a distinct genre of discourse intervention within the current evidence base with a novel operational definition of 'co‐constructed communication'. What are the potential or actual clinical implications of this work?: Co‐constructed communication interventions directly target elements of everyday communication by situating the therapy goals within a dyadic, interactive, multimodal task. A range of intervention tasks have been identified, including collaborative storytelling and problem‐solving. This review will be of interest to clinicians working with adults with ABI; co‐constructed communication interventions may offer a useful, replicable way to target aspects of everyday communication. This synthesis of the current evidence base encourages clinicians' informed, evidence‐based decisions around these interventions. [ABSTRACT FROM AUTHOR]

Background: People with an acquired brain injury (ABI) find it challenging to use social media due to changes in their cognition and communication skills. Using social media can provide opportunities for positive connection, but there is a lack of interventions specifically designed to support safe and successful social media use after ABI. Aims: To investigate the outcomes of completing a social media skills intervention and identify barriers and facilitators for future implementation. Methods & Procedures: The study used a mixed‐methods, pre‐post‐intervention design. A total of 17 adults with an ABI were recruited. Participants completed an intervention that included a short self‐guided course about social media skills (social‐ABI‐lity course), and then participated in a private, moderated Facebook group over a 12‐week period (social‐ABI‐lity Facebook group). Data were collected over this period through observation of group activity and weekly surveys. They were also collected on social media use and quality of life at pre‐intervention, post‐intervention and after 3 months. Participants provided feedback on the experience of participating in the programme via a post‐intervention interview. Outcomes & Results: At post‐intervention, there were significant improvements in confidence in using Facebook (p = 0.002) and enjoyment of using Facebook to connect with others (p = 0.013). There was no significant change in reported quality of life, although participants described the multiple benefits of connection they perceived from involvement in the group. Observational data and feedback interviews were informative about the feasibility and acceptability of the intervention. Conclusions & Implications: This pilot study provided preliminary evidence that an intervention comprising a short, self‐guided training course and a private, moderated Facebook group improved outcomes for people with ABI. Key recommendations for future implementation include embedding active peer moderators within groups and taking an individualized approach to delivery of the intervention. WHAT THIS PAPER ADDS: What is already known on the subject: Research has documented the challenges that people with ABI experience in using social media, and the difficulty for rehabilitation clinicians in providing appropriate support in this field. What this paper adds to existing knowledge: This pilot study reports the outcomes of people with ABI completing a short, self‐guided social media skills course and participating in a private, moderated Facebook group. After the intervention, participants reported significantly increased confidence and enjoyment in using Facebook, described the benefits of connection found in the groups, and suggested potential improvements for future implementation. What are the potential or actual clinical implications of this work?: With the growing use of social media for connection and participation, there is a professional obligation to address social media communication skills in cognitive–communication rehabilitation for people with ABI. The findings of this study will inform interventions and future research to assist people with ABI to build their social media skills for communication, social support and a sense of connection. [ABSTRACT FROM AUTHOR]

Inspired by new feminist materialism, this paper seeks to reimagine existing knowledge of girls, sexuality and playgrounds by considering how the socio‐material reality may unlock girls' capacities for what is possible through play. Focusing on semi‐structured interviews of girls (aged 12–13), the paper draws attention to the playground as an 'assemblage' of human and non‐human matter that connect to illuminate other ways of being, feeling and doing. We argue that the assemblage not only creates spaces for girls to disrupt hetero‐patriarchal ideologies but simultaneously serves to reinforce them. Interventions require attention to the oppressive materialities that underpin play. [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: Early identification and intervention for hearing loss is important for supporting language development. Despite this, parents are required to overcome barriers to access hearing assessments for their children. Aims: To identify the enablers and barriers to accessing hearing assessments for Australian children identified by their parents, and to compare between metropolitan, regional and rural areas. Methods & Procedures: This sequential, explanatory mixed‐methods study was undertaken online and included participants in metropolitan, regional and rural area of Queensland, New South Wales, Victoria, South Australia, Western Australia and the Northern Territory. A total of 56 participants participated in the surveys, and 10 participated in semi‐structured interviews. Outcomes & Results: Participants in metropolitan areas were more likely to have services in their area; however, access to hearing assessment was related more to individual circumstances (including health literacy skills) rather than geographical location. Many participants experienced long wait times, reduced flexibility, and a lack of audiologists experienced in working with children. Conclusions & Implications: Barriers to hearing assessments (which assist with early identification and intervention for hearing loss) should be addressed so that children have access to clear auditory information to assist with their speech and language development. WHAT THIS PAPER ADDS: What is already known on the subject: Poor audiological input can lead to poor speech, language and literacy outcomes for children. What this paper adds to the existing knowledge: Although previous research indicates that people in regional and remote locations experience difficulty accessing health services within a reasonable timeframe, in this study barriers were experienced regardless of geographical location, and were dependent on individual circumstances. Many parents are unaware of the impact of hearing on speech and language. What are the potential or actual clinical implications of this work?: Further research might examine how health literacy affects access to hearing assessment. Parents shared several potential solutions to these access barriers which should be considered by service providers. [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]

Aim: The risk of Type 2 Diabetes is 10 times higher after a pregnancy with Gestational Diabetes. Physical activity can independently reduce this risk, yet engagement with physical activity remains low after Gestational Diabetes. Therefore, the present study aimed to explore the barriers and facilitators to the uptake of physical activity after Gestational Diabetes in the United Kingdom, using a socio‐ecological approach. Methods: The paper was written following the Standards for Reporting Qualitative Research. Patient and Public Involvement contributed to the study's conceptualisation and design. Participants were recruited through an audit of Gestational Diabetes cases at a local Teaching Hospital in 2020. Twelve participants took part in semi‐structured one‐to‐one interviews. Reflexive thematic analysis was used to generate themes in iterative rounds of refinement. The final themes were then organised using the socio‐ecological model. Results: Participants were all over 31 years old, predominantly self‐identified as White British and were all in employment but were evenly spread across UK‐based deprivation deciles. Ten themes were generated and organised according to the four levels of the socio‐ecological model: intrapersonal (beliefs about activity, recovering from birth), social (health care professionals, family and partner, role as a mother), organisational (access and cost, environment, childcare and work) and community (connecting women with recent Gestational Diabetes). Conclusions: Many of the amenable barriers and facilitators to physical activity were beyond the intrapersonal level, based on higher levels of the socio‐ecological model (social, organisational and community). Multi‐level interventions are needed to effectively address all barriers. [ABSTRACT FROM AUTHOR]

Background: With the development of computational literacy, there has been a surge in both research and practice application of text‐based and block‐based modalities within the field of computer programming education. Despite this trend, little work has actually examined how learners engaging in programming process when utilizing these two major programming modalities, especially in the context of secondary education settings. Objectives: To further compare programming effects between and within text‐based and block‐based modalities, this research conducted a quasi‐experimental research in China's secondary school. Methods: An online programming platform, Code4all, was developed to allow learners to program in text‐based and block‐based modalities. This research collected multimodal data sources, including programming platform data, process data, and performance data. This research further utilized multiple learning analytics approaches (i.e., clustering analysis, click stream analysis, lag‐sequential analysis and statistics) to compare learners' programming features, behavioural patterns and knowledge gains under two modalities. Results and Conclusions: The results indicated that learners in text‐based modality tended to write longer lines of code, encountered more syntactical errors, and took longer to attempt debugging. In contrast, learners in block‐based modality spent more time operating blocks and attempt debugging, achieving better programming knowledge performances compared to their counterparts. Further analysis of five clusters from the two modalities revealed discrepancies in programming behavioural patterns. Implications: Three major pedagogical implications were proposed based on empirical research results. Furthermore, this research contributed to the learning analytics literature by integrating process‐oriented and summative analysis to reveal learners' programming learning quality. Lay Description: What is currently known about the subject matter: Programming has the potential to improve learners' higher‐order thinking skills.Block‐based and text‐based modalities are two major instructional methods.There has been a growing interest to understand how learning occurs in two modes.Most previous work has evaluated two modalities based on learners' knowledge, skills, and attitudes. What this paper adds: Code4all allows learners to programming in text‐based and block‐based modalities.Quasi‐experimental research was conducted to examine block‐based and text‐based programming modalities.Multimodal learning analytics were used to compare programming under two modalities.Learners' programming features, behaviouralbehavioral patterns, and knowledge gains were identified under two modalities. The implications of study findings for practitioners: Instructors should integrate text‐based and block‐based modalities into programming courses.Process‐oriented assessment should be integrated with summative assessment. Adaptive, timely scaffoldings should be provided with the external support (this should be marked like above two points). [ABSTRACT FROM AUTHOR]

Background: Game‐based learning can frame problem‐solving as a sense‐making experience with domain‐specific tasks for school students. However, multiple challenges arise when trying to support learners in such a complex, problem‐oriented learning environment. Objectives and Methods: With an architecture‐themed mathematics learning game, we conducted two mixed‐method studies to explore the impact and design of game‐based mathematical experience on the math problem‐solving performance of middle school students. Results and Conclusions: The study findings suggested a positive impact of game‐based math experience on math problem‐solving for middle school students. Problematization‐oriented game‐based math tasks with structuring features enhanced students' reasoning with problems and channelled it to doing mathematics. Takeaways: The current research findings support the initiative to frame learning as a sense‐making experience with domain‐specific tasks and inform the design of game‐based mathematical experience and learning support. Lay Description: What is already known about this topic: Realistic mathematical practices frame learning as a sense‐making experience.Challenges arise when involving learners in realistic mathematical experiences driven by domain‐specific tasks. What this paper adds: Game‐based simulation of math tasks framed learning as sense‐making experience.Game‐based math experiencing promoted math contextual problem‐solving performance.Structuring features enhanced problematized experiencing with math tasks. Implications for practice and/or policy: Teachers can integrate and facilitate game‐based math experiencing in class.Efforts should be made to make game‐based math tasks meaningful for students. [ABSTRACT FROM AUTHOR]

Background Study: Previous systematic reviews concluded that online professional‐learning communities (OPLCs) have positive effects on teachers' development, but explored neither the technological affordances that make this possible nor the potential negative impacts of technology use in OPLCs. Objectives: The aim of this study is to systematically analyse previous research on teachers' OPLCs, and thus help answer the question of what technological affordances (dis)empower members of teachers' OPLCs, and how they do so. Methods: This study applied the systematic‐review method. A total of 28 studies were identified and analysed using rigorously defined inclusion and exclusion criteria. The results are reported as a synthesis. Results and Conclusions: First, in theme, the selected articles primarily focused on features of OPLCs and of teachers' knowledge. Second, mixed‐methods approaches were commonly used in the sampled research, and the number of studies employing advanced statistical methods and machine learning increased over time. And third, the reviewed studies' findings suggest that technology supports 'bottom‐up' teachers' communities (as distinct from 'top‐down' professional development organized by educational authorities) in seven ways: that is, by promoting collaboration opportunities, expanding the participants' networks, facilitating knowledge sharing, delivering support more rapidly, providing emotional support, allowing ubiquitous learning, and enabling multiple modes of participation. Lay Description: What is currently known about the subject matter: Previous reviews found OPLCs have positive effects on teachers' development. What their paper adds to this: What technological affordances empower teachers in OPLCs.How technological affordances empower teachers in OPLCs. The implications of study findings for practitioners: The sampled articles primarily focused on OPLC features and teacher knowledge.Mixed‐methods approaches were commonly used.Technology provides various affordances to 'bottom‐up' teachers' communities. [ABSTRACT FROM AUTHOR]

Background: Undergraduates' collective epistemic agency is critical for their productive collaborative inquiry and knowledge building (KB). However, fostering undergraduates' collective epistemic agency is challenging. Studies have demonstrated the potential of computer‐supported collaborative inquiry approaches, such as KB—the focus of this study, and reflective assessment to foster collective epistemic agency. Objectives: This study used a quasi‐experimental design to examine the impact of reflective assessment on undergraduates' collective epistemic agency and the mechanisms of this impact. Methods: An experimental class, comprising 40 undergraduates, engaged in KB inquiry enhanced by analytics‐assisted reflective assessment, while a comparison class, comprising 41 undergraduates, engaged in portfolio‐supported reflective assessment in KB inquiry. Classroom observations, audio recordings of group discussions and reflections, and student artefacts were collected in both conditions. Results and Conclusions: The experimental class demonstrated significantly higher levels of collective epistemic agency than the comparison class, as indicated by their collective knowledge advancement and epistemic and metacognitive actions. Qualitative thematic analysis revealed that reflective assessment enhanced the undergraduates' collective epistemic agency through their collective monitoring and regulation of inquiry and ideas, negotiation and synthesis of the community's ideas, conceptualization of collective theories and identification of collective inquiry trajectories with an internal reflective structure. Major Takeaways: Higher‐level metacognitive actions are critical for productive collaborative inquiry and higher‐level epistemic agency that does not often occur naturally and should be promoted by appropriate scaffolding strategies. Students need data from learning analytics and accompanying prompt sheets to help them develop the internal metacognitive structure for agency and learning. Lay Description: What is currently known about this topic?: Undergraduates' collective epistemic agency (CEA) is critical for productive KB.Analytics‐assisted reflective assessment (AARA) are promising in fostering CEA. What does this paper add?: AARA has positive influences on students' CEAAARA helps students develop CEA through the following mechanisms.AARA supports students' collective regulation and negotiation of collective ideas.AARA enhances conceptualization and deepening of collective trajectories with an internal reflective structure. Implications for practice/or policy: Higher‐level metacognitive actions are critical for collaborative inquiry and CEAAnalytics‐assisted RA can enhance students' higher‐level metacognitive actions.Students should be provided with learning data and appropriate scaffolding strategies.These data and strategies can develop students' internal metacognitive structure crucial for agency and learning. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic resulted in rapid changes to head and neck cancer (HNC) services. Multidisciplinary team (MDT) face‐to‐face appointments were converted to telehealth appointments (telephone and video‐call) to reduce the risk of COVID‐19 transmission. The literature exploring HNC patient experience of these appointment types is limited. Aims: To explore patient experience of telehealth appointments at one UK centre during the COVID‐19 pandemic, as well as the variables that may influence patient preference for virtual or face‐to‐face appointments. Methods & Procedures: A survey‐based study design was used, with closed questions and open text options to capture the views of the participants. Quantitative data were analysed using descriptive statistics. Open text data was used to add depth to the findings. Outcomes & Results: A total of 23 participant surveys were returned. Six categories were identified: Usability; Information receiving & giving; Satisfaction; Emotions and comfort; Rapport; and Travel time and cost. Overall, participants gave positive responses to each category and indicated that telehealth appointments met their needs. Areas for clinical consideration are highlighted. Variables such as age, travel distance from hospital site, fear of COVID‐19 and information technology (IT) access did not appear to influence patient preference for appointment type. Conclusions & Implications: Going forward, telehealth may be considered for use in combination with face‐to‐face appointments in the HNC pathway. Areas for further development include a 'telehealth screening tool' that may help to identify those patients most appropriate for these appointment types, or who require support to access them. WHAT THIS PAPER ADDS: What is already known on this subject: The COVID‐19 pandemic resulted in major disruption to HNC centres across the world. Services adapted to meet the needs of patients with many implementing telehealth into pathways. Studies exploring telehealth in speech and language therapy (SLT) services with the HNC population indicate positive results. It is clear telehealth has a role in modern healthcare and should not be viewed as a temporary solution to the pandemic. It is, however, recognized that embedding telehealth into pathways is not straightforward and requires ongoing review and evaluation, which includes patient and clinician perceptions. What this study adds to the existing knowledge: The service evaluation gives insight into HNC patient experience of telehealth appointments for MDT clinics (led by SLT, dietician and clinical nurse specialist) during the COVID‐19 pandemic. Overall, patients report a positive experience of telehealth in the HNC pathway and are willing to accept this platform into their healthcare. Areas for clinical consideration are highlighted. What are the actual and clinical implications of this work?: This findings of this service evaluation can be used to support the co‐design of HNC pathways which embed telehealth as an option for patients. Areas that were important to the participants are highlighted; this includes the timing of telehealth appointments in the pathway, the need to meet the MDT face to face and the positive benefit of cost savings. The authors suggest a telehealth appointment screening tool as an area for future development. [ABSTRACT FROM AUTHOR]

Background: Above cuff vocalisation (ACV) involves the application of an external flow of air via the subglottic port of a tracheostomy. ACV can facilitate vocalisation and may improve swallowing and quality of life for patients with a tracheostomy. A recent systematic review highlighted the limited evidence available for the acceptability, effectiveness, safety or optimal implementation of ACV. Aims: To explore the experience of healthcare professionals (HCPs) using ACV and their perceptions of best practice. Methods and Procedures: Semi‐structured interviews were conducted with a range of HCPs with experience using ACV. Topics included: experiences with ACV, management of ACV, opinions about ACV, impact of COVID‐19, future directions for ACV and impact on length of stay. Interviews were conducted online from December 2020 to March 2022. Data were analysed using reflexive thematic analysis. Outcomes and Results: Twenty‐four HCPs were interviewed from seven countries and five professional groups. Four interconnected themes were developed: (1) moral distress amplifying the need to fix patients; (2) subjectivity and uncertainty leading to variations in practice and purpose; (3) knowledge and experience leading to control and caution; and (4) worth a try or a last resort. Theme four contained three sub‐themes: (a) part of the toolbox; (b) useful but limited tool; and (c) following the patient's lead. The moral distress experienced by HCPs and their essential 'need to fix' patients seems to underpin the varied opinions of ACV. These opinions appear to be formed primarily on the basis of experience, because of the underlying subjectivities and uncertainties. As knowledge and experience with ACV increased, and adverse events were experienced, most HCPs became more cautious in their approach to ACV. Conclusions and Implications: More research is needed to reduce the subjectivities and uncertainties surrounding ACV. The implementation of standardised procedures, processes, and competencies may help to reduce the frequency of adverse events and support a more controlled approach. Widening the focus of the purpose of ACV to include swallowing may help to maximise the potential benefits. WHAT THIS PAPER ADDS: What is already known on the subject: There is limited and low‐quality evidence for above cuff vocalisation (ACV) and clinical application and practice varies substantially. However, the reasons for this variation in practice and healthcare professionals' (HCPs') opinions of ACV were unclear. What this study adds: HCPs' experiences and opinions of ACV vary as a result of the uncertainty and subjectivity surrounding ACV compounded by their personal experiences with it. A need for caution also appears to emerge as HCPs become more familiar and experienced with using ACV. What are the clinical implications of this work?: Implementing standardised procedures, safety processes and competencies may help to compensate for the uncertainty and subjectivity surrounding ACV and may reduce the frequency of adverse events. Widening the focus of purpose of ACV, including swallowing in addition to communication, may increase the number of potential candidates and increase the potential benefits of ACV. Using multidisciplinary team (MDT) simulation training for ACV competency development might help to improve MDT working and ACV implementation. [ABSTRACT FROM AUTHOR]

Background: The complexity of communication presents challenges for clinical assessment, outcome measurement and intervention for people with acquired brain injury. For the purposes of assessment or treatment, this complexity is usually managed by isolating specific linguistic functions or speech acts from the interactional context. Separating linguistic functions from their interactional context can lead to discourse being viewed as a static entity comprised of discrete features, rather than as a dynamic process of co‐constructing meaning. The ecological validity of discourse assessments which rely on the deconstruction of linguistic functions is unclear. Previous studies have reported assessment tasks that preserve some of the dialogic features of communication, but as yet, these tasks have not been identified as a distinct genre of assessment. We suggest the term 'co‐constructed communication' to describe tasks which are specifically designed to capture the dynamic, jointly produced nature of communication within a replicable assessment task. Aims: To identify and summarize how co‐constructed communication has been assessed with individuals with non‐progressive acquired communication disability regarding task design, measures and psychometric robustness. Methods: A scoping review methodology was used to identity relevant studies. Systematic database searches were conducted on studies published before July 2021. Studies in the yield were assessed against eligibility criteria, with 37 studies identified as eligible for inclusion. Main contribution: This is the first time that co‐constructed communication has been defined as a genre of discourse assessment for stroke and traumatic brain injury populations. Co‐constructed communication has been assessed for 144 individuals with aphasia and 111 with cognitive–communication disability. Five categories of co‐constructed communication tasks were identified, ranging in complexity. Variability exists in how these assessment tasks are labelled and measured. Assessment measures require further psychometric profiling, specifically regarding test–retest reliability and validity. Conclusions: Co‐constructed communication is a discourse genre which offers researchers and clinicians a replicable method to assess language and communication in an experimentally rigorous way, within an ecologically valid context, bridging the gap between experimental and ecological assessment approaches. What this paper adds: What is already known on this subject: Standardized assessments of language skills and monologue offer reliable, replicable ways to measure language. However, isolating language from an interactional context fundamentally changes the behaviour under study. This raises questions about the ecological validity of the measures we routinely use to determine diagnoses, guide treatment planning and measure the success of treatment. What this study adds to the existing knowledge: This review highlights studies that conceptualize, and often quantify, interaction by combining experimental rigour and aspects of everyday dialogue. This is the first time this genre of discourse assessment has been identified. We propose the term 'co‐constructed communication' to describe this genre and provide an operational definition for the term. What are the practical and clinical implications of this study?: Co‐constructed communication assessment tasks require refinement, particularly regarding aspects of psychometric robustness. In the future, these tasks offer pragmatic, meaningful ways to capture the effect and impact of aphasia and cognitive–communication disability within interaction. [ABSTRACT FROM AUTHOR]

Background: Health professions education curricula are undergoing reform towards social accountability (SA), defined as an academic institution's obligation to orient its education, service and research to respond to societal needs. However, little is known about how or which educational experiences transform learners and the processes behind such action. For example, those responsible for the development and implementation of undergraduate medical education (UGME) programs can benefit from a deeper understanding of educational approaches that foster the development of competencies related to SA. The purpose of this paper was to learn from the perspectives of the various partners involved in a program's delivery about what curricular aspects related to SA are expressed in a UGME program. Methods: We undertook a qualitative descriptive study at a francophone Canadian university. Through purposive convenience and snowball sampling, we conducted 16 focus groups (virtual) with the following partners: (a) third‐ and fourth‐year medical students, (b) medical teachers, (c) program administrators (e.g., program leadership), (d) community members (e.g., community organisations) and (e) patient partners. We used inductive thematic analysis to interpret the data. Results: The participants' perspectives organised around four key themes including (a) the definition of a future socially accountable physician, (b) socially accountable educational activities and experiences, (c) characteristics of a socially accountable MD program and (d) suggestions for curriculum improvement and implementation. Conclusions: We extend scholarship about curricular activities related to SA from the perspectives of those involved in teaching and learning. We highlight the relevance of experiential learning, engagement with community members and patient partners and collaborative approaches to curriculum development. Our study provides a snapshot of what are the sequential pathways in fostering SA among medical students and therefore addresses a gap between knowledge and practice regarding what contributes to the implementation of educational approaches related to SA. We emphasise the need for educational innovation and research to develop and align assessment methods with teaching and learning related to SA. This study delves into how a medical training fosters socially accountable physicians. Findings underscore the importance of experiential learning, community engagement, and collaborative curriculum development. #MedEd #SocialAccountability [ABSTRACT FROM AUTHOR]

Children's right to participate has been one of the most challenging rights to implement due to dominant norms which position children under adults' authority. Notably, this has more negatively impacted girls than boys due to traditional gender norms and practices that often restrict girls' agency and are reproduced and unchallenged in many societies. To contest these struggles, young female activists (13–17 years) in Sierra Leone, who are the focus of this paper, engaged in direct actions to influence public decision‐making and prevent girls from being married during childhood. Drawing upon empirical evidence exploring the girls' activism experiences, this article explore, young female activists' practical work is an example of what intersectionality as praxis means by connecting social categories to inequalities and highlights that they saw themselves as social actors with the ability to negotiate power, take part in community‐based activism to end child marriage and network with others to seek justice for practices and attitudes they perceived to be abusive. [ABSTRACT FROM AUTHOR]

Background and Aims: Even though a ban of alcohol marketing has been declared a 'best buy' of alcohol control policy, comprehensive systematic reviews on its effectiveness to reduce consumption are lacking. The aim of this paper was to systematically review the evidence for effects of total and partial bans of alcohol marketing on alcohol consumption. Methods: This descriptive systematic review sought to include all empirical studies that explored how changes in the regulation of alcohol marketing impact on alcohol consumption. The search was conducted between October and December 2022 considering various scientific databases (Web of Science, PsycINFO, MEDLINE, Embase) as well as Google and Google Scholar. The titles and abstracts of a total of 2572 records were screened. Of the 26 studies included in the full text screening, 11 studies were finally included in this review. Changes in consumption in relation to marketing bans were determined based on significance testing in primary studies. Four risk of bias domains (confounding, selection bias, information bias and reporting bias) were assessed. Results: Seven studies examined changes in marketing restrictions in one location (New Zealand, Thailand, Canadian provinces, Spain, Norway). In the remaining studies, between 17 and 45 locations were studied (mostly high‐income countries from Europe and North America). Of the 11 studies identified, six studies reported null findings. Studies reporting lower alcohol consumption following marketing restrictions were of moderate, serious and critical risk of bias. Two studies with low and moderate risk of bias found increasing alcohol consumption post marketing bans. Overall, there was insufficient evidence to conclude that alcohol marketing bans reduce alcohol consumption. Conclusions: The available empirical evidence does not support the claim of alcohol marketing bans constituting a best buy for reducing alcohol consumption. [ABSTRACT FROM AUTHOR]

Background: Globally, it is estimated that one in three adults live with two or more long‐term conditions (multiple long‐term conditions, MLTCs), that require self‐management. People who experience socioeconomic deprivation face significant health inequalities due to a range of interrelated characteristics that lead to a lack of resources and opportunities. Previous research with underserved populations indicate low levels of trust towards primary care providers and potential barriers for developing patient‐healthcare professional relationships. The purpose of this paper is to explore the barriers and facilitators to self‐managing MLTCs, amongst people who experience socioeconomic deprivation. Methods: Semistructured one‐to‐one interviews with adults (n = 28) living in London and Sheffield, United Kingdom with MLTCs who are experiencing socioeconomic deprivation. Participants were recruited through general practices, community channels and social media. Data were analysed in NVivo using reflexive thematic analysis methods. Findings: Four analytical themes were developed: (1) challenges in accessing healthcare services, financial assistance, and cultural awareness; (2) empowerment and disempowerment through technology, including digital exclusion, and use of technology; (3) impact and causes of exclusion on self‐management, including social isolation, area‐based and economic exclusion, and health‐related stigma and (4) adapting self‐management strategies, including cost‐effective, and culturally/lifestyle appropriate strategies. Conclusions: Future health interventions and services need to be developed with consideration of the combined complexities of managing MLTCs while experiencing socioeconomic deprivation. Increased awareness in practitioners and commissioners of the complexities surrounding the lives of people experiencing socioeconomic deprivation, and the need for targeted strategies to promote self‐management of MLTCs are of great importance. Patient or Public Contribution: A patient advisory group contributed to all stages of the study, including providing important feedback on study documents (topic guides and recruitment materials), as well as providing critical insights surrounding the interpretation of interview data. [ABSTRACT FROM AUTHOR]

Introduction: In England, primary care networks (PCNs) offer opportunities to improve access to and sustainability of general practice through collaboration between groups of practices to provide care with a broader range of practitioner roles. However, there are concerns that these changes may undermine continuity of care. Our study investigates what the organisational shift to PCNs means for continuity of care. Methods: The paper uses thematic analysis of qualitative data from interviews with general practitioners and other healthcare professionals (HCPs, n = 33) in 19 practices in five PCNs, and their patients (n = 35). Three patient cohorts within each participating practice were recruited, based on anticipated higher or lower needs for continuity of care: patients over 65 years with polypharmacy, patients with anxiety or depression and 'working age' adults aged between 18 and 45 years. Findings: Patients and clinicians perceived changes to continuity in PCNs in our study. Larger‐scale care provision in PCNs required better care coordination and information‐sharing processes, aimed at improving care for 'vulnerable' patients in target groups. However, new working arrangements and ways of delivering care in PCNs undermine HCPs' ability to maintain continuity through ongoing relationships with patients. Patients experience this in terms of reduced availability of their preferred clinician, inefficiencies in care and unfamiliarity of new staff, roles and processes. Conclusions: New practitioners need to be effectively integrated to support effective team‐based care. However, for patients, especially those not deemed 'vulnerable', this may not be sufficient to counter the loss of relationship with their practice. Therefore, caution is required in relation to designating patients as in need of, or not in need of continuity. Rather, continuity for all patients could be maintained through a dynamic understanding of the need for it as fluctuating and situational and by supporting clinicians to provide follow‐up care. Patient and Public Involvement (PPI): A PPI group was recruited and consulted during the study for feedback on the study design, recruitment materials and interpretation of findings. [ABSTRACT FROM AUTHOR]

Background: This paper aims to explore the impact of recovery education on recovery knowledge, attitudes and the quality of life of students undertaking recovery education, contributing to the evidence base in relation to the impact of recovery education. It also explores the experiences of all stakeholders involved in the co‐facilitation, delivery and participation in recovery education. Setting and Participants: This study evaluates the experiences of stakeholders involved in the co‐facilitation, delivery and participation in recovery education across four recovery colleges in Ireland. Participants included students undertaking recovery education, peer educators, education facilitators, recovery college coordinators and practitioner/service providers. Discussion: Findings from the quantitative survey when compared with extant literature suggest that students had a good understanding of recovery education. The social aspect of empowerment for growth and wellbeing was identified through themes relating to co‐production and facilitating student learning. Support for equitable access to recovery education, including co‐production for both the public and staff, was identified as a challenge for the future. Conclusion: The findings from both the qualitative and quantitative components of the study show the positive impact of recovery education on stakeholders while acknowledging the need for ongoing support for people working in recovery education and the development of services. In particular, there was a high level of recovery knowledge found in students undertaking recovery education. Patient or Public Contribution: This study utilised a co‐created study design. From inception a steering group comprising stakeholders (peer educators, recovery education facilitators including past recovery college students and nonpeer staff involved in the co‐production of recovery education) directed the conduct of the evaluation. This steering group participated in an iterative process of information sharing, suggestions for evaluation process and language. [ABSTRACT FROM AUTHOR]

An important cause of stunting is limited consumption of complementary foods, in terms of both quantities and nutrients. Although existing studies show a positive association between fathers' engagement and children's diet, programmes designed to improve complementary feeding practices often only target mothers. In response to this, maternal behaviour change communication (BCC), paternal BCC and food voucher programmes were designed and implemented in Ethiopia using a clustered randomized controlled trial design. The paternal BCC programme included gender‐equal messages to increase fathers' participation in childcare, household labour and decision making. The research reported in this paper is an examination of the BCC programmes, characterizing the behavioural, normative and control beliefs of both mothers and fathers in BCC households compared to those in control households. In this study, a total of 40 participants were included, with 13 mother–father pairs in the BCC + food voucher group, and seven pairs in the control group. Each participant was interviewed separately. We found that BCC mothers showed more gender‐equal tendencies than the control mothers despite being more rural in location. By contrast, the beliefs of BCC and control fathers were similar overall, suggesting men are more resistant to gender‐equal BCC. More work is needed to develop and test effective methods for changing fathers' beliefs and practices. Key messages: Mothers in behaviour change communication (BCC) group mothers held more gender‐equal beliefs than control mothers, while BCC and control fathers shared similar views, suggesting a male resistance to gender equality.Mothers found fathers' involvement in childcare socially acceptable but often perceived them as inexperienced, which limited their participation.Control mothers' traditional view on household chores maintained the conventional labour division, influencing fathers' involvement.Fathers typically resisted maternal control of resources; however, they agreed that the more knowledgeable should lead decision‐making. BCC mothers showed greater confidence in making household decisions as effectively as fathers. [ABSTRACT FROM AUTHOR]

Aim: To develop and explore the validity of a Patient Reported Experience Measure (PREM) for adult inpatient diabetes care. Method: 27 in‐depth interviews were conducted to inform the development of the 42‐item PREM which was cognitively tested with 10 people. A refined 38‐item PREM was piloted with 228 respondents completing a paper (n = 198) or online (n = 30) version. The performance of the PREM was evaluated by exploring (i) uptake/number of responses and (ii) survey validity by investigating whether the PREM data were of adequate quality and delivered useful information. Results: The PREM had low drop‐out or missing data rates suggesting it was appropriately constructed. Analysis of item frequencies and variances, and problem score calculations concluded that questions provided sufficient score differentiation. Conclusions: This new PREM allows for experiences of inpatient diabetes care to be measured, understood and reported on to help identify priority areas for improving care quality. [ABSTRACT FROM AUTHOR]

Background: Haptic feedback has been shown to be an effective facilitator of the learning of scientific concepts in a series of studies. However, little is known about the underlying salient learning mechanisms, which are activated when learning from haptic feedback. Objectives: We investigate the learning mechanism in a higher chemistry education setting, in which the students learned about the abstract concept of potential energy in a quantum chemical context. Methods: In this work, we present a mixed‐methods problem‐solving prior to instruction (PS‐I) study with chemistry bachelor students. In an interactive quantum chemistry learning environment, the students explored the energetic profiles of nucleophilic substitution reactions and the corresponding activation barriers experienced as repulsion and attraction. We measured cognitive and affective mechanisms which have been shown to be activated in PS‐I designs, such as knowledge gap awareness, state curiosity, and positive affect as well as the learning outcome quantitatively and the learning trajectories qualitatively. Results and Conclusions: Planned contrasts revealed a small hindering effect of the haptic feedback on the learning outcome. Thematic analysis of the qualitative data lets us attribute this effect to the lack of scaffolding of the haptic feedback and the spontaneous atomic movements in the simulation, which may be interpreted as a visual representation of force in itself. This work highlights the importance of accurate mappings of the haptic feedback unto the target domain and further delivers insight into the prior conceptions of chemistry undergraduate students. Lay Description: What is already known about this topic: Haptic feedback can facilitate learning by grounding abstract concepts in sensory experiences.While previous studies have reported positive affective results, the cognitive results are ambiguous.Moreover, it was frequently reported that the learning of potential energy in a (quantum) chemical context is particularly difficult due to (i) the lack of grounding opportunities and (ii) the diverse previous conceptions. What this paper adds: A learning environment to interact with molecular systems in real‐time is proposed.The concept of activation energy is grounded in sensory experience of pushing and being pulled.The mixed‐methods design allows to explore cognitive and affective variables as well as the specific prior conceptions activated by the environment. Implications for practice and/or policy: We found a small negative effect of the haptic feedback on the learning outcome, potentially due to insufficient introduction of it to the students.The spontaneous movement of the atoms was identified as a more suitable external representation of the force.Future studies should investigate, if explicit introduction of the embodied metaphor can reverse this effect. [ABSTRACT FROM AUTHOR]

Background: Tele‐collaborative projects serve as invaluable platforms for students from diverse countries to engage in cross‐cultural communication and exchange cultural knowledge. These projects offer immense benefits in terms of fostering intercultural competence among participants. However, one challenge arises when participants engage in spoken communication rather than written. Those who may not share a common first language often rely on a lingua franca such as English for intercultural communication. In such spoken exchanges, varying levels of language proficiency can lead to communication errors that hinder the intercultural learning process and impede the development of intercultural competence in their fellow participants. Objectives: In the present trial study, our primary objective was to tackle the language‐related challenge associated with spoken communication head‐on. Our focus centred on addressing the discrepancies arising in spoken communication, and we aimed to mitigate these discrepancies by utilizing speech‐enabled corrective feedback technology. Methods: In a tele‐collaborative project involving 28 graduate students from the People's Republic of China and Republic of Kazakhstan, the participants engaged in spoken communication and cultural exchange in English via the internet. Given the emphasis on spoken communication and the recognition that English was not their first language, we implemented a speech‐enabled corrective feedback (SECF) technology to ensure effective communication in terms of pronunciation, grammar, and word choice. The SECF technology detected and provided instant feedback on any speech mistakes, enabling participants to make corrections accordingly. The main aim of our study was to explore the potential benefits of integrating SECF technology into a tele‐collaborative project for the development of participants' intercultural competence. Additionally, we sought to gather insights into the students' perceptions of the SECF support. Results and Conclusions: The results of our study revealed significant improvements in the participants' intercultural competence across dimensions such as knowledge, skills, attitude, and awareness. Furthermore, the participants expressed positive perceptions of the SECF technology. Drawing from our findings, we offer valuable implications and recommendations for educators and researchers in the field, enhancing their understanding of the role of SECF technology in supporting intercultural competence development in tele‐collaborative settings. Lay Description: What is currently known about the subject matter: Tele‐collaborative projects are widely utilized to enhance intercultural competence.Low language proficiency of participants often poses a significant challenge in tele‐collaborative projects. What this paper adds: The present study addressed the language barrier by incorporating speech‐enabled corrective feedback (SECF) technology to support our tele‐collaborative project.The study explored how our tele‐collaborative project, supported by SECF, facilitated the development of intercultural competence. The implications of study findings for practitioners: Scholars and practitioners should consider implementing SECF technology to address language‐related barriers in tele‐collaborative projects.Guidelines based on our study can be utilized to design tele‐collaborative projects with SECF support.Training on technology and constant support needs to be provided to participants. [ABSTRACT FROM AUTHOR]

Background Study: As flipped learning is a flexible pedagogical methodology to tailor students' needs and maximize the learning effects, this study integrated peer learning with MosoTeach‐supported flipped mode in an undergraduate blended EFL course. MosoTeach is a popular online learning platform in China with a variety of learning resources. Objectives: The study aimed to test the impact of MosoTeach flipped learning (MTFL) mode on undergraduate EFL students' perceived motivation, participation, feedback, and test performance. Methods: A quasi‐experimental design was carried out in Z university during the spring semester of 2020, with the experimental group (n = 34) adopting the MTFL model and a control group (n = 33) the non‐flipped mode. Results and Conclusions: The independent t‐test results showed that the experimental MTFL group outperformed the control group in post‐test scores, and a positive correlation was found in the relationship between the experimental MTFL group's post‐test scores and MosoTeach learning experience points (LEPs). Moreover, the course perception questionnaire survey indicated a higher level of students' perceived motivation, participation, and feedback in the experimental MTFL group, which corresponded to the results of the content analysis of students' responses to open‐ended questions and reflective reports. But students in both groups experienced challenges such as isolation, procrastination and technological anxiety. Lay Description: What is currently known about this topicFlipped language learning is mostly reported to be effective in improving EFL learning.Peer learning is mostly reported to be effective in improving EFL learning.MosoTeach was investigated in English learning contexts before, but without experimental design. What this paper addsMosoTeach proved as a valid online learning platform in flipped language learning, and the learning experience points (LEPs) on MosoTeach could predict students' exam performance.Students in the experimental group (MosoTeach‐supported flipped) had better exam performance and a higher level of motivation, participation and feedback.Students in both groups experienced isolation, procrastination and technological anxiety. Implications for practice:Peer discussion boards in MosoTeach provide learning support effectively for students in pre‐class learning.Group projects and peer assessment in MosoTeach integrate pre‐class peer discussion into in‐class interaction successfully.MosoTeach provides equal opportunity for every student in the large‐size Chinese English classes, thus contributing to the equity of in‐class peer interactions. [ABSTRACT FROM AUTHOR]

Background: Artificial Intelligence (AI) literacy is a crucial part of digital literacy that all individuals should possess in today's technologically advanced world. Despite the potential benefits that AI education offers, little research has been done on how to teach AI literacy to children. Objectives: This study aimed to fill that gap by investigating how children were engaged in AI literacy activities that are supported by intelligent agents. These activities were implemented in a Hong Kong kindergarten with a class of six 5‐year‐olds (Mage = 62.83 months, SD = 2.91) over a 6‐week period. Methods: The study gathered data from multiple sources, including classroom observations, teacher interviews, and documents/artefacts. Results and Conclusions: The results showed that children could learn about AI through interaction with intelligent agents in embodied learning contexts. The findings of this study have implications for the broader field of digital technology education, particularly in the context of early childhood education. Lay Description: What is already known about this topic: Artificial Intelligence (AI) literacy is essential in today's world.Little research exists on engaging young children in learning AI literacy. What this paper adds: Technology‐enhanced embodied learning approach affords multimodality in enabling young children's learning with AI‐related agents.Project‐based learning and real‐life examples can enhance children's learning. Implications for practice and/or policy: Early exposure to AI can help children navigate the increasingly digital world.Practical approaches, such as embodied and multimodal learning, seem to be effective.Teachers can enhance children's digital learning by using pedagogical strategies like project‐based learning and real‐life examples. [ABSTRACT FROM AUTHOR]

Background: Students who are blind are integrated into public schools in many countries, yet are often excluded from full participation in science since most learning materials are visual. To create a compensatory route, an existing model‐based inquiry‐learning environment was adapted by means of sonification (addition of non‐speech sounds that represent dynamic information). The learning environment uses agent‐based models and a complex systems approach to teach the Kinetic Molecular Theory (KMT) and Gas Laws. The models are accompanied by a workbook consisting of text (printed or auditory) and images (printed or tactile). Objectives: The current research examined whether such perceptual compensation creates a comparable learning environment for learners who are blind compared with learners who are sighted using the original learning environment. The aim of the study is to expand knowledge about how the auditory channel may compensate the visual channel among individuals who are blind. Methods: Conceptual learning in science and reasoning about complex systems were assessed using pre‐ and post‐questionnaires. To explore learners' learning progression throughout the unit, four progression analysis 'windows' were selected. These were groups of adjacent or nearly adjacent items in the workbook that permitted a glimpse of learners' progression. Results: The sonified environment not only supported the learning of learners who are blind compared with the learning of learners who are sighted using visual material, but even furthered their learning with respect to diffusion, one of the more challenging concepts in KMT. It seems the types of sonified representations used in this study increased listeners' sensitivity to the micro‐level interactions in a way less accessible in visual representations. Takeaways: Sonified environments can be provide learners who are blind with equitable participation by compensating and complementing the visual channel. Sonification can have implications for students who are blind as well as students who are sighted. Lay Description: What is already known: Sonification is the use of non‐speech sounds to represent dynamic information. Sonification can potentialy be used to allow equitable participation for students who are blind. What this paper adds: To test this, the study compared the outcomes of learners who are blind who used a sonified learning environment (L2C) to that of learners who are sighted who used a visual environment. Implications for practice: Learners who are blind showed equal or better learning outcomes using the sonified models compared with the learners who are sighted using the visual models. There are major implications for integrating students who are blind in public school classrooms. [ABSTRACT FROM AUTHOR]

Background: As the concept of flipped classrooms continues to gain interest across disciplines, more research is needed to strengthen the instructional design by integrating active learning strategies and emerging technologies. Among various possibilities, little is known about how game‐based learning combined with Augmented Reality (AR) can be effectively infused into language education to establish supportive flipped learning contexts. Objectives: This study thus proposed an AR‐enhanced game‐based learning (ARGBL) approach, featuring the use of an augmented board game to engage students actively in classroom activities. It further compared the effects of the proposed approach with traditional game‐based learning on the students' vocabulary acquisition and creative thinking as they were instructed to learn English as a foreign language (EFL) in flipped classrooms. Methods: A quasi‐experimental design was adopted to examine the effectiveness of the proposed approach to promote the students' participation in flipped in‐class activities, thereby improving their learning outcomes. Participants were recruited from two classes of the same undergraduate course, one of which was designated as the experimental group to take part in game‐based learning activities in class by playing an AR‐enhanced board game, and the other as the comparison group to learn by playing a paper‐and‐pencil game with identical puzzle content. The desired student learning outcomes were measured by pre‐ and post‐intervention vocabulary tests and creative thinking tests, supplemented by individual interviews. Results: Results indicated that the students in the experimental group significantly outperformed their counterparts in vocabulary acquisition and creative thinking. They also expressed positive perceptions of the augmented game‐based learning experience in the flipped EFL classroom. Take Away: ARGBL can be a promising approach to improving student learning, and it is particularly beneficial to the design of classroom activities in flipped learning contexts due to its affordances for enriched content visualization and active learner engagement through gameplay. Lay Description: What is already known about this topic: Flipping the classroom is becoming prevalent in education, and researchers have stressed the need to move beyond comparing the outcomes of flipped and non‐flipped settings in order to advance innovation and examine the effectiveness of instructional design.Recent research has shown positive effects of using AR technology for content delivery, with location‐based context‐aware applications being more commonly applied in language education, while the potential of image‐based AR also warrants research attention.Learning by playing games has been considered an engaging strategy that provides benefits for learner engagement, but not all game genres have been fully studied. What this paper adds: This study proposed an ARGBL approach, applying image‐based AR to augment board gaming activities in class when the classroom was flipped.The ARGBL approach was found to significantly improve the students' English vocabulary acquisition.The ARGBL approach was found to significantly enhance the students' creative thinking development. Implications for practice: The innovative merger of image‐based AR and physical board gaming pieces into a hybrid form of mediation, namely the AR‐enhanced board game, likely encouraged face‐to‐face interaction of meaningful language use in flipped in‐class activities, thereby leading to the vocabulary growth and creative thinking development of EFL learners.The effectiveness of the ARGBL approach should be considered as an integrated whole with a holistic understanding of the interplay between the AR technology and the active learning strategy through gameplay in the broader pedagogical context of flipped classrooms. [ABSTRACT FROM AUTHOR]

Paid carers play an important role in helping older adults with care needs to remain living in their own homes. This paper examines changes in the home care field, specifically the emergence of self‐employed care entrepreneurs ('microentrepreneurs'). To do this, it employs Bourdieu's concepts of field, capital and habitus. Drawing on 105 semi‐structured interviews with stakeholders working in home care, the paper describes how the interaction of changes to field structures, and altered practices of care have challenged the taken‐for‐granted acceptance of traditional, transactional forms of care provision. This process has been highly dependent on local state actors, their ability to mobilise relevant forms of capital and the factors which shaped their habitus. It should be seen within the context of changes to local field structures and the hierarchical classification processes which underpin them. These changes threaten the distribution of capital in the home care field in ways that are beneficial to microentrepreneurs. Bourdieu might categorise these developments as 'partial revolutions', which do not challenge the fundamental axioms of the field. However, for care entrepreneurs, formerly employed as low‐paid home‐care workers, a revolution that is only partial may be better than none at all. [ABSTRACT FROM AUTHOR]

The independent review of children's social care (2022) has proposed a radical reset of England's children's services, shifting a remote, assessment heavy system towards one that works alongside communities to help prevent statutory interventions. However, notions around the harnessing of community resources to deliver Early Help are often underpinned by assumptions regarding the voluntary, community and social enterprise (VCSE) sector and the ease with which such organizations can be integrated into preventative strategies. This paper reports findings from embedded research within a unitary authority in Southwest England during remodelling of its Early Help service to work more collaboratively with local VCSE organizations. The study generated data from ethnographic observations, semi‐structured interviews and focus groups with 95 participants, including local parents, service providers, VCSE organizations and Council leaders. The findings illustrate that families value the compassionate, responsive and flexible support available within many VCSE settings. However, differences in practice cultures, regulatory pressures on statutory providers, the need to (re)build trust in communities and sensitivities around power‐sharing and resourcing meant negotiating VCSE sector integration was fraught with complexities. Few studies have gained such privileged access to a Local Authority's remodelling of Early Help services, and this paper has significant insights for the debates surrounding the independent review of children's social care (2022) and its recommendation to bring services 'closer to communities'. [ABSTRACT FROM AUTHOR]

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

Background: The substantial growth in gamification research has connected gamified learning to enhanced engagement, improved performance, and greater motivation. Similar to gamification, personalized learning analytics dashboards can enhance student engagement. Objectives: This study explores the student experiences and academic achievements using a gamified dashboard in a large, introductory STEM course. Methods: We examined two groups of students enrolled in different sections of a one‐semester‐long physical geology course with a total enrollment of 223 students. The only difference between the groups was that one had access to the dashboard. The data collection included students' assignments, overall performances, and exam scores. Students in both sections completed a Science Literacy Concept Inventory survey at the beginning and end of the term. Additionally, students completed an end‐of‐term survey containing open‐ended questions on their experience and interactions with specific elements. Results: Students shared mostly positive comments about their experience with the dashboard, and the final grade of students with access to the dashboard was 13% higher, on average, compared to their peers in the non‐dashboard section. Conclusion: With low costs and little time invested, gamified dashboards could have a significant impact on student performance in large STEM lecture courses. Lay Description: What is already known about this topic: Leaner dashboards that provide personalized feedback are linked to improved student performance in undergraduate STEM courses. However, students may be reticent to adopt dashboards, especially students in the middle range of the performance distribution, for whom the impact of the dashboard may be most significant.Prior research on gamification in STEM courses suggests that adding gameful elements like progress trackers, badges, and rewards can increase students' engagement in undergraduate coursework.The combination of personalized learning in dashboards and the motivational experience of gamification should boost student engagement, dashboard adoption, and ultimately foster academic achievement. What this paper adds: In this paper, we examine the differences in academic performance between students with and without access to a gamified learning dashboard in an undergraduate Geology course.We observe that students with access to the dashboard (the treatment group), outperform students without access (the control group). The greatest benefit is observed for students who use the dashboard more frequently.Students reported that the progress tracker, the badges, and the rewards all incentivized their use and provided useful feedback about their performance. Students who did not adopt the dashboard expressed a need for more detail about the tool and its purpose. Implications for practice and/or policy: Instructors and instructional designers for large enrollment undergraduate STEM courses should consider the affordances of gamified learner dashboards for increasing engagement and for providing synchronous feedback about learners' strategies in the course.Aligning the dashboard to the content of the curriculum—by ensuring that badges reflect key concepts‐ encouraged participation and helped students identify the utility of the tool. Dashboards should be personalized to individuals and to the course.Adding gameful elements in a low‐cost intervention for increasing adoption and engagement of dashboards in large enrollment introductory courses. [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: Text comprehension research in relation to the reading medium showed that digital‐based reading represents a disadvantage compared with paper‐based reading. Most paper versus screen research; however, was conducted with university students. Objectives: This study investigated the contribution of reading medium to text comprehension and medium preference in beginner readers who use technology for school learning. The moderating role of text genre, word reading and medium preference on the reading medium effect on text comprehension was also analysed. Methods: First graders (N = 115; mean age = 6;8 years) read narrative and informational linear texts on paper and computer screen and answered main idea, literal and inferential comprehension questions. Medium preference questions and a word reading task were administered. Results and Conclusions: Logistic mixed models showed that the main idea and literal comprehension of narrative and informational linear texts were greater on screen and for higher word reading skills. Inferential comprehension was lower on screen at lower levels of word reading skills but became similar for the two media as word reading increased. Children had no clear medium preference and medium effect on text comprehension was independent of children's medium preference. The main results show that beginner readers who use technology for learning and are fast and accurate in word reading display no comprehension disadvantage in digital reading. Takeaways: Our results add to existing knowledge by clarifying how reading medium effects on beginner readers' text comprehension interact with factors such as fundamental reading skills and experience with technology. Lay Description: What is currently know about the subject matter: • Comprehension of informational texts is better on paper than on screen • Text comprehension is better on paper than on screen for independent readers from 4th grade onwards, even for those who prefer to read digitally. • Lower text comprehension on screen is related to shallow reading processing and navigation requirements of digital texts. • Shallow reading processing is related to the use of digital media for leisure. What the paper adds: • Comprehension of narrative and informational texts on screen is not disadvantaged in beginner readers who often use technology for school activities. • Word reading has a stronger role on inferential comprehension of digital texts with navigation requirements. • Word reading stronger role results in a screen comprehension disadvantage at lower levels of word reading skills. • Children have no clear medium preference and text comprehension on paper vs screen was independent of children's medium preference Implications of study findings for practitioners: • The use of technology for school activities may encourage deep text processing on screen. • Care should be taken when very young students with low reading skills are required to understand digital texts with navigation requirements. [ABSTRACT FROM AUTHOR]

Background: The Communicative Participation Item Bank (CPIB) is a patient‐reported outcome measure (PROM) designed to measure the extent of interference, or difficulty, experienced by adults with communication disorders participating in their day‐to‐day communication activities. To date, there is limited evidence regarding sensitivity of the CPIB for capturing change with intervention in people with Parkinson's disease (PwPD). Aims: The purpose of this study was to examine the following measurement properties of the CPIB in PwPD who received community‐based, standard care, speech‐language therapy focusing on motor speech concerns: Change over time between treatment and observation groups, comparison to patient‐defined ideal and satisfactory targets, comparison of static short form to computerised adaptive testing (CAT), comparison of self to proxy‐rated scores, and comparison to other common PROMs. Methods and Procedures: Forty‐six PwPD (20 treatment/26 observation) completed data collection upon enrolment (pre‐treatment) and 6 months later. In addition to the CPIB, PROMs included the Voice Handicap Index 10‐item short form (VHI‐10), PROMIS Global Health‐Related Quality of Life, Levels of Speech Usage, self‐rated speech severity, and Patient Health Questionnaire‐9 (PHQ‐9). Participants also engaged in qualitative interviews. Forty‐four family members completed proxy CPIB ratings. Outcomes and Results: There were no significant differences between treatment and observation groups on the CPIB pre‐treatment, but there were significant differences post‐treatment. The differences appeared to be largely due to significant gains in the treatment group. No participants reached their ideal CPIB target, and few reached their satisfactory target. Static CPIB short form and CAT scores were not significantly different, with an average of five CAT items administered per participant. Overall group similarities between patient and proxy scores may have obscured wide variability across individual patient‐proxy pairs. Associations between CPIB and VHI‐10, health‐related quality of life, self‐reported speech severity, and depression ranged from weak to moderate. Conclusions and Implications: The CPIB appears to be sensitive to capturing change with intervention, and similar results are obtained with the static short form and CAT formats. One clinical caution is that even with gains observed in the treatment group, no participants obtained their ideal communicative participation goals, and few obtained a satisfactory level of communicative participation. Thus, while current interventions are beneficial, they may not meet the full range of clients' communication needs. While responding to the CPIB through a proxy rater may be feasible, caution is warranted due to concerns about maintaining the autonomy of PwPD. What this paper adds: What is already known on this subject: The communication disorders associated with Parkinson's disease (PD) can have a negative impact on quality of life and life participation as measured by patient (or person)‐reported outcome measures (PROMs). The Communicative Participation Item Bank (CPIB) is one PROM available to use with adults with communication disorders. However, little is known about whether the CPIB captures changes in communicative participation as a result of standard care treatment for people with Parkinson's disease (PwPD). Use of computerised adaptive testing (CAT), proxy report and comparison to targeted participation outcomes have not been explored. What this study adds to existing knowledge: As a result of this study, we know that the CPIB captured differences between treatment and observation groups after community‐based, standard care speech therapy intervention focusing on motor speech production in PwPD. Static short form and CAT scores did not differ significantly, so the CAT option provides better efficiency requiring, on average, five items to administer compared to the 10‐item short form. Proxy and PwPD scores did not differ as a group, but wide variability was noted. What are the potential or actual clinical implications of this work?: The CPIB may be a clinically sensitive instrument for capturing changes in communicative participation after treatment. No participants met their ideal CPIB target, and few reached their satisfactory target, suggesting that while current interventions contribute to gains in communicative participation, there are still unmet needs that may call for support and interventions addressing the more complex array of factors affecting communicative participation outcomes for PwPD. [ABSTRACT FROM AUTHOR]

Policy PointsThe implementation of large‐scale health care interventions relies on a shared vision, commitment to change, coordination across sites, and a spanning of siloed knowledge.Enablers of the system should include building an authorizing environment; providing relevant, meaningful, transparent, and timely data; designating and distributing leadership and decision making; and fostering the emergence of a learning culture.Attention to these four enablers can set up a positive feedback loop to foster positive change that can protect against the loss of key staff, the presence of lone disruptors, and the enervating effects of uncertainty. Context: Large‐scale transformative initiatives have the potential to improve the quality, efficiency, and safety of health care. However, change is expensive, complex, and difficult to implement and sustain. This paper advances system enablers, which will help to guide large‐scale transformation in health care systems. Methods: A realist study of the implementation of a value‐based health care program between 2017 and 2021 was undertaken in every public hospital (n = 221) in New South Wales (NSW), Australia. Four data sources were used to elucidate initial program theories beginning with a set of literature reviews, a program document review, and informal discussions with key stakeholders. Semistructured interviews were then conducted with 56 stakeholders to confirm, refute, or refine the theories. A retroductive analysis produced a series of context‐mechanism‐outcome (CMO) statements. Next, the CMOs were validated with three health care quality expert panels (n = 51). Synthesized data were interrogated to distill the overarching system enablers. Findings: Forty‐two CMO statements from the eight initial program theory areas were developed, refined, and validated. Four system enablers were identified: (1) build an authorizing environment; (2) provide relevant, authentic, timely, and meaningful data; (3) designate and distribute leadership and decision making; and (4) support the emergence of a learning culture. The system enablers provide a nuanced understanding of large‐system transformation that illustrates when, for whom, and in what circumstances large‐system transformation worked well or worked poorly. Conclusions: System enablers offer nuanced guidance for the implementation of large‐scale health care interventions. The four enablers may be portable to similar contexts and provide the empirical basis for an implementation model of large‐system value‐based health care initiatives. With concerted application, these findings can pave the way not just for a better understanding of greater or lesser success in intervening in health care settings but ultimately to contribute higher quality, higher value, and safer care. [ABSTRACT FROM AUTHOR]

BACKGROUND: Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth‐centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school‐based clinics. METHODS: Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web‐based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. RESULTS: Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: School‐based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. CONCLUSION: Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health‐related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues. [ABSTRACT FROM AUTHOR]

Background: Co‐design is becoming common practice in the development of mental health services, however, little is known about the experience of such practices, particularly when young people are involved. Objective: The aim of this study was to conduct a process evaluation of the co‐design which was undertaken for the development of an intervention for youth and adolescents at risk of suicide. This paper briefly outlines the co‐design process undertaken during a COVID‐19 lockdown and then focuses on a qualitative evaluation of the experience of taking part in a co‐design process. Setting and Participants: The evaluation involved young consumers of a public youth mental health service, their carers/parents and service delivery staff who had taken part in the co‐design process. Method: This study used follow‐up semistructured interviews with the co‐design participants to explore their experience of the co‐design process. Inductive thematic analysis was used to draw out common themes from the qualitative data. Results: It was found that despite the practical efforts of the project team to minimise known issues in co‐design, challenges centred around perceptions regarding power imbalance, the need for extensive consultation and time constraints still arose. Discussion: Despite these challenges, the study found that the co‐design provided a human‐centred, accessible and rewarding process for young people, parents and staff members, leaving them with the feeling that they had made a worthwhile contribution to the design of the new service, as well as contributing to changing practice in service design. Conclusion: With sensitivity and adaptation to usual practice, it is possible to include young people with suicidal ideation, their parents/carers and professional staff in a safe and effective co‐design process. Patient and Public Contribution: The authors would like to thank and acknowledge the young people with a lived experience and their carers who participated in the co‐design process and research evaluation component of this study. We also wish to thank the clinical staff, peer workers and family peer workers who participated in this research. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) do not always access specialist outpatient services in a timely manner in Ireland. The perspectives of people living with PD, relating to service access, are largely absent in the existing literature. Aim: To explore experiences of PD service access for people living with PD, using a qualitative approach. Methods: Purposive maximum variation sampling was used. Semi‐structured telephone interviews were conducted with 25 service users, including people with PD (n = 22) and supporting carers (n = 3). Informed consent was obtained from all participants. Interviews ranged in duration from 30 to 90 min. Data were managed in NVivo 12 and interpreted inductively using thematic analysis. The researchers were reflexive throughout the research process. The Consolidated Criteria for Reporting Qualitative Research checklist was employed to maximise transparency. Results: The findings highlight several key barriers to and facilitators of equitable and timely service access. Three key themes were identified comprising experiences of PD service access including 'geographical inequity', 'discriminatory practices', and 'public and private system deficits'. Together, these themes illustrate how a two‐tiered and under‐resourced health system lacks capacity, in terms of infrastructure and workforce, to meet PD needs for both public and private patients in Ireland. Conclusions: These findings point to problems for PD care, relating to (i) how the health system is structured, (ii) the under‐provision and under‐resourcing of specialist outpatient PD services, including medical, nursing, and multidisciplinary posts, and (iii) insufficient PD awareness education and training across health settings. The findings also show that telemedicine can provide opportunities for making access to certain aspects of PD care more flexible and equitable, but the feasibility and acceptability of technology‐enabled care must be assessed on an individual basis. Implications for policy, practice and research are discussed. Patient or Public Contribution: The design and conduct of this study were supported by an expert advisory group (EAG) of 10 co‐researchers living with PD. The EAG reviewed the interview schedule and the protocol for this study and provided detailed feedback from their perspective, to improve the methods, including the interview approach. The group also reviewed the findings of the study and contributed their insights on the meaning of the findings, which fed into this paper. [ABSTRACT FROM AUTHOR]

Introduction: Associations between structural inequalities and health are well established. However, there is limited work examining this link in relation to mental health, or that centres public perspectives. This study explores people's experience and sense‐making of inequality in their daily lives, with particular consideration of impacts on mental health. Methods: We conducted a peer research study. Participants had to live in one of two London Boroughs and have an interest in inequalities and mental health. Using social media, newsletters, local organisations and our peer researchers' contacts, we recruited 30 participants who took photos representing their experience of inequality and discussed them during semi‐structured interviews. Data were analysed using reflexive thematic analysis. Results: Three themes were identified in this study: (1) inequalities are unjust, multilayered and intertwined with mental health. Accounts demonstrated a deep understanding of inequalities and their link to mental health outcomes, describing inequalities as 'suffering' and 'not good for anyone'. Financial, housing, immigration and healthcare problems exacerbated poor mental health, with racism, gender‐based violence and job loss also contributing factors for both poor mental health and experiences of inequality; (2) inequalities exclude and have far‐reaching mental health consequences, impacting personal sense of belonging and perceived societal value and (3) moving forwards—addressing long‐standing inequality and poor public mental health necessitated coping and resilience strategies that are often unacknowledged and undervalued by support systems. Conclusion: Lived experience expertise was central in this study, creating an innovative methodological approach. To improve public mental health, we must address the everyday, painful structural inequalities experienced by many as commonplace and unfair. New policies and strategies must be found that involve communities, redistributing resources and power, building on a collective knowledge base, to coproduce actions combatting inequalities and improving population mental health. Patient or Public Contribution: This study was peer‐led, designed and carried out by researchers who had experiences of poor mental health. Six authors of the paper worked as peer researchers on this study. [ABSTRACT FROM AUTHOR]

Introduction: People living with advanced cancer want to continue participating in their valued occupations amid cancer progression. However, increasing dependence and bodily deterioration challenge a person's ability to do so, thus requiring adaptation to how they engage in their occupations. Theoretical frameworks on the process of occupational adaptation often do not address the implications of progressive functional decline. Methods: A longitudinal phenomenological design was used to understand the lived experience of occupational engagement for working‐aged adults living with advanced cancer. A semi‐structured interview series explored participants' experience of occupational engagement and how this changed over time. Data were analysed thematically and mapped against the Model of Human Occupation (MOHO). Findings: Eight adults (40–64 years old) participated in 33 interviews over 19 months. Three themes were constructed from the data: ongoing adaptation through doing, the significance of volition in adaptation, and everyday life is contingent on my environment. Study findings demonstrate that the process of adaptation occurs through occupational engagement, is motivated by volition, and is affected by the environment. Volition and the environment play a more central role in occupational adaptation than occupational competency for the advanced cancer cohort. Conclusion: Study findings further MOHO's theoretical conceptualisation of occupational adaptation by identifying the centrality of volition and the environment in the process of adaptation. For people living with advanced cancer, disease progression results in unremitting functional decline, thus rendering competency an unstable and untenable construct. Rather, this paper argues that occupational adaptation is facilitated by volition (i.e., the motivation behind the doing) and the environment, thus fostering a sense of identity and meaning at the end of life. Occupational therapists' awareness of the significance of volition and the environment can thus foster continued occupational engagement and meaning at the end of life for people living with advanced cancer. [ABSTRACT FROM AUTHOR]

Introduction: In the past 30 years, 60% of South Australia's rural maternity units have closed. Evidence demonstrates midwifery models of care offer regional Australia sustainable birthing services. Five birthing sites within the York and Northern Region of South Australia, designed in collaboration with key stakeholders, offered a new all‐risk midwifery continuity of care model (MMoC). All pregnant women in the region were allocated to a known midwife once pregnancy was confirmed. In July 2019, the pilot program was implemented and an evaluation undertaken. Objective: The study aimed to evaluate the effectiveness, acceptability, and sustainability of the new midwifery model of care from the perspective of health care providers. Design: The evaluation utilised a mixed methods design using focus groups and surveys to explore experiences of health care providers impacted by the implementation of the MMoC. This paper reports on midwives, doctors and nurses experiences at different time points, to gain insight into the model of care from the care providers impacted by the change to services. Findings: The first round of focus groups included 14 midwives, 6 hospital nurses/midwives and 5 doctors with the overarching theme that the 'MMoC was working well.' The second round of focus groups were undertaken across the five sites with 10 midwives, 9 hospital nurses/midwives and 5 doctors. The overarching theme captured all participants commitment to the MMoC, with agreement that 'there is no other option ‐ it has to work'. Discussion: All participants reported positive outcomes and a strong commitment to navigate the changes required to implement the new model of care. Collaboration and communication was expressed as key elements for success. Specific challenges and complexities were evident including a need to clarify expectations and the workload for midwives, and for nurses who were accustomed to having midwives 24 hours a day in hospitals. Conclusion: This innovative model responds to challenges in providing rural maternity care and offers a sustainable model for maternity services and workforce. There is an overwhelming commitment and consensus that there is 'no other option–it has to work'. [ABSTRACT FROM AUTHOR]

Background: Video conferencing learning offers a more accessible and flexible learning mode for students who cannot attend face‐to‐face class in person. However, research about the video conferencing learning is still lacked, especially for students' engagement in this setting. Objectives: This study adopts the self‐system model of motivational development to uncover effects of the video conferencing learning environment (VCLE) to students' engagement. Methods: Two hundred and ninety‐eight primary school students involved in the VCLE were surveyed. The partial least square structural equation modelling was employed to explore the link between the VCLE and students' engagement with a mediating role of basic psychological needs satisfaction (BPNS). Results and Conclusions: Results showed that the BPNS played a mediating role in the processes from the VCLE to engagement. Both pedagogical and social affordance had a significant effect on the BPNS. However, their influences were different. Specifically, pedagogical affordance yielded a stronger effect on the BPNS for autonomy than social affordance. The predicting power of social affordance on BPNS for relatedness and competence was stronger than pedagogical affordance. Generally, social affordance yielded more contributions to behavioral and emotional engagement than pedagogical affordance. Moreover, BPNS for competence was the only significant mediator between the VCLE and behavioral engagement, and it owned the strongest mediating power on the relationship between the VCLE and emotional engagement, followed by autonomy, and the smallest of relatedness. This study suggests that practitioners and researchers should give more consideration to improve social affordance of the VCLE and to meet students' BPNS especially for competence in order to design and implement an engaged video conferencing course. Lay Description: What is already known about this topic: Video conferencing learning provides an accessible and flexible learning mode.Mechanism from learning environment to engagement is helpful to design an engaged video conferencing course.Less is known about how video conferencing learning affects students' engagement. What the paper adds: This study uncovered the functioning process of video conferencing learning to students' engagement.PLS‐SEM was employed to verify the mediating role of BPNS in this process.BPNS for autonomy, competence, and relatedness played mediating roles and their powers were different. Implications for practice and/or policy: More attention is needed to improve to social affordance to enhance students' emotional engagement.BPNS especially for competence deserves special consideration to improve students' behavioral and emotional engagement. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) is becoming increasingly accessible and being utilized in various organizations to meet education and training needs. Despite its potential, research regarding VR applications has focused on measuring the effectiveness of VR programs relative to non‐VR programs; consequently, the ways in which VR programs are effective remain unclear. Objectives: Recognizing this research gap, this study examined whether task type‐dependent differences in training outcomes exist between VR training and non‐VR training groups. Methods: To examine the effects of VR technology for training purposes in a military setting, we conducted a quasi‐experiment focusing on how the effects vary based on task characteristics. A total of 90 military personnel were randomly assigned to either an experimental group (VR) or a control group (non‐VR). After completing their respective training, the two groups participated in four tasks simulating real battle scenarios and designed to evaluate the effectiveness of the VR‐based training. We analysed primary data collected through survey instruments and performance evaluation using a one‐way between‐group analysis of covariance (ANCOVA) and supplementary interview data using thematic analysis. Results and Conclusions: The quantitative analysis showed that the VR group performed better than the control group on three tasks in which communication, interaction and immediate situational judgements were critical. No difference was found between the two groups in the other task, which involved the routine operation of physical objects. Additional interview data revealed the extent to which trainees perceived the VR training as effective in understanding in‐situ conditions, preparing and practising their own and their team's reactions to emergent situations and in manipulating virtual objects. Implications: Our findings provide insight into VR technology's potential to enhance human performance in various training contexts. VR is specifically effective in training that aim to improve immediate judgement and group coordination. Our findings provide useful information for those seeking to design and develop training environments that maximize the effects of VR. Lay Description: What is already known about this topic: Virtual reality training is widely used to train personnel in high‐risk/cost occupations (e.g. surgeons and military personnel).Virtual reality education and training help to improve cognitive and affective function as well as psychomotor skills.The success of technology adoption depends on how well the task characteristics are aligned with technological characteristics. What this paper adds: The current study helps verify the generalizability of the TTF theory and provides an in‐depth framework that can be used to classify task types to optimize VR training.VR training programs are more effective when assigned tasks involve solving problems in groups and/or require spontaneous decision‐making than individual physical operations. Implications for practice and/or policy: When considering VR integration to an existing or new training program, the types of tasks to be designed in the program should be well‐aligned with the technological characteristics.At the organizational level, strategic adoption of VR in the training field should be initiated instead of replacing the existence of areas in current/traditional training (i.e. individual physical operation in this study). [ABSTRACT FROM AUTHOR]

Background: Online collaborative learning has been widely adopted in the field of education. However, learners often find it difficult to engage in collaboratively building knowledge and jointly regulating online collaborative learning. Objectives: The study compared the impacts of the three learning approaches on collaborative knowledge building, group performance, socially shared regulation, behavioural engagement, and cognitive load in an online collaborative learning context. The first is the automatic construction of knowledge graphs (CKG) approach, the second is the automatic analysis of topic distribution (ATD) approach, and the third one is the traditional online collaborative learning (OCL) approach without any analytic feedback. Methods: A total of 144 college students participated in a quasi‐experimental study, where 48 students learned with the CKG approach, 48 students used the ATD approach, and the remaining 48 students adopted the OCL approach. Results and Conclusions: The findings revealed that the CKG approach could encourage collaborative knowledge building, socially shared regulation, and behavioural engagement in building knowledge better than the ATD and OCL approaches. Both the CKG and ATD approaches could better improve group performance than the OCL approach. Furthermore, the CKG approach did not increase learners' cognitive load, but the ATD approach did. Implications: This study has theoretical and practical implications for utilising learning analytics in online collaborative learning. Furthermore, deep neural network models are powerful for constructing knowledge graphs and analysing topic distribution. Lay Description: What is currently known about the subject matter: Online collaborative learning has been widely adopted in the field of education.Learners often find it difficult to engage in collaboratively building knowledge and jointly regulating collaborative learning. What the paper adds to this: This study compared the impacts of three learning approaches, namely, the automatic construction of knowledge graphs (CKG), the automatic analysis of topic distribution (ATD), and the traditional online collaborative learning (OCL) approach.The findings revealed that the CKG approach could encourage collaborative knowledge building, socially shared regulation, and behavioral engagement in building knowledge better than the ATD and OCL approaches. Both the CKG and ATD approaches could better improve group performance than the OCL approach. Furthermore, the CKG approach did not increase learners' cognitive load, but the ATD approach did. Implications of study findings for practitioners: It is strongly recommended that the CKG approach can be employed to enhance collaborative knowledge building, socially shared regulation, and behavioral engagement in building knowledge in an online collaborative learning context. Both the CKG and ATD approaches contribute to improving group performance.Deep neural network models are powerful for constructing knowledge graphs and analysing topic distribution. [ABSTRACT FROM AUTHOR]

Current evidence suggests understaffing is related to poor quality and missed care in a global context, but this relationship is complex. There is also a research gap for quality in mental health care in the United Kingdom that includes a wider set of patient outcomes. This paper aims to investigate RMN's perception of quality of care on their last shift, their self‐reported reasons for compromised care and potential impact on patient outcomes. A mixed methods approach, we used descriptive statistics to create a framework within which to qualitatively analyse data from the 2017 Royal College of Nursing (RCN) employment survey to consider the complex relationship between understaffing and care quality. We established three themes: 'Understaffing', 'Professional Code Expectations and Moral Distress' and 'Management'. In line with the current evidence; lack of resources and understaffing were consistently present throughout. Nurses also felt pressure from the Nursing and Midwifery Council (NMC) code of conduct which in turn instilled shame and fear for their registration when they were unable to achieve the standards expected. This was further exacerbated by poor management and supervision; leading nurses to reflect on poor outcomes for patients which compromised not only legal rights but safety of patients and staff alike. We conclude that focusing on staffing numbers alone is unlikely to improve care quality. [ABSTRACT FROM AUTHOR]