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Purpose. This study aims to elucidate the gender gaps in the strategies for maintaining the social participation and interaction of older adults with people in a local community. Methods. The subjects were 130 older adults aged 65 years or older and independently living in their homes in Saitama, Saitama Prefecture, Japan. The authors conducted an anonymous questionnaire survey on paper and performed multiple regression analysis for men and women separately using the Lubben Social Network Scale-6 (LSNS-6) as the dependent variable. Results. Among the independent variables used for the analysis, those that significantly influenced LSNS-6 in men were social activities related to the daily life satisfaction of the elderly (SARDS). The independent variables that significantly influenced LSNS-6 in women were SARDS, sense of coherence-13 (SOC-13), and the number of family members living with the subjects. Discussion. Health promotion is not associated with interaction with people in men compared with women. [ABSTRACT FROM AUTHOR]

Background. In addition to the usual difficulty of managing human capital in any organization, healthcare institutions have other problems to solve arising from the circumstances and the very nature of the work they perform, such as the ethical pressure on staff, emotional exhaustion, the distribution of work shifts, or the general shortage for nurses. In many cases, this situation has an impact on the quality of care. Objective. The main objective of this research is to compile, in a single document, human resource practices that help health centre managers improve results in terms of performance and quality of care, as well as avoid the intention of abandoning the job, specifically related to the work of nurses. Methods. To this end, a systematic literature review has been performed based on 229 papers published in the Web of Science database, from which the practical implications for nurses proposed by these authors have been extracted. Results. The main results suggest that developing affective commitment helps to improve organizational performance and enhance patient safety culture. Furthermore, improving communication and meaningfulness of work, recognition by superiors, or job flexibility would improve the quality of outcomes, for the work of nurses. Conclusions and Implications for Nursing. Stimulating normative commitment, reducing excessive control, and paying attention to job burnout and job stress help combat the intention of voluntary turnover or leaving the job, especially in the case of nurses. [ABSTRACT FROM AUTHOR]

Objective. The health benefits of medical care services for older adults have been well known. This study aims to identify trajectories of medical care accessibility and their impacts on Chinese older adults' psychological well-being to enrich findings on health outcomes of medical care accessibility. Methods. This study included 2660 participants aged 65 years and older from the 2005–2018 Chinese Longitudinal Healthy Longevity Survey, and this paper used the latent class growth model to analyze the heterogeneous trajectories of medical care accessibility among Chinese older adults. Ordinary least squares (OLS) regression was also used to explore whether the trajectories of medical care accessibility impact the psychological well-being of Chinese older adults and its heterogeneity among different subgroups of older adults. Results. Three distinct trajectories of medical care accessibility "maintaining high accessibility" (n = 2230, 84.1%), "medium to high accessibility" (n = 222, 8.10%), and "high to low accessibility" (n = 208, 7.80%) were identified, respectively. Regression results show that older adults maintaining high accessibility to medical care reported well psychological well-being. This result was particularly evident among older adults in urban and eastern areas. Discussion. Our findings highlight the importance of maintaining high accessibility to medical care and reducing inequalities in the accessibility to medical care for increasing psychological well-being of Chinese older adults. [ABSTRACT FROM AUTHOR]

Introduction: The present review aimed to establish prevalence rates of anxiety and depression in adults with haematology cancer, with a focus on the differences between patients under treatment and patients under watchful waiting. Method: Five databases (Scopus, Medline, PsycINFO, EThOS, CINAHL) were searched throughout June 2021. Key search terms included haematology cancer, anxiety, depression, in treatment and watchful waiting. Study and sample characteristics, prevalence rates and mean self‐reported scores of anxiety and depression data were extracted. Results: A total of 18 eligible papers were included in the review. Quality appraisal indicated papers were of adequate standard. Depression data from 2720 participants (14.5% under watchful waiting) and anxiety data from 2520 participants (15.9% under watchful waiting) were analysed through subgroup meta‐analyses. The prevalence of anxiety was 34% amongst adults receiving treatment and 24.5% amongst those under watchful waiting. The prevalence of depression amongst adults receiving treatment was 31.3%, significantly higher than 16.1% of adults under watchful waiting. Conclusion: Overall, adults with haematology cancer were at greater risk of experiencing anxiety and depression than the general population, with greatest risk in those under treatment. The findings indicate the need for future research to examine availability and effectiveness of targeted psychological interventions. [ABSTRACT FROM AUTHOR]

This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index‐Service Prioritization Decision Analysis Tool (VI‐SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap‐around supportive housing to address poor health outcomes. [ABSTRACT FROM AUTHOR]

The Care Act 2014 imposed new statutory duties on English local authorities in relation to family or informal carers and it broadened carers' statutory entitlements to assessment, care and support, irrespective of eligibility for local authority funding of the person they care for. Despite this legislative framework, local authorities appear to be translating the new legal obligation into practice in different ways. This paper draws on evidence from in‐depth interviews held during 2017–2018 with key stakeholders in three English local authorities to investigate whether and how local efforts meet the Act's intention of supporting carers. We explored local goals associated with supporting carers, local authorities' approaches to needs assessment and service provision as well as barriers and facilitators to adoption of the new legal obligations towards carers. The paper draws on Twigg, J., & Atkin, K. (1995), typology to explore perceptions of local stakeholders of the interaction between formal care system and carers post‐Care Act. The findings indicate that despite a clear Care Act emphasis on meeting carers' needs, when faced with financial constraints the formal care system approaches carers mainly as a resource and often supports carers to keep cared‐for people away from health and social care systems. Although replacement care is a vital element in the Care Act's ambitions to support carers, in sampled authorities, it was often newly being subject to needs thresholds and financial assessment of people they care for, leading to reported conflicts of interests between carers' needs and those of cared‐for‐people. The Care Act is nonetheless seen as having made progress in legitimising carers' needs as clients. Social care professionals increasingly emphasise the importance of meeting carers' needs and well‐being as valued and desirable outcomes. [ABSTRACT FROM AUTHOR]

Young carers support family members affected by disability or a health condition. The Young Carer Bursary Program aims to support young carers' education. This paper analysed data from consenting bursary applicants (2017–2019) to investigate relationships between wellbeing, educational attendance, home study and other factors. Descriptive statistics, correlation and regression analysis determined significant issues, relationships and influential factors related to young carer (N = 1,443) wellbeing and education. Sixty‐eight percent were aged between 13 and 18 years and attended secondary school. One third of the sample reported that they were the main carer in their family and 29% reported receiving no support. Female applicants from single parent households who were the main carer attended educational settings less often. Eighteen percent (n = 267) rated their wellbeing as poor/very poor. Better wellbeing was associated with increased educational attendance (rs = 0.33, p < 0.001) and home study (rs = 0.34, p < 0.001). Wellbeing was associated with main carer status, caring for a parent, having a disability, being older and having few supports. Educational attendance was associated with main carer status, higher care load and fewer supports. Home study was associated with having a disability, caring for a sibling, caring for more than 11 hr per week and having fewer supports. Important factors about the age, life situation and challenges experienced by young carers identified in this paper indicate that further research into preferred supports and effectiveness of the bursary in improving educational engagement is warranted. [ABSTRACT FROM AUTHOR]

Aim. This paper aimed to examine the current state of nurse safety behavior, and the effect of work engagement on it, and to explore the mediating effect of self-efficacy between work engagement and nurse safety behavior in specialized cancer hospitals. Background. Nurse safety behavior affects the quality of care and outcomes for patients with cancer. The research proves that self-efficacy is associated with work engagement, but the relationship between self-efficacy, work engagement, and nurse safety behavior needs to be clarified. Methods. This study used a convenience sampling method to survey 957 nurses from January to February 2023. The survey included tertiary specialized cancer hospitals in five provinces in China. Sociodemography information, the Work Engagement Scale, the Self-Efficacy Scale, and the Nurse Safety Behavior Scale were used for the survey. A Questionnaire Star program collected all the data automatically. The Statistical Package for the Social Sciences version 24 was employed for Pearson correlation and multiple regression analysis to examine the association between work engagement, self-efficacy, and nurse safety behavior. Structural equation models were built using Analysis of Moment Structures version 24.0 software. Results. The results showed that the nurse safety behavior was at a high level in specialized cancer hospitals. There was a significant positive relationship between the variables work engagement, self-efficacy, and nurse safety behavior with coefficients ranging from 0.244 to 0.564. The results of structural equation modeling revealed that self-efficacy partially mediated the effect between work engagement and nurse safety behavior, accounting for 25.3% of the total effect. Conclusion. Self-efficacy mediates the relationship between work engagement and nurse safety behavior, and by increasing self-efficacy, nurse safety behavior can be improved, thus ensuring patient safety. Implications for Nursing Management. Managers should promote high work engagement and nurse safety behaviors by fostering nurses' self-efficacy. [ABSTRACT FROM AUTHOR]

Background. With the continuous advancement of clinical application and experimental research of JTP, the application prospect of JTP in nervous system diseases and metabolic diseases is becoming increasingly clear. Jiaotai Pill (JTP) is a traditional Chinese medicine formula for insomnia, consisting of Coptidis rhizoma and Cinnamomi cortex, which dates back to Han Shi Yi Tong in the Ming Dynasty of China. Objective. Based on the brain-gut axis theory, this paper aims to explore the potential mechanism of JTP in the intervention of insomnia by using intestinal microbiome and metabolomics technology, taking the animal model of insomnia as the research object, so as to provide experimental basis for its further application and research. Methods. The insomnia mouse model was induced by intraperitoneal injection of para-chlorophenylalanine (PCPA). The clinical equivalent dose of JTP was administered by gavage for one week. The efficacy of JTP was evaluated by behavioral tests, serum biochemical detection, and brain histomorphological observation. The contents of cecum were analyzed by microbiomics and metabolomics. Results. The results show that insomnia caused by PCPA led to daytime dysfunction, higher HPA axis hormone levels, and morphologically impaired hippocampus. JTP reversed these anomalies. Omics research indicates that JTP significantly reduced gut α diversity; at the phylum level, JTP reduced the relative abundance of Firmicutes, Deferribacterota, Cyanobacteria, and Actinobacteriota and increased the relative abundance of Verrucomicrobiota, Proteobacteria, and Desulfobacterota. At the genus level, JTP reduced the relative abundance of Muribaculaceae, Lachnospiraceae_NK4A136_group, Alistipes, Colidextribacter, Muribaculum, and Mucispirillum and increased the relative abundance of Bacteroides and Akkermansia. JTP also reversed the activation of the linoleic acid metabolism pathway induced by insomnia. The combined analysis of omics suggests that JTP may play a role by regulating the inflammatory state of the body. Further gene expression analysis of brain tissue confirmed this. Conclusions. We hypothesize that JTP may achieve insomnia relief by eliminating inflammation-causing bacteria in the gut and reducing inflammation levels through the brain-gut axis, pointing to potential targets and pathways for future research on JTP. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to examine the effects of a learning programme for nurse managers on connecting learning with their own experiences and fostering competence. Background: In Japan, second‐level programmes for certified nurse administrators represent the main opportunity for formal training for nurse managers. However, it is difficult for nurse managers to transfer second‐level programme learning to their workplace. Methods: This quasi‐experimental study used a two‐group pretest–posttest design with purposive sampling and non‐random assignment of 29 consenting Japanese nurse managers who were participating in a second‐level programme through a prefectural nursing association. The programme provided reflection papers and feedback from a researcher, as well as reflective group sessions. The outcome measure was the Japanese First‐Line Nurse Managers Competence Inventory (JNMCI) score. Results: The intervention group showed significant improvement in JNMCI scores after participating in the programme. A significant difference in JNMCI scores was also observed between the intervention and comparison groups. Conclusion: This learning programme led to improved competency among nurse managers. Implications for Nursing Management: Nurse manager development programmes should include reflection papers and feedback, as well as reflective group sessions, to improve competency among nurse managers. [ABSTRACT FROM AUTHOR]

This paper constructs a platform framework for extensive data analysis of college students' psychological quality with the help of the thinking mode of big data and related technologies and proposes the construction principles, data sources, data processing methods, data platform construction, and platform application of big data analysis platform for college students' psychological quality assessment. This paper combines the application methods of big data technology, collects the management data related to the psychological quality assessment of college students, saves them into the system database with certain storage logic, and realizes the function of psychological quality assessment through the design of selected psychological quality assessment data, data management and data resource management and other parts based on the data results of extensive data analysis. This study provides some insights into the psychological quality assessment of college students. The strength of association between the variables of psychological quality assessment of college students changes over time, but the overall psychological structure is more stable. This stable psychological structure characteristic is conducive to constructing the policy of constant psychological education in large universities. [ABSTRACT FROM AUTHOR]

Informal carers play a vital part to ensuring that individuals in need of care, due to illness or disability, continue to experience a good quality of life. Care provision has been studied extensively, however, little is known about the associations of discontinuing care. This knowledge is important not only to ensure that informal carers are supported, even after caring episode, but also to ensure the care‐recipients are not left without support. By conducting longitudinal analysis of the English Longitudinal Study of Ageing (ELSA), this paper uniquely starts to unveil the associations of discontinuing the caring role and the patterns of care provision prior to discontinuing. A multivariable binary regression analysis was conducted of the ELSA waves 7 (2015) to 8 (2017), total sample size of N = 6,687. 10.5% (n = 701) respondents were identified as discontinued carers. The dependent variable was care provided in wave 7 but not in wave 8 (a discontinued carer), compared to providing care in both waves (a continuing carer). Socio‐demographic, such as age, gender, marital status, economic activity and health acted and caring patterns, such as intensity and relationship with care‐recipient, acted as independent variables. Results showed nearly 30% of discontinued carers had provided care to a spouse. Nearly a quarter of continuing carers had transitioned between care‐recipients, which raises the question of a potential 'Serial Carer Trajectory'. The regression analysis noted that being divorced or widowed increased the odds of discontinuing care. Providing 20–49 hr of care per week was associated with lower odds of discontinuing the role. This paper suggests that policymakers should take a holistic approach to policies to support carers through all stages of their caring journey, including after discontinuing the caring role. This could ensure carers settle into life post‐caring and continue to feel valued and recognised. [ABSTRACT FROM AUTHOR]

Objective. This study aims to explore the mediation role of perceived stress between nonrestorative sleep (NRS) and emotional distress, as well as the moderation role of resilience among NRS, perceived stress, and emotional distress in university students. Method. We recruited 851 students from the Be Resilient to Nursing Career program (BRNC, registration number: NFYKDX002) in June 2022. Nonrestorative sleep scale (NRSS), 10-item perceived stress scale (PSS-10), 10-item Kessler psychological distress scale (K10), and 10-item Connor–Davidson resilience scale (CD-RISC-10) were administered through a paper questionnaire. Latent profile analysis and moderated mediation analysis were performed. Results. Three profiles of perceived stress were identified: high ability-low stress (24.5%), middle ability-high stress (65.0%), and low ability-middle stress (10.5%). The mediation role of perceived stress between NRS and emotional distress was significant (SE = 0.025; 95% confidence interval = −0.369, −0.269). The moderation role of resilience among NRS, perceived stress, and emotional distress was not significant. Conclusion. Heterogeneity exists in freshmen students' perceived stress. Perceived stress plays a significant mediating role between NRS and emotional distress, while resilience cannot significantly moderate the associations among NRS, perceived stress, and emotional distress. The trial is registered with ChiCTR2000038693. [ABSTRACT FROM AUTHOR]

Social enterprises, which are businesses with social objectives, have been championed by the UK government as an opportunity to deliver more innovative, socially oriented, and commercially sustainable public services. However, very little is known about them, especially in a social care context. This paper therefore aims to answer the following three questions: (1) What are care social enterprises?, (2) What are their distinctive qualities?, and (3) How can they contribute to the adult social care sector? It presents evidence from a "mapping" of care social enterprises in three English local authorities, and from interviews with 35 stakeholders from across the social care and social enterprise sectors. Drawing on an institutional logics framework, we explore the influence of different norms, goals, and practices on care social enterprises and the extent to which they are aligned with those of the public, private, and not-for-profit sectors. We found that their unique combination of business and social logics, along with an entrepreneurial mindset, may make them more flexible, innovative, and able to diversify their income than public and not-for-profit care organisations. They were also considered more trustworthy than private care services. However, their competing social and business logics can create internal tensions and bring uncertainty about what organisational model they are. These tensions can make it challenging for us to define what a care social enterprise is and in turn for social enterprises to promote themselves and attract funding. [ABSTRACT FROM AUTHOR]

In order to explore and analyze the effect of music therapy interventions on college students with excessive anxiety, this paper selected 240 year 2017- to year 2020-enrolled undergraduates from a comprehensive university in Taiyuan City, Shanxi Province, in Central China as research objects. These college students had been diagnosed as excessive anxiety and were randomly divided into two groups—intervention group and control group—with 120 students in each group. The control group received conventional mental health treatment for college students, while the intervention group received music therapy interventions on this basis with 3 times a week for 24 times. The instruments used in the music therapy include piano, percussion instruments, melodic instruments, and diffuse instruments; the specific implementation of each therapy is divided into five parts: warm-up, rhythm percussion, song singing, instrumental ensemble, and music appreciation. The study results show that before treatment, the excessive anxiety score of college student in the control group was 63-76 with an average score of 72.58 ± 5.27 ; after treatment, that was 45-64 with an average score of 54.46 ± 6.82 ; before treatment, the excessive anxiety score of college student in the intervention group was 62-78 with an average score of 72.56 ± 5.51 ; after treatment, that was 26-44 with an average score of 33.19 ± 5.51. Before treatment, there was no significant difference in the excessive anxiety scores between the two groups of college students (P > 0.05); after treatment, the excessive anxiety scores of the two groups were lower than those before treatment, and the reduction degrees in the intervention group were bigger than those in the control group, with statistically significant difference (P < 0.05). Therefore, music therapy interventions can significantly reduce the excessive anxiety of college students; the analysis also shows that factors such as gender, grade, major, origin, repertoire type, therapy type, and anxiety type could affect the effect of music therapy interventions to some certain extent. For example, the effect of music therapy interventions on college students in psychology or related majors is better than that of students in other majors; the effect of receptive music therapy is better than that of creative and improvised music therapy; the effect of music therapy interventions on college students' life event, romantic relationship, and social anxiety is better than that on college students' test and job-hunting anxiety. [ABSTRACT FROM AUTHOR]

Objective. The purpose is to understand the depression status of the elderly in the community, explore its influencing factors, formulate a comprehensive psychological intervention plan according to the influencing factors, implement demonstration psychological intervention, and evaluate and feedback the effect, so as to provide a reference for improving the mental health of the elderly. Method. In order to make the output of different emotional data in LSTM more discriminative, a method to dynamically filter the output of LSTM is proposed. Combining the methods of Attention-LSTM, time-dimensional AI attention, and feature-dimensional AI attention, the best model in this paper is obtained. The multistage stratified cluster sampling method was used to conduct a questionnaire survey on the elderly aged 60 and above in a certain area, including the general demographic characteristics questionnaire of the elderly, the self-rating scale of mental health symptoms, and the health self-management ability of adults. All data were entered into a database using Excel software, and SPSS 19.0 statistical software was used for statistical analysis. Results/Discussion. The detection rate of depression (GDS ≥ 11 points) among the elderly in a community in a certain area was 39.38%. Multivariate logistic regression analysis showed that family history of mental illness, more negative life events, decreased ability of daily living, living alone, and suffering from physical diseases in the past six months were the risk factors for depression in the elderly. Community health education can partially alleviate depression in the elderly. The detection rate and degree of depression of the elderly in the comprehensive psychological intervention group were significantly lower than those in the control group, and the difference was statistically significant (P < 0.05). [ABSTRACT FROM AUTHOR]

Objective. Evidence-based research methods were applied to assess the efficacy of faecal microbiota transplantation (FMT) for the treatment of autism in children. Methods. We searched the Chinese Biomedical Literature, CNKI, Wanfang, PubMed, Embase, Web of Science, and the Cochrane Library databases to collect randomised controlled trials on faecal microbiota transplantation for the treatment of autism in children. The search included studies published from the creation of the respective database to 5 April 2022. Literature screening, data extraction, and quality evaluation were implemented by three investigators according to the inclusion and exclusion criteria. The meta-analysis was performed using the RevMan 5.1 software. Results. Nine studies with population-based subjects and four studies with animal-based subjects were included. Five papers were screened for the meta-analysis. The results showed that FMT markedly reduced Autism Behaviour Checklist (ABC) scores in children with autism spectrum disorder (weighted mean difference (WMD) = −14.96; 95% confidence intervals (CI), −21.68 to −8.24; P < 0.001 ; I2 = 0%). FMT also reduced Childhood Autism Rating Scale (CARS) scores (WMD = −6.95; 95% CI, −8.76 to −5.14; P < 0.001 ; I2 = 28.1%). Conclusion. Our results indicate that FMT can benefit children with autism by reducing ABC and CARS scores, but more high-quality studies are needed to verify these results. [ABSTRACT FROM AUTHOR]

Domiciliary care workers (DCWs) continued to provide care to adults in their own homes throughout the COVID‐19 pandemic. The evidence of the impact of COVID‐19 on health outcomes of DCWs is currently mixed. The OSCAR study will quantify the impact of COVID‐19 upon health outcomes of DCWs in Wales, explore causes of variation and extrapolate to the rest of the UK DCW population. An embedded qualitative study aimed to explore DCW experiences during the pandemic, including factors that may have varied risk of exposure to COVID‐19 and adverse health and wellbeing outcomes. Registered DCWs working throughout Wales were invited to participate in a semi‐structured telephone interview. 24 DCWs were interviewed between February and July 2021. Themes were identified through inductive analysis using thematic coding. Several themes emerged relating to risk of exposure to COVID‐19. First, general changes to the role of the DCW during the pandemic were identified. Second, practical challenges for DCWs in the workplace were reported, including staff shortages, clients and families not following safety procedures, initial shortages of personal protective equipment (PPE), DCW criticism of standard use PPE, client difficulty with PPE and management of rapid antigen testing. Third, lack of government/employer preparation for a pandemic was described, including the reorganisation of staff clients and services, inadequate or confusing information for many DCWs, COVID‐19 training and the need for improved practical instruction and limited official standard risk assessments for DCWs. Pressure to attend work and perceptions of COVID‐19 risk and vaccination was also reported. In summary, this paper describes the risk factors associated with working during the pandemic. We have mapped recommendations for each problem using these qualitative findings including tailored training and better support for isolated team members and identified the required changes at several socio‐ecological levels. [ABSTRACT FROM AUTHOR]

In recent years, Meals on Wheels (MoW) services have been in a state of decline as austerity policies have become entrenched. However, this decline is occurring with little knowledge of the impact withdrawal of MoW services has on the health and well‐being of those who use them. The pandemic has raised awareness of precarity and vulnerability in relation to food that affects many people in the UK and other Westernised countries and this provides further context for the analysis presented. This paper presents findings of a mixed methods ethnographic study drawing on qualitative interviews and visual methods underpinned by social practice theory to explore the household food practices of older people receiving MoW services. Interviews were conducted with 14 older people receiving MoW, eight MoW staff delivering MoW services in the east of England and one expert. The Covid‐19 pandemic interrupted the study, and once the first lockdown began visits to the homes of older people were terminated and the remaining interviews were undertaken by telephone. The study found that a number of threats accumulated to change food practices and moved people towards vulnerability to food insecurity. Threats included difficulty accessing food and cooking due to sensory and physical challenges. The MoW service increased participants' coping capacity. As well as benefiting from the food provided, the relational aspect of the service was important. Brief encounters between MoW staff built caring relationships that developed over time to ensure older people felt valued and cared for. The study demonstrates how MoW services make a positive contribution to food practices, supporting vulnerable adults to continue living well in their own homes and protecting them from food insecurity and ill‐being. Local authorities looking to make cost savings through ending MoW services should consider the impact this would have on the well‐being of older residents. [ABSTRACT FROM AUTHOR]

Women in low‐ and middle‐income countries where the prevalence and mortality of breast cancer are growing rapidly are more likely to be diagnosed at advanced stages, which negatively affects their treatment outcomes and chance of survival. The current literature in those settings tends to focus largely on explaining patient delay in seeking medical attention for breast symptoms. Meanwhile, little is known as to what prompts women to attend screening and diagnostic services after discovering symptomatic breasts. Drawn upon the data from in‐depth interviews with 33 breast cancer patients in Central Vietnam conducted in 2019, this paper examines the context of women's decisions about breast screening and how the practice of seeking cancer diagnosis occurred. Our findings reveal an absence of a national screening program and that seeking medical advice was conducted on an ad hoc basis after self‐detection of breast symptoms. Women's interpretations of symptomatic breasts as suspicious signs of cancer, the co‐occurrence of important life events, or encouragement by people in their social network motivated women to seek medical attention at different public and private health facilities. Their encounters with the health sector often involved multiple visits across time and space in which they experienced various forms of diagnosis delay produced by the health system. Our study carries implications for interventions to encourage women's awareness of early cancer symptoms and prompt medical presentation after self‐discovery of symptomatic breasts. [ABSTRACT FROM AUTHOR]

The role of formal volunteering in mental health promotion among older adults in China has been widely discussed during recent decades. However, the relationship connecting mental health with cross‐level interaction (i.e., average levels of participation in the community vs. individual participation) is still unclear. This paper examined the effects of cross‐level formal volunteering on depressive symptoms among older adults living in China. Using two waves of the China Longitudinal Aging Social Survey, a sample of 3128 Chinese older adults was surveyed in 2014 and 2016. Depressive symptoms were measured using the abbreviated CES‐D‐9. Individual fixed‐effects ordinary least squares regression models assessed the associations between individual‐ and community‐level formal volunteering and depressive symptoms in urban and rural areas separately. We found that in the urban sample, formal volunteering activities were negatively associated with depressive symptoms at the individual level (β = −0.49, SE = 0.22, p < 0.05). Higher community‐level formal volunteering was positively associated with depressive symptoms (β = 2.82, SE = 1.42, p < 0.05). When adding interactions between individual and community levels, engagement in individual‐level formal volunteering was associated with lower rates of depressive symptoms as community volunteering participation levels increased (β = −3.07, SE = 1.07, p < 0.01). High community‐level volunteering participation was detrimental for non‐volunteers. In rural areas, neither community‐ nor individual‐level formal volunteering was associated with changes in depressive symptoms. The current findings demonstrate formal volunteering may not always benefit mental health for all. The effects may depend on the community context and individual choices. Social policies aimed to promote mental health through formal volunteering need to be tailored according to the specific community social environment. [ABSTRACT FROM AUTHOR]

Translation of evidence into practice in healthcare is challenging, particularly with new innovations. Indocyanine Green (ICG) lymphography is a novel innovation where the superficial lymphatics are imaged to provide information about lymphoedema diagnosis and to guide individualised therapy for a person's long‐term chronic management of lymphoedema, supporting care across the continuum to the community setting. Despite the unique information ICG lymphography provides, the technology itself is complex and highly specialised and currently has limited adoption in clinical practice. This paper sought to determine the barriers and enablers to establishing an ICG lymphography clinic within an outpatient lymphoedema service by exploring staff perceptions and experiences. An interpretive descriptive design was used with semi‐structured interviews of key staff participants from a quaternary public hospital six months after ICG lymphography clinic establishment. An interview guide was developed, underpinned by the Consolidated Framework for Implementation Research (CFIR), to guide the inquiry. Interview data were transcribed, inductively coded and analysed to identify themes. All eligible management, clinical and ancillary staff were included (N = 8). Four key themes were identified from the data as essential to implementation success. These were support is critical for implementation; beliefs about the technology; practicalities are achievable; and sustainability for ongoing success. Themes were found to be interrelated and centred around support from staff and the organisation as a critical process facilitator. The study demonstrated an ICG lymphography clinic can be successfully established as part of an outpatient lymphoedema service. Key enablers related to positive staff attitudes and beliefs about ICG lymphography and its application. Future implementation sites may consider that although the complexity of this innovation creates process challenges, the use of an implementation framework can assist in identifying determinants of success for effective implementation to practice. [ABSTRACT FROM AUTHOR]

Entrustable professional activities (EPAs) is a recent concept that helps operationalise competency‐based education. In this paper, we report on the development of EPAs and incorporation into an e‐portfolio for work‐based assessment of final year dietetics students in a community and public health professional placement. We aimed to determine the utility of the EPAs for work‐based assessment in this context. We used action research methodology to conduct broad consultation with students and supervisors using anonymous surveys and focus groups to understand their beliefs and attitudes towards work‐based assessment. Consequently, 40 EPAs with an accompanying four‐point entrustment scale were developed and mapped to the National Competency Standards for Dietitians in Australia. The EPAs and assessment tool were piloted and evaluated via an anonymous online user survey across three cohorts of students (n = 133) and supervisors (n = 67). Following mediocre pilot year evaluation results, EPAs were revised and reduced in number. While students positively evaluated the e‐portfolio, their appraisal of the EPAs and entrustment scale was less positive compared to supervisors. Supervisor evaluation of the EPA‐based e‐portfolio supported the validity, feasibility and acceptability of this novel assessment method in a community and public health setting. Assessment using EPAs, and the resulting educational data collected by the tool, offers potential for individual learners to identify areas needing development during placement, as well as potential to inform curriculum improvements and increase understanding of learning opportunities and outcomes for dietetic students in community and public health settings. [ABSTRACT FROM AUTHOR]

Chronic pain is common in older people. However, little is known about how pain is experienced in residents of retirement villages ('villages'), and how pain intensity and associations are experienced in relation to characteristics of residents and village living. We thus aimed to examine pain levels, prevalence and associated factors in village residents. The current paper is a cross‐sectional analysis of baseline data from the 'Older People in Retirement Villages' study in Auckland, New Zealand. Between July 2016 and August 2018, 578 village residents were interviewed face‐to‐face by gerontology nurse specialists, using interRAI Community Health Assessment (CHA) and customised survey. We used a validated pain scale and multivariable logistic regression analyses adjusted for pre‐specified confounders. Residents' median age was 82 years; 420 (73%) were female; 270 (47%) exhibited/reported daily pain, and in 11% this was severe. After controlling for confounders, daily pain was positively associated with self‐reported arthritis (OR = 3.88, 95% CI = 2.57–5.87), poor/fair self‐reported health (OR = 3.19, 95% CI = 1.29–7.93), having no health clinic on‐site (OR = 1.76, 95% CI = 1.10–2.83), and minimal fatigue (diminished energy but completes normal day‐to‐day activities) (OR = 1.77, 95% CI = 1.11–2.81). Similar associations were observed for levels of pain. We conclude that levels of pain and prevalence of daily pain are high in village residents. Self‐reported arthritis, self‐reported poor/fair health, no health clinic on‐site and minimal fatigue are all independently associated with a higher risk of daily pain and with levels of pain. This study suggests potential opportunities for villages to better provide on‐site support to decrease prevalence and severity of pain for their residents, and thus potentially increase wellbeing and quality‐of‐life, though as we cannot prove causality, more research is needed. [ABSTRACT FROM AUTHOR]

Little is known about the reason behind the underutilisation of community pharmacy (CP) for children. This study explored the experiences, barriers and recommendations of parents/carers and young people regarding their use of CP services for children. Two‐stage facilitated, structured, audio‐recorded interviews were conducted at each of four CPs in London, England, between May and November 2019 [1 month in each CP]. Parents/carers or young persons (aged 16–18 years) who visited CP for a child‐related matter were invited to participate. Interviews were transcribed verbatim. Data were analysed both quantitatively and qualitatively, using thematic analysis to identify themes. In total, 249 (58.2% of 428 eligible) customers agreed to participate and completed the two interviews. Out of these, 82.3% (205/249) reported positive experiences with the CP. The general practitioner (GP) was the preferred healthcare provider for minor ailments (44.6%,111/249), while 35.7% (89/249) would choose CP. Eighty‐two participants (33%) visited an Emergency Department in the last 12 months, with 13.4% (11/82) of them visited for cold and cough reasons. Where a child was present with parents/carer (128/249), there was a low level of interaction between children and pharmacists (13.3%, 17/128). Lack of awareness about the CP services provided for children and privacy were among the barriers identified by participants. Advertising of CP services and creating a child‐friendly environment were recommendations suggested by participants. The findings of this paper show that CP remains an underutilised health service for children by parents/carers and young persons. More work is needed to increase public awareness of the roles of CP in children's health and well‐being. [ABSTRACT FROM AUTHOR]

Objective. This paper aims to systematically evaluate the intervention effect of mind-body exercise on cancer-related fatigue in breast cancer patients. Methods. Databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and SINOMED were retrieved to collect randomized controlled trials on the effects of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. The retrieval period started from the founding date of each database to January 6, 2021. Cochrane bias risk assessment tools were used to evaluate the methodological quality assessment of the included literature, and RevMan 5.3 software was used for meta-analyses. Results. 17 pieces of researches in 16 papers were included with a total of 1133 patients. Compared with the control group, mind-body exercise can improve cancer-related fatigue in breast cancer patients. The combined effect size SMD = 0.59, 95% CI was [0.27, 0.92], p < 0.00001. Doing Tai Chi for over 40 minutes each time with an exercise cycle of ≤6 weeks can improve cancer-related fatigue in breast cancer patients more significantly. Sensitivity analysis shows that the combined effect results of the meta-analysis were relatively stable. Conclusion. Mind-body exercise can effectively improve cancer-related fatigue in breast cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early‐stage and advanced CRC survivors. Methods: CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis. Results: Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early‐stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas. Conclusion: CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment‐specific impacts on QoL and long‐term (>5 years) impacts on CRC survivors. [ABSTRACT FROM AUTHOR]

Aim: This study aims to design a 100‐h training programme for nursing innovation teams and to evaluate the effect of this training programme using Kirkpatrick's model. Background: The innovative capability of nurses is a powerful driver for the development of the nursing discipline, and it is currently at a low to medium level in China. Innovation competency development has become a research trend in nurses' in‐service education, but only changes in nursing innovation behaviours before and after training have been evaluated. The cascading, continuous assessment tools are rarely used. Methods: This is a quasi‐experimental research design: pretest and posttest design. Totally, 61 clinical nurses from Hangzhou Hospital of Traditional Chinese Medicine were enrolled for innovation training. This innovation team training programme consisted of a 36‐h theoretical training phase and a 64‐h collaborative training phase. The four levels of Kirkpatrick's model, that is, reaction, learning, behaviour, and result, were applied for the evaluation together with questionnaires. Results: At reaction level, the nurses' attendance was over 85% in two phases. The differences between nurse organizational innovation climate scores of tested nurses before and after training were statistically significant (t = −22.559, P <.001). At learning level, there were statistically significant differences between nurses' innovation self‐efficacy scale scores of tested nurses before and after training (t = −16.832, P <.001). At behaviour level, the nursing innovation behaviour scale scores of tested nurses were significantly higher after training (t = −18.950, P <.001) than before the training. At result level, the clinical nurse innovation ability of tested nurses after the training were higher than before the training (t = −26.275, P <.001). The numbers of patent applications, granted patents, application for scientific research projects, sponsored scientific research projects, and papers published by team members after the training were larger than those before training (Z = −2.032, P =.042). Conclusion: Kirkpatrick's model can evaluate the effectiveness of nursing innovation training for clinical nurses. The nursing innovation training is beneficial to improve nurses' innovation capacity, organizational innovation climate and innovation self‐efficacy, and nursing innovation behaviour and promote the output of research and innovation projects. Implications for Nursing Management: Managers can flexibly develop training modules with regional characteristics based on this programme to effectively improve the innovation ability of clinical nurses, thus meeting the urgent demand for innovative nursing talents and the rapid development of nursing disciplines. [ABSTRACT FROM AUTHOR]

Aims: To analyze whether patient verbal aggression would be related to emotional exhaustion and whether this relationship would be mediated by work–family conflict and moderated by dehumanization and resilience. Background: Although patient verbal aggression has been identified as one of the most experienced forms of aggression, its effects on Italian health care providers during the pandemic are still poorly known. Methods: A total of 197 Italian health care professionals completed paper‐and‐pencil questionnaires. Descriptive statistics and moderated mediation analyses were performed. Results: Patient verbal aggression was positively related to health care professionals' emotional exhaustion, both directly and indirectly, as mediated by work–family conflict. Health care providers were more likely to become emotionally exhausted when they had low resilience and, simultaneously, tended to ascribe patients non‐uniquely human traits. Conclusions: Patient verbal aggression may spill over onto health care professionals' family lives. Dehumanization represents an ineffective coping strategy that exacerbates the effects of aggression on work–family conflict, whereas resilience represents a protective resource against emotional exhaustion. Implications for nursing management: Hospital organisations could benefit from providing their staff with stress management interventions, aggression management, psychological support and psychological resilience training programmes. These programmes should incorporate coping skills on establishing work–home boundaries and balancing empathy with cognitive problem‐solving abilities. [ABSTRACT FROM AUTHOR]

This study explores the experiences of professionals who worked with care home residents with impaired mental capacity in England and Wales during the COVID‐19 pandemic. It explores (i) how competing risks were balanced and (ii) how the Mental Capacity Act (MCA) functioned in care homes under pandemic conditions, with particular focus on its associated Deprivations of Liberty Safeguards (DoLS) and Independent Mental Capacity Advocacy (IMCA) systems. Between March and May 2021, we held an online survey and five focus groups aimed at professionals who worked in or with care homes during the pandemic. The study explored issues pertaining to residents with impaired mental capacity, alongside several other topics on which we report elsewhere. For this paper, we filtered data to only include responses from 'capacity professionals'. The resulting sample comprised 120 (out of 266) survey participants and 18 (out of 22) focus group participants. We performed manifest content analysis on the filtered data and found that (1) participants reported a 'massive discrepancy' between the ways different care homes balanced the risk of COVID‐19 infection with the risks associated with severe restrictions. (2) Some suggested this was due to vague guidance, as well as care home type and size. Participants told us the pandemic (3) obstructed smooth operation of statutory safeguards designed to protect residents' human rights and (4) resulted in confusion about the remit of the MCA during a public health crisis. Our findings raise concerns about the impact of pandemic‐related measures upon care home residents with impaired mental capacity. We urge further exploration and analysis of (a) the variability and inconsistency of restrictions applied at care homes, (b) the strain placed on key safeguards associated with the MCA, (c) uncertainty about the remit of the MCA during a public health crisis and (d) the human rights implications hereof. [ABSTRACT FROM AUTHOR]

An infinite number of fitness apps are available on various app stores. However, hardly any of them are fitted to the needs and requirements of care‐dependent people. This paper investigates the effectiveness of a customised fitness‐app prototype for increasing physical activity in home care service users. Home care service users from Austria and Italy were randomly assigned to two groups. In total, 216 participants were involved in the field trial, 104 received a tablet with the fitness app and an activity tracker (treatment group), 112 did not (control group). Regularity of physical activity, frequency of fitness exercises and walking behaviour were self‐reported by participants at baseline, after 4 months and after 8 months. In addition, the frequency of using the prototype was assessed based on the fitness app's logged usage data. We estimated multilevel mixed‐effects ordered logistic models to examine the effects of the intervention. After 4 months, the intervention increased the home care users' probability of agreeing strongly with being physically active on a regular basis by 28 percentage points (p < 0.001; 95% CI: 0.20, 0.36) and their probability of reporting to exercise more than once a week by 45 percentage points (p < 0.001; 95% CI: 0.32, 0.57). Walking behaviour was not affected on group‐level but improved for frequent users of the activity tracker. Frequent and regular users of the fitness app benefited most and effects persisted until the end of the 8 months controlled trial. Tailoring a fitness‐app prototype to the needs of care‐dependent people has the potential to support people with functional limitations to engage in a more active lifestyle. Future research is encouraged to seek further insights into how new technologies can support physical activities in people with long‐term care needs. [ABSTRACT FROM AUTHOR]

This paper presents findings from the evaluation of an Australian trial of self‐managed home aged care. The self‐management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self‐management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self‐managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre‐test post‐test quasi‐experimental design and mixed‐methods design were used to collect data over nine months in 2018–2019. The pre‐trial methods and findings have been published. The post‐trial evaluation replicated the pre‐trial data collection method of an online survey (n = 60) and semi‐structured telephone interviews with consumers (n = 9), family carers (n = 13), and consumers and carers jointly (n = 2), totalling 24 interviews. Semi‐structured telephone interviews were also conducted with CEOs and senior managers from each of the seven providers (n = 14). Three providers had prior experience supporting self‐management. Parametric and non‐parametric tests examined the statistical data. Qualitative data were analysed thematically and framed according to self‐determination principles and ecological systems theory. Both datasets demonstrated that consumers reported greater choice and control at post‐trial than pre‐trial. This finding was not affected by providers' prior experience with self‐management; therefore, it was not a confounding factor. Participants reported improved wellbeing in interviews, however this was not reinforced statistically. Key desirable features of self‐management included greater autonomy and control over spending, recruiting support staff and paying lower administration fees. There was no evidence of increased risks or fraud. The research limitations included a small sample size, convenience sampling with providers recruiting interview participants, no control group and differences in trial implementation. The findings support the expansion of self‐management opportunities and more comprehensive evaluations that use mixed methods. [ABSTRACT FROM AUTHOR]

The current researchers carried out a large online survey on 18 March 2020 and unintentionally provided a 'snap shot' of how the British population was responding in the early stages of the Covid‐19 pandemic. This paper aims to investigate the relationship between loneliness and mental health at the early stages of the global crisis. This cross‐sectional study was carried out using Prolific, an online participant recruitment platform that allowed 1608 responses in just 2 hr. Participants completed measures of Personal Well‐being, Psychological Distress, Flourishing and Loneliness. Numerous associations between loneliness and mental health were found. A multiple regression found that 43% of the variance in loneliness can be accounted for by age, psychological distress and flourishing. Responses were also categorised into three groups: the non‐lonely (n = 311), averagely lonely (n = 1054) and the severely lonely (n = 243), with analysis indicating that poorer well‐being was associated with increased loneliness. Due to the cross sectional nature of this research, determining the direction of causality is not possible. It remains uncertain whether increased loneliness negatively impacted on mental health, whether poor mental health lead to increased loneliness, or both in fact. Current findings suggest that severely lonely individuals may be particularly vulnerable to psychological distress and that individuals with poor mental health may be especially prone to loneliness. Individuals experiencing loneliness and/or poor mental health will almost certainly need additional support during and beyond the pandemic. [ABSTRACT FROM AUTHOR]

Healthcare professionals' advice on lifestyle behaviours is a key factor in improving a nation's health. Although allied health professionals have been well placed to provide such advice as part of patient care, little is known about the characteristics of allied health practitioners who discuss lifestyle topics with patients. This paper focused upon an overlooked avenue for lifestyle advice regarding an allied health profession – osteopathy. A workforce survey including questions about four lifestyle topics (including diet/nutrition, smoking/drugs/alcohol, physical activity/fitness, and stress management) was distributed to a nationally representative sample of Australian registered osteopaths in 2016. Separate multivariate logistic regression and Poisson regression models were developed to determine the most important predictors of the discussion of lifestyle factors. Amongst the 992 participating osteopaths, 89%, 49%, 38%, and 18% often discussed physical activity/fitness, stress management, diet/nutrition, and smoking/drugs/alcohol with their patients, respectively. Approximately 30% of participating osteopaths discussed at least three lifestyle topics with patients. Varied predictors were identified for discussing each lifestyle topic. Osteopaths who often discuss diet/nutrition in patient management plans were more likely to often discuss smoking/drugs/alcohol (OR = 14.13), physical activity/fitness (OR = 2.71), and/or stress management (OR = 1.69). In conclusion, lifestyle factors are often discussed with patients as part of osteopathy treatments in the Australian healthcare context. Osteopaths are well positioned to initiate discussions regarding patient lifestyles, and such discussions may be an effective contribution to health promotion. [ABSTRACT FROM AUTHOR]

Objective. Therapeutic intervention can improve the overall level of mental health of American postmodern fiction writers by improving their social communication skills and overall well-being. This paper discusses the application of art therapy in the mental health education of American postmodern novel creators and proves that expressive art therapy intervention is effective in improving the mental health level of American postmodern novel creators. Method. This article attempts to help American postmodernist novel creators understand their own mental health status by means of individualized assessment and therapeutic intervention and to analyze and discover their own potential mental health problems. The writers of postmodernist novels in the USA were measured and screened by means of scales and questionnaires, and the members who met the experimental intervention were divided into experimental group and control group, and the experimental group received a 30-day reception music therapy intervention. After the intervention, the data will be counted, and the quantitative and qualitative aspects will be analyzed to comprehensively evaluate the effect of the intervention. Results/Discussion. Receptive music therapy intervention has a significant effect in relieving the anxiety of American postmodernist novel creators and plays a positive role in helping American postmodernist novel creators better adapt to study life and build good emotional psychology and interpersonal relationships. Psychological counseling relies more on external forces to correct cognition and adjust psychology, while music therapy intervention, as a nonsemantic art, can arouse inner functions and mobilize the self-healing potential of American postmodern novel creators. Practice has proven that when the language intervention of traditional psychotherapy encounters resistance and silence, music as a special language plays a vital role. The nonlinguistic nature of music, through a mode of reproduction of sounds in nature, makes the beautiful and soothing melody stimulate a pleasant and peaceful psychological experience through human hearing. [ABSTRACT FROM AUTHOR]

This paper constructs an evaluation model of occupational competency in rehabilitation therapy and applies it to the improvement of college students' innovative and entrepreneurial competencies. Based on clarifying the connotation of college students' entrepreneurial competency, this study carries out research on the evaluation system of college students' entrepreneurial competency. First, the method of qualitative research is used to conduct in-depth interviews with college students and entrepreneurial mentors to understand the views of these groups on college students' entrepreneurial competency, and the coding of the interview contents is carried out by applying the rooting theory, and finally, a theoretical model of the composition of college students' entrepreneurial competency is derived. The front-line position of talent cultivation is the construction of faculty, because the faculty with high-quality vocational ability is an indispensable prerequisite for the development of universities, and the teaching level of the faculty is the key factor for the effectiveness of teaching to appear. Based on the perspective of role theory, we analyze the problems and reasons for the lack of competency in the role-playing process; integrate the three stages of understanding the role, playing the role, and adjusting the role with the competency model; and propose strategies to improve the competency of youth social workers in the process of playing the role, to help workers accurately understand the role, correctly play the role, and reasonably adjust the role. The curriculum is designed to cultivate the competency of college student nursing positions, which is conducive to improving the professional quality of college student nursing service providers and regulating college student nursing practice so that they can actively respond to problems. This will strengthen the entire teaching faculty and enhance the professional competence of full-time teachers. [ABSTRACT FROM AUTHOR]

Demographic situation, changes in the role of women in society and growing demand for long‐term care (LTC) of older people have challenged the ability to meet the growing LTC needs in most developed countries. In countries where responsibility for LTC is still largely laid on families, it is, however, even more critical and calls for improvements in formal LTC systems. More intensive stakeholder collaboration in LTC policy development, organising and delivery are of primary importance in improving LTC systems. Such collaboration, however, is not always successful; thus, it is critical to understand what makes it effective and efficient. In this paper, we specifically look into multistakeholder collaboration in LTC in Lithuania, one of the fastest ageing countries in the EU, with the demand for LTC services growing fast and exceeding the supply despite rising business and NGO engagement. To determine facilitators of such collaboration, we build on the data obtained through eight focus group discussions with all key stakeholder representatives (LTC policymakers, organisers and service providers [public, private and NGOs], 54 participants in total). Our findings indicate that in addition to national and organisational level facilitators studied in prior research, there are important individual level factors, such as meaningfulness at work, concern and care for others, possibility for personal growth and development, satisfaction with supervision, a sense of belonging and role clarity. On the other hand, our results show that collaboration is constrained by a shortage of human resources, increased workload caused by growing LTC demand, bureaucratic requirements, legal restrictions, lack of awareness of LTC service availability among elder persons, and prevailing social norms and attitudes to institutionalised care. Interestingly, a lack of financial resources is not perceived as a major constraint. [ABSTRACT FROM AUTHOR]

Aim: By studying an extreme context, we aim to provide an in‐depth understanding of the expanded nursing role in remote aboriginal communities, its dynamics and the main barriers to its full expansion. Background: While it is recognized that nurses play a major role in remote or rural areas, little is known about the dynamics of the expanded role and the nurses' daily practice and routines. Methods: We conducted 49 in‐depth interviews with nurses and key informants and more than 14 days of observation: two days of pre‐departure training and 12 days in dispensaries and a hospital in Hudson Bay, Québec, Canada. Results: We identified four sub‐roles within the nurses' expanded role: administrative, nursing, medical and community sub‐roles. This typology allowed us to document the evolving and dynamic nature of the role as well as the individual, organisational and community barriers that limit its expansion. Conclusion: This typology represents the first attempt to gain an in‐depth understanding of the enlarged nursing role in northern Québec and of the complexity of the daily nursing routines and dynamics. We believe it to be relevant for other contexts, such as rural areas, even if nurses there do not always take on all four sub‐roles during their nursing experience. Implications for nursing management: Our paper has significant practical implications for different stakeholders—educators, directors of nursing, recruiters, regulators and policymakers—as it may help with identifying the education and training requirements for developing specific sub‐roles, overcoming obstacles to widening the expanded role or better allocating the resources needed based on the predominant sub‐role in different contexts. More broadly, this study shows that, when properly regulated, extending professional nursing boundaries does not put the patient at risk and enables professionals to develop their practice. It represents a textbook case for rethinking our contemporary health care systems. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this paper was to investigate the relationship between high‐involvement human resource management, autonomy, affective organisational commitment and innovative behaviours of nursing staff who care for elderly clients. Background: Nursing teams are increasingly required to demonstrate innovative behaviours that enhance care quality. Nursing leaders need to create environments where nursing staff have sufficient autonomy and feel a sense of commitment to support these behaviours. The appropriate implementation of these processes and practices may lead to greater involvement. Methods: A cross‐sectional survey‐based research design was employed to explore the experiences of involvement practices, autonomy, affective organisational commitment and innovative behaviours of 567 nursing staff workers from four elderly care organisations in the Netherlands. Results: The results demonstrate that a bundle of high‐involvement practices positively influences innovative behaviour and that affective commitment and autonomy fully mediate this relationship. Conclusions: The study highlights the role of autonomy and commitment as routes towards translating involvement practices into nurses' innovativeness. Implications for Nursing Management: To create an innovative environment, leaders need to create a positive climate by providing nurses with opportunities to enhance their competence, relatedness and autonomy through active involvement. Leaders should, therefore, encourage involvement as a mechanism to promote innovation. [ABSTRACT FROM AUTHOR]

There is established literature on health workers' attitudes towards working with people living with stigmatised health conditions and behaviours, such as HIV, hepatitis C and injecting drug use. Less is known about health workers' attitudes and concerns around providing care to people living with hepatitis B virus (HBV), which is concerning as research indicates that negative attitudes may impact on the quality of care provided to these populations, with adverse health outcomes for clients. The aim of this paper is to examine health and medical workers' concerns about providing care to people living with HBV, and the factors that may influence these concerns. Australian health and medical workers (n = 551) completed an online survey measuring their concerns about providing care to people living with HBV, stigmatising attitudes towards this group, perceived comfort of themselves and colleagues in providing care towards clients with HBV, and witnessing their colleagues behaviour in a discriminatory way towards clients with HBV. Multiple regression was used to ascertain factors predictive of health workers' concerns about working with clients with HBV. Results showed that older participants and those who had spent less time working in the health and medical field had greater concerns about caring for people living with HBV. Workers who did not know someone living with HBV, who were less comfortable around clients with HBV, who perceived their colleagues to be less comfortable working with clients with HBV, and who had more negative attitudes towards this group also had greater concerns around providing care to people living with HBV. Efforts should be made to improve health and medical workers' attitudes towards working with people with HBV. This may also improve workers' level of comfort with people with HBV and reduce the reported reticence they have towards working with this client group. [ABSTRACT FROM AUTHOR]

Purpose. Exercise training is an essential treatment option for patients with chronic heart failure (CHF). However, it remains controversial, which surrogate measures of functional work capacity are most reliable. The purpose of this paper was to compare functional capacity work measured as capillary lactate concentrations area under the curve (AUC) with standard cardiopulmonary exercise testing (CPET) with VO2peak and the 6-minute walk test (6 MWT). Methods. Twenty-three patients in New York Heart Association (NYHA) class II/III with left ventricular ejection fraction (LVEF) <35% were randomised to home-based recommendation of regular exercise (RRE) (controls), moderate continuous training (MCT) or aerobic interval training (AIT). The MCT and AIT groups underwent 12 weeks of supervised exercise training. Exercise testing was performed as standard CPET treadmill test with analysis of VO2peak, the 6 MWT and a novel 30-minute submaximal treadmill test with capillary lactate AUC. Results. All patients had statistically significant improvements in VO2peak, 6 MWT and lactate AUC after 12 weeks of exercise training: 6 MWT (p =0.035), VO2peak (p =0.049) and lactate AUC (p =0.002). Lactate AUC (p =0.046) and 6MWT (p =0.035), but not VO2peak revealed difference between the exercise modalities regarding functional work capacity. Conclusion. 6-MWT and lactate AUC, but not VO2peak, were able to reveal a statistically significant improvement in functional capacity between different exercise modalities. [ABSTRACT FROM AUTHOR]

The availability of public services has been perceived as one of the parameters for evaluating the quality of services and a basic component of the effectiveness of the system. Social services have been understood as public services in the countries of the European Union. The state has the primary responsibility for ensuring the availability of social services and should have established powers in the areas of planning, coordination and evaluation. The aim of this paper is to comprehensively evaluate the availability of homes for seniors aggregated into individual districts of the Czech Republic. The method of multi‐criteria decision‐making was chosen for the evaluation, specifically the Technique for Order of Preference by Similarity to Ideal Solution in combination with the Coefficient of Variance method, as a method for the objective determination of the weights of input indicators. The evaluation in 2017 included 77 districts of the Czech Republic and 519 homes for seniors, which are registered providers of social services for persons who, due to age and reduced self‐sufficiency, cannot take care of themselves and are users of residential social services. Based on 14 defined indicators, the local accessibility within individual districts of the Czech Republic was evaluated, focusing on five research questions. The indicators were defined in such a way as to reflect the nature of the problems and to define the need for this service in the territory. Based on the results, a significant relationship was demonstrated between the amount of subsidy per bed, per month, granted to homes for seniors in individual districts of the Czech Republic and service availability, i.e. districts in which homes for seniors with higher subsidies per bed show better availability. [ABSTRACT FROM AUTHOR]