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Family engagement is a central ideology in pediatric occupational therapy; however, the literature indicates that engaging families is challenging in the school- based context. The purpose of this study is to explore occupational therapists' and families' experiences of family engagement in school-based occupational therapy services and to propose stakeholder-informed improvements to service delivery. An interpretive description design was applied. Interviews were the primary method of data collection and were analyzed using inductive thematic analysis. Family engagement was depicted metaphorically as a group dance. The findings outline how therapists' and families' capabilities and expectations, trust, communication, emotional connections, and contextual factors interact to impact family engagement. Important changes to practice are required. Technology might enhance opportunities for connection and communication. The adoption of service delivery models that endorse a needs-based approach to service, rather than a 'one-size-fits-all' approach, are necessary to increase the value families place on this service.

Premise of the Study:Herbarium specimens provide a robust record of historical plant phenology (the timing of seasonal events such as flowering or fruiting). However, the difficulty of aggregating phenological data from specimens arises from a lack of standardized scoring methods and definitions for phenological states across the collections community. Methods and Results:To address this problem, we report on a consensus reached by an iDigBio working group of curators, researchers, and data standards experts regarding an efficient scoring protocol and a data-sharing protocol for reproductive traits available from herbarium specimens of seed plants. The phenological data sets generated can be shared via Darwin Core Archives using the Extended MeasurementOrFact extension. Conclusions:Our hope is that curators and others interested in collecting phenological trait data from specimens will use the recommendations presented here in current and future scoring efforts. New tools for scoring specimens are reviewed.

This ACP clinical guideline updates recommendations on newer pharmacologic treatments in adults with type 2 diabetes. It is based on 2 systematic reviews that summarize the effectiveness, comparative effectiveness, harms, and cost-effectiveness of SGLT2 inhibitors, GLP1 agonists, DPP4 inhibitors, and long-acting insulins as monotherapy or combination therapy in treating adults with type 2 diabetes mellitus. Description: The American College of Physicians (ACP) developed this clinical guideline to update recommendations on newer pharmacologic treatments of type 2 diabetes. This clinical guideline is based on the best available evidence for effectiveness, comparative benefits and harms, consideration of patients' values and preferences, and costs. Methods: This clinical guideline is based on a systematic review of the effectiveness and harms of newer pharmacologic treatments of type 2 diabetes, including glucagon-like peptide-1 (GLP-1) agonists, a GLP-1 agonist and glucose-dependent insulinotropic polypeptide agonist, sodium–glucose cotransporter-2 (SGLT-2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, and long-acting insulins, used either as monotherapy or in combination with other medications. The Clinical Guidelines Committee prioritized the following outcomes, which were evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach: all-cause mortality, major adverse cardiovascular events, myocardial infarction, stroke, hospitalization for congestive heart failure, progression of chronic kidney disease, serious adverse events, and severe hypoglycemia. Weight loss, as measured by percentage of participants who achieved at least 10% total body weight loss, was a prioritized outcome, but data were insufficient for network meta-analysis and were not rated with GRADE. Audience and Patient Population: The audience for this clinical guideline is physicians and other clinicians. The population is nonpregnant adults with type 2 diabetes. Recommendation 1: ACP recommends adding a sodium–glucose cotransporter-2 (SGLT-2) inhibitor or glucagon-like peptide-1 (GLP-1) agonist to metformin and lifestyle modifications in adults with type 2 diabetes and inadequate glycemic control (strong recommendation; high-certainty evidence). • Use an SGLT-2 inhibitor to reduce the risk for all-cause mortality, major adverse cardiovascular events, progression of chronic kidney disease, and hospitalization due to congestive heart failure. • Use a GLP-1 agonist to reduce the risk for all-cause mortality, major adverse cardiovascular events, and stroke. Recommendation 2: ACP recommends against adding a dipeptidyl peptidase-4 (DPP-4) inhibitor to metformin and lifestyle modifications in adults with type 2 diabetes and inadequate glycemic control to reduce morbidity and all-cause mortality (strong recommendation; high-certainty evidence). [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient and Public Contribution To examine healthcare providers' extent of and perceived barriers and facilitators to screening for intimate partner violence in pregnant women attending prenatal clinics.Cross‐sectional descriptive design was used to collect data from 130 healthcare providers.Seventeen healthcare providers from 17 prenatal clinics in Kanungu district, Uganda, were recruited via convenience sampling to participate in an online survey implementing a modified Normalization Measure Development instrument. Data were collected between February 2023 and March 2023 (02/8/2023 to 03/12/2023) and analysed using descriptive and Mann–Whitney U test and chi‐square tests.Slightly more than half (56%) of healthcare providers report screening pregnant women for intimate partner violence. There was a statistically significant relationship between healthcare providers screening for intimate partner violence and having previous training on intimate partner violence screening. The only barrier to screening identified was a lack of understanding of how intimate partner violence screening affects the nature of participant's own work. There were numerous potential facilitators identified for healthcare providers' intimate partner violence screening.Although higher‐than‐expected number of healthcare providers reported screening of pregnant women for intimate partner violence, the extent of screening is still suboptimal. The barrier to screening identified needs to be addressed and facilitators promoted. Receiving training among healthcare providers on intimate partner violence screening was associated with higher levels of screening; thus, this needs to be enhanced to optimize screening rates. Future studies should assess screening practices objectively and implement interventions to improve healthcare providers’ intimate partner violence screening rates.Screening for intimate partner violence should be part of standard care provided by healthcare providers to all pregnant women during prenatal clinic visits. The study supports the need for more training for healthcare providers in aspects related to intimate partner violence screening in order to ensure prompt diagnosis and treatment of those affected, identify those at risk and increase awareness. There is a need to enhance healthcare providers' capacity for intimate partner violence screening through education by integrating intimate partner violence screening pre‐ and post‐registration courses and preparation programs or curriculum.Intimate partner violence (IPV) in pregnancy is a global health problem. Screening for IPV by healthcare providers is suboptimal. This study found that only 56% of healthcare providers were routinely screening for IPV in Ugandan prenatal clinics. This study identified the main facilitators and one barrier to IPV screening.This study has adhered to the relevant EQUATOR guidelines for quantitative studies.No patient was involved in this study. [ABSTRACT FROM AUTHOR]

The concept of family engagement within the rehabilitation literature focuses on clinic-based therapy sessions and is not particularly relevant to therapists working in school settings. In this study, we explored the concept of family engagement as represented in the education literature to provide school-based therapists with a better understanding of this concept in the school context. We applied scoping review methods for the literature search and screening process, and utilised concept evaluation methodology for our analysis of included articles. Specifically, we examined concept evaluation components, including definition, characteristics, boundaries, preconditions, and outcomes. The search strategy yielded 7112 documents, of which 17 met inclusion criteria. We did not find a clear definition of family engagement in the extant literature; however, there were some common characteristics. Our analysis of boundaries indicated family engagement and parent involvement are not synonymous but are closely linked. We also identified several preconditions for family engagement in education, including: an inviting and inclusive school culture; a broad understanding of engagement; positive educator-family relationships; and families' confidence, beliefs and supportive life contexts. Associated outcomes included academic achievement, high school completion and child social-emotional functioning. We proposed a broad definition based on our analysis of the included articles. Adopting a broad definition of family engagement is important for educators and school-based therapists to ensure families feel their efforts are meaningful. Educators and school-based therapists should consider their actions in supporting the individual needs of families, and the identified preconditions that support family engagement.

The Population Health and Medical Science Committee of the American College of Physicians (ACP) updates the living, rapid practice points on the treatment of adults with COVID-19 in an outpatient setting. Practice points are based on a living, rapid review done by the ACP Center for Evidence Reviews at Cochrane Austria at the University for Continuing Education Krems. Description: Evidence for the use of outpatient treatments in adults with confirmed COVID-19 continues to evolve with new data. This is version 2 of the American College of Physicians (ACP) living, rapid practice points focusing on 22 outpatient treatments for COVID-19, specifically addressing the dominant SARS-CoV-2 Omicron variant. Methods: The Population Health and Medical Science Committee (formerly the Scientific Medical Policy Committee) developed this version of the living, rapid practice points on the basis of a living, rapid review done by the ACP Center for Evidence Reviews at Cochrane Austria at the University for Continuing Education Krems (Danube University Krems). This topic will be maintained as living and rapid by continually monitoring and assessing the impact of new evidence. Practice Point 1: Consider molnupiravir to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease. Practice Point 2: Consider nirmatrelvir–ritonavir combination therapy to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease. Practice Point 3: Do not use ivermectin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting. Practice Point 4: Do not use sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting. [ABSTRACT FROM AUTHOR]

This is an updated guidance statement from the American College of Physicians on screening for colorectal cancer. The article provides guidance on the ages to start and stop screening and selection of type and frequency of screening tests in asymptomatic, average-risk adults on the basis of a critical review of existing guidelines and associated evidence reviews and modeling studies. Description: The purpose of this updated guidance statement is to guide clinicians on screening for colorectal cancer (CRC) in asymptomatic average-risk adults. The intended audience is all clinicians. The population is asymptomatic adults at average risk for CRC. Methods: This updated guidance statement was developed using recently published and critically appraised clinical guidelines from national guideline developers since the publication of the American College of Physicians' 2019 guidance statement, "Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults." The authors searched for national guidelines from the United States and other countries published in English using PubMed and the Guidelines International Network library from 1 January 2018 to 24 April 2023. The authors also searched for updates of guidelines included in the first version of our guidance statement. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to assess the quality of eligible guidelines. Two guidelines were selected for adoption and adaptation by raters on the basis of the highest average overall AGREE II quality scores. The evidence reviews and modeling studies for these 2 guidelines were also used to synthesize the evidence of diagnostic test accuracy, effectiveness, and harms of CRC screening interventions and to develop our guidance statements. Guidance Statement 1: Clinicians should start screening for colorectal cancer in asymptomatic average-risk adults at age 50 years. Guidance Statement 2: Clinicians should consider not screening asymptomatic average-risk adults between the ages of 45 to 49 years. Clinicians should discuss the uncertainty around benefits and harms of screening in this population. Guidance Statement 3: Clinicians should stop screening for colorectal cancer in asymptomatic average-risk adults older than 75 years or in asymptomatic average-risk adults with a life expectancy of 10 years or less. Guidance Statement 4a: Clinicians should select a screening test for colorectal cancer in consultation with their patient based on a discussion of benefits, harms, costs, availability, frequency, and patient values and preferences. Guidance Statement 4b: Clinicians should select among a fecal immunochemical or high-sensitivity guaiac fecal occult blood test every 2 years, colonoscopy every 10 years, or flexible sigmoidoscopy every 10 years plus a fecal immunochemical test every 2 years as a screening test for colorectal cancer. Guidance Statement 4c: Clinicians should not use stool DNA, computed tomography colonography, capsule endoscopy, urine, or serum screening tests for colorectal cancer. [ABSTRACT FROM AUTHOR]

This document is an update alert from the American College of Physicians (ACP) on the outpatient treatment of confirmed COVID-19 in adults, specifically focusing on the SARS-CoV-2 Omicron variant. The ACP Center for Evidence Reviews identified 9 newly published studies that met the inclusion criteria for the surveillance search. The new evidence supports the use of molnupiravir and nirmatrelvir-ritonavir combination therapy in the outpatient treatment of adults with confirmed COVID-19 at a high risk for severe disease. The document also states that ivermectin and sotrovimab should not be used for the treatment of mild to moderate COVID-19 in the outpatient setting. The Population Health and Medical Science Committee plans to perform a focused update of the evidence review and practice points in light of ongoing studies. [Extracted from the article]

This document is an update alert from the American College of Physicians (ACP) on nonpharmacologic and pharmacologic treatments for adults with major depressive disorder. The ACP conducted a surveillance search and identified one new study that met the inclusion criteria. However, the new evidence did not change the prior conclusions of the living systematic review. As a result, the ACP decided that an update of the review is not necessary at this time. The ACP reaffirms the recommendations in the living clinical guideline on nonpharmacologic and pharmacologic treatments for major depressive disorder. [Extracted from the article]

Diabetes distress has been shown to be highly prevalent in adults living with type 1 and type 2 diabetes with important implications for glycemic control, self-care, and self-management behaviors. Despite considerable focus on self-management and glycemic targets during pregnancy, current literature lacks information on diabetes distress in pregnancy, particularly in women with type 2 diabetes. This article outlines an explanatory sequential mixed methods research protocol to examine diabetes distress during pregnancy in women with pre-existing diabetes. The aims of the study were to: (1) establish the prevalence and correlates of diabetes distress in women attending a diabetes and pregnancy clinic; (2) use this quantitative data to inform development of an interview guide and plan for sampling for telephone interviews; and (3) explore and describe the experiences of diabetes distress during pregnancy. The quantitative strand was a cross-sectional survey of 76 women using self-reported questionnaires to collect demographic and clinical data, and validated tools to assess health variables, including the outcome of interest of diabetes distress using the Problem Area in Diabetes scale. The qualitative strand applied interpretive description methodology to explore the quantitative results using semi-structured qualitative interviews with 18 women to obtain patient perspectives of diabetes distress and experiences of managing diabetes in pregnancy. The explanatory sequential mixed methods research will provide an opportunity to add contextual qualitative experiences from women with pre-existing diabetes during pregnancy to provide a comprehensive picture of diabetes distress. The results will inform further research priorities that protect and promote mental health, psychosocial well-being, and self-management practices for this population. [ABSTRACT FROM AUTHOR]

Aims and objectives: Studies have shown that the COVID-19 pandemic has taken a toll on individuals who interact with patients with SARS-CoV-2 but focused largely on clinicians in acute care settings. This qualitative descriptive study aimed to understand the experiences and well-being of essential workers across settings during the pandemic. Background: Multiple studies of the well-being of individuals who have cared for patients during the pandemic have included interviews of clinicians from acute care settings and revealed high levels of stress. However, other essential workers have not been included in most of those studies, yet they may also experience stress. Methods: Individuals who participated in an online study of anxiety, depression, traumatic distress, and insomnia, were invited to provide a free-text comment if they had anything to add. A total of 2,762 essential workers (e.g., nurses, physicians, chaplains, respiratory therapists, emergency medical technicians, housekeeping, and food service staff, etc.) participated in the study with 1,079 (39%) providing text responses. Thematic analysis was used to analyze those responses. Results: Four themes with eight sub-themes were: Facing hopelessness, yet looking for hope; Witnessing frequent death; Experiencing disillusionment and disruption within the healthcare system, and Escalating emotional and physical health problems. Conclusions: The study revealed major psychological and physical stress among essential workers. Understanding highly stressful experiences during the pandemic is essential to identify strategies that ameliorate stress and prevent its negative consequences. This study adds to the research on the psychological and physical impact of the pandemic on workers, including non-clinical support personnel often overlooked as experiencing major negative effects. Relevance to clinical practice: The magnitude of stress among all levels of essential workers suggests the need to develop strategies to prevent or alleviate stress across disciplines and all categories of workers. [ABSTRACT FROM AUTHOR]

Tobacco use is associated with poor surgical outcomes and is the leading cause of preventable morbidity and mortality in the United States. Because of the risk for postoperative complications, researchers continue to examine the association between surgical patients' smoking status and adverse outcomes. This quantitative integrative review synthesizes evidence on the relationship between smoking status and postoperative outcomes according to information in the American College of Surgeons National Surgical Quality Improvement Program data set. The included studies involved 10 procedures and the evaluated outcomes comprise surgical complications (eg, surgical site infection), medical complications (eg, sepsis), and transitions in care (eg, discharge destination). The review results are mixed and are not generalizable because only two studies specified smoking status as a primary variable of interest. To develop policies for perioperative patient smoking cessation, perioperative nurses require additional research results on the relationships between smoking status and standardized variables. [ABSTRACT FROM AUTHOR]

In this article, the American College of Physicians updates its 2016 recommendations on pharmacologic and nonpharmacologic treatment of major depression and makes recommendations for initial or second-line treatment during the acute phase of a major depressive disorder episode. Description: The purpose of this guideline from the American College of Physicians (ACP) is to present updated clinical recommendations on nonpharmacologic and pharmacologic interventions as initial and second-line treatments during the acute phase of a major depressive disorder (MDD) episode, based on the best available evidence on the comparative benefits and harms, consideration of patient values and preferences, and cost. Methods: The ACP Clinical Guidelines Committee based these recommendations on an updated systematic review of the evidence. Audience and Patient Population: The audience for this guideline includes clinicians caring for adult patients in the acute phase of MDD in ambulatory care. The patient population includes adults in the acute phase of MDD. Recommendation 1a: ACP recommends monotherapy with either cognitive behavioral therapy or a second-generation antidepressant as initial treatment in patients in the acute phase of moderate to severe major depressive disorder (strong recommendation; moderate-certainty evidence). Recommendation 1b: ACP suggests combination therapy with cognitive behavioral therapy and a second-generation antidepressant as initial treatment in patients in the acute phase of moderate to severe major depressive disorder (conditional recommendation; low-certainty evidence). The informed decision on the options of monotherapy with cognitive behavioral therapy versus second-generation antidepressants or combination therapy should be personalized and based on discussion of potential treatment benefits, harms, adverse effect profiles, cost, feasibility, patients' specific symptoms (such as insomnia, hypersomnia, or fluctuation in appetite), comorbidities, concomitant medication use, and patient preferences. Recommendation 2: ACP suggests monotherapy with cognitive behavioral therapy as initial treatment in patients in the acute phase of mild major depressive disorder (conditional recommendation; low-certainty evidence). Recommendation 3: ACP suggests one of the following options for patients in the acute phase of moderate to severe major depressive disorder who did not respond to initial treatment with an adequate dose of a second-generation antidepressant: • Switching to or augmenting with cognitive behavioral therapy (conditional recommendation; low-certainty evidence) • Switching to a different second-generation antidepressant or augmenting with a second pharmacologic treatment (see Clinical Considerations) (conditional recommendation; low-certainty evidence) The informed decision on the options should be personalized and based on discussion of potential treatment benefits, harms, adverse effect profiles, cost, feasibility, patients' specific symptoms (such as insomnia, hypersomnia, or fluctuation in appetite), comorbidities, concomitant medication use, and patient preferences. [ABSTRACT FROM AUTHOR]

Description: Strategies to manage COVID-19 in the outpatient setting continue to evolve as new data emerge on SARS-CoV-2 variants and the availability of newer treatments. The Scientific Medical Policy Committee (SMPC) of the American College of Physicians (ACP) developed these living, rapid practice points to summarize the best available evidence on the treatment of adults with confirmed COVID-19 in an outpatient setting. These practice points do not evaluate COVID-19 treatments in the inpatient setting or adjunctive COVID-19 treatments in the outpatient setting. Methods: The SMPC developed these living, rapid practice points on the basis of a living, rapid review done by the ACP Center for Evidence Reviews at Cochrane Austria at the University for Continuing Education Krems (Danube University Krems). The SMPC will maintain these practice points as living by monitoring and assessing the impact of new evidence. Practice Point 1: Consider molnupiravir to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 to 7 days of the onset of symptoms and at high risk for progressing to severe disease.Practice Point 2: Consider nirmatrelvir-ritonavir combination therapy to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at high risk for progressing to severe disease.Practice Point 3: Consider remdesivir to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 7 days of the onset of symptoms and at high risk for progressing to severe disease.Practice Point 4: Do not use azithromycin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.Practice Point 5: Do not use chloroquine or hydroxychloroquine to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.Practice Point 6: Do not use ivermectin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.Practice Point 7: Do not use nitazoxanide to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.Practice Point 8: Do not use lopinavir-ritonavir combination therapy to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.Practice Point 9: Do not use casirivimab-imdevimab combination therapy to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting unless it is considered effective against a SARS-CoV-2 variant or subvariant locally in circulation.Practice Point 10: Do not use regdanvimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting unless it is considered effective against a SARS-CoV-2 variant or subvariant locally in circulation.Practice Point 11: Do not use sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting unless it is considered effective against a SARS-CoV-2 variant or subvariant locally in circulation.Practice Point 12: Do not use convalescent plasma to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.Practice Point 13: Do not use ciclesonide to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.Practice Point 14: Do not use fluvoxamine to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting. [ABSTRACT FROM AUTHOR]

INTRODUCTION. The ongoing COVID-19 pandemic substantially affects health care workers from multiple disciplines, including nurses, physicians, therapists, and first responders. The aims of this study were to 1) explore and describe the experiences of health care workers and first responders working with individuals with COVID-19 infection, and 2) identify the support and strategies that were helpful during their experience.METHODS. A qualitative descriptive study was conducted via online video interviews of 29 health care workers and first responders who agreed to be contacted for an interview. Thematic analysis resulted in three themes and corresponding subthemes.RESULTS. The three overriding themes were 1) experiencing vulnerability, 2) suffering loss and grief, and 3) coping with vulnerability. A sense of vulnerability and high levels of stress were described and affected participants during their professional work as health care workers and first responders as well as their roles in their homes and communities.DISCUSSION AND CONCLUSION. The findings indicate the need for effective measures to assist health care workers and first responders to minimize the negative consequences of persistent and severe stress and vulnerability as they care for individuals with COVID-19 and their families. [ABSTRACT FROM AUTHOR]

Background: Redundancy is an unethical, unscientific, and costly challenge in clinical health research. There is a high risk of redundancy when existing evidence is not used to justify the research question when a new study is initiated. Therefore, the aim of this study was to synthesize meta-research studies evaluating if and how authors of clinical health research studies use systematic reviews when initiating a new study. Methods: Seven electronic bibliographic databases were searched (final search June 2021). Meta-research studies assessing the use of systematic reviews when justifying new clinical health studies were included. Screening and data extraction were performed by two reviewers independently. The primary outcome was defined as the percentage of original studies within the included meta-research studies using systematic reviews of previous studies to justify a new study. Results were synthesized narratively and quantitatively using a random-effects meta-analysis. The protocol has been registered in Open Science Framework (https://osf.io/nw7ch/). Results: Twenty-one meta-research studies were included, representing 3,621 original studies or protocols. Nineteen of the 21 studies were included in the meta-analysis. The included studies represented different disciplines and exhibited wide variability both in how the use of previous systematic reviews was assessed, and in how this was reported. The use of systematic reviews to justify new studies varied from 16% to 87%. The mean percentage of original studies using systematic reviews to justify their study was 42% (95% CI: 36% to 48%). Conclusion: Justification of new studies in clinical health research using systematic reviews is highly variable, and fewer than half of new clinical studies in health science were justified using a systematic review. Research redundancy is a challenge for clinical health researchers, as well as for funders, ethics committees, and journals. [ABSTRACT FROM AUTHOR]

Valid, reliable, and acceptable tools for assessing self-reported competence in evidence-informed decision-making (EIDM) are required to provide insight into the current status of EIDM knowledge, skills, attitudes/beliefs, and behaviours for registered nurses working in public health. The purpose of this study was to assess the validity, reliability, and acceptability of the EIDM Competence Measure. A psychometric study design was employed guided by the Standards for Educational and Psychological Testing and general measurement development principles. All registered nurses working across 16 public health units in Ontario, Canada were invited to complete the newly developed EIDM Competence Measure via an online survey. The EIDM Competence Measure is a self-reported tool consisting of four EIDM subscales: 1) knowledge; 2) skills; 3) attitudes/beliefs; and 4) behaviours. Acceptability was measured by completion time and percentage of missing data of the original 40-item tool. The internal structure of the tool was first assessed through item-subscale total and item-item correlations within subscales for potential item reduction of the original 40-item tool. Following item reduction which resulted in a revised 27-item EIDM Competence Measure, a principal component analysis using an oblique rotation was performed to confirm the four subscale structure. Validity based on relationships to other variables was assessed by exploring associations between EIDM competence attributes and individual factors (e.g., years of nursing experience, education) and organizational factors (e.g., resource allocation). Internal reliability within each subscale was analyzed using Cronbach's alphas. Across 16 participating public health units, 201 nurses (mean years as a registered nurse = 18.1, predominantly female n = 197; 98%) completed the EIDM Competence Measure. Overall missing data were minimal as 93% of participants completed the entire original 40-item tool (i.e., no missing data), with 7% of participants having one or more items with missing data. Only one participant (0.5%) had >10% of missing data (i.e., more than 4 out of 40 items with data missing). Mean completion time was 7 minutes and 20 seconds for the 40-item tool. Extraction of a four-factor model based on the 27-item version of the scale showed substantial factor loadings (>0.4) that aligned with the four EIDM subscales of knowledge, skills, attitudes/beliefs, and behaviours. Significant relationships between EIDM competence subscale scores and education, EIDM training, EIDM project involvement, and supportive organizational culture were observed. Cronbach's alphas exceeded minimum standards for all subscales: knowledge (α = 0.96); skills (α = 0.93); attitudes/beliefs (α = 0.80); and behaviours (α = 0.94). [ABSTRACT FROM AUTHOR]

This article presents the final updated recommendations from the American College of Physicians on the use of SARS-CoV-2 antibody tests for diagnosis and to predict the degree or duration of natural immunity. Description: The Scientific Medical Policy Committee (SMPC) of the American College of Physicians (ACP) developed these living, rapid practice points to summarize the current best available evidence on the antibody response to SARS-CoV-2 infection and protection against reinfection with SARS-CoV-2. This is version 2 of the ACP practice points, which serves to update version 1, published on 16 March 2021. These practice points do not evaluate vaccine-acquired immunity or cellular immunity. Methods: The SMPC developed this version of the living, rapid practice points based on an updated living, rapid, systematic review conducted by the Portland VA Research Foundation and funded by the Agency for Healthcare Research and Quality. Practice Point 1: Do not use SARS-CoV-2 antibody tests for the diagnosis of SARS-CoV-2 infection. Practice Point 2: Do not use SARS-CoV-2 antibody tests to predict the degree or duration of natural immunity conferred by antibodies against reinfection, including natural immunity against different variants. Retirement From Living Status: Although natural immunity remains a topic of scientific interest, this topic is being retired from living status given the availability of effective vaccines for SARS-CoV-2 and widespread recommendations for and prevalence of their use. Currently, vaccination is the best clinical recommendation for preventing infection, reinfection, and serious illness from SARS-CoV-2 and its variants. [ABSTRACT FROM AUTHOR]

The concept of family engagement within the rehabilitation literature focuses on clinic- based therapy sessions and is not particularly relevant to therapists working in school settings. In this study, we explored the concept of family engagement as represented in the education literature to provide school- based therapists with a better understanding of this concept in the school context. We applied scoping review methods for the literature search and screening process, and utilised concept evaluation methodology for our analysis of included articles. Specifically, we examined concept evaluation components, including definition, characteristics, boundaries, preconditions, and outcomes. The search strategy yielded 7112 documents, of which 17 met inclusion criteria. We did not find a clear definition of family engagement in the extant literature; however, there were some common characteristics. Our analysis of boundaries indicated family engagement and parent involvement are not synonymous but are closely linked. We also identified several preconditions for family engagement in education, including: an inviting and inclusive school culture; a broad understanding of engagement; positive educator- family relationships; and families' confidence, beliefs and supportive life contexts. Associated outcomes included academic achievement, high school completion and child social- emotional functioning. We proposed a broad definition based on our analysis of the included articles. Adopting a broad definition of family engagement is important for educators and school- based therapists to ensure families feel their efforts are meaningful. Educators and school- based therapists should consider their actions in supporting the individual needs of families, and the identified preconditions that support family engagement. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic, the Scientific Medical Policy Committee (SMPC) of the American College of Physicians (ACP) began developing "practice points" to provide clinical advice based on the best available evidence for the public, patients, clinicians, and public health professionals. As one of the first organizations in the United States to develop evidence-based clinical guidelines, ACP continues to lead and advance the science of evidence-based medicine by implementing new methods to rapidly publish practice points and maintain them as living advice that regularly assesses and incorporates new evidence. The overarching aim of practice points is to answer targeted key questions for which there is a timely need to synthesize evidence for decision making. The SMPC believes these methods can potentially be adapted to address various clinical and public health topics beyond the COVID-19 pandemic. This article presents an overview of the SMPC's living, rapid practice points development process, which includes a rapid systematic review, use of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method, use of stringent policies on the disclosure of interests and management of conflicts of interest, incorporating a public (nonclinician) perspective, and maintenance of the documents as living through ongoing surveillance and synthesis of new evidence as it emerges. [ABSTRACT FROM AUTHOR]