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In its mission to optimise the quality of patient care and the level of clinician training within the fields of biotherapy, the BioTherapeutics, Education and Research (BTER) Foundation and its Maggot Therapy Competency Committee identified qualities and achievements assessed to be the minimum standards that health care professionals should attain in order to be deemed competent in maggot therapy. The set of six standards were selected to reflect the same high degree of professionalism that is used by the Accreditation Council of Graduate Medical Education for assessing other medical specialists, but with an emphasis on the principles and practice of maggot therapy. For each domain in which competency is expected, the rationale has been explained, specific competencies have been articulated, and methods for demonstrating or evaluating those competencies have been suggested. Applicable to any clinician applying maggot dressings professionally, these recommendations should assist those who wish to identify, assess, or achieve competency in maggot therapy. Specifically, these six competencies include: (1) knowledge about wound care in general and maggot therapy in particular; (2) skill in general patient care, to a level commensurate with their professional role; (3) ability to communicate effectively with colleagues, patients, and the general public; (4) professional and ethical behaviour; (5) ability to deliver systems‐based health care; (6) incorporation of continuing education and quality improvement into their practice. [ABSTRACT FROM AUTHOR]

The article discusses the concerns on the quality of scientific papers writing. Topics include the benefits of improved scientific paper writing for the researchers and on the progress of science, the factors that influence better writing and the rules that will boost the impact of a paper through the reinforcement of attitude toward scientific literature.

An editorial is presented on the topic of euthanasia/voluntary assisted dying (VAD). Topics include emphasising the disparity in support between responses of medical and nursing staff and highlighting the low support rate of high impact specialists; and showing a wide range of personal attributes, social relationships, professional experiences, and intellectual endeavours.

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

An introduction to the journal is presented that focuses on issues related to learning disabilities, including participation of people with learning disabilities in end-of-life care research, attitudes of support workers towards the affective and sexual lives of people with intellectual disabilities, and challenges concerning attention-deficit/hyperactivity disorder that is often misdiagnosed in people with learning disabilities.

ABSTRACT BACKGROUND The Healthy, Hunger-Free Kids Act of 2010 ( HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing the changes. METHODS Food service directors from rural school districts were invited to complete a semistructured telephone interview and online survey. A total of 51 respondents completed both, 6 completed only the online survey, and 16 completed only the telephone interview. Qualitative interview data were analyzed through open thematic coding; descriptive statistics were calculated for the quantitative data. RESULTS Food service directors mostly perceived the changes as negative, challenging, and burdensome. They believed that the changes resulted from concern about childhood obesity, which they did not view as a problem for their students. Diverse challenges were reported related to cost, preparation, and student preference. CONCLUSIONS Food service directors in isolated, rural areas need support to enhance understanding of HHKA requirements, build professional networks to learn from one another, and communicate with students, families, and other stakeholders. Future efforts should focus on changing perceptions and supporting directors in order to make implementation a success. [ABSTRACT FROM AUTHOR]

In this British Psychological Society (BPS) landmark paper, we employ an evidence synthesis approach to review the broad range of diversity research published in BPS journals between 2011 and 2021. By focusing on research that investigates stereotypes associated with, and discrimination towards, minority and minoritized groups, we seek to provide readers with a better understanding of the dynamics of a diverse workforce and, going forward, to facilitate the efforts of the psychology research community towards building a body of work that meaningfully addresses workplace inequalities. We thematically analyse and synthesize 25 articles, which fall into four interconnected themes: identity development and management; negative stereotypes, prejudice, and discrimination; working in a diverse team; and the broader organizational environment. Highlighting key strengths of this work and areas for future development, we note the absence of overarching theoretical debates and discussions that might facilitate the development of an on‐going narrative across diversity‐related research published within BPS journals. We outline a future research agenda to bridge methodological divides and to connect with diversity literatures in related disciplines such as human resource development (HRD), human resource management (HRM), and organization studies. In so doing, we advocate for psychologists to move beyond a solely individualistic perspective and instead recognize and account for the context within which diversity‐related processes take place. [ABSTRACT FROM AUTHOR]

Introduction: This paper provides a critical reflection from both the researcher and public contributor (PC) perspective on the benefits and the learnings taken from involving PCs in research related to Parkinson's. Approach to Patient and Public Involvement (PPI): This paper reports on how PCs shaped the design and development of the PRIME‐UK research programme study materials through input into information leaflets, consent forms and other patient‐facing documents used across three studies within the PRIME‐UK research programme. The PRIME‐UK research programme is designed to improve the quality of life of people with Parkinson's and this project included three studies: a cross‐sectional study, a randomised control trial and a qualitative study. We captured these impacts using Public Involvement Impact Logs, which provide a framework allowing researchers and PCs to report on the learnings, immediate outcomes and impacts from PPI. For this project, the impact logs enabled us to provide reflections from PCs and researchers on the process of involving 'the public' in Parkinson's research. Findings: This paper builds on existing evidence of the range of benefits and challenges that emerge from working with patients and the public in Parkinson's research; this includes reflecting on the changes made to the study materials and benefits for the people involved. Four themes emerged from the reflections that were common to the researchers and PCs; these were the importance of providing a supportive environment; recognition of the benefit of the evaluation of the impact of PPI; acknowledgement that engagement of PPI can make a positive difference to the research process and that timely communication and the use of face‐to‐face communication, where available, is key. Furthermore, we demonstrate how impact logs provide a useful and straightforward tool for evaluating public involvement practices and supporting the feedback process. Conclusion: We offer key recommendations for involving patients and the public in Parkinson's research and suggest approaches that could be implemented to capture the impacts of public involvement. Public Contribution: Public contributors (PCs) were involved in the design and development of the participant information leaflets, consent forms and other patient‐facing documents used for studies within the PRIME‐UK research programme. In addition, PCs evaluated their involvement using impact logs and co‐authored this paper. [ABSTRACT FROM AUTHOR]

Poorly controlled pain is a global public health issue. The personal, familial and societal costs are immeasurable. Only a minority of European patients have access to a comprehensive specialist pain clinic. More commonly the responsibility for chronic pain management and initiating opioid therapy rests with the primary care physician and other non-specialist opioid prescribers. There is much confusing and conflicting information available to non-specialist prescribers regarding opioid therapy and a great deal of unjustified fear is generated. Opioid therapy should only be initiated by competent clinicians as part of a multi-faceted treatment programme in circumstances where more simple measures have failed. Throughout, all patients must be kept under close clinical surveillance. As with any other medical therapy, if the treatment fails to yield the desired results and/or the patient is additionally burdened by an unacceptable level of adverse effects, the overall management strategy must be reviewed and revised. No responsible clinician will wish to pursue a failed treatment strategy or persist with an ineffective and burdensome treatment. In a considered attempt to empower and inform non-specialist opioid prescribers, EFIC convened a European group of experts, drawn from a diverse range of basic science and relevant clinical disciplines, to prepare a position paper on appropriate opioid use in chronic pain. The expert panel reviewed the available literature and harnessed the experience of many years of clinical practice to produce these series of recommendations. Its success will be judged on the extent to which it contributes to an improved pain management experience for chronic pain patients across Europe.Significance: This position paper provides expert recommendations for primary care physicians and other non- specialist healthcare professionals in Europe, particularly those who do not have ready access to specialists in pain medicine, on the safe and appropriate use of opioid medications as part of a multi-faceted approach to pain management, in properly selected and supervised patients. [ABSTRACT FROM AUTHOR]

Background: Exact quantification of research conducted by dietitians and tracking the effectiveness of interventions or training programs to increase either evidence‐based practice (EBP) or research behaviours have been hampered by the variety of tools used to measure these constructs. Methods: In this narrative review, we identified and classified the various tools previously used to measure constructs related to research and/or EBP in the dietetics profession, and to summarise estimates of the constructs measured. Results: We identified and classified 15 scored tools that had been used at least once in the dietetics profession and extracted tool parameter estimates from 22 resulting papers. We also identified six unscored tools and three qualitative studies. The most frequent constructs measured were attitudes and behaviours. Very few tools measured objective knowledge (skills). No objective measures of research outputs were identified. Several tools were closely related to one another. Conclusions: Even when tools were used across multiple papers, reporting method varied making comparisons difficult. This review should encourage future researchers to utilise existing tools when possible, and encourage the development or adaptation and testing of tools that fill identified gaps. The constructs measured by the tools identified may also provide a starting point for the development of educational interventions aiming to increase research or EBP skills among dietitians. Only by using consistent tools will the dietetics profession be able to track the progress in increasing research conduct and EBP implementation over time. Key points: In this narrative review, we identified 15 scored tools and nine unscored or qualitative tools for assessing research and/or evidence‐based practice knowledge and or conduct by dietitians. No tool was identified as a gold standard. Many tools measured overlapping constructs and/or had evolved over time. Few tools had objective measures of knowledge or behaviour. Researchers should strive to use consistent tools, and develop additional objective measures of these constructs. [ABSTRACT FROM AUTHOR]

Background: Self‐harm is a major public health concern. Lifetime prevalence is high, and rates of self‐harm are rising; however, available interventions do not benefit everyone, and engagement with therapy can be low. Qualitative accounts allow for a greater understanding of what is helpful to individuals. This study aimed to synthesize the experiences of interventions for self‐harm, from participants who have participated in these themselves. Methods: Participants had self‐harmed at least once and undergone an individual psychotherapeutic intervention for self‐harm. Papers not written or translated to the English language were excluded. Four databases (Medline, CINAHL, Web of Science and PsycINFO) were systematically searched and each paper was assessed using the CASP quality appraisal tool. A meta‐ethnographic approach to the synthesis was taken. Results: Ten studies encompassing 104 participants were included. Four overarching themes were developed and the importance of recognizing the person beyond the self‐harm emerged through a line of argument synthesis. Building a trusted, therapeutic relationship founded on patience and without judgement was essential for the perceived success of therapy, which was unique to each person and often went beyond reducing self‐harming behaviours. Limitations: Papers included in the study showed a lack of diversity with regard to ethnicity and gender. Conclusions: The findings illustrate the importance of the therapeutic alliance when working with self‐harm. Clinical implications of this paper include the importance of utilizing key therapeutic competencies which should be considered fundamental to change within psychotherapeutic interventions for self‐harm, with the uniqueness of each patient recognized throughout. [ABSTRACT FROM AUTHOR]

This paper critically examines the normative versus non‐normative distinction commonly used in collective action research. To explore the similarities and differences between antecedents of normative versus non‐normative actions, we conducted a systematic review on diverse predictors of non‐normative, radical and violent collective actions. We examined 37 social and political psychology studies published after 2010 and identified five recurring themes: identity, efficacy, injustice, emotions and norms. Findings exhibited significant overlaps with those predictors associated with normative collective action. Thus, a reconceptualization is needed to undermine the rigid boundaries between these action types, highlighting the intricate interplay of factors that transcend the conventional binary. Aiming to avoid conceptual ambiguity and challenge the perspective that associating particular collective actions with unwarranted violence using social norms as fixed and a priori, we propose the term 'confrontational collective action' to separate out form of action from societal approval. Through this reconceptualization, we discussed the main limitations in the literature, focusing on how studies approach normativity and efficacy and addressing the issue of decontextualization in the literature. This paper calls for a contextually informed understanding of confrontational collective action that recognizes what is seen as 'normative' can change over time through intra‐ and intergroup interactions. [ABSTRACT FROM AUTHOR]

This note aims to establish the influence of a system's political identity on its viability. Using an argumentative analysis of evolutionary theory, organisational cybernetics and other systems traditions, this paper demonstrates the importance of identity to the adaptability of viable systems. It demonstrates how the environment shapes viable systems and how natural selection makes certain political identities viable in systems. The conclusion of the paper presents some ideas for adaptation in viable systems and asserts that these ideas are anarchist in origin. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of childbearing women with a history of female genital mutilation (FGM) are accessing maternity services in high‐income countries across the world. For many of these women, their first contact with the health services in their host country is when they are pregnant. While the clinical consequences of certain categories of FGM are well documented, how high‐risk maternity services — designed to mitigate the obstetric consequences of FGM — impact upon women's experience of childbearing is less clear. Methods: Using a meta‐synthesis approach, this paper synthesizes 12 qualitative research papers, conducted in 5 high‐income countries, to explore how migrant women with a history of FGM experience maternity care in their host countries. Results: One over‐arching theme and four discrete subthemes of migrant women's experience of the maternity services in their host country were identified: feelings of alienation; fatalism and divine providence, positive and negative feelings about maternity care, different understandings of the birthing process, and feelings about FGM. Conclusions: The findings illustrate that migrant women with a history of FGM frequently encounter negative attitudes when accessing the maternity services in their host countries. Women's experiences suggest a concerning absence of sensitive and empathetic care; a more woman‐centered approach is recommended. [ABSTRACT FROM AUTHOR]

Don Marquis' future‐like‐ours account is regarded as the best secular anti‐abortion position because he frames abortion as a wrongful killing via deprivation of a valuable future. Marquis objects to the reductio ad absurdum of contraception as being immoral because it is too difficult to identify an individual that is deprived of a future. To demonstrate why Marquis' treatment of the contraception reductio is flawed by his own future‐like‐ours line of reasoning, I offer an argument for why there is indeed a candidate for harm—the ovum—for it can be viewed as providing the functional foundation for a new life through (1) mitochondrial DNA inheritance, (2) paternal histone restructuring during fertilization, and (3) ability to initiate parthenogenesis. As evidenced by these distinct and natural features of ova, candidate (2) "some ovum or other" should be morally prioritized as the direct candidate for harm in the contraception reductio. By assessing the philosophical inconsistencies in Marquis' future‐like‐ours argument, this paper provides strong metaphysical grounds for rejecting the best secular anti‐abortion position. [ABSTRACT FROM AUTHOR]

Background: As the prevalence of dementia increases, the need for appropriately trained and skilled care teams also increases. Staff attitudes towards people living with dementia have a significant impact on caregiving behaviours and staff and resident outcomes. Training within care settings is a potential way of improving staff attitudes towards residents in their care. Objectives: This review aimed to (i) assess the effectiveness of psychosocial training in improving care staff attitudes towards dementia; and (ii) examine the content and focus of training. Method: The review was conducted following PRISMA guidance and the protocol was registered on PROSPERO prior to conducting the review. A comprehensive search of peer‐reviewed literature was undertaken using CINAHL, Medline and PsycINFO from inception to March 2021. All papers were evaluated using a quality appraisal tool. Results: Ten studies met inclusion criteria and were of variable quality. However, six studies found significant improvements in staff attitudes towards dementia following staff training. The studies varied in terms of training focus and included behavioural, communication and cognitive‐based approaches. Conclusions: Staff training could be an effective method of improving staff attitudes towards dementia in care settings. Further research adopting high‐quality randomised controlled designs to further explore staff attitudes following psychosocial training would make a valuable contribution to the literature base. [ABSTRACT FROM AUTHOR]

This paper uses an extensive collection of historical surveys that have only recently been made available to researchers to examine the formation of British attitudes towards the then European Economic Community. It demonstrates that – up until 1967 – the demographic predictors of support for UK membership were unstable. Thereafter, coinciding with the second UK application, these attitudes started to stabilise and harden, with support becoming highest among men, the youngest age cohorts, the middle class and those with greater education. The renewed politicization of the issue in 1967 also coincided with Labour voters becoming significantly more likely to support membership. Following the change in the parties' positions, Labour voters subsequently become substantially less supportive than Conversative voters. The paper thus supports existing analyses on the role of elite cues, while providing new, robust evidence of the change in demographic associations over this formative period. [ABSTRACT FROM AUTHOR]

This paper argues that Reason Responsiveness (RR) accounts of rationality, proposed for example by Benjamin Kiesewetter and Error Lord, fail to explain structural irrationality (i.e., the irrationality involved in holding incoherent attitudes). Proponents of RR hold that rationality consists in correctly responding to available reasons. Structural irrationality, they argue, is just a "by‐product" of incorrect reason‐responding. Applying this idea to cases of means–end incoherence, this paper shows that RR accounts must rely on a certain transmission principle. Roughly, this amounts to the principle that necessarily, if (1) A has decisive available reason to intend to E and (2) A has decisive available reason to believe that intending to M is necessary for E‐ing, it follows that (3) A has decisive available reason to intend to M. By considering an example, this paper argues that even the most plausible version of this transmission principle does not hold true. It follows that one can correctly respond to one's available reasons while being means–end incoherent. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review is to identify, describe and synthesize evidence from experimental studies conducted to measure and conceptualize self‐efficacy within the context of nursing education and the transition of nursing students to practice as a registered practitioners. Design: Systematic review. Methods: Papers were screened by four independent reviewers, and data were extracted using a standardized data extraction tool. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidance and checklists were used to guide this review. Results: The review included 47 studies, using a quasi‐experimental pre‐test–post‐test design (n = 39) and randomized control trials (n = 8). Various teaching and learning interventions were used to enhance self‐efficacy; however, there is no definitive conclusion to be drawn regarding the most effective educational interventions. Various instruments were used in the studies to measure self‐efficacy. 10 of these were related to general self‐efficacy, while 37 instruments measured self‐efficacy in the context of specific skills. [ABSTRACT FROM AUTHOR]

Currently, Aboriginal children are significantly over‐represented in the out‐of‐home‐care system. Drawing on Aboriginal trauma scholarship and decolonizing methodologies, this paper situates the contemporary state removal of Aboriginal children against the backdrop of historical policies that actively sought to disrupt Aboriginal kinship and communities. The paper draws on submissions to the 2018 Australian Senate Parliamentary Inquiry into Adoption Reform from Aboriginal community controlled organizations and highlights four common themes evident throughout these submissions: (i) the role of intergenerational trauma in high rates of Aboriginal child removal; (ii) the place of children within Aboriginal culture, kinship and identity; (iii) the centrality of the principles of self‐determination and autonomy for Aboriginal communities and (iv) Aboriginal community controlled alternatives to child removal. Acknowledging the failure of both federal and state reforms to address the issues raised in these submissions, the paper reflects on the marginalization of Aboriginal voices and solutions within contemporary efforts to address the multiple crises of the child protection system and the implications for the future of Aboriginal children. [ABSTRACT FROM AUTHOR]

According to Universal Epistemic Deontology, all of our doxastic attitudes are open to deontological evaluations of obligation and permissibility. This view thus implies that we are responsible for all of our doxastic attitudes. But many philosophers have puzzled over whether we could be so responsible. This paper explores whether this puzzle can be resolved, and Universal Epistemic Deontology defended, by appealing to a view of responsibility it calls the Revelatory View. On that view, an agent is responsible for something when it reveals the kind of person the agent is. The paper explores four ways of developing the Revelatory View and argues that none of the views ultimately defends Universal Epistemic Deontology. [ABSTRACT FROM AUTHOR]

A growing interdisciplinary literature examines the role of hair textures and styles in Black and mixed‐race women's identity performances. Through an analysis of travel narratives, this paper extends and complements research on the context‐dependency of racialized identity performances. This paper presents an analysis of 24 qualitative interviews with Black and mixed‐race women in England and Germany. The question it seeks to answer is: 'How do changes in context alter Black and mixed‐race women's hairstyling practices as a performance of identity?' Navigating a novel context could lead the women to (1) conform to local standards of beauty and femininity, (2) resist external expectations, (3) try out novel performances and (4) negotiate the complex performance of belonging. All in all, this paper shows that Black and mixed‐race women dialogically re/negotiated and performatively re/created how they identify and how they are identified by others as they moved from one context to another. [ABSTRACT FROM AUTHOR]

This paper argues that the classification of propositional attitudes into the de re, de dicto, and de se is incomplete. De se attitudes are widely agreed to be closely connected to de re attitudes. But there is a species of belief that is linked to agent‐centered action in the way that de se beliefs are, but is also associated with entities, places, and especially times, under a description. These mark out a fourth kind. One way to think about what makes them distinctive is that, despite being 'essentially indexical' they can be retained across different contexts of evaluation without having diagonal content. The paper also discusses the connection between such beliefs and the kinds of utterances (like 'Don't put off for tomorrow what you can do today') that are contested as examples of what David Kaplan called 'monsters.' [ABSTRACT FROM AUTHOR]

Background: Intensive interaction is an approach used to develop the communication and social inclusion of those who are pre‐verbal. It is used in a variety of settings by healthcare and educational staff. Method: A systematic search was conducted to identify and review the literature which explores staff experiences of intensive interaction being implemented within their places of work. Thematic synthesis was utilized to synthesize the findings. Results: Nine papers were included. Three higher‐order themes were generated: "Personal Doubt, Discordance & Discomfort," "A Turning Point" and "Needing Implementation at All Levels." Conclusions: There were consistent findings across a range of settings. Findings suggest that intensive interaction is rewarding for staff and beneficial to those that they work with. Implementation was sometimes perceived to be challenging and this review attempts to highlight solutions with guidance of the literature. Limitations largely relate to heterogeneity of the papers and methodological limitations are discussed. [ABSTRACT FROM AUTHOR]

Little has been written on the financial support behind Timothy Leary's unorthodox research into mind‐altering drugs like LSD and psilocybin and his subsequent psychedelic movement. Indeed several individuals and organizations helped the psychedelic cause by directly funding Leary's ventures, offering legal and logistic assistance, and organizing fund‐raising campaigns. I argue that classic philanthropic attitudes and wealthy patrons played a major supporting role for Leary's psychedelic movement in the first part of the decade and that the changes in Leary's research objectives and his transition from academic to LSD guru were accompanied by changes in the patterns of support that occurred throughout the 1960s. This paper also connects Leary's legal troubles in the second part of the decade with the rise of the movement to legalize cannabis and points to historical continuity by looking at contemporary endeavors to fund psychedelic research. [ABSTRACT FROM AUTHOR]

This paper addresses a novel output redefinition method for the nonlinear H∞$$ {H}_{\infty } $$ attitude stabilization problem of a flexible spacecraft. As an idea, the flexible appendage tip‐point can be selected as attitude output which may improve attitude pointing accuracy. However, it makes the system non‐minimum phase. The output redefinition method is an effective method to make the system minimum phase. In this paper, a novel output redefinition is proposed to overcome the non‐minimum phase property such that it improves the attitude control system performance. Then, a nonlinear H∞$$ {H}_{\infty } $$ controller is designed based on back‐stepping approach and a modal observer. The simulation results show the effectiveness of the proposed method in the presence of model uncertainties and environmental disturbances. [ABSTRACT FROM AUTHOR]

This paper examines cyberbullying concerning therapeutic interventions. A section on bullying and how bullying impacts the therapeutic environment is included. The author provides his definition of bullying to incorporate cyberbullying and how it is no longer a "new issue" but an evolving one. The current status of therapeutic interventions used to support victims of cyberbullying has been explored, emphasising their effectiveness in assisting those experiencing bullying. A segment has been implemented to comprehend whether practitioners fully understand the potential implications of cyberbullying on clients, whether bullying is still seen as a "rite of passage" and what the possible consequences of this could be. Peer interventions and support groups concerning cyberbullying have been referenced, including The KiVa Programme, the Shared Concern Method and The Circle of Friends Method. These have highlighted specific examples of therapeutic and nontherapeutic approaches to intervene with cyberbullying. A section on potential further training is presented for practitioners working within educational environments. Moreover, physical, psychological, sexual and relational bullying are discussed in the article when applicable, with the umbrella term "bullying" used to discuss all forms of bullying at once. The paper has uncovered two key messages: (1) cyberbullying requires more awareness in counselling and is no longer a new issue and (2) more extensive training is required to assist therapists to work with cyberbullying victims. [ABSTRACT FROM AUTHOR]

Background: Research is beginning to shed light on the practices employed by speech‐language therapists (SLTs) for the management of acquired dysarthria. However, studies that explore SLTs' satisfaction with the effectiveness of current therapies and their interest in new treatment methods for this population have not been carried out. One potential new method is neuromuscular electrical stimulation (NMES): the pool of evidence for its use in rehabilitation is increasing, yet it has not been widely explored for use with dysarthria. Aim: To extend the understanding of acquired dysarthria management practices employed by SLTs across the globe and determine their satisfaction with current therapy options. To explore their interest in using NMES with this population. Methods and Procedures: A cross‐sectional international online survey was developed and disseminated to SLTs working with adults with acquired dysarthria through international professional associations. The survey collected information on demographic characteristics, dysarthria management practices, satisfaction with treatment effectiveness and interest in and knowledge of NMES. Survey responses were analysed using descriptive and inferential statistics, and quantitative content analysis. Outcomes and Results: A total of 211 SLTs (North America, 48.8%; Europe, 36%; Asia, 8.1%; Oceania, 5.7%; Africa, 0.9%; South America, 0.5%) completed the survey in full. Management practices varied considerably. There was a clear preference for informal assessments, mainly oral‐motor examinations, focusing on body functions and structures. The majority of respondents rejected the use of non‐speech oral motor exercises as a clinical or carryover exercise. Variable satisfaction with current speech subsystem treatments was noted; however, overall, there was a general dissatisfaction. Whilst a strong interest in the use of NMES for dysarthria was evidenced, it was noted that most SLTs lacked fundamental knowledge of NMES principles and application. Conclusion: SLTs' management practices and satisfaction with acquired dysarthria treatments differed substantially. Investigations of the potential use of NMES for dysarthria treatment are of interest. WHAT THIS PAPER ADDS: What is already known on the subject: Recent country‐specific surveys have explored speech‐language therapists' (SLTs') assessment and intervention practices for acquired dysarthria. These studies indicate that although clinical management for this speech disorder mainly involves informal assessment tools and impairment‐focused treatment, communication beyond the impairment, such as the activity and participation domains, is also frequently assessed and treated. What this paper adds to existing knowledge: The majority of SLTs are dissatisfied with the overall benefits of current acquired dysarthria treatment. Phonatory, respiration and speech rate therapies are perceived to be more effective than prosody, articulation and resonance treatments. Despite a general lack of theoretical knowledge, most SLTs are interested in neuromuscular electrical stimulation treatment for acquired dysarthria. What are the potential or actual clinical implications of this work?: New, evidence‐based treatments are needed for SLTs to be confident in the effectiveness of their acquired dysarthria treatment. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide a future research agenda to study how worldviews impact financial attitudes and behaviors. In addition, this paper will help operationalize many of the constructs associated with an individual's values and personal worldview. As a result of this research agenda, researchers and financial planners will move towards developing personal value and worldview identification tools that will help individuals more intrinsically adopt savings goals that help meet their life goals. [ABSTRACT FROM AUTHOR]

This qualitative study aims to contribute to our understanding of how second‐generation immigrants negotiate their multiple identities, and construct their feelings of belonging. We focus on second‐generation ethnic Kurds, a stateless ethnic group with a complex political and social history, who have seldom been investigated in a UK context. Drawing on data from interviews with 14 Kurds living in the UK, this paper outlines the tensions in Kurds' lived experiences of Kurdish and British identity; in particular, experiences of feeling "othered" and how this manifests in relation to their identities. We found that Kurds most commonly dealt with some of the tensions they experienced from not belonging or feeling like an "other" by constructing new identities with more permeable boundaries of belonging; in this study, this was achieved through a "place‐based" identity. In sum, this paper offers a novel contribution to discourses of belonging, by demonstrating how the nuances of belonging and its lived complexities manifest in the experiences of UK‐based second‐generation Kurds, and the resultant strategies that they adopt to navigate tensions. [ABSTRACT FROM AUTHOR]

Mental health recovery is an enabling process encouraging consumers to live a productive life, notwithstanding the presence of debilitating symptoms of illness. The recovery model has been integrated into all areas of mental health. However, literature shows that mental health professionals are not equipped to provide recovery‐oriented care to consumers. Researchers have recommended recovery‐based interventions to develop knowledge, attitudes, and skills to promote recovery‐oriented practice in mental health, yet there is a paucity of research regarding the effect of recovery‐oriented interventions on the knowledge and attitudes of mental health professionals to improve recovery‐oriented practice. Therefore, the purpose of the current review is to understand the effectiveness of interventions on recovery knowledge and attitudes of mental health professionals regarding recovery‐oriented practice. The papers were identified through the Population Intervention Comparison and Outcome strategy. The heterogeneity of the selected papers led to a narrative review instead of a systematic review with meta‐analysis. The analysis suggested that recovery‐based interventions are effective in enhancing the recovery knowledge and attitudes of mental health professionals. Recovery‐based interventions have the potential to reduce the use of physical restraints and improve work satisfaction among mental health professionals. The limitations of the studies were the heterogeneity of the selected populations and the absence of strong methodologies to assess the effect of the interventions. Therefore, future investigations should be focused on the effect of interventions on a homogeneous group using randomized controlled trials. [ABSTRACT FROM AUTHOR]

Background: People with motor neuron disease (pwMND) are routinely offered gastrostomy feeding tube placement and (non‐invasive and invasive) ventilation to manage the functional decline associated with the disease. This study aimed to synthesise the findings from the qualitative literature to understand how individual, clinical team and organisational factors influence pwMND decisions about these interventions. Methods: The study design was guided by the enhancing transparency in reporting the synthesis of qualitative research (ENTREC) statement. The search of five bibliography databases and an extensive supplementary search strategy identified 27 papers that included qualitative accounts of pwMND, caregivers and healthcare professionals' (HCPs) experiences of making decisions about gastrostomy and ventilation. The findings from each study were included in a thematic synthesis. Findings: Making decisions about interventions is an emotional rather than simply a functional issue for pwMND. The interventions can signal an end to normality, and increasing dependence, where pwMND consider the balance between quality of life and extending survival. Interactions with multiple HCPs and caregivers can influence the process of decision‐making and the decisions made. These interactions contribute to the autonomy pwMND are able to exert during decision‐making. HCPs can both promote and threaten pwMND perceived agency over decisions through how they approach discussions about these interventions. Though there is uncertainty over the timing of interventions, pwMND who agree to interventions report reaching a tipping point where they accept the need for change. Conclusion: Discussion of gastrostomy and ventilation options generate an emotional response in pwMND. Decisions are the consequence of interactions with multiple external agents, including HCPs treading a complex ethical path when trying to improve health outcomes while respecting pwMND right to autonomy. Future decision support interventions that address the emotional response and seek to support autonomy have the potential to enable pwMND to make informed and timely decisions about gastrostomy placement and ventilation. Patient or Public Contribution: The lead author collaborated with several patient and participant involvement (PPI) groups with regards to the conceptualisation and design of this project. Decisions that have been influenced by discussions with multiple PPI panels include widening the scope of decisions about ventilation in addition to gastrostomy placement and the perceptions of all stakeholders involved (i.e., pwMND, caregivers and HCPs). [ABSTRACT FROM AUTHOR]

Through the creation of safe spaces in which to explore and challenge dominant negative views of disabled children and young people, this co‐written paper presents unique insight into the meaning and impact upon disabled young people's lives of medical lenses and deficit models of disability. Bodies of work and dominant debates in medical sociology, disability studies and childhood studies have so far largely overlooked the experiences and positioning of disabled children and young people and have rarely involved them in the development or discussion of theory. Drawing on empirical data, and through a series of creative, reflective workshops with a UK‐based disabled young researchers' collective (RIP:STARS), this paper discusses areas of theoretical importance identified by the disabled young researcher collective—the validation of their lives, negotiation of their identity and acceptance in society. The implications, and possibilities, of platforming disabled children and young people's voices in theoretical debates are deliberated and are achieved through the yielding of privileged academic voice and the development of a symbiotic, genuine partnership which resonates with disabled young people and recognises them as experts in their own lives. [ABSTRACT FROM AUTHOR]

In this paper I explore three challenges to the morality of belief. First, whether we have the necessary control over our beliefs to be held responsible for them, i.e., the challenge of doxastic involuntarism. Second, the question of whether belief is really the attitude that we care about in the cases used to motivate the morality of belief. Third, whether attitudes weaker than belief, such as credence, can wrong, I then end by turning to how answers to the previous challenges suggest a way of extending the morality of belief to encompass a way of thinking of the moral mind more generally. [ABSTRACT FROM AUTHOR]

It is widely accepted among philosophers that there is a tension between acquaintance constraints on singular thought and the plausible assumption that the truths of singular attitude reports ensure the subject's having singular thoughts. From this, anti‐acquaintance theorists contend that acquaintance constraints must be rejected. As a response, many acquaintance theorists maintain that there is good reason to doubt a strong connection between singular attitude reports and singular thoughts. In this paper, however, I defend the acquaintance theory by arguing that there is in fact no tension at all. I consider three objections regarding singular attitude reports against the acquaintance theory: (i) ultra‐liberal singular attitude reports, (ii) the "There is something that S believes to be F" locution, and (iii) infelicities of singular attitude reports. Then, I argue that none of them succeed in showing a genuine tension. [ABSTRACT FROM AUTHOR]

Owing to the different models of disablement in different religions and cultures around the world, social and aesthetic representations of intellectually disabled people are diverse in various societies. Disability is perceived in a different way in India than in the West. There are very few studies on the complex role of Indian mainstream Hindi cinema in the representation of intellectual and developmental disabilities in India. This paper explores the potential of shifting representations of intellectual and developmental disability in the late twentieth and early twenty‐first century Bollywood films in the context of multiple aesthetic challenges they pose. The shift in screen image of intellectual impairment is strongly related to the shifting and ambiguous sociocultural model of personhood in India. In earlier Indian Hindi films, characters with intellectual disabilities were depicted in terms of good/bad moralistic labels, compromised body image, leading to aesthetic undesirability. In later Hindi films, they were instead represented as enduring human beings. In short, in earlier Hindi films, there was a discriminatory hegemonic bias in the depiction of intellectually disabled characters, in contrast to that in later Hindi films, where they were depicted in richly diverse perspectives. The changing artistic parlance becomes even more interesting in the context of major developments in Indian governmental policies and rights for the disabled in the last two decades. Thus, the paper highlights that contemporary Hindi films urge the audience to consider intellectual and developmental disability as a multilayered issue and rather than merely as a disease. Accessible summary: Our ideas about disability are linked with those of family, religion and tradition in a particular society.Cinema also reflects our perceptions and concepts of disability.This paper is about the how people with intellectual disabilities have been shown in Hindi cinema in the last 30 years, and how intellectual disability is understood in India.In Hindi cinema, intellectually disabled characters are represented in a way that is slightly different from those in Western literature and films.Research on representations of intellectual disability in cinema is important as it can stimulate healthy discussions on a more empathetic society with a better understanding of the various facts related to intellectual disability. [ABSTRACT FROM AUTHOR]

Introduction: Disparities in the uptake of routine and COVID‐19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further. Methods: This study used a theory‐informed, community‐based participatory research approach to co‐design a culturally tailored behaviour change intervention aimed at increasing COVID‐19 vaccine uptake among Congolese migrants in London, United Kingdom (2021–2022). It was designed and led by a community‐academic partnership in response to unmet needs in the Congolese community as the COVID‐19 pandemic started. Barriers and facilitators to COVID‐19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in‐depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co‐designed and tailored in workshops involving Congolese migrants. Results: Thirty‐two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in‐depth interviews and 16 (same sample) took part in co‐design workshops. Fourteen barriers and 10 facilitators to COVID‐19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co‐designed intervention comprising community‐led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event. Conclusions: Our study demonstrates how behavioural theory can be applied to co‐designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities. Patient or Public Contribution: Patient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co‐producing all stages of the study and co‐authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study. [ABSTRACT FROM AUTHOR]

Political apologies have been argued to contribute to reconciliation among groups and nations but their efficacy has also been questioned. This paper examines the acceptance of political apologies, their content and the protagonists in the victim nation, the perpetrator nation and their subgroups. Guided by studies on the structure of apologies, it distinguishes 10 features of apologies, seven of which concern their content and three of their protagonists. Following the analysis of apology statements by Japan to South Korea, the paper further breaks these features (factors) down into 32 elements (levels). The acceptance of around 70,000 possible apology combinations is examined in a randomized conjoint experiment, which was embedded in online quota‐based surveys in Japan (n = 2700) and South Korea (n = 3000). The analysis reveals that the content of apologies matters, protagonists matter more than content and some subgroups matter more than protagonists. The subgroup analysis showed that some within‐country differences are larger than cross‐country differences, which challenges the SIT. Apology statements that would be acceptable in both nations are summarised. [ABSTRACT FROM AUTHOR]

Despite a history of critique, concentrated discussion and improved assessment processes, neglect continues to be a major challenge for child protection services. This paper draws on findings from a government‐commissioned analysis of 'serious case reviews' (SCRs) in England, arising from incidents of serious child abuse in 2017–2019. There were 235 cases, for which 166 final reports were available. Alongside a quantitative analysis of the whole cohort, we undertook an in‐depth qualitative analysis of 12 cases involving neglect. A key challenge in responding to neglect in its different forms is that it can be so widespread amongst families that practitioners no longer notice its severity or chronicity – it becomes normalised. In this paper we explore two dimensions of the 'paradox of neglect' where it seems to be everywhere and nowhere simultaneously. The first is that neglect is so closely bound up with the prevalence of poverty that little action is taken to address it. The second is that the overwhelming nature of neglect can blind practitioners to other forms of maltreatment that may also be present within a family. Practitioners, now more than ever, need to recognise the dimensions of this paradox to protect children from neglect. [ABSTRACT FROM AUTHOR]

In this paper, we argue that nurses need to be aware of how the production of space in specific contexts – including health care systems and research institutions – perpetuates marginalized populations' state of social otherness. Lefebvre's idea regarding spatial triad is mobilized in this paper, as it pertains to two‐spirited, lesbian, gay, bisexual, trans and queer populations (2SLGBTQ*). We believe that nurses can create counter‐spaces within health care systems and research institutions that challenge normative discourses. Lefebvre's work provides us the necessary tools to understand how various places or environments produce identities. In understanding Lefebvre's principles, we believe that nurses can play an essential role in creating counter‐spaces, thereby instigating counter‐institutional practices, for those who experience otherness. [ABSTRACT FROM AUTHOR]

Introduction: Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well‐being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well‐being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. Methods: Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus‐based summaries, arriving at a preferred service model. Findings: This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well‐being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. Public Contribution: This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions. [ABSTRACT FROM AUTHOR]

This study focussed on evaluating the status of recent research on medical decision‐making for adolescents with depression and identifying research hotspots and frontiers via CiteSpace. We extracted studies that were concerned with medical decision‐making for adolescents with depression from the Web of Science Core Collection (WoSCC), covering the period from 1 January 1999 to 20 September 2022. We used CiteSpace to generate online maps of worldwide cooperation among countries, institutions, and authors. Hotspots and frontiers were systematically summarized. A total of 368 papers related to medical decision‐making for adolescents with depression were obtained from WoSCC. The most prolific author was Nick Midgley (seven papers). The United States and University College London were the leading country and institution in this research area, with 177 and 17 papers, respectively. Countries, institutions, and authors all actively collaborated. Main recent research trends include the preference or attitude towards medical treatment in adolescents with depression; approaches for adolescents with depression to seeking medical help; and the key role of parent, family, and primary care in medical decision‐making for adolescents. Thus, further attention should be paid to determining how to promote the role of parents, families, and primary care in the decision‐making process and create appropriate online help‐seeking tools and decision aids to facilitate shared decision‐making in the future. [ABSTRACT FROM AUTHOR]

Introduction: Involving service users in health service design and delivery is considered important to improve the quality of healthcare because it ensures that the delivery of healthcare is adapted to the needs of the users. Co‐production is a process used to involve service users, but multiple papers have highlighted the need for the mechanisms and values guiding co‐production to be more clearly stated. The aim of this paper was to evaluate the mechanisms and values that guided the co‐production approach of the Stories for Change project, which used Public Narrative as part of the co‐design process to create change in National Health Service maternity services. Methods: This study was conducted using a rapid feedback evaluation approach. Semistructured interviews (n = 16) were the main source of data, six of which were maternity service users, with observations (5 h) and documentary analysis also carried out in parallel. RREAL sheets were used for data analysis to organize data based on key topics of interest. Results: This study identified three broad mechanisms and values underpinning the co‐production approach: creating an open and safe space to share ideas, learning how to tell stories using Public Narrative and having service providers who play a key role in strengthening the health system listen to stories compelling them to action. This study identified the main areas for improvement of the Stories for Change project related to recruitment, the inclusion of participants, the co‐design process, the Skills Session and the Learning Event. Conclusion: Our study provided a deeper understanding of the co‐production approach that addresses the need to uncover the mechanism and values underlying co‐production and co‐design approaches. This study expands on the literature pertaining to the influence of storytelling in creating meaningful change in health care. We propose a co‐design methodology that uses Public Narrative as a model for service user engagement to help inform future healthcare development processes. Patient or Public Contribution: The experiences and perceptions of maternity service users and health professionals informed this evaluation. The project organizers were involved in the manuscript preparation stage by providing feedback, and service users wrote a commentary on the project from the lived experience perspective. [ABSTRACT FROM AUTHOR]

Background: Dysphagia impacts negatively on quality of life, however there is little in‐depth qualitative research on these impacts from the perspective of people with dysphagia. Aims: To examine the lived experiences and views of people with lifelong or ongoing dysphagia on the impacts of dysphagia and its interventions on quality of life, and barriers and facilitators to improved quality of life related to mealtimes. Methods & Procedures: Nine adults with lifelong or acquired chronic dysphagia engaged in in‐depth interviews and a mealtime observation. The observations were recorded and scored using the Dysphagia Disorders Survey (DDS). Interviews were recorded, transcribed and de‐identified before content thematic and narrative analysis, and verification of researcher interpretations. Outcomes & Results: Participants presented with mild to severe dysphagia as assessed by the DDS. They viewed that dysphagia and its interventions reduced their quality of life and that they had 'paid a high price' in terms of having reduced physical safety, reduced choice and control, poor mealtime experiences, and poor social engagement. As part of their management of dysphagia, participants identified several barriers to and facilitators for improved quality of life including: being involved in the design of their meals, being adaptable, having ownership of swallowing difficulties, managing the perceptions of others and resisting changes to oral intake. Conclusions & Implications: This research improves understanding of the primary concerns of people with dysphagia about their mealtime experiences and factors impacting on their quality of life. Clinicians working with people with dysphagia need to consider how self‐determination, autonomy and freedom of choice could be improved through involvement in food design of texture‐modified foods. It is important that future research considers the views of health professionals on how these findings could impact on policy and practice particularly in ways to address the barriers and enhance facilitators to improved quality of life for people with dysphagia. What this paper adds: What is already known on the subject: Dysphagia impacts on quality of life, particularly as the severity of the dysphagia increases. Research to date has focused on people with dysphagia associated with an acquired health condition and has used quantitative assessment methods to measure quality of life. What this paper adds to existing knowledge: This study provides a qualitative examination of the impacts of dysphagia on quality of life from the perspective of people with lifelong or ongoing acquired dysphagia and their supporters. This study also provides qualitative insights into the barriers and facilitators of mealtime‐related quality of life. What are the potential or actual clinical implications of this work?: Health professionals should engage in open communication with their clients with dysphagia regarding the impacts of dysphagia on their lifestyle and quality of life. By considering these impacts, health professionals may be able to recommend interventions that are more acceptable to the person with the dysphagia which may have a positive impact on their mealtime experience. [ABSTRACT FROM AUTHOR]

Background: Acquired laryngotracheal stenosis (LTS) is a rare condition that causes breathlessness and dyspnoea. Patients have reconstructive airway surgery to improve their breathing difficulties, but both LTS and the surgery can cause voice difficulties. The existing evidence base for management of voice difficulties for adults with LTS focuses on symptoms. There is limited information to provide clinical guidance for speech and language therapists (SLTs) and a limited understanding of the impact of voice changes on adults with LTS. Aim: To investigate the lived experience of adults with laryngotracheal stenosis (LTS), who have had reconstructive surgery; here focussing on voice concerns with the aim of guiding clinical care for SLTs. Methods and Procedures: A phenomenological, qualitative study design was used. Focus groups and semi‐structured interviews were completed with adults living with LTS who had had reconstructive surgery. Audio recordings were transcribed and inductive thematic analysis was used by the research team to identify themes and sub‐themes. Outcomes and Results: A total of 24 participants (five focus groups and two interviews) took part in the study before thematic saturation was identified in analysis. Three main themes were identified specific to the experience of living with LTS: the Medical, Physical and Emotional journey. All participants referenced voice difficulties as they related to each of these overall themes. Sub‐themes directly related to voice included experience of surgery, information provision, staff expertise/complacency, symptoms, symptom management, identity, support networks, impact on life and living with a chronic condition. Conclusions and Implications: In this qualitative study participants have described the integral part voice difficulties play in their lived experience of LTS and reconstructive surgery. This is considered in the context of their clinical care and the need for individualised management and information provision throughout the course of their condition. The broader research literature relating to voice difficulties is explored with links made to people with LTS and recommendations made for future research into people living with LTS and dysphonia. What this paper adds: What is already known on this subject: Adults with laryngotracheal stenosis (LTS) experience voice changes as a result of their condition, and the surgeries necessary as a treatment. These changes can lead to altered pitch, vocal fatigue, loss of pitch range and loss of volume control. Although there are known psychosocial implications both to living with a chronic condition and voice difficulties there has been no research exploring this in adults with LTS, and there is minimal clinical guidance for speech and language therapists (SLTs) working with these patients. What this paper adds to existing knowledge: This research is the first study to explore the lived experience of adults with LTS who undergo reconstructive surgery, focusing on their voice concerns. This study demonstrates the multifactorial impacts of voice changes on all aspects of the lives of adults with LTS and the need for individualised information provision and clinical care to help support them. What are the potential or actual clinical implications of this work?: Adults with LTS want expert SLTs to facilitate their care and support them throughout their LTS journey alongside other support networks. They want to be carefully prepared for reconstructive surgery and given clear information about symptoms and management of their voice difficulties. This has led to the reorganisation of the care pathway at our centre, and the introduction of a patient‐led pretreatment session. [ABSTRACT FROM AUTHOR]

What does it take to be prejudiced against a particular group? And is prejudice always epistemically problematic, or are there epistemically innocent forms of prejudice? In this paper, I argue that certain important forms of prejudice can be wholly constituted by the differential accessibility of certain pieces of information. These accessibility relations constitute a salience structure. A subject is prejudiced against a particular group when their salience structure is unduly organised around that category. This is significant because it reveals that prejudice does not require the presence of any explicit cognitive or emotive attitude, nor need it manifest in behaviour: it can be solely constituted by the organisation of information, where that information may be accurate and well‐founded. Nonetheless, by giving an account of 'undue organisation' in epistemic terms, I show that this account is compatible with an understanding of prejudice as a negatively valenced epistemic category. [ABSTRACT FROM AUTHOR]

This paper highlights the question, often asked, why does racism persist despite the many attempts to eradicate it? The paper provides some answers, first for social relations generally and second for systemic psychotherapy. Central to the answers is an acknowledgement of the obstacles in both spheres to address the structures, systems, organisation and processes which lie behind conceptualisations of race, racism, identity and relationships. It is in these structures and systems that the suffocating and inevitable effects of racism originate. The paper suggests that, if we want to begin to eradicate racism, we need to look in those places (mostly White) where we least suspect it, the places which seem 'natural' and therefore foundational. It concludes that we cannot teach race and equity, because by singling out this topic without looking behind it, we perpetuate a violence through which the very relations we want to eradicate are produced. This does not mean, however, that we should ignore the topic. Practitioner points: Racism is deeply rooted in action and ideas.The recent murders of Black persons demonstrate the slow, suffocating and strangling aspects of racist systems and structures in our society.Ideas and concepts are difficult to address because they tend to be buttressed by basic assumptions about life and relationships.Race, ethnicity and culture are processes rather than a list of items/things.Tools such as the Social GRRRAAACCEEESSS and the cultural genogram are inadequate for training because the assumptions they are based on are rarely made transparent. [ABSTRACT FROM AUTHOR]

Context: There have been significant advances in competency‐based medical education (CBME) within health professions education. While most of the efforts have focused on competency, less attention has been paid to the role of confidence as a factor in preparing for practice. This paper seeks to address this deficit by exploring the role of confidence and the calibration of confidence with regard to competence. Methods: This paper presents a conceptual review of confidence and the calibration of confidence in different medical education contexts. Building from an initial literature review, the authors engaged in iterative discussions exploring divergent and convergent perspectives, which were then supplemented with targeted literature reviews. Finally, a stakeholder consultation was conducted to situate and validate the provisional findings. Results: A series of axioms were developed to guide perceptions and responses to different states of confidence in health professionals: (a) confidence can shape how we act and is optimised when it closely corresponds to reality; (b) self‐confidence is task‐specific, but also inextricably influenced by the individual self‐conceptualisation, the surrounding system and society; (c) confidence is shaped by many external factors and the context of the situation; (d) confidence must be considered in conjunction with competence and (e) the confidence‐competence ratio (CCR) changes over time. It is important to track learners' CCRs and work with them to maintain balance. Conclusion: Confidence is expressed in different ways and is shaped by a variety of modifiers. While CBME primarily focuses on competency, proportional confidence is an integral component in ensuring safe and professional practice. As such, it is important to consider both confidence and competence, as well as their relationship in CBME. The CCR can serve as a key construct in developing mindful and capable health professionals. Future research should evaluate strategies for assessing CCR, identify best practices for teaching confidence and guiding self‐calibration of CCR and explore the role of CCR in continuing professional development for individuals and teams. @MGottliebMD @TChanMD @fzaver @drellaway review the concepts of confidence, competence, and the intersectionality between the two in this 'State of the Science' paper on "Self" in medical education. [ABSTRACT FROM AUTHOR]

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