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Research has been valued and given priority over teaching for a long time in academia. In recent decades, the Taiwanese Ministry of Education has pursued objective and quantitative research criteria and has encouraged higher education institutions to ask teachers to publish papers in SSCI or SCI journals as part of the criteria for promotion and evaluation. This policy strengthens the concept that research has priority over teaching because teachers must devote more time to research than to teaching in order to be promoted and evaluated. The purpose of this study is to explore the influences that cause teachers to value research over teaching. To achieve this purpose, document analysis, the analysis of Taiwan Higher Education database and interviews were adapted as methods. First of all, our researchers collected and analyzed the documents for promotion and evaluation of twelve different universities whose areas of specialty included general studies, education, medicine, vocational studies, and the arts. Then, the study used and analyzed the empirical data of teachers' working hours every week for different tasks from the Taiwan Higher Education Database which investigated the working conditions of teachers in higher education in 2004. Additionally, twenty professors who have different areas of study and work in different types of universities were interviewed to collect teachers' opinions of the task priority of research, teaching, and service duties. The results showed that academia in Taiwan exhibits the phenomenon that research is valued over teaching. The reasons are due to the requirements of the reward system. The reward system emphasizes research over teaching and service. Teachers' research achievements are judged based on publishing articles in different types of journals and the amount of research funding they can obtain. The results also showed that every week teachers spend the most time on teaching, then on research, and finally on service. However, teachers emphasize research as the most important task, then teaching, and finally service. Although the majority of teachers think research is the most important duty, there is still twenty percent of teachers who think it is the least important. Although teaching has been thought of as the second most important duty after research, it is the task that the most teachers give as the first priority as far as time spent and none of the interviewees thought it is the least important. Universities and teachers all try to use their professionalism as capital to gain financial support from the government. This situation forces teachers to try to put more time and energy into research, but they still need to maintain teaching and service work quality. Some teachers focus more time and energy on research and ignore the needs of students. Working time endlessly increases even for teachers who out value on both teaching and research. Some suggestions based on the findings have been proposed for Taiwanese higher institutions.

The Lidcombe Program was developed in the 1980s for children who stutter. This program relies on the efficacy of caregivers in managing their child's stutter within everyday environments, including rating the severity of their child's stuttering on a daily basis. The aim of this pilot project was to compare the traditional paper-based severity rating (SR) system to a newly developed online SR system and, in the context of one regional community health service, report on the outcomes of novel components such as the daily reminder text message. A descriptive comparative analysis was utilised to assess the opinions of participants on the two SR systems by using an online questionnaire. All participants (n = 7) preferred the online SR system compared to the paper-based SR system and in particular found the feature of an evening daily SMS text message to be useful in reminding them to rate their child's stuttering severity. This small pilot study demonstrated that adding a relatively small initiative to an established program can have a considerable impact on the monitoring of adherence to therapy in a small community health care service. [ABSTRACT FROM AUTHOR]

This paper reports on a content analysis of 633 biology education research [BER] papers published by Turkish science educators in national and international journals. The findings indicate that more research has been undertaken in environment and ecology, the cell and animal form and functions. In addition learning, teaching and attitudes were in the forefront as the frequently investigated subjects. Undergraduate and secondary school students were mostly studied and the sample size mostly varied between 31-100 and 100-300 and also, quantitative research was mostly preferred. Besides, commonly used data collection tool included; achievement tests, questionnaires and attitude scales and the commonly used data analysis and presentation techniques were frequency/percentage tables, central tendency measures, t-tests and ANOVA/ANCOVA analyses.

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Accessible Summary: What Is Known about the Subject?: One in five mothers and birthing parents are affected by postpartum depression (PPD), yet only a small proportion of those with PPD receive treatment.Given cost and accessibility barriers to treatment, brief therapies (e.g. 1 day) could help address PPD on a large scale, though understanding participants' unique experiences with this novel treatment will help guide its refinement and use. What this Paper Adds to Existing Knowledge?: This paper describes the experiences, perspectives and satisfaction of participants who attended a 1‐day workshop for PPD.Participants appreciate being taught practical techniques and the receipt of social support from facilitators and other attendees in the group setting, while some recommended further 'booster sessions' to enhance effectiveness. What Are the Implications for Practice?: One‐day CBT‐based workshops may be an effective, low‐intensity treatment option that provides helpful skills and builds social networks for individuals with PPD.Additional post‐workshop booster sessions may enhance participant satisfaction with this new treatment by providing a reinforcement of their learning and an opportunity to re‐connect with other birthing parents. Introduction: Postpartum depression (PPD) affects up to one in five mothers and birthing parents. Understanding their perceptions of therapeutic interventions is key to their effectiveness and scalability. Aim: The aim of the study was to understand participants' experiences attending an in‐person or online 1‐day cognitive behavioural therapy (CBT)‐based workshop for PPD and compare their experiences participating in either modality. Method: This descriptive qualitative study was embedded in two separate randomized controlled trials evaluating the effectiveness of 1‐day CBT‐based workshops for PPD delivered in‐person or online. Responses were provided by 94 in‐person and 95 online participants about their experiences. Content analysis was used to code and categorize the data. Results: Participants appreciated learning skills to improve PPD symptoms and joining a community of individuals with shared experiences. Integrating practical coping techniques after the workshop was reported to be most useful, though some wanted additional post‐workshop support. Online participants identified additional barriers to workshop engagement. Discussion: Participants who attended either workshop found them to be valuable and effective. Participants valued psychoeducation, social connections and applying practical CBT techniques. Implications for Practice: One‐day CBT‐based workshops may be an accessible treatment option for individuals with PPD, providing new skills and social support, though some prefer to receive additional post‐workshop support. [ABSTRACT FROM AUTHOR]

Objective: This study explored the experiences, concerns and perceptions of hospital clinical staff returning to work after parental leave during the COVID-19 pandemic. Methods: An exploratory mixed-methods study was performed. Eligible staff employed at a large metropolitan tertiary health service in Melbourne, Australia, completed an ethics-approved anonymous online cross-sectional survey and/or participated in an interview between February and June 2021. Results: Ninety-six staff completed a survey and four participated in an interview. Staff reported both positive and negative aspects of being on parental leave during the COVID-19 pandemic including disappointment their leave had not gone as planned; feeling isolated from family and friends; wanting greater communication from their health service; appreciating the increased opportunities for them and their partner to be at home and bond with their baby; and concerns about returning to work such as limited knowledge of COVID-19 workplace policies and potentially infecting their baby and family. Conclusions: The COVID-19 pandemic had a unique impact on the parental leave and return to work experiences of hospital clinical staff. The findings suggest that staff would benefit from formal return to work policies and programs including regular contact with their manager while on parental leave and workplace reorientation on their return, especially during events such as a pandemic. What is known about the topic? Healthcare workers often experience additional challenges and stressors returning to work after parental leave compared to other workers. What does this paper add? The COVID-19 pandemic had a unique impact on the parental leave and return to work experiences of healthcare workers who reported positive and negative aspects including isolation, limited workplace communication and increased opportunities for bonding with their baby. What are the implications for practitioners? Appropriate organisational initiatives may alleviate staff distress and support their return to work and could include formal return to work programs, regular managerial contact and workplace reorientation. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness. Methods: A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self‐efficacy were measured at pre‐intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self‐efficacy was measured at pre‐intervention and 3 months later. Results: The intervention was feasible and acceptable. No difference in self‐efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group. Conclusion: The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics. Trial registration: ClinicalTrials.gov ID: NCT03944642. Summary statement: What is already known about this topic? Breastfeeding is the gold standard for infant and young child nutrition.However, national and global prevalence is lower than expected.Breastfeeding support has focused on a biomedical approach with a predominantly clinical approach to breastfeeding difficulties.What this paper adds? Establishes an intervention proposal from an integral approach centred on a woman, her child and her family.Considers the perspective of health professionals in relation to their strengths and difficulties in supporting mothers with breastfeeding.Estimates the effect of the intervention on the self‐efficacy of professionals and mothers.The implications of this paper: This intervention was feasible and accepted by participants and health professionals working in primary health care centres. Therefore, the exploratory trial can be subjected to a full trial following the protocol and recommendations from the findings at this stage.Although the effects measurements of the intervention effects are preliminary, they show promising results regarding breastfeeding (BF) maintenance rates, together with a recovery of exclusive breastfeeding at 4 months and a decrease in maternal postpartum depression risk. [ABSTRACT FROM AUTHOR]

Patient-centered care is recognized as a key element in recent healthcare management strategies. However, the integrated collection of patient feedback capturing the entire journey of patients with complex medical conditions remains understudied. Herein, we aimed to describe the development of an instrument prototype for the collection of PROMs and PREMs that would encompass a whole patient journey at a single time point. We further describe the process of its integration into a hospital's information system (HIS) and the results of a pilot feasibility study in adult patients with kidney and hematological diseases. We developed an instrument consisting of original PREM and generic EQ-5D-5L questionnaires. E-questionnaires were handled with REDCap software (version 12.5.14) and integrated into the HIS. Patients refusing to use e-questionnaires (48%) were offered paper administration and were older (64 vs. 50 years). The overall response rate for e-questionnaires was 57.1% with a median completion time of 2.0 and 3.7 min for PROM and PREM, respectively. Psychological and social services and primary care setting (diagnosis establishment and involvement in continuous care) were identified as most problematic. The majority of PREM dimensions encompassing different levels of care significantly correlated with PROM responses. Our data indicate the feasibility and potential relevance of the proposed approach, although wider-scale studies in diverse settings are needed. [ABSTRACT FROM AUTHOR]

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

Aim: To explore the satisfaction and experiences of women and staff with the BSOTS in an Australian hospital. Design: Cross‐sectional descriptive survey. Methods: Surveys were distributed to women and staff between February and May 2022. Survey questions reflected satisfaction with triage and provision of care under the BSOTS system (for women) and confidence in using the BSOTS system and its impact on triage‐related care (for staff). Survey data were summarized using descriptive statistics, and qualitative responses were analysed using content analysis. Results: There were 50 women and 40 staff (midwives and doctors) survey respondents. Most women were satisfied with triage wait times, the verbal information they received and the time it took for them to receive care. Nearly all midwife participants indicated they had high knowledge and confidence in using the BSOTS. Most staff indicated that the BSOTS supported the accurate assessment of women and had benefits for women, staff and the hospital. Conclusion: The findings showed that women and staff were satisfied with receiving and providing care in a maternity triage setting under the BSOTS system. Implications for the Profession and/or Patient Care: Implementing standardized maternity triage approaches such as the BSOTS in health settings delivering care to pregnant women is recommended for improving flow of care and perceptions of care quality by women. Impact: Quality of maternity triage processes is likely to impact the satisfaction of women attending services and the staff providing care. The BSOTS was shown to improve maternity triage processes and was associated with satisfaction of women and staff. Maternity settings can benefit from implementing triage approaches such as the BSOTS as it standardizes and justifies the care provided to women. This is likely to result in satisfaction of women and staff engaged in maternity triage and improve the birth outcomes of women and babies. Reporting Method: The reporting of this paper has followed SQUIRE guidelines. Patient or Public Contribution: Women engaged with maternity services were participants in the study but did not contribute to the design, conduct or publication of the study. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Aim: To identify structural barriers to the uptake and practice of anti‐racism in nursing education, specifically in the Canadian context. Design: A deconstructive, critical, qualitative inquiry informed by critical race theory, critical whiteness, feminism and post‐colonialism. Methods: This study employed an anonymous online open‐ended questionnaire and online focus groups with Canadian nurse educators from April to June 2021. The data were analysed through a contextualist thematic analysis that accounts for data as essential experience and also a product of discourse. Results: Structural barriers identified are organized into themes of: the academic environment; position and power; racism; program delivery; and Whiteness. Pervasive silence, especially white silence, can be interpreted in related contexts of precarity, self‐interest and institutional violence. Overarching processes of precarity and resistance exert power over the environment of nursing education which act to destabilize, disrupt and discourage anti‐racist efforts and education. Conclusion: The sustainability of anti‐racism should be a primary focus. This entails attending to structures in nursing and higher education that make nursing education precarious work, especially for educators racialized as Other in the white supremacist racial binary of White: non‐White. Explicit and ongoing attention to conditions that silence is necessary for any progress to be made. Strategies of applying anti‐racism need to be as complex as the barriers. Implications: Many schools of nursing are engaged in attempts to include anti‐racism as learning and environment. The structural barriers that interfere with effective integration of anti‐racism as a lens for nursing education must be named and addressed so educators and schools can be successful. The implication of trying to incorporate anti‐racism without addressing the barriers is a very superficial or pocketed application of anti‐racism, and a continuation of the status quo that reproduces Whiteness and excludes and harms people racialized otherwise. Impact: The study addressed both strategies and barriers to anti‐racism in nursing education. This article addressed structural barriers in anti‐racism in Canadian nursing education. The main findings are that processes of precarity specific to nursing education in institutions of higher learning, and resistance through Whiteness, decision‐making hierarchy and regulatory structures interfere with the application of anti‐racism. This research impacts nurse educators in all nursing schools and leaders in higher education. It also impacts all current and future nursing students as the recipients of the education we provide. Reporting Method: The paper adheres to COREQ checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Purpose: This study discusses the creation of an online, asynchronous presentation to educate adolescents about prevention of noise-induced hearing loss (NIHL) through interprofessional collaborations and electronic service-learning (eSL) during the COVID-19 pandemic. Method: The Hearing Education and Research (HEAR) presentation, which included activities and videos to educate a group of ethnically diverse adolescents (n = 100) on NIHL, was created by 11 doctor of audiology (AuD) students through online collaborations toward course-related eSL requirements. Adolescents responded to a baseline survey to assess hearing health–related behaviors prior to reviewing the presentation. A postprogram survey was administered 1 week after the presentation to assess change in knowledge and attitudes toward NIHL prevention. Online collaborations with schoolteachers helped with project implementation. Postreflection papers written by AuD students regarding the eSL activities were analyzed. Lastly, suggestions from a focus group of educators were included that highlight the role of interprofessional collaborations to enhance school-based hearing conservation opportunities. Results: The HEAR presentation resulted in changes in knowledge about NIHL among the adolescents. Postreflection papers by the AuD students indicated that the eSL activity served as a high-impact pedagogical assignment, especially during the academic challenges of the pandemic. Feedback from a focus group of schoolteachers helped outline ideas for future implementation of sustainable hearing conservation programs in school settings. Conclusion: The pilot data collected in this study serve as a proof of concept for future hearing conservation projects in school-based settings via interprofessional collaborations and by engaging university students via eSL. [ABSTRACT FROM AUTHOR]

Aim: If not conducted correctly, nursing handover can threaten patient safety, and so nursing students require good handover education. This study evaluated a handover education programme based on situated learning theory in a clinical practicum. Methods: A quasi‐experimental design and convenience sampling technique were used. The participants (fourth‐grade nursing students recruited from a college in the C province of South Korea) were assigned to an intervention group (n = 38) or a control group (n = 39). A handover education programme that included lectures, expert observations, role playing, peer learning and reflection was received by the intervention group. The control group attended lectures and observed handovers. The handover skills of all participants were tested 2 weeks before and on the last day of the clinical practicum. Handover performance ability, handover clinical judgement ability and handover self‐efficacy were outcome variables. Results: Significant improvements in handover performance ability, handover clinical judgement ability and handover self‐efficacy were observed in the intervention group compared with the control group. Conclusion: The significance of this study lies in the development and application of a programme based on situated learning theory for handover education. Application of theory‐based handover education in clinical practicums is recommended to improve the handover capabilities of nursing students. Summary statement: What is already known about this topic? Nursing handover is considered very important for optimizing nursing performance and securing the continuity and safety of patient care.Nurse educators must develop and validate educational strategies to resolve handover deficiencies among nursing students. What this paper adds? The self‐evaluation of handover performance ability, handover clinical judgement ability and handover self‐efficacy were better in nursing students who received handover education based on situated learning theory than in the control group. The implications of this paper: Theory‐based handover education applied in a clinical practicum context can allow nursing students to improve relevant capabilities prior to graduating as a clinical nurse.Situated learning theory provides a theoretical basis upon which to support practical handover learning. [ABSTRACT FROM AUTHOR]

Objective: To establish the association of the mother's breastfeeding self-efficacy with infant feeding in the first six months of the child's life and identify the mothers' perception of their confidence to breastfeed. Background: Breastfeeding is a multi-determined process. Many factors contribute to a mother's ability to exclusively breastfeed until a child reaches six months of age. Among these factors is a mother's confidence in her abilities to breastfeed her baby, referred to as breastfeeding self-efficacy. Thus, self-efficacy for breastfeeding could be an essential predictor of reducing the risk of early weaning. Study design and methods: This is a mixed-method sequential explanatory study. The short form of the Breastfeeding Self-Efficacy Scale was used to determine the level of the mothers' confidence. 158 mothers were surveyed during their postpartum hospital stay, and 128 were included in a follow-up six months after delivery. Additionally, 22 participants were randomly selected for an in-depth interview (qualitative stage). Data were analysed using inferential statistics and thematic content analysis. Results: High levels of breastfeeding efficacy were identified during the hospitalisation and after discharge among all participants. Exclusive breastfeeding was practised among 45.31% of mothers six months after delivery. Return to work was a key factor contributing to early weaning. Family and health professional support during the breastfeeding process were associated as crucial for the duration of exclusive breastfeeding. Discussion: Exclusive breastfeeding for the first six months after delivery involves various factors, such as the mother's confidence in her breastfeeding skills and the specific circumstances she faces while breastfeeding. Thus, through the mixed qualitative and quantitative approaches, it was possible to identify the convergence of self-efficacy scores and the breastfeeding mothers' perception of their confidence and intention to maintain exclusive breastfeeding. Conclusion: High self-efficacy to breastfeed alone was not enough to maintain exclusive breastfeeding. It is necessary to combine self-efficacy and family or health service support and guidance to clarify the mother's doubts about potential difficulties that may appear throughout the breastfeeding process, the maintenance of lactation when she plans to return to work, and the breastfeeding technique. Implication for practice: Applying the Breastfeeding Self-Efficacy Scale associated with the breastfeeding mothers' interview during the prenatal and perinatal period facilitates early identification of mothers at risk for early weaning and helps nurses in planning interventions to support the breastfeeding mother and her child in favour of exclusive breastfeeding duration. What is already known about the topic? * Exclusive breastfeeding (EBF) is recommended for the first six months of a child's life; however, many mothers do not follow this recommendation due to multiple barriers such as mental health issues (i.e., postpartum depression or anxiety), educational gaps, physical discomfort like sore nipples, engorgement, return to work, and lack of support. * Breastfeeding self-efficacy has been associated with the duration of breastfeeding. What this paper adds * Breastfeeding mothers' self-efficacy is essential for stimulating maintenance. * Questions 3 (I always feed my baby without using powdered milk as a supplement) and 11 (I always breastfeed my baby on one breast and then switch to the other) of the Breastfeeding Self-Efficacy Scale (short form) predicted early weaning risk. * Planning nursing care intervention for breastfeeding mothers in their follow-up after birth should include assessing their breastfeeding self-efficacy and factors that could contribute to early weaning, such as returning to work and the lack of a support network. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This paper aims to explore users' perceptions of whether the Leadership Development Impact Assessment (LDI) Toolkit is valid, reliable, simple to use and cost-effective as a guide to its quality improvement. Design/methodology/approach: The Canadian Health Leadership Network codesigned and codeveloped the LDI Toolkit as a theory-driven and evidence-informed resource that aims to assist health-care organizational development practitioners to evaluate various programs at five levels of impact: reaction, learning, application, impact and return on investment (ROI) and intangible benefits. A comparative evaluative case study was conducted using online questionnaires and semistructured telephone interviews with three health organizations where robust leadership development programs were in place. A total of seven leadership consultants and specialists participated from three Canadian provinces. Data were analyzed sequentially in two stages involving descriptive statistical analysis augmented with a qualitative content analysis of key themes. Findings: Users perceived the toolkit as cost-effective in terms of direct costs, indirect costs and intangibles; they found it easy-to-use in terms of clarity, logic and structure, ease of navigation with a coherent layout; and they assessed the sources of the evidence-informed tools and guides as appropriate. Users rated the toolkit highly on their perceptions of its validity and reliability. The analysis also informed the refinement of the toolkit. Originality/value: The refined LDI Toolkit is a comprehensive online collection of various tools to support health organizations to evaluate the leadership development investments effectively and efficiently at five impact levels including ROI. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based practice involves the synthesis of multiple forms of evidence to inform clinical decision‐making and treatment evaluation. Practice‐ and patient‐based evidence are two forms of evidence that are under‐represented in the stuttering literature. The collection of such knowledge is essential to support the design and delivery of effective stuttering interventions for adults. Aims: To build stakeholder consensus on the core components of intervention for adults who stutter, and to establish a guiding framework for the design and development of evidence‐based interventions for adults who stutter. Methods & Procedures: Adults who stutter and speech and language therapists (SLTs) with experience in providing stuttering intervention participated in the three‐round e‐Delphi Survey focused on: (1) identifying key stuttering intervention components, including principles, practices, and structural and contextual elements; and (2) obtaining group consensus on stuttering intervention components. Statements were categorized using the International Classification of Functioning, Disability and Health (ICF) model adapted to the study of stuttering. Outcomes & Results: A total of 48 individuals agreed to participate: 48/48 (100%) completed the Round 1 questionnaire, 40/48 (83%) responded to Round 2 and 36/40 (90%) participated in Round 3. Following content analysis of Round 1, 101 statements were developed, and consensus was achieved on 89 statements perceived as representing the core components of stuttering intervention for adults. Categorization of these statements reflected the key stuttering intervention components relating to personal reactions to stuttering, limitations in life participation and environmental factors. Conclusions & Implications: Consensus on the core components of stuttering intervention was reached through engagement with key stakeholders. The evidence‐based framework presented highlights the range of key intervention components a clinician should consider when designing interventions for adults who stutter. What this paper adds: What is already known on the subject: Evidence‐based practice endorses the synthesis of multiple knowledge forms including research, practice and patient evidence to support clinical decision‐making and treatment evaluation. The stuttering literature is characterized by an over‐representation of efficacy evidence, with significantly less practice and patient evidence to guide clinical practice. What this paper adds to existing knowledge: This study adds valuable practice‐ and patient‐based evidence for effective stuttering intervention components for adults who stutter. These relate to personal reactions to stuttering, limitations in life participation and environmental factors. What are the potential or actual clinical implications of this work?: This research presents a stakeholder‐informed framework for stuttering intervention to guide SLTs working with adults who stutter in designing evidence‐based interventions. The framework supports the adoption of a person‐centred approach to intervention to ensure each client's unique needs, preferences, values and desired outcomes are explored and integrated into therapy. [ABSTRACT FROM AUTHOR]

Background: Although conventional writing procedures are still the dominant instructional procedures in English as a foreign language (EFL) contexts, instructors are still struggling with time limitations to improve EFL students writing skills properly. Additionally, EFL students are not engaged in the writing process since they lack the required information about the writing tasks. Objectives: The present study, therefore, applied a sequential explanatory mixed‐methods approach to explore the impact of a flipped writing classroom on EFL students' writing skills (i.e. writing content, writing organization, and language use) and writing motivation on the one hand and possibly recommend a better instructional procedure for students' writing skills and writing motivation in EFL context on the other hand. Methods: To this aim, two intact classes were selected as the participants of the study. The two classes were randomly assigned to a flipped classroom with 27 EFL students and a non‐flipped classroom with 24 EFL students. The non‐flipped classroom was instructed through conventional writing instruction over 16 sessions whereas the flipped classroom was taught with the same content in a flipped writing mode in 10 sessions. Two timed writing tasks, a writing motivation scale, and an individual semi‐structured interview were used to gather the required data. Results and Conclusions: The findings indicated that the flipped writing classroom outperformed the non‐flipped writing classroom in improving the EFL students' writing performance, writing organization, language use, and writing motivation; however, no significant differences were found between the two groups' writing content. Moreover, the data analysis from the individual semi‐structured interview indicated that the flipped students had positive attitudes and perceptions towards the flipped writing classroom which further supported the quantitative findings. Implications: Practical implications for collaborative writing instruction using video clips and other electronic materials are suggested. Lay Description: What is already known about this topic: In a flipped classroom model, English language students can view video clips prior to class time in order to use the class time for doing academic exercises and projects in a collaborative manner.As in student‐centred learning environments, a flipped classroom engages English language students in more active learning processes, encourages them to enquire about the video lectures, and tests and evaluates their skills in applying knowledge.Individual differences, such as motivational variables and affective factors disjointedly or conjointly affect writing processes, especially in English language contexts. What this paper adds: Flipping an English language collaborative writing course improves English language students' writing performance, writing organization, language use, and writing motivation.Flipped classroom is more effective than non‐flipped classroom in improving English language students' writing performance, writing organisation, language use, and writing motivation.Flipped English language students hold positive attitudes and perceptions towards flipped collaborative writing classroom. Pedagogical implications: English language instructors are recommended to design a flipped classroom to provide English language students with video clips before class time, so students can have more collaborative and evaluative writing activities during the class time.English language students can have and receive more peer/instructor writing mediations on the writing tasks and make better use of class time (based on the video clips) and develop their writing performance accordingly.By designing a flipped classroom, English language students can enhance their writing motivation, and also, they properly cover the required materials in a shorter time. [ABSTRACT FROM AUTHOR]

The purpose of the authors in this paper is to investigate the effects of negative experiences during delivery and postpartum period on the relationship between the mother. The quantitative part of this study was conducted with 289 mothers and the qualitative part with 40 mothers. It was found that experiencing upsetting problems during delivery (p = 0.006) and in the postpartum period (p = 0.002) had an effect on separation anxiety. Based on the examination of the feelings experienced during annoying or distressing situations in the postpartum period, it was determined that there was a significant correlation between guilt (p = 0.000), fear of not being a good mother (p = 0.035), and feeling weak (p = 0.001) and separation anxiety. Blues of birth is fear and anxiety that the baby will be harmed if the mother is separated from it, and it is attributed to negative experiences during delivery and the postpartum period. [ABSTRACT FROM AUTHOR]

The development of a tool to track participation in activity-based therapy (ABT) for people with spinal cord injury or disease (SCI/D) was identified as a priority of the Canadian ABT Community of Practice. The objective of this study was to understand multi-stakeholder perspectives on tracking ABT participation across the continuum of care. Forty-eight individuals from six stakeholder groups (persons living with SCI/D; hospital therapists; community trainers; administrators; researchers; and funders, advocates and policy experts) were recruited to participate in focus group interviews. Participants were asked open-ended questions concerning the importance of and parameters around tracking ABT. Transcripts were analyzed using conventional content analysis. Themes reflected the Who, What, Where, When, Why and How of tracking ABT. Participants described the importance of involving hospital therapists, community trainers and individuals with SCI/D in tracking ABT to capture both subjective and objective parameters across the continuum of care and injury trajectory. Digital tracking tools were favoured, although paper-based versions were regarded as a necessity in some circumstances. Findings highlighted the importance of tracking ABT participation for individuals with SCI/D. The information may guide the development of ABT practice guidelines and support the implementation of ABT in Canada. Tracking the details of activity-based therapy (ABT) sessions and programs across the continuum of care and injury trajectory may provide important information to support the development of ABT practice guidelines and implementation strategies. Tracking objective and subjective parameters are needed to provide a comprehensive description of an ABT session and program. Clinicians and individuals with spinal cord injury or disease (SCI/D) should both be able to track ABT to accommodate all settings and types of data. Digital tracking tools, such as an app, may provide an accessible, versatile and efficient way of tracking ABT. [ABSTRACT FROM AUTHOR]

Background: Formative online multiple‐choice tests are ubiquitous in higher education and potentially powerful learning tools. However, commonly used feedback approaches in online multiple‐choice tests can discourage meaningful engagement and enable strategies, such as trial‐and‐error, that circumvent intended learning outcomes. These strategies will not prepare graduates as self‐regulated learners, nor for the complexities of contemporary work settings. Objectives: To investigate whether providing only a score after formative online multiple‐choice test attempts (score‐only feedback) increases the likelihood of students to engage in self‐regulated learning compared with more directive feedback. Measurable outcomes included deeper learning, collaboration, information seeking, and satisfaction. Methods: Data in this mixed methods study were collected from nursing students through surveys, test results, focus groups, and student discussion board contributions. A quasi‐experimental design was used for quantitative data, and qualitative data were analysed thematically against domains of self‐regulated learning. Results and Conclusions: Students receiving score‐only feedback were more cognitively engaged with the content, collaborated constructively, and sought out richer sources of information. However, it was also associated with lower satisfaction. In this study, minimal feedback created states of uncertainty, which resulted in the activation of self‐regulatory actions. Implications for Practice: Providing overly directive feedback for formative online multiple‐choice tests is conducive to surface‐level learning strategies. By minimising feedback and allowing for extended states of uncertainty, students are more likely to regulate their learning through self‐assessment and problem‐solving strategies, all of which are required by graduates to meet the challenges of real‐world work settings. Lay Description: What is already known about this topic: Formative online multiple‐choice tests are widely used in higher education.Feedback is a critical element in the design of effective online multiple‐choice tests.Formative feedback should promote self‐regulated learning.Feedback types used in multiple‐choice tests facilitate strategies not conducive to self‐regulation. What this paper adds: Online multiple‐choice test feedback can influence how students self‐regulate their learning.Less feedback can result in greater self‐evaluation and performance in summative assessment.Less feedback can encourage richer help‐seeking strategies (collaboration and information seeking).However, less feedback can result in student dissatisfaction. Implications for practice and/or policy: Judicious use of feedback is required in the design of online multiple‐choice tests.Educators should consider providing less feedback to promote learner self‐regulation.Satisfaction with online multiple‐choice tests does not necessarily equate to greater learning. [ABSTRACT FROM AUTHOR]

Copyright of ZFA: Zeitschrift für Allgemeinmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To determine if there are cross‐national differences in nurse understandings of the terms: missed care, rationed care and care left undone. Background: Nurse researchers from a number of countries have published studies on missed and rationed care. It is not clear if there are differences in understanding the key terms across various language groups. Design A mixed method questionnaire was distributed to 26 member countries of a nursing research consortium in 2017. Methods: Forty‐five responses to a qualitative questionnaire were received; 80% were nurse researchers. These responses were categorized into language groups and analysed for congruence and differences. Findings There was congruence across all language groups in interpreting the three terms. Giddens' theory of globalization provides an explanation for this congruence. Conclusion: Shared understandings are explained by the fact that the majority of participants are nurse researchers with knowledge of English and the research literature. Shared understanding within the globalized academic community does not necessarily translate for clinical or nurse managers, nor does it predetermine solutions. SUMMARY STATEMENT: What is already known about this topic? Missed care is a global problem.Various research teams have conducted studies on missed, rationed and unfinished care, including cross‐national studies. What this paper adds? The findings suggest that there is a shared understanding of the terms despite language differences.This shared understanding is restricted to nurse researchers and does not include nurse clinicians or managers.Giddens' theory of globalization provides an explanatory theory for this shared understanding. The implications of this paper: While there might be a shared understanding within the academic research community, this does not mean this extends to nurse clinicians or managers.Globalization of missed nursing care concepts is currently achieved through increased digital communication technologies, international research and the diffusion process of peer reviewed science.Nurse researchers are faced with the challenge of ensuring globalized concepts are translated across cultures into clinical and managerial practice and effective change strategies. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education is seen as a key intervention to address the high HIV-incidence rate and low knowledge among young people in South Africa, yet this lacks inclusion of learners with disabilities. At the same time, educators of learners with disabilities experience cultural barriers and lack skills and knowledge on how to deliver sexuality education in accessible formats. In response, the Breaking the Silence approach, a curriculum implementation and disability-accommodating approach, was developed and tested. This paper presents findings from a formative evaluation using in-depth interviews with educators from eight “schools for learners with special educational needs”. The paper focuses on their experience with implementing the approach. The analysis used conventional content analysis and NVIVO software. Educators conceptualized sexuality education within a risk-protection discourse. They revealed that the training and tools enabled them to provide sexuality education in accessible formats, tackle difficult topics such as sexual orientation and masturbation, and improved awareness and assertiveness within their learners. Educators identified the need for further development including a whole school approach, adjustments to differentiating developmental stages and addressing gender-specific topics. Through its application within the South African mainstream Life Orientation curriculum, this approach lends itself for further development and testing through implementing the approach within a whole school setting and ongoing support that will not only drive change in educators’ skills and knowledge but also drive the needed shift in cultural norms and values. [ABSTRACT FROM AUTHOR]

Background: Community-living older adults may be susceptible to malnutrition (undernutrition) due to both physiological and non-physiological causes. The condition develops over time and the early signs and symptoms may not be obvious. Therefore awareness and early identification of nutrition risk factors may prevent, or at least slow, the progression of malnutrition. Objective: To describe community-living older adults' understanding of the signs of malnutrition, where they would seek malnutrition information and their self-perception of body weight. Design: Older adults (aged ≥ 65 years) living in the community setting completed an online or paper based questionnaire between May and August 2016. The questionnaire contained a mix of closed and open questions which related to weight perception, weight changes, perceived signs of malnutrition and sources of malnutrition information. Body mass index (BMI) from self-reported data was classified using BMI reference ranges for older adults and compared to self-perceived weight status. Textual data regarding the signs of malnutrition were analysed and reviewed by two authors using content analysis. Descriptive statistics were used to describe participant characteristics. Results: A total of 344 responses were received, the majority (90%) completed online. Mean participant age was 73 years and 57% of participants were female. Most (92%) reported their health to be good/very good. Body weight was perceived to be just right or more than it should be by 87% of underweight women and 97% of underweight men. Although 71% of the participants indicated their body weight had remained stable in the past six months, 37% reported they had been trying to change their weight. Signs of malnutrition resulted in four key categories of (i) psychological, (ii) physical appearance, (ii) bodily function and (iv) weight change. Very few reported the need to locate malnutrition information and indicated the top three sources for information would be (i) general practitioner, (ii) dietitian or (iii) internet. Conclusion: This paper has presented useful data about malnutrition from the perspective of the community-living older adult. We found there may be uncertainty about the best weight, for older age. As many indicated they had been trying to change their weight, awareness needs to be raised regarding the impact of weight changes on health outcomes in this population. In this study, the internet appeared to be a key provider of nutrition information. Healthcare professionals need to consider how this can be used in an informative manner among community living older adults as a tool for raising awareness about nutrition risk and malnutrition. [ABSTRACT FROM AUTHOR]

This mixed-methods paper describes the development and preliminary validation of the Behavioral Intentions Questionnaire (BIQ), a multi-scale questionnaire developed to assess determinants influencing Puerto Rican adolescents' intentions to engage in abusive behaviors in dating relationships. Items were developed qualitatively, and face and content validity were established by expert and target population judges via semi-structured interviews (n = 48), discussions, and four focus groups (n = 6 each). The questionnaire was pilot tested twice. An initial pilot test was conducted with students aged 13 to 17 from a private alternative education program in San Juan, Puerto Rico (n = 32). A second pilot test was conducted with a sample of students from the same site (n = 22), in addition to students in the same age range from a private school (n = 88) in San Juan. Confirmatory and Exploratory factor analysis was used to determine construct validity and Cronbach's coefficient alpha determined the subscales internal consistency reliability. Correlations between subscales were examined. Thematic content analysis was used to analyze qualitative data. Qualitative data suggested the need to revise or eliminate items and instructions and incorporate a social desirability measure. Factor analyses yielded a unidimensional structure for each subscale and each subscale demonstrated high internal consistency. Preliminary analysis on the factor structure, internal reliability, and validity of the BIQ were encouraging. However, further psychometric testing is needed before this measure can be considered a useful tool for measuring intentions to engage in abusive behaviors in dating relationships. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the content and multi‐method evaluation of a compassion‐focused cognitive behavioural psychotherapy (CBT) group for people who self‐harm/injure. Method: Quantitative questionnaires and a qualitative focus group were used for the three participants. Reflective diary contents were analysed. Results: Descriptive statistics were used to analyse the questionnaires. These demonstrated positive reductions in the GAD‐7 and PHQ‐9 scores but no significant change in self‐compassion scores. The Cognitions of Self‐Injurious Behaviour Scale demonstrated some positive belief changes. Participants reported improved self‐awareness, alternative coping and improved emotional regulation. All participants reported anger, anxiety and sadness in their diaries; one reported self‐hatred, and another reported feeling dead and numb. Distraction was considered a useful strategy to avoid or delay self‐harm. Interpretative Phenomenological Analysis (IPA) was used and identified six superordinate themes: 'The secret's out! Openness & Honesty', 'Care without fear: calm acceptance', 'Skills not Spills', 'We're all in it together', 'Compassion, not competition nor comparison' and 'Fear of flying solo'. Conclusion: Despite the small number of participants, the combination of compassion‐focused therapy and CBT appears to hold future promise for further research on effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: The Student Practice Evaluation Form – Revised Edition (SPEF‐R) was used across Australian universities from 2008 to 2020 to assess occupational therapy student performance on practice placement. Evolution of practice contexts, placement models and professional competency standards prompted updating of the tool. This paper describes the second and final action research cycle in the development of the SPEF‐R2. Methods: Cycle 2 included three phases: (a) piloting of the SPEF‐R2 and post‐pilot survey to determine utility and applicability; (b) post‐pilot focus groups/interviews; and (c) final amendments for publication and launch. Quantitative data were summarised descriptively, and qualitative data were analysed using qualitative content analysis and reported using illustrative quotes. Results: In Phase 1, 23 participants piloted the SPEF‐R2 and completed a post‐pilot survey. Results indicated participants found the SPEF‐R2 relevant to a range of traditional and contemporary settings, easy to understand and an improvement over the previous version of the tool. Most participants found it more concise and less repetitive than the SPEF‐R. Participants particularly valued additions regarding culturally responsive practice, student health and well‐being and reflective practice. In Phase 2, five post‐pilot focus groups/interviews were held, gathering a deeper understanding of its utility. Discussion highlighted desire for an additional core item within the self‐management domain (Domain Two). Increased confidence in rating and provision of feedback on student performance were also evident. Reflection on findings led to final amendments and publication of the SPEF‐R2. Conclusion: Extensive consultation with the occupational therapy community informed the development of the SPEF‐R2, reflecting contemporary practice and meeting the expectations of Australian occupational therapists. Action research was an effective approach to the development of the SPEF‐R2. Use of the manual and training website and support from universities are paramount if practice educators are to use the tool effectively. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to address how one Doctorate in Clinical Psychology (DClinPsy) programme contributes to the shaping of attitudes of its trainee clinical psychologists (TCPs) towards cognitive behavioural therapy (CBT). Design/methodology/approach: A total of 28 TCPs completed an online, mixed-methods questionnaire relating to their attitudes towards CBT, what factors had influenced their attitude and how competent they felt in applying CBT to clinical practice. Findings: The majority of respondents reported a positive attitude towards CBT. There was a statistically significant positive change at an individual level in TCPs' views of CBT between the point at which they applied for the DClinPsy and the present day. Thematic analysis of qualitative data identified influential factors on the development of TCP attitudes towards CBT. The vast majority of TCPs reported that they felt competent applying CBT in their clinical practice. Research limitations/implications: Overall, the DClinPsy has a positive effect on TCPs' attitudes towards CBT. However, the influence of placements has a more mixed effect on attitudes. A small sample size reduced the reliability of these conclusions. Recommendations for further evaluation have been made. Originality/value: This paper evaluates the effect of a DClinPsy programme on TCPs' attitudes towards CBT. The value is that it establishes which components of the course have different effects on trainee attitudes. [ABSTRACT FROM AUTHOR]

Aim: To develop a comprehensive, hands‐on assessment tool for assessing health in children under five in underserved regions. Design Methodological study design and usability testing were used. Sample Eight nurses working at two health posts and 261 children under five living in the migrant villages participated in the study. Measurement The developed tool was evaluated using 10 items of a questionnaire based on the honeycomb model of Morville (2004). Community nurses administered the questionnaire then followed with a focus group interview after completing a child health exam using the developed tool. Data were collected during July 2017. Results: The Hands‐on Assessment Tool for Child Health is composed of developmental screening, identification of risk factors and clinical signs, growth measurement, diagnostic tests and interpretation of each subdomain, and final impressions. Management strategies include parent education, resource networking, referral to a paediatrician, and follow‐up plans. Usability testing revealed high scores on the facets "valuable," "useful," "desirable," and "findable." Conclusions: Considering the demand for hands‐on tools in underserved regions, the developed tool can provide nurses with resources for competent management of child assessment, interpretation, and nurses' intervention strategies, fortified with clinical judgement processes. SUMMARY STATEMENT: What is already known about this topic? Many child health problems are preventable with early detection and intervention. Health problems in children under five affect the growth and development of the whole life.Community nurses in underserved regions need comprehensive and hands‐on assessment tools with point‐of‐care to identify child health problems and provide right care.Currently developed assessment tools for child health have limitations for use in underserved areas. What this paper adds? The Hands‐on Assessment Tool for Child Health (HATCH) helped community nurses to identify the child's health status and nurses to establish a proper care plan.The tool provided clinical judgement process of assessment, interpretation, and nurses' intervention strategies. The implications of this paper: The result of the research can contribute to a concrete intervention strategy for child health promotion by assessing health and development in underserved regions. [ABSTRACT FROM AUTHOR]

Purpose: An integral feature of Special Guardianship Orders (SGO) is that the children should have some contact with their parents after the order is granted. Local authority social workers have a duty to plan and recommend levels and types of contact. But there is no policy guidance provided on how to undertake these duties, and little is known about the process that practitioners undertake. The purpose of this paper is to investigate the recommending of contact in special guardianship cases, and to provide data on what contact social workers are recommending the factors they take into consideration and the reasons for their decisions. Design/methodology/approach: The research involved a mixed-methods approach comprising of a questionnaire and focus groups. This part of the study comprised of an online questionnaire that was completed by 102 local authority social workers. Responses were downloaded into SPSS Statistics v22 for data analysis and a content analysis was conducted. Findings: Quantitative results from the questionnaire are reported in this paper. Respondents provided comprehensive details on what they include in their recommendations, including levels of contact frequency and specific directions. Practitioners rated the factors they considered in reaching their decisions, and gave their general views on special guardianship contact. Results indicated that practitioners are recommending less contact for fathers than for mothers, and may feel less positively about paternal contact. Bivariate analysis suggests that some older and more experienced social workers are recommending lower levels of contact. Research limitations/implications: The statistical significance of the results was limited by the relatively small sample size. It was therefore decided to limit bivariate analyses to consideration of just three independent variables: the social worker's age and number of years in practice, and the age of the child at the time of their SGO, against dependent variables concerning the levels of contact that had been recommended for mothers and fathers and how positive these were considered to be. Because of the limited sample size, most of the results were above this level, and so were not statistically significant. Practical implications: Special guardianship has been in place for 12 years now, but apart from Jim Wade's 2014 study there has been no major research to guide and inform practice. Such major changes in child welfare require substantiating research, and this study is an attempt to begin filling that gap. The questionnaire part of this study has for the first time provided data on the views, motivations and practice of social workers across the country making recommendations on special guardianship contact. Social implications: The study provides a picture of the type of contact being recommended for birth parents. This information will be useful for practitioners, who might otherwise not know what their colleagues in other local authorities are recommending, and it is hoped that this will encourage further debate on the subject. Originality/value: Special guardianship has so far been poorly served by research. To the author's knowledge, apart from Wade's study there is very little research on the subject, and no significant research at all on special guardianship contact. This questionnaire, alongside the four focus groups that formed the second part of the study, provides the first picture of current practice across the country. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Physical activity (PA) has shown promise in addressing social, behavioural, and motor concerns in children with Autism Spectrum Disorder (ASD). In this paper, the experience of a seven-year-old girl ("Sophie") with ASD and other psychological disorders was examined as she participated in a 10-week PA program. Her motor and social skills were evaluated before and after the program via the Movement Assessment Battery for Children and the Social Responsiveness Scale. PA and social interactions were analyzed based on video recordings, interviews, and focus groups. Sophie demonstrated some improvements in her motor and social skills after the PA program, in addition to gaining PA and social interactions. Sophie also gained self-confidence as she was supported by the instructor and volunteer, and acceptance as she was included in an environment with other children of varying ages and abilities. Sophie's progress exemplifies the far-reaching effects of PA when offered in an accepting environment with adequate support. [ABSTRACT FROM AUTHOR]

Consensus on how to assess non-technical skills is lacking. This systematic review aimed to evaluate the evidence regarding non-technical skills assessments in undergraduate medical education, to describe the tools used, learning outcomes and the validity, reliability and psychometrics of the instruments. A standardized search of online databases was conducted and consensus reached on included studies. Data extraction, quality assessment, and content analysis were conducted per Best Evidence in Medical Education guidelines. Nine papers met the inclusion criteria. Assessment methods broadly fell into three categories: simulated clinical scenarios, objective structured clinical examinations, and questionnaires or written assessments. Tools to assess non-technical skills were often developed locally, without reference to conceptual frameworks. Consequently, the tools were rarely validated, limiting dissemination and replication. There were clear themes in content and broad categories in methods of assessments employed. The quality of this evidence was poor due to lack of theoretical underpinning, with most assessments not part of normal process, but rather produced as a specific outcome measure for a teaching-based study. While the current literature forms a good starting position for educators developing materials, there is a need for future work to address these weaknesses as such tools are required across health education. [ABSTRACT FROM AUTHOR]

Abstract: Despite the growing interest of users in online services, social workers are still reluctant to offer their services in an online environment. Moreover, little is known about online working methods and their contribution to an effective online session. This paper reports on the findings of a Dutch case study of the online intervention “Clickforhelp”. The first aim of this paper is to explore whether social workers believe that they are able to stimulate the problem‐solving abilities of the users in an online working environment. The analysis pertaining to this question was based on the results of a qualitative online survey completed by 26 online social workers. The second aim is to examine how social workers implement the five essential components of a solution‐focused approach in a chat and email environment. A qualitative content analysis of 50 online cases was carried out based on analytical questions derived from the problem‐solving method. The findings illustrate that the social workers of “Clickforhelp” believe that they are able to stimulate the problem‐solving abilities of users in an online environment, but prefer a face‐to‐face setting. They rarely implement all five components of a solution‐focused approach. They predominantly stimulate the self‐esteem and the power position of the user, while relatively little attention is given to the strengths of the user and the social support system. Neither do they translate the problem‐solving process into concrete and achievable steps or evaluate the progress and the user’s experience. It is necessary to further develop knowledge relating to online working skills and methods. [ABSTRACT FROM AUTHOR]

Background: Presbyopia is a progressive condition that reduces the eye's ability to focus on near objects with increasing age. After a systematic literature review identified no existing presbyopia-specific patient-reported outcome (PRO) instruments meeting regulatory guidance, a new PRO instrument, the Near Vision Presbyopia Task-based Questionnaire (NVPTQ), was developed. Results: To explore the patient experience with presbyopia, concept elicitation interviews were conducted with 20 presbyopic participants. The most frequently reported impacts were difficulty with reading menus/books/newspapers/magazines, reading on a cell phone/caller ID, and reading small print. Based on these results, a task-based PRO instrument (the NVPTQ) was developed instructing participants to complete four near-vision, paper-based reading tasks (book, newspaper, nutrition label, menu) under standardized settings, and subsequently assess their vision-related reading ability and associated satisfaction. The draft NVPTQ was cognitively debriefed with a sample of 20 presbyopes, which demonstrated that most participants interpreted the items as intended and endorsed the relevance of the concepts being assessed. After the qualitative research, the draft instrument was psychometrically tested using data from a Phase 2 study. Based on item-level analyses, all items in the NVPTQ demonstrated expected response option patterns and lacked substantial floor or ceiling effects. The reliability, validity, and responsiveness of the NVPTQ Performance and Satisfaction domain scores were assessed. All domains scores had large Cronbach's coefficient α values and good test–retest statistics, indicating that the scores are internally consistent and produce stable values over time. The pattern of correlations with a concurrent measure of visual functioning (National Eye Institute Visual Function Questionnaire 25) demonstrated that the NVPTQ domain scores were related to an alternative assessment of near-vision activities. The NVPTQ domain scores were able to distinguish between groups that were known to differ on the clinical outcome of uncorrected near visual acuity, supporting the construct validity of these scores. The NVPTQ domain scores showed evidence of responsiveness to change by being able to distinguish between groups defined as improved and not improved based on patient-reported and clinical outcomes. Conclusions: This research has resulted in a content-valid and psychometrically sound instrument designed to evaluate vision-related reading ability and satisfaction with vision-related reading ability. Trial registration: ClinicalTrials.gov NCT02780115. Registered 23 May 2016, https://www.clinicaltrials.gov/ct2/show/NCT02780115?term=NCT02780115&draw=2&rank=1. [ABSTRACT FROM AUTHOR]

This paper aims at describing the eating experience of people diagnosed with and treated for laryngeal cancer. Going beyond the mere conceptualization of "after-effect" or the quantification of the disease's impact on the basis of standardized questionnaires, we present a qualitative analysis of the narratives of such experiences. Ethnographic study. Data is obtained from conversations, semi-structured interviews, participant observation, and written documents. A discourse analysis of the narrative information was conducted, with process coding and using the constant comparative method, inductive content analysis, category analysis, units of meaning associated with each other, and triangulation. The impact of cancer on eating processes is not limited to nutrition, but also affects the social and cultural value of food, which is put into question. The symbolic and social values which accompany the traditional way of eating are modified, which is connected with impaired quality of life. The impact on the eating process and its relationship with quality-of-life impairment are clear and connect with the importance of eating ways in culture and social organization. Greater attention should be paid to these contexts in clinical practice, which can affect even more than the impact on communicative processes. [ABSTRACT FROM AUTHOR]

The current study examined the importance of personal goals to residents; assessed whether goal-related behavior was associated with mental health factors (i.e., depression, experiential avoidance, and quality of life); and explored residents' use of selection, optimization, and compensation (SOC) strategies. Interviews were conducted with eight residents at a nursing home along with paper-and-pencil measures of mental health factors. Transcripts were coded first for goal content and subsequently analyzed using an exploratory qualitative method. Most residents (five of eight) denied having goals. Experiential avoidance and depression were significantly negatively correlated with goal content; quality of life was significantly positively correlated with goal content. Eleven themes derived from exploratory analysis suggest SOC processes were important in residents' lives. The study demonstrated the relevance of SOC for residents' quality of life. The potential for developing person-centered interventions to evoke implicit goals and facilitate attainment is discussed. [Research in Gerontological Nursing, 14(6), 277–284.] [ABSTRACT FROM AUTHOR]

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Aim and objective This paper aims to explore the ways in which neonatal nurses understand the experience of parents who have experienced infertility, conceived a baby via in vitro fertilisation and delivered an extremely premature infant. The chance of a poor long-term outcome for the baby is significant; therefore, parental anguish plays out in the neonatal intensive care. Background Current literature suggests that infertility is a significant issue for ageing women and many couples experience multiple cycles of invitro-fertilisation ( IVF) treatment to achieve a pregnancy. Babies conceived through IVF are more likely to have genetic disorders, and be born prematurely. When the baby is born through IVF and is also born extremely prematurely, it creates a crisis situation for the parents. This paper will focus on the parental anguish of achieving a pregnancy through IVF to see the baby born extremely prematurely (defined as ≤ 24-week gestation). It will examine parental anguish from caregiver perspective of the neonatal nurse who supports the parents through this very difficult time. Design This study used interviews with neonatal nurses, and drew insights from interpretative phenomenology. Methods This research used a combination of a questionnaire and a series of interviews in a qualitative study informed by phenomenology. The analysis of the interview data involved the creation of key themes following extensive coding of thematic statements and the analysis of the emerging themes. Results This paper outlines the neonatal nurses' understanding of parental anguish and overwhelming sadness in parents whose baby was conceived by IVF, and was also born extremely prematurely. The theme of 'seeking parenthood' was synthesised from two sub-themes - 'longing for a baby' and 'the desperation to become parents'. Conclusion This study identified that neonatal nurses bear witness to parental anguish as their hopes of taking home a live baby might not be realised. The time, effort and money required to achieve a pregnancy does not mean that the baby will be spared the outcomes of extreme prematurity and the risk factors associated with IVF. The parents may be left empty handed. Therefore, the word precious becomes a metaphor for the IVF baby as the neonatal team try desperately to give the parents their much longed baby. Relevance to clinical practice Delayed child bearing has an impact on fertility, with maternal age having the most impact on the ability to conceive. Babies conceived through IVF technologies have a higher risk of genetic abnormalities and being born prematurely, and this will impact on the neonatal intensive care availability. Extreme prematurity and IVF can significantly impact on the baby's outcome. Witnessing parental anguish can be a major source of stress for the neonatal nurses. Neonatal nurses need to develop strategies not only to help the parents but also to prevent the parents' overwhelming sadness from affecting their ability to function in the neonatal intensive care unit. [ABSTRACT FROM AUTHOR]

This paper investigates the definitions and onset of an old person in South-Western Nigeria. Conventionally, anyone who has reached the age of 60 or 65 years is regarded as the onset of an old person. But on contrary, this recent study is strongly emphasizing that 50 years and above is the onset of an old person in South-Western Nigeria. Obviously, the definitions and onset of an old person are controversial, yet, revealing in this paper. The study captured 13 Local Government Areas in Lagos state while 11 Local Government Areas were covered in Oyo state. The study employed focus group discussions (FGDs) and in-depth interviews (IDIs). However, 938 old persons were interviewed through questionnaire administration in Lagos and Oyo states of South-Western Nigeria. The univariate, FGDs, and IDIs were employed in the analyses of this research. The major findings of this study are the following: firstly, that there are different dimensions of the definitions of an old person that include frailty, inactivity, loss of strength, respect, blessedness, sickness, growing old, and inability to do hard work. Secondly, that someone who has reached the age of 50 years and above can be regarded as an old person, which is the onset of an old person in South-Western Nigeria society. On the basis of earlier findings, the study hereby recommends that anyone who has attained the age of 50 years and above should be recognized, regarded, and honored as an Elder by the State Government of South-Western Nigeria society where they are presently residing. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: A community‐academic team implemented a study involving collection of quantitative data using a computer‐based audience response system (ARS) whereby community partners led data collection efforts. The team participated in a reflection exercise after the data collection to evaluate and identify best practices and lessons learned about the community partner‐led process. Design & Sample: The methods involved a qualitative research consultant who facilitated the reflection exercise that consisted of two focus groups—one academic and one community research team members. The consultant then conducted content analysis. Nine members participated in the focus groups. Results: The reflection identified the following themes: the positive aspects of the ARS; challenges to overcome; and recommendations for the future. Conclusion: The lessons learned here can help community‐academic research partnerships identify the best circumstances in which to use ARS for data collection and practical steps to aid in its success. [ABSTRACT FROM AUTHOR]

Purpose A previous publication in this journal reported the findings of a 2013 survey into people’s experiences of membership of a Christian church in the UK (author citation removed for the purposes of review). A major finding of this survey was that many people said they had been “harmed” by their experience with some labelling it as “Spiritual Abuse” (SA). Respondents in the 2013 study also stressed the importance of developing safeguarding policy and practice in this area. The purpose of this paper is to explore the findings of a more extensive survey conducted in 2017 which aims to identify people’s understanding of SA some four years after the initial work and within a context of some discussion and uncertainty around the term itself. The study also aims to assess the current status of safeguarding policy and practice in SA perpetrated against individuals in the Christian church in the UK. A secondary aim of the study is to ascertain how far understandings, policy and practice have developed since the initial survey was conducted. It is emphasised that the authors do not assert that SA is perpetrated solely in the Christian church. However, as this is their personal religious background it is the focus of this work.Design/methodology/approach A mixed methods online survey of Christians, Church attendees and members of Christian organisations was conducted in 2017. Data were analysed using descriptive statistics, inductive thematic and content analysis.Findings A clear definition of SA is required. There is an ongoing need to develop policy and practice in the area of SA in order to respond effectively to those who have these harmful experiences.Research limitations/implications This work has been conducted within the Christian faith community and thus, represents only this faith context. Accordingly, it is research with a specific group. The work would usefully be expanded to other faith contexts.Practical implications People are still being harmed by experiences in the Christian church. Safeguarding policy and practice in the area of spiritual abuse needs to be developed in the immediate future.Social implications Those working in statutory agencies, faith and community contexts need to develop an understanding of SA.Originality/value This is the largest survey conducted on the topic of SA in the Christian faith to date in the UK. [ABSTRACT FROM AUTHOR]

Background: Access to high-quality primary care has been identified as a pressing need for adults with intellectual and developmental disabilities (IDD). Adults with IDD live with complex physical and mental health conditions, use health services differently than the general population and continue to face challenges when accessing health services. Interprofessional primary care teams offer comprehensive and coordinated approaches to primary care delivery and are well-positioned to address the needs of adults with IDD and other vulnerable populations. Although interprofessional primary care teams are recommended, there is currently limited understanding of how interprofessional care is delivered and how access to a team of providers improves the health of this population. The aim of this paper is to describe the organizational attributes of interprofessional primary care for adults with IDD within and across models of team-based care in one local health service context. Methods: A multiple case study was conducted with five interprofessional primary care teams in Ontario, Canada. Multiple methods were used to generate data including: a survey, document review, electronic medical record report and qualitative interviews. Pattern matching was the primary analytic approach for the within and across case analysis. Results: Adults with IDD were found to be a small part of the patient population served and this group was poorly identified in three of five teams. Key organizational attributes that support the delivery of interprofessional primary care for adults with IDD were identified. Two examples of targeted programs of care for this group were also found. Despite the presence of interprofessional health providers in all teams, there were limited organizational processes to engage a wide-range of interprofessional services in the care of this group. There was no consistent reporting of outcomes or processes in place to measure the impact of interprofessional services for this population. Conclusions: This study provides important insights into the current state of interprofessional primary care for adults with IDD in Ontario and highlight a critical need for further work in the field to develop organizational structures and processes to engage in team-based care and demonstrate the value of the approach for this population. [ABSTRACT FROM AUTHOR]

Reflection journals (RJs) have been recognised as a vital tool in promoting student learning. However, little is known about how doctoral students use RJs to improve academic engagement. Through a mixed-method study, this paper explored how six international students from a Chinese normal university utilized RJs in their engagement in an advanced learning sciences course. This study used reflective journals, surveys, and interviews to examine doctoral students' perceptions of the effectiveness of reflective journals in their learning process in a 12-week 'Frontiers of the Learning Sciences' course. The quantitative results revealed that all items received a positive rating and were appropriate for exploring how reflective journals enhanced the participants' critical thinking, writing skills and engagement. Overall, the findings confirmed that reflective journals facilitate critical thinking, metacognition, and self-engagement. The findings of the study likewise provide information for course instructors to adjust their lesson plans in response to students' comments and suggestions. [ABSTRACT FROM AUTHOR]

Objective: To describe the perceptions of healthcare workers employed at a metropolitan public health service, with respect to how they identify, manage and care for refugee patients. Methods: This study surveyed healthcare workers using a cross-sectional, mixed methods descriptive design, which partially replicates a previous Australian study. A total of 215 responses to a brief online survey were received (n = 48 medical, n = 100 nursing and midwifery, n = 50 allied health, n = 4 other). Results: Nurses and allied health respondents were more likely to record working with refugees rarely or never (P = 0.00). Most respondents (70.3%) identified no negative effects from working with refugees, and perceived this patient group enhanced (71.3%) their work. Insufficient identification, interpreter availability, education, healthcare worker capacity and providing culturally specific treatment were all identified as potential service barriers. Allied health respondents were more likely to report low confidence about working with refugees in general (P = 0.04). Respondents with more than 10 years' experience with refugees (P = 0.02), and those with good self-perceived awareness of community services (P = 0.01), were more confident in their ability to manage social issues. Conclusions: This study suggests that contextual factors influence the perceptions of healthcare workers who provide care to refugee patients; however, communication, health literacy and healthcare worker capacity were consistently raised as key issues when working with refugees. What is known about the topic?: Refugee and asylum seeker patients may present with complex health needs to any part of the Australian health system. The majority of previous research has occurred in primary care settings. What does this paper add?: This study adds an acute and subacute perspective to the evidence base, and also includes medical respondents for the first time. Compared to previous research, respondents of this study saw refugee patients more frequently in their practice, and also reported fewer negative effects from working with them. Most demographic characteristics had no significant effect on worker-reported confidence in this study; however, greater experience of working with refugees and good self-perceived awareness of community services were both identified as positive influences. What are the implications for practitioners?: Practitioners should prioritise remedying barriers that are consistently identified as affecting the service provided to refugee patients (communication, health literacy and healthcare worker capacity) as part of their quality and service improvement efforts. [ABSTRACT FROM AUTHOR]