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The widespreadness of video games, particularly among digital natives, requires ongoing exploration of their profound effects. This study aligns with this need, investigating video games as possible tools for positive societal influence and exploring their potential to address sensitive social issues. Transportation theory underscores the transformative potential of video games, casting players as "travellers" who, traversing stages of reality dissolution, emotional connection, and altered return, present a pathway for attitude transformation. Participants (N = 98) engaged with "Survival," "Paper, Please," and "Against All Odds" to explore the effectiveness of video games in addressing the refugee crisis, increasing awareness of the issue at hand, changing perceptions, and encouraging them to take action in real life. The study's results align with integrated threat theory, revealing that immersive gaming experiences can induce significant changes in attitudes, decrease denial, and increase empathy. The results highlight the potential of video games to educate people about pressing global issues and invoke empathy without trivialising problems. Consequently, while this study extends the current body of knowledge, it offers some promising directions for further research to validate the affirmative impact of video games in this realm. [ABSTRACT FROM AUTHOR]

Saudi Arabia as a traditional society is mostly based on the medical model of disability to interpret autism that increases the stigma and the negative social attitude towards the condition. Additionally, the media plays a big role in portraying the condition as a "disorder" that contributes to the cultural judgment within the country. In this paper, the authors reviewed 57 articles between 2011 and 2021 using the databases of Google, Swisscows, and StartPage. Document analysis was used to analyse the data from both journals and newspapers. Results have shown that the studies exploring autism in media are quite limited with almost nonexistent papers on the roles of media and the medical model of disability in the stigmatisation of autism in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Pedestrian detection plays a vital role in the estimation of human posture, especially the pedestrian detector, which provides the position information of human body in the image. This paper proposes a pedestrian gesture recognition algorithm using radio frequency data based on RFID technology. Its goal is to serve as a starting point for research in the field of human gesture recognition. The position of pedestrians in the input picture can be adaptively adjusted by learning the transformation parameters of samples during network training, and the local features of each block can be trained by multiple cross entropy functions at the network's end, allowing the sample local area to be fully utilized as the network's training. More accurate DFL and attitude feature recognition can be achieved using the measured received signal strength information and channel state information. The pedestrian gesture recognition algorithm based on RF data proposed in this paper improves pedestrian recognition accuracy, especially in noisy environments, such as fuzzy or occlusion, according to experimental results. [ABSTRACT FROM AUTHOR]

Personal Assistants (PA) or client‐hired workers are directly employed by people needing care and support, often making use of government funding. In the context of Covid‐19, questions emerged about how this workforce is supported to practice safely. This paper reports PAs' understanding and views of infection control during the early months of the Covid‐19 pandemic in England. Telephone interviews were undertaken with 41 PAs between 16th April and 21st May 2020. PAs were recruited from a sample that had participated in a previous study in 2014–16. Interview questions focused on changes arising from the pandemic. Data were transcribed and analysed using Framework analysis. This paper focuses on PAs' perceptions of their role and responsibilities in preventing and managing infection. Arising themes were identified about barriers and facilitators affecting infection control in five areas: accessing information, social isolation, handwashing, hygiene, personal protective equipment and potential attitude to vaccines. Infection prevention and control are under‐researched in the home care sector generally and efforts are needed to develop knowledge of how to manage infection risks in home settings by non‐clinically trained staff such as PAs and how to engage home care users with these efforts, especially when they are the direct employers. [ABSTRACT FROM AUTHOR]

COVID-19 vaccination is particularly challenging among populations who have experienced discrimination in healthcare settings. This paper presents qualitative findings from in-depth interviews about COVID-19 vaccination conducted in Australia between October 2020 and November 2021. Data from four different studies are presented; each population has unique experiences of discrimination within the healthcare system: Aboriginal people; people who inject drugs (PWID); people living with HIV (PLHIV); and gay and bisexual men (GBM). Analyses were guided by the behavioural and social determinants model that forms the basis of the World Health Organization's "data for action: achieving high uptake of COVID-19 vaccines" interim guidance. All populations viewed vaccination as necessary for community protection, although narratives of community care were most common among Aboriginal people. Concerns about vaccine safety were expressed by all participant groups, although participants living with HIV and GBM were more trusting of vaccines possibly because of their ongoing and usually positive past experiences with biomedical technologies for HIV management and sexual health. Aboriginal participants reported distrust of mainstream government and participants who inject drugs expressed a more generalised suspicion about COVID-19 and its origins. Practical problems related to transport, booking appointments for vaccination and so forth, were more common among participants living with HIV and GBM, possibly because these specific interviews were conducted throughout 2021 when vaccines were more available, whereas data for the other populations were collected before the vaccine rollout. Findings show that vaccine willingness is shaped by past experiences of discrimination in healthcare setting, but different histories of discrimination can differently impact vaccine willingness. Promotional messaging and delivery must take account of these important differences so to not treat these populations homogenously. [ABSTRACT FROM AUTHOR]

Operating room nurses play a critical role in patient safety. The evaluation of safety attitudes of operating room nurses reflects their awareness and belief of patient safety. Currently, however, the research on the safety attitudes of operating room nurses is hard to track in the existing literature in China. Therefore, this paper was conducted to explore the factors influencing the safety attitudes of operating room nurses and their cognition and attitudes toward adverse event reporting. A total of 711 operating room nurses from 16 tertiary hospitals in Sichuan Province from March 1, 2018, to 2019 were selected. The general information of operating room nurses, such as age, gender, and years of service in the operating room, was obtained through the basic information questionnaire. The Chinese version of the Safety Attitudes Questionnaire (C-SAQ) was used to evaluate the safety attitude of operating room nurses, and the cognition and attitude of the subjects to adverse event reports were assessed through the questionnaire of cognition and attitude toward adverse event reporting. The average score of safety attitudes of operating room nurses was 4.20 ± 0.49. The two dimensions with a lower positive reaction rate of the safety attitudes of operating room nurses were stress recognition and working conditions. The main factors affecting the safety attitude of operating room nurses were night shifts, as well as cognition and attitudes toward adverse event reporting. There was a positive correlation between the total score of C-SAQ and the total score of cognition and attitudes toward adverse event reporting (P < 0.01 , r = 0.445). The safety attitude of operating room nurses is at the upper-middle level, but the stress recognition and working conditions need to be improved. Through the allocation of nursing human resources, the strengthening of hospital logistics support, and the establishment of nonpunitive nursing adverse event reporting system, the operating room safety can be significantly enhanced. [ABSTRACT FROM AUTHOR]

What is known and objectives: Despite the large body of evidence demonstrating equivalent efficacy and safety for branded drugs and their generic counterparts, some patients and providers have the perception that generics may be less safe and effective than branded agents. Authorized generics (AGs) are a category of generic drugs defined by the United States Food and Drug Administration (FDA) as being the same as the brand‐name drug without the brand's name on the label and which may have minor differences, such as tablet or capsule markings for identification. Studies in which AGs are considered along with other generics may increase our understanding of factors that may influence perceptions about generics and shed light on areas where education may be impactful. The objectives of this paper are to provide information about AGs, review studies in which they have been evaluated and explore the role that AGs may fill in the individualized treatment of patients. Methods: A literature review was conducted on 30 September 2019 with follow‐up search on 4 March 2020. The search was focussed on published papers and meeting abstracts that provided information on AGs with respect to medical and health outcomes of therapy as well as switching in individuals receiving branded, AG, or other generic agents. Information about patients' perceptions of generic medications and adherence to therapy was also included. Additional information, including relevant government sources, such as the FDA website and the Federal Trade Commission Report, was included as appropriate. Results: The literature specific to AGs is limited, but available data clearly highlight the importance of patient perception of generics as well as medication appearance as factors that may affect adherence and potentially more frequent switchbacks to branded agents from generics or AGs. What is new and conclusion: To our knowledge, this is the first narrative review to provide a summary of the published evidence about AGs with respect to clinical and health outcomes and switching. There is a need for more research and education regarding the use of AGs in clinical practice if they are to become more recognized as a potential treatment choice for patients. Generic medications play an important role in the healthcare system, and AGs may be able to provide an option to meet the specific needs of individual patients. [ABSTRACT FROM AUTHOR]

The wireless sensor network is an integral part of the physical information system. Disperse sensors through a set of special spaces track and record the natural state of the environment and manage the information collected in a central location. The sensors use wireless connections to create their own networks. Wireless sensor network technology has the advantages of flexible deployment and convenient use and has played an important role in the field of user behavior recognition. By deploying wireless sensor network technology, users can collect daily information, capture users' behavior habits, and analyze users' health status. In the deployment and application of this type of technology, it is very important to build an effective model of the logical sequence relationship of the monitored person's behavior. The sensor data can be sent to the target user through wireless transmission. Action recognition is often based on a single feature for learning and judgment, so there are many difficulties in practical applications. This article aims to study motion shake awareness and action prediction algorithms based on wireless sensor networks. Aiming at the research of human pose recognition algorithm, to optimize the overall performance of the model, this article suggests the use of multimodal input, uses a 2D and 3D network structure, and finally, proposes two network weighted fusion strategies. Aiming at the research of pedestrian motion discrimination, this article offers a behavior prediction algorithm based on multifeature joint learning. The algorithm adds the feature vectors output by gesture recognition and mask prediction and uses a cross-entropy cost function to jointly learn and predict classification. The results of the survey show that the pedestrian gesture recognition and motion recognition algorithm based on the wireless sensor network proposed in this paper has good performance and can be widely used in real scenes such as video surveillance. The accuracy of the gesture recognition algorithm in the UCF101 dataset and the HMDB51 dataset was 96% and 72%, respectively. [ABSTRACT FROM AUTHOR]

The uncertainty of emergencies makes the emergency procurement face many risks, so the risk management is particularly important of the emergency procurement. The risk attitude of decision makers will significantly affect the decision-making of risk management. In this paper, the risk management problem with different risk attitudes of emergency procurement consisting of dual-source suppliers and the single government is studied, and a government-led Stackelberg game is used to analyze the risks of each link to establish an emergency procurement model under the option contract, and the optimal decision-making is obtained. The effects of reserve period, risk avoidance coefficient, and probability of emergency on optimal decision-making are analyzed with different risk attitude. Moreover, we investigate the coordination of the government-led supply chain coordination under the risk aversion and risk-neutral conditions of emergency supply chain participants. The results show that the model can control the risk while reducing the cost of government procurement and ensuring the revenue of suppliers. Finally, the influence of each parameter on the optimization decision is verified by a numerical example. [ABSTRACT FROM AUTHOR]

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

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

Background: People around the world look hesitant to get the coronavirus disease‐2019 (COVID‐19) vaccine. Identifying factors behind people's hesitancy is of great importance. Aim: This paper aimed at examining the predictors of the intention to get the COVID‐19 vaccine in a sample of 281 Jordanians. Methods: A cross‐sectional online survey was employed to collect data on the intention to vaccination, knowledge and attitudes toward COVID‐19, the perception of measures taken by the government to control COVID‐19, self‐rated health, and perceived susceptibility and severity of COVID‐19. Results: The subjects were hesitant to get the vaccine. Intention to get the vaccine was predicted by being male, working in the education field, and having a poor perception of health, better perception of the adequacy of governmental measures, positive attitudes towards COVID‐19, and higher levels of perceived susceptibility to the disease. These predictor variables accounted for 25.5% of the total variance. Conclusion: This study demonstrated that this sample of Jordanian people had some hesitancy to take the COVID‐19 vaccine; variables in the study partially explained that. Several implications have been discussed, including further research is needed to fully understand the relationships between different variables and the intention to get the vaccine. [ABSTRACT FROM AUTHOR]

The finite-time attitude cooperative control problem for a group of multiple unmanned aerial vehicle systems with external disturbances and uncertain parameters is discussed in this paper. The dynamics of the systems is described by quaternion avoiding the singularity. Based on the attitude error and angular velocity error, a novel nonsingular terminal sliding mode surface is proposed for the controller with event-triggered scheme. The lumped disturbances are estimated by neural networks with adaptive law. The communication frequency is decreased by the proposed distributed event-triggered based sliding mode controller. Lyapunov theory is utilized to analyze the stability of the systems, and the Zeno behavior is avoided by rigorous proof. Finally, simulation examples are presented to illustrate the efficiency of the proposed control algorithm. [ABSTRACT FROM AUTHOR]

This paper contributes to scholarship on the medicalisation of mental health support for young people through a case study of a multidisciplinary mental health service in rural Australia. All staff (n = 13) working at the service participated in semi‐structured, individual interviews. Transcripts of interview data were read and selectively coded and interpreted in relation to the overarching question of how participants view and experience mental health care provision to a diverse range of young people. Following analytical reflection, codes pertaining to engagement, accessibility and care provision were re‐examined using the concept of medicalisation to understand the biomedical underpinning of mental healthcare and how this plays out in the experiences and perceived challenges participants talked about in responding to the mental health concerns of diverse young people. The resulting analysis is presented under five theme headings: (a) privileging clinical expertise and priorities within service provision, which was an important source of conflict for some participants; (b) 'multidisciplinary' teams—a 'difficult kind of culture at times'; (c) articulations of where cultural barriers lie; (d) the tracks along which young people are directed to 'engage' with 'mental health'; and (e) a clinical 'feel' to space. We suggest that service and system investment needs to be given to alternative ways of thinking about and approaching mental health and care provision that are cognisant of, and engage with, the inherent connections between individual circumstance and social, place, cultural, economic and political contexts. This is particularly relevant to the provision of care in rural contexts because of limited service options and the complexities of access and providing care to a diverse range of young people living in isolated environments. Interdisciplinary frameworks need to be enacted and services must acknowledge their own cultural positions for alternative ways of working to become possibilities. [ABSTRACT FROM AUTHOR]

In order to achieve the attitude maneuver performance of the noncontact close-proximity formation satellite architecture, this paper presents a compound control strategy with variable-parameter sliding mode control and disturbance observer-based feedforward compensation. Firstly, the variable-parameter sliding mode control is proposed to guarantee the attitude maneuver performance of the payload module. Secondly, the collision avoiding control with disturbance observer-based feedforward compensation is proposed to guarantee the synchronization of the two separated modules within the small air clearance constraint of the noncontact Lorentz actuator. Finally, a physical air-floating platform is established to verify the effectiveness of the proposed approach. [ABSTRACT FROM AUTHOR]

The aim of this paper was to understand the needs of family caregivers and professionals supporting people living with dementia with eating and drinking difficulties towards the end of life and the strategies they use to overcome them. A total of 41 semi‐structured interviews with family caregivers (n = 21) and professionals (n = 20) were conducted in London and surrounding areas of England. Interviews were audio‐recorded and transcribed verbatim. Four themes were identified: caregivers accessing and seeking help, perceived priorities of care, professionals' supportiveness and educational role, and strategies. Caregivers often struggle as they are not aware of the eating and drinking difficulties associated with dementia's progression. Care can change over time with families prioritising a person's comfort towards the end of life rather than ensuring a particular level of nutrition. Mutual support is required by both professionals and caregivers to enhance the care of the person living with dementia. Cognitive difficulties are often behind initial eating and drinking challenges in dementia, whereas physical challenges take over towards the later stages. Flexibility and creativity are key to adapting to changing needs. There is a need to raise awareness of the eating and drinking challenges associated with the progression of dementia. Professionals can help caregivers embark on the transition towards focussing on comfort and enjoyment of eating and drinking near the end of life rather than nutrition. This is particularly relevant for those caring for a relative living at home. Caregivers' input is needed to tailor professionals' recommendations. [ABSTRACT FROM AUTHOR]

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

In the UK support for older people living in residential care to undertake meaningful activities is provided by Activities Co‐ordinators. There is also a growing trend for care home providers to invite arts organisations into care settings to deliver a range of arts and cultural activities. These arts and cultural activities are delivered by Arts Facilitators, who are distinct from Activities Co‐ordinators because their practice is specifically in an art form. This paper presents findings from the Creative Journeys research project which focused on exploring the role of participatory arts within residential care home in developing and maintaining social relationships between residents and staff. One of the objectives of the research was to identify factors which facilitated or hindered the delivery and impact of the activities. Data collection methods included observations and semi‐structured interviews with residents and staff. Thematic analysis was conducted on the qualitative data. It was found that a key factor in the successful delivery of the groups was the working relationship between the Arts Facilitators and the Activities Co‐ordinators. This relationship is explored and presented under three main themes: the collaborative process, practicalities and preparation and the approach of the Arts Facilitator. The Activities Co‐ordinators' role is an under‐researched area, but they play a central role in supporting visiting arts organisations to deliver the sessions and in enabling residents to attend and engage with meaningful activities. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to understand how the behaviour of focal leaders impacts health care team performance and effectiveness. Background: Despite recent shifts towards more collectivistic leadership approaches, hierarchical structures that emphasize the role of an individual focal leader (i.e., the formal appointed leader) are still the norm in health care. Our understanding of the effect of focal leader behaviours on health care team performance remains unclear. Evaluation: A systematic review was conducted. Five electronic databases were searched using key terms. One thousand forty‐seven records were retrieved. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Key issues: Fifty papers met the criteria for inclusion, were reviewed and synthesized under the following categories: task‐focused leadership, directive leadership, empowering leadership and relational focused leadership. Conclusions: Categories are discussed in relation to team performance outcomes, safety specific outcomes, individual‐level outcomes and outcomes related to interpersonal dynamics. Emerging themes are explored to examine and reflect on how leadership is enacted in health care, to catalogue best practices and to cascade these leadership practices broadly. Implications for Nursing Management: Empowering and relational leadership styles were associated with positive outcomes for nursing team performance. This underscores the importance of training and encouraging nursing leaders to engage in more collaborative leadership behaviours. [ABSTRACT FROM AUTHOR]

The prevalence of heavy drinking is high among Korean Americans (KAs), but alcohol treatment utilisation is low. Korean American drinking behaviours may be attributable to the Korean drinking culture. However, relatively little research has been conducted to explore this narrative. The aim of this paper was to examine the social and cultural contexts of drinking and help‐seeking behaviours among second generation KAs. In 2016, we conducted a rapid ethnographic assessment (REA) in partnership with a Korean American church in Los Angeles. The REA involved participant observation and ten unstructured interviews. We used constructivist grounded theory to analyse the themes emerging from field notes and interview transcripts. Respondents perceived the existence of a Korean drinking culture in the United States that has been passed down from prior generations and preserved in ethnic enclaves. This Korean drinking culture was marked by festive occasions with heavy drinking, but the extent to which respondents adopted this drinking culture may have depended on their ethnic identities and connections to the community. For many second generation KAs, identity and community were tied to religious life. We found that KAs perceived professional treatment and recovery resources to be underutilised. We offer insights about church‐based participatory research as an approach to studying drinking among KAs. [ABSTRACT FROM AUTHOR]

Family caregivers (FCGs) are an integral part of the healthcare system. Currently, FCGs provide 70%–90% of the care required by community‐dwelling children and adults living with complex chronic conditions and frailty. Despite FCG's contributions and the growing proportion of distressed caregivers, support for FCGs has not been a health system priority. Researchers have proposed training to enhance the competencies of health providers to work effectively with FCGs. In the absence of best practices for the competency indicators for caregiver‐centred care, we have developed a competency framework for training the health workforce to support FCGs. The objectives in this paper are fourfold: (a) a brief review of stakeholder engagement that led to the development of the competencies the health workforce needs to support FCGs, (b) a description of the process used to name the competency domains, (c) a report on the Modified Delphi process (conducted 2019) used to validate the domain indicators, and (d) a description of the competency framework. We adopted a caregiver and a multilevel interdisciplinary stakeholder codesign approach throughout the competency development process. The competency domains include: (a) Recognising the Caregiver Role, (b) Communicating with FCGs, (c) Partnering with FCGs, (d) Fostering Resilience in FCGs, (e) Navigating Health and Social Systems and Accessing Resources, and, (f) Enhancing the Culture and Context of Healthcare. Our Caregiver‐Centred Care Competencies for the health workforce are only a first step in supporting FCGs in their vital roles. There are few education and training resources to enable and empower health providers to support FCGs, there is an urgent need to develop training resources for the health workforce to recognise and support FCGs. [ABSTRACT FROM AUTHOR]

The Mellow Futures programme is a specially adapted parenting programme for mothers with learning difficulties that combines group work with home‐based support. This paper reports on the findings of prospective and retrospective interviews with professionals who had referred mothers to the programme in England or Scotland between 2013 and 2015. The aim was to explore their perceptions of the programme as a whole, and its impact on the mothers they had referred to it. Mothers attending the Mellow Futures programme were invited to consent for a key professional to be contacted as part of the evaluation, generally those social workers who had referred the mothers to the programme. The 'referrers' were interviewed at the start and end of the programme. Thirty referrers contributed their views on the impact of the programme. Twenty‐six were very positive about the impact of the Mellow Futures programme on the mothers: the programme was thought to have increased the mothers' confidence and self‐esteem; supported them to work through issues; and helped them strengthen their relationship‐building skills. Four referrers felt that the programme had not had any impact on the mothers they were supporting. The Mellow Futures programme focused on relationships, rather than parenting techniques, and three fundamentally important relationships in the mothers and babies' lives were targeted: the relationship/attachment between mother and baby; the supportive, ongoing relationships between the mothers in the group; and the mothers' more positive engagement with the professionals concerned with the welfare of their baby. The research confirms that, from the perspectives of referrers, linking group and home‐based support can successfully help mothers with learning difficulties to care for their children. [ABSTRACT FROM AUTHOR]

Background. The dominant view in the literature is that informal payments in healthcare universally are a negative phenomenon. By contrast, we theorize that the motivation healthcare users for making informal payments (IP) can be classified into three categories: (1) a cultural norm, (2) "grease the wheels" payments if users offered to pay to get better services, and (3) "sand the wheels" payments if users were asked to pay by healthcare personnel or felt that payments were expected. We further hypothesize that these three categories of payments are differently associated with a user's outcomes, namely, satisfaction with healthcare, local and national government, satisfaction with life, and satisfaction with life of children in the future. Methods. We used microdata from the 2016 Life-in-Transition survey. Multivariate regression analysis is used to quantify relationships between these categories of payments and users' outcomes. Results. Payments that are the result of cultural norms are associated with better outcomes. On the contrary, "sand the wheel" payments are associated with worse outcomes. We find no association between making "grease the wheels" payments and outcomes. Conclusions. This is the first paper which evaluates association between three different categories of informal payments with a wide range of users' outcomes on a diverse sample of countries. Focusing on informal payments in general, rather than explicitly examining specific motivations, obscures the true outcomes of making IP. It is important to distinguish between three different motivations for informal payment, namely, cultural norms, "grease the wheels," and "sand the wheels" since they have varying associations with user outcomes. From a policy making standpoint, variation in the links between different motivations for making IP and measures of satisfaction suggest that decision-makers should put their primary focus on situations where IP are explicitly asked for or are implied by the situation and that they should differentiate this from cases of gratitude payments. If such measures are not implemented, then policy makers may unintentionally ban the behaviour that is linked with increased satisfaction with healthcare, government, and life (i.e., paying gratitude). [ABSTRACT FROM AUTHOR]

The choice of open innovation alliance has a significant impact on avoiding potential design risk. In order to reduce the enterprise design risk, an evaluation index system of innovation capability, including design risk, is constructed by considering the aspects of design risk identification, risk response, and risk monitoring. Then, a design risk evaluation method based on the prospect theory and fuzzy TOPSIS method is proposed. Combined with the prospect theory, the influences of three different risk attitudes (risk-taking, intermediate, and conservative) on design decisions are analyzed. Finally, the evaluation system and method are applied to the design evaluation of digital welding power source, and its feasibility is verified by a numerical example. The results show that the conservative risk attitude is consistent with the closeness evaluation results, and the intermediate risk attitude is consistent with the risk-taking attitude evaluation results. Introducing the psychological risk factors of the subject into the design decision-making behavior can help enterprises to choose the innovation alliance, which is more in line with the actual needs and reduces the innovation risk to the greatest extent. The index system and evaluation method established in this paper can provide theoretical reference for enterprise design risk analysis. [ABSTRACT FROM AUTHOR]

As an inevitable product of the development of the construction industry, safety production has attracted more and more attention. In particular, it affects sustainable development. It is important to study the unsafe behavior of individuals. This study integrated the hybrid method of necessary condition analysis (NCA) and structural equation model (SEM). Based on the institutional environment perspective of social cognition theory, an empirical analysis was conducted through field observation and 186 questionnaire data to explore the influence of the institutional environment, safety attitude, and unsafe behavior. The results showed that improved safety attitudes of workers are a key requisite to curb unsafe behavior, and it was confirmed that safety attitude plays a complete mediating role between institutional environment and unsafe behavior. Through the analysis of the necessary conditions and mediating effects of safety attitude, the study deepened the theoretical understanding of the interaction between institutional environment, safety attitude, and unsafe behavior. Also, it provided relevant management suggestions for the construction industry in safety management. [ABSTRACT FROM AUTHOR]

Background. There was a remarkable downgrade in China's COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members' SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members' SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized. [ABSTRACT FROM AUTHOR]

Two aspects of problems including selection of aggregation operator for extreme fuzzy evaluation value and risk attitude of decision makers cannot be well solved in Pythagorean fuzzy (PF) multiattribute group decision making (MAGDM). This paper extends the evidential reasoning aggregation method in the intuitionistic fuzzy environment, expands the dictionary ranking method by constructing interval‐valued numbers through the proposed credibility functions of PF values and the concept of closeness degree, widens the continuous generalized ordered weighted average (C‐GOWA) operator to establish a risk attitude ranking measure, and puts forward a PF MAGDM approach based on risk attitude and evidence reasoning methodology (ERM). First, the proposed method utilizes the ERM to aggregate each decision maker's decision matrix and the weights of the attributes to get his/her aggregated decision matrix. Then, it incorporates the obtained aggregated decision matrices of the experts, the weights of the experts and the ERM to accomplish the aggregated PF value of each alternative. Finally, the ranking measure value of risk attitude on each alternative's PF value is calculated, and the sensitivity analysis on the ranking measure function is carried out. The proposed method has overcome the drawbacks of the existing methods for fuzzy MAGDM in PF environments. [ABSTRACT FROM AUTHOR]

Background. Chimeric antigen receptor (CAR) T cell therapy, a "living drug" immunotherapy, harnesses the power of T-cells from a patient (autologous) or healthy donor (allogeneic) to target and kill cancer cells and has shown unprecedented outcomes in patients with relapsed and refractory malignancies. Treatment with CAR-T cells requires the application of unique skillsets in recognised specialist centres for successful outcomes and requires management by the multidisciplinary team incorporating the specialist pharmacist. Method. A multimodal research strategy was employed for this literature review whereby PubMed, Google Scholar, Embase, Stella Library Search, EMA website, and EBMT website were sources of information. The search was limited from 2020 onwards with key terms referring to CAR-T cell therapy. Results and Discussion. There are six CAR-T cell products currently approved by the European Medicines Agency (EMA) and Food and Drug Administration (FDA) which target haematological malignancies with abundant clinical trials underway exploring new and improved CAR designs and antigen targets. As CAR-T cell therapy is an advanced therapy medicinal product (ATMP), there is need for an extensive regulatory framework underpinning its safety and efficacy. The clinical pharmacist plays an integral role in the provision of safe and effective CAR-T cell therapy including governance, operational and clinical aspects of treatment. Pharmacists may also be involved through provision of "Qualified Person" (QP) expertise in clinical trials and for release within hospitals under certain circumstances. There is a need for harmonised and accessible guidance on the clinical delivery of ATMPs such as CAR-T cells, with fully delineated responsibilities of pharmacists involving the oversight and supervision of CAR-T cell treatment. Conclusion. There is an unmet need to provide suitable and applicable literature for clinical pharmacists who are involved in the delivery of CAR-T cells. We have provided an overview of T-cell biology and an explanation of CAR-T cell design and the biomanufacturing process. We reviewed the complex and multifaceted treatment cycle requiring considerable logistics, and described the involvement of the clinical pharmacist in each part of this cycle from patient selection to postinfusion care. Finally, we look to the challenges and future opportunities that will require the involvement of the clinical pharmacist. [ABSTRACT FROM AUTHOR]

Gender-sensitised weight management programmes have been developed to encourage more men to access support. Whilst these programmes have proved successful for some groups of men, they are not a panacea, and the views of men who have never attended any form of structured weight management programme remain unknown. The aim of this research was to explore the views of such men towards body weight, health, and weight management programmes. Participants were recruited purposefully at their place of work. Semi-structured interviews were conducted with 16 adult men with a BMI > 25 who worked in routine manual occupations and had no previous experience of attending a weight management programme. Interviews were analysed using an inductive thematic analysis approach. Interview findings were developed into five themes: "the indestructible breadwinner," "avoidance of feminine behaviour," "the body conscious man," "being one of the lads," and "doctor knows best." The findings suggest that these men have high levels of body consciousness, value guidance from GPs, have high levels of agency towards lifestyle choices, and wish to preserve their masculinity. The study identified various factors that help explain low participation in weight management programmes for men and potential ways to improve access. Future interventions should include gender sensitisation of resources and providing men with the opportunity to follow self-directed weight management programmes to increase participation. Individual and population-level interventions to address weight management that includes the perceived and actual needs of men working in routine manual occupations are urgently needed to address health inequalities. [ABSTRACT FROM AUTHOR]

Background. The issue of identity has been widely explored among migrant populations in western countries in the context of cultural integrations and acculturations. However, there is less evidence on identity as a determinant of health and social wellbeing. This study reports on identity as a determinant of health among the South Sudanese community who arrived as refugees through an Australian humanitarian program in the early 2000s. Methods. A qualitative study was undertaken, underpinned by a phenomenological framework that characterised the lived experiences of adult South Sudanese in Sydney, Australia. Semistructured in-depth interviews explored how 26 participants identified themselves in Australia, including changes in their experiences over time, their social and general life situation in Australia, and how they felt perceived in Australia. Data were audio-recorded using a digital voice recorder, transcribed verbatim, coded, and categorised into themes using interpretive thematic analysis. Results. Participants described a multiplicity of interconnected domains that governed the negotiating and making sense of identity, in turn mediated by other interwoven personal and structural factors that shaped experience and perception. Expressions of hope, pride, and achievement were threaded through several of the interviews, particularly in relation to their children. There were also frustrations related to employment challenges and discrimination that limited identity ownership. Conclusions. The evolving and often conflicting factors identified by participants can shape their sense of belonging, integration, and social and mental wellbeing. A deeper, more nuanced understanding of bicultural identity within a strengths-based framework is needed, with improved partnerships and services to support and strengthen South Sudanese community integration, belonging, and acculturation in Australia. [ABSTRACT FROM AUTHOR]

The existence of gender differences in the use of information and communication technology (ICT) impedes the attainment of gender equality and female empowerment. It is therefore essential to provide up-to-date knowledge on the gender ICT divide given that insight into ICT use by gender is often limited and not regularly updated, particularly for low- and lower-middle-income countries. Consequently, this study investigated gender differences in ICT usage, self-efficacy, attitude, and anxiety among technical university students in Ghana. The study is based on primary data conveniently collected from 409 students in a 3-year Higher National Diploma awarding technical university in Ghana using a self-administered questionnaire. Data were analyzed using descriptive statistics, Mann–Whitney U tests, and ordered logistic regression. Male students, compared to their female peers, reported frequent use of ICT, have a more confident and positive attitude, and are less anxious about the use of computers and their related applications. Access to computers and students' level of study were related to attitude and perceived ICT self-efficacy. Policymakers and administrators of higher education institutions should implement interventions to improve female self-confidence and the use of computers and their applications. [ABSTRACT FROM AUTHOR]

For people living with dementia, participatory community-based art activities have the potential to enhance the dignity of the individual, reaffirm a sense of identity, and provide social engagement. To identify opportunities to enhance the inclusion of people living with dementia in participatory community-based arts activities, this study sought the insights of people living with dementia. People living with dementia were invited to participate in semistructured group interviews to share their insights about participatory community-based arts activities. Interviews were analysed thematically to explore perceptions of benefits, opportunities, and ways to enhance participation in such activities. Participation in community arts was perceived to deliver benefits to social engagement and potentially reduce stigma through offering an education opportunity. Three key areas were identified as ways to enhance the engagement of people with dementia: knowing about the existing opportunities, accessing the activities (in terms of transport, venue proximity, timing, and wayfinding), and receiving support while attending the activity. Adequate information, easy access, a welcoming and inclusive atmosphere, the facilitators' enabling approach, and a judgement-free environment are desirable features which are congruent with dementia-inclusive arts activities. Enhanced engagement of people living with dementia may reduce stigma and improve community education. [ABSTRACT FROM AUTHOR]

Background. Cervical cancer is one of the most prevalent and fatal malignancies in women worldwide. Despite the fact that vaccination is an effective method in reducing cervical cancer, its uptake varies between public and private school adolescents and remains a challenge in low- and middle-income countries, including Ethiopia. Empirical evidence on how much variation there is among public and private school adolescent in their willingness to uptake human papillomavirus (HPV) vaccination is also limited. Thus, the aim of this study was to compare levels of willingness to uptake HPV vaccination among public and private school female adolescents and associated factors in Bahir Dar City, Ethiopia. Methods. A comparative cross-sectional study was conducted on 844 adolescents aged 10 to 19 in primary schools in Bahir Dar, Ethiopia. Multistage sampling was used. A self-administered, structured, and pretested questionnaire was used to collect data. The determinants of willingness to accept HPV vaccination were identified using logistic regression, and exploratory factor analyses were performed to determine load and mean. The level of statistical significance was determined using a P - value of 0.05. Results. The overall proportion of willing to uptake HPV vaccination was 50.6% (95% CI: 47.4-54), whereas in public and private primary schools, the magnitude was 61% (95% CI: 56.3-65.4%) and 40.2% (95% CI: 35.6-44.9), respectively. In terms of willingness to uptake HPV vaccination, the odds were likely to be significantly higher among those whose mothers had a postsecondary education (AOR = 2.0 , 95% CI: 1.29-3.05), a high cue to action (AOR = 1.92 , 95% CI: 1.20-3.05), and high self-efficacy (AOR = 2.34 , 95% CI: 1.58-3.48). High perceived barriers likely decreased the willingness to uptake HPV vaccination (AOR = 0.49 , 95% CI: 0.34-0.70). Conclusion. Adolescent girls in public primary schools were more likely to uptake HPV vaccination than those in private provided that income status and socioeconomic factors became less important. Willingness to uptake HPV vaccination was found to be low as compared to the WHO target for Ethiopian context and was influenced by maternal education status, perceived barriers, cues to action, and self-efficacy. As a result, greater emphasis should be placed on implementing a school-based and maternal educational program on cervical cancer prevention and control focusing on the behavioral contexts. [ABSTRACT FROM AUTHOR]

Family caregivers' sense of security benefits older adults who receive home care. Advance care planning (ACP) is reported to affect family caregivers' experience positively, but it might differ depending on family caregivers' kin relationships with the older adults. This study aimed to investigate whether ACP for older adults in home care settings is associated with family caregivers' sense of security and whether such an association depends on the family caregivers' status as spouses or adult children. Clarifying this association may offer practical support for implementing ACP while maintaining family caregivers' sense of security. This study was part of a prospective cohort study in Japan. The participants were older adults who used home-visit nursing services, their family caregivers, and the nurses who cared for them, recruited through the professional associations of home care nurses across Japan. Family caregivers answered a sense of security questionnaire, and the nurses were asked whether ACP was conducted. Data were collected three times from nurses and twice from family caregivers over a three-month period from August 2019 to June 2020. Multivariate logistic regression analyses were performed to examine the association between ACP implementation and positive changes in the sense of security scores after three months. Data from 169 cases were analyzed; 28.1% of the family caregivers were men and 55.6% were spouses. ACP was performed in 53.8% of the cases. The multivariate analysis showed an interactive effect between ACP implementation and family caregivers' kin relationships. For spouses, ACP was significantly associated with a positive change in their sense of security. For adult children, such an association was not found. Thus, ACP might have a positive effect on caregiving spouses' sense of security. Adult child caregivers, who often have multiple responsibilities and have difficulties facing their parents' physical decline, may need support in addition to ACP. [ABSTRACT FROM AUTHOR]

The drifting elderly are an interprovincial floating elderly population that is mainly composed of unemployed older parents in China. They have left their usual residence and relocated to urban areas, facing challenge about social integration. As a neighborhood has played important roles in the floating population's social integration, this study was designed to investigate the influence of neighborhood-based identity and social participation on the social integration of the drifting elderly. Five rounds of data collection and analysis were conducted in a continuous crossover sequence using grounded theory. Twenty-four participants were recruited from three districts in Shanghai, China. The neighborhood was shown to play a prominent role in the drifting elderly's perceptions of social integration. Good neighborhood relations help the drifting elderly establish effective social support networks, interact with inflowing society, get in touch with more human resources, and form social relationships and networks. Neighborhood-based participants and identity were more conducive to eliminating heterogeneity and creating homogeneity for the drifting elderly. Thus, the neighborhood affects the social integration of the drifting elderly, which directly impacts their social feelings, integrations, and networks. Management of social integration among the drifting elderly should be focused on creating general opportunities for them to participate in neighborhood-based social events with a reasonable identity. [ABSTRACT FROM AUTHOR]

This study examined the complex associations among coronavirus disease 2019 (COVID-19) risk perception, social distancing, social connectedness, and loneliness, as well as the mediating effects of social distancing and social connectedness in these associations in younger, middle-aged, and older Korean adults. We used multigroup structural equation modeling to analyze the results of a cross-sectional survey of 2,400 Korean adults aged 20 years or older. We found statistically significant age group differences in the mean values of COVID-19 risk perception, social distancing, social connectedness, and loneliness. The younger group showed significant associations among all major variables in the structural equation model, while their older counterparts demonstrated a significant association between COVID-19 risk perception and loneliness. Social distancing and social connectedness mediated the effect of COVID-19 risk perception on loneliness only for the younger group. In addition, we found significant mediating effects of social connectedness on the association between COVID-19 risk perception and loneliness in the middle-aged and older groups. Our findings imply that social distancing and social connectedness have impacted Korean adults' mental health during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction. While many individuals quit smoking during pregnancy, most relapse within one year postpartum. Research into methods to decrease smoking relapse postpartum has been hampered by difficulties with recruitment. Method. We conducted individual interviews with pregnant women (N = 22) who were interested in quitting smoking while pregnant about their attitudes regarding smoking and quitting during pregnancy, clinical trial participation, and smoking cessation medication use. Results. Participants were aware of the risks of smoking while pregnant. Many wanted to quit smoking before delivery. Few used empirically supported treatments to quit. While research was viewed positively, interest in taking on new commitments postpartum and taking a medication to prevent relapse was low. Medication concerns were evident among most participants, especially among those planning to breastfeed. Further, several women noted medication was unnecessary, as they did not believe they would relapse postpartum. Financial incentives, childcare, and fewer and/or remote visits were identified as facilitators to participating in research. However, these factors did not outweigh women's concerns about medication use and time commitments. Conclusions. Women are aware that quitting smoking during pregnancy and remaining smoke-free postpartum are important. However, beliefs that personal relapse risk is low and that medications are dangerous reduced enthusiasm for taking medication for postpartum relapse prevention. Future medication trials should educate women about the high likelihood of relapse, prepare to answer detailed questions about risks of cessation medications, and connect with participants' clinicians. For new mothers, studies conducted remotely with few scheduled appointments would reduce barriers to participation. [ABSTRACT FROM AUTHOR]

In recent years, technology-based tools have been used frequently in learning English as a foreign or second language. In addition, many studies have been conducted to examine the effects of technology-based tools on developing different types of language skills and subskills. Along the same line, this research examined the impacts of flipped learning as a kind of technology-based instruction on Saudi Arabia students' motivation, anxiety, and attitude. To reach this objective, 58 students at the intermediate level from one high school in Riyadh city, Saudi Arabia, were selected and assigned to two equal classes (flipped class and traditional class). After that, both classes were pretested with a motivation questionnaire and an anxiety questionnaire. Next, the flipped class received the treatment by applying the flipped instruction and the students of the other class received traditional instruction. After teaching six texts from Active Reading 1, the abovementioned motivation and anxiety questionnaires were readministered to both classes. Additionally, a questionnaire was given to the flipped class to find out how they felt about using flipped instruction for English language development. The results of independent samples and paired samples t-tests revealed that the flipped class outdid the traditional class both on the motivation and anxiety posttests. The outcomes discovered that using flipped instruction increased the students' motivation and reduced their learning anxiety. Also, the results of the one-sample t-test depicted that the students of the flipped class presented a positive attitude toward the flipped instruction. This research may encourage English as a foreign language instructors to integrate technology into their teaching to improve learning results. [ABSTRACT FROM AUTHOR]

Migration‐related stress is detrimental to children's mental health, yet little is known about the potential mechanisms behind this association. This study examines the mediating role of inflow city identity in the association between migration‐related stress and depression and the moderating role of social participation amongst Chinese migrant children. A sample of 484 migrant children aged 8–17 years is randomly recruited through a cross‐sectional survey in Kunming, China. Inflow city identity partially mediates the association between migration‐related stress and migrant children's depression. Moreover, social participation moderates the above relationship. The direct and indirect effects are significant for migrant children with low social participation but insignificant for migrant children with high social participation. This study deepens the theoretical understanding of the underlying mechanism between migration stress and psychological distress and provides practical implications for preventing mental disorders in Chinese migrant children. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender and gender diverse people, and queer people (LGBTQ people) are at increased risk of some chronic diseases and cancers. NSW Health palliative care health policy prioritises equitable access to quality care, however, little is known about community members' perspectives on palliative care. This study aimed to understand LGBTQ community views and preferences in palliative care in NSW. A community survey and follow‐up interviews with LGBTQ people in NSW were conducted in mid‐2020. A total of 419 people responded to the survey, with 222 completing it. Six semi‐structured phone interviews were conducted with participants who volunteered for follow‐up. The sample included LGBTQ people with varied levels of experience in palliative care. Thematic analysis was conducted on survey and interview data, to identify perceived barriers and enablers, and situate these factors in the socio‐ecological model of health. Some perceived barriers from community members related to considering whether to be 'out' (i.e., making one's sexual orientation and gender known to services), knowledge and attitudes of staff, concern about potential substandard care or mistreatment (particularly for transgender health), decision making, biological family as a source of tension, and loneliness and isolation. Perceived enablers related to developing and distributing inclusive palliative care information, engaging with community(ies), fostering inclusive and non‐discriminatory service delivery, ensuring respectful approaches to person‐centred care, and staff training on and awareness building of LGBTQ needs and issues. Most of the participants who had experienced palliative care recounted positive interactions, however, we identified that LGBTQ people require better access to knowledgeable and supportive services. Palliative care information should be inclusive and services respectful and welcoming. Particular consideration should be given to how services respond to and engage with people from diverse population groups. These insights can support ongoing policy and service development activities to further enhance palliative care. [ABSTRACT FROM AUTHOR]

This qualitative evaluation study examined the impact of unstructured intervention on people with depression in a community mental health centre in Hong Kong. In the intervention, service users initiated groups and designed group activities by themselves, with social workers as facilitators. Semi‐structured interviews were conducted with service users enrolled in unstructured intervention, their family members, and service providers in 2019. Overall, 32 participants were recruited through purposive sampling. The results revealed that peer interactions helped participants to feel accepted and understood. Participants also acquired experience with emotional coping strategies and practised their interpersonal skills, and by learning new skills from peers, they were able to rebuild their self‐esteem and improve their relationships with friends and family. To cater to clients' different needs and concerns, unstructured activities should be diversified. Family and social functioning should also be emphasised in the development of unstructured intervention because the generic skills and knowledge acquired from unstructured activities with peers could help to enhance family relationships, self‐confidence, and the ability to manage issues related to working and socialising. [ABSTRACT FROM AUTHOR]

In 2021, the COVID‐19 pandemic remained uncontrolled in Brazil, with more than 17.6 million cases diagnosed and more than a half a million deaths in total. It is known that an accurate risk perception by populations and a consequent adherence to preventive measures can increase the effectiveness of policies to contain the transmission of infectious diseases. The objective of this study was to draw a panorama of COVID‐19 in São Paulo State and investigate the population's risk perception about the new coronavirus, attitudes regarding preventive measures and vaccine confidence through an open web survey. A total of 1111 individuals participated (71.6% females). Of those, 15% declared themselves unemployed, almost 6% lost their jobs during the pandemic, and more than 30% suffered a decrease in their monthly income. As for the COVID‐19, almost 32% of the participants were tested sometime in 2020, and 11.3% reported a confirmed diagnosis for a level of hospitalisation of 5%. As for the risk perception, it was observed that situations with crowds of people were more frequently considered as of high risk and cause of greater concern with contamination of family members than with themselves. Almost 23% of the participants questioned whether they would take the vaccine when available and do not know if the COVID‐19 vaccine will be safe for the population. Almost 70% disagreed with the statement that the actions of the country's health authorities are effective in combating COVID‐19. Considering the Cramer's V coefficient, these variables were not associated with gender or educational level. [ABSTRACT FROM AUTHOR]

Older men are less likely than women to meet in social groups and have greater difficulty developing social relationships beyond paid work. Yet they are joining Men's Sheds in ever greater numbers, often with the support of women, as wives, partners and daughters. Little is known about women's perspectives of Men's Sheds and what women get from men's participation in Sheds. Informed by social role theory, the present study explored narratives from 26 significant women of male Shedders in Ireland and Australia. The narratives reveal how gender roles and unspoken rules shape people's lives, with three overarching themes emerging. These include (1) older men being vulnerable, with subthemes men's masculine persona, and women's vigilance, (2) gendered spaces for older men, with subthemes companionship: men mending men and healing in the Shed and (3) the spill over effects of Men's Sheds. Retirement, whether planned or prompted by ill‐health, ushers in a new stage of life, requiring new routines and social contacts. For men who lived their life according to gender social roles, which perceive men as masculine, independent and assertive and not inclined to open display of emotion and affection, adjusting to certain aspects of retirement may be difficult, particularly the lack of purposeful activity. Conversely, for women social role identity may be a source of strength for recognising and accepting vulnerability, and for seeking help. Our findings suggest women are central in encouraging older men to join Men's Sheds. In turn, women may experience an alleviation of stress when men participate in Sheds because they are not under the same pressure of their traditional social roles as carers and nurturers. [ABSTRACT FROM AUTHOR]

Objectives: Supporting cancer patients during COVID‐19 has posed unique challenges for health care providers. We investigated patient and carer–charity interactions to explore the role of charities and identify concerns expressed by patients. The study aims to address these concerns and learn how health care providers can support patients. Methods: Digital interactions on forum posts and social media were collected from four gynaecological cancer charities from March‐May 2019 (before COVID‐19) and 2020 (during COVID‐19). Thematic analysis of forum posts and semistructured charity staff interviews investigated patient and charity‐focused perspectives. Results: Thematic analysis of forum posts and charity staff interviews (n = 8) revealed three consistent themes: (1) Health care changes and the effect on cancer management concerns; (2) psychological impact of lockdown isolation and anxiety of changed treatment; (3) the complexity of shielding guidance on self‐risk assessment. Patients valued cancer charities' responses through digital and conventional methods (webinars, social media, forums, and websites). Conclusion: Gynaecological cancer patients had concerns about the risk and impact of changed treatment plans, contacting charities as the first port of call when anxious not to burden health systems. Real‐time analysis of charities' communications can be used to identify concerns and to proactively provide patient support, together with health care providers. [ABSTRACT FROM AUTHOR]

Objective: The objective of this work was to explore head and neck cancer (HNC) patients' and their family members' views on acceptability and feasibility of patient‐initiated follow‐up (PIFU), including concerns and anticipated benefits. Methods: Patients were recruited from UK HNC clinics, support groups and advocacy groups. They completed a survey (n = 144) and/or qualitative interview (n = 30), three with a family member. Qualitative data were analysed thematically, quantitative data using descriptive statistics. Results: Preference for follow‐up care in HNC was complex and individual. Many patients thought PIFU could beneficially reallocate health care resources and encourage self‐management. Patients' main concerns with PIFU were losing the reassurance of regular clinic appointments and addressing mental well‐being needs within PIFU, possibly using peer support. Patients were concerned about their ability to detect recurrence due to lack of expertise and information. They emphasised the importance of a reliable, direct and easy urgent appointment service and of feeling supported and heard by clinicians. Patients believed family and friends need support. Conclusion: PIFU may be feasible and acceptable for certain HNC patients, providing it addresses support for mental well‐being, provides quick, reliable and direct clinician access and information on "red flag" symptoms, and ensures patients and their caregivers feel supported. [ABSTRACT FROM AUTHOR]

Background. Coronavirus disease 2019 (COVID-19) is a highly infectious disease causing a catastrophic effect, and many of us are worried to find a new normal. Many burdens are occurring in households, predominantly to women and mothers. Women worldwide are naive on COVID-19 symptoms, transmission, and prevention measures and worried on being exposed to coronavirus. The study aimed to assess the mother's knowledge, attitude, and practice towards COVID-19. Methods. A community-based cross-sectional study was conducted from July 22 to August 7, 2020, in Dessie town, Ethiopia. A total of 634 mothers were included in the study. Multistage cluster sampling was used to take the proper sample. An interviewer-administered pretested structured questionnaire was used. Data were entered into EpiData, version 3.1, and analyzed by using SPSS, version 23. Both binary and multivariate logistic regression analyses were performed to find factors associated with dependent variables. The mean score was used to grade the knowledge, attitude, and practice towards COVID-19. Result. A total of 610 mothers participated in this study, making that a 96.2% response rate. More than half of the respondents 319 (50.3%) were in the age of 28–38 years. About 438 (71.8%) attended grades 1–12. About 531 (87.5%) were married, and most respondents 399 (65.4%) were housewives. The mean scores of knowledge, attitude, and practice were 15.36 (SD = 3.059), 6.4 (1.779), and 7.38 (3.068), respectively. Moreover, about 442 (72.5%), 354 (58%), and 338 (55.4%) of the respondents had good knowledge, a favorable attitude, and good practice on COVID-19, respectively. Conclusion. Almost three-fourths of the mothers had good knowledge of COVID-19. However, more than two-fifths of the participants had an unfavorable attitude and poor practice on COVID-19 preventive measures, which may put a high risk of infection that could worsen maternal morbidity and mortality during this pandemic. Therefore, health education programs for mobilizing and improving COVID-19-related knowledge, attitude, and practice are urgently needed, especially for those mothers who have low access to information due to home duty. [ABSTRACT FROM AUTHOR]

This cross-sectional study was designed to investigate the prevalence, knowledge, attitude, and predictors of waterpipe (WP) smoking among intermediate and secondary school adolescents in the Kingdom of Saudi Arabia (KSA). A self-administered anonymous questionnaire was used to collect data on demography, WP smoking status and patterns, the Arabic version of the Global Youth Tobacco Survey tool, and instruments to assess knowledge and attitude towards WP smoking. The Patient Health Questionnaire (PHQ-9) was also used. Descriptive and inferential statistical techniques were used. Modeling of WP smoking behavior was conducted using logistic regression. A total of 639 male students participated in this study. The prevalence of current WP and cigarette smokers were 17.7% and 14.6%, respectively. Out of the total population, 47.8% of students have the misconception that WP smoking is less harmful than cigarettes. A significant association (P < 0.05) of some demographic factors (age, school stage, residence, and parents’ educational level) on WP smoking status was observed. Pleasure, socializing, and happiness represented the primary motives for initiating WP smoking. The majority of students had misconceptions about WP’s health effects. More than 50% believed that smoking WP could ease anxiety, cause less harm, and has less addictive properties compared to cigarettes. Modeling suggested that the most significant predictors of WP smoking were cigarette smoking, depression, and the attitude index. Current findings warrant further research and official health programs to promote educational initiatives regarding WP smoking. [ABSTRACT FROM AUTHOR]

The ageing of the population has resulted in an increase in the demand for long‐term care services for older people, but with limited resources, its challenges have also been highlighted. Although factors affecting the willingness of older people to engage with long‐term care services have been widely reported, however, systematic review has not synthesised the evidence, and its associated factors remain unclear. This systematic review aims to study and synthesise the best available evidence on the potential factors related to the willingness of older people to engage with long‐term care services. Eight electronic databases were comprehensively searched from inception to January 2021: the Cochrane Library, PubMed, Web of Science, CINAHL, Wanfang Database, China Knowledge Resource Integrated Database (CNKI), Weipu Database (VIP), and Chinese Biomedical Literature Database (CBM). The original literatures were screened according to selection criteria. Two researchers used 11‐item checklist recommended by the Agency for Healthcare Research and Quality to evaluate the quality of the included literatures. And the review used narrative synthesis to integrate factors related to the willingness of older people to engage with long‐term care services. In total, 7794 studies were screened and 35 studies were included in this review. Among them, 23 studies were rated as moderate quality and 12 was high quality. Data synthesis identified that age, education, number of children, living arrangements, the relationship with children, primary caregivers, place of residence, social support, household income, medical insurance, activities of daily living ability and spiritual comfort should all be taken into account when establishing the appropriate long‐term care service model or formulating relevant policies. However, many factors remain undetermined and require more rigorous original literature support. And multiple areas can be also considered in the future studies, especially psychological factors. [ABSTRACT FROM AUTHOR]

This study used a qualitative, cross‐sectional design to address a gap in understanding the perspectives and practices of care planners and case managers in supporting consumer‐ directed care (CDC) for community dwelling people living with dementia. Semi‐structured telephone interviews were conducted with a convenience sample of n = 16 planners and managers from seven providers of the Australian home care packages (HCP) program in NSW (Australia). All interviewees described the aspirations of supporting choice within CDC as synergistic with their values and with person‐centred care. Some described new flexibilities within the more open‐ended planning conversations enabled by CDC. However, most acknowledged their capacity to enable choice for clients with dementia was limited by the capped care budgets, as well as the skills and time needed to support choice and decision‐ making. Organisational practice changes associated with the shift to a market‐based system were also perceived as limiting the capacity to support choices. Reducing centralised systems, increasing individual budgets and improving staff capacity to support decision‐making by people with dementia may help to improve this situation. However, results suggest a deeper need to re‐evaluate whether the CDC model is the most appropriate for supporting the rising numbers of people with dementia to age well in place. [ABSTRACT FROM AUTHOR]

Oral hypofunction is the stage at which recovery can be expected with proper diagnosis, management, and motivation before oral dysfunction occurs. The knowledge and attitude toward oral function can influence the maintenance and improvement of oral function. However, whether middle-aged and older adults with declining oral function have knowledge of their oral function and how this knowledge and their attitude affect their oral function are unclear. Therefore, we aimed to examine (1) the relationship between knowledge and attitude toward oral function and hypofunction in individuals with suspected oral hypofunction and (2) changes in knowledge and attitude toward oral function through evaluation and education. Participants aged ≥50 years were enrolled during their first community dental clinic visit. A questionnaire assessment of knowledge and attitudes before and after oral function evaluation was performed. The oral function was initially assessed with seven criteria: oral hygiene; oral dryness; occlusal force; tongue pressure; tongue-lip motor, masticatory, and swallowing function. Associations between knowledge and attitudes and their changes were statistically analyzed. Fifty-nine participants (93.7%) were unaware of "oral hypofunction." Associations between knowledge and attitudes and their changes in the negative to positive response groups, from 86.4% and 61.0% to 6.8% and 25.4%, respectively, after oral function evaluation, indicated that participants understood their oral function and the need for training. Middle-aged and older individuals with poor knowledge and attitudes were more likely to have a worse oral function; however, their knowledge and attitudes toward oral function could be improved through oral function assessment and education. [ABSTRACT FROM AUTHOR]