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Background: Despite significant progress in cardiovascular disease (CVD) management, it remains a public health priority and a global challenge. Within the disease process, health care after a cardiovascular event (secondary prevention) is essential to prevent recurrences. Nonetheless, evidence has suggested the existence of gender disparities in CVD management, leaving women in a vulnerable situation. The objective of this study is to identify all available evidence on the existence of gender differences in health care attention after a major adverse cardiovascular event. Methods: A scoping review following the structure of PRISMA-ScR was conducted. To define the inclusion criteria, we used Joanna Briggs Institute (JBI) population, concept, context framework for scoping reviews. A systematic search was performed in MEDLINE (PubMed), EMBASE and Cochrane. The methods of this review are registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) (INPLASY202350084). Results: The initial search retrieved 3,322 studies. 26 articles were identified manually. After the reviewing process, 93 articles were finally included. The main intervention studied was the pharmacological treatment received (n = 61, 66%), distantly followed by guideline-recommended care (n = 26, 28%) and cardiac rehabilitation (CR) referral (n = 16)". Literature described gender differences in care and management of secondary prevention of CVD. Women were less frequently treated with guideline-recommended medications and seem more likely to be non-adherent. When analysing guideline recommendations, women were more likely to make dietary changes, however, men were more likely to increase physical activity. Studies also showed that women had lower rates of risk factor testing and cholesterol goals attainment. Female sex was associated with lower rates of cardiac rehabilitation referral and participation. Conclusions: This review allowed us to compile knowledge on the existence of gender inequalities on the secondary prevention of CVD. Additional research is required to delve into various factors influencing therapeutic disparities, referral and non-participation in CR programs, among other aspects, in order to improve existing knowledge about the management and treatment of CVD in men and women. This approach is crucial to ensure the most equitable and effective attention to this issue. [ABSTRACT FROM AUTHOR]

Reactivating place cells during sharp-wave ripples in the hippocampus is important for memory consolidation. However, whether hippocampal reactivation is affected by the values of events experienced by the animal is largely unknown. Here, we investigated whether place cells in the dorsal (dHP) and intermediate hippocampus (iHP) of rats are differentially reactivated depending on the value associated with a place during the learning of places associated with higher-value rewards in a T-maze. Place cells in the iHP representing the high-value location were reactivated significantly more frequently than those representing the low-value location, characteristics not observed in the dHP. In contrast, the activities of place cells in the dHP coding the routes leading to high-value locations were replayed more than those in the iHP. Our findings suggest that value-based differential reactivation patterns along the septotemporal axis of the hippocampus may play essential roles in optimizing goal-directed spatial learning for maximal reward. [ABSTRACT FROM AUTHOR]

Physical literacy (PL) describes individuals’ unique relationship with physical activity by integrating physical, cognitive, affective, and social aspects. The person-centered concept highlights a ‘lifelong journey’ for each individual and postulates beneficial effects on biopsychosocial health. Despite extensive suggestions on how to assess the concept, no instrument has so far sufficiently aligned with these ‘individual journeys’ for PL. Therefore, the goal of this conceptual article is to introduce the biographical PL mapping (BMAP-PL) as a purposive, flexible, and paradigmatically open method for the broad physical activity and health context. Intending to provoke individual narratives by plotting domain-driven courses across the lifespan, the BMAP-PL involves four sequential phases guided by a trained facilitator: (a) introduction and overview; (b) personalization and registration of life events; (c) evaluation and biographical visualization of PL dimensions; (d) final overview. The idiosyncratic courses can undergo both qualitative and quantitative analysis, including a potential for synthetic integration. Qualitative analyses can span the identification of life events, transition phenomena, domain-differential analyses, and inter-individual patterns via narrative analysis, thematic analysis, typological analysis, or the grounded theory approach. We suggest quantitative analyses with descriptive and inferential statistical potential on the intra-individual, inter-individual, and group/population level. Given the profound cognitive engagement with the complex behavior of physical activity, BMAP-PL allows for a smooth transition to interventional endeavors (e.g. self-exploration of identity facets, prospective projections, goal setting). The application of the method has value for both research and practice but is based on requirements on the personal and atmospheric level. Emphasizing the need to complement the conceptual ideas through empirical data, we conclude by outlining an agenda for future activities. [ABSTRACT FROM AUTHOR]

Background: In the emergency department (ED), there are pre-assembled tonsillar hemorrhage trays for management of post-tonsillectomy hemorrhage and peritonsillar abscess. After use, the tray is sent to the medical device reprocessing (MDR) department for decontamination, sterilization, and re-organization, all at a significant cost to the hospital and environment. Objective: The goal of this project was to reduce unnecessary instruments on the tonsil hemorrhage tray by 30% by 1 year and report on the associated cost and carbon dioxide (CO2) emissions savings. Methods: This quality improvement project was framed according to the Institute for Healthcare Improvement's Model for Improvement. ED and Otolaryngology–Head & Neck Surgery staff and residents were surveyed to determine which instruments on the tonsil hemorrhage trays were used regularly. Based on results, a new tray was developed and compared to the old tray using MDR data and existing CO2 emissions calculations. Results: Tray optimization resulted in a total cost reduction from $1092.63 to $330.21 per tray per year, decreased processing time from 12 to 6-8 minutes per tray, and decreased CO2 emissions from 6.11 to 2.85 kg per year for the old versus new tray, respectively. Overall, the new tray contains half the number of instruments, takes half the time to assemble, produces 50% less CO2 emissions, and will save the hospital approximately $100,000 over 10 years. Conclusion: Healthcare costs and environmental sustainability are collective responsibilities. Surgical and procedure tray optimization is a simple, effective, and scalable form of eco-action. [ABSTRACT FROM AUTHOR]

Aim Method Results Conclusion Clinical or Methodological Significance of this Article This study aimed to assess the impact of a positive psychotherapy‐based hope placement program on life goal setting and hope levels in individuals diagnosed with multiple sclerosis (MS).A Solomon Four‐Group experimental design was used, involving 50 individuals diagnosed with MS who sought treatment at a university hospital's neurology outpatient clinic. Experimental (1‐2) and control (1‐2) groups were randomized, and pretests were administered exclusively to the experimental and control groups. Data were collected using a Personal Information Form, the Herth Hope Scale, and the Scale for Determining Life Goals in the Context of Positive Psychotherapy. A 5‐week/10‐session Positive Psychotherapy‐Based Hope Placement Program was conducted online for the Experimental groups. The research was conducted in the form of group therapy. Post‐tests were administered to all groups upon program completion.The experimental 1–2 group exhibited statistically significant improvements in the Scale for Identifying Life Goals in the Context of Positive Psychotherapy and Herth Hope Scale scores (p < .05). The Positive Psychotherapy‐Based Hope Placement Program effectively enhances hope levels and life goal setting for individuals diagnosed with MS.The results indicate that the program increased the sense of purpose in life and elevated levels of hope among MS patients. These findings suggest that positive psychotherapy‐based interventions significantly improve the quality of life for MS patients.This study examines the impact of a Positive Psychotherapy‐based hope placement program on determining hope and life purpose in patients with Multiple Sclerosis (MS). This research shows that HOPP (Hope Placement Program), an intervention based on Positive Psychotherapy, can significantly improve the quality of life of MS patients. These findings support the consideration of Positive Psychotherapy‐based approaches as a potential therapeutic option that can positively influence the life experiences of MS patients. Therefore, this article makes an important contribution to researchers interested in using Positive Psychotherapy‐based interventions in clinical practice and related research. [ABSTRACT FROM AUTHOR]

Individuals with intellectual disabilities often fail to learn complex tasks. Modified Goal Management Training (mGMT) or Errorless Learning combined with assistive technology (App + EL) can help. The goal is to demonstrate the effectiveness of mGMT and/or App + EL in learning complex tasks. We employed a randomized controlled crossover design. One group started with mGMT (N = 16), and the other with App + EL (N = 15). We compared their performance with that of a passive control group (N = 15). The training consisted of six sessions of 30 minutes each. Success was analyzed using the Goal Attainment Scale (GAS). Three different tasks were assessed before and after each intervention period: “Practiced”, “Non-Practiced”, or “Previously Practiced”. Generalization was evaluated through neuropsychological tests. Results indicated that both interventions significantly improved “Practiced” tasks compared with “Non-Practiced” tasks and the control group. Crossing the intervention did not interfere with the stable performance on the “Previously Practiced” task. However, starting with mGMT reduced, but did not eliminate, the efficacy of App + EL after crossing, but this pattern was not observed for the reverse sequence. Only the Tower of London task documented improvements related to interventions. In conclusion, the mGMT and App + EL were effective in learning complex tasks and retaining performance after learning a second task.Trial registration: German Clinical Trials Register identifier: DRKS00021674. [ABSTRACT FROM AUTHOR]

There is limited research about how groups solve collective action problems in uncertain environments, especially if groups are confronted with unknown unknowns. We aim to develop a more comprehensive view of the characteristics that allow both groups and individuals to navigate such issues more effectively. In this article, we present the results of a new online experiment where individuals make decisions of whether to contribute to the group or pursue self-interest in an environment with high uncertainty, including unknown unknowns. The behavioral game, Port of Mars is framed as a first-generation habitat on Mars where participants have to make decisions on how much to invest in the shared infrastructure to maintain system health and how much to invest in personal goals. Participants can chat during the game, and take surveys before and after the game in order to measure personality attributes and observations from the game. Initial results suggest that a higher average social value orientation and more communication are the key factors that explain why some groups are more successful than others in surviving Port of Mars. Neither other attributes of players nor the group's communication content explain the observed differences between groups. [ABSTRACT FROM AUTHOR]

Background: Recovery colleges are an education-based approach to supporting mental health recovery that incorporate the voice of both lived and living experience, and experience by training in their design, production, and delivery. Aims: To understand students' experiences of attending a youth-focused 'discovery college' course. Specifically, to see whether students were satisfied with the course, whether the learning goals of the courses were met, and what students felt makes discovery college different. Methods: A mixed methods design analysed quantitative data on students' ratings of the course and their learning goals. A co-produced thematic analysis, incorporating the voice of lived and living experience, was also conducted on students' responses to the question "what makes discovery college different?" Results: Overall, students rated their experience with the course very positively, and mostly met the learning goals of courses. The co-produced thematic analysis revealed students valued the incorporation of lived and living experience in courses, the lack of power imbalance between teachers and students, and felt it was a safe space to share and learn. Conclusions: Findings support the delivery of the recovery college model within a youth setting, and highlights this as a useful initiative in engaging people from a range of perspectives in education about mental health. [ABSTRACT FROM AUTHOR]

Growth mindsets, the belief that intelligence can grow with effort and training, have been associated with the adoption of mastery goals in children and adolescents. However, it is unknown whether these two factors are also correlated in adults. We conducted two online studies among three hundred participants to challenge this association. Results from (1) zero-order correlations, (2) structural equation modeling and (3) out-of-sample predictions converged on the finding that growth mindset was associated with the adoption of mastery goals in mathematics. This association generalized across different ways of measuring mindsets. Taken together the results provided new evidence for the idea that mindset and goal achievement are intrinsically related concepts, which remain associated across different life stages and generalize across populations. [ABSTRACT FROM AUTHOR]

Moral hazard involves a context where decision-makers engage in behaviors that prioritize self-interest while allowing the associated risk to be primarily borne by others. Such decision making can lead to catastrophic consequences, as seen in the 2008 global financial crisis after hedge fund managers indiscriminately invested their clients' money in subprime mortgages. This research examines which decision-makers are most likely to engage in moral hazard decision making and the psychological mechanism driving this behavior. Drawing on the dual model of social influence, we posit that individuals associated with dominance, but not prestige, will engage in greater moral hazard behaviors. We further contend that these behaviors are driven by dominant decision-makers' enhanced focus on end goals (outcomes) rather than the means (process) that they use to pursue such goals. We find support for our hypotheses across 13 studies (NObservations = 26,880; of which eight were preregistered and six studies are reported in the Supplemental Materials), using both correlational and experimental designs. Additionally, we vary the moral hazard context (e.g., a financial setting, a health and safety issue, etc.) and capture both behavioral intentions and actual behaviors, while also ruling out several alternative explanations. These findings demonstrate that dominant decision-makers engage in moral hazard behaviors because of their tendency to prioritize outcomes over processes. [ABSTRACT FROM AUTHOR]

A crucial aim in neuroscience is to understand how the human brain adapts to varying cognitive demands. This study investigates network reconfiguration during controlled semantic retrieval in differing contexts. We analyze brain responses to two semantic tasks of varying difficulty – global association and feature matching judgments – which are contrasted with non-semantic tasks on the cortical surface and within a whole-brain state space. Demanding semantic association tasks elicit activation in anterior prefrontal and temporal regions, while challenging semantic feature matching and non-semantic tasks predominantly activate posterior regions. Task difficulty also modulates activation along different dimensions of functional organization, suggesting different mechanisms of cognitive control. More demanding semantic association judgments engage cognitive control and default mode networks together, while feature matching and non-semantic tasks are skewed towards cognitive control networks. These findings highlight the brain's dynamic ability to tailor its networks to support diverse neurocognitive states, enriching our understanding of controlled cognition. An fMRI study on healthy participants suggests that two distinct brain states support controlled semantic cognition: one state facilitates the controlled retrieval of semantic associations, while the other state supports goal-driven control. [ABSTRACT FROM AUTHOR]

This article undertakes a comprehensive investigation into several common critiques of career politicians. Career politicians are said to be self‐serving: active and assertive when it suits their career interests, and much more interested in attaining higher offices than in serving as constituency‐oriented MPs. Yet, empirical investigations of their alleged behaviours are few, and the results are patchy and mixed. Focusing on the United Kingdom case and using a multi‐dimensional conceptualization that accords with academic and popular understandings of career politicians, the article draws on uniquely rich attitudinal and longitudinal behavioural data covering the first large generational wave of career politicians to be elected to parliament in the early 1970s. It reports findings consistent with contemporary critiques, suggesting that such dispositions are inherent in the role of career politician. The strongest career politicians among this first wave concentrated strategically on career‐serving activities, voted strategically to safeguard their careers, attained and retained successfully ministerial offices and prioritized their personal goals over their party obligations. The article further demonstrates that different measures used by researchers can produce contradictory results and that future comparative research should seek to range beyond unidimensional indicators. [ABSTRACT FROM AUTHOR]

Background and Objectives: The habit formation model of obsessive–compulsive disorder (OCD) suggests that overreliance on stimulus-driven behaviors leads to repetitive compulsive rituals. Failure in task control, which leads to the stimulus-driven behaviors overriding the goal-driven system, could explain the mechanisms involved in this process. Methods: Patients with OCD and non-psychiatric controls completed the affordance task to understand the role of task control in maintaining compulsive behaviors. In the affordance task, participants are required to respond to a stimulus with one hand, while the stimulus on screen triggers a motor activation in either the congruent (same) or incongruent (other) hand. The affordance effect (accuracy for incongruent minus congruent trials) measures task control—the ability to suppress irrelevant, stimulus-driven, behaviors. Results: The affordance effect was larger in the OCD group, indicating a deficit in task control in those patients. Furthermore, a binary logistic regression analysis, using the affordances effect as a predictor and group as the outcome variable, revealed that the affordance effect correctly classified about 65% of the individuals with OCD compared to the non-psychiatric controls. The correlation between the affordance effect and OCD symptom-severity was not significant. Limitations: Handedness was assessed through self-report and OCD symptoms were mild–moderate. Conclusions: These findings strengthen the notion that task control deficits might account for the imbalance between the goal-directed and habit formation systems and that this deficit might be a risk factor for OCD but does not account for symptom-severity. [ABSTRACT FROM AUTHOR]

Communicative competence for people who use augmentative and alternative communication consists of four interrelated domains: linguistic, strategic, social, and operational. Ongoing assessment and progress monitoring within these domains are crucial to (a) providing information to teach targeted skills in a manner contextualized within the curriculum, (b) determining measurable annual Individualized Education Program goals, and, ultimately, (c) ensuring maximal participation in the school environment. Currently, language sample analysis (LSA) is one of only three assessment techniques that provide information across each domain of communicative competence for children who use augmentative and alternative communication (AAC). As such, LSA is a valuable tool for assessing communication competence in children who use AAC in the school setting. This clinical forum describes information that may be obtained from an LSA as it relates to each domain of communicative competence and educational standards. [ABSTRACT FROM AUTHOR]

To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. Thirty-three Hispanic/Latinx caregivers, predominantly of low income. Patterns in goal content and anticipated barriers and facilitators. Thematic analysis of goal sheets with a mixed inductive-deductive approach. Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators. [ABSTRACT FROM AUTHOR]

Background Behavior change techniques (BCTs) have been extensively used in physical activity interventions for children, however, no systematic reviews have synthesized their effects. Purpose The present review aimed to identify the most promising BCTs used in physical activity interventions associated with (i) increased physical activity behavior and (ii) positive psychosocial outcomes in children with chronic conditions. Methods A systematic search of 6 databases identified 61 articles as eligible for inclusion. Data, including BCTs, were extracted from these studies and analyzed descriptively. Due to the heterogeneity of interventions, chronic conditions, and outcome measures, a meta-analysis was not conducted. Results Social support (unspecified) , graded tasks , generalization of target behavior , and credible source were the most commonly reported and most promising (i.e. present in 2+ studies evidencing significant effects) BCTs across all studies. These BCTs were found to be especially relevant to improving psychosocial outcomes in the short- and long-term and improving physical activity behaviors in the long-term. Meanwhile, to improve short-term physical activity behaviors, in addition to social support (unspecified) , action planning , goal setting (behavior) , and problem solving were found to be promising BCTs. Conclusions The BCTs identified in this review may be relevant to incorporate when planning future interventions to support physical activity and psychosocial outcomes for children with chronic conditions. [ABSTRACT FROM AUTHOR]

Background: As a person nears the end of their life, culture and ethnicity increasingly drive preferences and priorities for care. Understanding these preferences and priorities is fundamental to health care professionals' goals to respect decision making and support the individual throughout this phase of life. Across Africa, several countries are in the initial stages of implementing palliative care services in their burgeoning health care systems. Moving forward, it is imperative to consider cultural similarities and differences when compared with the Western world, where the field of palliative care evolved, to create a tailored palliative care approach that is consistent with African culture. In palliative care, understanding cultural preferences and priorities requires communication between the patient and the provider and is a crucial step toward a successful implementation in Africa. A paternalistic patient–provider relationship is the current leading model in sub-Saharan Africa.1 Aim: This narrative review explores the prevalence of paternalism and explores its appropriateness and necessity in the current application of palliative care in sub-Saharan African countries. Methods: This narrative review was conducted using four databases as well as hand searching of relevant articles sourced from references of already selected articles. A total of 730 articles were identified. Fourteen articles met the inclusion/exclusion criteria set for this narrative review. Results: In sub-Saharan Africa, the leading patient–provider relationship was determined to be paternalistic. Reasons for this were language, education, cultural norms and expectations, lack of time, and benevolence. Conclusions: The implementation of palliative care often relies on communication of patient desires and goals. Consideration is needed to determine how a provider can appropriately know these factors in a paternalistic relationship. [ABSTRACT FROM AUTHOR]

Alcohol and other drug (AOD) use problems among college students continue to represent a public health epidemic. In 2019, historically high rates of binge-drinking and marijuana use were reported among college-age adults, and the detrimental effects of excessive AOD use in college, such as poorer academic performance, sexual assault, injury or overdoses, and a range of other negative consequences, have been well-documented. Thus, there is a continued need for effective implementation of evidence-based, cost-effective interventions aimed at reducing risks associated with collegiate AOD use. Guided Self Change (GSC) is a brief intervention involving motivational enhancement and cognitive-behavioral strategies and has demonstrated effectiveness in reducing AOD use problems. Its brevity, client-driven style, and concrete here-and-now focus are appealing to individuals struggling with mild to moderate AOD use problems. In order to successfully intervene with collegians with AOD use problems attending minority-serving institutions, GSC requires developmental and cultural tailoring. The current report describes the developmental and cultural tailoring of GSC for emerging adult Latinx collegians, as well as our consumer-driven addition of mindfulness content. Key components of our GSC program are documented through qualitative feedback, quantitative results, and case vignettes. [ABSTRACT FROM AUTHOR]

We propose a memory-enhanced multi-stage goal-driven network (ME-MGNet) for egocentric trajectory prediction in dynamic scenes. Our key idea is to build a scene layout memory inspired by human perception in order to transfer knowledge from prior experiences to the current scenario in a top-down manner. Specifically, given a test scene, we first perform scene-level matching based on our scene layout memory to retrieve trajectories from visually similar scenes in the training data. This is followed by trajectory-level matching and memory filtering to obtain a set of goal features. In addition, a multi-stage goal generator takes these goal features and uses a backward decoder to produce several stage goals. Finally, we integrate the above steps into a conditional autoencoder and a forward decoder to produce trajectory prediction results. Experiments on three public datasets, JAAD, PIE, and KITTI, and a new egocentric trajectory prediction dataset, Fuzhou DashCam (FZDC), validate the efficacy of the proposed method. [ABSTRACT FROM AUTHOR]

To investigate the association between the mental health of nursing students, the stress of higher education, and academic goal orientation. At a medical college, 1170 nursing students volunteered for this cross‐sectional survey. The Warwick‐Edinburgh Well‐being Scale, the Higher Education Stress Scale, and the Academic Goal Orientation Questionnaire were utilised to collect data. Descriptive statistics, ANOVA, and Pearson correlation analysis were all performed to evaluate the data. The significance level for all statistical tests was p < 0.05. A total of 1126 valid samples, with a 96.23% effective recovery rate. The Higher Education Stress Scale score for nursing students was (38.31 ± 8.29), the Academic Goal Orientation Questionnaire result was (49.32 ± 9.62), and the Mental Health Scale value was (31.24 ± 14.00). Overall, there was a strong relationship between the stress associated with higher education, academic goal orientation, and the mental health of nursing students. Therefore, in future interventions, the Chinese government and its relevant educational authorities can enhance nursing students' ability to reasonably regulate stress related to higher education and set clear academic goals by adjusting the strategies for regulating nursing students' academic stress and increasing the number of academic goal‐oriented courses to improve their mental health. [ABSTRACT FROM AUTHOR]

Background: Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three‐arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian‐led telehealth intervention at 3 months. Methods: Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non‐core foods were reported. Results: The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) −0.0 to 12.9], p = 0.049), non‐core foods (−6.4%/day [95% CI −12.9 to 0.0], p = 0.049), sweetened drinks (−1.7%/day [95% CI −2.9 to −0.4], p = 0.013), takeaway foods (−2.3%/day [95% CI −4.5 to −0.1], p = 0.045) and sodium (−478 mg/day [95% CI −765 to −191 mg], p = 0.001). Conclusions: A dietitian‐led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change. Highlights: A full range of dietary intake variables, eating behaviours, sleep quality and physical activity was evaluated.There was a significant negative relationship between change in diet quality and change food addiction (FA) symptoms at 3 months compared to baseline, indicating that, as FA symptoms decreased, diet quality increased.Participants allocated to the active intervention group reported statistically significant improvements in a range of dietary intake variables compared to the participants allocated to the passive intervention or control groups. [ABSTRACT FROM AUTHOR]

Background More research is required to understand the effects of implementing structured goal-setting on trainee engagement in competency-based clinical learning environments. Objective To explore how residents experienced a rotation-specific goal-setting intervention on geriatric medicine rotations at 2 hospitals. Methods All rotating residents were expected to complete the intervention, consisting of a SMART-based (Specific, Measurable, Achievable, Relevant, and Time-Bound) goal-setting form and feedback sessions with teaching faculty. From November 2019 to June 2021, we recruited a convenience sample of rotating residents. Study participants completed pre- and postrotation 35-item Dutch Residency Educational Climate Test (D-RECT) questionnaires to compare scores from their rotation before the geriatric rotation and a postrotation semistructured interview, which we transcribed and analyzed using principles of constant comparison and reflexive thematic analysis. Results We interviewed 12 of 58 (20.7%) residents participating in the goal-setting intervention, 11 of whom completed both D-RECT questionnaires. Participants' D-RECT scores favored the geriatric medicine rotation versus the immediately preceding clinical rotation (M=4.29±0.37; M=3.84±0.44, P=.002). Analyses of interview transcripts yielded 3 themes on how participants perceived the intervention influenced their learning experience: (1) structured forms and processes mediate, inform, and constrain goal selection; (2) interactions with faculty, patients, and system factors influenced goal enactment; and (3) unstructured assessments led to uncertainty around goal achievement. Challenges included time restrictions and unpredictable clinical opportunities. Conclusions Goal-setting appeared to help many residents direct their learning efforts and engage in collaborative processes with teaching faculty. We identified challenges limiting residents' engagement with the goal-setting intervention, which may inform the practical implementation of goal-setting in other competency-based curricula. [ABSTRACT FROM AUTHOR]

Wearable technology may provide the possibility to monitor and quantify home exercises, to increase motivation for training and to facilitate cooperation between stroke survivors and physiotherapists. However, little is known about potential users' opinions about using such systems. To explore stroke survivors' and physiotherapists' perspectives on the potential benefit of such wearable technology consisting of a smartphone application and movement sensors. Four semi-structured focus group discussions, two with stroke survivors (n = 12) and physiotherapists (n = 11) respectively, were conducted to explore their perceptions on the potential of such technology. We developed four main themes through the thematic analysis: 1) the app should be well-developed, user-friendly and flexible; 2) the app's potential for feedback and the experience of progression; 3) the app as a tool for rehabilitation; and 4) the app's potential to strengthen the relationship between stroke survivors and physiotherapists. Stroke survivors' use of wearable technology to promote home exercise will depend as much on their trust in the professional and relational competence of the physiotherapist as the technical issues of an app. The potential benefits of wearable technology for cooperation between stroke survivors and physiotherapists and as a tool for rehabilitation were highlighted. [ABSTRACT FROM AUTHOR]

In competitive and elite sports, mental health and athletic performance cannot be considered separately. Mental disorders in sports are bidirectionally associated with reduced athletic performance. A decline in performance, both within and outside of sport, can be a sign of mental disorder. Additionally, poor athletic performance is a potential risk factor for mental disorders in athletes. The central role sports psychiatrists play in the mental health of athletes is well‐established. However, their role in athletic performance is less well‐described and more controversial, perhaps due to a perception that performance is purely a secondary outcome of good mental health. This paper discusses the role that sports psychiatrists can play in athletic performance within competitive and elite sports. Performance can be distinguished into three key focus areas for sports psychiatrists: (i) performance restoration, (ii) performance maintenance, and (iii) performance enhancement. These should be considered throughout the continuum of mental health care, from prevention, treatment, to ongoing care for mental disorders. When reduced performance is due to a mental disorder, psychiatric treatment should purposefully aim to restore functioning and performance as part of management. Maintenance of performance is, similarly, an important element of the prevention, psychiatric treatment, and ongoing care of mental disorders. Holistic sports psychiatrists may also choose to aim for athletic performance enhancement beyond the context of mental health symptoms and disorders, to help athletes flourish and achieve their goals. [ABSTRACT FROM AUTHOR]

The article shares strategies associated with reengineering the core functionalities of an electronic health record (EHR) system of a Kentucky geriatric-focused primary care (PC) clinic. It notes that the strategy necessitated a shift from traditional roles of geriatrician-led PC to team-based PC. It states that the success of the strategy relied on comprehensive education for team members on age-friendly health care.

Introduction: Advance care planning (ACP) aims to ensure that patients receive goal‐concordant care (GCC), which is especially important for racially or ethnically minoritized populations at greater risk of poor end‐of‐life outcomes. However, few studies have evaluated the impact of advance directives (i.e., formal ACP) or goals‐of‐care conversations (i.e., informal ACP) on such care. This study aimed to examine the relationship between each of formal and informal ACP and goal‐concordant end‐of‐life care among older Americans and to determine whether their impact differed between individuals identified as White, Black, or Hispanic. Methods: We conducted a retrospective cohort study using 2012–2018 data from the biennial Health and Retirement Study. We examined the relationships of interest using two, separate multivariable logistic regression models. Model 1 regressed a proxy report of GCC on formal and informal ACP and sociodemographic and health‐related covariates. Model 2 added interaction terms between race/ethnicity and the two types of ACP. Results: Our sample included 2048 older adults. There were differences in the proportions of White, Black, and Hispanic decedents who received GCC (83.1%, 75.3%, and 71.3%, respectively, p < 0.001) and in the use of each type of ACP by racial/ethnic group. In model 1, informal compared with no informal ACP was associated with higher odds of GCC (adjusted odds ratio = 1.38 [95% confidence interval, 1.05–1.82]). In model 2, Black decedents who had formal ACP were more likely to receive GCC than those who did not, but there were no statistically significant differences between decedents of different racial/ethnic groups who had no ACP, informal ACP only, or both types of ACP. Conclusions: Our results build on previous work by indicating the importance of incorporating goals‐of‐care conversations into routine healthcare for older adults and encouraging ACP usage among racially and ethnically minoritized populations who use ACP tools at lower rates. [ABSTRACT FROM AUTHOR]

The article presents a study on referral practices in the use of palliative care (PC) by nursing home (NH) residents. Topics discussed include the significance of palliative care for NH residents, the methods used in the study, factors that influence PC referrals, and the benefit of using a PC screening tool in NHs.

Background: Documenting goals of care in the electronic health record is meant to relay patient preferences to other clinicians. Evaluating the content and documentation of nurse and social worker led goals of care conversations can inform future goals of care initiative efforts. Methods: As part of the ADvancing symptom Alleviation with Palliative Treatment trial, this study analyzed goals of care conversations led by nurses and social workers and documented in the electronic health record. Informed by a goals of care communication guide, we identified five goals of care components: illness understanding, goals and values, end of life planning, surrogate, and advance directives. Forty conversation transcripts underwent content analysis. Through an iterative team process, we defined documentation accuracy as four categories: (1) Complete—comprehensive accurate documentation of the conversation, (2) Incomplete—partial documentation of the conversation, (3) Missing—discussed and not documented, and (4) Incorrect—misrepresented in documentation. We also defined—Not Discussed—for communication guide questions that were not discussed nor documented. A constant comparative approach was used to determine the presence or absence of conversation content in the documentation. Results: All five goals of care components were discussed in 67% (27/40) of conversation transcripts. Compared to the transcripts, surrogate (37/40, 93%) and advance directives (36/40, 90%) were often documented completely. Almost 40% of goals and values (15/40, 38%) and half of end of life planning (19/40, 48%) were incomplete. Illness understanding was missing (13/40, 33%), not discussed (13/40, 33%), or incorrect (2/40, 5%). Conclusion: Nurse and social worker led goals of care conversations discussed and documented most components of the goals of care communication guide. Further research may guide how best to determine the relative importance of accuracy, especially in the broad setting of incomplete, missing, and incorrect EHR documentation. [ABSTRACT FROM AUTHOR]

Objective: This study compared the utilization and outcomes of face-to-face (F2F) vestibular support groups and online support communities (OSC) for individuals with vestibular disorders. Methods: We distributed a 31-question anonymous electronic survey through the Vestibular Disorders Association (VeDA) to F2F participants, categorizing user involvement in F2F, OSCs, or both and assessed impact on medical decision-making, psychosocial benefits, and goals achieved. Results: The F2F cohort consisted of 97 individuals comprising primarily of non-Hispanic White women (mean age = 57 years, SD ± 14 years) with diagnoses including persistent postural-perceptual dizziness (19%), Meniere's disease (15%), and vestibular neuritis (13%). Most participants were diagnosed by an otolaryngologist (65%) and attended F2F meetings monthly or less frequently (78%). The OSC group comprised of 551 individuals, primarily of non-Hispanic White women, but was younger in age (mean age = 50 years, SD ± 13 years). OSC participants notably engaged more, with 36% participating on a daily basis and 32% multiple times a week. F2F participants were older (mean age 57 years vs 50 years, P <.001) and more commonly referred by medical professionals (22% F2F vs 6% OSC, P <.001). Both groups had similar achieved goals, including hearing from others with the same diagnosis (84% vs 89%, P >.05) and similar impact on medical decision-making (75% vs 78%, P >.05). More F2F participants reported increased development of coping skills (79% F2F vs 69% OSC, P =.037). OSC participants typically found the group via an online search (75%), compared to 51% for F2F. OSC participants had higher daily engagement (36%) compared to F2F (1%). Conclusion: F2F users are older and more commonly referred by medical professionals. Despite less frequent engagement, F2F participants reported similar influences on achieved goals, medical decision-making, and impact on psychosocial benefits. These findings highlight the importance of both F2F and OSC support groups for individuals with vestibular disorders. [ABSTRACT FROM AUTHOR]

How physical education teachers approach standards-based assessment of the new National Physical Education Standards is yet to be determined. But the use of technology for assessments may be one way to support and empower students in the education process toward physical literacy. This article focuses on the ways in which educators have adopted a particular technology, called Plickers, and how its use as an assessment tool can move physical education teachers' practice forward. [ABSTRACT FROM AUTHOR]

This study aimed to examine protective factors associated with resilience among unaccompanied refugee minors in comparison to their Norwegian peers and to examine associations between resilience factors and characteristics related to positive outcomes among unaccompanied minors. Data stem from the Pathways to Independence study conducted in Bergen municipality, Norway in 2018–2019 where 81 unaccompanied minors aged 15–20 participated (83.3% male; 80% response rate). An age- and sex-matched control group of 324 adolescents was retrieved from the youth@hordaland study conducted in Norway in 2012. Resilience factors were assessed by the Resilience Scale for Adolescents. Unaccompanied minors reported lower scores on Goal Orientation (d = 0.4), Social Competence (d = 0.4), and Social Support (d = 0.7) compared to Norwegian adolescents. Being male was associated with lower scores on Goal Orientation (standardized mean difference [SMD] = − 0.9) and Social Support (SMD = − 0.9) among unaccompanied minors, while being in frequent contact with family in the home country was associated with higher scores on all resilience factors (SMD range = 0.6–1.1). The number of leisure activities was associated with Social Competence (SMD = 0.22). There were no significant associations between the resilience factors and amount of support in the living arrangements or contact with the child welfare services. Unaccompanied minors reported fewer resilience factors compared to Norwegian adolescents, indicating that they may have different needs compared to other adolescents. Our study also suggests that frequent contact with family in the home country may be important to bolster positive development for unaccompanied minors after settlement. [ABSTRACT FROM AUTHOR]

Engineering design and construction teams commonly use decision tools, such as rating systems, to manage the complexity of infrastructure projects. However, these systems often focus predominantly on environmental dimensions, potentially overlooking the holistic economic and social aspects of sustainability. This can hinder decision-makers from recognizing the benefits, thereby inadvertently impeding optimal sustainability performance. This research explores a potential solution: reframing the goals of credits on rating systems to explicitly highlight the interconnectedness of environmental, social, and financial dimensions. The aim was to amplify engineers' motivation towards higher levels of sustainability performance. The study examined the effect of the goal-framed credits by comparing the sustainability scores between engineering professionals (n=42) who used the original Envision system and the reframed version when evaluating a case project. The control group participants averaged a score of 95.4 Envision points (37%), while the intervention group averaged 121.8 Envision points (48%). The reframed credits significantly increased engineering professionals' sustainability goal setting. Emphasizing financial and social objectives on credits from the Envision rating system, rather than solely focusing on the existing environmental goals, had a favorable influence on professionals' sustainable design choices. This reframing, by emphasizing the interconnectedness of environmental, social, and financial dimensions of each decision, appears to amplify the awareness, motivation, and selection of higher levels of sustainability achievement, thereby increasing their perceived value and leading to a shift in sustainability-oriented decision-making. The findings suggest that reframing rating systems to better emphasize the interconnectedness of the environmental, social, and financial dimensions of each decision can serve to help engineering teams set higher goals for sustainable performance. Practical Applications: For infrastructure project managers, architects, and designers, this research highlights the significance of considering economic and social aspects alongside environmental concerns. By doing so, it can further empower stakeholders to make more well-rounded and sustainable decisions that benefit both their projects and the communities they serve. Small changes in how decision tools are worded, or framed, can have a significant effect on project goal setting. A better understanding of how framing affects design cognition can also help inform how project managers, architects, and designers present information to their clients. Subtle changes in the decision tools and the way information about projects is expressed cost little compared to the actual cost of infrastructure, offering inexpensive and easy to implement strategies to influence and nudge project teams toward setting higher sustainability goals during the design and construction of infrastructure projects. [ABSTRACT FROM AUTHOR]

Background: Gender disparities in the field of ophthalmology have been increasingly recognized. Although mentorship has been proposed as a contributing factor, there are limited data on the differences in mentorship experiences by gender among ophthalmologists. Objective: The purpose of this study was to evaluate gender disparities in mentorship experiences among ophthalmologists, and the impact of mentorship disparities on career outcomes. Design: Prospective, cross-sectional study. Setting: Web-based survey distributed through ophthalmology listservs. Participants: Ophthalmologists and ophthalmologists-in-training who completed the survey. Exposure: Training and practicing in the field of ophthalmology. Main Outcome Measures: Mentorship score based on 10 items from a previously published scale of mentorship quality and self-reported career outcomes (income, job satisfaction, achievement of career goals, and support to achieve future career goals). Results: We received survey responses from 202 male and 245 female ophthalmologists. Female ophthalmologists reported significantly lower mentorship satisfaction and worse quality of mentorship (p < 0.03). Female ophthalmologists also reported significantly lower income, worse job satisfaction, and lower rates of goal achievement and support to achieve future goals; all of these career outcomes, except income level, were partly mediated by mentorship score (mediation effect ranged from 29% to 68%, p < 0.014). Conclusions and Relevance: Gender-based inequities in achievement of career goals and job satisfaction are partly mediated by disparities in mentorship. Therefore, focused mentorship of women in ophthalmology at all career stages is imperative to reduce these inequities. [ABSTRACT FROM AUTHOR]

We consider goal-oriented adaptive space-time finite-element discretizations of the regularized parabolic p-Laplace problem on completely unstructured simplicial space-time meshes. The adaptivity is driven by the dual-weighted residual (DWR) method since we are interested in an accurate computation of some possibly nonlinear functionals at the solution. Such functionals represent goals in which engineers are often more interested than the solution itself. The DWR method requires the numerical solution of a linear adjoint problem that provides the sensitivities for the mesh refinement. This can be done by means of the same full space-time finite element discretization as used for the primal non-linear problems. The numerical experiments presented demonstrate that this goal-oriented, full space-time finite element solver efficiently provides accurate numerical results for different functionals. [ABSTRACT FROM AUTHOR]

Intraoperative goal-directed hemodynamic therapy (GDHT) is a cornerstone of enhanced recovery protocols. We hypothesized that use of an advanced noninvasive intraoperative hemodynamic monitoring system to guide GDHT may decrease intraoperative hypotension (IOH) and improve perfusion during pancreatic resection. The monitor uses machine learning to produce the Hypotension Prediction Index to predict hypotensive episodes. A clinical decision-making algorithm uses the Hypotension Prediction Index and hemodynamic data to guide intraoperative fluid versus pressor management. Pre-implementation (PRE), patients were placed on the monitor and managed per usual. Post-implementation (POST), anesthesia teams were educated on the algorithm and asked to use the GDHT guidelines. Hemodynamic data points were collected every 20 s (8942 PRE and 26,638 POST measurements). We compared IOH (mean arterial pressure <65 mmHg), cardiac index >2, and stroke volume variation <12 between the two groups. 10 patients were in the PRE and 24 in the POST groups. In the POST group, there were fewer minimally invasive resections (4.2% versus 30.0%, P = 0.07), more pancreaticoduodenectomies (75.0% versus 20.0%, P < 0.01), and longer operative times (329.0 + 108.2 min versus 225.1 + 92.8 min, P = 0.01). After implementation, hemodynamic parameters improved. There was a 33.3% reduction in IOH (5.2% ± 0.1% versus 7.8% ± 0.3%, P < 0.01, a 31.6% increase in cardiac index >2.0 (83.7% + 0.2% versus 63.6% + 0.5%, P < 0.01), and a 37.6% increase in stroke volume variation <12 (73.2% + 0.3% versus 53.2% + 0.5%, P < 0.01). Advanced intraoperative hemodynamic monitoring to predict IOH combined with a clinical decision-making tree for GDHT may improve intraoperative hemodynamic parameters during pancreatectomy. This warrants further investigation in larger studies. [ABSTRACT FROM AUTHOR]

The context of this paper is family situations where young people are experiencing significant behavioural and emotional problems. Based on a qualitative study, it offers an empirical and theoretical contribution to the understanding of family‐related factors that promote or hinder behaviour change. Data were collected through face‐to‐face, semi‐structured group interviews with nine families (28 participants), all of them mandatory recipients of child welfare services in Croatia. Thematic analysis comprised primary coding designed to elicit information about individual family members' capacity for change and secondary coding of family‐level phenomena. The results indicated 10 phenomena that were judged to represent factors that helped or hindered change. The discussion section suggests three broad categories of capacity to change at family level (Goals and Priorities; Problem solving dynamics; and Development of role relationship). This analysis is offered as the basis for an examination of the concept of family capacity for change. [ABSTRACT FROM AUTHOR]

Although almost every study evaluating psychological interventions includes the two components of acceptability and effectivity, their relationship is rarely examined. The current study closes this gap by performing secondary analyses of the intervention program 'empCARE'. The goal was to analyze the relationship between these two evaluation components. The sample consists of 309 nurses (intervention group n = 172; control group n = 137). Data were collected before the training and longitudinally three times after the training. Psychological distress was assessed using the Symptom Checklist (SCL-90-R), and the Copenhagen Burnout Inventory. Personality traits were assessed using the HEXACO-60 and the Toronto Empathy Questionnaire. Acceptability was assessed using statements concerning participants' subjective evaluation of the training. The results show that the intervention program was effective. Acceptability, measured only in the intervention group, was quite high. However, no connection was found between effectivity and acceptability. On the contrary, the results show that acceptability assessments depend more on personality factors than on intervention success. Researchers should examine the relationship between acceptability and effectivity in their data. It does not seem appropriate to rely on acceptability measurements as the sole evaluation criterion capturing the success of an intervention. [ABSTRACT FROM AUTHOR]

Aim: To identify insights for supporting people at risk of suicide in the community based on primary healthcare workers' experiences. Design: Qualitative descriptive design. Methods: Semi‐structured interviews were conducted with fifteen primary healthcare workers employed by Japanese municipalities between August and October 2019. The data were subjected to qualitative descriptive analysis. Results: The analysis revealed eleven subthemes, clustered under the following three themes: (1) fostering 'opportunities for discovery' for people at risk of suicide by encompassing strategies such as increasing access to services and promoting a holistic understanding of the life cycle; (2) fostering 'meaningful connections' by searching for channels to reach the heart and taking approaches from different objectives; and (3) engaging in 'risk management', by understanding and coping with real‐life struggles and implementing timely crisis intervention. Conclusion: Not only direct care targeting suicide prevention but also holistic care that includes atypical perspectives such as 'approaches from different objectives' may provide important insights for supporting people with suicide risk. Implications for Practice: Beyond the limitations of existing suicide risk screening methods, this study highlights the importance of a holistic approach that sees people at risk of suicide in the context of their daily lives and aims to alleviate the difficulties in their lives that have brought them to the point of considering suicide. Impact: By describing support focused on the difficulties that people at risk of suicide face in their daily lives, this study identified insights for supporting people at risk of suicide in communities where screening and intervention are difficult. These findings will contribute to the relief of people at risk of suicide by stimulating suicide prevention measures in primary healthcare settings. Reporting Method: This study complied with the COREQ guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Why do we act on habit even when we intend to do something else? The answer lies in habit memories, or context-response associations, that form when people repeat rewarding actions in stable contexts. Although habits can form as people pursue goals, once habits develop, the perception of the context directly activates the response in mind. Because habit activation does not depend strongly on motivation, changing intentions has limited impact on habit memory. Instead, successful habit-change interventions directly impact the behavior itself: Along with classic behavior therapy interventions, habits change with (a) reward systems that form new habits, (b) disruption of context cues to forestall activation of the habit in mind, and (c) friction that makes the habitual response difficult and alternatives easier. Despite the strong evidence that habits are activated by contexts, people tend to believe that their own habits are a product of goal pursuit. This subjective reality might also explain why some researchers continue to maintain that habit performance depends on goals. [ABSTRACT FROM AUTHOR]

Childhood wellbeing is essential for positive outcomes in adulthood, as is academic attainment. Schools play a pivotal role in laying the foundations for children to live well. However, research investigating the relationship between wellbeing and attainment has relied on conceptualisations of wellbeing that are too broad (i.e. overall and domain-general wellbeing) or samples spanning large age ranges (thereby overlooking developmental differences). Additionally, the role of mindset, a potentially co-occurring psychological state of both wellbeing and attainment, has been neglected. This study therefore investigated the wellbeing-attainment relationship in 942 children aged 9–11 (447 male, M age = 10.5; 495 female, M age = 10.6) across 17 schools in England (UK). Structural equation models distinguished between overall wellbeing, life satisfaction, and eudaimonia, examining associations of each with children's attainment on standardised tests, accounting for mindsets, achievement goals, and sociodemographic factors. Results indicated lower life satisfaction was significantly associated with higher attainment on average, and in English and Mathematics, while eudaimonia was not significantly related to attainment. Overall wellbeing was negatively associated with Mathematics attainment only. A growth mindset was positively associated, while a fixed mindset was negatively associated, with wellbeing. In turn, a growth mindset was significantly positively associated, while a fixed mindset was negatively associated, with attainment. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Meaningful occupational therapy interventions for neurodivergent, transition‐age adolescents are understudied, and novel intervention approaches that are motivating to this population are needed. Accordingly, in this study we explored the acceptability and impact of a combined life skills/adventure therapy (LS/AT) intervention program for addressing self‐identified goals for adolescents with regulation‐ and sensory‐based challenges. Methods: We used a convergent mixed‐methods design. All adolescents accepted into the intervention program were invited to participate. We described our sample using data from the Child Occupational Self‐Assessment. Participants created and rated goals through a modified Canadian Occupational Performance Measure interview before intervention, after intervention and 3 months post‐intervention and participated in semi‐structured interviews pre‐ and post‐intervention. We calculated COPM change scores, analysed qualitative interview data, and integrated findings into a joint display for interpretation following recommended procedures for mixed‐methods data. Results: Ten adolescents consented to participate (n = 6 males, n = 4 females; mean age 13.92 years, SD = 0.54). Mean COPM performance change scores were 3.72 (SD = 1.39) from pre‐ to post‐intervention and 2.40 (SD = 1.19) from pre‐ to 3 months post‐intervention, with the largest change scores for goals related to life skills. Data from semi‐structured interviews expanded on these findings, revealing that participants made changes related to being in the moment, finding a sense of purpose and achieving a sense of belonging. Participants reported high acceptability of the intervention. Conclusion: This exploratory research supports the use of combined LS/AT intervention with transition‐age adolescents experiencing sensory and regulation‐based limitations on participation. Preliminary data shows positive changes in performance and satisfaction in self‐identified goal areas as well as changes related to mindfulness, a personal sense of competence and relatedness. In practice, occupational therapists should consider integrating elements of this LS/AT intervention to support this population, including addressing life skills through engagement in unique and motivating activities. Key Points for Occupational Therapy: Life skills and adventure therapy elements can be combined as part of occupational therapy practice with adolescents.Occupational therapists can effectively use life skills/adventure therapy elements that capitalise on motivation to support transition‐age youth.Transition‐age youth value interventions that facilitate a sense of purpose and belonging. [ABSTRACT FROM AUTHOR]

Introduction We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1 year. Methods In 2021–2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions. We conducted qualitative interviews with dyads and intervention facilitators, purposively selected for diverse follow-up GAS scores. We collected observational data from intervention session recordings. We thematically analysed data, then integrated qualitative and quantitative data. Results 174/204 (85.3%) dyads allocated to NIDUS-Family, fully completed it, 18 partially completed, while 12 received no intervention. We interviewed 27/192 (14%) of dyads receiving any sessions, and 9/10 facilitators; and observed 12 sessions. 47/192 (24.5%) of carers completed the acceptability questionnaire. We identified four themes: (A) 'Someone to talk to helps dyads feel supported'; (B) 'NIDUS-Family helps carers change their perspective'; (C) 'Personalisation helps people living with dementia maintain their identity' and (D) 'Small steps help dyads move forward'. Conclusion Key causal pathway mechanisms were: a respectful, trusting and impartial relationship with the facilitator: supporting the development of meaningful goals and support to find manageable solutions. Core implementation factors were delivery of the modules from a consistent facilitator across regular sessions. Core contextual factors influencing these mechanisms were dyadic participation and understanding of abilities. [ABSTRACT FROM AUTHOR]

Background: Science teachers' understanding of the roles of computing practices in science frame how they enact scientific computational practices in their teaching and how their students perceive the relationship between computational practices and scientific endeavours. Objectives: This critical, integrative review synthesizes teacher learning literature about the role of computational literacy and computing practices in K‐12 science teaching. Methods: We examined 54 peer‐reviewed articles and analysed the ways the researchers and teacher participants describe the affordances of integrating computational thinking (CT) and other computational practices in science. We characterize how CT and computational practices are framed in relation to scientific learning goals. We identify six primary affordances for integrating computational practices with science that are conveyed to teachers and by teachers, as represented in these studies of teacher learning. Results and Conclusions: These six perspectives include (1) learning computer science principles, (2) developing CT dispositions, (3) engagement and inclusion in science, (4) taking ownership of science, (5) supporting learning science content, and (6) participating in computational practice as a form of scientific epistemic practice. Our analysis indicates that computational thinking and computational practices are often integrated in science in order to teach something about computing (e.g., Perspective 1), rather than to support learners' scientific work. Only the 29 articles coded for the sixth perspective—that is, in service of epistemic aims in science—demonstrate commitment to students' uses of computational ideas and practices as epistemic tools to participate in the sensemaking work of science. Takeaways: Comparison of Perspectives 5 and 6 illustrates the nuance between computational practices in science that reify something students have already "figured out," rather than those that serve epistemic goals. Perspective 6 encapsulates the deep synergy among (1) the reflexive nature of computing with scientific ideas and (2) computing as a central practice in science and engineering. We contend that a more focused message of computational practices in service of scientific sensemaking goals is necessary if we expect teachers to enact CT and related computational practices in their classrooms. Lay Description: What is already known about this topic?: Science teachers' understanding of the roles of computing practices in science frame how they enact scientific computational practices in their teaching. What this paper adds?: We analysed 54 peer‐reviewed articles regarding teacher learning about the role of computational literacy and computing practices in K‐12 science teaching.We characterized the ways the researchers and teacher participants describe the affordances of integrating computational thinking (CT) and other computational practices in science.We present six primary affordances for integrating computational practices with science that are conveyed to teachers and by teachers, as represented in these studies of teacher learning. These six perspectives include (1) learning computer science principles, (2) developing CT dispositions, (3) engagement and inclusion in science, (4) taking ownership of science, (5) supporting learning science content, and (6) computational practices in service of epistemic aims in science. Implications for practice and/or policy: We find that computational thinking and computational practices are often integrated in science in order to teach introductory computer science principles, but not to support the original science learning aims.Only the 29 of 54 articles demonstrate commitment to students' uses of computational ideas and practices as epistemic tools to participate in the sensemaking work of science.We contend that a more focused message of computational practices in service of scientific sensemaking goals is necessary if we expect teachers to enact CT and related computational practices in their classrooms. [ABSTRACT FROM AUTHOR]

Background: Research on cognitive effects of educational games in general shows promising results. However, there are large variations in learning outcomes between individual educational games. Research on the design process and different design elements of educational games has led to some interesting directions, but some design aspects remain unclear. Objectives: We examined how an educational game designed on the basis of intrinsic integration theory, based on a strong alignment between game and learning goals, supports the learning of Newtonian mechanics. Methods: This study applied a mixed‐methods approach (N = 223). A pre‐ and post‐test design was used to examine possible learning and transfer effects fostered by playing the educational game, Newton's Race. To examine how players played the game, log data for each player were digitally recorded during gameplay. Results and Conclusions: Our findings demonstrated a significant positive learning effect of Newton's Race (p = 0.003, d = 0.201). This can be explained through the acquired log data. Log data show that players' gameplay mostly matched expected learning during the game, with physically correct game settings occurring more and more as gameplay progressed. The ability to transfer learned knowledge to other situations was shown to be limited to situations closely resembling the game environment. Implications: Similarly, designed intrinsically integrated games on different (physics) subjects could also foster learning in a relative short time. To foster transfer to other situations we propose embedding the game within other instructional activities. Lay Description: What is already known about this topic?: Research on cognitive effects of educational games in general shows promising results.There are large variations in learning outcomes between individual educational games.Some design aspects remain unclear on the design process and different design elements of educational games.Attempting to integrate learning with gameplay, without affecting the enjoyability of the game, is not easily achieved. What this paper adds?: The current study fits within the research body that emphasizes the importance of aligning gameplay with learning in educational games (i.e., intrinsic integration).Evidence for intrinsic integration as a key element in the design process, found by examining players' log data.A better understanding of how an intrinsically integrated game supports the learning of Newtonian mechanics. Implications for practice and/or policy: Similarly, designed intrinsically integrated games on different (physics) subjects could also foster learning in a relative short time.To foster transfer to other situations we propose embedding the game within other instructional activities. [ABSTRACT FROM AUTHOR]

Research has demonstrated that lay beliefs about emotions (i.e., whether they are viewed as malleable or fixed) may shape important outcomes in educational performance. Given the prominent role of emotions in learning and goal setting, the present study examined whether emotion beliefs moderated (1) the relationship between the experience of academic emotions and grades and (2) the relationship between academic emotions and shifts in goal setting. Undergraduate students (N =329) enrolled in an introductory psychology course reported on their emotions and goal orientations across two waves of data collection which took place before and after their first two exams. Multiple regression analyses revealed that emotion beliefs moderated the relationship between academic emotions and changes in goal orientation across the semester. Specifically, greater experience of negative outcome-related emotions was associated with decreases in mastery- and performance-avoidance goal orientations among individuals who tended to view emotions as more malleable. On the other hand, for students who felt their emotions were more fixed, change in avoidance goals was not influenced by negative outcome emotions. Our results point to the added benefit in students viewing emotions as malleable, as this perspective may lead to students disengaging less with course material (i.e., decreasing avoidance goal orientations) after learning experiences marked by negative emotions. Overall, our findings provide preliminary support for the inclusion of emotion beliefs in models of academic achievement. [ABSTRACT FROM AUTHOR]

Design: A multi‐methods, single‐centre pilot comprising a quasi‐experimental pre‐/post‐test design and an exploratory qualitative study. Setting: A rural Australian hospital and health service. Participants: Men newly diagnosed with localised prostate cancer who were scheduled to undergo, or had undergone, radical or robotic prostatectomy surgery within the previous 3 months. Intervention: The intervention comprised a 12‐week virtual care program delivered via teleconference by a specialist nurse, using a pre‐existing connected care platform. The program was tailored to the post‐operative recovery journey targeting post‐operative care, psychoeducation, problem‐solving and goal setting. Main Outcome Measures: Primary outcome: program acceptability. Secondary outcomes: quality of life; prostate cancer‐related distress; insomnia severity; fatigue severity; measured at baseline (T1); immediately post‐intervention (T2); and 12 weeks post‐intervention (T3). Results: Seventeen participants completed the program. The program intervention showed very high levels (≥4/5) of acceptability, appropriateness and feasibility. At T1, 47% (n = 8) of men reported clinically significant psychological distress, which had significantly decreased by T3 (p = 0.020). There was a significant improvement in urinary irritative/obstructive symptoms (p = 0.030) and a corresponding decrease in urinary function burden (p = 0.005) from T1 to T3. Conclusions: This pilot has shown that a tailored nurse‐led virtual care program, incorporating post‐surgical follow‐up and integrated low‐intensity psychosocial care, is both acceptable to rural participants and feasible in terms of implementation and impact on patient outcomes. [ABSTRACT FROM AUTHOR]

Although stories for children often feature supernatural and fantastical events, children themselves often prefer realistic events when choosing what should happen in a story. In two experiments, we investigated whether 3- to 5-year-olds (total N = 240 from diverse backgrounds) might be more likely to include fantastical events in stories about familiar fantasy characters. In Experiment 1, children saw stories about fantasy or real-world characters (e.g., a mermaid or an ordinary woman) and judged whether they would achieve goals using fantastic or realistic methods. Children were more likely to choose fantastic methods for the fantasy characters, and this tendency was more common in older children. In Experiment 2, children were asked yes/no questions about whether characters could use fantastic, realistic, and unusual methods to achieve goals. Children more often affirmed fantastic methods for fantasy than real-world characters. These findings contrast with previous work suggesting children avoid including fantastic events in fiction and suggest that children use precedent and familiarity to decide what can happen in a story. Public Significance Statement: This work helps us better understand how children see stories. Much previous work has found that young children are surprisingly prone to including realistic events in stories, even though so much of the fiction they encounter is fantastical. Our findings suggest children are more likely to include fantastic elements in stories when the stories are about familiar fantastic characters like fairies and superheroes. [ABSTRACT FROM AUTHOR]

Natural languages distinguish between telic predicates that denote events leading to an inherent endpoint (e.g., draw a balloon) and atelic predicates that denote events with no inherent endpoint (e.g., draw balloons). Telicity distinctions in many languages are already partly available to 4–5-year-olds. Here, using exclusively nonlinguistic tasks and a sample of English-speaking children, we ask whether young learners use corresponding temporal notions to characterize event structure—that is, whether children represent events in cognition as bounded temporal entities with a specified endpoint or unbounded temporal units that could in principle extend indefinitely. We find that 4–5-year-old children in our sample compute boundedness during an event categorization task (Experiment 1) and distinguish event boundedness from event completion (Experiment 2). Furthermore, 4–5-year-olds in our sample evaluate interruptions at event endpoints versus midpoints differently—but only for events that are construed as bounded, presumably because in such construals, events truly culminate (Experiment 3). We conclude that young children represent events in terms of foundational and abstract temporal properties. These properties could support the acquisition of linguistic aspectual distinctions and further scaffold the way children conceptualize and process their dynamic experiences. Public Significance Statement: The present study shows that 4–5-year-old children classify and interpret events in terms of abstract temporal structure (i.e., the way an event begins, develops, and ends). The sensitivity to event temporal profiles could support the acquisition of temporal distinctions in language and further scaffold the way children conceptualize and process their dynamic experience. [ABSTRACT FROM AUTHOR]

To investigate the usability and effectiveness of standardized circuit class group training (CCT) compared to individualized goal-directed group training (GDT) in subacute stroke survivors. This study consists of three parts. Part 1 involved a pragmatic, non-randomized controlled trial with subacute participants and their therapists, who participated in four weeks either CCT or GDT. Superiority of the intervention was defined as significantly larger improvement on the Motor Activity Log for patients and lower workload for therapists. In Part 2, six additional workstations were developed for CCT. Part 3 replicated the study of Part 1 with the expanded CCT. Part 1 showed no difference in effectiveness between training methods. CCT did not match the rehabilitation goals of the patient sufficiently, however mental workload seemed lower for therapists. An expansion of CCT could improve the match between the patient's goals and the training (Part 2). Results of Part 3 showed again no difference in effectiveness between methods. CCT was however perceived as less engaging compared to GDT, but mental load for therapists remained lower. A standardized training could reduce the mental workload for therapists, but patients seemed less engaged. A combination of both might be most beneficial.Trial registration: Dutch Trial Register: NL8844 and NL9471 Providing a standardized training program after stroke reduces therapists' mental workload. Individualized goal-directed group training results in the best achievement of rehabilitation goals. A combination of standardized and individual training would use best of both intervention modalities. Patients should be involved in the co-creation developing process of training programs. [ABSTRACT FROM AUTHOR]

Previous research has shown that action effects of self-generated movements are internally predicted before outcome feedback becomes available. To test whether these sensorimotor predictions are used to facilitate visual information uptake for feedback processing, we measured eye movements during the execution of a goal-directed throwing task. Participants could fully observe the effects of their throwing actions (ball trajectory and either hitting or missing a target) in most of the trials. In a portion of the trials, the ball trajectory was not visible, and participants only received static information about the outcome. We observed a large proportion of predictive saccades, shifting gaze toward the goal region before the ball arrived and outcome feedback became available. Fixation locations after predictive saccades systematically covaried with future ball positions in trials with continuous ball flight information, but notably also in trials with static outcome feedback and only efferent and proprioceptive information about the movement that could be used for predictions. Fixation durations at the chosen positions after feedback onset were modulated by action outcome (longer durations for misses than for hits) and outcome uncertainty (longer durations for narrow vs. clear outcomes). Combining both effects, durations were longest for narrow errors and shortest for clear hits, indicating that the chosen locations offer informational value for feedback processing. Thus, humans are able to use sensorimotor predictions to direct their gaze toward task-relevant feedback locations. Outcome-dependent saccade latency differences (miss vs. hit) indicate that also predictive valuation processes are involved in planning predictive saccades. NEW & NOTEWORTHY: We elucidate the potential benefits of sensorimotor predictions, focusing on how the system actually uses this information to optimize feedback processing in goal-directed actions. Sensorimotor information is used to predict spatial parameters of movement outcomes, guiding predictive saccades toward future action effects. Saccade latencies and fixation durations are modulated by outcome quality, indicating that predictive valuation processes are considered and that the locations chosen are of high informational value for feedback processing. [ABSTRACT FROM AUTHOR]