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In sport, there is extensive evidence that supports the benefits associated with a mastery climate. However, limited studies have explored how physical tools could be used to promote mastery climates in youth sport contexts. Using an action research approach, we sought to understand the benefits and drawbacks of applying tools grounded in goal setting to promote a mastery environment: (a) an "arm sleeve" to be worn by athletes during training and matches and (b) a "reflection sheet" for use pre- and posttraining/-matches. These tools were implemented for a 3-week period with a U13 academy team (18 players and two coaches). Based on observation notes, focus groups, and one-on-one interviews, the analysis showed that the arm sleeves were helpful reminders for process goals, whereas the coaches had abandoned the use of reflection sheets due to lack of time. The benefits and drawbacks of the tools are discussed while pedagogical and practical implications are considered. [ABSTRACT FROM AUTHOR]

This Perspectives paper advances understanding of coaching in pediatric rehabilitation. We compare three coaching approaches designed for pediatric rehabilitation: Coping with and Caring for Infants with Special Needs (COPCA), Occupational Performance Coaching (OPC), and Solution-Focused Coaching in Pediatric Rehabilitation (SFC-peds). Our objectives are to contrast the theory underpinning the approaches, discuss the evidence for outcomes and hypothesized mechanisms of change, consider the necessary mindsets of effective coaches, and propose directions for research and practice. The coaching approaches have different theoretical bases and are designed for specific contexts, yet are similar in their mechanisms of change and intended outcomes. There is growing evidence of important effects of coaching on coachees' goal achievement, empowerment, and capacity building. Studies indicate that stakeholders value coaching, and provide a preliminary understanding of the mechanisms, including engagement and self-efficacy, by which coaching approaches support clients' self-directed and sustained change. Open, curious, and client-centered practitioner mindsets are fundamental to effective coaching. Coaching is a distinctive group of relational, goal-oriented, and evidence-based approaches that support goal achievement and empowerment. These approaches reflect and advance an ongoing paradigm shift in pediatric rehabilitation—a movement from therapist-as-expert approaches to those that build empowerment and capacity. Coaching is a distinctive group of theory-based approaches that support clients' goal achievement and empowerment, and build capacity Coaching practitioners are collaborative facilitators who assist clients and families with their own discovery of solutions that fit their everyday contexts The evidence suggests that coaching triggers engagement and self-efficacy, which are the mechanisms by which changes in longer-term outcomes occur Open, curious, and client/family-centered practitioner mindsets are fundamental to effective coaching [ABSTRACT FROM AUTHOR]

Because people living with environmental sensitivities are poorly acknowledged in our society, we still know very little about their experiences navigating in the health care system, especially with respect to dental services. Our objective, therefore, was to describe their dental care pathway and better understand their experiences accessing oral health services. A qualitative descriptive study was conducted in partnership with organizations supporting people with environmental sensitivities. Through a criterion sampling technique, 12 people living with environmental sensitivities in Quebec (Canada) were invited to participate in individual semi-structured interviews. These interviews lasted around 90 min and were transcribed to be thematically analysed. Participants faced major barriers accessing dental services and thus lived for long periods of time with unmet dental needs. Their dental care pathways were often delayed or even interrupted for several reasons. First because they were exposed to pollutants upon leaving their house, which rendered their trip to the dentist perilous. Second because dentists lacked knowledge about environmental sensitivities and seemed reluctant to accommodate them. We invite governments, dental professionals, and researchers to develop policies and clinical approaches for improving people living with environmental sensitivities' quality of life and access to dental services. Although environmental sensitivities are recognized as disability in several countries such as Sweden and Germany, people with these conditions face major barriers to access healthcare services. Dental professionals, for instance, are reluctant to acknowledge environmental sensitivities as a disability and seldom accommodate sufferers' special needs. We invite dentists to foster holistic and person-centered approaches and be receptive to the health conditions and needs of people with environmental sensitivities. Dentists could address oral health needs of people with environmental sensitivities by doing home-visits with portable dental equipment as this removes barriers related to their exposure to pollutants. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) affects one in 66 children in Canada, and its symptoms may be particularly challenging for parents from a Chinese background. Further, when working with Chinese families, Western-educated service providers may experience difficulty in applying culturally relevant and family-centered care. This study examined the experiences of one Chinese-Canadian family as they receive intervention services for their two children with ASD. This pilot, single-case design, qualitative case study included semi-structured interviews with the parents, grandparents, as well as three service providers' views. Three major themes emerged from the data in the form of tensions: (1) within the family members; (2) within the therapeutic relationships, and (3) in addressing culture in therapy. Results suggested that although the family identified key cultural differences, service providers did not sufficiently address these within the therapeutic relationship, and the need for culturally-relevant and family-centered care was not fulfilled. Chinese-Canadian parents for children with autism spectrum disorder adopt both Chinese and Western values that fit best for their circumstances. Service providers and family members can have conflicting priorities, making family-centered care, culturally-relevant care challenging. Culture plays an important role in family expectations, and should be incorporated with more intention in the rehabilitation process. [ABSTRACT FROM AUTHOR]

This study aims to investigate whether the treatment effects, in terms of goal attainment, transfer effects and impact on executive functions, of an intervention in children with cerebral palsy or spina bifida using the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach are maintained over time, from immediately after the intervention to three months afterwards. A three-month follow-up study, from an intervention using CO-OP. Thirty-four children (7–16 years) each identified four goals (one untrained to examine transfer) and participated in an eleven-session intervention. Assessments were performed at baseline, immediately after the intervention and at a three-month follow-up using the Canadian Occupational Performance Measure and the Performance Quality Rating Scale. Executive function and self-rated competence were assessed at the same timepoints. Statistically significant and clinically relevant improvements in goal achievement were demonstrated for both trained and untrained goals after the intervention and were maintained at follow-up. The clinically relevant improvement in untrained goals continued to increase until follow-up. Self-rated competence increased after the intervention and was maintained at follow-up. The CO-OP intervention was effective in achieving and maintaining the children's own goals over time. The transfer effect was confirmed by higher goal attainment for the untrained goals. The children's self-defined goals were achieved after the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention and remained so at the three-month follow-up. The CO-OP Approach is useful for children with cerebral palsy or spina bifida. A transfer effect was demonstrated for untrained goals by both subjective and objective assessments. Using children's self-defined goals is effective. [ABSTRACT FROM AUTHOR]

Animals have evolved to seek, select, and exploit food sources in their environment. Collectively termed foraging, these ubiquitous behaviors are necessary for animal survival. As a foundation for understanding foraging, behavioral ecologists established early theoretical and mathematical frameworks which have been subsequently refined and supported by field and laboratory studies of foraging animals. These simple models sought to explain how animals decide which strategies to employ when locating food, what food items to consume, and when to explore the environment for new food sources. These foraging decisions involve integration of prior experience with multimodal sensory information about the animal's current environment and internal state. We suggest that the nematode Caenorhabditis elegans is well-suited for a high-resolution analysis of complex goal-oriented behaviors such as foraging. We focus our discussion on behavioral studies highlighting C. elegans foraging on bacteria and summarize what is known about the underlying neuronal and molecular pathways. Broadly, we suggest that this simple model system can provide a mechanistic understanding of decision-making and present additional avenues for advancing our understanding of complex behavioral processes. [ABSTRACT FROM AUTHOR]

Introduction: Passive exercise involves limb movement via an external force and is an intervention providing an immediate postexercise executive function (EF) benefit. It is, however, unknown whether EF is improved simultaneous with passive exercise--a salient question given the advent of passive (and active) exercise workstations designed to enhance productivity and wellbeing for individuals engaged in sedentary occupations. Methods: Here, participants (N = 23) completed separate 20-min conditions involving active (i.e., via volitional muscle activation) and passive (i.e., via mechanically driven cycle ergometer) cycle ergometry and a non-exercise control condition. EF was assessed prior to (i.e., preintervention), simultaneous with, and immediately after (post-intervention) each condition via the antipointing task. Antipointing involves a goal-directed limb movement mirror-symmetrical to a target and is an ideal tool for the current investigation given that the task is mediated via EF inhibitory control networks that show response-dependent changes following a single bout of exercise. Results and discussion: Results showed that passive exercise produced a simultaneous and post-intervention reduction in antipointing reaction time (RT), whereas active exercise selectively produced a post-intervention--but not simultaneous--RT reduction. Thus, passive and active exercise elicited a postexercise EF benefit; however, only passive exercise produced a simultaneous benefit. That passive--but not active--exercise produced a simultaneous benefit may reflect that the intervention provides the necessary physiological or psychological changes to elicit improved EF efficiency without the associated dual-task cost(s) of volitional muscle activity. [ABSTRACT FROM AUTHOR]

It is not always easy to attend to task-relevant information and ignore task-irrelevant distractions. We investigated the impact of task switching and emotional stimuli on goal-oriented selective attention and subsequent recognition memory. Results from two experiments with different stimulus materials (words and images) found that the memory advantage of task-relevant information over task-irrelevant information (i.e. memory selectivity) was attenuated on task switch trials and emotional distractor trials. In contrast, task repetitions and emotional targets improved memory selectivity. These results suggest that both task switching and emotional distractors divert limited cognitive resources needed for selective attention and selective encoding. Emotional targets likely supported selective encoding through the process of attentional prioritisation of emotional stimuli. The effects of task switching and emotional stimuli did not interact, suggesting distinct mechanisms, although this conclusion remains tentative. [ABSTRACT FROM AUTHOR]

Performance feedback has been identified as an evidence-based practice to improve teacher implementation fidelity. The efficacy of performance feedback might be enhanced with ancillary strategies such as goal setting. In this paper, we systematically reviewed 22 experimental studies in which a combination of goal setting and performance feedback was used to improve teacher implementation of practices. We summarized effects and explored which aspects of goal setting and performance feedback were associated with improved performance. Overall, we found the combination of goal setting and performance feedback was highly effective. We found that the features associated with consistent positive effects included visual presentation of data, verbal feedback, teacher-created goals, measurement of progress toward goals, and discussion of goals during feedback. We discuss why these particular features might be efficacious, and how administrators and teacher trainers can integrate them into their efforts to support teachers to improve their practice. [ABSTRACT FROM AUTHOR]

Understanding how HIV-related apps can positively impact, educate, and support patrons as a crucial tool in medication adherence, HIV testing and prevention, and education is something every librarian should consider undertaking. Librarians can further their usage by encouraging patrons to explore the possibility of incorporating them into their daily lives, regardless of their HIV status. [ABSTRACT FROM AUTHOR]

Over 160 years after Darwin and 70 years after the discovery of DNA, two fundamental questions of biology remain unanswered: What differentiates the living from the nonliving? How can mechanistic and finalistic or holistic biology be unified? Niels Bohr introduced a concept of complementarity in quantum physics and based on the paradox of light as a simultaneous wave and particle, conjectured that a similar concept might exist in biology that would solve the paradox of life originating from the nonliving. Bohr proposed that two mutually exclusive-independent observations may be necessary to explain a phenomenon and provided support to Immanuel Kant's idea that the "purposive" behaviour of organisms could only be explained in teleological terms and that mechanical and teleological approaches were necessary and complementary to explain biology. We present a concept of complementarity whereby biochemical pathways or cellular channels for the flow of information are simultaneously complex and redundant and complexity and redundancy complement each other. The postulates of biological complementarity are that (1) it was an essential condition in the origin of life; (2) it provided physiological flexibility that allowed organisms to mount self-protection response and complexity to evolve in the face of deleterious mutations before the evolution of bi-parental sex; (3) it laid the foundation for the evolution of a choice of response when confronted with threat; and (4) it applies to all levels of biological organizations and, thus, can serve as a basis for the unification of mechanistic and holistic biology. It is proposed that teleology is simultaneously constitutive and heuristic: constitutive because organisms' "purposive" behaviours are adaptive and are grounded in mechanism (complexity and redundancy), and heuristic because with our finite cognition and our goal-oriented (humans alone are aware of "tomorrow") and anthropomorphic pre-disposition, teleology will remain useful as a guide to our making sense of the world, even how to ask a meaningful question. [ABSTRACT FROM AUTHOR]

Social interactions involve both cooperation to achieve a shared goal and competition over shared resources and rewards. The ability to engage in inter-personal coordination is an important measure of socio-emotional and cognitive well-being. Both cooperation and competition require interpersonal coordination, however with different motivational backgrounds. Competition is defined by a higher level of extrinsic motivation, while cooperation is related to more intrinsic motivation. In the context of the parent-child dyad, each individual has different motivations and contributions to the dyad. The parent's and child's sense of competitiveness and contribution to inter-personal synchrony will presumably differ from each other and adapt to one another. The current research employed Motion Energy Analysis, an objective measure of coordination of movements between individuals, to measure motor in-phase and anti-phase synchrony during parent-child cooperative and competitive play, with a focus on parent and child-led synchrony. Findings highlight that parents rate themselves as less competitive than their children rate themselves; with no such difference noted in cooperation. Further, parent-led motor synchrony is defined more by in-phase coordination in competition, especially when the interaction is novel. Alternatively, child-led motor synchrony is more anti-phase during competition. In cooperation parents and children lead synchrony to the same extent and in the same phase. Current findings highlight that parent's and children uniquely adjust their leading behaviors in synchrony in competition, presumably adjusting their behavior to accommodate a complex situation. Given the importance of cooperative and competitive interactions to overall social well-being, and the parent's role of modeling behaviors for their child, findings may direct future guidance and treatment plans that will promote social development. [ABSTRACT FROM AUTHOR]

The article discusses lessons that a nurse leader can learn from the water sport of surfing. Topics covered include the importance of physical and mental fitness for both nurse leaders and surfers, their need to be setting- and operation-sensitive, to study, plan and execute actions with working equipment, and to be prepared for likely eventualities as change is inevitable. Also noted is the common value of enjoying one's self in the middle of the task at hand.

Introduction: This clinical focus article describes a structured counseling protocol for use with protected sound management and therapeutic sound in a transitional intervention for debilitating hyperacusis. The counseling protocol and its associated visual aids are crafted as a teaching tool to educate affected individuals about hyperacusis and encourage their acceptance of a transitional intervention. Description of Counseling Components: The counseling protocol includes five components. First, the patient’s audiometric results are reviewed with the patient, and the transitional intervention is introduced. An overview of peripheral auditory structures and central neural pathways and the concept of central gain are covered in the second and third components. Maladaptive hyper-gain processes within the auditory neural pathways, which underlie the hyperacusis condition, and associated connections with nonauditory processes responsible for negative reactions to hyperacusis are covered in the fourth component. Detrimental effects from misused hearing protection devices (HPDs) and the necessity to wean the patient from overuse of HPDs are also discussed. In the fifth component, the importance of therapeutic sound is introduced as a tool to downregulate hyper-gain activity within the auditory pathways; its implementation in uncontrolled and controlled sound environments is described. It is explained that, over the course of the transitional intervention, recalibration of the hyper-gain processes will be ongoing, leading to restoration of normal homeostasis within the auditory pathways. In turn, associated activation of reactive nonauditory processes, which contribute to hyperacusis-related distress, will be reduced or eliminated. As recalibration progresses, there will be less need for protected sound management and sound therapy. Sound tolerance will improve, hyperacusis will subside, and daily activities in typical healthy sound environments will again become routine. Results and Conclusion: The combination of counseling with protected sound management and therapeutic sound is highlighted in companion reports, including a summary of the outcomes of a successful trial of the transitional intervention. [ABSTRACT FROM AUTHOR]

Background and Objectives Paradoxical lucidity is defined as an instance of unexpected lucid behavior in a person who is assumed to be noncommunicative due to a progressive and pathophysiologic dementing process. To inform studies of the prevalence, characteristics, and impact of these behaviors, this interview study examined caregivers' experiences of witnessing paradoxical lucidity. Research Design and Methods Participants were family caregivers of persons living with advanced dementia caused by a neurodegenerative disease producing significant impairments in communication. Semistructured interviews elicited the caregivers' experiences of plausible lucid episodes. Data analysis used a thematic analysis approach. Results Most caregivers reported at least 1 episode of lucidity. Episodes were typically brief. Most involved utterances, but nonverbal behaviors were also common. The mental capacities associated with these behaviors included recognition, awareness of surroundings, recognizing others' emotions, and goal-directed behavior. Most caregivers' reactions were positive. Episodes did not lead to changes in major medical decisions but instead to efforts to either modify or reinforce daily caregiving efforts. Discussion and Implications Episodes of lucidity were common, a finding seen in other studies. If prevalence studies confirm this, the qualifier "paradoxical" should be eliminated. The caregivers' familiarity with the person living with dementia allowed them to attribute meaning to subtle behaviors that might not otherwise be detected or considered lucid. Clinicians who care for persons with advanced-stage dementia should routinely ask caregivers about episodes of lucid communication and their emotional reactions. [ABSTRACT FROM AUTHOR]

To improve productivity, several improved high-yielding sweetpotato varieties have been developed and released by breeders. However, most farmers still grow low-yielding landraces known also as farmers' varieties. Farmers choose varieties to grow based on their preference for the attributes (traits) embodied in those varieties. Past studies have examined drivers of trait preference using neoclassical economic theory. This study departs from previous ones by applying principles from economic psychology to assess preference for, and prioritization, of sweetpotato traits among male and female sweetpotato farmers. Data used was data collected using focus group discussions and laddering, an in-depth personal interview process, and analysed using descriptive and means-end chain analyses. The study identifies mental constructs associated with farmers' trait preference and prioritization, namely: the characteristics farmers mentally associate with the prioritized traits, the benefits those traits confer, and the life goals (i.e. values) they enable farmers to attain. Focus group discussions revealed that, among agronomic traits, high root yield is the most preferred/prioritized trait across gender categories and was followed by stress tolerance and underground root storage longevity. The most preferred quality traits across gender groups are root size and mealiness. Women, however, prioritized early maturity over men. The means-end-chain analysis identified several mental constructs farmers mentally associated with trait prioritization. They are increased sales, more income, food security, savings, and investment. These benefits are linked to various life goals (values) farmers aspire for namely, respect, security, achievement, and happiness. These findings imply that farmers' choice of sweetpotato varieties to grow is driven by the agronomic and quality traits the varieties embody. The findings further imply that psychosocial factors underpin trait preference and prioritization by farmers. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to investigate the association between negative aging stereotypes and goal pursuit in daily life among older adults. We also explored the roles of stereotype threat and stereotype challenge reactions in mediating this association. Additionally, this study investigated whether variations in these associations exist among older adults based on their self-integrity levels. Methods Participants were 100 older adults who completed daily measures assessing negative aging stereotype experiences, threat and challenge reactions, goal pursuit activities, and self-integrity over a week. Results More daily experiences of negative aging stereotypes were associated with greater avoidance of responsibilities in goal pursuit and less progress toward goals. Increased threat reactions and decreased challenge reactions were mediators of the association between stereotype experiences and avoidance of responsibilities, as well as that between stereotype experiences and progress toward goals, respectively. Moreover, the associations between threat reactions and avoidance of responsibilities as well as between stereotype experiences and challenge reactions were more pronounced in older adults with lower self-integrity levels. Discussion This study is pioneering in demonstrating the real-life interplay between aging stereotypes and goal pursuit among older adults. Its findings not only expand upon the literature concerning aging stereotypes, but also offer theoretical insights for the development of interventions aimed at goal pursuit. These insights have significant implications for fostering healthy aging. [ABSTRACT FROM AUTHOR]

Coaching in medical education facilitates learners' growth and development through feedback, goal-setting and support. This study explored how coaching relationships evolve throughout medical school and the impact of longitudinal coaching relationships on medical students' approach to feedback and goal setting in the clinical years. In this qualitative study using a constructivist paradigm, authors purposively sampled 15 senior medical students at University of California, San Francisco, to participate in individual semi-structured interviews (October–November 2021). The authors used an inductive approach to thematic analysis. The authors identified four themes: First, the student-coach relationship deepened over the course of medical school. Second, students identified factors that sustained and strengthened the student-coach relationship over time: a strong foundation to the relationship, the non-evaluative nature of the relationship, coach supportiveness and responsiveness, and coach knowledge of the institutional landscape. Third, coaches provided individualized advice, assessed trajectory, and guided feedback interpretation. Lastly, students applied skills of soliciting and responding to feedback and creating learning goals, originally learned through coaching experience. Coaching relationships, grounded in trust, evolve to meet students' changing needs as they grow into physicians. Students apply feedback and goal-setting skills learned with the coach in clinical settings with other supervisors. [ABSTRACT FROM AUTHOR]

Faculty Development (FD) has become essential in shaping design, delivery and quality assurance of health professions education. The growth of FD worldwide has led to a heightened expectation for quality and organizational integrity in the delivery of FD programmes. To address this, AMEE, An International Association for Health Professions Education, developed quality standards for FD through the development of the AMEE ASPIRE to Excellence criteria. This guide uses the ASPIRE criteria as a framework for health professions educators who wish to establish or expand approaches to FD delivery and scholarship within their institutions. [ABSTRACT FROM AUTHOR]

Aim: Best-practice in audiological rehabilitation takes a holistic client- and family-centred approach and considers hearing care in the context of personal well-being. Hearing loss not only impairs the ability to hear, but can also compromise the ability to communicate, thus negatively impacting both social and emotional well-being. Hearing care professionals play a key role in fostering their client's well-being. This paper aims to provide evidence-based recommendations to ensure inclusion of social-emotional well-being in audiologic rehabilitation clinical practice. Methods: A review of current research and expert opinion. Results: This guide proposes a 5-step plan which includes: identifying the client's social-emotional well-being; including family members in audiological rehabilitation; incorporating social-emotional needs and goals in an individualized management plan; relating identified hearing needs and goals to rehabilitation recommendations; and using counselling skills and techniques to explore and monitor social-emotional well-being. Each component of the 5-step plan is discussed and clinical considerations are presented. Conclusion: These comprehensive recommendations provide guidance to hearing care professionals looking to ensure clients' social-emotional well-being are considered throughout the rehabilitation journey. [ABSTRACT FROM AUTHOR]

Goal-oriented requirements engineering aims to describe both stakeholders and system goals and their relationships using goal models. Large goal models for complex systems are often constructed from sub-models describing various stakeholders' views and context-related aspects. These goal-oriented sub-models, also called views, may exhibit overlaps and present discrepancies. Hence, integrating such views is considered a significant barrier to the construction of a unified goal model. Current approaches to merging goal models require intensive human intervention. This paper proposes an approach and a prototype tool, called GRLMerger, to integrate two GRL (Goal-oriented Requirement Language) models into one consolidated model that is correct, complete, and free from any conflict that may arise during the merging process. GRLMerger considers both syntactic and semantic aspects of the GRL models and allows analysts to merge them either interactively or in a fully automated mode. GRLMerger employs natural language processing (NLP) techniques to match intentional elements based on their semantic similarity. The proposed GRLMerger approach and tool have been validated using 12 experimental tasks derived from two case studies, exhibiting very promising performance. [ABSTRACT FROM AUTHOR]

BACKGROUND: Transitioning into oncology practice can be challenging for new graduate RNs. High patient acuity, a steep learning curve, psychosocial challenges, and frequent patient deaths can be overwhelming. OBJECTIVES: The purpose of this program was to provide resilience training for new graduate oncology nurses as part of an existing nurse residency program. Building resilience among oncology nurses was a primary goal during the COVID-19 pandemic and continues to be an important goal. METHODS: Resilience training in this program consisted of didactic lectures, personalized goal setting, one-on-one mentoring, and a follow-up support group. Various measurement scales were used at baseline, 6 months, and 12 months to assess resilience, professional quality of life, and new graduate experience measures, including communication and organizational skills. FINDINGS: Resilience significantly declined from baseline to six months; professional quality of life and new graduate experience measures also worsened. Some improvements in organizational skills and communication emerged at 12 months. Results indicate an ongoing need to consider extending nurse residency programs, resilience training, and support beyond the traditional oneyear period. [ABSTRACT FROM AUTHOR]

This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. Both countries have made progress on child stunting (Brazil: PC = −38%; Ecuador: PC = −43%) and child wasting prevalences (Brazil: PC = −42%; Ecuador: PC = −41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = −75%; Ecuador: PC = −60%) and neonatal mortality rates (Brazil: PC = −69%; Ecuador: PC = −51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = −40%; Ecuador: PC = −58%), tuberculosis (Brazil: PC = −27%; Ecuador: PC = −55%) and malaria incidences (Brazil: PC = −97%; Ecuador: PC = −100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = −89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = −37%; Ecuador: PC = −40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = −67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters. [ABSTRACT FROM AUTHOR]

Multi‐scale modeling allows the description of real reactive systems under industrially relevant conditions. However, its application to rational catalyst and reactor design is hindered by the prohibitively high computational cost associated with the chemical kinetics on the catalyst scale. Here, the computational cost is drastically reduced by introducing goal‐oriented kernel models that serve as surrogates for the chemical kinetics. This special model type allows for automated training set design and reliable results, even outside the training region. Therefore, it can be envisioned as a plug‐and‐play solution for accelerating reactive flow simulations with guaranteed accuracy. [ABSTRACT FROM AUTHOR]

Drawing on the goals-plans-action (GPA) model, we explore how individuals encourage hesitant family members to get vaccinated for COVID-19. We test models analyzing how multiple goals mediate associations between (a) perceived threat to the family member’s health, (b) anticipated resistance, and (c) participants’ political ideology, with their (d) planning effort and (e) message features. Participants who perceive a greater threat, anticipate greater resistance, and are more liberal put greater emphasis on the primary goal, which in turn predicts greater effort, directness, and reason giving. Liberal participants also place less emphasis on secondary goals, and thus exert more pressure. Theoretical implications linking the GPA model with fear appeals and intergroup communication frameworks and practical implications for families and public health campaigns are discussed. [ABSTRACT FROM AUTHOR]

Implementation of evidence-based practices for autistic students must be informed by robust research literature. Randomized-controlled trials (RCTs) are often considered a "gold standard" methodology for determining the effectiveness of interventions. However, the complex nature of schools presents challenges for implementing successful RCTs. We review common challenges that researchers may face when implementing RCTs of interventions for autistic students in school settings. Additionally, we provide recommendations to researchers for avoiding and addressing such challenges, based on our own experience conducting a school-based RCT. Limitations and directions for future research are also discussed. [ABSTRACT FROM AUTHOR]

Some authors argue that it is permissible for clinicians to conscientiously provide abortion services because clinicians are already allowed to conscientiously refuse to provide certain services. Call this the symmetry thesis. We argue that on either of the two main understandings of the aim of the medical profession—what we will call "pathocentric" and "interest‐centric" views—conscientious refusal and conscientious provision are mutually exclusive. On pathocentric views, refusing to provide a service that takes away from a patient's health is professionally justified because there are compelling reasons, based on professional standards, to refuse to provide that service (e.g., it does not heal, and it is contrary to the goals of medicine). However, providing that same service is not professionally justified when providing that service would be contrary to the goals of medicine. Likewise, the thesis turns out false on interest‐centric views. Refusing to provide a service is not professionally justified when that service helps the patient fulfill her autonomous preferences because there are compelling reasons, based on professional standards, to provide that service (e.g., it helps her achieve her autonomous preferences, and it would be contrary to the goals of medicine to deny her that service). However, refusing to provide that same service is not professionally justified when refusing to provide that service would be contrary to the goals of medicine. As a result, on either of the two most plausible views on the goals of medicine, the symmetry thesis turns out false. [ABSTRACT FROM AUTHOR]

Although evidence-based parenting programs are widely available, they remain inaccessible to many families of children with social, emotional and behavioural problems, particularly in remote settings. In partnership with Aboriginal communities in the remote Fitzroy Valley, Western Australia, we introduced and evaluated the Indigenous Triple P – Positive Parenting Program, with additional Stepping Stones Triple P strategies (for children with complex needs). Implementation followed community consultation and program adaptation to acknowledge local culture, social complexities and language. The initiative was named Jandu Yani U, meaning "for all families" in the local Bunuba language. Local practitioners (parent coaches) were trained to deliver Triple P. Parents and carers (henceforth carers) of children up to 15 years of age were invited to participate. Families attending the program reported on child behaviour, parenting practices, self-efficacy, wellbeing and empowerment pre- and post-intervention and at 8-month follow-up using standardised assessment tools delivered by local community navigators. Of 30 participating families, 100% completed Triple P and reported the program was culturally appropriate. Of the index children, 93% were Aboriginal, 63% boys, median age 6.83 years. Following the program, carers reported high levels of empowerment and reaching goals for behaviour change (p <.001) and less use of unhelpful parenting strategies (over-reactivity and hostility; p <.05), and this maintained at 8-month follow-up (p <.001). At follow-up, improvement in carer self-efficacy (p <.001) and reduced anxiety (p <.001) were documented. Significant improvements in prosocial behaviour, reductions in challenging behaviour and decreased intensity and frequency of behavioural problems (all p <.05) were reported in children at follow-up. The average level of goal attainment was 65% at post, which was maintained at follow-up. This study demonstrates the feasibility of delivering Indigenous Triple P to Aboriginal families in remote settings, and the importance of partnership with communities. Program tailoring, flexible delivery, use of Aboriginal parent coaches and provision of practical support to families resulted in a culturally acceptable parent support program. With local Aboriginal co-design, this initiative should be generalisable to similar remote communities elsewhere. What is already known about the topic: Aboriginal and Torres Strait Islander families are more often exposed to stressful life events than non-Indigenous families, with children overrepresented in hospitalisation rates, poor health outcomes, early school dropout, out-of-home care, involvement with the justice system and youth suicide. There is a significant evidence base that parenting programs, such as Triple P, built on the principles of social learning and self-regulation, can be effective in addressing emotional and behavioural problems in children in the short and longer term. Despite the availability of evidence-based parenting programs, a minority of parents of children with behavioural and emotional problems access such programs, and access by Aboriginal and Torres Strait Islander families is lower. What this topic adds: This study determined the feasibility of delivering a community tailored, evidence-based parenting program to families in a very remote Western Australian Aboriginal community. Families reported significant reductions in unhelpful parenting strategies, carer anxiety and challenging child behaviours and significant increases in parenting confidence and empowerment and prosocial child behaviour following the program. Co-design methods, community-led modifications to resources, two-way learning with Aboriginal and non-Indigenous trainers, training local parent coaches, flexible program delivery and long-term practical support were essential for delivering a culturally acceptable parenting program implementation strategy that could be adapted for remote communities elsewhere. [ABSTRACT FROM AUTHOR]

Processing and learning from affective cues to guide goal-directed behavior may be particularly important during adolescence; yet the factors that promote and/or disrupt the ability to integrate value in order to guide decision making across development remain unclear. The present study (N = 1046) assessed individual difference factors (self-reported punishment and reward sensitivity) related to whether previously-rewarded and previously-punished cues differentially impact goal-directed behavior (response inhibition) in a large developmental sample. Participants were between the ages of 8–21 years (Mage = 14.29, SD = 3.97, 50.38% female). Previously-rewarded cues improved response inhibition among participants age 14 and older. Further, punishment sensitivity predicted overall improved response inhibition among participants aged 10 to 18. The results highlight two main factors that are associated with improvements in the ability to integrate value to guide goal-directed behaviour – cues in the environment (e.g., reward-laden cues) and individual differences in punishment sensitivity. These findings have implications for both educational and social policies aimed at characterizing the ways in which youth integrate value to guide decision making. [ABSTRACT FROM AUTHOR]

Medical and health sciences librarians who are involved in evidence synthesis projects will know that systematic reviews are intensely rigorous, requiring research teams to devote significant resources to the methodological process. As expert searchers, librarians are often identified as personnel to conduct the database searching portion and/or are approached as experts in the methodology to guide research teams through the lifecycle of the project. This research method has surged in popularity at our campus and demand for librarian participation is unsustainable. As a response to this, the library created self‐directed learning objects in the form of roadmap to assist researchers in learning about the knowledge synthesis methodology in an expedient, self‐directed manner. This paper will discuss the creation, implementation and feedback around our educational offering: Systematic & Scoping Reviews: Your Roadmap to Conducting an Evidence Synthesis. [ABSTRACT FROM AUTHOR]

Objective: Traditional masculinity norms displayed by men attempt to signal a dominance or 'toughness' to others; however, traditional masculine norms are associated with a range of mental health difficulties, including depression and anxiety. Based on social rank theory, we tested the mediating role of insecure striving, social safeness and fears of compassion on the relationship between masculinity, anxiety and depression. We also examined whether compassionate goals were negatively correlated with masculine norm adherence. Design: We used a cross‐sectional survey design recruiting 844 men, aged 18–60 years (M = 34.0, SD = 14.4). Results: Our results replicated previous findings with masculine norms significantly associated with depression and anxiety. Extending on previous work, we found insecure striving, social safeness and fears of compassion fully mediated these relationships for anxiety and partially for depression. This relationship was strongest for the masculinity subtypes of self‐reliance and emotional control. Compassionate goals were negatively associated with masculine norm adherence. Conclusions: Social rank theory offers a helpful explanatory framework to understand the links between traditional masculinity and mental health, highlighting the importance of social safeness and insecure striving for men. [ABSTRACT FROM AUTHOR]

Objective: Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients. Design: Randomised, assessor-blinded, controlled trial. Setting: Primary care. Subjects: Patients with clinically verified hip or knee osteoarthritis, <150 min/week with moderate or vigorous physical activity, aged 40–74. Intervention: The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups. Main measures: Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months. Results: There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74–130) minutes/week at baseline to 214 (95% CI 183–245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103–157) to 176 (95% CI 145–207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by −514 (95% CI −567–462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was −852 (95% CI −900–804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5–8.2) and in the prescription group by 14.7 points (95% CI 14.3–15.1) from baseline to 24 months (p = 0.024 between groups). Conclusions: There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis. [ABSTRACT FROM AUTHOR]

There is a growing focus on developing person-adaptive strategies to support sustained exercise behaviour, necessitating conceptual models to guide future research and applications. This paper introduces Flexible nonlinear periodisation (FNLP) – a proposed, but underdeveloped person-adaptive model originating in sport-specific conditioning – that, pending empirical refinement and evaluation, may be applied in health promotion and disease prevention settings. To initiate such efforts, the procedures of FNLP (i.e., acutely and dynamically matching exercise demand to individual assessments of mental and physical readiness) are integrated with contemporary health behaviour evidence and theory to propose a modified FNLP model and to show hypothesised pathways by which FNLP may support exercise adherence (e.g., flexible goal setting, management of affective responses, and provision of autonomy/variety-support). Considerations for future research are also provided to guide iterative, evidence-based efforts for further development, acceptability, implementation, and evaluation. [ABSTRACT FROM AUTHOR]

Objective: Statin treatment compliance and achieving target levels differ between populations. This study aimed to determine the status of achieving the lipid targets and evaluate patients' compliance to statin treatment in type 2 diabetic patients with dyslipidemia. Method: This cross-sectional study included type 2 diabetes mellitus (T2DM) patients with dyslipidemia who applied for treatment at our polyclinics. Statin compliance was evaluated using the Modified Morisky Adherence Scale (MMAS-8) through a face-to-face interview. Cardiovascular (CV) risk was calculated according to the 2019 ESC (European Society of Cardiology) criteria by evaluating the patients' individual risk factors. LDL targets were determined according to risk categories with the same criteria. Results: A total of 504 patients (F/M: 274/230) were included. The serum LDL levels were 102.6 ± 39.2 mg/dL. Of the patients, 56.1% were under statin treatment. CV risk was very high in 73.6% of patients. LDL levels were significantly lower in users than in non-users (91.2 ± 26.0, 117.3 ± 38.4, p < 0.0001). The rate of reaching the LDL target was 14.8% in statin users. Treatment compliance was low for 40.6% of statin users. Discontinuation of statin treatment due to side effects was 15.7% (n = 14). N = 49 patients willingly discontinued statin treatment. They reported that 40.8% considered the treatment unnecessary. Conclusion: It was observed that 56.1% of type 2 diabetic patients were on statin therapy. A small percentage of them 14.8% (n = 42) reached the LDL target. Statin non-compliance and a lack of awareness of the statin treatment are the main reasons for high LDL levels in type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

The article explores ethical challenges related to deactivating left ventricular assist devices (LVADs), highlighting the need for clear communication with patients and families, the role of palliative care, and conflicts arising from differing views on the benefits and burdens of LVAD therapy.

The article focuses on the lack of access to ethics resources in long-term care facilities, which leads to challenges in managing ethical conflicts, particularly regarding end-of-life care and the need for clearer policies and training to respect patient wishes while avoiding risk management issues.

The article focuses on the importance of documenting patient goals and preferences in medical records to ensure continuity of care and alignment with patient preferences, highlighting the role of nurses and social workers in facilitating these discussions.

Formulating goals in therapy may facilitate young people and parents/carers' engagement in mental health support settings. A number of goal taxonomies have been developed, which involve organising goals set at the outset of therapy into themes. Goal taxonomies are considered useful for service planning and outcome purposes. In order to build on the knowledge about what young people choose as goals, and to best support good practice, it is important to explore the links and differences between the existing goal taxonomies. A systematic review was conducted to identify goal taxonomies based on goals set using the goal‐based outcome (GBO) tool. Framework analysis was conducted to investigate the extracted goal taxonomies. Overall, four core concepts were identified: "Goals targeting specific issues, symptoms, emotions, and behaviours," "Return and engage in activities," "Personal growth goals" and "Interpersonal goals." Goals regarding specific issues, personal growth and interpersonal relationships were present in most studies. Using these overarching core concepts could be useful for practitioner‐level, or service‐level organisation of goal data, for activities such as service planning and delivery. [ABSTRACT FROM AUTHOR]

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Inclusive postsecondary education (PSE) programs at institutions of higher education are emerging as opportunities for individuals with intellectual and developmental disabilities (IDD), including those with extensive support needs (ESN), to progress toward their desired outcomes. This qualitative study aimed to understand the experiences and supports that current and recently graduated students in a dual enrollment nonresidential PSE program perceive as contributing to their self-directed employment, education, and social goals. Furthermore, this study explored how students' perceived PSE affected their goal achievement and future lives. Findings from interviews with 10 participants with IDD, including eight with ESN, revealed that obtaining and maintaining competitive employment was negatively impacted by COVID-19, paid employment during PSE was not aligned with participants' employment goals, internship experiences led to participants learning about their work preferences and changing their employment goals, and peer mentors impacted the achievement of participant's employment, education, and social goals. Implications for practice and research and study limitations are described. [ABSTRACT FROM AUTHOR]

Items held in visual working memory can be quickly updated, replaced, removed, and even manipulated in accordance with current behavioral goals. Here, we use multivariate pattern analyses to identify the patterns of neuronal activity that realize the executive control processes supervising these flexible stores. We find that portions of the middle temporal gyrus and the intraparietal sulcus represent what item is cued for continued memorization independently of representations of the item itself. Importantly, this selection-specific activity could not be explained by sensory representations of the cue and is only present when control is exerted. Our results suggest that the selection of memorized items might be controlled in a distributed and decentralized fashion. This evidence provides an alternative perspective to the notion of "domain general" central executive control over memory function. [ABSTRACT FROM AUTHOR]

This qualitative study explores the opportunities and challenges of collaboration experienced by social workers and police officers when dealing with cases of intimate partner violence (IPV) and stalking. The study aims to examine their collaborative approaches in risk assessment and risk management by identifying the structures, supports, and foundations crucial for effective collaboration. Our data, collected from twelve interviews and one focus group interview with social workers and police officers, reveals that collaboration was facilitated by assigning specific roles to involved parties, proximity, structure and professionalism. These key factors emerged as crucial and contributing to the effectiveness of the collaborative efforts. Practitioners should consider integrating these key elements into their practices to enhance and improve collaboration when addressing cases of IPV and stalking. The study underscores the need for a well-defined framework and support structures to optimise the collaborative response to such complex and sensitive issues. [ABSTRACT FROM AUTHOR]

Background: Intraoperative fluid therapy maintains normovolemia, normal tissue perfusion, normal metabolic function, normal electrolytes, and acid–base status. Plethysmographic variability index has been shown to predict fluid responsiveness but its role in guiding intraoperative fluid therapy is still elusive. Aims: The aim of the present study was to compare intraoperative goal‐directed fluid therapy based on plethysmographic variability index with liberal fluid therapy in term neonates undergoing abdominal surgeries. Methods: A prospective randomized controlled study was conducted in a tertiary care centre, over a period of 18 months. A total of 30 neonates completed the study out of 132 neonates screened. Neonates with tracheoesophageal fistula, congenital diaphragmatic hernia, congenital heart disease, respiratory disorders, creatinine clearance <90 mL/min and who were hemodynamically unstable were excluded. Neonates were randomized to goal‐directed fluid therapy group where the plethysmographic variability index was targeted at <18 or liberal fluid therapy group. Primary outcome was comparison of total amount of fluid infused intraoperatively in both the groups. Secondary outcomes included intraoperative and postoperative arterial blood gas parameters, biochemical parameters, use of vasopressors, number of fluid boluses, complications and duration of hospital stay. Results: There was no significant difference in total intraoperative fluid infused [90 (84–117.5 mL) in goal‐directed fluid therapy and 105 (85.5–144.5 mL) in liberal fluid therapy group (p =.406)], median difference (95% CI) −15 (−49.1 to 19.1). There was a decrease in serum lactate levels in both groups from preoperative to postoperative 24 h. The amount of fluid infused before dopamine administration was significantly higher in liberal fluid therapy group (58 [50.25–65 mL]) compared to goal‐directed fluid therapy group (36 [22–44 mL], p =.008), median difference (95% CI) −22 (−46 to 2). In postoperative period, the total amount of fluid intake over 24 h was comparable in two groups (222 [204–253 mL] in goal‐directed fluid therapy group and 224 [179.5–289.5 mL] in liberal fluid therapy group, p =.917) median difference (95% CI) cutoff −2 (−65.3 to 61.2). Conclusion: Intraoperative plethysmographic variability index‐guided goal‐directed fluid therapy was comparable to liberal fluid therapy in terms of total volume of fluid infused in neonates during perioperative period. More randomized controlled trials with higher sample size are required. Trial Registration: Central Trial Registry of India (CTRI/2020/02/023561). [ABSTRACT FROM AUTHOR]

Differential attainment (DA) in post graduate medical training is a recognised challenge and refers to unexplained variation across groups when split by several protected characteristics. The Royal College of Radiology is committed to fostering diversity, inclusivity, and equality with the goal of narrowing existing gaps and improving training outcomes. This was a mixed methods study aiming to understand the causes of DA with view to helping the RCR develop strategies to address this. A cross-sectional survey was completed by 140 clinical oncology trainees in September 2022. Trainees and trainers (17 and 6 respectively) from across England, Scotland, Wales and Northern Ireland, took part in focus group and interviews from August to December 2022. Quantitative and qualitative data merged and interpreted. Results showed international medical graduates and trainees from ethnic minority backgrounds were more likely to encounter challenges. The qualitative findings were used to identify three themes through which these problems could be framed. The trainee as a "space invader," the hidden curriculum of clinical oncology training and the process of navigating and tacking the training journey. Differential attainment is the product of a complex interplay between the trainee, trainer, and the training environment. Therefore, interventions must be tailored to different people and contexts. At a national level, the RCR can adopt general policies to promote this such as mentorship programmes, protected time for supervision and cultural competency training. Efficacy of proposed interventions for trial and their impact on DA should be evaluated to drive evidence-based changes. • The GMC and Royal Colleges are committed to bridging existing gaps and addressing differential attainment. • A mixed-method research approach to provide a holistic understanding of differential attainment in Clinical Oncology. • Analysis of exclusionary mechanisms identified three main themes: space invaders, hidden curriculum and navigating. [ABSTRACT FROM AUTHOR]

There is a "positive–negative" debate on the development of the bottom‐line mentality (BLM) concept. Previous research showed a relationship between BLM and unethical pro‐organizational behaviour (UPB) and revealed that BLM positively affected UPB. This research aims to challenge this partial view and calls for a more balanced and comprehensive view of the BLM concept by revealing the potential negative influencing mechanism between BLM and UPB. Drawing from social information processing theory, we construct a moderated‐mediation model to test the mediating mechanism through different individual‐level processes in the Chinese context. Findings indicate that team BLM positively affects member UPB via state performance‐prove goal orientation and perceived insider status and negatively affects member UPB via state performance‐avoid goal orientation. These results confirm the overall positive relationship between team BLM and member UPB but also document the possible inhibitory mechanism of BLM on UPB. This study is the first to acknowledge the potential negative relationship between BLM and UPB, which deserves attention. This research also presents a complete picture of the BLM literature. The findings of this work have significant implications in enabling organizations to appropriately handle BLM and its relationship with UPB dynamically. [ABSTRACT FROM AUTHOR]

Background: Chronic disease (CD) accounts for more than half of the overall global disease burden and physical activity (PA) is an established evidence-based strategy for the prevention and management of CD. Global policy emphasises the value of embedding PA into primary healthcare, highlighting the positive effects on PA behaviour. However, there is limited implementation of PA protocols in primary care, and research is needed to guide its integration into routine practice. The voice of the patient is underrepresented in the literature, resulting in the absence of critical insights into determinants of PA promotion in primary care. The purpose of the research was to identify the perspectives of people at risk of or living with CD on the determinants of PA promotion in primary care and to map these determinants across the six COM-B constructs. Methods: Semi-structured interviews (n = 22), guided by the COM-B model were conducted with people aged 35–60 years, at risk of or living with CD and not meeting the PA guidelines. A hybrid analytic approach of thematic inductive and deductive analysis was applied to the participant transcripts guided by a COM-B informed coding framework. Results: In total, 37 determinants across constructs related to capability, opportunity and motivation were prominent, examples include; physical capability constraints, the conflation of exercise with weight management, credibility of the health services in PA advice, communication styles in PA promotion, expectations of tailored support for PA, social support, accessibility, and integration of PA into routine habits. Conclusion: Exploring the determinants of PA promotion through the lens of the COM-B model facilitated a systematic approach to understanding the primary care user perspective of the healthcare professional (HCP) broaching the topic of PA. Findings emphasise the value of HCPs being supported to broach the issue of PA in a therapeutic and patient-centred manner using diverse and flexible approaches, while highlighting the importance of tailored, accessible PA opportunities that build self-efficacy and foster social support. The research provides valuable learnings to support PA promotion and the development of strategies in primary care through encompassing the perspective of those living with or at risk of CD. [ABSTRACT FROM AUTHOR]

Background: The work of the WHO Commission on the Social Determinants of Health has been fundamental to provide a conceptual framework of the social determinants of health. Based on this framework, this study assesses the relationship of income inequality as a determinant of neonatal mortality in the Americas and relates it to the achievement of the Sustainable Development Goal target 3.2 (reduce neonatal mortality to at least as low as 12 deaths per 1,000 live births). The rationale is to evaluate if income inequality may be considered a social factor that influences neonatal mortality in the Americas. Methods: Yearly data from 35 countries in the Americas during 2000–2019 was collected. Data sources include the United Nations Inter-agency Group for Child Mortality Estimation for the neonatal mortality rate (measured as neonatal deaths per 1,000 live births) and the United Nations University World Institute for Development Economics Research for the Gini index (measured in a scale from 0 to 100). This is an ecological study that employs a linear regression model that relates the neonatal mortality rate (dependent variable) to the Gini index (independent variable), while controlling for other factors that influence neonatal mortality. Coefficient estimates and their robust standard errors were obtained using panel data techniques. Results: A positive relationship between income inequality and neonatal mortality is found in countries in the Americas during the period studied. In particular, the analysis suggests that a unit increase in a country's Gini index during 2000–2019 is associated with a 0.27 (95% CI [− 0.04, 0.57], P =.09) increase in the neonatal mortality rate. Conclusion: The analysis suggests that income inequality may be positively associated with the neonatal mortality rate in the Americas. Nonetheless, given the modest magnitude of the estimates and Gini values and trends during 2000–2019, the findings suggest a potential limited scope for redistributive policies to support reductions in neonatal mortality in the region. Thus, policies and interventions that address higher coverage and quality of services provided by national health systems and reductions in socio-economic inequalities in health are of utmost importance. [ABSTRACT FROM AUTHOR]

Background: Adherence to physiotherapeutic treatment and recommendations is crucial to achieving planned goals and desired health outcomes. This overview of systematic reviews synthesises the wide range of additional interventions and behaviour change techniques used in physiotherapy, exercise therapy and physical therapy to promote adherence and summarises the evidence of their efficacy. Methods: Seven databases (PEDro, PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO and CINAHL) were systematically searched with terms related to physiotherapy, motivation, behaviour change, adherence and efficacy (last searched on January 31, 2023). Only systematic reviews of randomised control trials with adults were included. The screening process and quality assessment with AMSTAR-2 were conducted independently by the two authors. The extracted data was synthesised narratively. In addition, four meta-analyses were pooled in a panoramic meta-analysis. Results: Of 187 reviews identified in the search, 19 were included, comprising 205 unique trials. Four meta-analyses on the effects of booster sessions, behaviour change techniques, goal setting and motivational interventions showed a significantly small overall effect (SMD 0.24, 95% CI 0.13, 0.34) and no statistical heterogeneity (I2 = 0%) in the panoramic meta-analysis. Narrative synthesis revealed substantial clinical and methodological diversity. In total, the certainty of evidence is low regarding the efficacy of the investigated interventions and techniques on adherence, due to various methodological flaws. Most of the RCTs that were included in the reviews analysed cognitive and behavioural interventions in patients with musculoskeletal diseases, indicating moderate evidence for the efficacy of some techniques, particularly, booster sessions, supervision and graded exercise. The reviews provided less evidence for the efficacy of educational and psychosocial interventions and partly inconsistent findings. Most of the available evidence refers to short to medium-term efficacy. The combination of a higher number of behaviour change techniques was more efficacious. Conclusions: The overview of reviews synthesised various potentially efficacious techniques that may be combined for a holistic and patient-centred approach and may support tailoring complex interventions to the patient's needs and dispositions. It also identifies various research gaps and calls for a more holistic approach to define and measure adherence in physiotherapy. Systematic review registration: PROSPERO CRD42021267355. [ABSTRACT FROM AUTHOR]

Mindfulness is a popular technique that helps people to get closer to their self. However, recent findings indicate that mindfulness may not benefit everybody. In the present research, we hypothesized that mindfulness promotes alienation from the self among individuals with low abilities to self-regulate affect (state-oriented individuals) but not among individuals with high abilities to self-regulate affect (action-oriented individuals). In two studies with participants who were mostly naïve to mindfulness practices (70% indicated no experience; N1 = 126, 42 men, 84 women, 0 diverse, aged 17–86 years, Mage = 31.87; N2 = 108, 30 men, 75 women, 3 diverse, aged 17–69 years, Mage = 28.00), we tested a mindfulness group (five-minute mindfulness exercise) against a control group (five-minute text reading). We operationalized alienation as lower consistency in repeated preference judgments and a lower tendency to adopt intrinsic over extrinsic goal recommendations. Results showed that, among state-oriented participants, mindfulness led to significantly lower consistency of preference judgments (Study 1) and lower adoption of intrinsic over extrinsic goals (Study 2) compared to text reading. The alienating effect was absent among action-oriented participants. Thus, mindfulness practice may alienate psychologically vulnerable people from their self and hamper access to preferences and intrinsic goals. We discuss our findings within Personality-Systems-Interactions (PSI) theory. [ABSTRACT FROM AUTHOR]