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Objective: To comparatively evaluate performances of tablet-based versus paper-based Venous Insufficiency Epidemiologic and Economic Study-Quality of Life/Symptom (VEINES-QOL/Sym) questionnaire. Methods: We prospectively evaluated 78 consecutive patients who completed tablet-based and paper-based VEINES-QOL/Sym questionnaires and compared their scores, completion time, data entry time, and ease of use. We used Student's t-test and Wilcoxon test for quantitative variables, Bland–Altman test and kappa coefficient for agreement between questionnaires and patients, respectively. Spearman's correlation coefficient was used to assess correlations. Results: Most participants (83.3%) found it easier to use the tablet device. Less time was needed to complete the tablet-based (median, 4.75; IQR, 3–7 min) than the paper-based (median, 8.3; IQR, 6.3–11.3 min) questionnaire (p <.001). Better educated patients took less time to complete paper-based (p =.003) and tablet-based (p =.001) questionnaires and considered the latter easier to use (p =.010). Conclusions: The tablet-based VEINES-QOL/Sym proved to be an easy-to-use and time-saving tool. [ABSTRACT FROM AUTHOR]

The gold standard for measuring anhedonia is the Snaith-Hamilton Pleasure Scale (SHAPS). To date, there are no validated electronic versions of this questionnaire. We aim to study the equivalence between the traditional paper-and-pencil format and a digital version of the SHAPS. A group of 67 patients completed both SHAPS formats, and differences between formats were assessed. McNemar's test showed no significant differences between the two systems. The Kappa coefficient was over 40% for most items, and reliability was above 0.8, showing good to excellent levels of internal consistency. Thus, we have demonstrated a close equivalence between paper-and-pencil and electronic SHAPS. [ABSTRACT FROM AUTHOR]

Paper-based visual analogue scale (VAS) items were developed 100 years ago. Although they gained great popularity in clinical and medical research for assessing pain, they have been scarcely applied in other areas of psychological research for several decades. However, since the beginning of digitization, VAS have attracted growing interest among researchers for carrying out computerized and paper-based data assessments. In the present study, we investigated the research question "Which different design characteristics of paper-based VAS items are preferred by women and men?" Based on a sample of 115 participants (68 female), our results revealed that the respondents preferred a paper-based VAS item with a horizontal, 8-cm long, 3 DTP ("desktop publishing point") wide, black line, with flat line endpoints, and the ascending numerical anchors "0" and "10", both for women and men. Although we did not identify any gender difference in these characteristics, our findings uncovered clear preferences on how to design paper-based VAS items. [ABSTRACT FROM AUTHOR]

Background: The WHO definition of palliative care includes bereavement support as integral to palliative care, yet a previous survey of bereavement support in palliative care in Europe has shown a range of service responses to loss. A rigorous approach to agreeing and implementing a palliative care bereavement framework was required. Aim: The aim of this study was to develop consensus on best-practice recommendations for bereavement care principles, structures, processes and delivery based on current practice and evidence. Design: In accordance with Guidance on Conducting and Reporting Delphi Studies, a consensus-building five-round Delphi technique was performed. A scoping review of research literature informed drafting of 54 statements by the EAPC Bereavement Task Force. Evaluation of the statements was performed by an expert panel using a 5-point Likert scale. ⩾80% agreement were defined as essential items and 75%–79% agreement were defined as desirable items. Items with a consensus rating <75% were revised during the process. Setting/participants: The Delphi study was carried out by an expert panel among membership organisations of the European Association for Palliative Care. Results: In total, 376 email requests to complete Delphi questionnaire were distributed with a response rate of 23% (n = 87) and a follow-up response-rate of 79% (n = 69). Of the initial 54 statements in six dimensions, 52 statements were endorsed with 26 essential statements and 26 desirable statements. Conclusions: The six dimensions and 52 statements agreed through this Delphi study clarify a coherent direction for development of bereavement services in palliative care in Europe. [ABSTRACT FROM AUTHOR]

Questionnaire instruments are routinely translated to digital administration systems; however, few studies have compared the differential effects of these administrative methods, and fewer yet in authentic contexts-of-use. In this study, 326 university students were randomly assigned to one of two administration conditions, paper-based (PBA) or web-based (WBA), and given a set of questionnaires. Instructions were to complete the instruments in an environment of their choice, and data included reporting context characteristics. Outcomes of interest included data quality and participant affect—WBA showing a slightly higher percent of data loss and lower overall time to complete; PBA producing higher overall mean scores across measures, greater variability in responses, and higher positive affect for responding. Administration methods showed no difference on internal consistency of subscales, positive-response bias, or strength of interscale correlations. Contexts-of-use included involvement in television viewing, conversation, and other activities, raising questions about the accuracy and independence of survey responses completed in independently-chosen, uncontrolled contexts. The qualitative data demonstrated longer responses in WBA than PBA, but little difference in type and clarity of responses. [ABSTRACT FROM AUTHOR]

Object personification is the attribution of human characteristics to non-human agents. In online forums, autistic individuals commonly report experiencing this phenomenon. Given that approximately half of all autistic individuals experience difficulties identifying their own emotions, the suggestion that object personification may be a feature of autism seems almost paradoxical. Why would a person experience sympathy for objects, when they struggle to understand and verbalise the emotions of other people as well as their own? An online survey was used to assess tendency for personification in 87 autistic and 263 non-autistic adults. Together, our results indicate that object personification occurs commonly among autistic individuals, and perhaps more often (and later in life) than in the general population. Given that in many cases, autistic people report their personification experiences as distressing, it is important to consider the reasons for the increased personification and identify structures for support. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disabilities often present with unique challenges that make it more difficult to meet their palliative care needs. Aim: To define consensus norms for palliative care of people with intellectual disabilities in Europe. Design: Delphi study in four rounds: (1) a taskforce of 12 experts from seven European countries drafted the norms, based on available empirical knowledge and regional/national guidelines; (2) using an online survey, 34 experts from 18 European countries evaluated the draft norms, provided feedback and distributed the survey within their professional networks. Criteria for consensus were clearly defined; (3) modifications and recommendations were made by the taskforce; and (4) the European Association for Palliative Care reviewed and approved the final version. Setting and participants: Taskforce members: identified through international networking strategies. Expert panel: a purposive sample identified through taskforce members’ networks. Results: A total of 80 experts from 15 European countries evaluated 52 items within the following 13 norms: equity of access, communication, recognising the need for palliative care, assessment of total needs, symptom management, end-of-life decision making, involving those who matter, collaboration, support for family/carers, preparing for death, bereavement support, education/training and developing/managing services. None of the items scored less than 86% agreement, making a further round unnecessary. In light of respondents’ comments, several items were modified and one item was deleted. Conclusion: This White Paper presents the first guidance for clinical practice, policy and research related to palliative care for people with intellectual disabilities based on evidence and European consensus, setting a benchmark for changes in policy and practice. [ABSTRACT FROM AUTHOR]

Background: Questionnaires are often used to quantify the subjective aspects of illness such as disability, coping strategies, or symptoms of depression. Most questionnaires were validated in a paper-based format, but direct entry into a computer is becoming commonplace. The aim of this study was to assess differences in outcome of questionnaires pertinent to hand and upper extremity illness when they were administered in a computer or paper format. Methods: Ninety-nine patients completed both paper and web versions of the short forms of the Disabilities of Arm, Shoulder, and Hand; the Pain Catastrophizing Scale; the Short Health Anxiety Index (SHAI-6); the Patient Health Questionnaire Depression Scale; and a pain scale and the Pain Self-Efficacy Questionnaire sequentially during a single visit. We alternated starting with the paper or the web version after every five patients. Results: The cohort consisted of 46 females and 53 males with a mean age of 49 years. There were significant differences in SHAI-6 and the pain scale, but not in the other measures. The intraclass correlation was high. Conclusions: The use of these questionnaires in electronic format is valid provided that the small differences we observed are not important to the primary study question. In our opinion, for most studies, the advantages of using an electronic format outweigh the small additional variation that might be introduced in the measures in an electronic format. [ABSTRACT FROM AUTHOR]

While previous studies found that origami, when used for cognitive training and education, can improve spatial ability, the underlying mechanisms of this change, presumably associated with the origami folding process, remain unclear. In the present study, we focused on origami imagery in which participants imagined the process of folding paper to create a work of art; and we examined the cognitive factors involved in the imagery process and their association with mental transformations and the extent to which visual imagery was vivid. We identified four specific relevant cognitive factors in origami imagery: (a) controllability of origami transformations, (b) visual imagery of shapes, (c) hand sensations, and (d) visual imagery of colors. We associated the first two of these with non-rigid transformations: the controllability of origami transformations and the visual imagery of shapes. Moreover, vividness of visual imagery was related to all four cognitive factors. We propose this cognitive model of origami as one that considers the key relationships between origami imagery, mental transformations, and vividness of visual imagery. [ABSTRACT FROM AUTHOR]

This study investigates the measurement equivalence of a five-factor measure of personality across two groups applying for jobs, who completed the same questionnaire using either a paper-and-pencil (n = 429) or a web online answer format (n = 651). The data were collected using the Big Five Questionnaire–2 (BFQ-2; which is a measure of the Five Factor Model) of personality traits. Multiple-group confirmatory factor analysis was used to test for the equivalence of factor covariance and mean structures of the BFQ-2. Findings suggested that the Five Factor Model scales have the same measurement unit and origin across applicants using different administration modes. However, latent means were slightly higher for applicants who responded in a web and unproctored condition than for applicants who completed a paper-and-pencil version of the same test. Practical implications for personality assessment are discussed. [ABSTRACT FROM PUBLISHER]

To examine the effectiveness of mixed-mode methodology, this article draws on a study that used both online and paper surveys to collect data on a sample of the over 50 population in a small New England town. Respondents were offered the option of responding online or with a paper survey, an approach that addresses some of the major concerns about using online surveys among groups with limited Internet access while also reducing costs and simplifying data entry. The authors demonstrate that response mode does not have a significant effect on survey answers once demographic variables (such as employment and income) are added to the analysis. In addition, the results from this survey suggest that the Internet is useful as a tool to collect data from those over 50. [ABSTRACT FROM PUBLISHER]

This study examined the psychometric equivalence of paper-and-pencil and Internet formats of key questionnaires used in couple research. Self-report questionnaires assessing interpersonal constructs (relationship satisfaction, communication/conflict management, partner support, emotional intimacy) and intrapersonal constructs (individual traits, psychological symptoms, contextual influences) were administered to young adults in committed dating relationships. The same measures were administered twice via paper-and-pencil and/or Internet methods over a 2-week period. Method order was counterbalanced among participants, and temporal stability was controlled. Intrapersonal and interpersonal measures generally remained reliable when administered online and demonstrated quantitative and qualitative equivalence across methods. The implications of online administration of questionnaires are discussed, and specific recommendations are made for researchers who wish to transition to online data collection. [ABSTRACT FROM PUBLISHER]

Respondents in self-administered, paper-based surveys answer open-ended frequency questions differently depending on the size of the response field provided. Longer fields increase the proportion of alphanumeric elaborations or answers explicitly designated as an estimate ("about 20," "60-70"). By contrast, shorter fields yield higher proportions of pure digit responses. It is assumed that respondents interpret the size of the response field as an instruction regarding the format of the expected answer. In this article, the authors assess the effect of the length of the response field in a web survey compared to a paper-and-pencil questionnaire. Results indicate that the effect of the length of the response field is more pronounced in the paper-and-pencil condition compared to the web survey condition. This raises the question as to what extent the underlying visual design language differs across self-administered survey modes. [ABSTRACT FROM AUTHOR]

The existence of a mode effect is assessed using data from two matched groups of 15- to 16-year-olds (n = 466) who completed a questionnaire either as a Web-based online version or an "optical mark recognition" paper version. This article focuses specifically on the length of answers to four open-ended questions included in the questionnaire. It was found that although the online answers to three of the four questions tended to be slightly longer than those from the paper version, the differences were not statistically significant. Other factors, specifically gender and educational aspirations, appeared to have much more influence on the length of answers to open-ended questions than the mode of delivery per se. The findings do not provide conclusive evidence of any mode effect with respect to the online delivery of questionnaires. [ABSTRACT FROM AUTHOR]

The psychometric properties of two paper-and-pencil versions of the Children’s Attributional Style Interview (i.e., CASI-I and CASI-II) were evaluated in a sample of 166 third and fourth graders and a sample of 245 sixth and seventh graders. The results demonstrated strong internal consistency reliability, convergent validity, and a factor structure that was consistent with theory in both samples. Furthermore, analyses demonstrated adequate evidence of the reliability and validity of several dimensional subscale scores and the composite measures of attributional style for both positive and negative events. These results suggest the utility of the CASI in research testing specific attributional predictions of cognitive theories of depression with the dimensional subscale scores. They further add to the literature by demonstrating item-level factor analytic support for a children’s attributional style measure and the feasibility of administration sizes larger than previously tested, which add to the utility of the CASI in large-scale research designs. [ABSTRACT FROM AUTHOR]

Introduction: A National Cancer Information System is planned for phased implementation in Irish cancer centres to enable electronic prescribing (ePrescribing) of systemic anti-cancer therapy. This study aimed to capture the opinions of healthcare professionals in a hospital setting relating to the current paper-based workflow for systemic anti-cancer therapy prescribing and their attitudes and expectations of the new ePrescribing system to develop recommendations, which assist in the planning and implementation of future ePrescribing systems. Methods: A mixed methods study of concurrent design was conducted. Interviews with healthcare professionals primarily aimed to evaluate processes and identify areas requiring improvement within the current paper-based workflow for systemic anti-cancer therapy prescribing. An online questionnaire adapted from the Information Systems Expectations and Experiences tool primarily aimed to capture expectations of the new ePrescribing system and attitudes towards the transition. Results: Twelve healthcare professionals were interviewed, and 50 healthcare professionals responded to the online questionnaire (response rate: 33.3%). Eight major themes emerged from interview transcripts relating to opinions on the paper-based workflow. Questionnaire respondents reported positive attitudes towards ePrescribing implementation and had high expectations for workflow improvements and functionalities of the new system. Seven recommendations for ePrescribing implementation were developed: (1) prioritise specific processes; (2) plan for changes in communication; (3) repeat research in the post-implementation setting; (4) ensure good information technology infrastructure and system support; (5) ensure optimum training; (6) outline limitations of clinical decision support; (7) provide clear instructions on local configurability. Conclusion: This study identifies potential challenges in transitioning to ePrescribing and provides recommendations, which assist stakeholders in ensuring safe and effective transitions, thus informing future ePrescribing systems' implementation in haematology/oncology settings. [ABSTRACT FROM AUTHOR]

Multigroup confirmatory factor analysis was applied to the responses of 4,909 employees of a multinational organization with locations in 50 countries to examine the measurement equivalence of otherwise identical Web-based and paper-and-pencil versions of 20 items comprising the transformational leadership component of Bass and Avolio's Multifactor Leadership Questionnaire. The results supported configural, metric, scalar, measurement error, and relational equivalence across administration modes, indicating that the psychometric properties of the 20 items were similar whether administered as a paper-and-pencil or Web-based measure. Although caution is always advised when considering multiple modes of administration, the results suggest that there are minimal measurement differences for well-developed, psycho-metrically sound instruments applied using either a paper-and-pencil or an online format. Thus, the results open a methodological door for survey researchers wishing to (a) assess transformational leadership with a Web-based platform and (b) compare or combine responses collected with paper-and-pencil and Web-based applications. [ABSTRACT FROM AUTHOR]

This paper reports follow-up findings for an Mentalization based treatment (MBT) parenting intervention delivered to a community mental health sample. Parents completed the 12-week version of the Lighthouse Parenting Program (LPP) and were evaluated on parenting practices, parent-child relationships, parental mental health indicators, and child problem behaviour levels. We evaluated the extent to which improvements in mentalizing at follow-up mediated changes in parenting, parental adjustment, mental health, and child outcomes. Results included a reduction in parental coercive behaviours and child problems, improved parent-child relationship, and better parental psychological adjustment and mental health. Improvement in self-focused mentalizing were observed. Self-focused mentalizing mediated the changes in most outcomes from baseline to 3-month follow-up. These results provide strong preliminary evidence that the LPP improves parent and child outcomes. [ABSTRACT FROM AUTHOR]

Bereavement and mourning are arguably one of the research interests of psychologists, psychoanalysts, and psychiatrists since Freud's publication of Mourning and Melancholia. This paper is a qualitative case study that sought to examine the mourning experience of the participant from childhood until his adolescence. For theoretical foundation, the four tasks of mourning primarily developed by James Worden was utilized for the proper direction of the research inquiry; namely: a.) accepting the reality of death; b.) experiencing the feeling of grief; c.) adjusting and creating new meanings in the post-loss world; and d.) reconfiguring the bond with the lost person. The paper finds that the participant's cognitive attitude, emotional experiences, and personal observations of the environment enable him to overcome actively (in an overlapping manner) the three tasks of mourning. However, the failure to find an enduring connection with his deceased parents is not a result of strong attachment but with the absence of personal belief about the meta-existence of God. [ABSTRACT FROM AUTHOR]

Background: Ethical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviour within teams. Aim: This paper sought to explore perceptions of ethical climate amongst healthcare workers as measured by the Ethical Climate Questionnaire (ECQ), the Hospital Ethical Climate Survey (HECS) and the Ethics Environment Questionnaire (EEQ). Methods: A systematic review and meta-analysis was utilised. PSYCINFO, CINAHL, WEB OF SCIENCE, MEDLINE and EMBASE were searched, and papers were included if they sampled healthcare workers and used the ECQ, HECS or EEQ. Ethical consideration: Ethical approval was not required. Results: The search returned 1020 results. After screening, 61 papers were included (n = 43 HECS, n = 15 ECQ, n = 3 EEQ). The overall sample size was over 17,000. The pooled mean score for the HECS was 3.60. Mean scores of individual studies ranged from 2.97 to 4.5. For the HECS studies, meta-regression was carried out. No relationship was found between the country of the studies, the study setting (ICU v non-ICU settings) or the mean years of experience that the sample had. For the ECQ, sub-scales had mean scores ranging from 3.41 (instrumental) to 4.34 (law) and were all observed to have significant and substantial heterogeneity. Three studies utilised the EEQ so further analysis was not carried out. Conclusions: The above results provide insight into the variability of scores as measured by the HECS, ECQ and EEQ. To some extent, this variability is not surprising with studies carried out across 21 countries and in a range of healthcare systems. Results also suggest that it may be that more local and context specific factors are more important when it comes to predicting ethical climate. [ABSTRACT FROM AUTHOR]

Aim: A systematic review to identify which mood and depression measures are valid for use with people with severe cognitive and communication impairments following severe acquired brain injury. Method: A systematic search of Cochrane, Web of Science, Ovid, and EBSCOhost was performed in March 2020, July 2021, and September 2022. The search focused on self-report and observer-rated assessment tools used to assess mood, depression, and/or distress in those described as having a severe acquired brain injury. Psychometric properties were extracted using the Consensus-based standards for the selection of health measurement instruments (COSMIN) risk of bias checklist. Qualitative synthesis was performed on extracted patient data. Results: Nineteen papers detailing the psychometric properties of 25 measures were included, involving 2,914 participants. Nine papers provided details confirming the severity of participants' cognitive and communication impairments. The remaining papers described including severely injured participants but provided limited details so that precise level of severity could not be confirmed. Only one paper showed evidence of adequate psychometric properties and included those with severe cognitive impairments in a study of two observer-rated measures, the Stroke Aphasia Depression Questionnaire (10 items) and the Aphasia Depression Rating Scale. Conclusions: Due to the exclusion of individuals with severe cognitive and communication consequences following brain injury, no studies using self-report measures showed adequate validity evidence to recommend their use in this population. A small study using two observer-rated scales included those with severe cognitive impairments and showed satisfactory evidence that these measures can be validly used with this population. [ABSTRACT FROM AUTHOR]

Covid-19 was declared a pandemic in March 2020, and the world has witnessed significant changes since then. Spain has been forced to go into extreme lockdown, cancelling all school classes and outdoor activities for children, which may have significant consequences on young people. This paper explores how young children have experienced lockdown as a consequence of the ongoing Covid-19 pandemic and what they think about their future lives after Covid-19. Data were collected from 73 students aged from 7 to 9 years old, using participant-produced drawings and short questions with children's and parents' descriptive comments. We used a children's rights perspective and the Freirean approach of a pedagogy of love and hope to analyse the data. Results suggest that participants have been through significant changes in their routines, and that what they miss most from their lives before Covid-19 is playing outdoors with their friends and visiting their grandparents. To our knowledge, this paper is the first of its kind in investigating how the Covid-19 pandemic has influenced the ways that children lived during pandemic and its possible implications for their futures. [ABSTRACT FROM AUTHOR]

The purpose of this study is to provide an overview of patients' experiences using a precision medicine (PM) clinic that conducts pharmacogenomics-based (PGx) testing for adverse drug reactions. The study aimed to identify the features of the clinic valued most by patients and areas for improvement. A paper survey was used to collect data. Survey questions focused on patients' perceptions of the PM testing and the overall clinic experience. Sixty-seven patients completed the survey. Quantitative data were analyzed using SPSS and frequencies were reported. Open-ended responses were coded and organized thematically. Patients reported that the clinic services increased confidence in their medication usage. Feeling respected by staff, receiving education, and quick appointments were highly valued by patients. Suggested areas for improvement included better communication from the clinic to patients, expansion of clinic services, and education for other healthcare providers. The findings demonstrate that patient experience goes beyond the clinical care provided. Current and potential future providers of PM should invest the time and energy to configure their care delivery system to enhance the patient experience. [ABSTRACT FROM AUTHOR]

Due to the growing population and advancing economy, medical waste accumulation has come to the attention of all facets of society. Although the issue of medical waste management planning has been addressed in developed nations, it still exists in several developing nations. This paper examines the effects of barriers under the Organization action, work handling, and Human Resource Practices section on the healthcare waste management (HCWM) sector in a developing country India. In this study, three hypotheses were constructed and tested using Structural equation modeling. The questionnaire was distributed among 200 health professionals to collect their responses. Ninety-seven responses were received, and 15 barriers were identified affecting the healthcare waste management sector. The results show that all three barriers (i.e., Organizational, Waste handling, and Human resources) hinder the Healthcare waste management sector. Organizational Barriers are the most significant among other barriers. So, the hospitals have to take appropriate actions to overcome these barriers. This paper helps to complete the research gap by providing the different characteristics of barriers. The development of a model for the analysis of barriers influencing HCWM is the Author's original contribution. [ABSTRACT FROM AUTHOR]

The paper examined how dissociation is experienced and manifested in the drawings and narratives of female survivors of childhood sexual abuse (CSA) diagnosed with dissociative identity disorder. Fifteen Israeli women filled out a self-report questionnaire consisting of demographics, traumatic events, and dissociation severity. Then, they were asked to draw a dissociation experience and provide a narrative. The results indicated that experiencing CSA was highly correlated with indicators such as the level of fragmentation, the figurative style, as well as with the narrative. Two main themes emerged: a constant movement between internal and external worlds, and distorted perceptions of time and space. [ABSTRACT FROM AUTHOR]

Parents and preschool teachers play a key role in shaping children's dietary behaviors. Knowledge of nutrition and healthy dietary choices is a key component to improve dietary habits and reduce the prevalence of obesity and associated co-morbidities. Using valid and reliable instruments is necessary for accurate assessment of knowledge to tailor interventions and measure effectiveness specific to the population of interest. The objectives of this paper are to (1) identify potential gaps in the baseline nutrition knowledge among parents and teachers using a previously validated questionnaire prior to a preschool obesity prevention intervention; and (2) assess the instrument's reliability and construct validity for a low socioeconomic status population using a post hoc Rasch analysis. Participants included 177 parents and 75 teachers who participated in a Head Start intervention study. Knowledge scores, instrument reliability, and item fit and difficulty were assessed using a Rasch analysis; t-tests were used to determine differences in scores between parents and teachers. Parents answered 38% of questions correctly while teachers correctly answered 46% of the questions. Adequate item fit and reliability were indicated for Sections 1 and 2 of the Nutrition Knowledge Questionnaire (NKQ). Section 3 demonstrated less adequate reliability. The items were found to adequately and reliably define the unidimensional measures of the three components of knowledge represented in this instrument, providing evidence of construct validity. However, Rasch measures indicated the NKQ overall was difficult for participants. Recommendations for improving the instrument for nutrition education/intervention and research practice areas related to obesity and obesity-related conditions are addressed. [ABSTRACT FROM AUTHOR]

Palliative care is expanding in Africa as the continent faces a rising disease burden. As the specialty takes form, it is important to acknowledge the cultural mores regarding health and disease. Many Africans perceive health as more than the individual's physical body, instead include the spirituality and well-being of family, community and ancestors. Much of living is done with the goal of becoming an ancestor, which is tied to the individual's burial and ceremonies. Despite their importance, conversations about death are often thought to be culturally taboo. This poses a challenge to palliative care which is based on the individual preferences and priorities, usually identified through shared decision-making. Little is known about the end-of-life priorities and preferences in Africa, leading to the research question: What are the end-of-life preferences and priorities for community dwelling adults in Mozambique? This paper examines instruments that can be used to measure end-of-life preferences. [ABSTRACT FROM AUTHOR]

There is increasing interest in asking patients questions before their visits to elicit goals and concerns, which is part of the move to support the concept of coproducing care. The phrasing and delivery of such questions differs across settings and is likely to influence responses. This report describes a study that (i) used a three-level model to categorize the goals and concerns elicited by two different pre-visit questions, and (ii) describes associations between responses elicited and the phrasing and delivery of the two questions. The questions were administered to patients with rheumatic disease, and patients with inflammatory bowel disease (IBD). Paper-based responses from 150 patients with rheumatic disease and 338 patients with IBD were analyzed (163 paper, 175 electronic). The goals and concerns elicited were primarily disease or symptom-specific. The specific goal and concern examples featured in one pre-visit question were more commonly reported in responses to that question, compared to the question without examples. Questions completed electronically before the visit were associated with longer responses than those completed on paper in the waiting room. In conclusion, how and when patients' goals and concerns are elicited appears to have an impact on responses and warrants further investigation. [ABSTRACT FROM AUTHOR]

Background and Objectives: People living with dementia have historically been excluded from qualitative research and their voices ignored due to the perception that a person with dementia is not able to express their opinions, preferences and feelings. Research institutions and organizations have contributed by adopting a paternalistic posture of overprotection. Furthermore, traditional research methods have proven to be exclusionary towards this group. The objective of this paper is to address the issue of inclusion of people with dementia in research and provide an evidence-based framework for dementia researchers based on the five principles of human rights: Participation, Accountability, Non-discrimination and equality, Empowerment and Legality (PANEL). Design: This paper adapts the PANEL principles to the research context, and uses evidence from the literature to create a framework for qualitative research in people with dementia. This new framework aims to guide dementia researchers in designing studies around the needs of people with dementia, to improve involvement and participation, facilitate research development and maximize research outcomes. Results: A checklist is presented with questions related to the five PANEL principles. These questions cover ethical, methodological and legal issues that researchers may need to consider while developing qualitative research for people with dementia. Conclusions: The proposed checklist offers a series of questions and considerations to facilitate the development of qualitative research in patients with dementia. It is inspired by current human rights work of recognized dementia researchers and organizations who have been directly involved in policy development. Future studies need to explore its utility in improving participation, facilitating ethics approvals and ensuring that outcomes are relevant to people with dementia. [ABSTRACT FROM AUTHOR]

Five surveys were conducted using the Internet for various constituents of the Evangelical Lutheran Church in America (ELCA). In three cases, participants were sent e-mail invitations with links to the on-line surveys. Two questionnaires were primarily paper-and-pencil instruments with the option of completing the survey on-line. A new software package that integrates Web forms and scannable paper forms was tested and implemented. Overall, the five Web surveys conducted were successful, with response rates ranging from ten to 58 percent. In almost all cases, paper response rates were higher than Web response rates. An item analysis for one survey revealed several differences between Web and paper respondents, suggesting possible systematic differences between those who chose one response format over another. Age was also a significant factor with older respondents generally choosing the paper format. Methods to increase Web response rates are discussed and the strengths and weaknesses of Web surveys in a denominational context are explored. [ABSTRACT FROM AUTHOR]

Research that 'grows apart' from its original design and proposal is not uncommon, especially when involving participatory and creative methods. However, the disconnect between research intentions and research realization is seldom probed for the insights offered; this paper addresses this gap. Taking up the conceptual lens of research imaginaries, this paper dives into the tensions and discoveries experienced in between the design and the practice of a multi-site participatory research project. The study involved two groups of young people, in two cities in two countries, with a focus on digital lives. In a commitment to collaboration with artists, senior researchers, research assistants, and young people in community spaces, a complex project emerged. This paper describes the tensions and possibilities of an emergent methodology and in doing so argues for increased attention to the movement of research designs; rather than the adherence to them. [ABSTRACT FROM AUTHOR]

Introduction: Globally, healthcare organizations have transitioned from paper-based documentation to electronic health records (EHR), including in Saudi Arabia. However, the adoption of EHR at the national level in Saudi Arabia needs more attention. Thus, this study aimed to determine the workflow integration of EHR and associated factors. Objectives: The specific aims were to examine the level of EHR use and workflow integration among nurses, to determine the differences in EHR use and workflow integration based on nurses' demographic characteristics, and to determine the association between the predictive factors and EHR workflow integration. Methods: This is a cross-sectional, correlational descriptive study. The data were collected from 293 nurses using the convenience sampling method. The participating nurses completed a questionnaire that included two measures: the Information System Use Survey and the Workflow Integration Survey (WIS). The data were analyzed using descriptive and multivariate statistics with SPSS software. Results: The nurses had a positive perception of EHR use and workflow. The EHR use scores differed based on workplace (P <.01), education level (P <.05), and area of practice (P <.001). Similarly, the EHR workflow integration scores varied according to workplace (P <.05), education level (P <.05), and area of practice (P <.001). Education level and workplace significantly predicted information system use. Furthermore, education level and information system use significantly predicted the EHR integration into nurses' workflow. Conclusion: The nurses expressed a greater perceived use of EHR regarding the integrated health information system, which was a predictor of EHR integration into nurses' workflow. [ABSTRACT FROM AUTHOR]

The Revised Illness Perception Questionnaire (IPQ-R) assesses patients' perspectives of their illnesses. Original psychometric testing occurred in limited populations. The purpose of this reliability generalization meta-analysis was to: (1) estimate internal consistency reliability of each IPQ-R subscale, and (2) test moderators of these estimates. Web of Science was searched in July 2022 for articles citing the original IPQ-R paper that reported IPQ-R reliability data. Cronbach's alphas (⍺) were pooled for each IPQ-R subscale using inverse variance weighting and DerSimonian and Laird estimation. Sixty-six studies met criteria. Overall pooled ⍺ estimates were acceptable: 0.71–0.87. Treatment control reliability was reduced among cardiac (⍺ = 0.68), diabetes/kidney disease (⍺ = 0.63), and mixed/other (⍺ = 0.66) samples; cyclical reliability was reduced in cancer (⍺ = 0.65) samples. Age, gender, and race were also significant moderators. Subscale reliability varied based on sample characteristics. Adapting IPQ-R subscales to account for sample variation could improve measurement of illness perception constructs. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Social determinants of health (SDoH) screening and intervention in pediatric primary care depends upon caregiver disclosure of adverse household or social conditions and thus may be influenced by perceived bias or stigma. This paper examines to what extent parents' experience of their child's medical home is associated with their perceptions of a practice-based social needs intervention. Methods: We conducted a cohort study of data reported by 73 parents of children obtaining care in a medical home with an embedded SDoH navigation program. Using survey data collected in October 2021 and October 2022, we calculated descriptive statistics and non-parametric bivariate analyses of the association between engagement with the SDoH navigation program and parent-reported social needs, stress, and perception of care quality as measured by the Person-Centered Primary Care Measure (PCPCM). Results: Initial ratings of care quality were high (mean baseline PCPCM score = 3.63) and remained high on second interview (mean change in PCPCM score = −0.04, 95%CI −0.16, 0.09, P =.58) despite significant reductions in parents' ratings of access to care over time. Parents reported substantial stress, unmet social needs, and unmet healthcare needs, with 41 families (56%) ever using the practice-based SDoH program, including 16 (22%) who were new users in 2022. There was no association observed between PCPCM score and parent stress, unmet social needs, or use of SDoH services. Conclusions: Parents' perceptions of care delivered in their child's medical home appears to be stable on repeat measurement, and independent of family context or interactions with social needs navigation services offered in the practice. [ABSTRACT FROM AUTHOR]

Background: Working in pediatric palliative care (PPC) impacts healthcare and allied professionals' work-related quality of life (QoL). Professionals who lack specific PPC training but who regularly provide services to the affected children have articulated their need for support from specialized PPC (SPPC) teams. Objectives: This study had two objectives: (1) to evaluate whether the availability of a SPPC team impacted the work-related QoL of professionals not specialized in PPC; and (2) to explore the work-related QoL of professionals working in PPC without specialized training. Design: Repeated cross-sectional comparative effectiveness design. Methods: One hospital with an established SPPC program and affiliated institutions provided the intervention group (IG). Three hospitals and affiliated institutions where generalist PPC was offered provided the comparison group (CG). Data were collected by paper-pencil questionnaire in 2021 and 2022. The Professional Quality of Life (ProQOL 5) questionnaire was used to assess work-related QoL, yielding separate scores for burnout (BO), secondary traumatic stress (STS) and compassion satisfaction (CS). A descriptive statistical analysis was performed and general estimation equations were modelled. To increase the comparability of the IG and CG, participants were matched by propensity scores. Results: The 301 participating non-PPC-specialized professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. However, none of these scores (BO: p = 0.36; STS: p = 0.20; CS: p = 0.65) correlated significantly with support from an SPPC team. Compared to nurses, physicians showed higher levels of BO (1.70; p = 0.02) and STS (2.69; p ⩽ 0.001). Conclusion: Although the study sample's overall work-related QoL was satisfactory, it showed a considerable proportion of moderate BO and STS, as well as moderate CS. To provide tailored support to professionals working in PPC, evidence regarding key SPPC support elements and their effectiveness is needed. Trial registration: ClinicalTrials.gov ID, NCT04236180. Plain language summary: Work-related quality of life in professionals involved in pediatric palliative care - Why was this study done? Caring for children suffering from life-limiting conditions and their families impacts professionals' work-related Quality of Life (QoL). Professionals without specific training often provide pediatric palliative care (PPC) to children and their families. - What did the researchers do? We aimed to determine whether the work-related the QoL of professionals without specialised PPC training would be positively influenced when they were supported by PPC specialists. We also wanted to explore what person-specific factors might correspond with higher or lower work-related QoL. Work-related QoL was analysed in relation to burnout (BO), secondary traumatic stress (STS), and compassion satisfaction (CS). These variables' levels were assessed with a questionnaire survey in 2021 and 2022. - What did the researchers find? The 301 participating professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. There was no substantial difference in work-related QoL in the professionals supported by PPC specialists compared to those who did not receive specialist support. Physicians showed higher levels of BO and STS than nurses. - What do the findings mean? Although the studied professionals' overall work-related QoL was satisfactory, there is a considerable proportion of moderate BO and STS scores in professionals working with children suffering from life-limiting conditions. Further research should explore the specific needs of professionals not specialised in PPC. [ABSTRACT FROM AUTHOR]

Background and Objectives: Children with autism spectrum disorder (ASD) continue to experience significant delays in diagnosis and interventions. One of the main factors contributing to this delay is a shortage of developmental-behavioral specialists. Diagnostic evaluation of ASD by primary care pediatricians (PCPs) has been shown to be reliable and to decrease the interval from first concern to diagnosis. In this paper, we present the results of a primary care ASD diagnosis program in which the PCP serves as the primary diagnostician and leverages the infrastructure of the primary care medical home to support the child and family during the pre- and post-diagnostic periods, along with data on parental satisfaction with this model. Methods: Retrospective data from a cohort of patients evaluated through this program were analyzed to determine the mean age at diagnosis and interval from referral for evaluation to diagnosis. We used survey methodology to obtain data from parents regarding their satisfaction with the process. Results: Data from 8 of 20 children evaluated from April 2021 through May 2022 showed a median age of diagnosis of 34.5 months compared to the national average of 49 months. Mean interval from referral for evaluation to diagnosis was 3.5 months. Parental survey responses indicated high satisfaction. Conclusions: This model was successful in shortening the interval from referral to diagnosis resulting in significant decrease of age at diagnosis compared with the national average. Widespread implementation could improve access to timely diagnostic services and improve outcomes for children with ASD. [ABSTRACT FROM AUTHOR]

This paper explores Facebook's role in shaping the political perception of youth during the 2018 general elections in Pakistan. It also gauges the ideological standpoint of youth in Pakistan that influences their voting decisions. An online campaign has become an indispensable source for politicians to influence the masses without the constraints of distance and time. It is a quantitative study based on a questionnaire survey of young Pakistani voters. Findings show that Facebook has presumed the role of an instigator in shaping the voting behavior of educated youth. Respondents perceived Facebook as biased while expressing views and assisted political entities in manipulating the data to increase their vote bank. Though the majority of them haven't experienced fake news so either they are not conscious or they trust blindly the information. Furthermore, respondents' cognitive abilities are not obstructed by politicians using Facebook, instead, friends and family network seems more persuasive in determining voters' choice. Results manifest that ideological standpoint impacts voters' decisions substantially. There is no statistical difference in the voting behavior of respondents based on gender and/or age. The individuality of this study is that it focuses on the medium of communication between politicians and youth instead of emphasizing the social cleavages and their impact on voters' decisions, which Pakistani scholars largely study. This study will prompt the field of psephology in Pakistan, which is largely ignored, and help scholars to move out of the domain of identity politics. [ABSTRACT FROM AUTHOR]

One's attachment style forms early in life and can aid in dealing with future setbacks. Equally, Coping and resilience are two specific psychological mechanisms that form how one deals with problems and recovers from stressful situations. These three concepts are well-known interrelated concepts within psychology but to what extent they overlap is still unclear. The present study investigated attachment, resiliency and coping using structural equation modeling. Participants (N = 390), aged between 9 and 12 y old, completed an paper survey including Experiences in Close Relationship-Revised questionnaire (ECR-RC-12), Resiliency Scales for Children & Adolescents (RSCA), and the Brief-CPE (Coping Orientation to Problems Experienced). Path analysis revealed strong associations between attachment and resiliency as well as strong associations between resiliency and coping. Specifically, the predictive value of anxious attachment on resiliency was seen for all three resiliency sub-scales. However, the predictive value of avoidance attachment on resiliency was only revealed for two of the resiliency sub-scales. The two resiliency protective factors (sense of mastery and sense of relatedness) have a positive predictive value for three coping strategies. Equally, the resiliency risk factor (emotional reactivity) also positively predicted two coping strategies. The current findings demonstrate clear associations between these three concepts. Equally, the theoretical connections are discussed in light of these findings. Equally, stemming from this study, clinical implications are discussed that can inform practice in terms of approaching psychopathologies from different angles (resilience, coping, and attachment) as well as, the development of coping and resilience skills in order to support healthy development. [ABSTRACT FROM AUTHOR]

We compared the administration of the 9-item Patient Health Questionnaire (PHQ-9) to assess depressive symptoms using interactive voice response (IVR) technology with the method of administration using paper-and-pencil. Data were collected from 51 veterans participating in an 8-week randomized controlled trial of an illness management programme for heart failure. To counter possible bias in answering questions via IVR technology, the anchoring responses of the PHQ-9 questionnaire were reversed so that lower numbers corresponded to more severe depression. The mean for the pencil-andpaper administered PHQ-9 was 4.1 (SD = 4.5) and the mean for IVR administration was 2.8 (SD = 3.1). The internal consistency (Cronbach's alpha) of the PHQ-9 was 0.76 for IVR administration and 0.82 for paper administration. The intraclass correlation coefficient for the two modes of administration was 0.65, indicating moderate agreement. IVR administration of the PHQ-9 produces similar results to pencil-and-paper administration, but the former is not as sensitive to higher levels of depressive symptom severity. This suggests that a lower threshold for probable depression is warranted when assessing depressive symptoms with IVR. [ABSTRACT FROM AUTHOR]

Focuses on the methodological issues related to the measuring instruments used in evaluating the attitudes toward men and women. Format of questionnaires; Limitation on the test scales; Strategy in constructing test scales predicting gender behavior.

The pilot survey presented herein explores the possibilities given by three-dimensional (3D)-printed maps to students with visual impairment (VI) for learning the spatial distribution of geographic phenomena. The main research questions are: (a) whether students with VI can perceive two phenomena depicted on the same 3D-printed map and (b) whether they perform better when interacting with individual tactile maps for each spatial phenomenon than when interacting with a single 3D-printed map displaying the two spatial phenomena simultaneously. Our analysis indicates that 3D-printed maps can be a valuable alternative for the education of students with VI even when they represent two spatial phenomena simultaneously. [ABSTRACT FROM AUTHOR]

Introduction: Radiotherapy is the main treatment modality in cancer. There is sparse knowledge on how patients with cancer experience their radiotherapy trajectory, and which factors might be associated with patients' experiences. Objectives: The aim of the present study was to explore how adults with cancer receiving radiotherapy evaluate the quality of their care, utilizing a patient-reported experience measure, and how patient- and service-related characteristics are associated with their evaluation. Methods: An explorative cross-sectional study using a self-completed questionnaire to assess patients' radiotherapy experiences was performed. Participants were recruited consecutively, within their last week of treatment, from two different hospitals in Norway from January 2021 to January 2022. Four hundred and eighty paper questionnaires were distributed to recruited patients, 240 at each hospital. Questionnaires were self-completed at home and returned by mail. The instrument person-centered coordinated care experience questionnaire (P3CEQ) was used. In addition to this, participants completed the European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and The Sense of Coherence 13 scale (SOC-13). Data were analyzed using descriptive statistics, parametric tests, and unadjusted/adjusted linear regression models were estimated. Results: The study included 373 patients. Patients evaluated quality of care in terms of P3CEQ scores, with a mean score of 19.5 (standard deviation = 5.4). Lowest scores were identified in areas concerning person-centeredness and service coordination. There were no significant differences in P3CEQ scores between the younger and older groups. Having a partner and better SOC-13 scores were independently associated with the overall patient-reported experience score, whereas age was not. Conclusion: Patient-reported experience scores indicate that improvements are needed in some areas, such as informing and involving patients in the planning and coordination of their care. Findings suggest paying special attention to patients without a partner to offer patients the best possible care. [ABSTRACT FROM AUTHOR]

Background: Individualised goal-setting outcome measures can be a useful way of reflecting people living with dementia and family carers' differing priorities regarding quality-of-life domains in the highly heterogeneous symptomatology of the disease. Evaluating goal-setting measures is challenging, and there is limited evidence for their psychometric properties. Aim: (1) To describe what goal-setting outcomes have been used in this population; (2) To evaluate their validity, reliability, and feasibility in RCTs. Method: We systematically reviewed studies that utilised goal-setting outcome measures for people living dementia or their family carers. We adapted a risk of bias and quality rating system based on the COSMIN guidelines to evaluate the measurement properties of outcomes when used within RCTs. Results: Thirty studies meeting inclusion criteria used four different goal-setting outcome measures: Goal Attainment Scaling (GAS), Bangor Goal Setting Interview (BGSI), Canadian Occupational Performance Measure (COPM) and Individually Prioritized Problems Assessment (IPPA); other papers have reported study-specific goal-setting attainment systems. Only GAS has been used as an outcome over periods greater than 9 months (up to a year). Within RCTs there was moderate quality evidence for sufficient content validity and construct validity for GAS, COPM and the BGSI. Reliability was only assessed in one RCT (using BGSI); in which two raters reviewed interview transcripts to rate goals with excellent inter-rater reliability. Feasibility was reported as good across the measures with a low level of missing data. Conclusion: We found moderate quality evidence for good content and construct validity and feasibility of GAS, BGSI and COPM. While more evidence of reliability of these measures is needed, we recommend that future trials consider using individualised goal setting measures, to report the effect of interventions on outcomes that are most meaningful to people living with dementia and their families. [ABSTRACT FROM AUTHOR]

Recent research has shown an indirect effect of generativity on fear of death through ego-integrity in older adults. The present paper aims at demonstrating that the indirect effect is valid even when controlling for social desirability. For that purpose, participants (N = 260 German adults) in study 1 provided self-reports on generativity, ego-integrity, fear of death, and social desirability. Analyses confirmed the indirect effect when the tendency for socially desirable responding was statistically controlled. In study 2, participants (N = 133 German adults) also reported on their generativity and ego-integrity. Fear of death, however, was assessed with a reaction time-based measure (i.e., the Implicit Associations Test). Again, the indirect effect could be confirmed. Taken together, the studies lend further credibility to the extant findings on the indirect effect of generativity on fear of death through ego-integrity. [ABSTRACT FROM AUTHOR]

This paper describes the development and validation of an instrument to assess how students deal with emotionally challenging classroom situations (the DECCS Questionnaire). The questionnaire is based on a vignette with one learning and one performance situation in a classroom, and is intended for students in grades 4 to 7. On a sample of N = 639 students (M ag e = 10.6 years; SD = 1.25, 52.4% girls) in northwest Germany, factor analytic procedures for the subdimensions of students dealing with emotionally challenging classroom situations show that two factors can be distinguished each for students' appraisals, for students' adaptive behavior, for students' maladaptive behavior, and for students' desired teacher behavior. The questionnaire and subscales demonstrate good reliability and validity values. Thus, the DECCS questionnaire shows good psychometric properties and is well suited for determining how students deal with emotionally challenging classroom situations. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides new estimates of disability prevalence for the archipelago and mainland-residing Puerto Rican populations ages 40 and above and compares disability by place of birth and place of residence to investigate drivers of middle and older age health. Methods: Large nationally representative samples from 2013 to 2017 American Community Survey and Puerto Rico Community Survey data are used to estimate age-specific disability prevalence for archipelago-born/archipelago-residing, archipelago-born/mainland-residing, mainland-born/mainland-residing Puerto Ricans. Results: Mainland-born/mainland-residing Puerto Ricans have the lowest age-adjusted disability rates and archipelago-born/archipelago-residing Puerto Ricans have the highest rates. Differences in education explain part of this disparity. Discussion: Similarities in disability prevalence are strongest based on where one was born as opposed to current residence, pointing to early life as a critical period in the disablement process for later-life health. Early life socio-economic disadvantage on the archipelago may have an enduring impact on later-life disability prevalence for archipelago-born Puerto Ricans. [ABSTRACT FROM AUTHOR]

This study employs a poststructuralist theoretical framework to explore parents' attitudes towards children's right to play in Shanghai, China. It adopted mixed methods of online questionnaires (N = 880) and semi-structured interviews (N = 11). The findings suggest that participants struggle with embracing and practising children's right to play as defined by the United Nations Convention on the Rights of the Child (UNCRC), reflecting culturally-sensitive and -contextualised concerns around their children's future success. Those concerns are connected with the hegemony of Confucianism in shaping educational values in Chinese education. In the context of globalisation, this paper points to the empowerment of parents in practising children's rights to play in China. [ABSTRACT FROM AUTHOR]

Design thinking, having applications in many fields, is emerging to be a pragmatic technique for facilitating Human Centred Design (HCD), a modern-day necessity, through a well-defined systematic process. This paper presents a case study detailing the application of design thinking principles to approach and develop solutions for the visually challenged to recognize the denomination of Indian currencies. Throughout the paper, specific implementations of design thinking principles have been detailed with emphasis on the key takeaways from the various stages. A comprehensive review of our approach compared to existing and unconventional applications has been provided to underline the importance of incorporating design thinking into emergent consumer-oriented solutions. A lot of research has been done in developing denomination classification models, however, there seems to be a lack of solutions designed through the perspective of a blind person who plays the critical factor in determining effectiveness once deployed. The design procedure helped us realize the importance of developing a simple user-friendly interface with a single input button and audio relays to guide the blind user during operation. Establishing a good platform for interaction and feedback was found to be critical in helping us modify and prioritize aspects such as achieving a low false-positive percentage and the addition of a high threshold Softmax function which made the solution design effective. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) often coexists with lower airway disease. With the overlap between upper and lower airway disease, optimal management of the upper airways is undertaken in conjunction with that of the lower airways. Biologic therapy with targeted activity within the Type 2 inflammatory pathway can improve the clinical signs and symptoms of both upper and lower airway diseases. Knowledge gaps nevertheless exist in how best to approach patient care as a whole. There have been sixteen randomized, double-blind, placebo-controlled trails performed for CRSwNP targeted components of the Type 2 inflammatory pathway, notably interleukin (IL)-4, IL-5 and IL-13, IL- 5R, IL-33, and immunoglobulin (Ig)E. This white paper considers the perspectives of experts in various disciplines such as rhinology, allergy, and respirology across Canada, all of whom have unique and valuable insights to contribute on how to best approach patients with upper airway disease from a multidisciplinary perspective. Methods: A Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. A national multidisciplinary expert panel of 34 certified specialists was created, composed of 16 rhinologists, 7 allergists, and 11 respirologists who evaluated the 20 original statements on a scale of 1–9 and provided comments. All ratings were quantitively reviewed by mean, median, mode, range, standard deviation and inter-rater reliability. Consensus was defined by relative interrater reliability measures—kappa coefficient (κ ) value > 0.61. Results: After three rounds, a total of 22 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with upper airway disease. Conclusion: This white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of upper airway disease from a multidisciplinary perspective, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years. [ABSTRACT FROM AUTHOR]