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Background: The implementation science literature acknowledges a need for engagement of key stakeholders when designing, delivering and evaluating implementation work. To date, the literature reports minimal or focused stakeholder engagement, where stakeholders are engaged in either barrier identification and/or barrier prioritisation. This paper begins to answer calls from the literature for the development of tools and guidance to support comprehensive stakeholder engagement in implementation research and practice. The paper describes the systematic development of the Implementation‐STakeholder Engagement Model (I‐STEM) in the context of an international, large‐scale empirical implementation study (ImpleMentAll) aimed at evaluating the effectiveness of a tailored implementation toolkit. The I‐STEM is a sensitising tool that defines key considerations and activities for undertaking stakeholder engagement activities across an implementation process. Methods: In‐depth, semistructured interviews and observations were conducted with implementers who were tailoring implementation strategies to integrate and embed internet‐based cognitive behavioural therapy (iCBT) services in 12 routine mental health care organisations in nine countries in Europe and Australia. The analytical process was informed by principles of first‐ and third‐generation Grounded Theory, including constant comparative method. Results: We conducted 55 interviews and observed 19 implementation‐related activities (e.g., team meetings and technical support calls). The final outcome of our analysis is expressed in an initial version of the I‐STEM, consisting of five interrelated concepts: engagement objectives, stakeholder mapping, engagement approaches, engagement qualities and engagement outcomes. Engagement objectives are goals that implementers plan to achieve by working with stakeholders in the implementation process. Stakeholder mapping involves identifying a range of organisations, groups or people who may be instrumental in achieving the engagement objectives. Engagement approaches define the type of work that is undertaken with stakeholders to achieve the engagement objectives. Engagement qualities define the logistics of the engagement approach. Lastly, every engagement activity may result in a range of engagement outcomes. Conclusion: The I‐STEM represents potential avenues for substantial stakeholder engagement activity across key phases of an implementation process. It provides a conceptual model for the planning, delivery, evaluation and reporting of stakeholder engagement activities. The I‐STEM is nonprescriptive and highlights the importance of a flexible, iterative approach to stakeholder engagement. It is developmental and will require application and validation across a range of implementation activities. Patient or Public Contribution: Patient contribution to ImpleMentAll trial was facilitated by GAMIAN‐Europe at all stages—from grant development to dissemination. GAMIAN‐Europe brings together a wide variety of patient representation organisations (local, regional and national) from almost all European countries. GAMIAN‐Europe was involved in pilot testing the ItFits‐toolkit and provided their views on the various aspects, including stakeholder engagement. Patients were also represented in the external advisory board providing support and advice on the design, conduct and interpretation of the wider project, including the development of the ItFits‐toolkit. Trial registration: ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018. [ABSTRACT FROM AUTHOR]

The aim of this paper is to assess to what extent prohibitive drug policies hamper the management of drug problems from the perspective of young people who have experience with the criminal justice systems (CJS). Qualitative, in-depth interviews were carried out in six European countries (Austria, Denmark, Germany, Italy, Poland, and the UK) following a common interview guide to obtain comparative data on the life trajectories of drug experienced youth. Altogether 198 interviews with people aged 14–25 years were collected and analysed by national teams following a common coding book. Unintended consequences of drug policies for the individual and society were identified. Individual consequences included health consequences and traumatic experiences with law enforcement. Social consequences included those affecting social relations such as stigmatisation and those impacting on institutions, for example, focusing on drug use and neglecting other problems. This paper confirmed earlier research indicating unintended consequences of prohibitive drug policies but also added to the literature its cross-national perspective and use of young people narratives as a source of analyses. There are, however, policy measures available that may reduce the volume and range of unintended effects. Their implementation is crucial to reduce the array of unintended consequences of prohibitive drug policies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to explore and theorise about the desistance process of Maltese mothers who previously used drugs. The study unpacks how initial and continued desistance from high-risk drug use (HRDU) is impacted by being a mother within the Maltese context and identifies contingencies for desistance and examines how they are negotiated along the desistance pathways. Design/methodology/approach: The study adopted a symbolic interactionist-inspired career framework and involved in-depth exploration of trajectories of mothering and desistance of eight Maltese women with a history of HRDU. Data were gathered through in-depth interviews and analysis used an evolved grounded theory methodology. Findings: Four explanatory categories were identified in the interview data to document the role of mothering in the various pathways to desistance recounted by the women. These are: becoming a mother; differing pathways of desistance in relation to mothering; the lived experience; identity negotiation and transformation. This study highlights how identity fluidity and transformation is central to the desistance process. Practical implications: The paper aims to inform policy and practice with mothers who use drugs and their families and has important implications for the development and delivery of gender transformative interventions. Originality/value: This study challenges taken-for-granted beliefs about the influence of mothering on desistance and identifies the complexities involved. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: ●Expert by Experience participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goal.●Involving mental health Experts by Experience in the education of nursing students demonstrates positive attitudinal change. What the paper adds to existing knowledge: ●The paper presents perspectives from Experts by Experience about the unique knowledge and expertise they derive from their lived experience of mental distress and mental health service use. As a result, they can make a unique and essential contribution to mental health nursing education. They utilize this knowledge to create an interactive learning environment and encourage critical thinking.●The international focus of this research enriches understandings about how Experts by Experience might be perceived in a broader range of countries. What are the implications for practice: ●Mental health policy articulates the importance of service user involvement in all aspects of mental health service delivery. This goal will not be fully achieved without nurses having positive attitudes towards experts by experience as colleagues.●Positive attitudes are more likely to develop when nurses understand and value the contribution experts by experience bring by virtue of their unique knowledge and expertise. This paper provides some important insights to achieving this end. Introduction: Embedding lived experience in mental health nursing education is increasing, with research findings suggesting the impact is positive. To date, research has primarily targeted the perspectives of nursing students and academics from the health professions. Aim: To enhance understanding of the unique knowledge and expertise experts by experience contribute to mental health nursing education. Methods: Qualitative exploratory research methods were employed. In‐depth individual interviews were conducted with experts by experience who delivered a coproduced learning module to nursing students in Europe and Australia. Results: Participants described their unique and essential contribution to mental health nursing education under four main themes: critical thinking, beyond textbooks; interactive and open communication; understanding personal recovery; and mental health is health. Conclusions: These findings present an understanding of the unique knowledge and expertise Experts by Experience contribute to mental health education not previously addressed in the literature. Appreciating and respecting this, unique contribute is necessary as Expert by Experience contributions continue to develop. Implications for Practice: Mental health services purport to value service user involvement. Identifying and respecting and valuing the unique contribution they bring to services is essential. Without this understanding, tokenistic involvement may become a major barrier. [ABSTRACT FROM AUTHOR]

Mobile applications for digital contact tracing have been developed and introduced around the world in response to the COVID-19 pandemic. Proposed as a tool to support 'traditional' forms of contact-tracing carried out to monitor contagion, these apps have triggered an intense debate with respect to their legal and ethical permissibility, social desirability and general feasibility. Based on a large-scale study including qualitative data from 349 interviews conducted in nine European countries (Austria, Belgium, France, Germany, Ireland, Italy, the Netherlands, German-speaking Switzerland, the United Kingdom), this paper shows that the binary framing often found in surveys and polls, which contrasts privacy concerns with the usefulness of these interventions for public health, does not capture the depth, breadth, and nuances of people's positions towards COVID-19 contact-tracing apps. The paper provides a detailed account of how people arrive at certain normative positions by analysing the argumentative patterns, tropes and (moral) repertoires underpinning people's perspectives on digital contact-tracing. Specifically, we identified a spectrum comprising five normative positions towards the use of COVID-19 contact-tracing apps: opposition, scepticism of feasibility, pondered deliberation, resignation, and support. We describe these stances and analyse the diversity of assumptions and values that underlie the normative orientations of our interviewees. We conclude by arguing that policy attempts to develop and implement these and other digital responses to the pandemic should move beyond the reiteration of binary framings, and instead cater to the variety of values, concerns and expectations that citizens voice in discussions about these types of public health interventions. [ABSTRACT FROM AUTHOR]

Research demonstrates that relationships are key when working to support young people affected by sexual violence. Within these relationships, young people show a preference for non‐judgemental, flexible, consistent and informal support. Peer support – defined here as support provided by those with similar experiences – is however an uncharted area for assisting young people affected by sexual violence. This paper draws on interviews with 25 respondents with knowledge and experience of setting up, supervising and/or participating in peer support initiatives for young people impacted by different forms of sexual violence in Europe and North America. The article highlights how one form of peer support, peer or 'survivor' mentoring, can provide emotional and social support; create space for 'normality'; and give choices to young people. It outlines three unique dimensions to the support provided by peers more generally: relatability, credibility and translatability. The discussion reflects on what this might mean for traditional support provided by professionals. It also draws attention to the significance of recognising both the variety of experience and identity of young survivors of sexual trauma and the impact this may have on promoting relatability within relationships. [ABSTRACT FROM AUTHOR]

Background: The concept of stigma has been widely used to understand patterns of discrimination and negative ideas surrounding people with mental health problems, yet we know little of the specific nuances of how this might operate beyond the 'Global North'. Aim: This paper aims to explore the notion of stigma in an Indian context by considering the lived experience of patients, carers and community members. Methods: A sample of 204 participants, representing mental health patients, informal carers and community members was recruited from urban and rural areas in Kerala, India. Participants took part in interviews where they were encouraged to talk about their experiences of mental ill health, attitudes towards these problems, barriers encountered and sources of support. Results: Experiences akin to the experience of stigma in Europe and the United States were elicited but there were important local dimensions specific to the Indian context. The difficulties faced by people with diagnoses of mental disorders in finding marriage partners was seen as an important problem, leading to marriage proposals being refused in some cases, and secrecy on the part of those with mental health problems. Rather than the 'self-stigma' identified in the US, participants were more likely to see this as a collective problem in that it could reflect badly on the family group as a whole rather than just the sufferer. Conclusions: In the Indian context, the idioms of stigma emphasised impairments in marriage eligibility and the implications for the family group rather than just the self. [ABSTRACT FROM AUTHOR]

Applied theories in social work are social constructs that evolve according to cultural, political and social trends. The history of community work in Europe after the Second World War provides an example of a family of practices that is constantly evolving, in terms of its integration into social work, its methods, and the political project that underpins it. While the development of broad-based and conscientising approaches were challenged by neo-liberalism from the 1980s on, community work practice is currently undergoing a revival based on community building and person-centred methods, under the influence of the new public management. This paper is based on a doctoral research conducted in six European countries, examining the relationship between social work and community work, and the various forms of community work across Europe. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of the Paediatric International Nursing Study was to explore the utility of key performance indicators in developing person-centred practice across a range of services provided to sick children. The objective addressed in this paper was evaluating the use of these indicators to benchmark services internationally. Background This study builds on primary research, which produced indicators that were considered novel both in terms of their positive orientation and use in generating data that privileges the patient voice. This study extends this research through wider testing on an international platform within paediatrics. Design The overall methodological approach was a realistic evaluation used to evaluate the implementation of the key performance indicators, which combined an integrated development and evaluation methodology. Methods The study involved children's wards/hospitals in Australia (six sites across three states) and Europe (seven sites across four countries). Qualitative and quantitative methods were used during the implementation process, however, this paper reports the quantitative data only, which used survey, observations and documentary review. Results The findings demonstrate the quality of care being delivered to children and their families across different international sites. The benchmarking does, however, highlight some differences between paediatric and general hospitals, and between the different key performance indicators across all the sites. Conclusions The findings support the use of the key performance indicators as a novel method to benchmark services internationally. Whilst the data collected across 20 paediatric sites suggest services are more similar than different, benchmarking illuminates variations that encourage a critical dialogue about what works and why. Relevance to clinical practice The transferability of the key performance indicators and measurement framework across different settings has significant implications for practice. The findings offer an approach to benchmarking and celebrating the successes within practice, while learning from partners across the globe in further developing person-centred cultures. [ABSTRACT FROM AUTHOR]

Whilst 50% of child protection workers across much of Europe and the affluent ‘West’ leave after two years, many stay and develop substantial professional careers. This paper discusses research in Italy, Sweden and England examining what factors explain ‘remaining’ for more than three years in this stressful job. Underpinned by a hermeneutic epistemology, qualitative interviews were undertaken and subject to an interpretative thematic analysis. The findings proved to be complex and multi-layered and this paper presents an overview of these. The theoretical framework for the project mainly drew on organisations and resilience, and the initial sections of the paper consider how formulations of resilience as contextual and relational can elucidate professional sustainability. Organisational issues are considered, including the impact of work management, of supervision and of allocation in different national contexts. The paper also focuses on the role of friendships and informal support at work. Threaded through these established themes are more, perhaps surprising, concepts: for example, creativity, power, reflexive spaces and interpersonal relations as explanatory of remaining in child protection work. [ABSTRACT FROM AUTHOR]

Objective: To explore the availability and accessibility of medically assisted reproduction (MAR) for people living with HIV in Europe, including the feasibility of cross‐border care. Methods: We used a polymorphous engagement approach, primarily based on digital and email‐based interviews with representatives of national HIV organizations, clinical researchers (infectious disease and/or infertility specialists), European and national professional societies (fertility and/or infectious disease), national regulatory authorities and individual clinics in 14 countries in the WHO European region. The research design and results were also informed by two surveys and a review of the secondary literature, news articles and clinic websites. Results: Although MAR is possible for people living with HIV in 12 out of the 14 countries mapped, accessing services can be challenging for logistical or financial reasons. People living with HIV also face barriers to MAR independent of their HIV status, such as limitations on single women and same‐sex couples accessing services. Cross‐border care is available for most patients who are self‐financing but is limited for publicly funded patients. Conclusions: Even when MAR is available to and accessible for people living with HIV, there may still be barriers to treatment. Further research on patient experiences is needed to understand these discrepancies between availability and accessibility on paper and in practice. [ABSTRACT FROM AUTHOR]

Background: The aim of the study is to analyse the association between job stress and interpersonal relationships on and outside of the job in Europe. The main assumption of the paper is that since social relations at various levels enhance individual well-being, they may counteract stress created by an unfavourable work environment.Methods: The econometric analysis, based on a standard ordered probit model, employs data taken from the Sixth European Working Conditions Survey carried out in 2015 and released in 2017.Results: The results show significant correlations between interpersonal contacts on and outside of the job and job stress. Help and support provided by one's manager decreases the probability of being stressed at work, while receiving help and support from co-workers is likely to increase the probability of job stress occurrence. However, maintaining cooperation and getting on well with colleagues decrease the probability of experiencing stress, confirming the positive and gratifying features of contact with co-workers reported by the literature.Conclusions: While we were not able to establish the direction of causality between job stress and interpersonal relationships (a limitation of this paper), the present work contributes new evidence to the literature on occupational stress. Our results show that interpersonal relationships on and outside of the job can be considered valuable resources that, when available to an individual, are useful for managing stress created by workplace stressors. [ABSTRACT FROM AUTHOR]

Purpose: Research has long focused on the notion of access and the trajectory towards a healthcare encounter but has neglected what happens to patients after these initial encounters. This paper focuses attention on what happens after an initial healthcare encounter leading to a more nuanced understanding of how patients from a diverse range of backgrounds make sense of medical advice, how they mix this knowledge with other forms of information and how they make decisions about what to do next. Design/methodology/approach: Drawing on 160 in-depth interviews across four European countries the paper problematizes the notion of access; expands the definition of "decision partners"; and reframes the medical encounter as a journey, where one encounter leads to and informs the next. Findings: This approach reveals the significant unseen, unrecognised and unacknowledged work that patients undertake to solve their health concerns. Originality/value: De-centring the professional from the healthcare encounter allows us to understand why patients take particular pathways to care and how resources might be more appropriately leveraged to support both patients and professionals along this journey. [ABSTRACT FROM AUTHOR]

Amidst the widespread stigma and exclusion attached to dementia in dominant narratives of successful ageing, this article addresses a gap in the scientific literature concerning our understanding of the medicalization of cognitive decline as a natural phenomenon. To this end, it explores how a dementia diagnosis acquires its symbolic power of exclusion in later life through an ethnography of cognitive rehabilitation therapy in two memory clinics in a southern European nation. It argues that this symbolic power of exclusion is locally produced through the meaning making practices of therapists and researchers administering regular cognitive training therapy and exercises to support autonomy. It shows how the different steps involved in rehabilitation play a role in dividing later life by defining and reifying a category of abnormal ageing during the cognitive assessment, and by applying a confrontational approach exposing decline. It shows how this approach generates the position of older adults who can be rehabilitated against those who cannot; the latter representing a "failed" ageing in the narrative of successful ageing. This article proposes the adoption of the concept of "technologies of ascription" to characterize this process of exclusion through reification and confrontation of "abnormal cognitive decline." The paper argues that such practices are central to the local production of the symbolic power attached to a dementia diagnosis as well as its capacity to fragment later life. Finally, it argues for the utility of this concept in offering new opportunities for anthropology to characterize exclusion in later life through medicalization. [ABSTRACT FROM AUTHOR]

The internationalization of universities and the aging of the global population are two current issues that converge and challenge undergraduate gerontology curriculum development in Canada. One response to this challenge is to envision an intercultural gerontology curriculum. What might this curriculum encompass? How might it be taught? An exploratory study was undertaken to address these two questions. This paper presents findings from this study based primarily on interviews with university-based stakeholders from Canada, the United States, and Europe. Thematic analysis of the interviews resulted in five themes: multiple perspectives on cultural diversity; the dynamic nature of cultural diversity and aging; flow of an intercultural curriculum; institutional culture and intercultural curricula; and principles and practice for intercultural gerontology. Framed by principles of gerontology theory and educational approaches, this paper focuses on the principles and practice suggested by study participants. Scaffolding learning, active learning strategies, experiential learning opportunities, teacher modelling, and internet-based learning are discussed as key to intercultural learning. An appendix includes a list of resources that may be useful to developing an intercultural gerontology curriculum. [ABSTRACT FROM AUTHOR]

Background: People with dementia are often marginalized and excluded from influence, also in relation to dementia research. There is, however, a growing requirement for inclusion through Patient and Public Involvement (PPI), but there is still limited knowledge on how researchers can fully benefit from the involvement of people with dementia in the development and testing of psychosocial interventions. This paper describes the results of a pan‐European consultation with people with dementia, synthesizing their views on outcomes of psychosocial interventions. Objective: To involve people with dementia in establishing what are meaningful outcomes when participating in psychosocial interventions. Setting and participants: Consultations took place at four divergent sites across Europe, involving twenty‐five people with dementia from nine European countries. Methods: The methods used for the consultation were developed through an iterative process involving people with dementia. Data from the consultation were analysed from a thematic analysis approach. Results: The results suggested that people with dementia wish to participate in interventions that enhance their well‐being, confidence, health, social participation and human rights. This highlights a need for improvements in psychosocial research to capture these outcomes. Discussion and conclusions: Involving people with dementia in discussions of psychosocial interventions has enhanced our understanding about meaningful outcome measures in research and methods of data collection. This study suggests that new outcome measures in psychosocial research are needed where concepts of positive psychology and social health can guide innovation and outcome measurement. [ABSTRACT FROM AUTHOR]

Objective Tobacco companies have made extensive efforts to build alliances against comprehensive smoke-free legislation. This article analyses the interaction between actors who opposed the development of the European Council Recommendation on smoke-free environments. Methods Drawing on data from 200 policy documents and 32 semistructured interviews and using qualitative textual analysis and organisational network analysis, opponents' positions on, and responses to, the policy initiative, strategies to oppose the policy, and efforts to build alliances were investigated. Results The non-binding nature of the policy, scientific evidence and clear political will to adopt EU-wide measures combined to limit the intensity of commercial sector opposition to the comprehensive EU smoke-free policy. Most tobacco companies, led by the Confederation of European Community Cigarette Manufacturers (CECCM), voiced reservations against the proposal, criticised the policy process and fought flanking measures on product regulation. However, some companies focused on instigating harm reduction debates. These divergent approaches and the reluctance of other commercial actors to demonstrate solidarity with the tobacco sector prevented the establishment of a cohesive commercial sector alliance. Conclusions The comparatively limited opposition to EU smoke-free policy contrasts with previous accounts of tobacco industry resistance to tobacco control. While context-specific factors can partially explain these differences, the paper indicates that the sector's diminished credibility and lack of unity hampered political engagement and alliance building. Industry efforts to emphasise the benefits of smokeless tobacco during smoke-free policy debates highlight the potential of harm reduction as a gateway for tobacco companies to re-enter the political arena. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work within OptTEST by HiE has been to demonstrate the role of legal and regulatory barriers in hindering access to HIV testing, treatment and care across Europe and to produce tools to help dismantle them. Methods: An online survey to assess country‐specific data on legal and regulatory barriers distributed widely across the WHO Europe region. Literature reviews conducted in January‐October 2015 in English, in November 2015 in Russian, and updated in April 2017. Semi‐structured interviews were conducted with 25 key actors within the HIV field to feed into case studies and tip sheets on how to dismantle legal and regulatory barriers. Results: More than 160 individuals and organisations from 49 countries across the WHO European region provided responses which were analysed and cross checked with other data sources and a searchable database produced (legalbarriers.peoplewithhiveurope.org). The conducted literature reviews yielded 88 papers and reports which identify legal and regulatory barriers to key populations’ access to HV testing and care. Based on the interviews with key actors, ranging from PLHIV activists to government officials, on lessons‐learned, a series of tip sheets and ten case studies were written‐up intended to inform and inspire the HIV community to address and overcome existing barriers (opttest.eu/Tools). Conclusion: While some of the barriers identified may require major changes to wider health systems, or long term legal reform, many are open to a simple change in regulations or custom and practice. We have the tools. Why can't we finish the job? [ABSTRACT FROM AUTHOR]

This paper examines the influence of the Troika on the retrenchment and reform of social security in Ireland during its bailout between 2010 and 2013. To do this, it draws on data from in-depth interviews with senior civil servants and civil society organisation staff who met with the Troika as part of their quarterly missions to Ireland during this period. The key themes which emerged from these interviews include the largely domestic origins of social security retrenchment and reform; the surprising, and distinctive, positions adopted by the European Commission and the International Monetary Fund (IMF); the extent of the Irish government's room for manoeuvre in this area, and the ways in which the Irish government defended social security against proposals for additional cuts put forward by the Troika. The paper concludes by arguing that the scope for domestic decision-making was heavily constrained, yet non-trivial, and that the Troika's influence comprised not only ‘powering’ but also ‘persuasion’. [ABSTRACT FROM PUBLISHER]

Purpose: People with mental disorders experience higher rates of disability and mortality disproportionately than the general population. Until recently, psychiatric palliative care (PPC) for people with serious mental illness (SMI) was not explored as a treatment option. This paper aims to explore the feasibility of PPC as a supportive care model for people with serious mental illness. Design/methodology/approach: Fifteen health-care professionals' in the USA and Europe participated in semi-structured phone interviews regarding PPC for people with SMI. The Qualitative Analysis Guide of Leuven (QUAGOL) was used to conduct thematic analysis of the data. Findings: PPC was identified as a supportive care model that could improve quality of life and enhance patient autonomy for people with SMI. While PPC was endorsed as a possible new standard of care, it is imperative that the model be piloted to determine its efficacy as a viable treatment option among adults. Originality/value: There are limited studies that investigate the perceptions of health professionals' regarding the use of PPC as a treatment option for people with SMI. [ABSTRACT FROM AUTHOR]

The engagement of young people has been a neglected area in youth justice and drug policy and practice. This paper explores the concept of 'engagement' in relation to drug interventions in custodial and community settings in different European countries. Interviews were undertaken with young people (aged 14–25 years) in contact with the criminal justice system who use illegal drugs and with practitioners involved in the delivery of interventions for our target group in Denmark, Italy, Poland, and the UK. The key techniques to engage young people were described in similar terms across the countries. These included forming relationships based on trust, honesty, and empathy, setting goals collaboratively, and employing practitioners with lived experience and understanding. The objectives and activities on offer are often constrained by criminal justice contexts. Despite the differences between the countries in terms of criminal justice systems and the structure of drug interventions, there were remarkable similarities in the ways young people and practitioners described effective engagement. Strong emphasis on operational engagement to ensure positive relationships between young people and practitioners was important in the design and delivery of interventions. Practitioners working in criminal justice contexts need to have flexibility and autonomy to work creatively to find ways to engage, connect, and inspire young people. [ABSTRACT FROM AUTHOR]

Based on research undertaken as part of the EU funded EPPIC project, this paper aims to update and elaborate on the relationship between drug use and offending behaviours by exploring variations within a cross-national sample of drug-experienced young people in touch with criminal justice systems. Adopting a trajectory-based approach, interviews were undertaken with 198 young people aged 15–25 in six European countries (Austria, Denmark, Germany, Italy, Poland, and UK). Data were analysed by applying the Bennett and Holloway categorization of the drugs-crime link, with a focus on the concept of social exclusion as developed by Seddon. Three main types of mechanisms (economic, pharmaceutical, and lifestyles) are used to interpret the data, showing how the relationship between drugs and offending can vary according to type of substances and over time. Furthermore, it can be associated with very different degrees of social exclusion and needs. The results suggest that while economic inequalities still play key roles in explaining drug use and offending, both behaviours can originate from a state of relative deprivation, resulting from the contradictions inherent in 'bulimic societies' that raise aspirations and desires while providing young people scarce opportunities for self-realisation and social recognition. [ABSTRACT FROM AUTHOR]

BACKGROUND: This paper presents part of the work undertaken by the European Network for Technology Enhanced Learning in an Inclusive Society (ENTELIS) to respond to the need for bridging the digital divide. It is based on previous evidence of lack of digital skills of people with disabilities of all ages to effectively participate in the digital society. OBJECTIVE: The paper aims to present the results of an exploratory study conducted in different European countries in order to identify needs, barriers, opportunities and good practices. METHODS: Data collection included the collection of experiences and best practices, and interviews conducted with different groups of people with disabilities of all ages and other stakeholders in five countries. RESULTS: Results emphasize the vital role of ICT-AT for independence, social integration, educational success, employment opportunities, and overall quality of life, while there seems to be heterogeneity in the way technology is considered and utilized among various groups of PwD. A number of challenges and barriers for ICT-AT competence development are also identified. CONCLUSIONS: Considerations and suggestions for further research, for policy and for practice implications are discussed, mainly focused on reducing the abandonment of ICT-AT, on responding to user's heterogeneous needs and on strengthening facilitating factors for the acquisition of digital competencies. [ABSTRACT FROM AUTHOR]

The current study explores the ways in which Greek migrants in their early adulthood position themselves in discourse on mobility decisions. For the purposes of the study, 17 virtual interviews with Greek migrants (aged between 25–40 years old) in European cities were conducted. Analysis, based on the principles of critical discursive social psychology, indicated that, in their accounts of migration decision‐making, participants positioned themselves in various ways: as career/job seekers, as adventurers, as well as (personal or institutional/economic) crisis‐ridden individuals. Multiple subject positions were constituted by an amalgam of rational/practical and affective repertoires which depicted migration as a multifaceted, dynamic and non‐linear project. Analysis also highlighted the multiple spatial (transnational, national and local) and dynamic temporal constructions mobilized by participants, in order to construct their motivations for migrating. Discussion of findings suggests that social psychology (a) can vitally contribute to migration literature, by considering ways in which social actors position themselves by the use of historically and culturally specific resources and by their orientation to local interactional concerns in the context of accounting for their mobility and (b) can be benefited by considering spatial and temporal aspects in the analysis of migration. [ABSTRACT FROM AUTHOR]

The paper aims at exploring how the university understands, manages and improves the quality culture related to the national and European/international principles of quality assurance, based on interviews having as subject academic staff, students and partners/employers. After a brief introduction and the presentation of the scope and methodology of the research the paper relates some issues of quality culture in the higher education to the literature, followed by a briefing presentation of the results. The main findings are discussed in correlation with the questions used with the interviews: the presence of the university in the social-economical life, the continuing improvement of the quality of teaching-learning process, the satisfaction of participation/collaboration on research projects, the students' involvement in the university governance and life and the role of quality culture system in assuring the university beneficiaries expectations. Finally, a quality culture system and some reflective views are proposed. [ABSTRACT FROM AUTHOR]

The social work profession in Albania is relatively young and social services in the country continue to develop. But over the past three decades, Albania has experienced significant growth and transformation in its social work education programmes. Nevertheless, there is very little published work on the Albanian social work education system and its implementation on the ground. Currently, the main sources of social work graduates are three Schools of Social Work in Tirana, Shkodra, and Elbasan. Programmes at the bachelor's and master's level all incorporate policy, research, and practice education. The social work curriculum, originally transplanted from the United States, has gone through reforms following the Bologna process and continues to be revised to meet local needs. Drawing from a multi-country study of the social service workforce in southeast Europe, this paper presents baseline data on social work education in Albania. 62 participants were interviewed using semi-structured interviews, case stories, and focus group discussions with consensus-building exercises. The findings highlight both the opportunities and challenges of this relatively young profession in Albania. Besides increasing understandings of social work education in Albania, this research adds to emerging regional and global themes in the development of social work education and practice. [ABSTRACT FROM AUTHOR]

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The research field of crisis informatics examines, amongst others, the potentials and barriers of social media use during conflicts and crises. Social media allow emergency services to reach the public easily in the context of crisis communication and receive valuable information (e.g. pictures) from social media data. However, the vast amount of data generated during large-scale incidents can lead to issues of information overload and quality. To mitigate these issues, this paper proposes the semi-automatic creation of alerts including keyword, relevance and information quality filters based on cross-platform social media data. We conducted empirical studies and workshops with emergency services across Europe to raise requirements, then iteratively designed and implemented an approach to support emergency services, and performed multiple evaluations, including live demonstrations and field trials, to research the potentials of social media-based alerts. Finally, we present the findings and implications based on semi-structured interviews with emergency services, highlighting the need for usable configurability and white-box algorithm representation. [ABSTRACT FROM AUTHOR]

To evaluate critically the common assumption that consumers purchase goods and services on an off-the-books basis so as to save money, this paper reports a 27-nation European survey that interviewed 26,659 citizens in 2007 about their undeclared transactions. This reveals that saving money is the sole motive in just 31% of off-the-books transactions, one of several rationales in 35% of exchanges, and not cited as a rationale in the remaining 34% of cases. Besides saving money, such transactions are conducted to circumvent the shortcomings of formal sector provision in terms of its availability, speed, reliability and quality, as well as for social and redistributive rationales. The paper concludes by discussing the implications for tackling Europe's cash-in-hand consumer culture. [ABSTRACT FROM AUTHOR]

This paper focuses on the diversity in patients' experience of biomedicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients' choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to provide insight into teachers’ practice in implementing school-based health promotion. Design/methodology/approach – This qualitative research was designed as a multiple case study. The study involved five schools, 233 pupils in the age 12-16 and 23 teachers. The primary data generation method were focus groups. Findings – According to the national guidelines the health education in primary schools in Denmark should be based on the critical approach to health education developed within the European Network of Health Promoting Schools. However, the study showed that teachers’ implementation of the guidelines in practice was closer to traditional health education, which focuses only lifestyle change, than to critical health education which also explores the underlying conditions for health. Research limitations/implications – The study explored teachers’ implementation practices, and the individual and institutional factors that influence the practice. This paper restricts itself to examining teachers’ practice against the national curriculum guidelines. Practical implications – The teachers were not sufficiently familiar with the curriculum guidelines or the critical approach to health education. The inclusion of the national curriculum and the principles of critical health education in the initial and in-service professional development of teachers is an urgent priority if this gap is to be reduced. Originality/value – This paper contributes to the debate related to the potentials and barriers for implementing of health promotion interventions in a school context. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results. However, the integration between these apps and PHC has not been thoroughly explored in Europe. Objective: To describe if governmental COVID-19 apps allowed COVID-19 patients to connect with PHC through their apps in Europe and to examine how the Digital COVID-19 Certificate was obtained. Methodology: Design and setting: Retrospective descriptive study in PHC in 30 European countries. An ad hoc, semi-structured questionnaire was developed to collect country-specific data on primary healthcare activity during the COVID-19 pandemic and the use of information technology tools to support medical care from 15 March 2020 to 31 August 2021. Key informants belong to the WONCA Europe network (World Organization of Family Doctors). The data were collected from relevant and reliable official sources, such as governmental websites and guidelines. Main outcome measures: Patient's first contact with health system, governmental COVID-19 app (name and function), Digital COVID-19 Certification, COVID-19 app connection with PHC. Results: Primary care was the first point of care for suspected COVID-19 patients in 28 countries, and 24 countries developed apps to complement classical medical care. The most frequently developed app was for tracing COVID-19 cases (24 countries), followed by the Digital COVID-19 Certificate app (17 countries). Bulgaria, Italy, Serbia, North Macedonia, and Romania had interoperability between PHC and COVID-19 apps, and Poland and Romania's apps considered social needs. Conclusions: COVID-19 apps were widely created during the first pandemic year. Contact tracing was the most frequent function found in the registered apps. Connection with PHC was scarcely developed. In future pandemics, connections between health system levels should be guaranteed to develop and implement effective strategies for managing diseases. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. Design: A multi‐country, phenomenological, qualitative study. Methods: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Results: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. Conclusions: A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. Implications for the profession: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Impact: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Public Contribution: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement. [ABSTRACT FROM AUTHOR]

In recent decades, disappointing poverty trends and welfare state limitations in many European countries – including constraints on minimum income benefits – have paved the way for a larger role of the third sector. An interesting but controversial form of third-sector in-kind support is food aid provision. In Europe, food aid is, so far, a non-rights-based practice displaying worrisome discretionary and stigmatizing characteristics. Yet, the phenomenon of food aid in Europe has spread, professionalized, and penetrated the institutions of the welfare state. This raises the question if, how and to what extent food aid plays a role in bypassing structural constraints on minimum income protection. This article applies an exploratory case study approach to estimate the monetary value of food aid in relation to statutory minimum incomes in four EU-countries. We use cross-nationally comparable food reference budgets to price food aid packages in Belgium, Finland, Hungary and Spain. The results show that food aid, although not sufficient to close the at-risk-of-poverty gap, is non-trivial for some European households. In Spain and Belgium food aid packages can reach up to €100 a month (expressing 7% to 11% of respective minimum income benefit levels). Importantly, we perceive (formalized) cooperation and interaction between local welfare agencies and food charities in all countries, suggesting that welfare state actors use non-rights-based food aid for filling gaps in the social safety net. The large between- and within-country variation of the monetary values of food aid packages points, however, to food aid as a problematic discretionary practice. [ABSTRACT FROM AUTHOR]

This paper reports on qualitative data from the Actifcare study investigating experiences, attitudes, barriers and facilitators concerning access to and use of formal care. A total of 85 semi‐structured in‐depth interviews were conducted in eight European countries. Results were analysed with a deductive content analysis, first within country and then integrated in a cross‐national analysis. Overall, analysis of the in‐depth interviews revealed two major themes with five subcategories. The results can be summarised in an optimal pathway for access to dementia care. This pathway includes fixed factors such as disease‐related factors and system‐related factors. In addition there are personal factors that are subject to change such as attitudes towards care. An important finding consisted of the necessity of having sufficient information about the disease and available care and having a key contact person to guide you through the process of finding suitable care while monitoring your needs. In addition, it is important to involve your social network as they can take on care‐giving tasks. It is helpful to have a diagnosis (in most countries). Concerning decision‐making, the person closest to the person with dementia is in the majority of cases the one who makes the ultimate decision to access and use services and he/she should therefore be supported in this process. These results provide insight into the factors that influence the pathway to formal care use and help professionals to enhance access to formal dementia care by focusing on factors that can be modified. [ABSTRACT FROM AUTHOR]

Qualitative methods, and specifically narrative interviews, have received increasing attention in recent years in the United States and the English-speaking world in general. In this paper, the authors aim to illustrate the value of the role of biographical sociology and, more specifically, of the narrative interview developed by Fritz Schütze that is commonly used in German-speaking Europe for social work and pastoral care. They focus on interviewees' biographical trajectories for a better understanding of the ways people afflicted by homelessness respond to living in a local, evangelical-based homeless shelter and the initial steps they take to improve their lives. In order to understand the role of biographical trajectory and how participants address it, the authors provide two case studies of individuals living in homeless shelters at the time of the interview. They then contend that this form of narrative interview has the capacity to help in understanding a person's life history and biographical trajectory in-depth and could be used as a form of assessment that would contribute to social work and pastoral care in the United States. [ABSTRACT FROM AUTHOR]

Within Northern Europe, gendered roles and responsibilities within the family have been challenged through an emergence of different family forms, increasing cultural diversity, and progressive developments in welfare policies. To varying degrees, welfare policies in different countries support a dual‐earner model and encourage men to be more active as fathers by reinforcing statutory rights and responsibilities. In child welfare practice, there has traditionally been a strong emphasis on the mother as primary carer for the child; the father has been less visible. This paper explores, in four national welfare contexts, how child welfare social workers include fathers in practice decisions. Data were collected using focus group interviews with social workers from England, Ireland, Norway, and Sweden. Similarities and differences emerge in relation to services and the focus of social work assessments. However, overall, the research suggests that despite gains in policy and legislation that promote gender equality, fathers remain largely absent in child welfare practice decisions about the parenting of their children. From the research, we raise questions for social work practice and the development of welfare policies. [ABSTRACT FROM AUTHOR]

Based on the Eurobarometer data from 2009 (N = 26,788), this paper investigates the correlates of sports participation. In addition to examining standard socio-demographic, economic and lifestyle factors, the paper also focuses on the impact of motivational factors, the availability of sports infrastructure and government support, for the first time collectively at the European level. A further contribution of the paper is that it simultaneously investigates both the decision to participate in sport and the frequency of sports participation in this context. This is made possible through the application of a Zero-Inflated Ordered Probit estimator. This estimator also takes into account two types of non-participants: those who have never participated in sport and those who did not participate at the time of the survey. The results show that the decision to participate in sports and the frequency of sports participation of males and females are affected by different factors, therefore distinct government policies should be applied to attract new, and retain the existing, participants. For example, women are affected more by a need to improve self-esteem, while the men to produce social integration. The provision of sports facilities is of more importance for males, which may indicate a male-oriented nature of the sports facilities, for example, the gym. However, the number of adults and the number of children in the household reduce the probability of sports participation by females. Therefore, higher provision of childcare may be important if female participation is to be increased. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine differences in the experience of somatic symptoms by domain (exhaustion, musculoskeletal, gastrointestinal, heart distress) between psychologically abused and non-abused older persons, and to scrutinize associations between abuse and somatic symptoms while considering other factors (e.g. social support). Design/methodology/approach – The design was cross-sectional. The participants were 4,467 women/men aged 60-84 years living in seven European cities. The data were analysed using bivariate/multivariate methods. Findings – Psychologically abused participants scored higher on all somatic symptom domains than non-abused, and thus were more affected by the symptoms. The regressions confirmed a positive association between psychological abuse and most somatic symptom domains, but other factors (e.g. depression, anxiety) were more salient. Demographics/socio-economics were positively (e.g. marriage/cohabitation) or negatively (e.g. education) associated with somatic symptoms depending on the domain. Social support and family structure “protected” the experience of somatic symptoms. Research limitations/implications – The research focused on psychological abuse. It did not incorporate other abuse types calling for further research on the effects of other abuse types on somatic symptoms. Nevertheless, the findings indicate that psychological abuse is linked to somatic symptoms, but the role of other factors (e.g. depression, anxiety, social support) is also important. Practical implications – Improvements in the older person's situation regarding somatic symptoms need to consider psychological abuse, co-morbidities, social support and living conditions. Originality/value – The paper reports data from the ABUEL Survey, which collected population-based data on elder abuse. [ABSTRACT FROM AUTHOR]

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Over the past few decades, governments all over Europe have drawn upon a diversity of Electronic Information Systems (EISs). One of the aims of these EISs is the creation of a transparent Child Welfare and Protection (CWP) system. In that context, Gillingham and Graham (2016) argue that the implementation of EISs in social work has made the daily work of practitioners visible in ways that social workers in the 1970s and 1980s would have find unimaginable. However, this has not gone unchallenged as research reveals that practitioners develop strategies which can also undermine the aim of transparency. This paper aims to capture the tension between this aim and the reality of social work practice in using EISs. We undertook semistructured interviews with seventeen social practitioners and uncovered a complex struggle in which practitioners showed how EISs are capable of both increasing and hindering the creation of transparency. We therefore argue that the problem does not lie so much in the implementation or design of EISs, but in the idea that transparency can be increased by EISs. [ABSTRACT FROM AUTHOR]

Objective: To identify barriers and facilitators to international implementation of a prospective system for standardized outcomes measurement in cleft care. Design: Cleft teams that have implemented the International Consortium for Health Outcomes Measurement Standard Set for cleft care were invited to participate in this 2-part qualitative study: (1) an exploratory survey among clinicians, health information technology professionals, and project coordinators, and (2) semistructured interviews of project leads. Thematic content analysis was performed, with organization of themes according to the dimensions of the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework: reach, effectiveness, adoption, implementation, and maintenance. Results: Four cleft teams in Europe and North America participated in this study. Thirteen participants completed exploratory questionnaires and 5 interviewees participated in follow-up interviews. Survey responses and thematic content analysis revealed common facilitators and barriers to implementation at all sites. Teams reach patients either via email or during the clinic visit to capture patient-reported outcomes. Adopting routine data collection is enhanced by aligning priorities at the organizational and cleft team level. Streamlining workflows and developing an efficient data collection platform are necessary early on, followed by pilot testing or stepwise implementation. Regular meetings and financial resources are crucial for implementing, sustaining, analyzing collected data, and providing feedback to health care professionals and patients. Fostering patient-centered care was articulated as a positive outcome, whereas time presented challenges across all RE-AIM dimensions. Conclusions: Identified themes can inform ongoing implementation efforts. Intentionally investing time to lay a sound foundation early on will benefit every phase of implementation and help overcome barriers such as lack of support or motivation. [ABSTRACT FROM AUTHOR]

Background: Minimal research has been done to determine how well European nursing students understand the core principles of academic integrity and how often they deviate from good academic practice. Aim: The aim of this study was to find out what educational needs nursing students have in terms of academic integrity. Research design: A quantitative cross-sectional study in the form of a survey of nursing students was conducted via questionnaire in the fall of 2020. Participants: The sample was composed of 79 students in the BScN and MScN programs at Zürich University of Applied Sciences. Ethical considerations: An application for a non-competence clearance was approved by the Ethics Committee in Zurich (BASEC No. Req-2020-00868). The survey was anonymous, and informed consent was obtained prior to participation. Results: The participants had a high level of confidence in their own knowledge but were in many cases unable to correctly identify clear-cut examples of misconduct and to differentiate them from questionable practices. About 13% of the participants admitted that during their university education they had copied shorter passages from other sources into their own text without marking them as quotes. Conclusions: The study documents extensive knowledge gaps among nursing students regarding both academic misconduct and questionable practices and indicates a need for improved academic integrity training. [ABSTRACT FROM AUTHOR]

This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, effective contact tracing was recognized as a crucial public health response to mitigate the spread of SARS-CoV-2 and reduce COVID-19-related morbidity and mortality, particularly before widespread vaccination. The World Health Organization (WHO) recommended implementing active surveillance strategies to trace and quarantine contacts of confirmed or suspected COVID-19 cases. Methods: A detailed review and analysis of the COVID-19 contact tracing responses was conducted in five European countries and territories, between March 2021 and August 2022. The countries and territories were selected to ensure geographical representation across the WHO European Region and applied a mixed-methods approach of in-depth interviews with various stakeholders across different administrative levels to identify good practices in COVID-19 contact tracing. The interviews covered 12 themes, including methods and procedures for COVID-19 contact tracing, information technology, quality assurance and key performance indicators. Results: The findings demonstrate that the policy approach, digitalization capabilities and implementation approach varied in the countries and territories and were dynamic throughout the pandemic. The analysis revealed that some practices were applicable across all countries and territories, while others were context-specific, catering to each country's and territory's unique needs. The study highlighted a need for all countries to institutionalize contact tracing as an essential function of existing health systems, to digitalize contact tracing practices and processes, and to build and retain contact tracing capacities for better pandemic preparedness. Conclusion: The lessons related to COVID-19 contact tracing should be utilized to strengthen future outbreak response operations as part of epidemic and pandemic preparedness. [ABSTRACT FROM AUTHOR]

Aims To synthesize evidence and knowledge from published research about nurses' experiences of nurse-patient relationships with adult patients in general, acute inpatient hospital settings. Background While primary research on nurses' experiences has been reported, it has not been previously synthesized. Design Meta-ethnography. Data sources Published literature from Australia, Europe, and North America, written in English between January 1999-October 2009 was identified from databases: CINAHL, Medline, British Nursing Index and Psyc INFO. Review methods Qualitative studies describing nurses' experiences of the nurse-patient relationship in acute hospital settings were reviewed and synthesized using the meta-ethnographic method. Results Sixteen primary studies (18 papers) were appraised as high quality and met the inclusion criteria. The findings show that while nurses aspire to develop therapeutic relationships with patients, the organizational setting at a unit level is strongly associated with nurses' capacity to build and sustain these relationships. The organizational conditions of critical care settings appear best suited to forming therapeutic relationships, while nurses working on general wards are more likely to report moral distress resulting from delivering unsatisfactory care. General ward nurses can then withdraw from attempting to emotionally engage with patients. Conclusion The findings of this meta-ethnography draw together the evidence from several qualitative studies and articulate how the organizational setting at a unit level can strongly influence nurses' capacity to build and sustain therapeutic relationships with patients. Service improvements need to focus on how to optimize the organizational conditions that support nurses in their relational work with patients. [ABSTRACT FROM AUTHOR]

This paper outlines the approach taken to iteratively evaluate a set of VR/AR (virtual reality / augmented reality) applications for five different manual-work applications - terrestrial spacecraft assembly, assembly-line design, remote maintenance of trains, maintenance of nuclear reactors, and large-machine assembly process design - and examines the evaluation data for evidence of the effectiveness of the evaluation framework as well as the benefits to the development process of feedback from iterative evaluation. ManuVAR is an EU-funded research project that is working to develop an innovative technology platform and a framework to support high-value, high-knowledge manual work throughout the product lifecycle. The results of this study demonstrate the iterative improvements reached throughout the design cycles, observable through the trending of the quantitative results from three successive trials of the applications and the investigation of the qualitative interview findings. The paper discusses the limitations of evaluation in complex, multi-disciplinary development projects and finds evidence of the effectiveness of the use of the particular set of complementary evaluation methods incorporating a common inquiry structure used for the evaluation - particularly in facilitating triangulation of the data. [ABSTRACT FROM AUTHOR]

The article presents a research paper regarding the impact of 2007 financial crisis on commercial mortgage-backed securities (CMBS) and how to reestablish the financial market in Europe. It uses a questionnaire to identify the views of research participants on the future of CMBS, while structured interviews were conducted with credit rating agencies to obtain their opinions on steps to improve business confidence. Results suggest that the revival of the market relies on the simplification of contract structures and transparency. It says that better and open risk assessment, improve information disclosure and due diligence are the top priorities in regulation of CMBS instruments.

The article discuses the research paper based on the study related to the development of leaders by organization according to need for the ensurement of sustainability of organization. It mentions the research format consisting of two phases including questionnaire survey on managers from various private sector companies in Europe, and interviews with 11 multinational companies from Europe. It highlights the finding related to the importance of reflexive abilities for the translation of individual into individual managerial behaviors, and informs the small size for the surveys and interviews as the major limitation of the research.