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The apps for drawing are present in our children's life. Nevertheless, little is known about the impact of mobile technology on the freehand drawing educational activity. There are few works which are contextualised within short periods of time, with teachers who are not theirs and, in some cases, outside the children's classroom. In this paper, we are focussed on the use of technology on freehand drawing activity. Thus, we have compared the graphics produced by 4- and 5-year-old children with paper&crayon in comparison with those with tablet-finger. Children made the drawings during a planned free-drawing activity, in their ordinary classrooms, with their teachers and during five sessions. Assessment of drawings has evidenced tablet feasibility for making graphics. Nevertheless, with the passing of time, quality of graphics (tablet-finger vs paper&crayons), are nearly matched, demonstrating the low impact level technology has on this activity. In addition, if drawings are analysed specifically according to ages, results have shown that both groups have to develop adaptation strategies of visual perceptual skills and fine motor skills for the touch screen in order to obtain the same quality in the drawings made on both support types. [ABSTRACT FROM AUTHOR]

This paper investigates retracted articles indexed in the Scientific Electronic Library Online (SciELO) Brazil, using bibliometric techniques to identify the characteristics of these retractions and relevant citation trends. All records of retracted articles from the first record in October 2004 to April 2022 were included. Sixty-seven retractions and 870 citations pre- and post-retraction were analyzed. Results indicate a change of scenario that began in 2015, with recurrences of retracted articles allegedly produced by paper mills. The prevalence of retractions derived from professional misconduct in health research and the frequency of post-retraction citations in health sciences raise concerns in the chain of stakeholders, public health, and scientific development. [ABSTRACT FROM AUTHOR]

In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples' organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi. More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi. There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers. Following the development of the priority assistive products list (APL) by WHO, member states should develop their own contextually based APL. The development of the APL should be based on research evidence. All key stakeholders including persons with disabilities and other functional limitations, government, and development partners should participate in this process. The APL should be part of the national health system or community services. The Department of Disability and Elderly Affairs in the Ministry of Gender, Community Development, being the Government of Malawi line ministry coordinating disability issues participated actively in this study including inviting participants in the stakeholders' validation workshop. [ABSTRACT FROM AUTHOR]

The application of STEM (Science, Technology, Engineering, and Math) education in solving real-world problems is challenging. To tackle this challenge, a project-based learning approach that integrates robots with cost-effective self-made toys to problem-solving was adopted to assist rural primary school students to apply STEM skills. The purpose of this study was to evaluate the effects of the project-based learning approach which includes lecturing and hands-on activities on primary school students' STEM learning outcomes and attitudes. An experiment was conducted with 25 primary school students who voluntarily participated in a STEM summer-camp programme. Students were asked to assemble a paper house equipped with an IoT control module and LED light switches, and write and edit robot scripts to produce a robot-based storytelling narrative using the paper house they made as a context. The results show that the project-based learning approach was an effective approach for cultivating primary school students' STEM knowledge and skills as evidenced from the post-written test. The relationships between the students' STEM learning outcomes and attitudes were also confirmed by a clustering analysis. Students who had higher learning attitudes also achieved higher STEM learning outcomes; the findings are also supported by the feedback from the open-ended questionnaire items. This study suggests that integrating low-cost self-made toys and robots in project-based learning activities is an effective and practical approach to enhance primary school students' learning outcomes and learning attitudes in STEM education. [ABSTRACT FROM AUTHOR]

Experiencing spinal cord injury (SCI) can be life-changing for individuals and their families. Previous reviews have focused on coping and psychological adjustment, sexual function and sexuality, or factors facilitating or impeding interpersonal relationships after SCI. However, there is a very little synthesis of research focusing on changes to adult attachment and emotional intimacy post-SCI. This review aims to examine the mechanisms of change in adult attachment and intimacy in romantic relationships following SCI. Four online databases (Psycinfo, Medline, CINAHL, and Scopus) were searched for qualitative papers concerning romantic relationships, attachments, and intimacy post-SCI. Sixteen of the 692 papers met the inclusion criteria. These were quality assessed and analysed using meta-ethnography. Three main themes emerged from the analysis: (a) strengthening and maintaining adult attachment; (b) changes in roles; and (c) changing views of intimacy. Many couples face significant changes to adult attachment and intimacy following SCI. Systematic ethnographic analysis of their negotiations enabled the identification of underlying relational processes and adaptation strategies associated with changes to inter-dependence, communication, role revision, and re-definition of intimacy. The findings indicate that healthcare providers should assess and respond to challenges faced by couples post-SCI using evidence consistent with adult attachment theory. Professionals should support both partners to develop strategies to try to cope with spinal cord injury (SCI) and its associated stressors following injury. Information and support regarding both the physical and emotional impact of the injury on coupledom and romantic relationships should be provided after SCI. Support should be tailored to reflect an individual with SCI and their partner's cultural and societal background and needs. [ABSTRACT FROM AUTHOR]

Addressing sexting in sexual health education classrooms is one way of supporting young people to become good sexual citizens and to emphasise respect and consent in their sexual practices and in their lives. While a fair amount of research has worked with youth to understand their motivations for sexting, less research has been conducted with in-service teachers to understand their perspectives, pedagogical approaches, and beliefs regarding young people and sexting. Set in this context, this paper discusses findings from interviews with Canadian teachers who were teaching a new Ontario Health and Physical Education curriculum that included discussions of sexting. Our findings suggest that many teachers are still engaging discourses of risk, shame and blame when they talk to their students about sexting. Likewise, longstanding gender norms and stereotypical sexual scripts are evident in the ways in which many teachers both understand and teach sexting. Some teachers, however, are engaging in more promising pedagogical practices that frame sexting as having a range of uses, outcomes, and purposes, painting a more holistic picture of young people's sexting landscapes. Findings from this paper may be useful for educators and policymakers creating sexting curriculum for young people in educational settings. [ABSTRACT FROM AUTHOR]

Generation of reliable data underpins the effectiveness of Occupational Health and Safety (OHS) surveillance systems. Despite the importance of understanding OHS data systems, there are few papers that provide overviews of their structure and/or content. This paper introduces a basic framework for assessing OHS data systems that will be of use to researchers internationally. We applied this approach to assess the Irish OHS data system by undertaking a data mapping exercise. We developed a checklist based on recommendations of monitoring and measurement of OHS proposed by the National Academies of Sciences, Engineering, and Medicine (USA). An assessment of published reports that present systematic OHS surveillance data was undertaken to identify the institutions or organisations responsible for collecting and curating the data, their remit, and, associated with this, their respective case definitions. We then provide an overview of the variables collected and these are then mapped against the checklist. The assessment highlights that whilst the farm fatalities dataset provides complete coverage of all fatalities, regardless of age or employment status, the same is not true of the three non-fatal injuries datasets reviewed. There are important differences in the data collection methods and, associated with this, which populations are covered. The assessment approach provides valuable insights into the strengths and weaknesses of a critical element of OHS surveillance systems, namely the production of datasets. This knowledge is important for researchers as understanding the data that informs their research is fundamental to good science. It is critical for policy-makers and other stakeholders to understand the strengths and weaknesses on which OHS policy, strategies, or education and training interventions are developed. [ABSTRACT FROM AUTHOR]

This is the second of two papers summarizing studies reporting on the design of electronic graphic symbol-based augmentative and alternative communication (AAC) systems. The aim of this paper was to describe the design approaches used and to determine to what extent the principles of human-centred design (HCD) were reflected in the design approaches and processes used. A scoping review was conducted. A multifaceted search resulted in the identification of 28 studies meeting the selection criteria. Data were extracted relating to four areas of interest, namely, (1) the general characteristics of the studies, (2) features of the systems designed, (3) availability of the systems to the public and (4) the design processes followed. In this paper, findings related to the last area are presented. Design approaches were often inconsistently described. User-centred design was mentioned more often than HCD. Even so, various HCD principles were considered in most studies. Notably, stakeholders were involved in the design process in all studies. However, users were not involved in all studies and stakeholder roles were predominantly informative rather than collaborative. Prototype and product evaluations focussed mostly on usability rather than user experience. Although many design teams were multidisciplinary, engineers and computer scientists predominated. There is a need for designers to be more transparent about the type of design approach used to guide the system design and also to clearly report on design approaches and processes used. The application of HCD to the design of graphic symbol-based AAC systems is still limited. Human-centred design approaches can productively guide the design of electronic graphic symbol-based augmentative and alternative communication (AAC) systems. Creative methods are needed to involve stakeholders with complex communication needs in all phases of the design process. Evaluation of electronic graphic symbol-based AAC systems should consider both usability and user experience. [ABSTRACT FROM AUTHOR]

Strengthening the health literacy (HL) skills of the healthcare users is a multicomponent process involving the users, the healthcare professionals, the stakeholders, and the environment. Health organizations, universities, private initiatives, and funded projects focused on developing and implementing continuing education courses target at increasing healthcare professionals' HL. This scoping review aimed at reporting the HL continuing education courses for healthcare professionals to enhance their knowledge and skills in identifying and supporting healthcare users with limited HL, and particularly, older people. This review followed the five stages by Arksey and O'Malley framework and the guidelines by Joanna Briggs Institute for scoping reviews. Peer-reviewed papers and gray literature published between years 2000 to 2020 were included in this bibliometric search utilizing four electronic databases (PUBMED, MEDLINE, CINAHL, PSYCHINFO, and Opengrey). Twenty-seven (27) papers met the criteria, including twenty-one (21) full-texts and six (6) other records (website contents, eLearning, and funded projects). There is a lack of HL tools that address the training needs of healthcare professionals working with older adults. Tailored HL tools could benefit healthcare professionals' clinical work by improving their communication with older adults. [ABSTRACT FROM AUTHOR]

Background: Incarcerated trans women experience significant victimization, mistreatment, barriers to gender-affirming care, and human rights violations, conferring high risk for trauma, psychological distress, self-harm, and suicide. Across the globe, most carceral settings are segregated by sex assigned at birth and governed by housing policies that restrict gender expression—elevating ‘safety and security’ above the housing preferences of incarcerated people. Aim/methods: Drawing upon the lived experiences of 24 formerly incarcerated trans women in Australia and the United States and employing Elizabeth Freeman’s notion of chrononormativity, Rae Rosenberg’s concept of heteronormative time, and Kadji Amin’s use of queer temporality, this paper explores trans women’s carceral housing preferences and contextual experiences, including how housing preferences challenge governing chrononormative and reformist carceral housing systems. Findings: Participants freely discussed their perspectives regarding housing options which through thematic analysis generated four options for housing: 1) men’s carceral settings; 2) women’s carceral settings; 3) trans- and gay-specific housing blocks; and 4) being housed in protective custody or other settings. There appeared to be a relationship between the number of times the person had been incarcerated, the duration of their incarceration, and where they preferred to be housed. Conclusions: This analysis contributes to richer understandings regarding trans women’s experiences while incarcerated. This paper also informs the complexities and nuances surrounding housing preferences from the perspectives of trans women themselves and considers possible opportunities to enhance human rights, health and wellbeing when engaging in transformative approaches to incarceration. [ABSTRACT FROM AUTHOR]

This paper considers matters of time in online mental health peer support. Significant evidence of the value of peer support exists, with new digital platforms emerging as part of the digitisation of mental health support. This paper draws from a project exploring the impact of digital platforms on peer support through interviews with users of a major UK-based online peer support platform. Drawing on Gilles Deleuze's concept of the 'living present', the paper highlights how notions of past, present and future operate as co-existing dimensions of the present. The analysis highlights how the immediacy of digital platforms elicits expectations of peer support being 'on tap', which creates challenges when support is not received synchronously. Unlike in-person support, digital platforms facilitate the archiving of support, which can (re)enter the present at any moment through asynchronous communication. Anticipations of the future feature as dimensions of the present in terms of feelings regarding when support may no longer be needed. The paper offers potential implications for social scientific understanding of digital peer support, which include valuable insight for mental health services designing and delivering digital peer support. [ABSTRACT FROM AUTHOR]

Despite the many health benefits of physical activity (PA) and healthy eating (HE) most adolescents do not meet current guidelines which poses future health risks. This review aimed to (1) identify whether adolescent PA and HE interventions show promise at promoting behaviour change and maintenance, (2) identify which behaviour change techniques (BCTs) are associated with promising interventions, and (3) explore the optimal approaches to training deliverers of adolescent PA/HE interventions. Nine databases were searched for randomised controlled, or quasi-experimental, trials targeting 10–19 year olds, with a primary aim to increase PA/HE, measured at baseline and at least six months post-intervention, in addition to papers reporting training of deliverers of adolescent PA/HE interventions. Included were seven PA studies, three HE studies and four studies targeting both, with two training papers. For PA studies, two were promising post-intervention with two promising BCTs, and five were promising for maintenance with two promising BCTs. For HE studies, three were promising at post-intervention and four at maintenance, both with four promising BCTs. There is preliminary evidence that interventions support adolescents to improve their PA and HE behaviours over a period of at least six months. [ABSTRACT FROM AUTHOR]

This paper presents findings from a literature review on relationships and sexuality education for primary (elementary) school programme effectiveness. Using a theory-generating approach informed by realist evaluation, the review takes a deep dive into the literature to identify contexts, mechanisms and outcomes likely to influence the effectiveness of programmes. This paper will be of interest to researchers, evaluators, RSE programme designers and practitioners as findings provide a catalogue of factors (variables) that can be considered for application in future programme evaluations and for inclusion in programme logic models. It identifies areas of opportunity to incorporate children's voices into research and points to the need for longitudinal studies to address the context- and time-sensitive nature of relationships and sexuality education. [ABSTRACT FROM AUTHOR]

Sexuality and relationship education (SRE) for trans young people is fraught with ongoing institutional and informational erasure, even as trans young people display considerable agency in navigating their SRE needs. This paper reports on a survey of 112 Australian trans young people, who shared their experiences of SRE (in terms of delivery and content), and their views on three story completion tasks where they were asked to respond to prompts about three fictional stories focused on trans young people (and for some their cisgender partners) and intimacy. Participants reported that SRE was delivered in class and focused on puberty and anatomy, although many participants accessed SRE information informally. Participants overwhelmingly reported the erasure of trans-specific SRE content and suggested that SRE content should include a trans focus. Responses to the story completion task emphasised the agency of the fictional trans young people in asserting their boundaries, deserving respect, being knowledgeable about their bodies and ensuring their safety. Fictional cisgender young people in the story completion tasks were expected to be respectful, and to be guided by trans people (but also to educate themselves). The paper concludes with recommendations for harnessing trans young people's agency in the context of SRE. [ABSTRACT FROM AUTHOR]

While innovation is known to catalyse solutions to global sustainable development challenges, lack of engagement from stakeholders during conceptualisation and development may influence the degree of success of implementation. This paper presents a complete and novel engagement methodology, developed from value led business modelling approaches, for working with multi-sector stakeholders. The methodology can be used to determine barriers and facilitators to clinical practice innovations or translational research, within a country-specific context. The approach has then been applied in the Cambodian prosthetics and orthotics sector to provide a practice-based exemplar application of the framework. This approach seeks to ensure the suitability and sustainability of clinical practice and research programmes being implemented within a complex ecosystem. A theoretical basis, drawn from academic and business innovation sectors, has been consolidated and adapted for practical application to design, direct, and inform initiatives in low resource settings. The methods presented provide a way to both develop and articulate the mission, vision, and goals of any proposed change, and to effectively communicate these with stakeholders in a way that engages the personal and professional values that exist in their ecosystem. It provides a structured process through which meaningful conversations can happen, and a basis for relationship management with key stakeholders; intrinsic to enable a sustained legacy from research and development. The engagement from stakeholders during conceptualisation and throughout development can determine the success, or not, of any implementation and scale of innovation. This paper presents a conceptual stakeholder-led engagement methodology, developed from value led business modelling approaches, for determining barriers and facilitators to translational global healthcare research in a country-specific context, in this case the Cambodian prosthetics and orthotics sector. Subsequent research and development work in this area needs to carefully manage and negotiate influencing factors identified through the application of the described methodology, to ensure initiatives (whether research or wider national development work) are sustainable and successful. [ABSTRACT FROM AUTHOR]

This paper presents findings from a study on blindness discourses found in South African non-profit organisations that provide rehabilitation services to visually impaired adults. The paper investigates what the public relations materials of these organisations communicate about blindness. It also considers the ideological assumptions that blindness discourses reinforce and embed in rehabilitation practice. The primary focus is a discourse analytic review conducted on a sample of organisation public facing material. The findings comprise three clusters of assumptions, with concomitant enactments in practice. These are i) third-person alliances around the blind subject and a resulting objectification of service users ii) 'journey discourse' which prohibits the expression of complex disability experiences and iii) polarised blindness fantasies which promote othering and prescribe acceptable ways of being for blind subjects. This paper questions what might be imparted to blind persons at a symbolic level through rehabilitative practices. This article explores the ways that blindness and blind persons are represented on the websites of organisations that provide visual impairment rehabilitation services in South Africa. These representations affect the way that society views visually impaired people, and the way that visually impaired people feel about themselves. Organisation websites describe visually impaired people in ways that make it seem as though they play little active role in the rehabilitation process. The idea that rehabilitation is a journey from dependence and depression to independence and self-acceptance might make it difficult for rehabilitation service users to express ongoing feelings of grief and loss. There is a need for more focus on interdependence in rehabilitation services. Rehabilitation organisations must think carefully about what their public relations materials communicate to society about blindness and blind persons. [ABSTRACT FROM AUTHOR]

Smartphones have become a core piece of assistive technology (AT) for people with vision impairment (PVI) around the world. This scoping review sought to provide a comprehensive picture of the current evidence base of smartphones for PVI. Seven electronic databases (CINAHL, Cochrane Library, EMBASE, IEEE Xplore, Scopus, PubMed and Web of Science) were searched for papers published from 2007 to 2021. Peer-reviewed articles published in English which discussed smartphones use by PVI; smartphone technologies designed for PVI or training and learning support on the use of smartphones were included. There were 16,899 records retrieved and 65 articles were included in this review. The majority (48%) of the papers focussed on developing better interfaces and Apps for PVI. Contrastingly, there was a paucity of papers (5%) discussing training or learning support for PVI to use smartphones and Apps effectively, even though it was highlighted to be important. Proper training will ensure that PVI can use this everyday technology as an AT to increase participation, enhance independence and improve quality of life overall. The findings highlighted that smartphones and Apps can be used as effective and affordable AT by PVI. The many recent developments and research interest in smartphone technologies can further support its use. However, good training and learning support on the use of smartphones and Apps by PVI, is lacking. Future research should focus on the development, provision and evaluation of evidence based tailored training and support, especially in low- and middle-income countries. There is a need for more training and learning support for people with vision impairment (PVI) on the use of smartphones and Apps. Individualized and a graded approach to training has been recommended for PVI to learn to use smartphones. When supporting or training people to use smartphones, the person's level of vision impairment as well as their age, are important considerations. Health professionals should be cognizant of the steep learning curve that some PVI may experience when using smartphones and Apps, especially when they switch from a phone with physical buttons to touchscreen. Certain smartphones features are useful to particular vision loss conditions. For example, zoom and magnification are helpful for those with low vision but text input and output, and commands using speech (e.g., Siri and TalkBack) are useful for those who are blind. [ABSTRACT FROM AUTHOR]

This paper considers the possibilities of analysing children's own designs to contribute to the design of inclusive paediatric mobility interventions. The aim of this paper is threefold: (1) to develop a framework for child-centred design analysis, (2) to analyse children's designs to explore both quantitative and qualitative insights and (3) to explore how children's voice could be elevated through design research. A Child-centred Design Analysis Framework is developed in an interdisciplinary manner, comprising four dimensions including Child, Content, Context and Format. It is used as a vehicle to analyse and code 130 "Dream Wheelchair" designs by children. The children's "Dream Wheelchair" designs reference a range of features and priorities, which are gathered into themes through the framework, providing insights into children's individual and collective mobility narratives, values and requirements. Themes are explored through a qualitative interdisciplinary lens to understand the nature of children's lived experiences. The framework promotes child-centred framing through extracting meaning from children's own designs. It is suggested that child-centred framing and a rights-respecting approach to assistive technology design research can lead to more appropriate design outcomes and improved user experiences for children with disabilities. The design analysis framework developed and presented in this paper facilitates child-centred framing to elevate children's voice in a design process. Analysis of 130 children's visual and textual designs elicited narratives, values, and requirements around their "Dream Wheelchairs"; these findings contribute insights which can be used for designing inclusive paediatric mobility interventions. This paper invites industry practitioners and design researchers to use a child-centred and rights-respecting approach when designing with or for children. [ABSTRACT FROM AUTHOR]

Black Alaskans face serious barriers to health care. This paper reports on qualitative results of a health needs assessment to understand the health challenges facing Black Alaskans. Utilizing exploratory thematic analysis, the findings indicate that Black Alaskans experience barriers such as high cost of care, underinsurance, lack of information and education, a shortage of BIPOC health providers, stigma, negative perceptions by health-care providers, and racism both in the community and in the health-care system. The paper concludes by discussing emerging health equity initiatives to advance responsive care for Black Alaskans. [ABSTRACT FROM AUTHOR]

Emotion detection and Sentiment analysis techniques are used to understand polarity or emotions expressed by people in many cases, especially during interactive systems use. Recognizing users' emotions is an important topic for human–computer interaction. Computers that recognize emotions would provide more natural interactions. Also, emotion detection helps design human-centred systems that provide adaptable behaviour change interventions based on users' emotions. The growing capability of machine learning to analyze big data and extract emotions therein has led to a surge in research in this domain. With this increased attention, it becomes essential to investigate this research area and provide a comprehensive review of the current state. In this paper, we conduct a systematic review of 123 papers on machine learning-based emotion detection to investigate research trends along many themes, including machine learning approaches, application domain, data, evaluation, and outcome. The results demonstrate: 1) increasing interest in this domain, 2) supervised machine learning (namely, SVM and Naïve Bayes) are the most popular algorithms, 3) Text datasets in the English language are the most common data source, and 4) most research use Accuracy to evaluate performance. Based on the findings, we suggest future directions and recommendations for developing human-centred systems. [ABSTRACT FROM AUTHOR]

Hospital to home transfers for older people require effective communication, coordination and collaboration across multiple service settings. Rural Nursing Theory and the Beyond Periphery model explain why this is particularly difficult in rural areas, but there are few examples of how rural services respond. This paper presents a case study of the district of Tärnaby in the inland north of Sweden. Data are drawn from interviews with health and care staff in Tärnaby, observations, and experiences of the researchers. Data were analyzed thematically, with four main themes emerging – role clarity, communication, geography, and understanding of the rural context. Responses to challenges included increasing opportunities for communication between service providers and improving documentation. The paper concludes that informal "workarounds" run the risk of further disconnecting rural service settings from "the city". Rather, the aim needs to be to improve contextual understanding through formally incorporating "the rural" in service design. [ABSTRACT FROM AUTHOR]

Industries are currently struggling with ageing workforce in modern production systems associated with Industry 4.0. The industrial socio-demographic problem is more and more present as the increasing of the ageing population results in the prolongation of the working life and the consecutively in the ageing of the workforce in industries. This paper aims to conduct a systematic literature review on the challenges and concerns of ageing operators, including the physical, cognitive, ergonomic, and well-being conditions of the ageing workforce in the Industry 4.0 environment. The ScienceDirect, Scopus, Web of Science and PubMed scientific databases were used to survey the studies and selected using PRISMA guidelines. This paper was structured and analysed by clusters: Ageing, Industry 4.0, Human Factors, and Ergonomics. These clusters were developed as research lines: Ageing as the socio-demographic challenge, Industry 4.0 as the technological development, Human Factors as the individual characteristics of the operator, and Ergonomics as the work environment. Thus, human--centric approaches and ideas are discussed with the insights and issues of Industry 4.0 technologies, Human Factors, and Ergonomics to achieve a sustainable system at the engineering and social level. [ABSTRACT FROM AUTHOR]

There have been growing concerns that social distancing and stay-at-home mandates have exacerbated loneliness for older people. Empirical evidence about older people's experiences of loneliness and COVID-19 have quantified this phenomena without considering how older people themselves define and understand loneliness. This paper explores how older New Zealanders conceptualized and experienced loneliness under 'lockdown' stay-at-home measures. This multi-methods qualitative study combines data from letters (n = 870) and interviews (n = 44) collected from 914 people aged over 60 and living in Aotearoa, New Zealand during the COVID-19 pandemic. We conducted a reflexive thematic analysis to conceptualise this data. We identify three interconnected ways in which older people conceptualised and experienced loneliness: (1) feeling disconnected relating to lack of emotional closeness to another often resulting from being physically separated from others and not being able to touch; (2) feeling imprisoned relating to separation from preferred identities and activities and was frequently associated with boredom and frustration; and (3) feeling neglected which often related to feeling let down by generalised and idealised forms of support, such as one's neighbourhood and health care system. Older New Zealanders experienced lockdown loneliness in three interconnected ways rather than as a stable and homogenous experience. Māori, Pacific, Asian and New Zealand European older people often discussed loneliness in different ways; attesting to loneliness being a culturally-mediated concept shaped by expectations around desirable social interaction. We conclude the paper with implications for research and policy. [ABSTRACT FROM AUTHOR]

Tracheostomy and dysphagia are independently associated with increased complications and poorer functional outcome after acquired brain injury (ABI). The aim of this study was to identify and evaluate rehabilitation to restore functional swallowing ability and respiratory capacity during tracheal tube weaning. The review was conducted according to PRISMA guidelines. Any study design with adult patients with ABI and tracheostomy was eligible. The primary outcome was decannulation. A total of 2647 records were identified and eight papers included. Four studies investigated pharyngeal electrical stimulation (PES), two explored Facial Oral Tract Therapy (F.O.T.T.), one respiratory physiotherapy (RPT), and one study investigated external subglottic air flow (ESAF). Two RCTs found a significant difference between intervention and control on successful decannulation and readiness for decannulation in favour of PES. Time from rehabilitation admission and tracheostomy to decannulation was significantly reduced after implementing an F.O.T.T.-based protocol. Four interventions were identified, PES, F.O.T.T., RPT, and ESAF, all aimed at increasing oropharyngeal sensory input through stimulation. Due to heterogeneity of interventions, designs and outcome measures, effect could not be estimated. This review highlights the limited research on rehabilitative interventions and thus the limited evidence to guide clinical rehabilitation. Rehabilitation for early decannulation after brain injury Dysphagia and tracheostomy often coexist in neurocritical care and early rehabilitation. Four rehabilitative interventions were identified—pharyngeal electrical stimulation, external subglottic airflow, respiratory physiotherapy and facial-oral tract therapy. Interventions points to a consensus that sensory stimulation of the oropharynx can increase excitability of the swallowing network and support pharyngeal sensorimotor cortex reorganisation. This review highlights the limited research on therapeutic rehabilitative interventions and thus the limited evidence to guide clinical rehabilitation. [ABSTRACT FROM AUTHOR]

This paper provides insights into the experiences of children with disabilities in an Ethiopian context during prolonged school closures due to the COVID-19 pandemic. Drawing on data gathered through telephone surveys from parents of children with disabilities who had been attending school prior to closures and teachers working in different educational settings, we discuss children's learning journeys during closures, motivations to return to school and the implications of this on current educational reform efforts in Ethiopia. Our findings highlight the significant merits of including children with disabilities explicitly in wider education reform efforts; the many positive gains seen in parental desires to send their child back to school; and the need to recognize and strengthen the role of schools as spaces for promoting children's socio-emotional well-being. Schooling of children with disabilities in Ethiopia was significantly impacted due to the lack of accessible learning materials available at home and in schools Caregivers expressed that returning to school was a strong priority for their child with disabilities Teachers and caregivers noted significant negative impact of closures on children's social and emotional well-being, with many reporting heightened feelings of sadness, loneliness, isolation, and diminished interest in learning and playing among their children. Caregivers and teachers felt that more could be done to support families and schools during such times, especially with better allocation of resources. [ABSTRACT FROM AUTHOR]

One central aim of disability studies is to shift understandings of disability, such that disability comes to be understood as about the social disadvantage/oppression that people face when society does not cater to impairment of body/mind. Nevertheless, there remains a need for more practical tools for disability advocacy, through which to transmit disability studies' ideas of disability to the general community. Drawing on a qualitative study of the perspectives of 23 people with physical and sensory impairments, this paper proposes virtual reality as an advocacy tool to communicate the principles and beliefs of disability studies. The findings highlight that, due to the nature of the technology, participants feel virtual reality has clear potential as a disability advocacy tool that can facilitate empathy, perspective-taking and positive social change, with a particular focus on how it is the environmental barriers and social attitudes around people that disables them. More practical advocacy or informal education tools are needed that align with the principles of disability studies. This research conducted in-depth interviews with 23 people with physical and sensory impairments. The research finds that virtual reality has clear potential as a disability advocacy tool. The participants reported that virtual reality can facilitate empathy, perspective-taking and positive social change. The research finds that virtual reality focuses on how environmental barriers and social attitudes around people with disability disable them, rather than focusing on impairment experiences. [ABSTRACT FROM AUTHOR]

Financial exploitation (FE) is one of the most common reports to Adult Protective Services (APS) and the cases are often complex. Consequently, APS caseworkers report FE investigations to be among the most difficult while simultaneously reporting low confidence in productive outcomes for these investigations. This necessitates finding ways to support APS FE investigations. This paper describes the structure, process, and formative findings of a collaboration between forensic accounting examiners and APS workers to investigate complex cases of FE. Among the 77 FE cases completed, forensic examiners reviewed multiple years of financial records which included over 101,000 transactions, totaling over $213,000,000.00 in finances, and identified over $8,000,000 in questionable activity. Scores on the 8-item Client Satisfaction Questionnaire were high indicating high program satisfaction by APS workers, subject matter experts, and forensic examiners. These findings support the feasibility and acceptability of forensic accounting and APS collaborations to investigate complex cases of FE. [ABSTRACT FROM AUTHOR]

Informed by existing gaps in the research of elder abuse and neglect (EAN) outcomes and very limited knowledge from Central-European cultural contexts, this paper analyzes the link between domestic-based EAN and three measures of well-being, namely subjective loneliness, sense of control over one's life, and a broader outlook on life. To do this, we used recently (2022) collected EAN survey fielded among home-dwelling residents of the Czech Republic aged 65 +. The results show that there is a clear relationship between EAN and these selected outcomes. Controlling for several sets of potential modifying or confounding factors further indicates that this relationship is substantial and direct, rather than weak and indirect. Among controls, only variables related to disadvantage (health, income, dependency, history of abuse) partly account for the link between EAN and its outcomes due to their relation to both heightened risk of EAN and lower well-being. [ABSTRACT FROM AUTHOR]

Patients previously examined for cancer with a negative result may present in general practice with ongoing or new symptoms or signs suggestive of cancer. This paper explores the potential existence of a relatively safe period for cancer occurrence after receiving negative examination results for specific types of cancer, including lung (CT thorax), upper gastrointestinal (gastroscopy), colorectal (colonoscopy), bladder (cystoscopy), and breast (clinical mammography). Register-based time-to-event analyses. Denmark. All 3.3 million citizens aged 30–85 years who on January first, 2017, had not previously been diagnosed with the specific type of cancer were categorized based on the time since their most recent examination. Using 1-year follow-up, we calculated the age- and sex-adjusted hazard ratios of being diagnosed with the related cancer, with non-examined individuals as reference. Negative examination results were defined as the absence of a cancer diagnosis within 6 months following the examination. Previous negative examination results were common, also among those diagnosed with cancer during follow-up. For 10 years after a negative colonoscopy the risk of diagnosing a colorectal cancer was nearly halved. However, already 1 year after a clinical mammography and 2 years after a CT thorax the risk of diagnosing the related cancers was significantly higher among those with a previous negative result compared to non-examined individuals. This study did not identify a post-examination period in which the cancer risk, compared to non-examined individuals, was sufficiently low to confidently rule out any of the investigated cancers. What should one expect when considering re-examining a patient with a negative result of a previous examination for cancer? We found that previous negative examination results are common in the general population and among those subsequently diagnosed with cancer. We did not find a safe period after any of the examinations in which a negative result alone could safely rule out the presence of cancer. [ABSTRACT FROM AUTHOR]

In palliative care in the UK, occupational and/or physiotherapists consult with patients to assess how they are managing their activities for daily living in light of their life-limiting condition(s), and to identify any activities that might benefit from therapeutic intervention. In this paper we use conversation analysis to describe a patient's practice in these consultations, which we call "procedural detailing," whereby they produce a step-by-step description of how they do some everyday activity, such that it is depicted as adequate, stable, and unproblematic. Based on a collection of 15 cases identified in video recordings of consultations in a large English hospice, we demonstrate how patients use this practice to normalize their routine conduct and thereby reject or rule out an actual or anticipated therapeutic recommendation. Our analysis suggests that such descriptions let patients participate in shared decision-making by revealing their preference for routines that preserve their level of independence and dignity. [ABSTRACT FROM AUTHOR]

In 2023, the UK Government published its long-awaited reform strategy for England's children's social care system. Whilst the strategy set out planned reforms for several aspects of the wider system, an area requiring particular 'priority' was the purported workforce instability seen within child protection social work. However, the strategy has subsequently faced criticism on the basis that the suggested reforms were not satisfactorily informed by the testimonies of practicing social workers. This paper draws from a mixed-method study to report on the lived experiences of a sample of 201 child protection social workers practicing across England, in the context of better understanding the factors which they believed were impacting on workforce stability within England's child protection system. Implications that emerge are the need for an increase in the monetary commitment offered by the UK Government (especially in the context of tackling high caseloads, and improving local authority pay scales to reduce the allure of agency work); a targeted emphasis on challenging local cultures preoccupied with evidencing compliance over time spent with children; and the Government taking a more assertive role in tackling the often-counterproductive commentary perpetuated by politicians and media. [ABSTRACT FROM AUTHOR]

A growing number of researchers are trying to provide explanations for continuity and change in drug policy in different contexts. Such research predominantly falls in the pluralist realm of public policy where various actors compete to have their policy proposals accepted. Using a critical framework called Policy Constellations (PC), developed by Stevens and Zampini, this paper attempts to explain reactions of the British Government to Novel Psychoactive Substances (NPS) between 2008 – 2016. Qualitative data comes from in-depth interviews with stakeholders (N = 15), including NGO workers, a former Home Secretary, drugs ministers, governmental advisors, a former senior police officer, former Deputy Drug Coordinator, and a former Advisory Council for the Misuse of Drugs (ACMD) member. Two 'constellations' competed in British NPS policy setting. The PC framework illustrates power imbalances between these competing stakeholders. Abstinence orientated actors (the conservative constellation) enjoyed strategic advantages and media power which allowed them to create a favourable policy setting. These advantages were not enjoyed by the liberal constellation who struggled to access the policy setting and influence policy developments. The prohibitive nature of the policy used to counter NPS can be explained with the domination of actors whose values align with the conservative constellation. [ABSTRACT FROM AUTHOR]

This study explores the usability, usefulness and user experience of the Forward with Dementia website for people with dementia and family carers, and identifies strategies to improve web design for this population. The website was iteratively user-tested by 12 participants (five people with dementia, seven carers) using the Zoom platform. Data collection involved observations, semi-structured interviews and questionnaires. Integrative mixed-method data analysis was used, informed by inductive thematic qualitative analysis. Users of Version 1 of the website experienced web functionality, navigation and legibility issues. Strategies for desirable web design were identified as simplifying functions, streamlining navigation and decluttering page layouts. Implementation of strategies produced improvements in usability, user experience and usefulness in Version 2, with mean System Usability Scale scores improving from 15 to 84, and mean task completion improving from 55% to 89%. The user journey for people with dementia and carers overlapped, but each group had their own unique needs in the context of web design. The interplay between a website's content, functionality, navigation and legibility can profoundly influence user perceptions of a website. Dementia-related websites play an important role in informing audiences of management strategies, service availability and planning for the progression of dementia. Findings of this study may assist in guiding future web development targeting this population. People with cognitive impairment can provide useful feedback on design and accessibility of websites, and their input should be obtained when developing digital applications for this group. This paper provides practical suggestions for website design features to improve function, legibility and navigation of websites for older people and people living with dementia. [ABSTRACT FROM AUTHOR]

Rehabilitation robots with intent recognition are helping people with dysfunction to enjoy better lives. Many rehabilitation robots with intent recognition have been developed by academic institutions and commercial companies. However, there is no systematic summary about the application of intent recognition in the field of rehabilitation robots. Therefore, the purpose of this paper is to summarize the application of intent recognition in rehabilitation robots, analyze the current status of their research, and provide cutting-edge research directions for colleagues. Literature searches were conducted on Web of Science, IEEE Xplore, ScienceDirect, SpringerLink, and Medline. Search terms included "rehabilitation robot", "intent recognition", "exoskeleton", "prosthesis", "surface electromyography (sEMG)" and "electroencephalogram (EEG)". References listed in relevant literature were further screened according to inclusion and exclusion criteria. In this field, most studies have recognized movement intent by kinematic, sEMG, and EEG signals. However, in practical studies, the development of intent recognition in rehabilitation robots is limited by the hysteresis of kinematic signals and the weak anti-interference ability of sEMG and EEG signals. Intent recognition has achieved a lot in the field of rehabilitation robotics but the key factors limiting its development are still timeliness and accuracy. In the future, intent recognition strategy with multi-sensor information fusion may be a good solution. As a technology, intent recognition can become a part of rehabilitation, assist patients to complete daily life activities, and improve their quality of life. Rehabilitation training equipment for treatment usually adopts a relatively stable prediction method, which aims to stimulate the enthusiasm of users to participate in training. Functionally enhanced rehabilitation aids have high requirements for the timeliness of movement intent recognition, and its purpose is to assist patients to complete activities of daily life. [ABSTRACT FROM AUTHOR]

People with physical disabilities often require lifetime support and experience challenges to maintain or (re)define their level of independence. Assistive living technologies (ALT) are promising to increase independent living and execution of activities of daily living (ADL). This paper provides a systematic literature review that aims to analyse the present state of the literature about the impact of ALT on perceived independence of people with a physical disability receiving long-term care. Databases Embase, Medline, and Web of Science were searched for eligible studies from 2010 or later. Nine studies were included, of which seven qualitative, one quantitative, and one mixed methods. Quality was generally high. ALT enabled participants to execute ADL. We found six themes for the impact of ALT on perceived independence: feeling enabled, choice and control, feeling secure, time alone, feeling less needy, and participation. ALT appears to impact perceived independence in many ways, exceeding merely the executional aspect of independence. Existing research is limited and quite one-sided. More large-scale studies are needed in order to inform care organisations how to implement ALT, especially considering societal developments and challenges impacting long-term care. People with a physical disability receiving long-term care experience that assistive living technology impacted their independence. Their independence is increased by making them feel enabled, secure, and less needy and increasing their choice and control, time alone, and participation. Most studies focused on the use of environmental control systems by people with spinal cord injury. More research is needed to evaluate long-term effects of diverse assistive living technologies used by people with a physical disability receiving long-term care. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to describe non-participation during the outcome measurement step of the wheeled mobility service delivery process (WMSDP) based on the Functional Mobility Assessment (FMA)-Uniform Dataset (UDS) Registry. The WMSDP is a standard framework for the provision of wheeled mobility devices, and several factors influence the client's experience throughout the process. Patient-reported outcomes are one way to measure the client's experience as part of a quality improvement program. A retrospective descriptive study was conducted on the FMA-UDS Registry to measure the response rate during the outcome measurement step of the WMSDP and describe the reasons an individual did not complete the FMA-UDS. The FMA-UDS was examined at two time points: pre-delivery and post-delivery of the wheeled mobility device. As of September 2, 2021, 10,253 cases have been entered into the FMA-UDS Registry. 2,247 cases were no longer participating pre-delivery, and an additional 3,905 cases were no longer participating post-delivery. The most common reasons for non-participation in the FMA-UDS pre-delivery and post-delivery included: equipment not delivered; provider no longer participating in the FMA-UDS; funding issues; no new equipment; client opted out; loss in contact; deceased; returned equipment; and other. The type and frequency of non-participation in the outcome measurement step of the WMSDP is critical to understanding why individuals participate in outcome measures and provides insight into the barriers and facilitators for the implementation of quality improvement programs. The outcome measurement system provides a structured mechanism for consistent communication between the client and the professionals providing the service, thereby identifying issues earlier in the process and mitigating frustration throughout the wheeled mobility service delivery process. The role of a credentialed professional, specifically an Assistive Technology Professional, in the wheeled mobility service delivery process could emphasize the importance of the follow-up and outcome measurement steps, which may increase the consumers' participation rate and demonstrate the effectiveness of devices and services. Clients who no longer participate in the outcome measurement process do not have the sustained support of the interprofessional team, and possess an increased chance that they will not get their mobility needs met through the health care system. [ABSTRACT FROM AUTHOR]

Persuasive gamified systems are effective tools for motivating behaviour change using various persuasive strategies. In line with the reinforcement theory, some persuasive gamified systems employ reward and punishment in their design to achieve the intended behavioural outcome. Research has argued both in favour and against using these strategies in behaviour change applications due to mixed results with respect to their effectiveness. However, there is a lack knowledge about how interventions using these strategies could motivate or demotivate behaviours. Therefore, this paper explores the mechanism through which Reward and Punishment motivate or demotivate behaviours with respect to their strengths and weaknesses. The results of large-scale exploratory studies (N = 1768) uncover important strengths and weaknesses that could facilitate or hinder the effectiveness of Reward and Punishment at motivating behaviour change. These include their ability to engage users and make behaviour fun, reinforce commitments to goals, and reveal some consequences of bad behaviour. We also compared the perceived effectiveness of reward and punishment quantitatively. [ABSTRACT FROM AUTHOR]

Despite a sound policy framework, the right of learners with disabilities in South Africa to inclusive and equitable quality education is not being met. A key reason hindering the realisation of this right is that there are very few teacher education programs focused on supporting learners with disabilities. Acknowledging the urgency of teacher education, in this paper we draw on qualitative data from 109 teacher participants and 39 course facilitators of a series of disability inclusion-focused teacher education short courses in the Western Cape province of South Africa. Based on their experience of the courses, we consider how teachers can be empowered to meet the diverse needs of their learners within an inclusive framework. Findings highlight that professional and personal growth facilitated a more empathic understanding of learners and the opportunity to collaborate with others, enabling teachers to find creative ways of solving problems faced in their workplaces. To support teachers in meeting the needs of their learners, teacher training should facilitate active reflection on the role they play in shaping the lives of their learners, and prepare teachers to respond to challenges strategically, taking advantage of the resources available to them within and beyond their school environment. [ABSTRACT FROM AUTHOR]

Background: During the past two decades of cannabis legalization, the prevalence of medical cannabis (MC) use has increased and there has also been an upward trend in alcohol consumption. As less restricted cannabis laws generate more adult cannabis users, there is concern that more individuals may be simultaneously using medical cannabis with alcohol. A few studies have examined simultaneous use of medical cannabis with alcohol, but none of those studies also assessed patients' current or previous non-medical cannabis use. This paper explores simultaneous alcohol and medical cannabis use among medical cannabis patients with a specific focus on previous history of cannabis use and current non-medical cannabis use. Methods: A retrospective cohort study of MC patients (N = 319) from four dispensaries located in New York. Bivariate chi-square tests and multivariable logistic regression are used to estimate the extent to which sociodemographic and other factors were associated with simultaneous use. Results: Approximately 29% of the sample engaged in simultaneous use and a large share of these users report previous (44%) or current (66%) use of cannabis for non-medical purposes. MC patients who either previously or currently use cannabis non-medicinally, men, and patients using MC to treat a pain-related condition, were significantly more likely to report simultaneous alcohol/MC use. Conclusions: Findings indicate that there may be differential risks related to alcohol/MC use, which should be considered by cannabis regulatory policies and prevention/treatment programs. If patients are using cannabis and/or alcohol to manage pain, clinicians should screen for both alcohol and cannabis use risk factors. [ABSTRACT FROM AUTHOR]

Recent years have seen a shift in the number of bereavement studies examining daily grief processes, but our knowledge is still limited due to the lack of dyadic research. In this paper, we explored the change in mental health in the course of a seven-day dyadic diary with bereaved couples who lost their child during pregnancy, labor, or afterward. We conducted dyadic latent growth curve analyses. In the bereaved parents who experienced a pregnancy loss, we found reduced grief (for both partners) and anxiety symptoms (only for women) and no changes in depression symptoms or personal strength levels across the diary days. In the bereaved parents who lost their child during labor or afterward, both partners' grief and depression symptoms and women's anxiety symptoms stayed stable, men's anxiety symptoms decreased, but women experienced a decline in their personal strength. Overall, negative aspects of mental health showed no sign of a dyadic diary's harm to the bereaved parents and even pointed to increased mental health in some respects during the study. However, a feeling of reduced capacity to deal with difficulties during the diary was also observed in women. Our findings indicated that both negative and positive aspects of mental health should be considered to evaluate the impact of diary studies on the participants. [ABSTRACT FROM AUTHOR]

This paper aims to examine the spatial attributes in the hospital ward environment and their impact on medical students' learning and experience of the clinical workplace. An ethnographic study was conducted in a Scottish teaching hospital, combining observations and interviews over a period of 10 months. Two teaching wards served as the field-sites where approximately 120 h of non-participant observations took place sequentially. In addition, 34 individual interviews were conducted with identified key informants that included medical students, junior doctors, postgraduate trainees, consultant supervisors, ward nurses and hospital pharmacist. A combination of Actor-network Theory (ANT) and Social cognitive theory (SCT) was applied to analyse data pertaining to spatial attributes and their relevance to clinical teaching and learning. Analysis of the observational and interview data led to generation of the following themes: spatial attributes in the clinical workplace can enable or constrain teaching and learning opportunities, inadequate spaces impact students' and junior doctors' sense of value, short clinical rotations influence a sense of ownership of doctors' spaces, and contested nature of space in the clinical environment. Several illustrations of the field-sites help to contextualise the themes and aid in understanding the participants' experiences and perceptions. Our findings suggest a complex entanglement of space with medical students learning and wellbeing in the clinical workplace. Provision of suitable spaces needs to be a core consideration to realise the full potential of work-based learning in medicine. [ABSTRACT FROM AUTHOR]

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient's interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. [ABSTRACT FROM AUTHOR]

This paper explores teenage girls' responses to general advice, and formal prevention messages, designed to reduce sexting-related risk and prevent harm. We conducted workshops with seven groups of girls (28 in total), aged 16–17 years, in a New Zealand city. Each group participated in a series of three workshop sessions. Drawing on a Freirean 'problem-posing' approach, we designed the workshops as spaces in which girls were invited to observe and critically discuss norms related to sharing nudes as well as harm prevention messages. Girls noticed the problematic gender and sexual politics that shape abstinence-based models that target girls (implicitly) to not send nudes, but which leave boys who distribute or otherwise misuse them out of the picture. Participants navigated a careful path between attending to risk and protection on the one hand, and endorsing their right to freedom of expression on the other. We argue for a subtle, but significant, shift away from a focus on sexting safety to a focus on the prevention of image-based sexual coercion, harassment and abuse. This reframing would help to direct prevention efforts to the gendered drivers and dynamics of harm perpetration, and the ways in which they are problematically socially ignored or condoned. [ABSTRACT FROM AUTHOR]

Chronic pain is a common feature of hypermobile Ehlers–Danlos Syndrome (hEDS), yet how patients assess and communicate their pain remains poorly understood. The objective of the present study was to explore the use of numeric pain assessment in individuals with hEDS, from a patient-centered perspective. Our analysis is based on in-depth qualitative interviews. The interviews were conducted over the phone. Our participants were patients living with hEDS (N = 35). Interviews were recorded, transcribed, and analyzed to identify factors related to their use of these pain assessment instruments. Three primary themes emerged from these data, namely, (1) confusion around the quantification of multidimensional pain, (2) the subjectivity of pain experience, and (3) a strategic use of assessments for practical purposes beyond the accurate representation of pain. These results demonstrate the need for caution in relying exclusively on numeric pain assessment instruments. We conclude with a brief proposal for a clinical communication strategy that may help to address the limitations of numeric pain assessment that were identified in our interviews. Chronic pain is a common feature of hypermobile Ehlers–Danlos Syndrome (hEDS), yet how patients assess and communicate their pain remains poorly understood. Clinicians should be aware that patients have difficulties with the Numeric Rating Scale (NRS) for at least three reasons: (1) confusion around the quantification of multidimensional pain, (2) the subjectivity of pain experience, and (3) a strategic use of assessments for practical purposes beyond the accurate representation of pain. Clinicians should use caution in relying exclusively on NRS instruments. Clinicians may benefit from using clinical communication strategies outlined in our paper, which may help to address the limitations of the NRS that were identified in our interviews. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic led many couples to stay at home together with minimal contact with others. As social distancing measures reduced contact with outside households, many partners could seek support only from one another. In two studies using a sequential mixed methods design, we investigated support-seeking behaviors in romantic relationships during COVID-19. In the qualitative study, semi-structured interviews (n = 48) showed differences in how and why partners seek support with an initial consideration of the role of attachment. We identified the following themes: direct support-seeking, indirect support-seeking, (in)dependence, and gender dynamics. In the quantitative study (n = 588), high COVID-19 worry, high attachment anxiety, and low attachment avoidance were associated with more support-seeking. Interestingly, we also found that when COVID-19 worry was high, individuals high in attachment avoidance were more likely to report seeking support. The paper provides a unique insight into the impact of COVID-19 on support-seeking behaviors in romantic relationships. [ABSTRACT FROM AUTHOR]

Community housing services adopt care models such as rehabilitation, recovery-oriented care and person-centered planning to improve the quality of life of service users with an intellectual or psychiatric disability. However, the way these care models are implemented and practiced can negatively impact service users' experience with the service as their complex needs go unmet. In this paper, we conceptualize these experiences through developing the counternarrative of burdens of support. For this we draw on burden of treatment theory. We conducted ethnographic fieldwork in a community service organization in the Netherlands. This included participant observation (84 h), interviews with service users (n = 20), experts-by-experience (n = 8), family members (n = 10) and photovoice workshops. Our analysis identifies four burdens of support: burden of self-determination; re-identification; responsibilisation and re-placement. The results show that burden of support is very much a relational concept: through their support, professionals can aggravate or alleviate burden. People with intellectual or psychiatric disabilities often receive support with living in the community. Good support fits people's needs (e.g. person-centered planning), builds on people's strengths and contributes to recovery and community participation. Even when support is practiced or organized with such aims, service users can have negative experiences. In this research we call this: 'burden of support'. Examples of burden of support identified include: Clients' needs and wishes are sometimes not sufficiently attended too when working with a personal care plan. Too much responsibility is sometimes shifted to clients, which results in feelings of failing or abandonment. The focus on strengths and recovery sometimes leaves too little room for clients to voice support needs. Having to move to a different home or neighborhood as part of becoming more independent can result in many difficulties including loneliness. The research recommended that those who improve services should also alleviate these burdens. [ABSTRACT FROM AUTHOR]

This paper sought to determine risk factors of occupational injury in the Irish dairy farming sector and to estimate the roles of both dairying expansion and the discipline of agricultural extension in influencing reducing injury occurrence. Data for this study was obtained via the Irish National Farm Survey (NFS). In total, 260 farm (83.6% of NFS dairy farm sample) workplace injury survey questionnaires were completed by NFS recorders by interviewing principal farm operators for year 2017. Injury survey data was analysed for 48 variables in conjunction with NFS core farm socio-economic, physical and financial data. Additionally, core data from 2010 for 78.5% of farms surveyed in 2017 was included in the study. Data were analysed using a three-step statistical testing process which met all Binary Logistic Regression assumptions. The study found that dairy farms had a higher farm workplace occupational injury level compared to a previous study. The study data indicates occurrence of elevated injury levels on farms which expanded and which were intensively managed from a milk production perspective. Farm expansion was associated with increased labor units used and increased investment per hectare. The study also found that use of extension services and farm discussion group participation were not associated with injury occurrence. This study demonstrates how a retrospective farm workplace occupational injury survey of Irish dairy farms, analysed in combination with farm business data can be used to identify injury risk factors, including those associated with production expansion. Irish dairy farms have a heightened farm workplace occupation injury level while dairy production expansion increased injury levels. Extension engagement did not influence on injury levels. Approaches to improve farm safety on dairy farms are outlined. [ABSTRACT FROM AUTHOR]

Researchers and epidemiologists are working to improve the capture of agriculture, forestry, and fishing (AgFF) injuries in a variety of ways. A critical component of any surveillance system is the dissemination of information. The purpose of this paper is to report on a survey conducted with AgFF injury surveillance stakeholders to understand preferred dissemination strategies. The survey was distributed using REDCap via web link to organizational stakeholders, which included advisory board members, safety trainers, industry managers and workers, and research collaborators. In total, there were 75 respondents (21% response rate). Occupation and industry influenced preference in update methods. Regarding the length and breadth of updates, 63% of respondents prefer reports (one to five pages), followed by 57% desiring a summary (less than one page), while only 24% wanted a detailed analysis. Social media and news preferences were also different among stakeholders. Surveillance data were desired for 1) trend analysis, 2) tailoring activities and solutions for education, training, outreach and interventions and 3) for research purposes such as grant proposals and evaluation. The dissemination of injury surveillance data should be tailored to the intended audience. Greater attention needs to be paid to the ways in which we share our findings. [ABSTRACT FROM AUTHOR]

Farming is one of the top industries in Michigan and has the highest fatality rate. National sources of non-fatal farm injuries underestimate the burden, especially among children. In this paper, we provide a more accurate estimate of non-fatal farm injuries in Michigan by using an ongoing multi-source surveillance system. Michigan's farm-injury surveillance system includes abstractions of hospital-based medical records, poison control center calls, ambulance runs, and workers' compensation claims for individuals with a farm-related injury. For this analysis, injury onset occurred in 2015 to 2021 and included all injuries regardless of age or occupation. We identified 4,306 injuries in adults and 336 injuries in youth. For those 0–13 years of age all but two were family members. For those 14–15 and 16–17 years of age, 19% and 45%, respectively were hired hands. For adults, 51% were owner/operators, 43% were hired hands, and 5% were family members. For all ages, the most frequent injury source was cattle. Lacerations/cuts/punctures were the most common type of injury for those < 14 years of age while for older individuals it was contusions/bruises. The plurality of injuries occurred in the summer months. Children working on a farm are in unique situation and tracking injuries and identifying injury sources provide necessary information to protect their health and well-being. Michigan's farm-injury surveillance system will continue to provide a comprehensive count of work-related injuries among Michigan's farming population. The information is used to direct public health intervention both at the individual and population level. [ABSTRACT FROM AUTHOR]

Literature on occupational risks among organic farmers is scarce. This study explored safety practices and non-fatal injuries among organic producers, and the role of sociodemographic, work, and farm characteristics on safety and injury. Cross sectional survey of certified organic crop producers in the Southwest (SW) region of the United States (US). The Organic Integrity Database was used for recruitment. Data were collected through an electronic and paper survey. Analyses were conducted on 115 cases; response rate was estimated at 25%. A high majority of respondents owned their operation and were younger than 65 years, male, educated beyond high-school, and non-Hispanic whites. Less than half had more than 10 years of experience in organic farming; one-third worked off the farm year-round. Safety practices were very basic despite the widespread use of equipment and machinery, and limited to wearing normal clothing and apparel such hats and glasses. About half of respondents (52.6%) reported non-fatal injuries in the past year; and one-third (32.7%) time lost due to injuries. The overall cumulative incidence rate was estimated at 5.3 injuries per 10 workers within the last year. The injury rate decreased with hours worked. Significant differences were found on gender and education level and safety practices, with female respondents and the more educated being more proactive in practicing safety. Those working less than 40 h/week, in farms smaller than 50 acres, using light machinery or compact utility tractors, and tractors without roll-over protection reported significantly higher injury frequency compared to their counterparts. This study contributes unique data on an essential workforce not captured by current occupational injury and illness surveillance systems. It identifies important personal and contextual factors that may contribute to safety and injury in this population. The findings indicate the need to promote safety and prevent injuries that result in work time lost. This study may also inform future occupational safety and health research and practice, including surveillance, injury prevention programs that target certain workers and production practices, and policies that support and protect the organic farmer. [ABSTRACT FROM AUTHOR]