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

Kidney stones, a persistent urological condition, continue to affect people globally. In this critical review, we examine the work of Borghi et al. who evaluated patients with idiopathic stone formation and randomised 99 patients to increased water intake (≥ 2 L/day) and 100 patients to usual care in a 5-year randomized controlled trial. The study examined baseline urine volume in individuals with idiopathic calcium stones, recurrence rates, and relevant biochemical factors. The study found reduced recurrence rate (12.1% vs. 27% (p = 0.008)), and time to recurrence with increased water intake (38.7 ± 13.2 months) vs. (25 ± 16.4 months) (p = 0.016). These findings inform clinical practice, contributing to the guideline recommendations that kidney stone patients should aim for fluid intake of at least 2.5 L per day to prevent stone recurrence. [ABSTRACT FROM AUTHOR]

Higher education professional recognition programs, which lead to the awarding of such accolades as teaching and learning fellowships, offer participants opportunities to reflect carefully on their practice. However, few resources exist to help participants engage in reflection after the award-receiving stage. This reflection is important in helping participants not rest on their laurels and, instead, build on the practices for which they received recognition. Through a process of collaborative reflection, a group of fellowship-recipients, from different disciplines and higher education institutions, addressed this gap as stakeholder-participant-researchers by developing a transdisciplinary approach to undertaking post-award reflective practice. From this collaboration, a novel two-stage tool was developed using an iterative design methodology. The tool presented in this paper as the result of this research can be understood as a means of supporting self-paced, continued post-award reflective practice; the tool's first stage guides users through retrospective reflection, looking back on previous achievements, while the second stage leads users through anticipatory planning, looking towards the future, to achieve fresh goals. The tool thus deepens the reflective practice of recognition program awardees and supports their ongoing professional development. This paper reports on the development of this bespoke tool, which may be enacted in varied settings. [ABSTRACT FROM AUTHOR]

The types of obstacles encountered in the road environment are complex and diverse, and accurate and reliable detection of obstacles is the key to improving traffic safety. Traditional obstacle detection methods are limited by the type of samples and therefore cannot detect others comprehensively. Therefore, this paper proposes an obstacle detection method based on longitudinal active vision. The obstacles are recognized according to the height difference characteristics between the obstacle imaging points and the ground points in the image, and the obstacle detection in the target area is realized without accurately distinguishing the obstacle categories, which reduces the spatial and temporal complexity of the road environment perception. The method of this paper is compared and analyzed with the obstacle detection methods based on VIDAR (vision-IMU based detection and range method), VIDAR + MSER, and YOLOv8s. The experimental results show that the method in this paper has high detection accuracy and verifies the feasibility of obstacle detection in road environments where unknown obstacles exist. [ABSTRACT FROM AUTHOR]

Two major research issues for longitudinal investigations are the 'naturalness' of the learner language being studied, and the extent to which the research design is truly longitudinal. Regarding the first issue, data for longitudinal studies are usually collected in language classrooms or exams, with the writing tasks/topics being tightly controlled. A major disadvantage is that tasks can be unrepresentative of the writing required in disciplinary content courses. The present study analyzes writing development as it occurs 'naturally' in university disciplinary content courses, using four complexity features (i.e., finite adverbial clauses, finite relative clauses, attributive adjectives, and nouns as pre-modifiers) with the goal of comparing the kinds of findings in a True-longitudinal approach, a Quasi-longitudinal approach, and a Case study approach. This close examination of writing development that controlled for discipline and task showed an increase in development as measured by these linguistic indicators. [ABSTRACT FROM AUTHOR]

Background: Robotic surgery has gained widespread acceptance in elective interventions, yet its role in emergency procedures remains underexplored. While the 2021 WSES position paper discussed limited studies on the application of robotics in emergency general surgery, it recommended strict patient selection, adequate training, and improved platform accessibility. This prospective study aims to define the role of robotic surgery in emergency settings, evaluating intraoperative and postoperative outcomes and assessing its feasibility and safety. Methods: The ROEM study is an observational, prospective, multicentre, international analysis of clinically stable adult patients undergoing robotic surgery for emergency treatment of acute pathologies including diverticulitis, cholecystitis, and obstructed hernias. Data collection includes patient demographics and intervention details. Furthermore, data relating to the operating theatre team and the surgical instruments used will be collected in order to conduct a cost analysis. The study plans to enrol at least 500 patients from 50 participating centres, with each centre having a local lead and collaborators. All data will be collected and stored online through a secure server running the Research Electronic Data Capture (REDCap) web application. Ethical considerations and data governance will be paramount, requiring local ethical committee approvals from participating centres. Discussion: Current literature and expert consensus suggest the feasibility of robotic surgery in emergencies with proper support. However, challenges include staff training, scheduling conflicts with elective surgeries, and increased costs. The ROEM study seeks to contribute valuable data on the safety, feasibility, and cost-effectiveness of robotic surgery in emergency settings, focusing on specific pathologies. Previous studies on cholecystitis, abdominal hernias, and diverticulitis provide insights into the benefits and challenges of robotic approaches. It is necessary to identify patient populations that benefit most from robotic emergency surgery to optimize outcomes and justify costs. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to investigate how nursing students utilised the "DiagNurse" mobile app to assess patient health conditions during their clinical apprenticeships. Material and methods. This prospective, quasi-experimental post-test study included a convenience sample of 62 undergraduate nursing students. In the course of the work, they utilized paper-based measurement scales (first measurement) and the mobile app (second measurement) to assess patient health conditions during clinical practice. In total, 432 clinical condition assessments were performed on patients in the first measurement and 432 in the second measurement. Following the clinical assessment, two types of post-tests were employed to ascertain the usability of the mobile app: quantitative testing using the System Usability Scale and qualitative testing. Results. The mean SUS score was 80.2 (SD 15.67). The majority of the students agreed that the utilisation of the mobile app to assess a patient's health condition is faster (M=3.21) and more convenient (M=3.16) than the use of paper-based scales and questionnaires. On a 0–10 scale, the study participants rated it as "highly recommended" (M=8.03) for fellow nursing students or practicing nurses. Conclusions. Although the "DiagNurse" mobile app was considered a suitable tool for learning clinical patient assessment, the students also proposed some improvements to the app's design. [ABSTRACT FROM AUTHOR]

Background: The gold standard treatment for periprosthetic joint infections is the two-stage revision that includes the spacer placement before definitive reimplantation. The management of PJI affects patients' joint function and, subsequently, their mental health. Even though significant advances have been achieved, little to no attention has been paid to the psychological implications. So, based on standardized patient-reported outcome measures (PROMs), this study aimed to clarify the effect of spacer treatment of infected hip and knee arthroplasties on patients' mental health. Methods: We performed research on the literature on PJIs in the English language using the MEDLINE database with the search strings "spacer" OR "spacers" AND "hip" OR "knee" AND "SF-12" OR "SF-36" OR "EQ-5" OR "mental" OR "depression" OR "anxiety." The reference lists of selected articles were also hand-searched for any additional articles. Results: A total of 973 published papers were extracted, and 9 papers were finally included. A total of 384 patients who underwent spacer placement for PJI were identified. Of these 384 patients, 54% were female. The mean age ranged from 62 to 78.2 years. Of the11 papers identified for this review, 4 analyzed only hip spacers, including 119 patients; 4 only knee spacers, evaluating 153 patients; while a single study included 112 patients for both joints. Conclusions: Patients with the spacer are living in a state of mental upset, albeit better than the preoperative state. Clinical improvement with the review is not assured. The alteration of mental state turns out not to be transient for all the patients. [ABSTRACT FROM AUTHOR]

Objectives: Unwarranted clinical variations in radical prostatectomy (RP) procedures are frequently reported, yet less attention is given to the variations in associated costs. This issue can further widen disparities in access to care and provoke questions about the overall value of the procedure. The present paper aimed to delve into the disparities in hospital, medical provider and out-of-pocket costs for RP procedures in Australia, discussing plausible causes and potential policy opportunities. Methods: A retrospective cohort study using Medibank Private claims data for RP procedures conducted in Australian hospitals between 1 January 2015 and 31 December 2020 was undertaken. Results: Considerable variations in both medical provider and out-of-pocket costs were observed across the country, with variations evident between different states or territories. Particularly striking were the discrepancies in the costs charged by medical providers, with a notable contrast between the 10th and 90th percentiles revealing a substantial difference of A$9925. Hospitals in Australia exhibited relatively comparable charges for RP procedures. Conclusions: Initiatives such as enhancing transparency regarding individual medical provider costs and implementing fee regulations with healthcare providers may be useful in curbing the variations in RP procedure costs. What is known about the topic? Unwarranted clinical variations in radical prostatectomy procedures are well documented in the literature; however, variations in cost are less widely reported. What does this paper add? This paper aims to highlight the cost variations in radical prostatectomy procedures in Australia, discussing their plausible causes, implications and proposing potential policy opportunities. What are the implications for practitioners? Excessive fees imposed by medical providers may contribute to inequalities in healthcare access. Enhancing transparency of individual medical provider costs and implementing fee regulations may be useful in controlling unwarranted variations in procedure costs. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Background: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. Aim: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. Methods: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single‐use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. Results: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). Conclusions: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less. Summary statement: What is already known about this topic? Traditional and dry bed baths are personal care procedures that are frequently carried out by nurses with patients in intensive care units.Bed baths may affect the hemodynamic parameters of patients in intensive care units, but few studies have evaluated their effects.Determination of the hemodynamic parameters of patients during bed baths, the duration of bathing and the cost of consumable bathing materials may help nurses to achieve patients' body hygiene in a more reliable way and to decide on and adopt measures to minimize risks. What this paper adds? This paper contributes to the performance of personal hygiene. It is necessary to closely monitor the hemodynamic parameters of intensive care patients when they are being given bed baths.This study has direct effects in awakening nurses to the potential risk of bed baths causing a change in hemodynamic parameters in intensive care patients and in taking measures to reduce these risks to a minimum. Also, giving dry bed baths, which are superior in taking less time and having lower costs, provides advantages to nurses in terms of work load, physical difficulties and finance. The implications of this paper: This study emphasizes the positive impacts of dry bed baths carried out by nurses for patients in intensive care units.The dry bed bath can be accepted as enhancing patient safety by being easy to perform and by shortening the time when the patient is exposed to environmental risks. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to evaluate the effect of the Roy adaptation model‐based strengthening program (RAMBSP) applied to nursing students on social media addiction, healthy lifestyle behaviours and self‐esteem. Methods: One hundred five nursing students studying at a nursing faculty of a university were included in this prospective, two‐armed (1:1), randomized controlled study. The study group (n:54) had 12 weeks of RAMBSP online group sessions. No intervention was made to the control group (n:51). The social media addiction level, which was the primary outcome of the study, was evaluated with the Bergen Social Media Addiction Scale (BSMAS) and healthy lifestyle behaviours and self‐esteem, which were secondary outcomes, were evaluated with the Healthy Lifestyle Behaviours Scale II (HLBS‐II) and the Rosenberg Self‐Esteem Inventory (REI). Students filled out BSMAS, HLBS‐II, and REI online via Google Forms before and after RAMBSP. Findings: At the end of the programme, there was no significant difference between the groups in terms of BSMAS scores of the students in the study group (p > 0.05); however, the difference was significant in terms of HLBS‐II and REI scores (p < 0.05). It was determined that the empowerment programme increased students' awareness of social media addiction. Conclusion: It is recommended to implement programmes that will increase students' awareness of social media addiction and its effects and to conduct new research that will cover large and different sample groups. Trial registration: It was registered at ClinicalTrials.gov in March 2021 (NCT04820517). Summary statement: What is already known about this topic? With the development of technology, social media addiction is widely seen in nursing students, who are a fragile group.Biopsychosocial approaches should be presented together in practices aimed at reducing or controlling the use of social media.It is not known whether an empowerment programme based on the nursing model (Roy adaptation model) to reduce social media addiction in nursing students is effective. What this paper adds? This programme constitutes an example of how to combine Roy adaptation model, one of the nursing models related to reducing social media addiction and providing controlled social media use, with the empowerment programme.The strengthening programme based on Roy adaptation model helped student nurses to acquire and maintain healthy lifestyle behaviours by increasing their awareness of social media addiction and improving their self‐esteem. The implications of this paper Roy adaptation model‐based psychoeducation should be conducted to enable nursing students to gain awareness of social media addiction and its consequences.Roy adaptation model‐based activities should be planned and implemented to intervene in students with social media addiction and to lead them to healthy social media use.Course contents should be added to the nursing curriculum to encourage the use of social media in a way that is effective, safe and contributes to personal development. [ABSTRACT FROM AUTHOR]

Background: The United States is increasingly recognizing period product insecurity, insufficient access to menstrual products and limited private spaces for managing menstruation due to financial constraints, as an issue impacting the well-being and dignity of Americans. One strategy to address period product insecurity has been distributing free period products via period supply banks. The outcomes of period product distribution outside the school setting are absent from the literature. Objectives: This study, a formative evaluation of the free period product distribution efforts of the Alliance for Period Supplies, aims to identify (1) characteristics of individuals receiving products from period supply banks and their experiences of period product insecurity and (2) health and social outcomes experienced by recipients of free period products. Design: Survey data collection occurred at two points: baseline and one-year follow-up. All study participants provided verbal consent. Methods: Between Fall 2018 and Spring 2020, 1863 baseline and 80 follow-up surveys were administered. Participants received free period products for themselves and/or a household member from one of 20 participating Alliance for Period Supplies period supply banks directly or from one of their 64 partner agencies. Results: At baseline, 72.4% of participants had to choose between buying period products and another basic need. One year after accessing a period supply bank, 36.3% of participants reported this experience (p = 0.018). Participants reported at baseline, on average, 7.8 days in the past year of avoiding seeing others, canceling appointments, or skipping work or school because they did not have access to period products. At follow-up, this was reduced to 1.2 days, on average, t (68) = 2.214, p < 0.05. Conclusion: Period supply banks play an essential role in facilitating access to period products and the resulting benefits. Our study highlights the need for sustainable, well-funded policies and interventions to address period product insecurity effectively in society. Plain Language Summary: How people in the United States benefit when they get free period products from a period supply bank Why we did this study: In the United States, many individuals cannot afford to buy period supplies and the other stuff they need to live. Period supply banks want to help by giving them free period products. Researchers do not know if getting free period products is helpful for individuals. What we wanted to learn: The Alliance for Period Supplies is a membership program for period supply banks. We wanted to learn about the individuals who get free period products and whether getting them was helpful. What we did: For a year, starting in Fall 2018, we asked 1863 individuals to fill out paper surveys. A year later, we asked 80 of those same individuals to fill out a second survey. We asked participants to take the survey if they got free period products from a period supply bank for themselves or someone they live with. Individuals only participated in the study if they told us they wanted to. What we learned: Individuals who cannot afford period products must navigate difficult decisions between purchasing products or choosing other basic needs. Providing free products through a period supply bank has lessened the burden on these individuals, reducing the number who had to choose. Individuals unable to afford period products may sometimes opt out of going places they want to go for pleasure or miss important events, like work or school, because they do not have period products. Getting free period products has eased these challenges, letting individuals participate more fully in activities and engagements without worry about period products. Why is this important: Period supply banks are essential places where individuals receive free period products. The period supply banks need more individuals, including our government, to donate period supplies or money to buy them so they can help more individuals. [ABSTRACT FROM AUTHOR]

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

Simple Summary: This manuscript systematically reviewed the literature on the use of vascular shunts during advanced pancreatic surgery, analyzing intraoperative and postoperative outcomes, and enlightening excellent long-term patency, negligible additional operative time, and acceptable postoperative morbidity. The importance of the study was to underline feasibility of this technical artifice, which may help expert surgeons to achieve clear margins in borderline or locally advanced PDAC. Background: The rising diffusion of vascular resections during complex pancreatectomy for malignancy, for both oncological and technical matters, brought with it the use of vascular shunts, either temporary or definitive, to prevent bowel congestion and liver ischemia. This study aimed to systematically review the literature on the technical feasibility of vascular shunts during advanced pancreatic surgery, analyzing intraoperative and postoperative outcomes. Methods: A systematic literature search was performed on PubMed, Scopus, Web of Science, and the Cochrane Library Central, according to PRISMA guidelines. Studies published before 2006 were excluded, considering the lack of a standardized definition of locally advanced pancreatic cancer. The main outcomes evaluated were the overall complication rate and shunt patency. Results: Among 789 papers retrieved from the database search, only five fulfilled the inclusion criteria and were included in the review, amounting to a total of 145 patients undergoing a shunt creation at the time of pancreatectomy. Pancreatic adenocarcinoma (PDAC) was found to be the most common diagnosis and pancreaticoduodenectomy was the main surgical procedure, accounting for 88% and 83% of the overall cohort, respectively. The distal splenorenal shunt was the most performed. Overall, 44 out of 145 patients (30%) experienced postoperative complications; the long-term patency of definitive shunts was 83% (110 out of 120 patients). Conclusions: An increasing number of patients with borderline resectable or locally advanced PDAC are becoming amenable to resection and shunt creation may facilitate vascular resection with clear margins, becoming a valid tool of modern pancreatic surgery. [ABSTRACT FROM AUTHOR]

Loneliness is increasingly common, especially among older adults. Technology like mobile telepresence robots can help people feel less lonely. However, such technology has challenges, and even if people use it in the short term, they may not accept it in the long term. Prior work shows that it can take up to six months for people to fully accept technology. This study focuses on exploring the nuances and fluidity of acceptance phases. This paper reports a case study of four older adult participants living with a mobile telepresence robot for seven months. In monthly interviews, we explore their progress through the acceptance phases. Results reveal the complexity and fluidity of the acceptance phases. We discuss what this means for technology acceptance. In this paper, we also make coding guidelines for interviews on acceptance phases more concrete. We take early steps in moving toward a more standard interview and coding method to improve our understanding of acceptance phases and how to help potential users progress through them. [ABSTRACT FROM AUTHOR]

Purpose: Through a systematic literature review, this paper aims to endeavor to present a thorough historical perspective on the evolution of employee-based brand equity (EBBE), offering a comprehensive understanding of its development. The study explores the general model, causes and effects of EBBE, as well as the role of culture, leadership and brand management in building EBBE. The paper proposes an integrative framework to understand the interrelationships between the various dimensions of EBBE and offers practical guidelines for future research and the business world. Design/methodology/approach: The paper uses a systematic literature review approach to analyze and synthesize 30 studies on EBBE retrieved from SCOPUS and Web of Science. The analysis involves a thematic and content-based examination of the literature, which is organized into three thematic groups. Findings: The review highlights the importance of EBBE as a driver of organizational performance and success. The paper identifies the evolution of the major themes, trends and debates in the literature and suggests areas for future research. It underscores the need for more qualitative, multi-level and longitudinal research on EBBE, as well as the exploration of the links between EBBE and other forms of brand equity. Originality/value: This paper is one of the first systematic literature reviews of EBBE, offering a comprehensive and integrated view of the existing literature since the beginning of this concept. The paper's originality lies in its proposed integrative framework that captures the interrelationships between the various dimensions of EBBE and provides practical guidelines for future research and the business world. [ABSTRACT FROM AUTHOR]

Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

Objectives: Internationally, hip or knee arthroplasty (TJA) with a 1-day hospital length of stay (LOS) is common and demonstrates improved patient and health service outcomes. This study aimed to develop and pilot an enhanced recovery program (ERP) for patients undergoing TJA to achieve a next-day discharge in an Australian public hospital setting. Methods: A project lead and six perioperative clinical craft group leads developed an ERP protocol based on enhanced recovery after surgery (ERAS) principles. Strict patient eligibility criteria were developed. Quality improvement methodology was used to implement the ERP. A patient navigator was put in place as a single contact point for patients. Results: A total of 825 patients were screened for the ERP and 47 patients completed the protocol. The mean ± standard deviation (s.d.) of the LOS was 34.7 (± 7.2) h with 41 patients (87%) achieving next-day discharge, the remaining six (13%) discharged on Day 2. Compliance with ERAS was high (96%) with mobilisation within 12 h occurring on 87% of occasions. There were no adverse events. Patient experience was positive. Conclusion: Next-day discharge was achieved with a selected cohort of patients with no adverse events and positive patient experience, using a multidisciplinary approach and an improvement framework. Broadening inclusion criteria will make ERP available to more patients. What is known about the topic? Next-day discharge following hip or knee arthroplasty in Australian public hospital settings is uncommon and little has been published reflecting enhanced recovery principles in this local context. What does this paper add? This paper describes the development and piloting of an enhanced recovery program using a novel approach to achieve next-day discharge following hip and knee replacement. What are the implications for practitioners? Other health services may leverage this approach to design and implement an enhanced recovery program to reduce hospital length of stay and improve patient and health service outcomes. [ABSTRACT FROM AUTHOR]

Background: This study takes on the challenge of quantifying a complex causal loop diagram describing how poverty and health affect each other, and does so using longitudinal data from The Netherlands. Furthermore, this paper elaborates on its methodological approach in order to facilitate replication and methodological advancement. Methods: After adapting a causal loop diagram that was built by stakeholders, a longitudinal structural equation modelling approach was used. A cross-lagged panel model with nine endogenous variables, of which two latent variables, and three time-invariant exogenous variables was constructed. With this model, directional effects are estimated in a Granger-causal manner, using data from 2015 to 2019. Both the direct effects (with a one-year lag) and total effects over multiple (up to eight) years were calculated. Five sensitivity analyses were conducted. Two of these focus on lower-income and lower-wealth individuals. The other three each added one exogenous variable: work status, level of education, and home ownership. Results: The effects of income and financial wealth on health are present, but are relatively weak for the overall population. Sensitivity analyses show that these effects are stronger for those with lower incomes or wealth. Physical capability does seem to have strong positive effects on both income and financial wealth. There are a number of other results as well, as the estimated models are extensive. Many of the estimated effects only become substantial after several years. Conclusions: Income and financial wealth appear to have limited effects on the health of the overall population of The Netherlands. However, there are indications that these effects may be stronger for individuals who are closer to the poverty threshold. Since the estimated effects of physical capability on income and financial wealth are more substantial, a broad recommendation would be that including physical capability in efforts that are aimed at improving income and financial wealth could be useful and effective. The methodological approach described in this paper could also be applied to other research settings or topics. [ABSTRACT FROM AUTHOR]

Purpose: Using perspectives from the technology affordance and social capital theories, this study aims to unpack the process through which platform-enabled co-development unfolds in supply chain contexts. Specifically, it explores how innovation outcomes can be fostered through platform affordances and supply chain relationship (SCR) capital. Design/methodology/approach: The paper integrates literature on digital platforms, SCRs and co-development to produce an integrative framework, developing propositions on the relationships among digital platforms, SCR capital and innovation outcomes. Findings: The authors identify affordances for distinctive strategic use of platforms: value co-creation, relationship building and strategic learning. The authors discuss ways in which each affordance contributes to the advances in SCR capital, thus altogether enabling focal firms to orchestrate and integrate internal and external resources to attain incremental and radical innovation. Research limitations/implications: Based on the proposed research framework, further empirical studies can use quantitative data to measure the relationship between affordances and SCR capital and use longitudinal case studies to explore how affordances and SCR capital evolve to provide more fine-grained and contextualised information in different research settings. Originality/value: This paper sheds light on how the relation between the adoption of digital platforms and SCR capital shapes digitally enabled service co-development. The authors provide an alternative explanation of resource integration in platform-mediated supply chain contexts and enrich the related literature on how digital platforms can maximise value from introducing ambidextrous innovation by leveraging internal and external resources. [ABSTRACT FROM AUTHOR]

Industry 4.0 represents the most advanced stage of organization of industrial companies, allowing them to respond to an uncertain and changing environment, particularly as accentuated by the recent crisis resulting from COVID-19. Management innovation (MI) contributes to this process of permanent adaptation. The MI implementation phase is a critical step in MI generation that can generate many potential obstacles. This study focuses on these obstacles while considering the different activities (or subprocesses) embedded in this phase and the different actors involved in this complex process. We conducted a longitudinal case study in real time to investigate the implementation of MI internally generated by a multinational industrial company. Our results show that the obstacles encountered during the MI implementation phase may differ depending on the different activities and actors of this phase, thus leading us to question current implementation frameworks. This paper contributes by refining the theoretical model of MI generation and providing a better understanding of the obstacles that occur during the MI implementation phase. From a managerial perspective, this paper highlights key management principles to overcome the obstacles identified. [ABSTRACT FROM AUTHOR]

This article presents the findings of a study on the amount of waste generated during gastrointestinal endoscopic examinations in German hospitals and offices. The study aimed to calculate the recycling potential of this waste. Over a four-week period, waste was collected and categorized into residual waste, accessories, personal protective equipment, plastics, and paper. The study found that an average of 1.15 kg of waste was generated per examination, with 69.9% being residual waste. Although the recycling potential for plastic and paper was low, it could still contribute to reducing the amount of residual waste. [Extracted from the article]

Aim: The aim of this study was to investigate the incidence, predictors, and outcomes of delirium in intensive care units. Background: Delirium is a common complication in intensive care units. In developing countries, it can be misdiagnosed or unrecognised. Design: Prospective cohort study reported according to the strengthening the reporting of observational studies in epidemiology criteria. Methods: We included patients who were conscious, >18 years old, and admitted to the intensive care units for at least 8 h between December 2019 and February 2020. Patients with a Richmond score of −4 or −5, mental disability, receptive aphasia and/or visual or auditory impairment were excluded from the study. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM‐ICU), whereas the functional outcome was assessed by the Katz Activity of Daily Living Index. Results: This study included 111 patients with a delirium incidence of 31.5%. The severity of illness was the only significant predictor of delirium. Patients with delirium had longer intensive care unit and in‐hospital stays in contrast to those without delirium. Delirium was associated with in‐hospital and 4‐month mortality but not the activities of daily living. Conclusions: Delirium is associated with increased length of stay and mortality. Further investigation to determine whether delirium management can improve outcomes is warranted. Summary statement: What is already known about this topic? Delirium is a common complication in the intensive care unit and can affect patients' outcomes.The incidence and the effect of delirium on patients' outcomes in low‐resource countries remain largely unexplored. Delirium is potentially underdiagnosed and commonly undetected in these countries. What this paper adds? Delirium is associated with a longer duration of stay in the hospital and the intensive care unit as well as mortality in the hospital and 4 months after discharge.Delirium may not affect long‐term functional outcomes after discharge.The severity of illness is an independent predictor of delirium. The implications of this paper In low‐resource countries, the increased length of stay can add a significant burden on healthcare systems.Proper management of delirium will potentially maximise resource utilisation.Delirium affects mortality and length of stay, thus investigating the effect of the current management protocols on these outcomes is warranted. [ABSTRACT FROM AUTHOR]

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Aims: Glioma patients are at high risk for postoperative delirium (POD), yet studies focusing on this population in general neurosurgical ward settings are limited. This paper investigates the incidence of POD and related risk factors in glioma patients hospitalized in general wards. Design: Prospective observational study. Methods: This prospective study included 133 adult glioma patients hospitalized in the general neurosurgery ward. In addition to collecting routine perioperative general clinical data, patients' psychological status was assessed preoperatively using the Hospital Anxiety and Depression Scale (HADS). POD was assessed within 3 days postoperatively using the Confusion of Consciousness Assessment method, twice daily. The incidence of POD was calculated, and risk factors were identified using logistic regression analysis. Results: The incidence of POD in glioma patients admitted to the general ward was 31.6% (40/133). Multivariate regression revealed advanced age (age > 50 years), frontal lobe tumour, presence of preoperative anxiety or depression, retention of a luminal drain, postoperative pain, indwelling catheter these six factors were independent risk factors for the development of delirium in patients after surgery. Conclusion: In general ward settings, supratentorial glioma patients exhibit a high risk of POD. Critical risk factors include preoperative psychological conditions, as well as postoperative pain, drainage and catheterization. Rigorous preoperative evaluations, effective pain management strategies and the integration of humanistic care principles are essential in mitigating the risk of POD for glioma patients. Relevance to Clinical Practice: In general ward settings, this study reveals the high occurrence of POD in glioma patients and identifies preoperative psychological states, age, tumour location and several postoperative factors as significant risk factors for POD, which provides a framework for targeted interventions. By integrating these insights into clinical practice, healthcare teams can better identify glioma patients at risk for POD and implement preventive measures, thereby enhancing recovery and overall care quality for glioma patients in general neurosurgical wards. Reporting Method: This study adheres to the STROBE guidelines, ensuring a transparent and comprehensive reporting of the observational research methodology and results. Patient or Public Contribution: Patients involvement was limited to the provision of data through their participation in the study's assessments and the collection of clinical information. The study did not involve a direct patient or public contribution in the design, conduct, analysis, or interpretation of the data, nor in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Background: Simulation is an important tool for assessing the performance of statistical methods for the analysis of data and for the planning of studies. While methods are available for the simulation of correlated binary random variables, all have significant practical limitations for simulating outcomes from longitudinal cluster randomised trial designs, such as the cluster randomised crossover and the stepped wedge trial designs. For these trial designs as the number of observations in each cluster increases these methods either become computationally infeasible or their range of allowable correlations rapidly shrinks to zero. Methods: In this paper we present a simple method for simulating binary random variables with a specified vector of prevalences and correlation matrix. This method allows for the outcome prevalence to change due to treatment or over time, and for a 'nested exchangeable' correlation structure, in which observations in the same cluster are more highly correlated if they are measured in the same time period than in different time periods, and where different individuals are measured in each time period. This means that our method is also applicable to more general hierarchical clustered data contexts, such as students within classrooms within schools. The method is demonstrated by simulating 1000 datasets with parameters matching those derived from data from a cluster randomised crossover trial assessing two variants of stress ulcer prophylaxis. Results: Our method is orders of magnitude faster than the most well known general simulation method while also allowing a much wider range of correlations than alternative methods. An implementation of our method is available in an R package NestBin. Conclusions: This simulation method is the first to allow for practical and efficient simulation of large datasets of binary outcomes with the commonly used nested exchangeable correlation structure. This will allow for much more effective testing of designs and inference methods for longitudinal cluster randomised trials with binary outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe and compare the proportion of patients classified as an emergency department (ED) mental health presentation under different definitions, including the Australian Institute of Health and Welfare (AIHW) definition. Methods: This retrospective cohort study enrolled all patients that presented to the EDs of a multi-centre Victorian health service between 1 January 2020 and 30 June 2023. Varying definitions of a mental health presentation were applied to each ED attendance, applying the current AIHW definition (using selected diagnosis codes), broader diagnosis-based coding, the presenting complaint recorded at triage and whether the patient was seen by or referred to the emergency psychiatric service (EPS). The proportion of all ED presentations meeting each definition and any overlap between definitions were calculated. The agreement between each definition and the AIHW definition was evaluated using Kappa's coefficient. Results: There were 813,078 presentations to ED of which 34,248 (4.2%) met the AIHW definition for a mental health presentation. Throughout the study, 45,376 (5.6%) patients were seen and/or referred to EPS, and 36,160 (4.4%) patients were allocated a mental health presenting complaint by triage staff. There was moderate interrater agreement between these definitions, with a kappa statistic (95% confidence interval) between the AIHW definition and a mental health presenting complaint recorded at triage of 0.58 (0.58–0.59) and between the AIHW definition and review by EPS of 0.58 (0.57–0.58). Conclusions: The AIHW definition is a conservative measure of ED mental health presentations and may underestimate emergency psychiatry workload in Australian EDs. What is known about this topic? It is unknown whether the Australian Institute of Health and Welfare (AIHW) definition of an emergency department (ED) mental health presentation definition accurately reflects ED mental health workload. What does this paper add? The AIHW definition appears to underestimate the clinical workload related to ED mental health presentations. There is moderate agreement between the AIHW definition and mental health presentations classified according to complaint recorded at triage, or whether the patient is reviewed by psychiatry services. What are the implications for practitioners? Accurate measurement of emergency psychiatry workload should not rely on the AIHW definition alone. [ABSTRACT FROM AUTHOR]

This case study evaluated the effects of a health package (HP) of a light intensity individualised exercise program and advice on anxiety management and nutrition, on the physical and mental health of people with or without COVID-19, who were quarantined in hotels used as Special Health Accommodation and admitted to the Royal Prince Alfred Virtual Hospital, Sydney during the COVID-19 pandemic. After initial screening and consenting, participants completed three surveys: Depression, Anxiety, Stress Scale; Brief Fatigue Inventory; and the European Quality of Life 5-Dimensions 5-Levels, and were provided with the HP for the duration of their quarantine. The three surveys and a participant reported experience measure were completed prior to discharge. The HP for people in quarantine demonstrated stability of health outcomes and reduction in fatigue. Most participants reported that the HP helped them cope with isolation. Provision of a HP during quarantine could be useful to support physical and mental health. What is known about the topic? Quarantine during the COVID-19 pandemic could negatively impact physical and mental health. What does this paper add? A health package of light intensity exercise, advice on anxiety management and nutritional information demonstrated maintenance of physical and mental health and reduced fatigue in people with and without mild COVID-19 in hotel quarantine. What are the implications for practitioners? Practitioners should consider providing a health package of exercise, anxiety management and nutritional information to help people in quarantine to cope with the physical and mental isolation. Adequate staffing is required to enable implementation. [ABSTRACT FROM AUTHOR]

Backgrounds: Freezing of gait (FoG) is a common and debilitating symptom of Parkinson's disease (PD) that can lead to falls and reduced quality of life. Wearable sensors have been used to detect FoG, but current methods have limitations in accuracy and practicality. In this paper, we aimed to develop a deep learning model using pressure sensor data from wearable insoles to accurately detect FoG in PD patients. Methods: We recruited 14 PD patients and collected data frommultiple trials of a standardized walking test using the Pedar insole system. We proposed temporal convolutional neural network (TCNN) and applied rigorous data filtering and selective participant inclusion criteria to ensure the integrity of the dataset. We mapped the sensor data to a structured matrix and normalized it for input into our TCNN. We used a train-test split to evaluate the performance of the model. Results: We found that TCNN model achieved the highest accuracy, precision, sensitivity, specificity, and F1 score for FoG detection compared to othermodels. The TCNN model also showed good performance in detecting FoG episodes, even in various types of sensor noise situations. Conclusions: We demonstrated the potential of using wearable pressure sensors andmachine learningmodels for FoG detection in PD patients. The TCNNmodel showed promising results and could be used in future studies to develop a real-time FoG detection system to improve PD patients' safety and quality of life. Additionally, our noise impact analysis identifies critical sensor locations, suggesting potential for reducing sensor numbers. [ABSTRACT FROM AUTHOR]

The incidence and histological type of spinal cancer is diverse. It is our role as physicians to explore the epidemiology of spinal cancers so that several projections can be made. Resource allocation, cost analyses, and the requirement of rehabilitation facilities all need to be considered. The objective of this paper is to provide an account of the acute spinal oncological admissions to the National Spinal Injuries Unit (NSIU) in both 2010 and 2020 with the hypothesis that upward trends will be noted. Only by exemplifying this trend, will it highlight the need to give spinal cancer the attention it deserves in the Republic of Ireland. All patients who were to undergo spinal surgery for primary or metastatic spinal cancer in the Mater Misericordiae University Hospital (MMUH) in 2010 and 2020 were included in this retrospective cohort study. A list of medical record numbers (MRNs) for all patients who underwent spinal surgery in the MMUH were included. Data pertaining to patient demographics were noted. 90 patients were included in this retrospective cohort study. 37 patients in 2010, had increased to 53 by 2020. Metastatic disease to the spine was still the most prominent reason for referral. The most common spinal region affected was the thoracic spine. Breast cancer was the most prevalent metastatic cancer to the spine in 2010. Lung cancer became the most prevalent by 2020. Posterior spinal fusion was the most frequent surgical procedure performed. The length of stay in higher care facilities decreased from 5.4 days in 2010, to 4 days in 2020. Decreased were also seen in the mean length of hospital stay, plummeting from 23.6 days in 2010, to 7.6 days in 2020. The same could not be said for the 30-day mortality rate, increasing from 5.4% in 2010, to 9.4% in 2020. The results of this study show a substantial rise in the incidence and prevalence of both primary and metastatic spinal disease here in Ireland. One can see clear improvements in operative technique, with less patients proceeding to higher levels of post-operative care, and earlier discharge times. This data can be used for future planning. The paper highlights the economic cost of spinal oncological care, but it also identifies key areas where preventative campaigns can be targeted. [ABSTRACT FROM AUTHOR]

Strategic flood risk management of river catchments involves significant increases in the complexity both of the contents (e.g. the aims and measures) of a given strategy and also its social, spatial, and temporal scales. Conceptually, flood risk management research to date has underestimated the importance of time and temporality. This paper, which is based on ‘historical Institutionalism,’ introduces a temporal lens to focus on strategic flood risk management; it highlights issues of duration and timing as well as tempo and change in tempo with respect to the implementation of measures to reduce flood risk at catchment level. The application of a temporal lens is illustrated through empirical research into strategic flood risk management for the medium-sized Aist river catchment in Austria. The paper uses a longitudinal qualitative research design to analyze the changes in strategic flood risk management in the catchment. The analysis shows that strategy efforts in reaction to an extreme flood event in the catchment in August 2002 can be differentiated into three phases. Phase 1 is characterized by the design of ambitious catchment-wide management; Phase 2 by struggles to implement the strategy due to institutional conditions and protests by citizens; and Phase 3 by redesign of the initial strategic plan to make it less ambitious and by changes to the actor constellation supporting the plan. The present paper offers a process-oriented institutional explanation for this pattern of phases, and it highlights issues of timing and tempo. It concludes with general suggestions for enhancing the temporal dimension in flood risk management. [ABSTRACT FROM AUTHOR]

In order to slow the spread of COVID-19, on March 23, 2020, a strict lockdown was implemented in the UK. This was followed by alternating periods of less restrictive lockdowns until most public health restrictions were lifted in the summer of 2021. While these measures were necessary, they significantly affected people's daily activities, lifestyles, and mental well-being. This paper presents a longitudinal research study that focused on females aged 55 + in the UK, aiming to understand how COVID-19 and the subsequent 15-month period of lockdowns affected their lifestyles and emotions. The study collected data through online surveys, where respondents reported the frequency and mode of access to activities, and their positive and negative emotional experiences during distinct study phases that encompassed both lockdown and less strict periods. In contrast to previous studies highlighting vulnerabilities for females and the elderly during lockdowns, this research found that the studied group maintained an overall positive outlook throughout the study period and successfully adapted to the lockdowns by increasing their engagement in certain activities, in particular, activities like 'getting active'. In addition, our findings indicate rapid adaptive behaviour change towards many online activities, such as cultural activities. However, the study also revealed negative emotions and a decrease in some activities during the second lockdown in 2020 and the subsequent lockdowns in 2021, underscoring the challenges inherent in prolonged periods of confinement. In addition, the study found negative affect associated with some activities, including working and studying from home. The findings provide valuable insights into how females aged over 55 coped with stressful circumstances, which can inform the development of resilient and mental health-conscious public health policies and responses in preparation for future pandemics or other hazards. [ABSTRACT FROM AUTHOR]

Background: We implemented a contextualized innovative mentorship program in the Clinical Master in Family Medicine (CMFM) program established in April 2020 at Arabian Gulf University. In this paper, we describe the process of this program and derive the major challenges faced by trainees and related corrective actions and their outcomes on high-risk trainees for optimal performance. Methods: We conducted a mixed-method longitudinal study of 80 trainees, analyzing information extracted from the Moodle learning platform about five key performance indicators as well as the contents (quantitative and qualitative) of mentoring meeting reports submitted through a validated online form between 2020 and 2022. We analyzed frequencies and themes of challenges and compared trainees' performance according to time and level of risk. Results: The follow-up of all 80 trainees in two cohorts (40 for each cohort) shows that most are female (93.75%) and the mean age is 30.00 ± 2.19 years with a ratio of mentors to mentees of 1 to 5. Meetings are conducted through phone calls, virtually, and face-to-face in 62%, 29%, and 8.3% respectively. The mean number and duration of meetings are 30.88 ± 2.31 and 20.08 ± 9.50 min respectively. Time management is the most reported challenge (41.3%), followed by health, social, and psychological-related issues in 7.6%, 4.6%, and 3% respectively. We extracted four main themes related to trainees, settings of training, e-Portfolio, and the COVID-19 pandemic. The mentorship program captured 12 trainees at high risk for low academic progress (12%) of whom six graduated on time and the remaining had to repeat a few courses the following terms. The performance of the program is stable over time (mean GPA of 3.30 (SE = 0.03), versus 3.34 (SE = 0.05) for cohorts 1 and 2 in the two years respectively, (P = 0.33). However, it is slightly lower among high-risk trainees compared to the remaining (GPA = 3.35 (SE = 0.03) versus 3.14 (SE = 0.08), P = 0.043) though above the minimum of the threshold of 3 out of 4, required for the master's degree. Conclusion: The mentorship program captured the struggling trainees and permitted to implement pertinent corrective actions timely, particularly in the context of a two-year intensive CMFM program during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Globally, HCC presents a significant health burden, characterized by high incidence and mortality rates. Epidemiological studies have increasingly suggested a link between dietary patterns and the risk of hepatocellular carcinoma (HCC), yet consensus on this relationship remains elusive. Objective: This study aims to synthesize existing literature and provide a comprehensive analysis of the association between dietary patterns and HCC risk through meta-analytical methods. Methods: A systematic search of PubMed, Embase, and the Cochrane Library databases was conducted to identify studies examining common dietary patterns in relation to HCC, published up to August 2023. Study quality was rigorously evaluated using the Newcastle–Ottawa Scale. We employed a random effects model to synthesize effect sizes, calculating hazard ratios (HRs) and 95% confidence intervals (CIs). Results: We identified 13 papers, of these 10 investigating a priori dietary patterns(index-based dietary patterns) and 3 focusing on a posterior dietary patterns (data-driven dietary patterns). Analysis of a priori dietary patterns revealed that higher scores in the Healthy Eating Index (HEI) & alternative HEI (HR = 0.67, 95% CI: 0.54–0.85), Dietary Approaches to Stop Hypertension (DASH) (HR = 0.77, 95% CI: 0.66–0.91), and the Mediterranean diet (HR = 0.65, 95% CI: 0.56–0.75) were associated with a reduced risk of HCC. Conversely, pro-inflammatory dietary patterns were linked with an increased risk (HR = 2.21, 95% CI: 1.58–3.09). In a posterior dietary patterns, a vegetable-based diet was negatively correlated with HCC risk (HR = 0.63, 95% CI: 0.49–0.81). Conclusion: This meta-analysis underscores a significant association between dietary patterns and the risk of HCC. Adherence to healthy dietary patterns characterized by high in vegetables, whole grains, legumes, nuts, and low in red and processed meats may confer a protective effect against HCC, whereas inflammatory diets appear to elevate risk. [ABSTRACT FROM AUTHOR]

Background: Endovascular clot retrieval (ECR) is known to reduce global disability at 3 months post stroke however limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits between onset and 3 months. Aims: To assess language, swallowing, and cognitive performance following ECR and explore whether impairment severity is correlated with modified Thrombolysis in Cerebral Infarction score (mTICI), stroke severity or quality of life (QoL). Methods: Assessment was completed within 7 days (T1), 1 month (T2) and 3 months (T3) post‐stroke. Performance was measured with the Functional Oral Intake Scale (FOIS), Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT A and B) and Brixton Spatial Awareness Test. The Western Aphasia Battery (WAB) was used for left hemisphere stroke. QoL was measured with the Stroke and Aphasia Quality of Life Scale. Results: Twenty‐five participants (median 72 years; 64% male) were prospectively recruited following ECR. High reperfusion success (68% mTICI 3) and low stroke severity post ECR (median 24 h NIHSS = 3, IQR 7–18) were noted. At T1, 10 participants presented with aphasia, eight required a modified diet and 20 had impaired cognition. At T3 all had recovered to a normal oral diet, 39% had persistent cognitive impairment and 45% of patients with left hemisphere stroke remained aphasic. Performance on the WAB, FOIS, RBANS and TMT changed significantly over time (all p < 0.05). The severity score at T1 for all measures, excluding TMT B and Brixton, was significantly correlated with 24 h NIHSS. WAB scores at T3 were correlated with QoL (r = 0.618; p = 0.043). Conclusion: This exploratory study found the longitudinal performance of language, swallowing and cognition significantly improved over time and severity in the first‐week post‐ECR was correlated with 24 h NIHSS rather than the degree of reperfusion. WHAT THIS PAPER ADDS: What is already known on the subject: Randomised control trials have demonstrated the benefit of ECR in patients with ischemic stroke using global measures of disability and function. Limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits. There is also a reliance on screening assessments and a lack of consideration of the influence of co‐occurring impairments. What this paper adds to existing knowledge: This prospective study is amongst the first to explore the longitudinal trajectory of language, swallowing and cognitive impairment using a standardised assessment battery. Twenty‐four‐hour NIHSS was significantly correlated with language, swallowing, global cognition and some measures of executive function. Language performance post ECR was correlated with domain‐specific cognitive assessment of attention, immediate memory and delayed memory, which differed from swallowing performance post ECR that correlated with measures of executive function. What are the potential or actual clinical implications of this work?: It is important for speech‐language pathologists and the wider medical team to monitor language, swallowing and cognitive performance post ECR regardless of treatment success. Stroke severity at 24 h post‐ECR influences the severity of language, swallowing and cognitive impairments. [ABSTRACT FROM AUTHOR]

Background: Competent clinical reasoning forms the foundation for effective and efficient clinical swallowing examination (CSE) and consequent dysphagia management decisions. While the nature of initial CSEs has been evaluated, it remains unclear how new information gathered by speech–language therapists (SLTs) throughout a patient's acute‐care journey is integrated into their initial clinical reasoning and management processes and used to review and revise initial management recommendations. Aims: To understand how SLTs' clinical reasoning and decision‐making regarding dysphagia assessment and management evolve as patients transition through acute hospital care from referral to discharge. Methods & Procedures: A longitudinal, qualitative approach was employed to gather information from two SLTs who managed six patients at a metropolitan acute‐care hospital. A retrospective 'think‐aloud' protocol was utilized to prompt SLTs regarding their clinical reasoning and decision‐making processes during initial and subsequent CSEs and patient interactions. Three types of concept maps were created based on these interviews: a descriptive concept map, a reasoning map and a hypothesis map. All concept maps were evaluated regarding their overall structure, facts gathered, types of reasoning engaged in (inductive versus deductive), types of hypotheses generated, and the diagnosis and management recommendations made following initial CSE and during subsequent dysphagia management. Outcomes & Results: Initial CSEs involved a rich process of fact‐gathering, that was predominantly led by inductive reasoning (hypothesis generation) and some application of deductive reasoning (hypothesis testing), with the primary aims of determining the presence of dysphagia and identifying the safest diet and fluid recommendations. During follow‐up assessments, SLTs engaged in increasingly more deductive testing of initial hypotheses, including fact‐gathering aimed at determining the tolerance of current diet and fluid recommendations or the suitability for diet and/or fluid upgrade and less inductive reasoning. Consistent with this aim, SLTs' hypotheses were focused primarily on airway protection and medical status during the follow‐up phase. Overall, both initial and follow‐up swallowing assessments were targeted primarily at identifying suitable management recommendations, and less so on identifying and formulating diagnoses. None of the patients presented with adverse respiratory and/or swallowing outcomes during admission and following discharge from speech pathology. Conclusions & Implications: Swallowing assessment and management across the acute‐care journey was observed as a high‐quality, patient‐centred process characterized by iterative cycles of inductive and deductive reasoning. This approach appears to maximize efficiency without compromising the quality of care. The outcomes of this research encourage further investigation and translation to tertiary and post‐professional education contexts as a clear understanding of the processes involved in reaching diagnoses and management recommendations can inform career‐long refinement of clinical skills. WHAT THIS PAPER ADDS: What is already known on the subject: SLTs' clinical reasoning processes during initial CSE employ iterative cycles of inductive and deductive reasoning, reflecting a patient‐centred assessment process. To date it is unknown how SLTs engage in clinical reasoning during follow‐up assessments of swallowing function, how they assess the appropriateness of initial management recommendations and how this relates to patient outcomes. What this paper adds to the existing knowledge: Our longitudinal evaluation of clinical reasoning and decision‐making patterns related to swallowing management in acute care demonstrated that SLTs tailored their processes to each patient's presentation. There was an emphasis on monitoring the suitability of the initial management recommendations and the potential for upgrade of diet or compensatory swallowing strategies. The iterative cycles of inductive and deductive reasoning reflect efficient decision‐making processes that maintain high‐quality clinical care within the acute environment. What are the potential or actual clinical implications of this work?: Employing efficient and high‐quality clinical reasoning is a hallmark of good dysphagia practice in maximizing positive patient outcomes. Developing approaches to understanding and making explicit clinical reasoning processes of experienced clinicians may assist SLTs of all developmental stages to provide high standards of care. [ABSTRACT FROM AUTHOR]

In 2004, California became the first state to require that employers provide paid family leave (PFL) to their employees. This paper examines the effect of California's PFL law on time spent caregiving to parents and to grandchildren by older adults aged 50–79. To identify the effect of the law, the paper uses the 1998–2016 waves of the Health and Retirement Study and a difference-in-differences approach comparing outcomes in California to other states before and after the implementation of the law. Results suggest that the law induced a switch in caregiving behavior with older adults spending less time caring for grandchildren and more time helping parents. Focusing on women, results further suggest that PFL affected older adults both through their own leave-taking and through reallocations of their caregiving time in response to leave-taking by new parents. The findings motivate thinking more broadly when calculating the costs and benefits of PFL policies; to the extent that California's PFL law enabled older adults to provide more care for their parents they otherwise would not have received, such an outcome represents an indirect benefit of the policy. [ABSTRACT FROM AUTHOR]

This paper undertakes an analysis and discussion of the methodological challenges and insights derived from three longitudinal qualitative studies, all conducted in Chile during the COVID-19 pandemic and subject to comprehensive theoretical-methodological reflection processes centred on their respective designs. This analysis makes a significant contribution to interdisciplinary discussions within social research, with a particular emphasis on longitudinal trajectories. First, we present a comparative analysis of three studies in social work, utilising Saldaña's questions addressing changes and learning in longitudinal studies. The first study explores the labour trajectories of researchers, the second focuses on the educational trajectories of students, and the last examines therapeutic alliance trajectories between social workers and families within the child protection system. Following this, we delve into the methodological decisions made by the research group during the execution of these longitudinal studies. This encompasses an examination of participant involvement, temporal definitions of the adopted designs, and the most suitable methodological tools for analysing change processes over time. The outcomes of this comparative analysis reveal the distinctive characteristics of the three longitudinal studies, providing insights into how the time dimension is explored within them. We highlight key criteria essential for consideration in longitudinal qualitative research, particularly regarding participants and methodology. In conclusion, we advocate for an expanded reflection within the realm of longitudinal qualitative methodology, encompassing aspects such as design choices, approaches to data analysis, integration of technology in information processing, and strategies for maintaining participant engagement. [ABSTRACT FROM AUTHOR]

Severe acute malnutrition (SAM) remains a major global public health problem. SAM cases are treated using ready‐to‐use therapeutic food (RUTF) at a dosage of ∼200 kcal/kg/day per the standard treatment protocol (STD). Emerging evidence on simplifications to the standard protocol, which among other adaptations, includes reducing the daily RUTF dosage, indicates that it is effective and safe for treating children with SAM. In response to a foreseen stock shortage of RUTF, the government of Afghanistan endorsed the temporary use of a modified treatment protocol in which the daily RUTF dosage was prescribed at 1000 kcal/day (irrespective of body weight) until the child achieved moderate acute malnutrition status (weight‐for‐height z‐score ≥ −3 or mid‐upper arm circumference [MUAC] ≥ 115 mm), at which point 500 kcal/day was prescribed until cured (modified treatment protocol [MTP]). In this paper, we report the results of this nonweight‐based daily RUTF dosage experience. Data of 2042 children with SAM, treated using either the STD protocol (n = 269) or the MTP protocol (n = 1773) from August 2019 to March 2021 in five provinces, were analyzed. The per‐protocol analyses confirmed noninferiority of MTP protocol when compared to STD protocol for recovery rate [93.3% vs. 90.2%; ∆ (95% confidence interval, CI) = 3.1 (−0.9; 7.2) %] and length‐of‐stay [82.6 vs. 75.6 days; ∆ (95% CI) = 6.9 (3.3; 10.5) days], considering the margin of noninferiority of −10% and +14 days, respectively. Weight gain velocity was smaller in the MTP protocol group than in the STD protocol group [3.7 (1.7) vs. 5.2 (2.9) g/kg/day; ∆ (95% CI) = −1.5 (−1.8, −1.2); p < 0.001]. The STD group had a significantly higher mean than the MTP group for absolute MUAC gain [∆ (95% CI) = 1.7 (1.0; 2.3) mm; p < 0.001] and the MUAC velocity [∆ (95% CI) = 0.29 (0.20; 0.37) mm/week; p < 0.001]. Our results confirm the noninferiority of a nonweight‐based daily dosage and support the endorsement of this modification as an alternative to the standard protocol in resource‐constrained contexts. Key messages: More evidence supporting the use of the nonweight‐based daily ready‐to‐use therapeutic food (RUTF) dosage for treating uncomplicated severe acute malnutrition (SAM), in specific contexts, is needed.Our real‐world prospective nonrandomized study showed that the fixed nonweight‐based daily RUTF dosage protocol is as effective as the standard weight‐based protocol for treating uncomplicated SAM in children <5 in the Afghanistan context.Our findings support the reflection of a nonweight‐based daily RUTF dosage in resource‐constrained contexts in national and global policies and guidelines to improve coverage of all children in need of treatment. [ABSTRACT FROM AUTHOR]

Increases in the numbers of older adults with mental health and substance use concerns compel us to identify best practices in training to address these issues. Senior Centers are an ideal location for behavioral health education programs as they are the go-to place for many older adults. This paper describes an online certificate program in Behavioral Health and Aging offered by the Center for Aging and Disability Education and Research at Boston University School of Social Work in collaboration with the National Council on Aging to increase senior center staff knowledge and skills. A total of 228 senior center staff in Illinois, Florida, and Wisconsin completed the online certificate program. There were statistically significant changes in key competencies for all courses based on pre-post assessment. We held key informant interviews to assess the impact of training and participants stated that their knowledge, skills, and behaviors were influenced by the program. [ABSTRACT FROM AUTHOR]

Introduction: The All of Us Research Program (Program) is an ongoing epidemiologic cohort study focused on collecting lifestyle, health, socioeconomic, environmental, and biological data from 1 million US-based participants. The Program has a focus on enrolling populations that are underrepresented in biomedical research (UBR). Federally Qualified Health Centers (FQHCs) are a key recruitment stream of UBR participants. The Program is digital by design where participants complete surveys via web-based platform. As many FQHC participants are not digitally ready, recruitment and retention is a challenge, requiring high-touch methods. However, high-touch methods ceased as an option in March 2020 when the Program paused in-person activities because of the pandemic. In January 2021, the Program introduced Computer Assisted Telephone Interviewing (CATI) to help participants complete surveys remotely. This paper aims to understand the association between digital readiness and mode of survey completion (CATI vs. web-based platform) by participants at FQHCs. Methods: This study included 2,089 participants who completed one or more surveys via CATI and/or web-based platform between January 28, 2021 (when CATI was introduced) and January 27, 2022 (1 year since CATI introduction). Results and discussion: Results show that among the 700 not-digitally ready participants, 51% used CATI; and of the 1,053 digitally ready participants, 30% used CATI for completing retention surveys. The remaining 336 participants had “Unknown/Missing” digital readiness of which, 34% used CATI. CATI allowed survey completion over the phone with a trained staff member who entered responses on the participant’s behalf. Regardless of participants’ digital readiness, median time to complete retention surveys was longer with CATI compared to web. CATI resulted in fewer skipped responses than the web-based platform highlighting better data completeness. These findings demonstrate the effectiveness of using CATI for improving response rates in online surveys, especially among populations that are digitally challenged. Analyses provide insights for NIH, healthcare providers, and researchers on the adoption of virtual tools for data collection, telehealth, telemedicine, or patient portals by digitally challenged groups even when in-person assistance continues to remain as an option. It also provides insights on the investment of staff time and support required for virtual administration of tools for health data collection. [ABSTRACT FROM AUTHOR]

The increasing prominence of the problem of censored data in various fields has made studying how to perform parameter estimation and variable selection in censored mixed-effects models one of the hotspots of current research. In this paper, considering the situation that the response variable is restricted by the bilateral limit, a double-penalty Bayesian Tobit quantile regression model was constructed to carry out parameter estimation and variable selection in the interval-censored mixed-effects model, and at the same time, the fixed-effects and random effects coefficients are compressed in Tobit's mixed-effects model, so as to reduce the estimation error of the model at the same time as the variable selection of the model is carried out. The posterior distribution of each unknown parameter was derived using the conditional Laplace prior and the mixed truncated normal distribution of interval-censored data, and then the Gibbs sampling algorithm for unknown parameter estimation was constructed. Through Monte Carlo simulation, it was found that the new method is more advantageous than the classical method in terms of variable selection and parameter estimation accuracy in various situations, such as different model sparsity, different data censoring ratios and different random error distributions, and the model is able to realize automatic variable selection. Finally, the new method is used to analyze the correlation between the crime rate and various economic indicators in China. [ABSTRACT FROM AUTHOR]

Meeting individuals' social care needs is a core element of UK social policy. However, the conceptualisation and operationalisation of 'unmet need' remain a challenge. This paper advances our understanding by incorporating a temporal dimension into the conceptual framework on unmet need to investigate the dynamics of met and unmet need for social care over time. Using data from Waves 8 and 9 of the English Longitudinal Study of Ageing, this paper examines five possible trajectories among individuals with a social care need for bathing or dressing at baseline: (a) no longer having such a need; (b) having continued needs met; (c) delayed needs met; (d) newly arisen unmet needs; and (e) repeated unmet needs. The results indicate that amongst those with need at baseline, unmet need has decreased over time – indicating that some needs for social care may be fulfilled with a delay. However, a significant proportion of older people experienced repeated unmet needs, particularly those who were younger, with no spouse or civil partner, and those whose activities of daily living index scores worsened over time. Understanding the dynamics of unmet need can support policy makers in better ensuring that those facing an elevated risk of repeated unmet need over time do not fall through the social care safety net. [ABSTRACT FROM AUTHOR]

This paper shows how system-level data can generate useful insights into the profile of first-year graduates who are teaching out-of-field (OOF). Understanding in-school demand and impacts on first-year graduates teaching OOF is important, especially when the first years of teaching are complex, busy, and involve a steep learning curve. A mixed methods sequential explanatory design was used to generate qualitative and quantitative data collected from teacher and principal surveys. This study establishes the prevalence of OOF teaching amongst first-year graduates in Western Australian public schools and develops a profile of their OOF experiences and support needs based on their perceptions and their principals' perceptions. This study details the supports that will make a difference to teachers' capability, in particular a reduction in load where the OOF teaching workload is high, and access to formal subject-specific mentoring, both noted in research as important support mechanisms. This paper provokes new research questions, highlights areas for further research, and establishes the need for more large-scale datasets and longitudinal studies to examine change over time and the enduring effects of OOF teaching, both in relation to transitions into teaching, as teachers learn on-the-job, and when teachers undertake formal professional development programmes or courses. [ABSTRACT FROM AUTHOR]

Aim: To assess the risks, benefits, and resource implications of home‐blended food for children with gastrostomy tubes compared with a formula diet. Method: This prospective cohort study of children (aged 0–18 years) collected baseline data on gastrointestinal symptoms, nutritional intake, anthropometric outcomes, parent and child quality of life, and resource use. A propensity score‐weighted generalized linear mixed model was used to compare children receiving a home‐blended versus formula diet. Results: Baseline data were obtained for 180 children (2019–2021; 107 males, 73 females; mean age 9 years 7 months [SD 4 years 5 months]). Children receiving a home‐blended diet (n = 104) had similar diagnoses and age but more lived in areas of lower deprivation and parental education was higher compared to the parents of children receiving a formula diet (n = 76). Children receiving home‐blended diets had significantly better gastrointestinal scores than those receiving formula diets (B = 13.8, p < 0.001). The number of gut infections and tube blockages were similar between the two groups but with fewer stoma site infections in the group receiving home‐blended food. Children receiving a home‐blended diet had more fibre in their diet compared to children receiving a formula diet. Interpretation: Home‐blended diets should be seen as a safe option for children who are gastrostomy‐fed unless clinically contraindicated. Equality of access to home‐blended diets for children with gastrostomy should be assessed by local clinical teams. What this paper adds: Children with gastrostomy receiving a home‐blended diet had fewer gastrointestinal symptoms compared to children receiving a formula diet.Children with gastrostomy receiving a home‐blended diet had no more complications than children receiving a formula diet. What this paper adds: Children with gastrostomy receiving a home‐blended diet had fewer gastrointestinal symptoms compared to children receiving a formula diet.Children with gastrostomy receiving a home‐blended diet had no more complications than children receiving a formula diet. [ABSTRACT FROM AUTHOR]

Recent societal challenges highlight the importance of learning in organizations. Nurturing employee learning requires leaders who prioritize learning-oriented leadership. While many studies have used qualitative methods to study how this leadership is performed in daily work, there have been no previous attempts to synthesize this body of research. This paper presents a framework based on a review of 38 qualitative papers on how leaders facilitate workplace learning. The framework identifies two elements of leadership: direct leadership behaviors, which involve supporting, educating, making demands, and role modelling, and indirect leadership behaviors, which facilitate learning through building a learning climate, influencing work organization, freeing up resources for learning, and encouraging knowledge dissemination. The review finds that situational factors shape learning-oriented leadership, and that this leadership involves the deployment of activities located on a planned-spontaneous continuum to facilitate learning. Longitudinal studies across professional groups and contexts will deepen our understanding of this concept. [ABSTRACT FROM AUTHOR]

Dynamic Pattern Synthesis (DPS) provides a new longitudinal method for evaluating the impacts of macroeconomic and public policy interventions. Situated within complexity theory and critical realism, it has evolved from the established methods of Cluster Analysis and Configurational Modelling approaches. Dynamic Pattern Synthesis identifies case convergence and divergence (using quantitative techniques), while remaining close to the qualitative uniqueness of each case. In this paper, the DPS approach is used to consider macroeconomic convergence across Sub-Saharan Africa during the Millennium Development Goals, and the possible impacts of IMF interventions in stimulating long-term macroeconomic outcomes. The findings reveal a high degree of economic instability experienced across the region and varying responses to an external shock. The importance of 'outliers' and inconsistency in country convergence are also observed. The DPS method highlights the importance of individual country experiences in relation to external shocks. When factoring in IMF interventions, the findings highlight multiple paths to a given policy outcome, rather than a single optimal economic strategy. This opens up the debate on policy issues associated with economic complexity, including how best to create an overall environment of stability that might promote convergence and reduce the instability that undermines planning and investment. [ABSTRACT FROM AUTHOR]

Objectives: This paper has two objectives. First, it assesses whether the existing informal care provided by adult children has an impact on older people's propensity to demand community care services. Second, it compares the different statuses of sons and daughters in the formal/informal support trade‐off. Methods: The paper is based on an analysis of data from the 2018 wave of the China Longitudinal Ageing Social Survey, within the framework of a revised version of Andersen's model, and applies multilevel models to analyse the effects of adult children's gender, numbers and the quality of their support, on older people's willingness to purchase community care services. Results: Older people who had sons as well as daughters demanded fewer services, while the number of sons increased service demand. Regarding sons, community care services compensated for economic support, daily life care and spiritual consolation, but did so only in respect of daily life care from daughters. Conclusions: Many families have only one son or one daughter as a result of the one‐child policy and therefore often require support from formal care services. Moreover, there is a distinct gender division and an influential filial culture governing the impact of services on the support provided by adult children. Because ageing in place depends on both informal family support and formal services, this key policy goal is at risk if the latter provides insufficient support to the former. [ABSTRACT FROM AUTHOR]