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Traditionally males have been regarded as the more aggressive sex. However, recent research in several countries has challenged this notion by considering different forms of aggression. This paper provides an overview of a qualitative investigation of teenage girls' indirect forms of aggression (e.g., exclusion from the group, spreading false stories). Focus groups and pair and individual interviews were used to collect data from adolescent girls and their teachers in two schools. The study provides some clear insights into the nature of teenage girls' indirect aggression. The predominant indirectly aggressive behaviors include talking about others and excluding peers from the group. Key explanations for these behaviors concern a desire to create excitement and a range of friendship and group processes centered on girls' needs for close personal relationships and to be a part of the peer group. The girls described the devastating effects of indirect aggression, particularly on girls with certain characteristics that predispose them to victimization. The girls were pessimistic about the potential of interventions, although peer mediation processes may be a way forward. Aggr. Behav. 26:67–83, 2000. © 2000 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Background: Collaborations between patient organisations (POs) and the pharmaceutical industry can help identify and address the unmet needs of people living with a disease. In Alzheimer's disease (AD), the scale and complexity of the current unmet needs call for a broad and cross‐sectoral collaboration, including people living with Alzheimer's (PLWA), their care partners and the wider research community. Objective: This study aimed to describe learnings from the Finding Alzheimer's Solutions Together (F.A.S.T.) Council, a collaboration between POs and Roche, convened to better understand the unmet needs of PLWA and their care partners. Results: 1. Learnings from the collaboration, including clarifying objectives and members' expectations upfront, and establishing a set of guiding values and engagement principles. 2. Insights and recommendations for improving care in AD, including a wide range of unmet needs and potential solutions, systematically captured throughout the PLWA journey. These have resulted in several published reports and other outcomes, including (1) 'Portraits of care', highlighting the role of care partners, and the impact of coronavirus disease 2019 on care; (2) Clinical trial guidebook, recommending how PLWA and care partner experience can be incorporated into trial design; (3) 'Commitments Catalogue', highlighting progress by governmental organisations in achieving their commitments; and (4) a report to guide policy on improving diversity, equity and inclusion in clinical trials. Conclusions: Close collaboration between POs and the pharmaceutical industry in AD can enable effective research, in which PLWA and care partners are engaged as 'experts through experience' to help identify key unmet needs and co‐create solutions with the wider AD research community. This paper and the work undertaken by the F.A.S.T. Council may act as a blueprint for meaningful collaboration between POs and the pharmaceutical industry. Patient or Public Contribution: The paper reports the collaboration between POs, the F.A.S.T. Council and Roche to progress towards a future in which PLWA can live fulfilling lives with their disease managed well. Clinical Trial Registration: Not applicable. [ABSTRACT FROM AUTHOR]

This paper is concerned with the situated production of opinions in human geography research. Drawing on an online focus group project in which university students were asked to discuss smartphone use in urban greenspace, I'm interested in how our methods can make opinions as much as collect those that are already assumed to exist. Why were these students inclined to speak of having and sharing opinions? How important should opinions be to us if they are not actively influencing the everyday lives of those who we hope to understand in our studies? And what does this all say about staging effective group discussion in the discipline? This paper considers how opinions feature in human geography research and how focus groups are organised most effectively. It does this by drawing on a study in which university students were asked to discuss smartphone use in urban greenspace. [ABSTRACT FROM AUTHOR]

Background: This paper describes the experience of conducting a co‐researched project with people with learning disabilities in Madrid, Spain, during the COVID pandemic and lockdown. I discuss the advantages and limitations of working online and challenges encountered while coordinating and facilitating the research. Methods: Our research project was on the impact of COVID on the lives of people with learning disabilities, which the eight co‐researchers chose. As part of my PhD, I offered my services as researcher to work together with persons with learning disabilities. Eight people took up my offer. We worked together from January 2021 to March 2022 virtually and I recorded this experience. I have written the paper, but as part of my co‐researcher agreement, I have shared my reflections and work with my co‐researchers, and we have co‐written a section to share our findings. Findings: In this paper, I discuss the advantages and limitations of working online, challenges I encountered while coordinating and facilitating the research and the work together. Remote work enabled the group to work on a biweekly basis and with members from different parts of Madrid. It saved people time and effort getting around town, yet we had to introduce express times and spaces to socialise and create a working relationship that is less natural than during in‐person interactions and breaks. During our fieldwork, we found that the pandemic had spurred the access to digital devices and programmes, but people may still be reliant on their environment, carers or supporters to facilitate it. I included a section written with my co‐researchers, in which we reflect together on the experience of working online and how we reached out to their peers during our fieldwork. We identified limitations due to our online research methodology such as lack of owning a digital device, the difficulties having access to a private space from which to connect online and the joy of meeting other people to exchange experiences. Conclusion: Human rights based participatory research can be done online. There are different ways of overcoming barriers to participation. However, there are people with no access to the internet or without digital skills that are being excluded and we must ensure that we reach out to them as well. Accessible summary: I did an online participatory research project with 8 people with learning disabilities from Spain using Zoom. Participatory research means taking part and being involved in the decisions on how the research is done.I discuss online way to make decisions, share power and control over the research, have some social connection in the group, and give information.I show that people with learning disabilities can work remotely but need more opportunities to learn digital skills. Digital skills are the skills to use technological devices, e.g., a smartphone, a tablet or a computer.Digital skills were very important during the pandemic and the lockdown, for example knowing how to find and use information and stay safe online and how to communicate with others over the internet.Participatory research projects need to support co‐researchers to learn new skills and apply them. The researchers need to be creative to make the online work engaging. [ABSTRACT FROM AUTHOR]

Background: Instructional videos constitute a pivotal component in flipped learning. Despite their significance, there is a dearth of research specifically dedicated to instructional videos within the context of flipped classrooms. This paucity has led to an empirical void in verifying the efficacy of instructional videos in flipped learning environments. Objectives: The present study endeavours to contribute to the extant literature on flipped pedagogical practices by providing empirical evidence regarding the effectiveness of instructional videos in flipped learning environments. Methods: This study employs a convergent mixed‐methods design. Forty‐five instructional videos in three subtypes were administered in two classes over a 15‐week semester. Data, both quantitative (log data from the learning management system) and qualitative (from focus group discussions at two time points), were concurrently collected from a flipped class (n = 25) and a blended class (n = 28) with the aim of gauging student engagement and learning outcomes in the flipped class and understanding video‐viewing features typical of the flipped class. Results: Both datasets corroborated that participants in the flipped class outperformed their counterparts in the blended class in terms of video‐watching, peer interaction, knowledge retention, and transfer skills. Conclusions: The instructional videos within the flipped classroom setting serve to enhance student engagement in the learning process and improve learning outcomes. The efficacy of these instructional videos in flipped learning can be further augmented through strategic approaches in both their design and implementation. Lay Description: What is currently known about this topic: The flipping pedagogy is conducive to learning.Videos play a crucial role in flipped learning.Videos prepared students for classroom activities.However, engaging students with pre‐class videos presents a challenge. What this paper adds: This paper furnishes direct empirical evidence supporting the effectiveness of instructional videos in flipped learning.It uncovers factors affecting student engagement with videos in flipped learning.It offers insights into the design and implementation of videos in flipped learning. Implications for practice: Considering facilitating conditions and affective factors when creating videos.Acknowledging learner characteristics when designing videos.Utilizing instructional strategies when implementing videos. [ABSTRACT FROM AUTHOR]

Background Study: Asynchronous online discussions are vital venues for collaborative knowledge construction. However, the lack of appropriate instruction designs poses challenges in promoting deep and substantive engagement with the core subject matter. This paper explores how to enhance adult students' knowledge construction in the context of asynchronous online discussions at an open university in Taiwan. Objectives: This study explores instructional designs aimed at promoting online knowledge construction among adult students and overcoming barriers to this process. Methods: This study used a convergent parallel mixed methods design to collect concurrently both quantitative data from the students' online discussion postings for content analysis and qualitative data from the focus group and individual interviews, the online open‐ended questionnaire, and the instructor's observation logs for thematic analysis. Then the results were merged in the interpretation stage. Results and Conclusion: The research highlights the significance of instructional designs in influencing students' level of knowledge construction during online discussions. The findings suggest that instructional designs that provide teacher‐led interim summaries, pose Socratic questions, and incorporate problem‐solving projects can promote higher‐level knowledge construction. However, time constraints, cultural influences, and unfamiliarity with peers negatively affected higher‐order knowledge construction. To address these challenges, culturally responsive and technologically inclusive instructional designs that take into account the specific challenges faced by adult learners are proposed to enhance learning outcomes through active participation. Limitation: The study's limited sample size warrants further research with a larger and more diverse cohort to validate the effectiveness of the proposed instructional designs. Another limitation is the lack of a robust theoretical base for the instructional strategies presented by the current action‐research study. Further examination and broader exploration in online education are needed to prop up proposed pedagogical approaches. Lay Description: What is currently known about this topic: Online discussions are essential for collaborative knowledge construction among adult students.Existing research primarily indicates that online knowledge construction often remains at a basic level, predominantly involving the sharing and comparing of information. What this paper adds: This study explores instructional designs aimed at elevating online knowledge construction among adult students at an open university in Taiwan.It identifies specific instructional strategies, such as teacher‐led interim summaries, the use of Socratic questioning, and the integration of problem‐solving projects, as effective in promoting higher‐level knowledge construction.The paper also sheds light on the challenges hindering higher‐order knowledge construction, including time constraints, cultural influences, and unfamiliarity among peers. Implications for practice and/or policy: The findings underscore the need for culturally responsive and technologically inclusive instructional designs. These should be tailored to the unique challenges faced by adult learners, particularly in asynchronous online environments.The paper suggests that such instructional designs can significantly improve learning outcomes by fostering more active and deeper participation in online discussions.It also highlights the importance of further research to validate these strategies, given the study's limited sample size and the need for a more robust theoretical foundation for the proposed instructional methods. [ABSTRACT FROM AUTHOR]

The criminalization of young women in care remains an important practice and policy issue in England despite 2018 national guidance and the subsequent development of local authority protocols to reduce the criminalization of care‐experienced young people. This paper contributes to the emerging research on young women whose behaviour challenges professionals, through secondary analysis of case file data and narrative interviews with 24 care‐experienced young women from a national project on care and offending. Analysis focused on young women's pathways through the care, justice and education systems and identified five domains within young women's lives where available risk or resilience factors were significant in directing young women towards prosocial opportunities, to new types of victimization or to criminalization and offending. These domains consisted of placements and caregiver relationships; partner relationships; pregnancy and motherhood; participation in education; and the transition to adulthood through leaving care. The paper concludes with implications for practice for professionals working with young women, in particular emphasizing that how the care, justice and education systems respond to young women can contribute to negative pathways or transform them. [ABSTRACT FROM AUTHOR]

Background: Given students' lack of self‐directed learning skills and the growing concern about implementing massive online open courses (MOOCs) in K12 education, learning strategies are needed to facilitate MOOC learning. Many studies have provided different strategies for effective learning in MOOCs. However, there is still limited research to confirm whether these strategies effectively support MOOC learning when deployed by secondary schools, which are not MOOC developers. Objectives: This mixed‐method study examines the provision of different learning strategies, including a learning guide, an academic mentoring programme, a training workshop, and a reimbursement scheme, and investigates the impact of these strategies on student learning in MOOCs. Methods: The study uses two data sources: (1) surveys with 40 participants and (2) semi‐structured interviews with 12 participants. The quantitative data were analysed with descriptive statistics and Fisher's exact test, and the qualitative data were analysed with thematic analysis. Results and Conclusion: The findings indicate that MOOC learners had positive attitudes towards the overall school support, with mentoring enjoying great popularity amongst the students. In terms of the effectiveness of the school support, the mentoring programme and reimbursement scheme were more effective than the university training and learning guide. The paper discusses the implications for researchers and educators. Lay Description: What is already known about this topic: There are a large number of K12 MOOC implementations, which are (i) STEM‐related and computer science courses, and (ii) from Europe and the USA.Limited studies provided different learning strategies for MOOC learning from the perspective of K12 schools, which are not MOOC developers.There is a need to explore MOOC initiatives encompassing a wide variety of subjects, including computer science MOOCs and non‐computer science MOOCs, in regions beyond Europe and the USA.There is also a need for further scrutiny of the effectiveness of learning strategies provided by the K12 school. What this paper adds: Our study launched the first MOOC implementation in K12, encompassing several subject areas beyond computer science in the region of Asia.Our study provided different learning strategies adopted by the K12 school, and the analysis revealed that MOOC learners took positive attitudes towards overall school support with mentoring enjoying great popularity with these students.Our study examined the effectiveness of school support and identified that mentoring and reimbursement are more effective than university training and the learning guide. Implications for practitioners: The insights gained from the study enable other K12 schools and educators to implement MOOC into existing school infrastructures successfully.These strategies provided in the MOOC implementation program can be helpful in many different online learning contexts. [ABSTRACT FROM AUTHOR]

Background: People with severe mental illness (SMI) experience higher rates and poorer outcomes of physical long‐term conditions (LTCs). The management of SMI and LTCs is highly complex and many people with SMI rely on informal carers for support, which may lead to high levels of caregiver burden, and caregiver burnout. Caregiver burnout can result in poor health outcomes for informal carers and a reduction in the quality of care they are able to provide. Therefore, it is important to understand the caring experience to identify and address factors that contribute to burden and burnout. Methods: This paper reports a secondary qualitative analysis of semistructured interviews and focus groups conducted with informal carers of people who have coexisting SMI and LTCs. We recruited 12 informal carers in England between December 2018 and April 2019. The transcripts were coded and analysed thematically. Results: We identified two overarching themes and five subthemes. The themes included 'Fighting on all fronts: Mounting strain between demands and resources', which described the challenge of providing care in the context of coexisting SMI and LTCs, and 'Safekeeping: The necessity of chronic hypervigilance', which captured how informal carers' roles were defined by managing high‐risk situations, leading to hypervigilance and paternalistic approaches to care. Conclusion: The experience of informal carers for people with SMI and coexisting LTCs is marked by limited access to support and the management of significant risk, which could contribute to high caregiver burden. Further primary research is needed to understand how the experiences of the caregiver role for people with SMI and LTCs influence caregiver burden. Patient or Public Contribution: Our PPI panel DIAMONDS Voice provided guidance on this study from conception, design and development of interview guides and recruitment materials to final write‐up. DIAMONDS Voice consists of service users and carers who have experience of SMI and LTCs. Three carer members reviewed the final manuscript, and two are credited as authors. [ABSTRACT FROM AUTHOR]

Background: Those supporting children and young people who use augmentative and alternative communication (AAC) contribute to ongoing complex decision‐making about communication aid selection and support. Little is known about how these decisions are made in practice and how attributes of the communication aid are described or considered. Aims: To understand how communication aid attributes were described by those involved in AAC recommendations and support for children and young people, and how these attributes were described as impacting on AAC use. Methods & Procedures: A secondary qualitative analysis was completed of interview and focus group data from 91 participants involved in the support of 22 children and young people. Attributes of communication aids described by participants were extracted as themes and this paper reports a descriptive summary of the identified software (non‐hardware) attributes. Main Contribution: Decisions were described in terms of comparisons between commercially available pre‐existing vocabulary packages. Attributes related to vocabulary, graphic representation, consistency and intuitiveness of design, and ease of editing were identified. Developmental staging of vocabularies, core and fringe vocabulary, and vocabulary personalization were attributes that were described as being explicitly considered in decisions. The potential impact of graphic symbol choice did not seem to be considered strongly. The physical and social environment was described as the predominant factor driving the choice of a number of attributes. Conclusions & Implications: Specific attributes that appear to be established in decision‐making in these data have limited empirical research literature. Terms used in the literature to describe communication aid attributes were not observed in these data. Practice‐based evidence does not appear to be supported by the available research literature and these findings highlight several areas where empirical research is needed in order to provide a robust basis for practice. What This Paper Adds: What is already known on the subject: Communication aid attributes are viewed as a key consideration by practitioners and family members in AAC decision‐making; however, there are few empirical studies investigating language and communication attributes of communication aids. It is important to understand how those involved in AAC recommendations and support view communication aid attributes and the impact different attributes have. What this paper adds to existing knowledge: This study provides a picture of how communication aids are described by practitioners and family members involved in AAC support of children and young people. A range of attributes is identified from the analysis of these qualitative data as well as information about how participants perceive these attributes as informing decisions. What are the potential or actual clinical implications of this work?: This study provides a basis on which practitioners and others involved in AAC support for children and young people can review and reflect on their own practice and so improve the outcomes of AAC decisions. The study provides a list of attributes that appear to be considered in practice and so also provides a resource for researchers looking to ensure there is a strong empirical basis for AAC decisions. [ABSTRACT FROM AUTHOR]

Community engagement (CE) at Rhodes University (RU) and community psychology draw on similar principles: using an asset‐based community development approach; recognising and drawing on the skills, capabilities, and knowledge of all parties, which they contribute to a partnership. Working from a strategic model of engagement, mutuality is foreground in all CE activities, where both student volunteers and community partners jointly benefit from the engagement. This paper examines CE at RU and how CE principles are translated into practise, using Siyakhana@Makana (S@M) as a case study. In S@M, a 19‐week‐long volunteer programme, community partners and student volunteers are jointly involved in planning, executing, and evaluating CE activities together. This paper illustrates how being involved in such CE activities has enabled community partners to mobilise for effective change in their communities. Community partners reflect on how they have been empowered to taken on leadership roles, addressing local challenges in collaborative ways, while drawing on the skills and knowledge that they have gained through their engagements in S@M. This resonates with the social action model of community psychology, a participatory approach that seeks to mobilise people to bring about change in the contexts in which they live. [ABSTRACT FROM AUTHOR]

This paper explores the relationships between low‐income single mothers and their adolescent and early adult children utilizing qualitative interview and focus group data with youth from three Canadian cities. The research explored youth provisioning roles in these families. Provisioning, a concept widely understood in the global south, refers to labour used to sustain low‐income families and includes emotional labour, care work, trade and exchange and paid labour. Findings from this study identified strong expressions of positive attachment and close relationships between youth and their family members. The paper queries whether positive attachment may be built through roles where youth see themselves as integral parts of a family team and where their contributions are acknowledged. These findings invite us to explore and perhaps challenge the oft‐reported correlations between living in a low‐income, lone mother‐led family and poor childhood outcomes and poor attachment. Can these outcomes be mediated and can the provisioning roles youth undertake possibly be such mediators? [ABSTRACT FROM AUTHOR]

Background: Degree apprenticeships (DA) help employees gain new knowledge and skills by allowing them to study towards a university degree while working full time. For these programmes to be effective, the learning design should be adapted to the needs of these students, who are goal oriented (i.e. they want to gain only knowledge that can be applied within their workplace), have limited time for studying, and usually have not attended formal education for some time. As these programmes are relatively new, there is limited research on how these students can be supported to achieve the programmes' learning goals by using information and communication technologies. Objectives: This paper aims to understand whether a learning design that combines game‐based learning with online flipped classrooms can engage DA students in their learning and help them develop their reflective skills. Methods: Two focus groups were conducted with DA students that study at a UK Business School towards gaining the Chartered Manager status. The focus groups recordings have been analysed using reflexive thematic analysis. Results and Conclusions: The three main themes, "change can be helpful and challenging at the same time", "the ideal game", and "the effect of others", show that DA students find game‐based learning and online flipped classrooms useful, with the right support. Simulation games can be more fulfilling to DA students than quiz games, even if they take more of their out‐of‐class time. In addition, instructors are advised to work more closely with diverse teams to enable students share their work experiences and learn from each other. Lay Description: What is already known about this topic?: Online flipped classrooms offer flexibility in learning, but instructors need to find solutions to challenges, like students' limited e‐learning readiness and lack of motivation.Game‐based learning has been found to facilitate learning in general, but there is a need to identify the specific circumstances (i.e. settings, gaming elements) under which it is effective.Degree apprenticeship students need more support with their learning compared to traditional university students, as they face additional challenges in terms of family life‐work balance and connecting their learning to their working experience. What this paper adds?: Game‐based learning can be useful to degree apprenticeship students providing that focuses on the application of knowledge and provides feedback.Despite facing challenges related to maintaining work‐study‐life balance, degree apprenticeship students are willing to complete the flipped classroom's out‐of‐class activities, if they see a clear benefit from doing so.Online group activities can be challenging for degree apprenticeship students, if they are not able to form teams with other learners that work for the same organisation. The implications of study findings for practitioners: Avoid quiz‐like games and select the ones that use real‐life scenarios for degree apprenticeship students to help them link their learning to their practice.Formative feedback should be provided by both the instructor and the game to motivate degree apprenticeship students to spend the additional time to complete the out‐of‐class activities.Students should be reminded frequently of the purpose of any new learning elements (e.g. learning analytics) as they may not have the time to explore them on their own.When forming student teams based on students' workplace is not possible, spend more time in each breakout room to facilitate the online group discussion and help students bring their different working experiences together. [ABSTRACT FROM AUTHOR]

Introduction: Many studies have investigated patients' understandings of how to optimise mental health services. However, only a few studies in the Italian context have involved experts by experience (EbEs), who can be ex‐users, family members of ex‐users or current service collaborators. Their role is crucial in implementing collaborative service quality assessment projects. Method: The study investigated the experience of 35 EbEs, users, and family members who carried out a 9‐month fortnightly project aimed at imagining an 'ideal service'. The facilitators of the discussion groups (two EbEs) were interviewed; written reports of each meeting were produced with relevant comments, notes and specific suggestions; and content analysis was applied. Results: The most important result concerns the effectiveness of the project management method and group leadership carried out by the two EbEs. This approach allowed for complete autonomy of the work, without professional gaze or power imbalance. Also, the ideas and specific contents focused on by the two groups offer strategies to facilitate users' entry and reception in health care centres, to reduce the stigma of mental illness, to improve the centres' physical environment, to improve organisational aspects, to keep family members actively involved and to network mental health services with other territorial services. Conclusions: EbEs have proven to be key figures in ensuring equity of role in the service co‐design process. This also concerns a context, the Italian one, where their role has not yet been recognised and legalised. Their contribution and ideas to improve services could be fundamental not only in mental health centres, but also in other health facilities, and could concern the entire service delivery process rather than being limited to quality assurance, according to a virtuous circle based on active participation and transformation of the role of users. Patient or Public Contribution: This work resulted from close collaboration between the two EbEs who conducted the groups, users and family members, the university, and the psychiatrist in charge of the service. All of them contributed to the research. The EbEs, researchers and psychiatrist participated in the interpretation of the data and are the co‐authors of this paper. [ABSTRACT FROM AUTHOR]

Background: This paper aims to explore the impact of recovery education on recovery knowledge, attitudes and the quality of life of students undertaking recovery education, contributing to the evidence base in relation to the impact of recovery education. It also explores the experiences of all stakeholders involved in the co‐facilitation, delivery and participation in recovery education. Setting and Participants: This study evaluates the experiences of stakeholders involved in the co‐facilitation, delivery and participation in recovery education across four recovery colleges in Ireland. Participants included students undertaking recovery education, peer educators, education facilitators, recovery college coordinators and practitioner/service providers. Discussion: Findings from the quantitative survey when compared with extant literature suggest that students had a good understanding of recovery education. The social aspect of empowerment for growth and wellbeing was identified through themes relating to co‐production and facilitating student learning. Support for equitable access to recovery education, including co‐production for both the public and staff, was identified as a challenge for the future. Conclusion: The findings from both the qualitative and quantitative components of the study show the positive impact of recovery education on stakeholders while acknowledging the need for ongoing support for people working in recovery education and the development of services. In particular, there was a high level of recovery knowledge found in students undertaking recovery education. Patient or Public Contribution: This study utilised a co‐created study design. From inception a steering group comprising stakeholders (peer educators, recovery education facilitators including past recovery college students and nonpeer staff involved in the co‐production of recovery education) directed the conduct of the evaluation. This steering group participated in an iterative process of information sharing, suggestions for evaluation process and language. [ABSTRACT FROM AUTHOR]

Background: Negative attitudes remain a major barrier to the equality of people with disability, especially when coupled with the lack of autonomy imposed on many people. This paper analyses how disability self‐advocacy groups seek to change community attitudes and work towards systemic change by mobilising knowledge from their lived experience. Methods: The paper applies a cycle of praxis community development approach (a cycle of experience, learning and reflection, synthesis and planning, and implementation and review) to conceptualise and analyse their activities. The methods were a desktop document search, focus groups and reflective analysis with members of two self‐advocacy groups. Findings: A synthesised data analysis found that applying the four‐part community development framework was useful to understand the practice and the purpose of work by self‐advocacy groups to change attitudes. The analysis also demonstrates the benefits for advocates and codesigned activities to intentionally apply the cycle of praxis model to guide their future efforts to change attitudes. Conclusions: The research provides evidence that self‐advocacy groups achieve sustained impacts on attitudes in the community, beyond the direct benefit to their members. Government investment in self‐advocacy has potential to leverage wider system change in attitudes to achieve policy goals for the rights of people with disability. Methodologically, the research also has implications for the benefit of inclusive roles in reflective analysis to understand the lived experience of how practices contribute to system change. The design is an opportunity for inclusive researchers to intentionally incorporate reflective analysis into research processes. Accessible summary: Bad attitudes towards people with disability are a hard problem to fix.People with disability are more involved in changing community attitudes than they used to be.This paper talks about how the work of self‐advocacy groups changes attitudes.By working with self‐advocates, we learned that they used their own experiences in an organised way to change community attitudes.It would be good to share this success more widely. [ABSTRACT FROM AUTHOR]

This paper reports on data that is part of a wider evaluation of a small‐scale project that offers support to parents, children and families affected by alcohol and substance use. Using semi‐structured interviews and a focus group, the data in this paper explore mother's sense making of their substance use and their experiences of various professional interventions which have helped or hindered their personal journeys of recovery. Mothers' narratives suggested a self‐critical inner dialogue conceptualized as shame. Fear of stigma and a sense of shame derived from historical abuse and had a profound effect on how mothers perceived themselves and how they negotiated a web of professionals involved in their lives. Community projects with a focus on understanding mothers and their needs, and not the risk they posed to their children, were considered most supportive. Interventions working within a non‐judgemental and empathetic framework that fostered the importance of relationships and connection had a greater impact on mothers' long‐term recovery goals. [ABSTRACT FROM AUTHOR]

Qualitative research has long critiqued a simplistic association between youth parenting and poor outcomes. Despite this, the UK youth parenting policy continues to view young parents through a narrow deficit lens, focused on assumed risk rather than structural inequalities. The paper brings together the direct accounts of young parents' experiences, with ethnographic observation of practice, to argue that discrimination is the critical issue associated with being a young parent. This is then set within a wider critique of the policy framework which, it is argued, perpetuates and normalises negative ideas about young parents prevalent in political, societal and cultural processes. An integrative theoretical approach is used to highlight how a deficit lens at a policy level upholds, rather than undermines, young parents' intersectional experiences of discrimination and has ethical implications for practitioners working with them. The paper calls for a reorientation of policy which addresses and disrupts discrimination. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and subsequent measures to reduce transmission risk has led to unprecedented digital transformation across health, education and social care services. This includes UK paediatric speech and language therapy (SLT), which sits at the crossroads of these services. Given the rapid onset of this pandemic‐induced digital transition, there is now a need to capture, reflect and learn from the SLT profession so that benefits can be sustained, and barriers addressed. Aims: To survey the impact of COVID‐19 remote working on UK paediatric SLTs' digital views and experiences using the Capability, Opportunity, Motivation and Behaviour (COM‐B) model. Methods & Procedures: An online survey was conducted from May to October 2020. Respondents were asked to rate their use of technology in service delivery before and during the pandemic, to select factors facilitating digital practice, and to provide open‐response aspirations for the future role of technology in paediatric SLT which were analysed thematically using the COM‐B behaviour change model. Outcomes & Results: A total of 424 UK paediatric SLTs responded to the survey. Findings indicate a marked increase in clinicians' perception of their frequency, convenience and confidence with digital practice during COVID‐19 compared with before the pandemic. Respondents identified that specialist training (27%), funding for workplace devices (22%) and supportive leadership (19%) were most likely to facilitate sustained digital practice. Clinicians hoped for a blended approach going forward with technology enhancing existing best practice. Further prominent themes included digital accessibility for all and maintaining the increased opportunity for multidisciplinary working that videoconferencing has afforded. More service‐specific aspirations were bespoke technological solutions as well as parents/carers being able to engage remotely with school‐based provisions. Conclusions & Implications: During COVID‐19, paediatric SLTs' recognition and acceptance of how technology can augment practice has accelerated, with particular value being placed on inclusivity, choice, training, resources, leadership and indication of effectiveness. These are important considerations to help guide the profession towards the long‐term digital enhancement of SLT services. WHAT THIS PAPER ADDS: What is already known on the subject: The COVID‐19 pandemic led to an unprecedented interest in the use of technology across SLT practice. Studies are emerging nationally and internationally to identify the digital priorities of the SLT workforce, the areas of digital SLT provision that are thriving or lacking, and the evidence to guide clinical practice and service development. What this study adds to existing knowledge: This is the first UK‐wide COVID‐19 survey solely focusing on the digital practice of paediatric SLTs. The findings provide critical insights into SLT perception of how practice has been impacted in the early stages of the COVID‐19 pandemic, including digital trends that are service, condition and demographic specific. Tools and channels required to support sustained beneficial change are also discussed. What are the potential or actual clinical implications of this work?: This paper demonstrates the potential for digital solutions to enhance SLT practice, as long as implementation is guided by clinicians' experiences and perspectives. The findings lay groundwork for service development work, such as the creation of training packages, updating of clinical guidelines and care pathways, and development of processes to ensure equitable allocation of evidence‐based resources. [ABSTRACT FROM AUTHOR]

Background: This paper describes the development of learning from novice to expert in Stage 4: Clinical Decision Making (CDM) in surgery: Postoperative reflection and review. It also outlines some or the assessment and teaching approaches suitable to facilitate that transition in skill level. Methods: This paper is drawn from a much broader study of learning and teaching CDM, that used qualitative methodology based on Constructivist and Grounded Theory. Data was collected in individual interviews and focus groups. Using thematic analysis the data were analysed to identify key ideas. All participants worked in the Department of Surgery at one large regional hospital in Victoria. Results: For each stage there is a sequence of learning beginning from relying on external resources, gradually developing internal resources to guide and direct the learner's CDM. Those internal resources built through experience include multisensory and kinaesthetic memories that expand to facilitate the ability to cope with complexity. Discussion: Armed with the mind‐map and rubric table included in this paper it should be possible for any senior clinician or teacher to diagnose their trainees' progression in Stage 4 CDM. This will enable them to tailor their teaching to best match the capabilities of the trainee and to enable to be more effectively targeted. Conclusion: CDM can be taught and both trainees and senior clinicians can benefit from understanding the processes involved. [ABSTRACT FROM AUTHOR]

This paper explores the potential of the perspective of epistemic injustice to reconcile medical sociology's attention to the micro level of experience and interpersonal exchange, and disability studies' focus on the macro level of oppressive structures. The first part of the paper provides an overview of the concept of epistemic injustice and its key instances—testimonial, hermeneutical, and contributory injustice. We also consider previous applications of the concept in the fields of health care and disability, and we contextualise our investigation by discussing key features of postsocialism from the perspective of epistemic injustice. In the second part, we explore specific epistemic injustices experienced by people who use disability support by drawing on interviews and focus groups conducted with parents of disabled children in present‐day Bulgaria. In our conclusion, we revisit our methodological and theoretical points about the potential of epistemic injustice to facilitate mutually beneficial exchanges between medical sociology and disability studies. [ABSTRACT FROM AUTHOR]

Objective: A shared care model was implemented in 2006 in Queensland to facilitate paediatric oncology, haematology and palliative care patients receiving care as close to home as possible. Following initial diagnosis, care planning and treatment at the tertiary children's hospital, appropriate local care was coordinated by Regional Case Managers (RCMs) established at each of 10 Shared Care Units (SCUs). This enabled safe and quality regional care supported by a statewide network providing clinical governance and education. This paper examines learnings from 15 years of this shared care. Setting: Ten hospitals throughout Queensland facilitated a statewide model of shared care for paediatric oncology, haematology and palliative care patients, supported by a tertiary hub in Brisbane. Participants: Regional Case Managers in Shared Care Units and their supporting staff. Design Staff from SCUs were surveyed and focus group interviews conducted. Results: The paper reviews the attributes, knowledge and experience required for RCMs. Standards of care were supported through education workshops, clinical placements, chemotherapy credentialing, guidelines and standards. RCMs facilitated communication and information sharing with the tertiary centre, advocated for their cohort of patients locally and streamlined and supported the family's experience of care. Conclusion: The RCM role provided invaluable clinical leadership for the care of paediatric oncology, haematology and palliative patients across Queensland. As new treatments evolve, the expertise and coordination provided by the RCMs will be even more critical. Achieving high‐quality shared care outcomes is underpinned by the RCMs drive to achieve statewide safety and support for this cohort of children. [ABSTRACT FROM AUTHOR]

People with Down syndrome have complex health care needs which are not always fully met. Health care improvements are required to better meet these needs. Quality indicators are an important tool for improving health care. However, quality indicators for health care for people with Down syndrome are scarce. Existing quality indicators focus on medical (physical) needs or the clinical setting, even though it is acknowledged that quality measures should reflect the total of quality aspects relevant to the population at stake, which may encompass aspects beyond the medical domain. These aspects beyond the medical domain are the focus of the current paper, which aims to provide insight into the way people with Down syndrome live their lives, how health care may fit in, and how this may impact the development of quality indicators. The paper is based on data originating from interviews with people with Down syndrome and their parents as well as focus groups with support staff members working in assisted living facilities for people with intellectual disability. The data revealed a lot of variation in how people with Down syndrome live their lives. Nevertheless, we were able to identify 11 topics, which we grouped into three overarching themes: (1) Being different yet living a normal life; (2) Down syndrome‐(un)friendly society and services; and (3) family perspective. The variation in our data stresses the importance of health care that takes a person's life into account beyond the medical domain, as exemplified by the identified topics. Our findings also show that a good life is not merely depending on good health care supported by well‐defined quality indicators, but on (support in) all life domains. [ABSTRACT FROM AUTHOR]

This paper uses the concept of intersectionality to think about the ways people negotiate diversity on a daily basis in Glasgow, Scotland. The paper draws on ethnographic fieldwork, in‐depth interviews and focus groups carried out in semi‐formal spaces such as public libraries, community‐centres and local cafes. Discussing the ways in which people speak about their experiences of encountering others across ethnicity, age, gender, religion, and class, the paper examines situations where different positionalities interconnect to produce mundane and fleeting moments of relation. Despite tensions, misunderstandings and moments of uneasiness, the paper finds that connections and relations are built. Set in the political context of contemporary Scotland, the paper argues that being together in diversity can be a decisive act that marks the everyday as political. It contends that an openness to and through these intersectional relations can counteract notions of crisis and emergency normatively constructed around issues of immigration and multiculturalism in Scotland. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to evaluate the nurses' experiences with the Nursing Crisis Meetings and to identify nurses' needs regarding the future governance structure. Design: Qualitative study. Methods: Two focus groups were conducted in February 2022 with participants of the Nursing Crisis Meetings (N = 15). We used thematic analysis to describe themes. Results: We identified five themes: opportunity to speak up, call for nursing leadership, call for control over practice and autonomy, development of a governance infrastructure and development of the professional nurse role. Conclusion: Nurses experienced the Nursing Crisis Meetings to be a positive and empowering infrastructure, which facilitates the unique opportunity to speak up and share experiences and concerns. This new infrastructure is a promising strategy to engage nurses during a pandemic and to build on a professional governance structure. Impact: This paper highlights the need for nurses to speak up and be engaged during the COVID‐19 pandemic and gives a practical example of how to put this infrastructure into practice. [ABSTRACT FROM AUTHOR]

Background: School is an important setting for creating healthy and sustainable food environments. Using participatory methods, this pilot study examined food and packaging waste and nutrition quality within the school food system. Methods: One secondary school in Ireland participated in a waste audit. Eleven male students (15–17 years) participated as citizen scientists. Students collected waste over 1 day and documented data on waste categories. Nutrition labels were photographed for analysis. Students created a video and participated in a focus group. Quantitative data were summarised using descriptive frequencies. A Nutrient Profile Model was applied to summarise nutrition quality. The focus group discussion was analysed using content analysis. Results: Highest weights of waste were organic waste (14.2 kg), paper and cardboard (5.0 kg), and hard plastics (4.1 kg). Materials banned by the European Union Single Use Plastics Directive were found. Recycling bins were contaminated with food waste. Nutrition labels from 132 food packages were analysed, of which 115 items (87%) were low‐nutrient, energy dense foods. Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups. Students were not surprised by the unhealthy food choices; however, they were shocked and saddened at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. Conclusions: The methodologies allowed successful engagement with students on this topic. The use of unnecessary plastics to serve food, poor waste separation practices, and the production of avoidable waste from low‐nutrient, energy‐dense products were key issues identified. Students proposed solutions that are achievable in the short‐term. Key highlights: Eleven 15–17‐year‐old secondary school students successfully participated as citizen scientists in a waste audit at their school that characterised the quantity, type and nutrition quality of waste associated with the food system.Organic waste, paper and cardboard, and hard plastics represented the most frequent waste. Recycling bins were contaminated with organic waste.Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups.The researchers conduced a focus group with students when they expressed shock and sadness at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. [ABSTRACT FROM AUTHOR]

Introduction: Student‐led clinics can provide health services to marginalised groups where service offerings are sparse or difficult to access, such as rural areas. Offering these services to children and young people can promote health and well‐being by addressing the individual challenges and the social determinants of health. There is uncertainty, however, as to whether student‐led clinics can meet Australian accreditation standards for health professionals completing degree programs. Objective: This study aims to determine the capacity for health student placements in school‐based student‐led clinics to meet accreditation standards. Design: A systematic scoping review was conducted based on Arksey and O'Malley's framework and the PRISMA‐ScR statement. Setting: Several databases were examined, including Ebsco (Academic Source and CINAHL), ProQuest (PsycINFO, ERIC) and grey literature sources along with a desktop review of accreditation standards across seven health disciplines. Two independent reviewers screened eligible studies. Findings: The search retrieved 1037 records with 65 full‐text papers assessed for eligibility. Eleven papers met the inclusion criteria. Based on the evidence, both nursing and exercise and sports science accreditation standards were best suited to student‐led clinics. Discussion: Although broad categories of work‐integrated learning activities were applied, it appears feasible to expect accreditation standards for health disciplines at an Australian university to be a good fit for health student‐led school‐based clinics. Conclusion: Increasing health student placement opportunities within student‐led clinics can improve the health and well‐being of children and young people in regional, rural and remote (RRR) areas of Australia who may otherwise have limited access to allied health services. [ABSTRACT FROM AUTHOR]

Background: Community‐based health interventions have been implemented as a key strategy for achieving improved health outcomes in Ghana. Effectiveness, however, largely depends on the successful implementation of patient–public engagement (PPE). Although several PPE studies have been conducted in Ghana, little research has been done to understand the specific role of PPE in the context of implementing community‐based health programmes. This paper, therefore, examines the extent of PPE implementation in three selected community‐based health programmes (Community‐based Health Planning and Service [CHPS], Community‐based Maternal and Child Health and Buruli Ulcer) to understand their specific effects on health outcomes. Methods: Three focus groups, involving 26 participants, were held in three districts of the Ashanti region of Ghana. Participants were mainly health service users involving community health committee members/volunteers, residents and health professionals. They were invited to participate based on their roles in the design and implementation of the programmes. Participants focused on each of Rifkin's spider‐gram components. Data were transcribed and analysed descriptively using NVIVO 12 Plus. Results: PPE implementation was found to be extensive across the three programmes in specific areas such as organisation and resource mobilisation. PPE was more restricted in relation to community needs assessment, leadership and management, particularly for the CHPS and Buruli Ulcer programmes. Conclusion: Findings suggest that benefits from community‐based health interventions are likely to be greater if PPE can be widely implemented across all dimensions of the spider‐gram framework. [ABSTRACT FROM AUTHOR]

Introduction: Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well‐being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well‐being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. Methods: Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus‐based summaries, arriving at a preferred service model. Findings: This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well‐being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. Public Contribution: This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the design and pilot program of a parent designed clothing option for hospitalized infants and children and to better understand the importance and effects of hospital clothing on families. Little research has been done on how clothing a hospitalized child impacts the child's quality of life and their parent's perception of care. Research has been limited to clothing in adults and its relation to infection. Design and Methods: A pediatric outfit (the Georgie) for hospitalized infants and children was designed based on insight from bedside nursing, physicians, parents, and supply chain personnel. The garment was pilot tested on select patients from intensive care units of a large children's hospital. A pre‐ and post‐use questionnaire was disseminated with questions focused on aspects of the child's care, comfort in changing child's clothes/diapers, number of times the Georgie was used and comfort level of using the Georgie. Survey responses were summarized using descriptive statistics. Results: Parents overall response to the Georgie was positive with great value placed on having their child dressed. All parents (n = 5) responded that too many lines were an obstacle to having their child dressed. Compared to the hospital Johnny, the Georgie (80%, n = 4) was the most preferred when placement and securement of monitoring lines was taken into consideration with one parent preferring a blanket and diaper only. Nurses felt the benefit outweighed the added effort in dressing the patient. The majority of the nurses had a positive initial reaction to the Georgie (80%, n = 4) and felt the lines or external devices were "very secure/secure" (80%, n = 4) when the patient was wearing the Georgie. Practice Implications: Implementing a new family centered care initiative of dressing critically ill patients in the Georgie may improve patient and family's quality of life while hospitalized. A larger scale study is indicated to assess the importance of dressing hospitalized pediatric patients for their families, to clarify the effect on nursing care, to optimize ability to stabilize lines, and to understand logistical issues. [ABSTRACT FROM AUTHOR]

Background: Communication difficulties are common in people with dementia, and often present from an early stage. However, direct treatment options for people with dementia that positively influence their daily communication are scarce. Aims: To evaluate the potential impact and feasibility of a personalized logopaedic intervention. Methods & Procedures: A total of 40 community‐dwelling persons with dementia and their caregivers were recruited. Five experienced speech and language therapists (SLTs) delivered the six‐session Com‐mens intervention at home. Com‐mens aims to improve positive communication between people with dementia and their primary caregivers and comprises five elements: interactive history‐taking, dynamic observational assessment, education about the consequences of dementia on communication, development and use of personalized communication tools, use motivational, and person‐centred strategies by the SLT. We conducted a single‐group mixed‐methods pilot study with five measurements: baseline, directly after intervention, and at 3, 6 and 9 months follow‐up. Semi‐structured interviews and questionnaires for Experienced Communication in Dementia, quality of life, psychological well‐being and caregiver burden were conducted. Process evaluation was performed by interviewing participants, drop‐outs, SLTs and other stakeholders. Outcomes & Results: A total of 32 dyads completed the intervention. Repeated measures analyses revealed no significant changes over time. In the interviews, participants reported a positive impact on their feelings, increased communication skills and better coping with the diagnosis. Participants would recommend the intervention to others. Facilitators were timely delivery, personalized content and adequate reimbursement. Barriers were unfamiliarity with Com‐mens among referrers, an overburdened caregiver or disrupted family relationships. Conclusions & Implications: This newly developed logopaedic intervention is feasible and has a perceived positive impact on both people with dementia and their caregivers, which is confirmed by a stable pattern over a period of 1 year. Future comparative studies are needed to test the effectiveness of personalized interventions in this patient population. What this paper adds: What is already known on the subject?: SLTs are experts in the field of communication, but even though communication problems are common between people with dementia and their caregivers, there is a lack of logopaedic guidelines and materials for the direct treatment for this population. Interventions that are available either focus on (professional) caregivers only or aim to enhance cognitive functioning and do not target on joined communication. What this paper adds to the existing knowledge?: A newly developed intervention called Com‐mens can be provided by trained SLTs and takes an average of six 1‐h sessions. The intervention is perceived to be valuable and feasible for people with dementia and their caregivers, by the participants themselves, as well as by healthcare professionals and other stakeholders. What are the potential or actual clinical implications of this work?: Dissemination of this intervention will give SLTs skills, tools and materials to provide meaningful care to home‐dwelling persons with dementia and their caregivers. Also, persons with dementia and their caregivers will receive education and materials that can help them increase their understanding of communication problems, enhance their communication skills and better cope with the communication problems that result from dementia. We consider the Com‐mens intervention to be a valuable addition to the field of speech language therapy and dementia. [ABSTRACT FROM AUTHOR]

Young people are more likely to seek help about abusive relationships from friends, rather than adults or professionals, irrespective of gender, age or ethnic group. However, friends may be unequipped to deal with relationship problems and unable to provide adequate emotional or practical support. The aim of this paper is to explore how young people would support friends if they were seeking help or shared experiences of abuse. Qualitative findings drawn from a larger UK mixed‐methods study are used to explicate this. Data was gathered using 16 focus groups and one interview with girls, young women and non‐binary young people aged 13 to 24 years. Thematic analysis provided six themes pertaining to supporting friends and help‐seeking around relationship abuse. Findings showed young people recommended supporting friends in a non‐judgemental way to keep conversations open and help them recognise unhealthy behaviours. However, young people confirmed this is a difficult topic and many would feel fearful, helpless and under pressure. Conversations illustrated the need for more awareness of non‐physical abuse and resources specifically aimed at young people to enable them to help friends and know where and when to seek professional support. [ABSTRACT FROM AUTHOR]

Introduction: Co‐production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co‐production and how to operationalize it. The current paper describes the development of a co‐production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. Methods: The strategy used Appreciative Inquiry (AI), an approach following a five‐step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in‐depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co‐production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. Results: Nine principles for how to do co‐production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long‐term; co‐production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. Conclusion: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co‐production. This documentation of one approach to operationalizing co‐production serves to avert any misappropriations of the term 'co‐production' by listening to service users, stakeholders and other relevant groups, to develop trust and long‐term relationships, and build on the learning that already exists amongst such groups. Patient or Public Contribution: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co‐production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process. [ABSTRACT FROM AUTHOR]

Background: Laryngectomy is a pivotal event in patients. lives, with pervasive and far‐reaching effects. Understanding gender differences in these effects may improve care of laryngectomy patients. This paper describes gender differences in the experience after laryngectomy. Aim: To explore the similarities and differences in the laryngectomee experience based on gender. Methods & Procedures: Four gender‐matched focus groups were conducted; dialogue was audio recorded, transcribed and studied using interpretative phenomenological analysis (IPA). Outcomes & Results: A total of 17 laryngectomees, eight female and nine male, age range 41–80 years, participated in focus groups. Laryngectomy represented a turning point in the lives of both genders. Four themes emerged: perception of loss, adjusting to alaryngeal communication, finding a positive outlook and re‐establishing the self. Themes applied to both genders, with subthemes demonstrating similarities and differences between men and women. Conclusions & Implications: Men and women experienced destabilization after laryngectomy related to perceived losses and shifts in identity. Men described navigating from physical disability toward recovery of function, while women described an emotional journey concerning loss and rediscovery of meaning in their lives. Understanding the laryngectomee experience in better detail, which includes recognizing gender differences and rejecting a one‐size‐fits‐all approach, may facilitate more effective preoperative counselling and post‐operative support from providers. WHAT THIS PAPER ADDS: What is already known on the subject: Patients who undergo total laryngectomy often struggle with problems with physical, emotional, and social functioning and decreased quality of life. As the literature currently stands, the understanding of the experience of laryngectomees has primarily focused on the perspective of a singular gender. Thus, this is the first qualitative study specifically investigating differences in the laryngectomee experience between men and women. What this paper adds to existing knowledge: This study finds that women and men both endorse significant mental and physical changes following laryngectomy; however, their perception of their experience differed by gender. Women endorsed alteration to meaningful life and men demonstrated distress related to loss of physical functioning; both genders described laryngectomy as a formative event that helped them rediscover joy and redefine themselves for the better. What are the potential or actual clinical implications of this work?: Our findings suggest men and women have distinct mental and emotional struggles after laryngectomy despite similar physical changes. This suggests that tailoring care with consideration of these gender differences, including preoperative counselling, post‐operative support and gender‐matched visitors or support groups, may help beneficial in recovery after laryngectomy. [ABSTRACT FROM AUTHOR]

Background: Acquired laryngotracheal stenosis (LTS) is a rare condition that causes breathlessness and dyspnoea. Patients have reconstructive airway surgery to improve their breathing difficulties, but both LTS and the surgery can cause voice difficulties. The existing evidence base for management of voice difficulties for adults with LTS focuses on symptoms. There is limited information to provide clinical guidance for speech and language therapists (SLTs) and a limited understanding of the impact of voice changes on adults with LTS. Aim: To investigate the lived experience of adults with laryngotracheal stenosis (LTS), who have had reconstructive surgery; here focussing on voice concerns with the aim of guiding clinical care for SLTs. Methods and Procedures: A phenomenological, qualitative study design was used. Focus groups and semi‐structured interviews were completed with adults living with LTS who had had reconstructive surgery. Audio recordings were transcribed and inductive thematic analysis was used by the research team to identify themes and sub‐themes. Outcomes and Results: A total of 24 participants (five focus groups and two interviews) took part in the study before thematic saturation was identified in analysis. Three main themes were identified specific to the experience of living with LTS: the Medical, Physical and Emotional journey. All participants referenced voice difficulties as they related to each of these overall themes. Sub‐themes directly related to voice included experience of surgery, information provision, staff expertise/complacency, symptoms, symptom management, identity, support networks, impact on life and living with a chronic condition. Conclusions and Implications: In this qualitative study participants have described the integral part voice difficulties play in their lived experience of LTS and reconstructive surgery. This is considered in the context of their clinical care and the need for individualised management and information provision throughout the course of their condition. The broader research literature relating to voice difficulties is explored with links made to people with LTS and recommendations made for future research into people living with LTS and dysphonia. What this paper adds: What is already known on this subject: Adults with laryngotracheal stenosis (LTS) experience voice changes as a result of their condition, and the surgeries necessary as a treatment. These changes can lead to altered pitch, vocal fatigue, loss of pitch range and loss of volume control. Although there are known psychosocial implications both to living with a chronic condition and voice difficulties there has been no research exploring this in adults with LTS, and there is minimal clinical guidance for speech and language therapists (SLTs) working with these patients. What this paper adds to existing knowledge: This research is the first study to explore the lived experience of adults with LTS who undergo reconstructive surgery, focusing on their voice concerns. This study demonstrates the multifactorial impacts of voice changes on all aspects of the lives of adults with LTS and the need for individualised information provision and clinical care to help support them. What are the potential or actual clinical implications of this work?: Adults with LTS want expert SLTs to facilitate their care and support them throughout their LTS journey alongside other support networks. They want to be carefully prepared for reconstructive surgery and given clear information about symptoms and management of their voice difficulties. This has led to the reorganisation of the care pathway at our centre, and the introduction of a patient‐led pretreatment session. [ABSTRACT FROM AUTHOR]

The use of focus groups is a well-established qualitative research method in the social sciences that would seem to offer scope for a significant contribution to the advancement of knowledge and understanding in the field of business ethics. This paper explores the potential contribution of focus groups, reviews their contribution to date and makes some recommendations regarding their future use. We find that, while the use of focus groups is not extensive, they have been utilised in a non-negligible number of studies. Focus groups are usually used as a supplementary method, often as part of the development of a research instrument. Whether used on their own or in conjunction with other methods, we find that in the majority of cases there is insufficient information for a reader to judge that the method has been carried out well and hence that the 'findings' may be trusted. Nor is it easy for future researchers to learn about the practical application of the method in business ethics contexts. We therefore recommend improved reporting in future published studies. Based on an analysis of a subsample of papers that provided a reasonable level of methodological detail, we provide further insights into, and recommendations for, the use of focus groups in business ethics research. [ABSTRACT FROM AUTHOR]

Although there has been increasing international emphasis on creativity in education, many creativity training programmes have focused on enhancing students' creative thinking skills with few studies on how these skills can be integrated into the teaching of subject disciplines. As a member of a Community of Practice project that ran from spring 2021 to summer 2022 at my university, I worked with ten university teachers from multiple disciplines to develop and implement instructional strategies to foster students' creative thinking skills. The paper documented the development, implementation and evaluation of creative thinking skills teaching strategies for a higher education course in visual arts. Both the development of the teaching strategies and the measurement of the impact on student learning have undergone vigorous research procedures and made reference to the existing literature. The effectiveness of the activities was assessed using multiple methods including the Torrance Test of Creative Thinking, a self‐report inventory, and a focus group interview. The results indicated the new learning activities enhanced students' creative thinking skills. They also showed that creativity can be developed through teaching while revealing that playfulness, freedom and structure, group interactions, and problem‐solving activities are beneficial for the development of creative thinking skills. Readers may better understand the different ways in which creative thinking skills instruction materials can be developed and incorporated into teaching of visual arts by making reference to the strategies suggested and the process of development in the paper. [ABSTRACT FROM AUTHOR]

Objectives: This paper presents findings from our collaborative research on the perceptions and preferences of people experiencing homelessness regarding outreach nursing services. Method: We conducted qualitative research using a critical ethnography approach. Sample: A total of 15 participants were interviewed individually (n = 12 people experiencing homelessness) and in focus groups (n = 3 care providers). We also conducted direct observation. Results: This paper focuses on one of the core categories that emerged from the data analysis "Perception of Health Care." This category emerged from the following three subcategories, which we will present in this paper: (1) Conflicting Relationships with Institutional Health Services; (2) Perception of Outreach Services; (3) Recommendations from Mobile Clinic Users. Conclusion: There are a range of perceptions of health services among people experiencing homelessness. Some are satisfied with the care received in the public health system, while many have experienced dehumanizing practices. Overall, outreach services are a promising strategy to reach people who are not served by the traditional modes of care delivery. Based on our findings, we suggest several key practices to personalize and adapt healthcare services and foster inclusive environments to better serve people experiencing homelessness. [ABSTRACT FROM AUTHOR]

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The independent review of children's social care (2022) has proposed a radical reset of England's children's services, shifting a remote, assessment heavy system towards one that works alongside communities to help prevent statutory interventions. However, notions around the harnessing of community resources to deliver Early Help are often underpinned by assumptions regarding the voluntary, community and social enterprise (VCSE) sector and the ease with which such organizations can be integrated into preventative strategies. This paper reports findings from embedded research within a unitary authority in Southwest England during remodelling of its Early Help service to work more collaboratively with local VCSE organizations. The study generated data from ethnographic observations, semi‐structured interviews and focus groups with 95 participants, including local parents, service providers, VCSE organizations and Council leaders. The findings illustrate that families value the compassionate, responsive and flexible support available within many VCSE settings. However, differences in practice cultures, regulatory pressures on statutory providers, the need to (re)build trust in communities and sensitivities around power‐sharing and resourcing meant negotiating VCSE sector integration was fraught with complexities. Few studies have gained such privileged access to a Local Authority's remodelling of Early Help services, and this paper has significant insights for the debates surrounding the independent review of children's social care (2022) and its recommendation to bring services 'closer to communities'. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 20% of people with a long‐term condition (LTC) experience depressive symptoms (subthreshold depression [SUBD]). People with SUBD experience depressive symptoms that do not meet the diagnostic criteria for major depressive disorder. However, there is currently no targeted psychological support for people with LTCs also experiencing SUBD. Online peer support is accessible, inexpensive and scalable, and might offer a way of bridging the gap in psychosocial care for LTC patients. This article explores the psychosocial needs of people living with LTCs and investigates their perspectives on online peer support interventions to inform their future design. Methods: Through a co‐produced participatory approach, online focus groups were completed with people with lived experience of LTCs. Focus groups were audio recorded and transcribed verbatim. Reflexive thematic analysis (TA) was conducted adopting a critical‐realist approach and an inductive analysis methodology that sought to follow participants' priorities and concerns. Results: Ten people with a range of LTCs participated across three online focus groups, lasting an average of 95 (±10.1) min. The mean age was 57 (±11.4) years and 60% of participants identified as female. The three key emerging themes were: (1) relationship between self and outside world; (2) past experiences of peer support; and (3) philosophy and vision of peer support. Adults living with LTCs shared their past experiences of peer support and explored their perspectives on how future online peer support platforms may support their psychosocial needs. Conclusion: Despite the negative impact(s) of having a long‐term physical health condition on mental health, physical and mental healthcare are often treated as separate entities. The need for an integrated approach for people with LTCs was clear. Implementation of online peer support to bridge this gap was supported, but there was a clear consensus that these interventions need to be co‐produced and carefully designed to ensure they feel safe and not commercialised or prescriptive. Shared explorations of the potential benefits and concerns of these online spaces can shape the philosophy and vision of future platforms. Patient or Public Contribution: This work is set within a wider project which is developing an online peer support platform for those living with LTCs. A participatory, co‐produced approach is integral to this work. The initial vision was steered by the experiences of our Patient and Public Involvement (PPI) groups, who emphasised the therapeutic value of peer‐to‐peer interaction. The focus groups confirmed the importance and potential benefit of this project. This paper represents the perspectives of PPI members who collaborate on research and public engagement at the mental–physical interface. A separate, independent Research Advisory Group (RAG), formed of members also living with LTCs, co‐produced study documents, topic guides, and informed key decision‐making processes. Finally, our co‐investigator with lived experience (E. A.F.) undertook the analysis and write‐up alongside colleagues, further strengthening the interpretation and resonance of our work. She shares first joint authorship, and as a core member of the research team, ensures that the conduct of the study is firmly grounded in the experience of people living with LTCs. [ABSTRACT FROM AUTHOR]

Paediatric burns are a major public health issue because of long‐term physical, psychological and social consequences and the high cost of treatment. The aim of this study was to design and evaluate a mobile‐based self‐management application for caregivers of children with severe burns. A participatory design technique was employed to develop the Burn application, which included three main phases: the determination of application requirements, the design and evaluation of the low‐fidelity prototype, and the design and evaluation of the high‐fidelity prototypes. In the first phase, application requirements were determined via validated paper questionnaires using the Delphi technique. In the second step, a low‐fidelity prototype was prepared using conceptual models and evaluated through a focus group with specialists. Seven specialists reviewed the application and evaluated how this prototype meets functional requirements and objectives. The third phase was performed in three stages. First, the high‐fidelity prototype was designed and developed by the JAVA programming language. Second, a cognitive walk‐through was carried out to show how users can interact with the mobile application and how it works. Third, this program was installed on the mobile phones of 28 caregivers of burned children, eight IT experts, and two general surgeries, and the prototype's usability was evaluated. In the present study, most caregivers of children with burns stated that after discharge, they face problems regarding infection control and wound care (4.07) and how to perform physical activity (4.12). User registration, educational materials, caregiver‐clinician communication, chat box, and appointment booking, safe login were the most important characteristic of the Burn application. Mean usability evaluation scores were in the range of 7.92 ± 0.238 to 8.10 ± 0.103, which is considered at a "good" level. From the Burn program design experience, it can be concluded that co‐design with health care specialists can significantly support and meet the specialists' and patients' needs and ensure the program's usefulness. In addition, application evaluation by users involved and not involved in the application design process can help enhance usability. [ABSTRACT FROM AUTHOR]

Background: Bridging the research–practice gap in autism communication services is an identified priority for improving services. Limited research has investigated the views of practitioners regarding this research–practice gap. Investigation of the barriers experienced and facilitators used in clinical practice may assist to identify scalable and sustainable strategies to increase use of evidence‐based practices (EBPs) in the delivery of communication services to children with autism. Aims: To elucidate how Australian speech pathologists engage with external evidence and how communication outcomes are measured to demonstrate the effectiveness of service provision to children with autism. Methods & Procedures: A total of 15 Australian speech pathologists, with experience ranging from less than 1 to more than 16 years, participated in three focus groups. Data from focus groups were analysed using reflexive thematic analysis within an interpretive phenomenological paradigm. Outcomes & Results: Seven themes were identified. Participants reported on the diversity of individuals with autism, their experiences of resource constraints, seeking collegial advice and accessing a diverse range of evidence sources, the role of clinical expertise in translating evidence to practice, the barriers experienced in outcome measurement and use of stakeholders to facilitate data collection to demonstrate outcomes. Conclusions & Implications: Individual practitioner skill and beliefs are facilitators to translating research to practice. Interventions to improve clinician use of EBP should address the skill and belief barriers, aiming to increase a clinician's EBP self‐efficacy and increasing their expectation that investing in EBP activities will result in improved services for children with autism. Modelling and reflective practice are two strategies that may have an application as interventions to improve EBP use in clinical practice. What this paper adds: What is already known on the subject: Constrained resources, especially lack of time, is a barrier to routine uptake of best available evidence in clinical services for children with autism. What this paper adds to existing knowledge: In this study, the perception that speech pathologists lacked time to engage in EBP activities was linked with the speech pathologist's research skill and their beliefs about the benefits of engaging in EBP. Speech Pathologists reported using a range of information sources, as "evidence" but also reported feeling uneasy when using evidence of disputable, or unknown quality. Accessibility and relevance to their individual client were highly prioritised in selecting evidence. Clinical expertise was an essential skill for research translation. What are the potential or actual clinical implications of this work?: Interventions which target professional beliefs and research translation capability are requisite for motivating speech pathologists to improve their use of EBP.Modelling of EBP use, individual reflective practice and collegial active listening to facilitate reflective practice, might be useful strategies which target beliefs and capability of individual speech pathologists; thereby changing their EBP use. [ABSTRACT FROM AUTHOR]

Background: Phonetic transcription is recognized in regulatory standards as an essential skill for Speech and Language Therapists (SLTs) in the assessment, diagnosis and management of clients with speech difficulties. Previous research has identified that approaches to phonetic transcription vary, and that SLTs often lack confidence in transcribing. However, SLTs' views and working practices have not been investigated in detail, particularly in terms of whole service approaches and following the recent increase in telehealth. Aims: To investigate SLTs' views about phonetic transcription, their working practices at both individual and service levels, and the factors that influence these. Methods & Procedures: A total of 19 SLTs from the UK were recruited to online focus groups via social media and local networks. Participants discussed their views of, and practices in, phonetic transcription. Themes were identified using reflexive thematic analysis. Outcomes & Results: Three broad themes were generated division and unity; one small part of a big job; and fit for purpose. SLTs were uniformly proud of their ability to phonetically transcribe and viewed this as a unique skill, but clear differences existed between different groups of SLTs in their views and practices. Investing in phonetic transcription was not always a priority for SLTs or services, and although many felt under‐confident in their skills they considered these to be adequate for the populations they usually encounter. SLTs make an early judgement about possible therapy targets, which influences the level of detail used in their phonetic transcription. Practical barriers are often not addressed at service level, and assessment via telehealth poses some specific challenges. Conclusions & Implications: SLTs and services would benefit from increased investment in phonetic transcription in terms of time, opportunities for continuing professional development (CPD) and initiatives such as electronic patient records (EPRs) which support the use of phonetic symbols. Identifying target sounds at an early stage raises questions about the implications of disregarding other features of speech, and the selection of appropriate intervention approaches. Further research is needed to analyse actual rather than reported practices, and to consider the relationship between phonetic transcription and intervention approaches. Future studies could also identify precise CPD requirements and evaluate the effectiveness of CPD. What this paper adds: What is already known on the subject: Previous research has demonstrated that SLTs often lack confidence in phonetic transcription and that practices are varied, with relatively little use of narrow transcription. SLTs are interested in opportunities to maintain and develop transcription skills but do not often undertake CPD for transcription. What this paper adds to existing knowledge: By using focus groups as a forum for discussions, this study provides a rich and detailed insight into SLTs' views about clinical transcription and their working practices, with previously unreported details about the reasons for these practices in a clinical context and at a service‐wide level. What are the potential or actual clinical implications of this work?: Transcription is often de‐prioritized in non‐specialist contexts, with practical barriers and a lack of clear and consistent protocols at a whole‐service level. There is an opportunity for service managers to address the systemic difficulties in using transcription effectively by raising the profile and value of transcription amongst clinicians, and promoting CPD opportunities, using the findings of this study as a rationale for funding this. Together, these recommendations have the potential to improve client outcomes through more accurate assessment and diagnosis, and hence more appropriate intervention. [ABSTRACT FROM AUTHOR]

The safety of practitioners working in the area of domestic abuse is a current subject of research and practice concern, as services endeavour to better understand constantly evolving tactics of violence and abuse and respond appropriately. This paper reports on a subset of findings from a practice‐led research project focussed on capacity‐building workers and their organizations to address domestic abuse, which highlighted the ongoing concerns expressed by practitioners—particularly female practitioners—about their own physical, emotional, and professional safety. Ethnographic notes were taken of Community of Practice discussions in four regions of New South Wales, Australia, involving 69 senior health practitioners from a range of service streams: specialist domestic abuse, mental health, substance use, and child protection. Themes identified through thematic analysis included the following: a tailored approach to practising safely; attending to physical safety; threats to professional identity; promoting emotional well‐being; documentation to support worker safety; and attending to cultural safety. These themes are encapsulated in the practitioner question: Who's got my back?—highlighting the importance of legislation, policy, and practices that provide an environment in which safety and support are embedded in a culture of care at every organizational level. [ABSTRACT FROM AUTHOR]

Background: Dysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician‐specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke. Aim: To explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke. Methods & Procedures: We used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi‐structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method. Outcomes & Results: Four themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: 'Following what other people have done', (2) need for collaborative learning: 'A safe space to share and train', (3) variation between settings impacts on continuity of care: 'There's a difference between community and acute', and (4) working effectively with multidisciplinary teams (MDT): 'An MDT which can listen to the voice of speech pathology'. Conclusions & Implications: Relationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke. WHAT THIS PAPER ADDS: What is already known on this subject: Dysphagia rehabilitation can improve swallowing after a stroke. However, dysphagia rehabilitation is characterised by variability in clinical practice. Clinician‐specific and workplace factors influence clinical practice and may contribute to variability in dysphagia rehabilitation. What this study adds: Professional relationships influence speech pathologists' clinical practice, including relationships between senior and junior clinicians, between inpatient and community settings and with peers and multidisciplinary teams. Workplace norms and hierarchies, poor continuity of care between settings and competing priorities from other disciplines can hinder dysphagia rehabilitation. However, collaborative learning, positive workplace cultures and respectful transdisciplinary care can improve the quality and consistency of clinical practice. What are the clinical implications of this work?: Flattening hierarchies in the workplace can foster a safe learning space. Further, questioning workplace norms and seeking out peer learning within and across settings can build clinical skills and confidence. Developing positive workplace cultures that support continuous development may be key for empowering speech pathologists to provide high‐quality and consistent dysphagia rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Evidence supports the effectiveness of shared book reading for promoting language and literacy development, but it is known that families experiencing vulnerability may have reduced access to books and are less likely to share books regularly at home. Community hubs often provide support to families experiencing vulnerability and may provide an opportunity to create environments that support families to engage in shared book reading, especially if families are invited into the creation of these environments through co‐design. However, there is currently little evidence regarding the impact of co‐designing shared book reading environments with families in community settings. Aims: The current study is part of a broader project which used co‐design to develop a shared book reading environment in collaboration with stakeholders in a community hub. This small‐scale study aimed to provide a preliminary evaluation of the impact of this co‐designed shared book reading environment at the community hub on (1) the frequency of shared book reading at the hub; (2) participants' confidence and enjoyment of reading with children at the hub; and (3) participants' experiences of shared book reading at the hub. Method & Procedures: The co‐design project was carried out in four phases with families, staff and community partners at the community hub. A convergent mixed‐methods approach was used to collect and analyse quantitative and qualitative data in the first and last phase of the project to evaluate project outcomes. Quantitative data (environmental observations of reading at the hub and participant ratings of confidence and enjoyment of reading with children at the hub) were analysed using descriptive statistics and nonparametric statistical tests. Qualitative data (participants' responses regarding their experiences of changes implemented in the community hub) were analysed using inductive content analysis. Outcome & Results: An increased frequency of shared book reading was observed within the community hub after changes were implemented, and positive changes in enjoyment of book reading were recorded. Qualitative responses from participants following conclusion of the project were organised into three main categories, which showed that (1) children and families were reading more and enjoying reading activities that were happening; (2) children and families were borrowing more books; and (3) families had changed the way they were reading at home with their children. Conclusions & Implications: A co‐designed shared book reading environment within a community hub had a positive impact on shared book reading experiences for families in areas with high levels of vulnerability. WHAT THIS PAPER ADDS: What is already known on this subject: Community hubs provide a unique opportunity to support early language and literacy development in partnership with families in areas of vulnerability; however, there is limited literature investigating the impacts of these supports. A previous study utilised co‐design to develop a shared book reading environment with stakeholders at a community hub in an area where a high proportion of children are considered to be 'vulnerable' in terms of language and literacy development. It was found that co‐design enabled the development of collaborative changes to support shared book reading that were valued and owned by families, staff and community partners at the community hub. What this study adds: The current study focused on evaluating the impact of a co‐design project on the frequency of shared book reading at the hub and participants' experiences, confidence and enjoyment of reading with children at the hub. Analysis of pre‐ and post‐data provide preliminary evidence that a co‐designed shared book reading environment in a community hub can have a positive impact on increasing families' awareness and engagement with book borrowing, engagement in shared book reading activities in the community and at home, and participants' confidence and enjoyment of reading with children. What are the clinical implications of this work?: Speech pathologists have an important role to play in prevention and promotion. This study has shown that collaboration with families experiencing vulnerability can support the implementation of strategies to promote shared reading in a community hub and demonstrate increased quality and frequency of shared book reading. The utilisation of a community hub also highlights the opportunities for the speech pathology profession to deliver community‐based promotion and prevention initiatives as a strategy to address equitable language outcomes. [ABSTRACT FROM AUTHOR]

Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper‐based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job‐demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job‐demand‐control‐support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. [ABSTRACT FROM AUTHOR]

Background: In Oman, limited access to adequately prepared healthcare providers in primary healthcare threatens the provision of quality care to patients and families and access to healthcare services. Nurse practitioners (NP) are in an excellent position to address safety issues and ensure quality healthcare with their advanced nursing skills, knowledge, and acumen for acceptable cultural and religious practices. Aims: To explain Oman's national strategic plans, processes, challenges, opportunities, and both regional and global implications for the facilitation of NP role implementation and policies. Sources of evidence: The Nursing and Midwifery Human Resources framework guided the NP implementation project. Guided by the framework, the World Health Organization and the Omani Ministry of Health conducted multiple situational analyses (2004–2016). Later, the NP role was planned and implemented in Oman. During and after implementation, monitoring and evaluation of the NP role implementation were continuously conducted using multiple focus groups, individual interviews, and field visits. Discussion: The NP role implementation revealed multiple challenges and opportunities that either hinder or support NP role implementation. Additionally, the NP implementation project revealed various lessons learned. Implications for nursing and health policy: National and global nursing leaders and health policymakers should collaborate to discuss NP issues, especially NP role sustainability, legal approval and recognition, prescriptive authority, title protection, practice acts, and professional regulation. Conclusion: This paper informs nursing leaders and policymakers in the Middle East and other countries in the global community about Oman's experience regarding NP role implementation. [ABSTRACT FROM AUTHOR]

In January 2021, we assessed the implications of temporary regulations in the United Kingdom allowing pubs and restaurants to operate on a takeaway basis without instigating a change of use. Local authorities (LAs) across the North‐East of England were unaware of any data regarding the take‐up of these regulations, partially due to ongoing capacity issues; participants also raised health concerns around takeaway use increasing significantly. One year on, we repeated the study aiming to understand the impact of these regulations on the policy and practice of key professional groups. Specifically, we wanted to understand if LAs were still struggling with staff capacity to address the regulations, whether professionals still had public health trepidations, and if any unexpected changes had occurred across the local food environment because of the pandemic. We conversed with 16 public health professionals, planners and environmental health officers across seven LAs throughout the North‐East of England via focus groups and interviews. Data collated were analysed via an inductive and semantic, reflexive‐thematic approach. Through analysis of the data, three themes were generated and are discussed throughout: popular online delivery services as a mediator to increased takeaway usage; potential long‐term health implications and challenges; continued uncertainty regarding the temporary regulations. This paper highlights important changes to local food environments, which public health professionals should be aware of, so they are better equipped to tackle health inequalities across urban and sub‐urban areas. [ABSTRACT FROM AUTHOR]