Search

Considering the high‐risk, stressful, and fast‐paced nature of the perioperative environment and vulnerability of surgical patients, the quest for maintaining a safety culture in the OR is ongoing. Speaking up—an interaction between perioperative team members to address a concern—requires team member empowerment to advocate for patient safety when needed. Hierarchical gradients, lack of psychological safety, incivility, and a nonsupportive organizational culture can impede speaking‐up behaviors. Strategies to improve speaking up include using multimethod education initiatives, enhancing psychological safety, and managing conflict. Perioperative nurses can experience barriers to speaking up, such as lack of team familiarity, normalization of deviance, and differing perceptions among team members. The logistics of whole‐team training initiatives can be challenging; however, such initiatives can help participants improve their understanding of the perspectives and communication goals of all involved personnel. Perioperative nurses and leaders should collaborate to promote speaking up for safety when warranted. [ABSTRACT FROM AUTHOR]

The search methods used in systematic reviews provide the foundation for establishing the body of literature from which conclusions are drawn and recommendations made. Searches should aim to be comprehensive and reporting of search methods should be transparent and reproducible. Campbell Collaboration systematic reviews strive to adhere to the best methodological guidance available for this type of searching. The current work aims to provide an assessment of the conduct and reporting of searches in Campbell Collaboration systematic reviews. Our objectives were to examine how searches are currently conducted in Campbell systematic reviews, how search strategies, search methods and search reporting adhere to the Methodological Expectations of Campbell Collaboration Intervention Reviews (MECCIR) and PRISMA standards, and identify emerging or novel methods used in searching in Campbell systematic reviews. We also investigated the role of information specialists in Campbell systematic reviews. We handsearched the Campbell Systematic Reviews journal tables of contents from January 2017 to March 2024. We included all systematic reviews published since 2017. We excluded other types of evidence synthesis (e.g., evidence and gap maps), updates to systematic reviews when search methods were not changed from the original pre‐2017 review, and systematic reviews that did not conduct their own original searches. We developed a data extraction form in part based on the conduct and reporting items in MECCIR and PRISMA. In addition, we extracted information about the general quality of searches based on the use of Boolean operators, keywords, database syntax and subject headings. Data extraction included information about reporting of sources searched, some aspects of search quality, the use and reporting of supplementary search methods, reporting of the search strategy, the involvement of information specialists, date of the most recent search, and citation of the Campbell search methods guidance. Items were rated as fully, partially or not conducted or reported. We cross‐walked our data extraction items to the 2019 MECCIR standards and 2020 PRISMA guidelines and provide descriptive analyses of the conduct and reporting of searches in Campbell systematic reviews, indicating level of adherence to standards where applicable. We included 111 Campbell systematic reviews across all coordinating groups published since 2017 up to the search date. Almost all (98%) included reviews searched at least two relevant databases and all reported the databases searched. All reviews searched grey literature and most (82%) provided a full list of grey literature sources. Detailed information about databases such as platform and date range coverage was lacking in 16% and 77% of the reviews, respectively. In terms of search strategies, most used Boolean operators, search syntax and phrase searching correctly, but subject headings in databases with controlled vocabulary were used in only about half of the reviews. Most reviews reported at least one full database search strategy (90%), with 63% providing full search strategies for all databases. Most reviews conducted some supplementary searching, most commonly searching the references of included studies, whereas handsearching of journals and forward citation searching were less commonly reported (51% and 62%, respectively). Twenty‐nine percent of reviews involved an information specialist co‐author and about 45% did not mention the involvement of any information specialist. When information specialists were co‐authors, there was a concomitant increase in adherence to many reporting and conduct standards and guidelines, including reporting website URLs, reporting methods for forward citation searching, using database syntax correctly and using subject headings. No longitudinal trends in adherence to conducting and reporting standards were found and the Campbell search methods guidance published in 2017 was cited in only twelve reviews. We also found a median time lag of 20 months between the most recent search and the publication date. In general, the included Campbell systematic reviews searched a wide range of bibliographic databases and grey literature, and conducted at least some supplementary searching such as searching references of included studies or contacting experts. Reporting of mandatory standards was variable with some frequently unreported (e.g., website URLs and database date ranges) and others well reported in most reviews. For example, database search strategies were reported in detail in most reviews. For grey literature, source names were well reported but search strategies were less so. The findings will be used to identify opportunities for advancing current practices in Campbell reviews through updated guidance, peer review processes and author training and support. [ABSTRACT FROM AUTHOR]

In the coming decades, the number of people in the Australian population over the age of 65 is predicted to increase to 23% by the year 2066. The process of physiological ageing is associated with an increase in the presentation of disease pathologies, an increased potential for physical and cognitive deficits and a decrease in health literacy. The ageing of the Australian population presents challenges for the sonography profession including an increasing age gap between the sonographer and their patient as well as increasing complexities in performing ultrasounds on older patients. The natural changes that accompany ageing can create barriers to effective communication between sonographers and their patients. Ageist beliefs can lead to conscious and unconscious bias and unfounded judgements by sonographers decreasing the quality of patient care. To combat the decline in the quality of healthcare that is reported for older patients, sonographers can endeavour to put into place deliberate practical tools and strategies to avoid ageism and improve communication with older patients. Conversely, institutional awareness, education and policies that address age related judgements and bias from older patients towards younger sonographers can foster respectful dialogue, promote understanding and stimulate positive communication across different age groups. [ABSTRACT FROM AUTHOR]

Background: Little is known about dental healthcare workers reported suspected child maltreatment to and received inquiry from the child welfare services (CWS). Aim: Assess time lag differences in public dental healthcare workers' information sharing with CWS and identify sociodemographic and attitudinal covariates of information sharing with CWS in 2014 and 2019. Design: In 2014 and 2019, a national census of 1542 and 1791 Norwegian dental health care workers, respectively, were invited to participate in an electronic survey. Of them, 1200 (77.8%) and 1270 (70.9%) replied to the questionnaires. Time trends of reported child maltreatment and received inquiries were estimated and adjusted for sociodemographics, attitudes, trust, and collaborative routines in logistic regression analyses. Results: The likelihood of reported child maltreatment to and received inquiry from CWS was higher in 2019 than in 2014 (OR 1.4 [95% CI 1.2–1.7] and OR 1.1 [95% CI 0.9–1.4]). Significant associations occurred with sociodemographic characteristics, attitudes, and collaborative routines. The likelihood of receiving inquiry about whether being employed long versus short term was higher in 2019 than in 2014. Conclusion: Information sharing between dental healthcare workers and CWS improved across time and might promote beneficial outcomes. [ABSTRACT FROM AUTHOR]

ABSTRACT Two views claim to account for the origins of great ape gestural forms. On the Leipzig view, gestural forms are ontogenetically ritualised from action sequences between pairs of individuals. On the St Andrews view, gestures are the product of natural selection for shared gestural forms. The Leipzig view predicts within‐ and between‐group differences between gestural forms that arise as a product of learning in ontogeny. The St Andrews view predicts universal gestural forms comprehensible within and between species that arise because gestural forms were a target of natural selection. We reject both accounts and propose an alternative “recruitment view” of the origins of great ape gestures. According to the recruitment view, great ape gestures recruit features of their existing behavioural repertoire for communicative purposes. Their gestures inherit their communicative functions from visual (and sometimes tactile) presentations of familiar and easily recognisable action schemas and states and parts of the body. To the extent that great ape species possess similar bodies, this predicts mutual comprehensibility within and between species – but without supposing that gestural forms were themselves targets of natural selection. Additionally, we locate great ape gestural communication within a pragmatic framework that is continuous with human communication, and make testable predications for adjudicating between the three alternative views. We propose that the recruitment view best explains existing data, and does so within a mechanistic framework that emphasises continuity between human and non‐human great ape communication. [ABSTRACT FROM AUTHOR]

This qualitative study explores how structural factors and self‐talk mediate early career math teachers' experiences implementing student‐centered reforms in high‐need urban schools. Results indicate that implementing instructional changes can sometimes interfere with the success of classroom interaction rituals, and can contribute to internal conversations containing blame of self and students. However, various supports can help teachers develop the “ingredients” for positive, action‐oriented self‐talk, including successful interactions within reform‐oriented communities and autonomy in planning curriculum. For one of the teachers in the study, access to distance communities focused on project‐based learning combined with alterations in self‐talk supported a reform‐oriented teaching identity, instruction that values students' interests, and commitment to teaching mathematics in high‐need urban schools. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion Facemasks represent an essential measure of prevention against the spread of infectious diseases; however, they lessen the ability to convey and understand emotions through facial expressions. In blood donation settings, facemask wearing could interfere with professionals' tasks, reduce the satisfaction of blood donors and affect their future blood donation behaviour. This preliminary cross‐sectional study explored the association of mandatory facemask wearing with the quality of the blood donation process at the end of the coronavirus 2019 (COVID‐19) pandemic.A sample of 615 voluntary unpaid Italian blood and plasma donors completed an online survey assessing their attitude towards facemask wearing, the perceived distress due to facemasks in the different steps of the donation process, self‐reported vasovagal reactions after donation and the intention to donate again.Nearly 24% of donors reported a worsened quality of the donation process due to facemask wearing, and 36% reported moderate to severe distress during the donation itself. Donors with a more negative attitude towards facemasks reported a worse donation experience, mainly related to the interactions and the communication with physicians and nurses, and a higher probability of experiencing vasovagal reactions at their last donation. No significant correlations were observed between negative facemask attitudes towards facemask wearing, distress or future intention to donate blood/plasma.Facemasks have worsened the quality of blood and plasma donations for one fourth of donors, confirming the interference with the quality of communications and relationships with healthcare professionals. [ABSTRACT FROM AUTHOR]

Intraspecific communication among carnivores can be complex and risky, and many solitary carnivores (including pumas; Puma concolor) primarily communicate with potential mates and competitors indirectly via scent marking at communication hubs. We used multiple temporal analyses to understand if pumas of three classes (males, solo females, and females traveling with dependent kittens) varied in their temporal use of communication hubs to reduce risk while gathering information. We hypothesized that males would visit scrapes at typical times (nighttime), but that female behavioral strategies might vary based on whether they had dependent kittens or not. We found that pumas of different classes varied in their temporal patterns: male pumas concentrated their temporal activity at night (which is typical for pumas), solo females also tended to visit during the nighttime (although slightly earlier on average than males), while females with kittens were more active in the daytime. Our findings highlight the importance of communication hubs for intersexual communication in pumas and the flexibility that is inherent in puma behavioral ecology. Females adjusted their temporal behavior and visitation based on their reproductive status and life history stage, likely to assess dominant territorial males while also limiting their risk. Our study provides a mechanistic view of how communication through scent marking allows both long‐term and spatially separated communication to occur and that may allow pumas at different life stages with different risk tolerances to communicate with each other. [ABSTRACT FROM AUTHOR]

Purpose: Multidisciplinary care (MDC) meetings improve the quality of cancer care by providing a space for interdisciplinary communication. The Pediatric Oncology Facility Integrated Local Evaluation (PrOFILE) tool assesses MDC meetings as part of the Service Integration module. We aimed to evaluate the characteristics of MDC meetings at institutions that completed PrOFILE. Methods: From 2019 to 2021, 112 institutions from 23 countries collected data by utilizing the abbreviated version of PrOFILE. Within a secondary data analysis, we descriptively analyzed the characteristics of MDC meetings stratified by income level. Results: Participating institutions were located in low‐income countries (LICs) (n = 6), lower‐middle‐income countries (LMICs) (n = 34), upper‐middle‐income countries (UMICs) (n = 55), and high‐income countries (HICs) (n = 17). Of the 112 participating facilities, 79% reported having MDC meetings. The existence of an MDC varied with income, with 50% of LICs and 100% of HICs hosting MDCs. The frequency of MDC meetings also differed, with 100% of MDCs in LICs occurring weekly, while 53% of MDCs in HICs occurred monthly. Specialties regularly represented at MDC meetings across all participating institutions were hematology/oncology (93%), pathology (52%), radiology (60%), general surgery (57%), and radiation oncology (51%). All MDC meetings in LICs reported representation from these specialties. Availability of test results and discussion of new cases did not vary with income. Residual disparities were identified for the following characteristics: discussion of new and interesting cases, inclusion of patient preferences, and ability to meet urgently. Conclusions: The existence and components of a functional MDC meeting may vary between countries' income levels. Variation in certain components, such as access to tests, may be due to differences in resource distribution, but other factors such as inclusion of patient preferences and ability to meet urgently can be optimized in all settings to foster high‐quality teamwork and communication. [ABSTRACT FROM AUTHOR]

Background Aims Methods Main Contribution Conclusions WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the clinical implications of this work? Communication impairments are a leading concern for parent caregivers of individuals with rare neurodevelopmental disorders (RNDDs). Clinical trials of disease modifying therapies require valid and responsive outcome measures that are relevant to individuals with RNDDs. Identifying and evaluating current psychometric properties for communication measures is a critical step towards the selection and use of appropriate instruments.This systematic review offers (1) a description of parent‐reported communication measures and (2) evidence for their psychometric properties, in RNDDs.The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022334649). MEDLINE (Ovid), Embase, PsychINFO, Web of Science, CINAHL Plus, Cochrane Library, ClinicalTrials.gov, the Australian New Zealand Clinical Trials Registry were searched from inception to August 2023. Methodological assessment of quality was completed using the COnsensus‐based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. Parent‐reported measures used in observational studies and clinical trials were identified. Data on utility, reliability and validity for RNDDs were extracted.Sixteen parent‐reported communication measures were used in RNDD research, the Vineland Adaptive Behavior Scales being most commonly used. Validation data in RNDDs were identified for six of these measures. Limitations related to sample size or the scope of psychometric testing.Many communication measures have been used for RNDDs but there are few data validating their use. Valid and reliable methods of measuring communication in persons with RNDDs is a priority for future high‐quality clinical trials. Communication is a critical domain for families with a child with a rare neurodevelopmental disorder (RNDD). Validated outcome measures are essential for accurate evaluation and interpretation of responses to treatments in clinical trials. We identified 16 parent‐reported communication measures that have been used with RNDDs, but only six measures had validation data for at least one RNDD. High quality evidence is accumulating, with all validation studies in this review published between 2020 to 2023. Modifications of existing measures may be required to assess communication for RNDDs. This systematic review catalogues the available psychometric data for communication measures and indicates an ongoing need for new validation studies to ensure they are fit‐for‐purpose for upcoming clinical trials in RNDDs. This review will inform the selection of communication measures for clinical trials and research studies. [ABSTRACT FROM AUTHOR]

Patients with congenital heart disease are living longer due to improved medical and surgical care. Congenital heart disease encompasses a wide spectrum of defects with varying pathophysiology and unique anesthetic challenges. These patients often present for noncardiac surgery before or after surgical repair and are at increased risk for perioperative morbidity and mortality. Although there is no singular safe anesthetic technique, identifying potential error traps and tailoring perioperative management may help reduce morbidity and mortality. In this article, we discuss five error traps based on the collective experience of the authors. These error traps can occur when providing perioperative care to patients with congenital heart disease for noncardiac surgery and we present potential solutions to help avoid adverse outcomes. [ABSTRACT FROM AUTHOR]

Based on the Work–Home Resources Model and Conservation of Resources Theory, we develop dual mechanisms by which nice interactions (patients' compliments and coworkers' informational support) predict sleep quality. Specifically, we expect these nice interactions to help individuals conserve their personal energy in the form of less cognitive depletion (a cognitive process) and diminished physical fatigue (a physical process). Further, we propose employees utilise their energy resources to experience better sleep quality. To test the proposed model, we utilised an experience‐sampling method by recruiting 223 female nurses working in a regional university hospital in South Korea. Specifically, we measured nice interactions and personal resources at 3 PM on Day t and sleep quality at 5–6 AM on Day t + 1, and we administered the questionnaire for 10 consecutive days. Overall, after removing 79 invalid observations (not completing questionnaire in a timely manner), we had a final total of two‐wave 1997 daily observations from 223 nurses. Receiving more compliments from patients and more information from coworkers positively affects nurses' cognitive energy (less cognitive depletion) and physical energy (less physical fatigue), which predicts better sleep quality. Finally, results supported indirect effects of these nice interactions on sleep quality via cognitive and physical processes. [ABSTRACT FROM AUTHOR]

Background: Existing evidence indicates that atypical sensory reactivity is a core characteristic of autism, and has been linked to both anxiety (and its putative infant precursor of fearfulness) and repetitive behaviours. However, most work has used cross‐sectional designs and not considered the differential roles of hyperreactivity and hyporeactivity to sensory inputs, and is thus limited in specificity. Methods: 161 infants with and without an elevated likelihood of developing autism and attention‐deficit hyperactivity disorder (ADHD) were followed from 10 to 36 months of age. Parents rated an infant precursor of later anxiety (fearfulness) using the Infant Behaviour Questionnaire at 10 and 14 months, and the Early Childhood Behavioural Questionnaire at 24 months, and sensory hyperreactivity and hyporeactivity at 10, 14 and 24 months using the Infant Toddler Sensory Profile. Domains of autistic traits (restrictive and repetitive behaviours; RRB, and social communication interaction, SCI) were assessed using the parent‐rated Social Responsiveness Scale at 36 months. Cross‐lagged models tested (a) paths between fearfulness and hyperreactivity at 10–24 months, and from fearfulness and hyperreactivity to later autism traits, (b) the specificity of hyperreactivity effects by including hyporeactivity as a correlated predictor. Results: Hyperreactivity at 14 months was positively associated with fearfulness at 24 months, and hyperreactivity at 24 months was positively associated with SCI and RRB at 36 months. When hyporeactivity was included in the model, paths between hyperreactivity and fearfulness remained, but paths between hyperreactivity and autistic traits became nonsignificant. Conclusions: Our findings indicate that alterations in early sensory reactivity may increase the likelihood of showing fearfulness in infancy, and relate to later social interactions and repetitive behaviours, particularly in individuals with a family history of autism or ADHD. [ABSTRACT FROM AUTHOR]

To be a desirable social partner and develop healthy relationships with peers, a child must be able to engage with peers across a variety of contexts. Understanding the factors supporting high levels of social engagement with peers is thereby essential, requiring the development of nuanced and ecologically valid indices of social engagement. Building on recent adult work, the current study explores conversational response time as a novel index of children's social engagement with peers in a dyadic context. This study further explores relationship between conversational response time and children's shyness. Fifty‐six 9‐ to 11‐year‐old children interacted with an unfamiliar peer in an unstructured setting and completed a self‐report measure of shyness. Children's behaviour was coded for their conversational RTs and overall social engagement. Faster conversational RTs were significantly related to children's own social engagement and marginally related to their partners' engagement. Moreover, higher shyness in children's partners predicted faster conversational RTs in children themselves. New directions for using conversational RT as an index of children's social engagement and implications for accounts children's social development are discussed. [ABSTRACT FROM AUTHOR]

Nursing staff engage readily with patients and associates in mental health/forensic inpatient settings. These settings are known to have instances of workplace violence directed towards staff and such violence includes racism. Racism is a form of workplace violence that must be better understood and supported within this complex setting. Completing a systematic review to coalesce preexisting research and suggested interventions can be beneficial to supporting nurses. Systematic review following PRISMA guidelines. CINAHL, PsycInfo, Medline, British Nursing Database and Web of Science databases were searched. Reviewers screened the papers for inclusion (29 articles out of 7146 were selected for inclusion) and completed the quality appraisal using the Mixed Methods Appraisal Tool. Subsequently, data extraction was completed, and findings were summarised through narrative synthesis. The way racism was conceptualised impacted how data was collected, reported and interpreted; racism was silenced or exposed depending on how studies were undertaken. If exposed, evidence indicates racism is a problem but is not always acknowledged or acted upon. Some evidence determined racism led to negative work‐related outcomes. The literature provided limited examples of interventions. These included changing education/orientation for staff, openly discussing racist events and better planning for patients among colleagues and management. Increasing diversity within the workforce requires more research exploring and addressing issues related to racism towards nurses. Narratives of racism being normalised and embedded in mental health/forensic settings need to be challenged. [ABSTRACT FROM AUTHOR]

Australians with a psychosocial disability (PSD) and a National Disability Insurance Scheme (NDIS) plan may at times require emergency care due to the fluctuating nature of their physical and mental health conditions or when their supports have become insufficient. This nationwide study investigated the experiences of people presenting to an emergency department (ED) who have a PSD and an NDIS plan. The objective was to understand current care and communication practices and to provide recommendations for service integration. Twenty‐four interviews were conducted with people who had a PSD and an NDIS plan. Participants were asked semi‐structured questions about their experiences when engaging with NDIS processes and when engaging with the ED as an NDIS recipient and how communication practices could be improved between the two services. A qualitative, descriptive thematic analysis approach was used. A lived experience advisory group participated in the research and provided commentary. The findings of this study indicate that the NDIS, as a personalised budget scheme, presents challenges for people with complex PSD and physical needs. ED clinicians appear to be unclear about what the NDIS provides and communication between the two systems is fragmented and inconsistent. The themes identified from the analysed transcripts are: (a) People with PSD experience distress when dealing with the NDIS; (b) There's a blame game between the ED and the NDIS; and (c) Inadequate service integration between the ED and NDIS. Recommendations to assist with service integration include building service capacity, providing overlapping care and bridging the diverse biomedical, psychosocial and disability care services. [ABSTRACT FROM AUTHOR]

While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self‐reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant–participator in a single‐case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health. [ABSTRACT FROM AUTHOR]

Eating disorders are complex mental health conditions exacerbated by high mortality rates. International and national guidelines recommend family involvement in the treatment process, recognising the family as an important source of support to young people. Research suggests fathers engage less in the process compared to mothers. In studies exploring parental perspectives, most samples consisted of mothers, with fathers minimally represented. Few studies explore family involvement from the perspective of fathers. This study aimed to explore the experiences of fathers regarding their involvement in the treatment process. Qualitative descriptive methods were used, involving focus group interviews of seven fathers. Interviews were assisted by a semi‐structured interview guide. A qualitative content analysis approach was used to analyse the data regarding paternal experiences of engagement in the treatment process. Fathers understood the importance of the whole family working together but viewed mothers as taking a more central role in the treatment process, with fathers more at the periphery. Gender emerged as an influencing factor in paternal involvement, with mothers primarily taking on responsibility for the child with the eating disorder and fathers providing secondary support. Healthcare providers need to be aware of the contribution of gendered roles within the family system and consider this when working with families within the treatment process. Consequently, mental health nurses have an important role in encouraging fathers to become actively involved in the treatment process. [ABSTRACT FROM AUTHOR]

Background: Oral forms of assessment remain a common part of competency‐based assessment systems, yet their feasibility is being challenged. The focus on individual competence is problematic given the need to prepare health professionals for teamwork. The present study aimed to investigate how the assessment of collective competence compares to individual assessment, and to explore whether there is a need for individual assessment at all in community or population‐based practice. Methods: A behavioural‐based interview assessment was developed and trialled and correlated to performance as a team on placement. Correlation between student performance on individual behavioural‐based interview and teamwork artefacts was assessed using Spearman rho. Differences between performance on individual oral assessment and team performance on artefacts at the cohort level was determined using the Mann–Whitney U‐test. Bland–Altman analysis was completed to analyse agreement between performance on the individual oral assessment and team performance at the student level. Results: Students were final year nutrition and dietetics students from 2020, 2021 and 2022 years (total sample = 216) from one Australian university. There was a difference in performance between assessment types in each year and as a total cohort (p < 0.001) with students performing better in teamwork. There was no correlation between individual oral interview and team performance across all years. The results of the Bland–Altman analysis showed little agreement between the two assessment tasks. Conclusions: Assessment of teamwork performance as part of a program of assessment is essential. More valid and reliable tools are needed to assess collective competence. Highlights: A behavioural‐based interview assessment was developed and trialled as a novel form of individual student oral examination and correlated with performance on team artefacts developed as part of dietetics student placement.There was no correlation or agreement between individual behavioural‐based interview and team performance across all years. Students generally performed better in teamwork artefacts.Assessment of teamwork or collective competence is essential with more valid and reliable tools needed. [ABSTRACT FROM AUTHOR]

Background: Guidelines recommend enteral feeding via gastrostomy should be considered for adult survivors of stroke with dysphagia who cannot eat or drink sufficiently for >4 weeks. Many people continue long‐term tube‐feeding via this route in the community where healthcare professionals contribute to their care and nutritional management, although little is known about their experiences of or attitudes towards enteral feeding in this situation. The present study aimed to explore the experiences and attitudes of healthcare professionals working with this patient group. Methods: Healthcare professionals were invited to complete a questionnaire devised for the study which comprised closed and open questions about tube‐feeding including their patients' participation in feeding processes and mealtimes and how these might be improved. Responses to closed questions were analysed descriptively and free‐text responses analysed using thematic analysis. Results: Fifty‐seven participants met the inclusion criteria. They identified patients' quality of life (77% of respondents) and nutritional support (75%) as the most important aspects of tube‐feeding. Good communication and training with healthcare teams and carers were considered important. Their patients' participation in tube‐feed administration and mealtime involvement were described as variable and potentially beneficial, but both were related to patients' choice and health impairment. Blended tube‐feeding was considered an option by 89% provided practical and safety conditions were met. Conclusions: Participants' experiences of and attitudes towards tube feeding in adults living with stroke in the community in the sample in the present study are varied and focussed on individual patients' needs, safety and professional standards. Highlights: Quality of life and nutritional support are considered the most important aspects of tube‐feeding in adults living in the community following stroke.Patient choice should be considered in all aspects of decision‐making about tube‐feeding.Good communication and training are considered important for successful tube‐feeding in the community.Patients' participation in administering their own feed or involvement in mealtimes is variable and related to their choice and health impairment.Blended feeding is considered an option providing practical and safety consideration are addressed. [ABSTRACT FROM AUTHOR]

The article presents insights on the U.S. Health Resources and Services Administration Geriatrics Workforce Enhancement Program (GWEP) special supplement. It stresses the need for all GWEP recipients to have at least three partner types, academia, primary care clinical sites, and community-based organization. It notes on the efforts of GWEP recipients continuously update their educational methods and develop new ways to educate primary care providers about older adults.

Introduction: Advance care planning (ACP) aims to ensure that patients receive goal‐concordant care (GCC), which is especially important for racially or ethnically minoritized populations at greater risk of poor end‐of‐life outcomes. However, few studies have evaluated the impact of advance directives (i.e., formal ACP) or goals‐of‐care conversations (i.e., informal ACP) on such care. This study aimed to examine the relationship between each of formal and informal ACP and goal‐concordant end‐of‐life care among older Americans and to determine whether their impact differed between individuals identified as White, Black, or Hispanic. Methods: We conducted a retrospective cohort study using 2012–2018 data from the biennial Health and Retirement Study. We examined the relationships of interest using two, separate multivariable logistic regression models. Model 1 regressed a proxy report of GCC on formal and informal ACP and sociodemographic and health‐related covariates. Model 2 added interaction terms between race/ethnicity and the two types of ACP. Results: Our sample included 2048 older adults. There were differences in the proportions of White, Black, and Hispanic decedents who received GCC (83.1%, 75.3%, and 71.3%, respectively, p < 0.001) and in the use of each type of ACP by racial/ethnic group. In model 1, informal compared with no informal ACP was associated with higher odds of GCC (adjusted odds ratio = 1.38 [95% confidence interval, 1.05–1.82]). In model 2, Black decedents who had formal ACP were more likely to receive GCC than those who did not, but there were no statistically significant differences between decedents of different racial/ethnic groups who had no ACP, informal ACP only, or both types of ACP. Conclusions: Our results build on previous work by indicating the importance of incorporating goals‐of‐care conversations into routine healthcare for older adults and encouraging ACP usage among racially and ethnically minoritized populations who use ACP tools at lower rates. [ABSTRACT FROM AUTHOR]

Background: Rural family caregivers (FCGs) in the United States often experience high economic costs. This randomized controlled trial compared a transitional palliative care intervention (TPC) to support FCGs of seriously ill care recipients (CRs) to an attention control condition. We evaluated the TPC's effect on healthcare use and out‐of‐pocket spending for both FCGs and CRs. Methods: TPC FCGs received teaching, guidance, and counseling via video calls for 8 weeks following CR discharge from the hospital. After discharge, a research assistant called all FCGs once a month for up to 6 months or CR death to collect self‐reported healthcare utilization (e.g., outpatient, emergency department, and hospital), out‐of‐pocket healthcare spending (e.g., deductibles and coinsurance), and health‐related travel costs (e.g., transportation, lodging, food) for FCGs and CRs. Incidence rate ratios (IRRs) were estimated using negative binomial regressions. Results: The study included 282 FCG–CR dyads across three U.S. states. Follow‐up over the 6‐month period was shortened by high CR mortality rates across both arms (29%), but was similar across arms. TPC reduced nights in the hospital for CR (IRR = 0.75; 95% confidence interval [CI] = 0.56–0. 99). Total out‐of‐pocket spending was not significantly different for TPC versus control. Across both groups, mean out‐of‐pocket spending for dyads was $1401.85, with healthcare payments contributing $1048.58 and transportation expenses contributing $136.79. TPC dyads reported lower lodging costs (IRR = 0.71; 95% CI = 0.56–0.89). Conclusions: This study contributes to evidence that palliative care interventions reduce the number of nights in the hospital for seriously ill patients. Yet, overall rural FCGs and seriously ill CRs experience substantial out‐of‐pocket economic costs in the 6 months following hospitalization. Transitional care intervention design should consider impacts on patient and caregiver spending. Clinicaltrials.gov # is NCT03339271. [ABSTRACT FROM AUTHOR]

Background: Assisted living (AL) community caregivers are known to report lower quality of hospice care. However, little is known about hospice providers serving AL residents and factors that may contribute to, and explain, differences in quality. We examined the association between hospice providers' AL patient‐day volume and their quality ratings based on Hospice Item Set (HIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Surveys. Methods: This cross‐sectional study employed information from the Medicare Compare website and Medicare claims data. Medicare‐eligible AL residents were identified using previously validated methods and merged with hospice claims. Linear probability models adjusting for county fixed effects were used to examine the association between hospice provider AL volume, measured as the share of annual hospice patient days from AL residents, and quality measures obtained from HIS and CAHPS. Models controlled for hospice providers' profit status and daily patient census. Results: Higher AL‐volume hospice providers were 7 percentage points more likely to have caregivers reporting lower median scores on domains of pain assessment, dyspnea treatment, and emotional support. Their caregivers also reported lower scores in team communications and training family to provide care. Higher AL‐volume hospice providers also were 5 percentage points less likely to get higher aggregated scores from all CAHPS domains and 7 percentage points less likely to have higher HIS composite scores. Conclusions: Hospice providers serving higher volumes of AL patient days had lower quality scores. In order to identify targeted opportunities for quality improvement, research is needed to understand why lower quality providers are concentrated in the AL market. [ABSTRACT FROM AUTHOR]

A retired oncologist describes the unexpected death of his wife, Claudia, who spent 25 years as head of the geriatrics service of a major VA hospital. The couple drew comfort in their orchestration of a "good death"; nevertheless they understood that her death was hastened by a number of missteps. In the 2 months following a hip fracture, a chain of complications that required five surgical interventions led to massive hemorrhage from necrotizing esophagitis. Claudia lacked resilience to recover from a sequence of traumas sustainable by a younger person—but even the most experienced geriatrician might not have identified or even suspected her risk. Despite multiple well‐controlled comorbidities Claudia was active and independent. She exercised daily and traveled extensively. She did not fit the profile of a frail or vulnerable person, according to assessing instruments in current use. According to the e‐prognosis calculator, her mortality risk was 10% lower than that of women her age. It is not surprising, nor deplorable, that after Claudia developed mild dysphagia, a gastroenterologist put off an EGD, awaiting a cardiac consult. That delay, however, proved fatal. Had the procedure been performed as soon as possible, it would have revealed esophagitis caused by a hiatal hernia, signaling need for different medications and prompt treatment. This might have prevented the terminal hemorrhage. The first important lesson from this case is that for an older patient with multiple comorbidities, even under control, delayed treatment is treatment denied. Current evaluation instruments are unable to spot critical resilience reductions in functional seniors. Inadequate pain management, premature discharge after surgery, and poor communication also contributed to the death. The second important lesson is that older patients, even when they are medical doctors, would benefit from a trained advocate to help them navigate the medical system. [ABSTRACT FROM AUTHOR]

Substrate‐borne vibrations are ubiquitous in nature and are used by diverse taxa to communicate and to obtain information about their environments. However, substrate‐borne vibrations remain understudied compared with other sensory and signaling modalities, in part due to human sensory biases. In addition, understanding and quantifying the transmission of vibrations remains a challenging task due to it being dependent on both signal properties and properties of the substrates that the signals transmit through. Here, we provide methods for playing back and measuring the transmission of vibrations throughout a substrate. Using linear resonant actuators, we conducted playbacks of pure tones and frequency sweeps on wooden dowels and on the stems of potted Ptelea trifoliata L. (Rutaceae) plants. We used scanning laser Doppler vibrometry to measure the signals at multiple locations along the length of the dowels and plant stems. We demonstrate that playback of a frequency sweep yields more data in a shorter amount of time than multiple playbacks and measurements of pure tone signals. Our results are also consistent with previous findings showing that signals produce frequency and location specific minima and maxima (nodes and antinodes) throughout the substrates, rather than simply attenuating with distance. This results in filtering of signals, such that their spectra are unique at any given measurement location—illustrating the importance of measuring vibrations at multiple locations. We discuss the implications of such filtering phenomena for vibrationally signaling animals and the biotremologists that study them. [ABSTRACT FROM AUTHOR]

The author discusses the updated Osteoarthritis of the Knee Clinical Care Standard in Australia, an important tool that can support best practice care for people presenting with suspected knee osteoarthritis. Topics include aims of the Clinical Care Standards developed by the Australian Commission on Safety and Quality in Health Care, an overview of the updated Osteoarthritis of the Knee Clinical Care Standard, and features to support cultural safety, equity, and effective communication.

Background: Despite the established knowledge that recurrent copy number variants (CNVs) at the 16p11.2 locus BP4–BP5 confer risk for behavioural and language difficulties, limited research has been conducted on the association between behavioural and social–communicative profiles. The current study aims to further delineate the prevalence, nature and severity of, and the association between, behavioural and social–communicative features of school‐aged children with 16p11.2 deletion syndrome (16p11.2DS) and 16p11.2 duplication (16p11.2Dup). Methods: A total of 68 individuals (n = 47 16p11.2DS and n = 21 16p11.2Dup) aged 6–17 years participated. Standardised intelligence tests were administered, and behavioural and social–communicative skills were assessed by standardised questionnaires. Scores of both groups were compared with population norms and across CNVs. The influence of confounding factors was investigated, and correlation analyses were performed. Results: Compared with the normative sample, children with 16p11.2DS showed high rates of social responsiveness (67%) and communicative problems (69%), while approximately half (52%) of the patients displayed behavioural problems. Children with 16p11.2Dup demonstrated even higher rates of social–communicative problems (80–90%) with statistically significantly more externalising and overall behavioural challenges (89%). In both CNV groups, there was a strong positive correlation between behavioural and social–communicative skills. Conclusions: School‐aged children with 16p11.2 CNVs show high rates of behavioural, social responsiveness and communicative problems compared with the normative sample. These findings point to the high prevalence of autistic traits and diagnoses in these CNV populations. Moreover, there is a high comorbidity between behavioural and social–communicative problems. Patients with difficulties in both domains are vulnerable and need closer clinical follow‐up and care. [ABSTRACT FROM AUTHOR]

The potential risks associated with administration of psychedelic drugs call for a standardized approach to patient informed consent that addresses factors such as potentially disturbing symptoms and the danger of patient exploitation, authors of a recently published article suggest. The diverse contexts for therapeutic use of these substances and the variety of providers potentially involved in their administration necessitate strong informed consent procedures, the authors explained. The special communication was published online April 10, 2024, in JAMA Psychiatry. [ABSTRACT FROM AUTHOR]

Rough‐and‐tumble play in juvenile rats and song in flocks of adult songbirds outside a breeding context (gregarious song) are two distinct forms of non‐sexual social behavior. Both are believed to play roles in the development of sociomotor skills needed for later life‐history events, including reproduction, providing opportunities for low‐stakes practice. Additionally, both behaviors are thought to be intrinsically rewarded and are associated with a positive affective state. Given the functional similarities of these behaviors, this study used RNA‐sequencing to identify commonalities in their underlying neurochemical systems within the medial preoptic area. This brain region is implicated in multiple social behaviors, including song and play, and is highly conserved across vertebrates. DESeq2 and rank–rank hypergeometric overlap analyses identified a shared neurotranscriptomic profile in adult European starlings singing high rates of gregarious song and juvenile rats playing at high rates. Transcript levels for several glutamatergic receptor genes, such as GRIN1, GRIN2A, and GRIA1, were consistently upregulated in highly gregarious (i.e., playful/high singing) animals. This study is the first to directly investigate shared neuromodulators of positive, non‐sexual social behaviors across songbirds and mammals. It provides insight into a conserved brain region that may regulate similar behaviors across vertebrates. [ABSTRACT FROM AUTHOR]

If you've listened to the news recently, you may have been struck by a sense of impending doom. This is perhaps especially true for adolescents, who have faced a global pandemic and the constant threat of school shootings and gun violence. Persistent feelings of hopelessness are experienced at alarming rates by adolescents. Hopelessness (defined as the negative expectation toward oneself or the future) has been widely reported to play a major role in the development of depressive symptoms, suicidal ideation, and unsafe behaviors (Berardelli et al., 2022; Stoddard et al., 2011). [ABSTRACT FROM AUTHOR]

Background: Higher vocational education is an essential part of the higher education system that complements conventional education. In the context of information and communication technology (ICT) development and academic competition, more and more literature has proved the importance of ICT use in educational development (academic achievement and mental health) and the relationship between information literacy and the educational development of higher vocational students. Objectives: Based on one of the most extensive surveys of higher vocational students, the study combined the Opportunity‐Propensity (O‐P) framework and ecological model to explore the direct effects of different types of ICT use on educational development and the indirect effects from psychological and social factors. Methods: The data involved 28,956 students from seven higher vocational colleges. The class fixed effect and causal mediation analysis models verified the results. Results and Conclusion: The results found differential effects of different types of ICT use on academic achievement and mental health. Information literacy ability can improve the academic achievement of higher vocational students, but at the cost of mental health. ICT use not only directly impacts the academic achievement and mental health, but also has an indirect impact through psychological factors represented by self‐efficacy and technostress and social factors represented by social support. Implications: This study promotes integrating and expanding the O‐P framework and ecological model, enriching the relevant research in ICT use and educational development. Meanwhile, it also provides practical suggestions for realizing rational interventions in ICT use and improving the educational development level of higher vocational students. Lay Description: What is already known about this topic: Information and communication technology (ICT) use is closely related to the educational development of higher vocational students.The trend of ICT use in higher vocational education has become increasingly apparent.The effects of ICT use are heterogeneous among groups with different information literacy. What this paper adds: O‐P framework and ecological model provide the perspective of theoretical integration.The impact of different types of ICT use on educational development varies.Information literacy can improve academic achievement at the cost of mental health.Psychological and social factors play a mediating role in educational development. Implications for practice and/or policy: The research is helpful to guide students to allocate their time reasonably for different ICT uses.Mental health counselling should be strengthened while cultivating information literacy ability.Develop appropriate ICT usage strategies for students with different information literacy.It is helpful to develop appropriate interventions from a psychological and social perspective. [ABSTRACT FROM AUTHOR]

Background: The existing research on dialogue‐based learning and teaching predominantly highlights its capacity to yield productive educational outcomes, yet it often overlooks the pivotal factor of participation equity, which is fundamental to ensuring the efficacy of dialogic teaching and learning. Objectives: In this study, participation equity refers to a condition in which participation itself and opportunities to participate are fairly distributed among participants and all participants are equally listened to and respected. We designed a technology‐enhanced participatory visual learning analytical approach to promote equitable participation in dialogic collaborative problem solving from four dimensions: participation (i.e., ensuring equal contributions from all participants), opportunity (i.e., promoting equal engagement with others), responsiveness (i.e., encouraging equal attentiveness and responsiveness to others' input), and respect (i.e., cultivating a respectful communication style). Methods: The intervention class of fourth‐grade students (n = 59) interacted with a participatory visual learning analytical tool to reflect on their participation equity and learn productive peer talk moves to address equity issues concerning the four dimensions, while a comparison class (n = 59) only received simple feedback on participation and respect. Results: The results indicated that equal participation rates among group members were insufficient to secure participation equity. The intervention was effective in helping students realize and address equity‐related issues. Intervention students were more equitable regarding responsiveness and participation opportunity than the comparison students. Conclusions: The proposed multidimensional participation equity framework has the potential to deepen the understanding of equity and promote equitable learning interactions. Lay Description: What is currently known: Peer discussion has the potential to bring productive educational gains.Participation equity is essential in productive collaborative discussion.Participation equity currently mainly concerns the equality of participation. What we add: We use technology to help children analyse, visualize and reflect on participation equity.We use technology to teach students how to talk in an equitable approach.We define equity in four dimensions: participation, opportunity, responsiveness and respect. The implications for practitioners: Students should be guided to participate equally and respectfully in a group.Students should also be guided to equally listen to other group members' voices.Students should also be guided to equally address other group members. [ABSTRACT FROM AUTHOR]

Background: Education is often the primary arena for exploring and integrating new technologies. AI and human‐machine communication (HMC) are prevalent in the classroom, yet we are still learning how student perceptions of these tools will impact education. Objectives: We sought to understand student perceptions of credibility related to written feedback attributed to a human or an AI grader (Study One). We also investigated how corrective messages containing verbal immediacy and social support influenced student perceptions of an AI grader's credibility based on feedback in an evaluated essay (Study Two). Methods: We used an online experimental design to assess the perceived credibility of a grader. In Study One, we randomly assigned students (N = 155) to a condition that contained a paragraph they were told was evaluated by a human or an AI grader. In Study Two (N = 222), we investigated ways of increasing perceptions of an AI grader's credibility by writing messages with higher/lower levels of immediacy and social support. Results: In Study One, the students rated both the human and AI grader as credible (yet rated the AI grader lower on goodwill). The data suggest that students in Study Two attributed more goodwill (i.e., caring) to the AI grader when the feedback included more verbal immediacy. Conclusions: Our results highlight the importance of student perceptions and communication styles when integrating technology into education. The two studies imply that students viewed the human and AI graders as competent, caring, and trustworthy, specifically when feedback included more immediacy cues. Lay Description: What is currently known about this topic: An instructor's use of verbal and non‐verbal behaviours is a crucial component of establishing credibility within a student‐instructor relationship.Non‐human actors (artificial intelligence and social robots) are perceived as credible when they use appropriate verbal and non‐verbal messages.Education plays a central role in exploring and integrating new technologies, but initial impressions and perceived utility impact acceptance and adoption. What does this paper add: Students perceived both human and machine graders as credible based on measures of competence, goodwill, and trustworthiness.This is the first study that sought to alter perceptions of a machine grader's credibility by manipulating verbal and non‐verbal immediacy cues.Results suggest that a machine grader's communication style, especially verbal immediacy, would influence student engagement. Implications for practice/or policy: This study offers initial insights into using machine grading as a supplementary engagement tool.Communication style is a key factor to consider when designing courses that include automated scoring systems or AI graders. [ABSTRACT FROM AUTHOR]

The article focuses on the need for ongoing and extensive efforts to promote diversity in alcohol research. It highlights how increasing diversity among research samples and within the scientific community can enhance the generalizability and applicability of research findings. It underscores the importance of continued progress in this area, including improved reporting and representation of diverse demographic characteristics in research studies.

Background and Aims: Communication is important in determining how patients understand the diagnostic process. Empirical studies involving direct observation of communication within diagnostic processes are relatively limited. This ethnographic study aimed to identify communicative practices facilitating or inhibiting shared understanding between patients and doctors in UK acute secondary care settings. Methods: Data were collected in acute medical sectors of three English hospitals. Researchers observed doctors as they assessed patients; semistructured interviews were undertaken with doctors and patients directly afterwards. Patients were also interviewed 2–4 weeks later. Case studies of individual encounters (consisting of these interviews and observational notes) were created, and were cross‐examined by an interdisciplinary team to identify divergence and convergence between doctors' and patients' narratives. These data were analysed thematically. Results: We conducted 228 h of observation, 24 doctor interviews, 32 patient interviews and 15 patient follow‐up interviews. Doctors varied in their communication. Patient diagnostic understanding was sometimes misaligned with that of their doctors; interviews revealed that they often made incorrect assumptions to make sense of the fragmented information received. Thematic analysis identified communicative practices that seemed to facilitate, or inhibit, shared diagnostic understanding between patient and doctor, revealing three themes: (1) communicating what has been understood from the medical record, (2) sharing the thought process and diagnostic reasoning and (3) closing the loop and discharge communication. Shared understanding was best fostered by clear communication about the diagnostic process, what had already been done and what was achievable in acute settings. Written information presents an underutilised tool in such communication. Conclusions: In UK acute secondary settings, the provision of more information about the diagnostic process often fostered shared understanding between doctor and patient, helping to minimise the confusion and dissatisfaction that can result from misaligned expectations or conclusions about the diagnosis, and the uncertainty therein. Patient/Public Contribution: A patient and public involvement group (of a range of ages and backgrounds) was consulted. They contributed to the design of the protocol, including the timing of interviews, the acceptability of a follow‐up telephone interview, the development of the interview guides and the participant information sheets. [ABSTRACT FROM AUTHOR]

Introduction: Outcome measurement instruments (OMIs) are used to gauge the effects of treatment. In post‐stroke aphasia rehabilitation, benchmarks for meaningful change are needed to support the interpretation of patient outcomes. This study is part of a research programme to establish minimal important change (MIC) values (the smallest change above which patients perceive themselves as importantly changed) for core OMIs. As a first step in this process, the views of people with aphasia and clinicians were explored, and consensus was sought on a threshold for clinically meaningful change. Methods: Sequential mixed‐methods design was employed. Participants included people with post‐stroke aphasia and speech pathologists. People with aphasia were purposively sampled based on time post‐stroke, age and gender, whereas speech pathologists were sampled according to their work setting (hospital or community). Each participant attended a focus group followed by a consensus workshop with a survey component. Within the focus groups, experiences and methods for measuring meaningful change during aphasia recovery were explored. Qualitative data were transcribed and analysed using reflexive thematic analysis. In the consensus workshop, participants voted on thresholds for meaningful change in core outcome constructs of language, communication, emotional well‐being and quality of life, using a six‐point rating scale (much worse, slightly worse, no change, slightly improved, much improved and completely recovered). Consensus was defined a priori as 70% agreement. Voting results were reported using descriptive statistics. Results: Five people with aphasia (n = 4, > 6 months after stroke; n = 5, < 65 years; n = 3, males) and eight speech pathologists (n = 4, hospital setting; n = 4, community setting) participated in one of four focus groups (duration: 92–112 min). Four themes were identified describing meaningful change as follows: (1) different for every single person; (2) small continuous improvements; (3) measured by progress towards personally relevant goals; and (4) influenced by personal factors. 'Slightly improved' was agreed as the threshold of MIC on the anchor‐rating scale (75%–92%) within 6 months of stroke, whereas after 6 months there was a trend towards supporting 'much improved' (36%–66%). Conclusion: Our mixed‐methods research with people with aphasia and speech pathologists provides novel evidence to inform the definition of MIC in aphasia rehabilitation. Future research will aim to establish MIC values for core OMIs. Patient or Public Contribution: This work is the result of engagement between people with lived experience of post‐stroke aphasia, including people with aphasia, family members, clinicians and researchers. Engagement across the research cycle was sought to ensure that the research tasks were acceptable and easily understood by participants and that the outcomes of the study were relevant to the aphasia community. This engagement included the co‐development of a plain English summary of the results. Advisors were remunerated in accordance with Health Consumers Queensland guidelines. Interview guides for clinicians were piloted by speech pathologists working in aphasia rehabilitation. [ABSTRACT FROM AUTHOR]

Introduction: In 2020, surging cases of COVID‐19 meant that health services had to plan for crisis‐level triage. In the Australian Capital Territory, the Clinical Health Emergency Coordination Centre sought to develop a triage policy in collaboration with a range of consumer, carer and community groups. This study aims to map the collaborative development of the COVID‐19 ICU triage policy onto the principles of co‐production. Methods: Interviews were conducted with facilitators, members of advocacy or consumer groups and clinicians who were involved in the development of the triage policy. Interviews were thematically analysed using both theory‐ and data‐driven approaches to, respectively, draw on the theoretical framework of co‐production, and to explore participants' perspectives relevant to but beyond the scope of this theoretical framework. Results: The findings suggest that at each stage of the initiative, there were ways in which the principles of co‐production were met, and ways in which they were not met. One of the fundamental concerns that arose was about whether trying to solve a problem based on resources was compatible with a solution based on human rights. Conclusion: Literature about co‐production has been critiqued for being limited to aspirational concerns, or implying co‐production is easily achievable. The current study contributes to existing research through the application of the theoretical framework of co‐production and exploring ways its aims were met and not met within a system‐level collaboration developing a high‐stakes health policy. Patient or Public Contribution: This study has been conducted and written by researchers working from lived experience perspectives, and other researchers working from traditionally mainstream health disciplines, including psychology and medicine. Further, the study is about patient and public involvement in the development of a health policy. Thus it both embodies and is about non‐tokenistic collaboration between people with lived experience and other health professionals. [ABSTRACT FROM AUTHOR]

Introduction: There have been some concerns about the impact of temporary doctors, otherwise known as locums, on patient safety and the quality of care. Despite these concerns, research has paid little attention to the implications of locum working on patient experience. Methods: A qualitative semi‐structured interview study was conducted with 130 participants including locums, people working with locums and patients with experience of being seen or treated by locums. Analysis was conducted using a reflexive thematic approach and abductive analysis to position themes against wider knowledge. Results: Three main themes were constructed through analysis: (1) Awareness and disclosure; patients were not always aware if their doctor was a locum, and there was some debate about whether patients had a right to know, particularly if locum working presented quality and safety risks. (2) Continuity and accessibility of care; access was regarded as priority for acute conditions, but for long‐term or serious conditions, patients preferred to see a permanent doctor who knew their history, although it was acknowledged that locums could provide fresh perspectives. (3) Communication and practice; locums and patients described how consultations were approached differently when doctors worked as locums. Patients evaluated their interactions based on how safe they felt with practitioners. Conclusion: Patients reported that they were unlikely to have continuity of care with any doctors delivering care, regardless of their contractual status. Locums sometimes provided new perspectives on care which could be beneficial for patient outcomes, but for patients with long‐term, complex or serious conditions continuity of care was important, and these patients may avoid or delay seeking care when locums are the only available option. Patient or Public Contribution: Patients and carers were involved in our study from inception to dissemination. Our Patient and Public Involvement (PPI) forum was involved throughout project design and planning and gave us feedback and guidance on research materials and outputs (e.g., study protocol, participant information sheets, survey tools, interview schedules, emerging findings). Our PPI forum co‐produced our patient interview schedule, two members of our PPI forum led the patient focus groups and all were involved in analysis of patient interviews. Our PPI Chair was involved in the preparation of this manuscript. [ABSTRACT FROM AUTHOR]

Introduction: The Emergency Department (ED) has seen increased patient attendance and difficulty meeting demands. New healthcare professions such as Physician Associates (PAs) are being utilised to complement the existing medical workforce. Despite the growth of their professions in the United Kingdom, little evidence is available about the perceptions of their roles. Objective: This study aims to provide evidence of doctors', PAs' and patients' perceptions of the PA role in the UK ED. Methods: A mixed methods approach consisted of the following: 1.An online exploratory survey of ED doctors at one English ED over 1 month (February–March 2022).2.Post consultation semi‐structured patient questionnaires over 2 weeks (April 2022).3.Semi‐structured virtual interviews with ED consultants across the four regions of the United Kingdom (3 months in 2022).4.Semi‐structured virtual interviews with ED PAs across the four regions of the United Kingdom (3 months in 2022). The analysis methods that were used included frequency counts and percentages from closed questions, and hybrid thematic analysis of free text and interview transcripts. Results: Four ED consultants and four ED PAs across the United Kingdom were interviewed. Twenty‐eight ED doctors participated in the online survey. Fifty‐seven patients completed the post consultation questionnaire. Four main themes (PAs being fit for purpose; patient recognition of PAs, PAs providing continuity of care, and future PAs and regulation) were deduced as per the General Medical Council, Good Medical Practice domains (knowledge, skills and development; patients, partnership and communication; colleagues, culture and safety; and trust and professionalism). Other subthemes were induced via hybrid thematic analysis. In this study, doctors and patients had mixed comments about the role of PAs. Most of them were positive as doctor participants perceived PAs to be knowledgeable, highly skilled, with mostly good communication skills, team players, providing continuity of care and overall being fit for purpose. However, some doctor participants commented negatively about PAs for providing little quality healthcare and being inexperienced. There was a desire for career progression among the PA participants and a need to work to their full potential. Although the clinicians of this study displayed a clear understanding of the PA role in the ED, a high frequency of surveyed patients mistook PAs for doctors. It was suggested that future PAs could complete a postqualification programme in emergency medicine, combine roles, be paid on an alternative scale and be formally regulated. Conclusion: In this study, mixed views were expressed by ED consultants, ED junior doctors and patients regarding the role of the PA in the ED. Stakeholders can use the information presented to develop a better understanding of the perceptions of the PA role within the UK ED. Patient or Public Contribution: The Patient and Public Involvement and Engagement (PPIE) group, led by Healthwatch, made significant contributions to the study's design by providing valuable feedback on the information sheets and consent forms utilised. The patients' responses helped guide the study's direction and shape its future work. As part of the dissemination activities, the study findings was shared with both the PPIE team and Healthwatch media production team. [ABSTRACT FROM AUTHOR]

Introduction: There is currently limited guidance for researchers on Patient and Public Involvement (PPI) for preclinical spinal cord research, leading to uncertainty about design and implementation. This study aimed to develop evidence‐informed principles to support preclinical spinal cord researchers to incorporate PPI into their research. Methods: This study used a modified Delphi method with the aim of establishing consensus on a set of principles for PPI in spinal cord research. Thirty‐eight stakeholders including researchers, clinicians and people living with spinal cord injury took part in the expert panel. Participants were asked to rate their agreement with a series of statements relating to PPI in preclinical spinal cord research over two rounds. As part of Round 2, they were also asked to rate statements as essential or desirable. Results: Thirty‐eight statements were included in Round 1, after which five statements were amended and two additional statements were added. After Round 2, consensus (> 75% agreement) was reached for a total of 27 principles, with 13 rated as essential and 14 rated as desirable. The principles with highest agreement related to diversity in representation among PPI contributors, clarity of the purpose of PPI and effective communication. Conclusion: This research developed a previously unavailable set of evidence‐informed principles to inform PPI in preclinical spinal cord research. These principles provide guidance for researchers seeking to conduct PPI in preclinical spinal cord research and may also inform PPI in other preclinical disciplines. Patient and Public Involvement Statement: This study was conducted as part of a project aiming to develop PPI in preclinical spinal cord injury research associated with an ongoing research collaboration funded by the Irish Rugby Football Union Charitable Trust (IRFU CT) and the Science Foundation Ireland Centre for Advanced Materials and BioEngineering Research (SFI AMBER), with research conducted by the Tissue Engineering Research Group (TERG) at the RCSI University of Medicine and Health Sciences. The project aims to develop an advanced biomaterials platform for spinal cord repair and includes a PPI Advisory Panel comprising researchers, clinicians and seriously injured rugby players to oversee the work of the project. PPI is included in this study through the involvement of members of the PPI Advisory Panel in the conceptualisation of this research, review of findings, identification of key points for discussion and preparation of the study manuscript as co‐authors. [ABSTRACT FROM AUTHOR]

Background: Experience‐Based Co‐Design (EBCD) is a multi‐stage participatory action research process which was developed originally to increase patient involvement in service improvement initiatives. This viewpoint article serves as a reflection on the researchers' experiences, focusing on the application and feasibility of participatory approaches, particularly co‐design, in the specific context of early‐phase clinical trials. Methods: We reflect on the opportunities and challenges of applying EBCD in a new context of early‐phase clinical trials in oncology where experimental treatments are increasingly perceived as a therapeutic option and, in certain instances, their efficacy may lead to accelerated approval facilitating a swifter integration into standard care. Results: We propose that the opportunity of applying EBCD in such trials lies in improving the delivery of person‐centered care, care coordination, and support during the transition from experimental to standard care. Three potential challenges when applying EBCD in early‐phase clinical trials are discussed related to: the need for standardization in trial processes; planning EBCD in a context of high uncertainty; and vulnerability of patient populations. Conclusion: Integrating EBCD into early‐phase oncology trials presents an opportunity to enhance person‐centered care and can lead to simultaneous improvements in care processes and therapeutic development. Patient or Public Contribution: This article has been developed with the collaboration of a patient partner who serves on the advisory board of our ongoing EBCD study in early clinical trials. [ABSTRACT FROM AUTHOR]

A set of four vignette studies (total N = 1600) examined whether voluntariness, novelty, vulnerability and irrevocability of reconciliation events serve as conciliatory signals that communicate serious intentions for improved relations. Studies 1 and 2 manipulated the presence of the four factors in the reconciliation event initiated by the political leader of a country in a relatively disadvantageous (Study 1) or advantageous (Study 2) position. Studies 1 and 2 revealed that the presence of substantial concession ('public announcement of abandonment of disputed region' in Study 1 and 'demolition of a military facility in the disputed region' in Study 2) enhanced signal effectiveness (participants perceived these concessions reflecting the political leader's serious conciliatory intention). Follow‐up studies (Studies 3A and 3B), which manipulated the level of concession (high vs. intermediate vs. low), confirmed the main result: High and intermediate levels of concession enhanced signal effectiveness compared to low concession. [ABSTRACT FROM AUTHOR]

Aim: To gain insight into child‐health nurses' experiences of using pictorial support in health visits within child‐health services. Methods: A qualitative study involving interviews conducted with 17 child‐health nurses in Sweden. The interview data were analysed using content analysis. Results: The nurses experienced that pictorial support could facilitate communication with families and increase opportunities for children to participate in child‐health services, although it may come with challenges. This theme can be broken down into three main categories: (1) Pictorial support makes interaction with families clearer and easier and is used in different ways; (2) The design and extensiveness of the pictorial support can create obstacles; and (3) Pictorial support influences children's attitudes towards, and participation in, health visits. Conclusion: Pictorial support is an important and useful tool in child‐health nurses' own work and improves their communication with children and caregivers during health visits. It can also increase children's participation and help them express themselves. Communicative tools such as pictorial support are very helpful to healthcare professionals striving to offer child‐ and family‐centred care. [ABSTRACT FROM AUTHOR]

Standardised terminology in science is important for clarity of interpretation and communication. In invasion science – a dynamic and rapidly evolving discipline – the proliferation of technical terminology has lacked a standardised framework for its development. The result is a convoluted and inconsistent usage of terminology, with various discrepancies in descriptions of damage and interventions. A standardised framework is therefore needed for a clear, universally applicable, and consistent terminology to promote more effective communication across researchers, stakeholders, and policymakers. Inconsistencies in terminology stem from the exponential increase in scientific publications on the patterns and processes of biological invasions authored by experts from various disciplines and countries since the 1990s, as well as publications by legislators and policymakers focusing on practical applications, regulations, and management of resources. Aligning and standardising terminology across stakeholders remains a challenge in invasion science. Here, we review and evaluate the multiple terms used in invasion science (e.g. 'non‐native', 'alien', 'invasive' or 'invader', 'exotic', 'non‐indigenous', 'naturalised', 'pest') to propose a more simplified and standardised terminology. The streamlined framework we propose and translate into 28 other languages is based on the terms (i) 'non‐native', denoting species transported beyond their natural biogeographic range, (ii) 'established non‐native', i.e. those non‐native species that have established self‐sustaining populations in their new location(s) in the wild, and (iii) 'invasive non‐native' – populations of established non‐native species that have recently spread or are spreading rapidly in their invaded range actively or passively with or without human mediation. We also highlight the importance of conceptualising 'spread' for classifying invasiveness and 'impact' for management. Finally, we propose a protocol for classifying populations based on (i) dispersal mechanism, (ii) species origin, (iii) population status, and (iv) impact. Collectively and without introducing new terminology, the framework that we present aims to facilitate effective communication and collaboration in invasion science and management of non‐native species. [ABSTRACT FROM AUTHOR]

Objectives: The Three Delays model is a well‐established global public health framework for the utilization of obstetric services where each delay represents a series of factors affecting utilization: (1) Delay #1—Deciding to seek care, (2) Delay #2—Reaching an appropriate facility and (3) Delay #3—Receiving adequate care. The aim of this qualitative study was to explore the application of the Three Delays model to dental service utilization and describe factors attributed to delayed utilization within this framework. Methods: This study utilized a framework analysis, underpinned by the Three Delays model, to examine delays in dental care utilization. A criterion purposive sample of English‐speaking adults (18+ years) in Massachusetts and Florida, USA with limited dental care access was recruited. Data were collected via semi‐structured interviews conducted in two phases: 17 individual interviews, followed by interviews with a subset of five participants over 3 months (a total of 18 interviews). The analysis involved inductive thematic coding and systematic organization within the framework. Results: Major themes and subthemes were constructed from the participants' narratives, identified and categorized as factors in the Three Delays framework. Each of the delays was interrelated to the other two, and Delay #1 was the most common delay based on the participants' interviews. The themes and subthemes contributing to one or more delays included interpersonal communication, prior dental experience, financial considerations, childcare costs, social connection, technology literacy, time constraints, competing priorities, stressors such as eviction and immigration status and microaggressions including racism and stigma. Conclusion: The Three Delays model was applicable to the study of dental care utilization and factors that impact the decision to seek dental care, reaching an appropriate dental facility and receiving adequate dental care in this study context. [ABSTRACT FROM AUTHOR]

Objective: Dental regulatory bodies aim to ensure the health and safety of dentists, dental staff patients and the public. An important responsibility during a pandemic is to communicate risk and guidelines for patient care. Limited data exist on the perceptions and experiences of dentists navigating new guidelines for mitigating risk in dental care during the pandemic. The objective of this study was to use a qualitative approach to explore how dentists in Canada experienced and perceived their regulatory bodies' communication about COVID‐19 risks and guidelines during the pandemic. Methods: Participants were Canadian dentists (N = 644) recruited through the email roster of nine provincial dental associations or regulatory bodies. This qualitative analysis was nested within a prospective longitudinal cohort study in which data were collected using online questionnaires at regular intervals from August 2020 to November 2021. To address the objective reported in this paper, a conventional qualitative content analysis method was applied to responses to three open‐ended questions included in the final questionnaire. Results: Participants encountered challenges and frustrations amid the COVID‐19 pandemic, grappling with diverse regulations and communications from dental bodies. While some bodies offered helpful guidance, many participants felt the need for improved communication on guidelines. Dentists urged for expedited, clearer and more frequent updates, expressing difficulty in navigating overwhelming information. Negative views emerged on the vague and unclear communication of COVID‐19 guidelines, contributing to confusion and frustration among participants. Conclusion: As COVID‐19 persists and in planning for future pandemics, these experiential findings will help guide regulatory bodies in providing clear, timely and practical guidelines to protect the health and safety of dentists, dental staff, patients and the public. [ABSTRACT FROM AUTHOR]

Aims: To explore UK healthcare professionals' practice and attitudes towards asking women with diabetes about sexual health problems, including symptoms of female sexual dysfunction (FSD). Methods: An online questionnaire to address the study aims was developed, piloted by ten healthcare professionals (HCPs) and completed by 111 eligible HCPs, recruited via professional networks and social media. Free text data were analysed and reported thematically. Two questions were analysed to test the hypothesis of differences between men's and women's responses. Results: The majority of respondents did not ask women with diabetes about sexual problems. Multiple barriers to inquiry were reported, including inadequate training, time constraints, competing priorities, the perceived likelihood that questions will cause surprise or distress (especially for certain groups of women), the belief that sexual problems are to be expected as women age, and the belief that FSD is complex or untreatable, with unclear management pathways. Exploratory findings indicated significant differences in men and women's responses (men disagreed more strongly with prioritisation, and fewer reported routine inquiry about sexual problems in their usual practice). Conclusions: HCPs reported not asking women with diabetes about sexual problems during routine care. They described multiple factors reinforcing the silence about sexual health, including inadequate education and perceived social risk for individual HCPs who deviate from the patterns of topics usually discussed in diabetes consultations. [ABSTRACT FROM AUTHOR]

An editorial is presented the Journal of Evaluation in Clinical Practice's role in fostering interdisciplinary debate on practical healthcare issues. Topics include the evolution of discussions on evidence-based practice, the journal's commitment to exploring health philosophy, and the ongoing critical examination of assumptions influencing clinical decision-making.

Background: Narrative Medicine (NM) and Indigenous Story Medicine both use narrative to understand and effect health, but their respective conceptualizations of narrative differ. Aims: I contrast the concept of narrative in NM with that of Indigenous Story Medicine. Materials and Methods: The article relies Western narrative theorists as well as Indigenous epistemologists to frame a discussion‐by‐contrast of the Judeo‐Christian creation myth with a Haundenosaunee Creation Story. Results: I demonstrate that the deficiencies of Narrative Medicine exist because the latter's use of narrative is a mere application in an otherwise reductive field, whereas Indigenous epistemologies rely on story as medicine itself. Discussion: OMIT. Conclusion: I call for more scholars to take up different narratives to further investigate the ethical space between NM and Indigenous Story Medicine. [ABSTRACT FROM AUTHOR]