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Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

This study focused on how adopted adults who have reunited with at least one birth family member experienced identity shifts related to their original birth certificates (OBCs). Framed by the Communication Theory of Identity (CTI), 50 adopted adults discussed their experiences related to their OBCs and how their identities are connected to this symbol through three of the layers of CTI, the personal, enacted, and relational layers. Participants discussed the presence of an ambiguous and unsolvable identity that interpenetrated with their other identity layers. Findings extend CTI to include an additional layer for adoptees – phantom identity – which can explain the life adoptees would have lived had they not been adopted. This identity was salient for participants as it manifested in ways such as expressing frustration with obstacles in gaining access to their OBC and refocusing their professional life to support other adopted adults. Moreover, findings offer implications for the examination into current adoption record practices in the United States, additional state mutual consent registries, and increased access to adoption-competent counselors for adoptees. [ABSTRACT FROM AUTHOR]

The process of development, manufacturing, registration, distribution, and postmarketing support of drug and biologic products includes the need for clear, active, and ongoing communication between the sponsor/applicant and the Food and Drug Administration (FDA). Such communication occurs in written and spoken form, involving multiple media (including letters, secure e-mail, fax, face-to-face meetings, and teleconferences). Personnel in PhRMA member companies and FDA recognize the importance and challenges of communication. FDA's attention to a number of key principles of communication is illustrated in the guidance document Good Review Management Principles and Practices for PDUFA Products. this white paper, members of PhRMA's Best Practices Working Group have summarized key information on communication from the guidance document, proposed expectations for communications to facilitate a shared understanding between FDA and applicant about a communication strategy during review of a New Drug Application (NDA) or Biologics License Application (BLA), and drafted some basic principles for companies to adopt to help foster constructive, professional, and efficient communication with FDA on Prescription Drug User Fee Act (PDUFA) products. Dialogue with FDA and other stakeholders about these principles and proposals is suggested as the logical next step in discussion of best practices for communication. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including description of a free neurorehabilitation clinic staffed by volunteers to fill the gap for people with physical, cognitive, and communication disorders, concussion recovery as a dichotomous state, and how and why we do what we do in clinical practice.

An introduction to articles in the issue is presented on topics including description of a free neuro-rehabilitation clinic staffed by volunteers to fill the gap for people with physical, cognitive, and communication disorders, concussion recovery as a dichotomous state, and how and why we do what we do in clinical practice.

The emphasis on research evaluation has brought scrutiny to the role of self‐citations in the scholarly communication process. While author self‐citations have been studied at length, little is known on national‐level self‐references (SRs). This paper analyses the citation context of national SRs, using the full‐text of 184,859 papers published in PLOS journals. It investigates the differences between national SRs and nonself‐references (NSRs) in terms of their in‐text mention, presence in enumerations, and location features. For all countries, national SRs exhibit a higher level of engagement than NSRs. NSRs are more often found in enumerative citances than SRs, which suggests that researchers pay more attention to domestic than foreign studies. There are more mentions of national research in the methods section, which provides evidence that methodologies developed in a nation are more likely to be used by other researchers from the same nation. Publications from the United States are cited at a higher rate in each of the sections, indicating that the country still maintains a dominant position in science. On the whole, this paper contributes to a better understanding of the role of national SRs in the scholarly communication system, and how it varies across countries and over time. [ABSTRACT FROM AUTHOR]

Lists the top-ranking doctorate-granting institutions in communication studies in the United States. Combination of the National Communication Association and International Communication Association awards from 1994 to 1998; Use of the rankings to assess the programs of particular doctoral institutions.

EU-US data transfers for health research remain a particularly thorny issue in view of the stringent rules of the EU General Data Protection Regulation (GDPR) and the challenges related to US mass surveillance programs, particularly the manner in which US law enforcement and national security agencies can access personal data originating from the EU. Since the entry into force of the GDPR, evidence of impeded collaborations is increasing, particularly in the case of sharing data with US public institutions. The adoption of a new EU-US adequacy decision in July 2023 does not hold the promise for a long-lasting solution due to the risks of being challenged and invalidated – yet again – at the Court of Justice of the EU. As the research community is calling for answers, the new proposal for a European Health Data Space regulation may hold a key to solving some of the existing issues. In this paper, we critically discuss the current rules and outline a possible way forward for transfers between public bodies. [ABSTRACT FROM AUTHOR]

Examines the common scholarly characterizations of the U.S. penny press during the 1830s and 1840s. Provision of a myth of origins of the contemporary press; Inaccuracies and misleading elements in penny press methodology; Relationships among objectivity, market forces and freedom of the press.

Aims: To elicit experiences of patients, family caregivers, and healthcare professionals in intermediate care units (IMCUs) in an academic medical centre in Baltimore, MD related to the challenges and intricacies of multimorbidity management to inform development of a multimorbidity symptom management toolkit. Design: Experience‐based co‐design. Methods: Between July and October 2021, patients aged 55 years and older with multimorbidity admitted to IMCUs at an academic medical centre in Baltimore, Maryland, USA were recruited and interviewed in person. Interdisciplinary healthcare professionals working in the IMCU were interviewed virtually. Participants were asked questions about their role in recognizing and treating symptoms, factors affecting the quality of life, symptom burden and trajectory over time, and strategies that have and have not worked for managing symptoms. An inductive thematic analysis approach was used for analysis. Results: Twenty‐three interviews were conducted: 9 patients, 2 family caregivers, and 12 healthcare professionals. Patients' mean age was 67.5 (±6.5) years, over half (n = 5) were Black or Hispanic, and the average number of comorbidities was 3.67. Five major themes that affect symptom management emerged: (1) the patient–provider relationship; (2) open and honest communication; (3) accessibility of resources during hospitalization and at discharge; (4) caregiver support, training, and education; and (5) care coordination and follow‐up care. Conclusion: Patients, caregivers, and healthcare professionals often have similar goals but different priorities for multimorbidity management. It is imperative to identify shared priorities and target holistic interventions that consider patient and caregiver experiences to improve outcomes. Implications for the Profession and/or Patient Care and Impact: This paper addresses the paucity of research related to the shared experience of disease trajectory and symptom management for people living with multimorbidity. We found that patients, caregivers, and healthcare professionals often have similar goals but different care and communication priorities. Understanding differing priorities will help better design interventions to support symptom management so people with multimorbidity can have the best possible quality of life. Reporting Method: We have adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines in our reporting. Patient or Public Contribution: This study has been designed and implemented with patient and public involvement throughout the process, including community advisory board engagement in the project proposal phase and interview guide development, and member checking in the data collection and analysis phases. The method we chose, experience‐based co‐design, emphasizes the importance of engaging members of a community to act as experts in their own life challenges. In the coming phases of the study, the public will be involved in developing and testing a new intervention, informed by these qualitative interviews and co‐design events, to support symptom management for people with multimorbidity. [ABSTRACT FROM AUTHOR]

Routines and rituals are ubiquitous across scholarship in family communication yet are overlapping and idiosyncratic concepts, making a clear distinction between them difficult. This paper builds clarification around the concepts by arguing for attending to what we call the routinized and ritualized aspects of family activities. We demonstrate this approach's utility through a qualitative thematic discourse analysis of 697 Twitter posts discussing the COVID-19 pandemic's impact on family food practices in the United States. We identify three themes that convey the broad impacts of lockdown conditions on family food practices: bolstering, disruption, and reimagining. We then analyze each theme's salience within daily meals and holiday meals – two food provisioning sites frequently considered routines and rituals, respectively. Theoretically, this paper forwards a conceptualization of routines and rituals that delineates the symbolic and instrumental elements embedded within each; empirically, it demonstrates the multifaced effects of the pandemic on family food life. [ABSTRACT FROM AUTHOR]

The article offers information on the Inaugural Discussion Paper on Patient-Clinician Communication from the Institute of Medicine (IOM) which highlights issues of strategic importance to progress in health and health care.

Via analysis of online survey data of 262 people aged 18 to 70 in the United States who have been involved in a long-distance romantic relationship (LDR) since 2005, we investigate how paper, audio, visual, and digital communication formats may be used and viewed as differentially meaningful. While in most intimate relationships, digital formats such as e-mail, messaging, and texts are frequently used, LDR couples are more likely to use and find most meaningful video chat and audio platforms compared with paper or digital formats. The reason for each platform’s meaningfulness varies according to survey respondents’ subjective understandings. Audio and visual formats are seen as meaningful because they offer intimacy, paper formats offer thoughtfulness, and digital formats offer ease as well as thoughtfulness. This research contributes to understanding the subjectively constructed meaning of ever-changing communication platforms, as well as definitions of shared sociomental spaces, for couples who are geographically separated. [ABSTRACT FROM AUTHOR]

Background: Impaired discourse production is commonly reported for individuals with traumatic brain injury (TBI). Discourse deficits can negatively impact community integration, return to employment and quality of life. COVID‐19 restrictions have reduced in‐person assessment services for people with communication impairments. Advances in telehealth may help speech and language therapists (SLTs) to assess monologic discourse more systematically and improve access to services for patients who may find it difficult to attend in‐person. Aims: To examine the feasibility of telehealth administration of narrative and procedural discourse tasks with individuals with TBI and matched controls. Methods & Procedures: A total of 20 individuals with TBI and 20 healthy controls, aged 18–55 years, were directly recruited from the UK and indirectly recruited from the US. For participants with TBI, time post‐injury was at least 3 months with no diagnosis of aphasia. Control participants were matched for sex and as closely as possible for age. Feasibility of measures was based upon the time to administer both narrative tasks, the report of any technological problems, and participant feed. Discourse samples were transcribed verbatim and analysed using story grammar analysis (for narrative discourse) and identification of propositions (for procedural discourse). Interrater reliability was calculated using percentage agreement for 50% of the data. Non‐parametric analyses were used to analyse the performance of the two groups. Outcomes & Results: Narrative and procedural discourse samples were collected via telehealth in approximately 10 min with no reported technical difficulties or complaints from any participants. For narrative discourse performance, there were significant differences for the TBI and control groups for measures of complete episodes (p < 0.001) and missing episodes (p = 0.005). No significant group differences were noted for any of the procedural discourse measures. Conclusions & Implications: Results support the feasibility of collecting discourse samples via telehealth. Although the participants' discourse performance distinguished the TBI and control groups on the narrative task, no differences between the groups were noted for the procedural task. The narrative discourse task may have been more difficult than the procedural task, or video cue support reduced the cognitive load of the procedural task. This finding suggests the use of more complex procedural tasks without video cue support may be needed. WHAT THIS PAPER ADDS: What is already known on this subject: Although little research has explored the feasibility of administering discourse assessments for individuals with TBI via telehealth, some studies have found that discourse interventions can be feasibly administered via telehealth. It is also well established that individuals with TBI struggle with the supra‐structural and macro‐linguistic elements of discourse production. Both procedural and narrative discourse tasks have been found to differentiate individuals with TBI from healthy controls. What this paper adds to existing knowledge: Few studies have investigated the feasibility of, and procedures for, administering discourse tasks via telehealth. Additionally, the inclusion of multiple types of discourse tasks to parse cognitive–communication abilities is lacking in the current literature. Findings from this study support that narrative and procedural discourse can be feasibly sampled via telehealth and that international collaboration for research on this topic can facilitate such studies. Individuals with TBI performed more poorly on three measures of narrative discourse. No differences between groups were identified for the procedural task. What are the potential or actual clinical implications of this work?: Telehealth assessment for discourse provides flexibility for both the individual with TBI and the speech–language therapist and does not compromise the quality of data collected. The administration of discourse tasks and collection of data was not time‐consuming and was well accepted by the study participants. Additionally, international research collaboration not only expands potential participation in research but increases the opportunity to recruit and study more diverse groups. [ABSTRACT FROM AUTHOR]

Background: As delays or disorders in early language and communication are the most prevalent symptom in children with disabilities, early screening is crucial to promote prevention, early diagnosis, and intervention. However, to the best of our knowledge, no screening tool is available for the joint assessment of early language and social communication skills in European Portuguese (EP)‐learning children, which is critical for screening, monitoring and enrolment in appropriate early intervention services. Aims: (1) To adapt and validate the EP version of the Communication and Symbolic Behaviour Scales Developmental Profile™ (CSBS DP™) Infant–Toddler Checklist, a parental report for the screening of early language and social communication skills. (2) To conduct a cross‐cultural comparison between the EP adaptation and the original US version. Methods & Procedures: A total of 611 EP‐learning children (ages 6–24 months) were assessed on the CSBS DP Infant–Toddler Checklist. Normative data, psychometric characteristics (i.e., internal consistency and test–retest reliability), and cross‐cultural comparison between the EP and the original version were explored. Outcomes & Results: Internal consistency ranged from good to excellent and the test–retest reliability was excellent. The performance of the EP and US samples matched on almost all scores. However, EP children performed significantly better than their American peers in the Social compositive at 22 months and in the Symbolic composite at 20 months. No further differences were found. Conclusions & Implications: These findings showed that the EP CSBS DP Infant–Toddler Checklist seems to be a reliable screening tool of communicative and symbolic behaviours for EP‐learning children, which can be particularly relevant for decision‐making in clinical practice. WHAT THIS PAPER ADDS: What is already known on the subject: Early communication skills are known to be related to later language outcomes. Thus, screening tools for the early identification of children at risk for language and communication impairments, which may lead to monitoring and early intervention, have the potential to promote better outcomes. However, to the best of our knowledge, no screening tool is available for the assessment of early communication abilities in EP‐learning children. What this paper adds to existing knowledge: This study adapted and validated the EP CSBS DP Infant–Toddler Checklist, the first published parental report checklist for the assessment of early communication skills in EP. It described the psychometric characteristics of the adapted checklist, summarized the newly available normative data for EP‐learning infants and toddlers, and compared the performance of EP‐learning children with the original standardization sample reported for American English. The results demonstrated that this tool is a reliable instrument for the early screening of language, communicative and symbolic behaviours for EP‐learning children between 6 and 24 months of age. What are the potential or actual clinical implications of this work?: Given that early screening is crucial to promote prevention, early diagnosis and intervention, the availability of this tool is particularly relevant for children monitoring and their enrolment in appropriate early intervention services, helping decision‐making in clinical practice, in line with current guidelines regarding early monitoring and intervention to promote and support better outcomes. Thus, the tool and related normative data will be useful for paediatricians, family doctors, primary healthcare providers, developmental psychologists and speech–language therapists, among other professionals in the healthcare and educational fields, concerned with speech, language, and communication development and impairments. [ABSTRACT FROM AUTHOR]

Management can only thrive in the prevalence of communication. Indeed, the present paper is timely. A 2002 survey of 1,104 employees of organizations in the United States showed that, while managers spend 60 to 80 percent of their time on operational communication, only 17 percent said their managers communicated effectively. Thus, every possible constructive measure must be taken to disentangle areas that stand in the way of effective communication within a given business organization. Efforts must be exhausted to create a business environment in which managers and staff pay close attention to the conceptualization and dissemination of communication media and the messages they transmit. Since the desired purpose of transmitting information from sender to receiver is effective communication, the paper will review pertinent literature to ascertain harbors of problems that result in communication problems in management. To this end, the paper intends to examine attitudes of senders that generate poor and/or ineffective communication; investigate media choices that are inappropriate in certain communication instances; consider cultural/gender insensitive implications prevalent in management communication; as well as the importance of placing the receiver at the center when designing information or messages to be transmitted. In addition, the proposed paper intends to analyze management communication mistakes, such as making controversial announcements, lying [sic], ignoring the realities of power, underestimating the intelligence of the receiver or audience, using inappropriate media or channels of communication, and ignoring to admit mistakes. It is a truism that, 60 percent of corporate public relations effort is devoted to internal communication, which is a reflection that good communication is at the heart of every productive workplace. The paper's objective is to produce a document that chronicles not only missteps in management communication, but also to advance ways of creating awareness and to forge management policies that foster good and effective communication in a business environment. [ABSTRACT FROM AUTHOR]

Background: There is a large body of research showing the negative impact of a total laryngectomy on the resultant voice signal across multiple outcomes (e.g., speech intelligibility/acceptability, listener comprehension, voice quality). However, there is limited information on the effects of laryngectomy on broader communication acts, particularly in the area of pragmatics, commonly referred to as the social use of language. Considering that individuals with a laryngectomy (IWL) frequently report reduced quality of life as well as reduced communicative competency, expanding the current research to include pragmatics is warranted. Aim: To explore the pragmatic changes in communication experienced by tracheoesophageal speakers. Methods & Procedures: The current study adapted an existing 17‐item measure to assess verbal, non‐verbal, paralinguistic and receptive communication competence via self‐report. This adapted measure was then distributed to 65 tracheoesophageal speakers (52 males, 13 females, mean age = 63.4 ± 8.5 years). Outcomes & Results: Both negative and positive pragmatic changes to communication were reported by participants secondary to laryngectomy. This included changes in verbal (negative –37.5%, positive –15.15%); non‐verbal (negative –9.54%, positive –35.45%; and paralinguistic acts (negative –29.55%, positive –34.09%). Changes to receptive communication were also noted (negative –14.78%, positive –43.19%). Conclusions & Implications: The overall results suggest that communication changes post‐laryngectomy exist well beyond the paralinguistic areas (e.g., intelligibility, voice quality) and that males and females may approach or respond to changes in communication differently. Results are discussed specific to clinical intervention and the importance of including assessment of pragmatic function post‐laryngectomy. WHat this paper adds: What is already known on this subject: While there is a large body of research on the changes to the speaker and listener following laryngectomy, there is minimal information on how the use of alaryngeal speech affects overall communication, specifically in the area of pragmatics or the social use of language. What this paper adds to existing knowledge: This study used an adapted version of the widely used Pragmatic Protocol to delineate changes in pragmatic components of communication for tracheoesophageal speakers. What are the potential or actual clinical implications of this work?: Clinically, this information can be used by healthcare professionals to educate and prepare IWL on potential changes in the underrecognized area of pragmatics. [ABSTRACT FROM AUTHOR]

This article focuses on the condition of periodical postal rates in the U.S. The cost of delivery is more than the cost of printing or the cost of writing. For a magazine, postage costs are like extra pounds around the waist and hips. This scenario can even endanger the life of a publication. With this reality, it is no surprise that magazine publishers are looking for ways to reduce the load, even if it means adopting a strategy as drastic as giving up a substance they have grown to love. To alleviate this situation, the author decided to suggest budget reduction aids for magazine publishers. And one such aid is electronic delivery of content.

Accessible Summary: What is known on the subject?: International guidelines for trans‐and‐gender‐non‐conforming (TGNC) exists in outpatient settings.Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. What does this paper add to existing knowledge?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. What are the implications for practice?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States. Introduction: Access to culturally sensitive care is critical for addressing known mental health disparities among trans‐and gender‐non‐conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. Aim: To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. Method: A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. Results: Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. Discussion: The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. Implications for practice: To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings. [ABSTRACT FROM AUTHOR]

To perform a systematic search of instruments for the early identification of risk of sexual exploitation in children (CSE) and appraise their metric properties. Searches were conducted in four electronic databases to identify instruments that only evaluated child sexual exploitation with no restrictions of date or language. Two reviewers independently carried out the initial selection of titles and abstracts, appraisal of the methodological quality, compliance with the entry criteria in the analysis, and extraction of data necessary to systematize the information available. Twenty-three articles were found that used 15 CSE detection instruments. The instruments varied with regard to number of questions, ease of administration, sources of information, rating methods, and the training information provided. What they had in common is that most were designed and used in the English-speaking world, basically in the United States, with few instruments providing solid proof of their validity and reliability in the scores derived thereof. Although instruments were obtained with significant similarities in their conceptualization, differences in multiple characteristics made it difficult to draw clear conclusions regarding their greater or lesser suitability. What did become clear was the need to keep working on obtaining rigorous empirical psychometric evidence. [ABSTRACT FROM AUTHOR]

Against the backdrop of a global pandemic, this study investigates how U.S. higher education leaders have centered their crisis management on values and guiding ethical principles. We conducted 55 in-depth interviews with leaders from 30 U.S. higher education institutions, with most leaders participating in two interviews. We found that crisis plans created prior to the COVID-19 pandemic were inadequate due to the long duration and highly uncertain nature of the crisis. Instead, higher education leaders applied guiding principles on the fly to support their decision-making. If colleges and universities infuse shared values into their future crisis plans, they will not have to develop a moral compass on the fly for the next pandemic. This paper suggests the following somewhat universal shared values: (1) engage in accuracy, transparency, and accountability; (2) foster deliberative dialog; (3) prioritize safety; (4) support justice, fairness, and equity; and (5) engage in an ethic of care. To navigate ethics tensions, leaders need to possess crisis-relevant expertise or ensure that such expertise is present among crisis management team members. Standing up formal ethics committees composed of diverse stakeholders also is instrumental in navigating tensions inherent in crises. The next pandemic is already on the horizon according to experts. Through infusing values into future crisis plans, higher education leaders can be confident that their responses will be grounded in their communities' shared values. [ABSTRACT FROM AUTHOR]

Background: The language of the science curriculum is complex, even in the early grades. To communicate their scientific observations, children must produce complex syntax, particularly complement clauses (e.g., I think it will float; We noticed that it vibrates). Complex syntax is often challenging for children with developmental language disorder (DLD), and thus their learning and communication of science may be compromised. Aims: We asked whether recast therapy delivered in the context of a science curriculum led to gains in complement clause use and scientific content knowledge. To understand the efficacy of recast therapy, we compared changes in science and language knowledge in children who received treatment for complement clauses embedded in a first‐grade science curriculum to two active control conditions (vocabulary + science, phonological awareness + science). Methods & Procedures: This 2‐year single‐site three‐arm parallel randomized controlled trial was conducted in Delaware, USA. Children with DLD, not yet in first grade and with low accuracy on complement clauses, were eligible. Thirty‐three 4–7‐year‐old children participated in the summers of 2018 and 2019 (2020 was cancelled due to COVID‐19). We assigned participants to arms using 1:1:1 pseudo‐random allocation (avoiding placing siblings together). The intervention consisted of 39 small‐group sessions of recast therapy, robust vocabulary instruction or phonological awareness intervention during eight science units over 4 weeks, followed by two science units (1 week) taught without language intervention. Pre‐/post‐measures were collected 3 weeks before and after camp by unmasked assessors. Outcomes & Results: Primary outcome measures were accuracy on a 20‐item probe of complement clause production and performance on ten 10‐item unit tests (eight science + language, two science only). Complete data were available for 31 children (10 grammar, 21 active control); two others were lost to follow‐up. Both groups made similar gains on science unit tests for science + language content (pre versus post, d = 2.9, p < 0.0001; group, p = 0.24). The grammar group performed significantly better at post‐test than the active control group (d = 2.5, p = 0.049) on complement clause probes and marginally better on science‐only unit tests (d = 2.5, p = 0.051). Conclusions & Implications: Children with DLD can benefit from language intervention embedded in curricular content and learn both language and science targets taught simultaneously. Tentative findings suggest that treatment for grammar targets may improve academic outcomes. What this paper adds: What is already known on the subject: We know that recast therapy focused on morphology is effective but very time consuming. Treatment for complex syntax in young children has preliminary efficacy data available. Prior research provides mixed evidence as to children's ability to learn language targets in conjunction with other information. What this study adds: This study provides additional data supporting the efficacy of intensive complex syntax recast therapy for children ages 4–7 with Developmental Language Disorder. It also provides data that children can learn language targets and science curricular content simultaneously. What are the clinical implications of this work?: As SLPs, we have to talk about something to deliver language therapy; we should consider talking about curricular content. Recast therapy focused on syntactic frames is effective with young children. [ABSTRACT FROM AUTHOR]

This article investigates the profound impact of language policies on identity and communication within multilingual societies, employing case studies from Morocco and the United States. Through an analysis of existing literature, this paper reveals that language policies significantly influence individuals' self-perception and interactions in various social and political contexts. By exploring the experiences of these two countries, this study aims to exemplify the intricate interplay between language policies, identity formation, and communication patterns. The methodology used for this research involves a comprehensive literature review, encompassing works by scholars such as Fishman, Kroskrity, and Blommaert. The case study of Morocco uncovers a multilingual country with Arabic, Amazigh, and French as prominent languages, each contributing to the nation's cultural and historical heritage. The recognition and promotion of Amazigh languages are significant milestones in Morocco's language policy, empowering the Amazigh community and fostering a sense of identity among Amazigh speakers. However, the prevalence of French, stemming from the country's colonial history, raises concerns about its impact on local languages and cultural identities. Conversely, the United States, without an officially designated national language, exemplifies cultural abundance and linguistic diversity. The paper concludes by urging further research into the relationship between language policies, identity, and communication in multilingual societies, and advocates for policies that foster linguistic diversity while promoting social cohesion and inclusion. [ABSTRACT FROM AUTHOR]

This paper describes the authors' exploration of an arts-based practice, called imagined dialogue, as a means for engaging in reflective discourse in the current, global context of political polarization. We introduce the practice of imagined dialogue, taking the readers along on our continued learning journey of the implications of this practice for educational contexts. We highlight the connections of imagined dialogue to the theory and practice of transformative learning. This paper suggests that writing and embodying imagined dialogue can prepare people for real dialogue, allowing them to more deeply understand their own positions, as well as to empathize with and respect the positions of others. In addition to introducing the theoretical background and steps to engaging in the imagined dialogue process, we share several examples; including our own experiences using imagined dialogue in personal contexts, and group processing of a dialogue about an issue of national political significance. Using imagined dialogue is a skill that can be learned and strengthened, enabling learners to engage in and model the practice of critical, reflective discourse over time – even in the emotionally charged political sphere. [ABSTRACT FROM AUTHOR]

This paper presents qualitative field research conducted at a radiology department in the USA. It examines 'the radiologist at work' and analyses the intersubjective ground for her individual diagnostic intentions and personalized strategies for enacting diagnostically-relevant experiences via imaging technology. The paper incorporates the radiologists' use of 'enactive proofs'—observations and professional memories made explicit through their interaction with medical imaging technology and other practitioners in the field. The observations strongly support the development of enactive phenomenology and provide a critique of representationalism and of the primacy of inference in cognition. The results demonstrate the crucial role of shared intentions, providing insight into expert performance in the form of concrete dealings with imaging technology, habituality, the origin of mistakes, multilayered communication, and discovering new ways for improving professional praxis. The findings have much to offer to philosophy, anthropology and radiological practice. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

Water is a salient issue in the Intermountain West of the United States (U.S.), with concerns ranging from water scarcity and drought to intermittent flooding and water quality risks. This paper investigates coverage of water issues across seven newspapers in the core of the U.S. Intermountain West region. Newspapers have the potential to set agendas and influence perceived salience of issues among consumers. The Intermountain West region shares common concerns about water supply and demand, climate change, and water quality. We investigate whether or not local daily newspaper coverage of water issues provides a more local or regional sensitivity. Findings from this exploratory study reveal differences in water coverage across local daily newspapers. The overall volume of water‐related articles differed across newspapers as did proportion of articles on specific water topics and connecting issues. Coverage of local issues was more dominant than might be expected given mass media trends, but water geography in articles extended across the U.S. and the world in every newspaper studied. Variations in newspaper coverage of water issues suggests more local nuance persists despite the experience of common water issues across the region. Research Impact Statement: Coverage of water varies across seven newspapers in the Intermountain West, thus potentially influencing local and regional agenda setting on water issues. [ABSTRACT FROM AUTHOR]

The tactics used by the food industry to influence public policy have been well documented, but there is little direct evidence of the rationale behind food industry actions and their level of support from within individual companies. This paper provides an analysis of an email exchange (from 2015) between former senior executives of Coca-Cola to gain insider insight into ways in which the food industry seeks to influence policy-makers as well as scientific evidence and opinion with respect to nutrition and non-communicable disease (NCD) prevention. The results provide direct evidence that senior leaders in the food industry advocate for a deliberate and co-ordinated approach to influencing scientific evidence and expert opinion. The paper reveals industry strategies to use external organisations, including scientific bodies and medical associations, as tools to overcome the global scientific and regulatory challenges they face. This evidence highlights the deliberate approach used by the food industry to influence public policy and opinion in their favour. It also demonstrates the importance of identifying and managing potential conflicts of interest when assessing the evidence base and when making policy decisions related to nutrition and NCD prevention. [ABSTRACT FROM AUTHOR]

Writing formats have expanded beyond the pen to include new technologies, particularly in this era of immediate digital communication. Rehabilitation professionals are not routinely incorporating writing formats using technology, such as texting, keyboard, or tablet interfaces when evaluating and treating adult writing disorders. The purpose of this study was to obtain normative baseline information about the writing behaviors of typical adults across generations. A total of 199 respondents, ages 18–106, provided data on rating importance of format, frequency of use, and ranking of writing activities. Findings indicated that the importance of technology for communication, learning, and work activities exists across the generations (except the centenarian). Written forms of enjoyment, such as crossword puzzles, song lyrics, and story writing, were meaningful to younger as well as older generations. Obtaining client perspectives on writing activities and formats that are personally relevant and meaningful can help the clinician create a more client-based program. [ABSTRACT FROM AUTHOR]

Background Study: Technology‐supported learning environments, act as significant observational and enabling indicators for evaluating and encouraging the digital revolution of education, are of vital importance in current educational research. Keeping track of the dynamics of technology‐supported learning environment research allows for the enrichment of theoretical studies and a prompt innovation of talent‐training environments. Objectives: The present study carried out a bibliometric analysis of the core collection of WoS database over the last two decades. Method: This study is a bibliometric research. We applied CiteSpace and VOSviewer for co‐occurrence and evolution analysis. In addition, we extracted the fundamental ideas and thoughts through reading and analysis. Results: First, the study found that technology‐supported learning environment research is in a growth phase, with core journals such as Interactive Learning Environments or Computers & Education. The findings show that a core research team comprised of such scholars as Hwang Gwo‐Jen, Lester James C. and Wong Lung‐Hsiang. Key nations of publishing and research strength are from China, the United States, the United Kingdom and the Netherlands. Second, the hot topics in research on technology‐supported learning environments were virtual learning environments, technology‐enabled learning environments and interactive learning environments. Nine study specifics were derived from these three topics such as moulding function, generating scenario, stimulating sensation, effect verification, design idea, research reflection, inquiry and research, virtual community, and mixed environment. Lastly, the frontier evolution offers a pattern of development from enhancing performance to changing mode to incorporating experience. Conclusion: Looking ahead, our research recommendations for the field of technology‐supported learning environments include a multifaceted approach. We should aim to enhance research designs and methodologies, develop contemporary guiding theories and strive for a balanced representation across various educational domains, expanding our scope to encompass all academic disciplines. In terms of practical application, it is imperative to focus on the design and implementation of technology‐supported learning environments from three critical perspectives: "change‐demand," "student‐learning" and "online‐offline." These approaches will collectively ensure that technology‐supported learning environments are both innovative and responsive to the diverse needs of the educational landscape. Lay Description: What is already known about this topic: Technology‐supported learning environments are currently a focal and hot research topic in the field of education.Although numerous studies have been conducted on the learning environment of technical support, there has yet to be a systematic and comprehensive review of the related research. What this paper adds: This study provides a comprehensive review of research on the technology‐supported learning environments over the past two decades.This study primarily presents an overview of research on the technology‐supported learning environments over the past two decades, focusing on main literature, research strength, hot topics and frontier evolution. Implications for practice and/or policy: Researchers need to further advance research on technology‐supported learning environments by enriching research designs and methods, constructing up‐to‐date guiding theories and achieving a balance across different educational domains while extending the reach to all disciplines.Educational practitioners need to pay attention to the design and implementation of technology‐supported learning environments from the three viewpoints of "change‐demand," "student‐learning" and "online‐offline." [ABSTRACT FROM AUTHOR]

Introduction. Site visits (SVs) are a common component of clinical education. The purpose of this paper was to explore clinicians' perspectives regarding SVs, including methods of communication used and their effectiveness, purposes of SVs, and the level of interaction between the stakeholders. Review of the Literature. Several communication methods are used to conduct SVs, with varying levels of "richness" and effectiveness. Previous studies have explored the perceptions of physical therapist (PT) students and Directors of Clinical Education regarding communication methods used during SVs, as well as reporting the purposes, effectiveness, and logistics. Subjects. Clinicians, including clinical instructors (CIs) and Site Coordinators of Clinical Education, from across the United States, representing various geographical locations and settings were invited to participate. Methods. An electronic survey was distributed to participants using information from 2 PT education programs and the Physical Therapist Clinical Performance Instrument database. Results. A total of 273 responses were included in the analysis. Clinicians ranked in-person visits as their first choice of communication for future SVs (n = 157, 59.9%) and indicated that inperson communication was "very effective" (n = 143, 52.4%) when compared with videoconferencing (n = 55, 20.1%) and telephone (n = 49, 17.9%). Clinicians ranked verifying the competency level of the student and verifying site resources during the SV as "extremely important" or "important" (n = 257, 94.2% and n = 250, 91.5%, respectively). Answering CI's questions and providing support to the CI were also identified as "extremely important" or "important" (n = 262, 96% and n = 244, 89.4%, respectively). Analysis of open-ended responses revealed 5 themes: Communication is important, flexibility allows best fit for a situation, on-site visits offer a more complete picture, real-time dialog is preferred, and email can lead to misinterpretation. Discussion and Conclusion. Communication is a key component of the clinical-academic relationship. Although clinicians prefer in-person communication, flexibility is necessary when planning and conducting SVs. Future research recommendations include gathering student and clinician perceptions regarding faculty involvement in SVs, as well as gathering faculty perspectives regarding their participation in SVs. In addition, the impact of the pandemic on the future of SVs warrants further exploration. [ABSTRACT FROM AUTHOR]

People with intellectual and developmental disabilities have the right to access appropriate and comprehensive sexuality and relationship education (SRE), but face a long history of exclusion from SRE in the USA due to myths about the sexuality of people with intellectual and developmental disabilities, biases against people with disabilities, and segregationist educational policies. Additionally, people with autism/autistic people are more likely to report having an LGBTQIA+ identity, and need comprehensive SRE content to become socially competent members of their communities. Teachers and other practitioners are often placed in the uncomfortable position of addressing many SRE topics while feeling unprepared, trying to stay aligned with educational policies, managing caregiver expectations, and providing scientifically accurate fact-based information in an increasingly politicised social climate. This paper provides recommendations on how to teach about LGBTQIA+ issues to students with intellectual and developmental disabilities including recommendations for modifying existing SRE curricula, identifying effective instructional strategies, and outlining a process for including LGBTQIA+ identities in SRE content. [ABSTRACT FROM AUTHOR]

This paper investigates dynamic changes in instrumental (i.e., work‐related) tie‐seeking patterns and the structure of a communication network following a downsizing event—whereby many employees are simultaneously eliminated from a network. Our analysis spans a two‐year period and applies a resource‐ and network‐change approach to examine how survivors develop revised resource‐acquisition strategies while repositioning themselves after a downsizing. Our results demonstrate that two temporary logics of tie formation—a suspension of within‐unit homophily and a preference for seeking ties with long‐tenured employees—help employees acquire betweenness centrality during the disruption period. Specifically, we find that disruption initiates a transitional period after downsizing in which new tie‐making logics are employed, including seeking out ties with long‐tenured employees and employees outside of one's department. We observed post‐disruption, during the stabilization period after downsizing, where logics used for tie‐making in the disruption period were abandoned, pre‐disruption tie‐making logics were resumed, and betweenness centrality remained relatively constant. We discuss the theoretical and managerial implications of these results and suggest future research directions. [ABSTRACT FROM AUTHOR]

Using 2021 data and information related to COVID‐19, this paper discusses the contribution of colonization, medical mistrust and racism to vaccine hesitancy. Vaccine hesitancy is defined as 'delay in acceptance or refusal of vaccines despite availability'. Colonization is described as the 'way the extractive economic system of capitalism came to the United States, supported by systems of supremacy and domination, which are a necessary part of keeping the wealth and power accumulated in the hands of the colonizers and ultimately their financiers'. The system of colonization results in policies and practices, including those related to health, that continue to create oppression and support racism. Persons experience trauma as the byproduct of colonization. Chronic stress and trauma create chronic inflammation and all diseases, whether genetic or lifestyle, have a common pathogenesis that is a component of inflammation. Medical mistrust is the absence of trust that healthcare providers and organizations genuinely care for patients' interests, are honest, practice confidentiality and have the competence to produce the best possible results. Finally, racism is described as everyday racism and perceived racism in healthcare. [ABSTRACT FROM AUTHOR]

Recent interdisciplinary scholarship has drawn increased critical attention to issues related to race, gender, class, and culture within public physical activity (PA) spaces, foregrounding the importance of rethinking dominant narratives of PA and promoting diverse and more inclusive practices within these contexts to address PA disparities. This paper addresses issues related to diversity and inclusion within community fitness spaces by examining the experiences of stakeholders and members involved in 'The Collective' Free Fitness Group (CFFG), a free, open-to-the-public fitness community based in Oakland, Ca (the original name has been changed for purposes of anonymity). This organization has made intentional efforts towards addressing diversity and inclusion across its membership and is located in one of the most ethnoracially diverse regions of the country. Drawing on McGee's (1980) concept of ideographs, we explore the potential limitations and consequences of how the CFFG Oakland community members communicated discourses and lived experiences of and to one another and the broader Oakland community. Specifically, we argue that by emphasizing certain expressions of and while deemphasizing alternative forms, participant responses reflected a 'paradox' of diversity, despite their shared in-group identification around as an important individual moral virtue and their open and community. This study contributes new knowledge to the 'paradox' literature and may inform future physical activity interventions and theoretical directions of study. [ABSTRACT FROM AUTHOR]

Given the politicization of abortion, professionals working in U.S. health departments (HDs) may not be receptive to communications about abortion, despite often regulating abortion facilities. This paper reports results of a randomized, prospective, observational study to test the effects of e-mail language when disseminating evidence on abortion to HD professionals. Our sample was 302 HD employees who oversee healthcare facilities inspection/regulation in all 50 U.S. state HDs, clustered by HD and randomized into two study groups. In November–December 2019, we sent biweekly e-mails containing links to a website summarizing evidence on abortion facility regulation. E-mails/headers sent to one group emphasized public health values and did not include the word abortion; e-mails/headers to the other group used the word abortion. Primary outcome measures were e-mail open rates and click-through rates. Among 221 participants to whom e-mails were deliverable, the overall open rate was 36%. Open rate was 25% for PH values and 46% for abortion groups (p <.05). Effects were moderated by state abortion policy environment: in both supportive and restrictive environments, participants in the abortion messaging group were statistically more likely to open e-mails than those in the PH values group. There was no difference between groups in states with middle-ground abortion policy environments. Among participants opening at least one e-mail, 19% clicked through to the website, with no significant difference by group. This study demonstrates that repeated targeted e-mail campaigns can reach HD professionals with research summaries. Concerns that communications to HDs should avoid the word abortion are unsupported. [ABSTRACT FROM AUTHOR]

Forty-five years ago, the first author of this paper surveyed the US medical schools to determine their offerings on EOL (End-of-Life) issues. The results showed limited exposure for medical school students to learn about dying and death, thus their "learning" was apparently on-the-job training. The EOL offerings were so limited that the American Association of Medical Colleges (AAMC), following the 1975 publication from the survey, contacted the first author to inquire about death and dying in the curricula of their medical schools. Apparently, it was so insignificant that the AAMC did not have such information. Palliative medicine, geriatric medicine, and hospice were then in the "birthing" process, a mere blur on the horizon. Today, as in 1975, it is likely that most medical students have personally had minimal experience with death and that for many entering students, other than on television, the cadaver is their first sight of a dead person. The objective of this research is a longitudinal study at five-year intervals since 1975 reporting on EOL education in US medical schools. The total number of medical schools has increased from 113 in 1975 to 150 in 2020. The current study surveyed medical schools electronically and via postal services with a response rate of 37%. Findings from the survey over time revealed significant inclusion of death and dying and palliative medicine as well as geriatrics and hospice. Gross anatomy has evolved from strictly hands-on to integrating 3D/virtual models, a change not without controversy. A noticeable difference in emphasis is obvious as care now plays a more significant role in medical training than previously, thus making modern medicine not only about cure, but more about care than was previously emphasized. Communication with dying patients and families, analgesics for chronic pain, and advance directives all are covered in over 90% of schools today. The current emphasis on EOL care, not just disease management, is increasing and puts more of a human face on modern medicine. [ABSTRACT FROM AUTHOR]

Arts-based training programs can aid in building observational skills, communication, team building, and leadership through targeted analysis of works of art. Furthermore, arts-based training programs are unique in that they highlight non-technical skills (NTS). The goal of this study was to investigate the extent to which NTS were developed through an arts-based training program among entry-level occupational therapy doctorate (OTD) students. This study used a mixed methodological approach to analyze retrospective data. Quantitative analysis of the Kentucky Inventory of Mindfulness Skills (KIMS) assessment was conducted. Qualitative analysis was completed through analysis of the participants’ reflection papers. Quantitative results (n = 69) from the KIMS show significance (p = 0.011; 0.013), and qualitative analysis (n = 32) resulted in five central themes: evolution of thinking, holistic approach, diverse perspective, lived reality of context, and development of NTS (collaboration, self-awareness, mindful of others, creativity, and effective communication). Quantitative and qualitative findings suggest arts-based training programs can improve students’ ability to reduce their bias through implementation of a mindfulness lens. Results and recommendations from this study can be used as an example for occupational therapy academic programs to implement an evidence-based teaching methodology. [ABSTRACT FROM AUTHOR]

Reports on the 'Conference in Communication' held September 1978, which aimed at providing undergraduate students in speech communication an opportunity to experience an event similar to the regional and national speech communication conventions. Purpose behind the provision of such experience to students; Models adopted for the conference; Steps required for maintaining the efficiency of the actual conference.

Purpose: Karen people from Burma are a new population in resettlement countries. While research increasingly documents their health needs, few studies describe how health-care providers adapt their practices to serve this group. The purpose of this study was to explore the experiences of providers who work with Karen patients/clients in health settings, documenting the challenges they face, how they adapt their practice and recommendations. Design/methodology/approach: This study used a qualitative survey and one phone interview with a total of 20 providers who had first-hand experience caring for Karen people in health settings. Data were analyzed using qualitative content analysis. Findings: Two main categories described challenges providers faced in working with Karen people in health settings: system-level challenges and interpersonal communication challenges. Five main categories described specific strategies and support needed to adapt practice for Karen patients in health settings: strategies for improving communication and mutual understanding; partnering with Karen staff, interpreters and cultural brokers; strategies for building trust and rapport; addressing needs related to case management, care coordination and social determinants of health; recommendations for provider training. Originality/value: This paper contributes suggestions for adapting practice to meet the health needs of Karen people from the perspective of health-care providers in a location that is nationally recognized for its excellence in refugee health. [ABSTRACT FROM AUTHOR]

The sudden termination of nearly 40% of U.S. WIL experiences during the summer of 2020 caused employers to quickly adapt to virtual WIL experiences. What employers learned from these adjustments to their traditional WIL practices and perceptions of the advantages and disadvantages of virtual experiences form the basis of this paper. Over 350 employers provided comments to a special set of questions pertaining to virtual WIL experiences in their organizations. A strong virtual experience required constant communicate, set schedules, structured workflow, and prepared supervisors to handle remote student employees. The advantages included more innovative practices, safe experiences, and cost savings for both students and the organization. Virtual experiences present challenges, including organizational enculturation, loss of serendipitous connections, and inability to provide hands-on learning opportunities. For virtual experiences to play a more prominent role, issues around tacit knowledge acquisition, trust building, serendipity, and mentoring need to be addressed. [ABSTRACT FROM AUTHOR]

Objectives: Using Google online reviews, this study investigated why patients were satisfied or dissatisfied with their public dental clinic in Victoria, Australia. Methods: This mixed methods study gathered Google reviews published by users pre-March, 2021. The reviews were coded and subthemes and major themes were identified. The most common reasons why patients gave reviews were tabulated and stratified according to star rating, remoteness and accessibility index classification, and socio-economic status. Results: Of the 522 reviews included in this study, in 317 (60.7%) satisfaction was expressed. Compliments and complaints were documented. A total of 53 subthemes were identified. Major themes included Treatment, Staff, Communication and Professionalism, Patient Factors and Non-Clinical Reasons. From the reviews, more patients were satisfied with general unspecified treatment (n = 195; 14.7%) and dissatisfied with reception staff (n = 64; 4.8%). More reviews were generated by patients who visited clinics in major cities and lower socio-economic areas. Conclusion: This study found that most patients expressed satisfaction and identified reasons why patients were satisfied or dissatisfied. Consumer feedback, including compliments and complaints, is an integral aspect of monitoring and improving health service quality. It is important to continue seeking feedback and improve accordingly. What is known about the topic? Research has identified common factors for patient satisfaction or dissatisfaction with dental clinics including: facilities and location, waiting list time, cost, gentleness during procedures, communication, and staffing. What does this paper add? This study identified causes of patient satisfaction and dissatisfaction with Victorian public dental clinics. The focus is on the Victorian public dental system because almost half of the eligible population for public dental services are not utilising them. What are the implications for practitioners? Practitioners can use this study to self-reflect and improve the quality of health service delivery. [ABSTRACT FROM AUTHOR]

This paper seeks to contribute to the ongoing policy debate about mandated posting of health department hygiene ratings for establishments that sell food. Posted restaurant hygiene ratings, or 'scores on doors,' exemplify a public health transparency policy in the form of words, letters, numbers, or symbols displayed at entrances to food-serving establishments summarizing their most recent health inspection. After describing the scope of restaurant hygiene inspections and the problem of foodborne illness, this paper critically examines the 'mandation' debate on economic, practical, ethical, and legal aspects. It concludes that mandated posting of hygiene ratings, if done properly, is a potentially effective public policy that fosters transparency, population health, and informed consumer choice. [ABSTRACT FROM AUTHOR]

Information and communication technology for development (ICT4D) research sporadically leverages information science scholarship. Our qualitative study employs the "information grounds" (IG) lens to investigate the consequences of information exchanges by pregnant women on Facebook, who are vulnerable in the doctor‐centric birth culture in rural America. The thematic analysis of in‐depth interviews with members and administrators of the Vaginal Birth After Cesarean (VBAC) group shows that positive consequences outweigh negative consequences of information exchanges and lead to the following progression of outcomes: (a) VBAC group as an information ground, (b) social capital (e.g., cognitive, structural, and relational capital) built on the information ground, (c) seven emergent properties of the information ground, and (d) value co‐created (e.g., local, affordable, timely, enduring, and reliable support) by VBAC group members. The IG lens reveals the following roles of Facebook, an ICT, in development: (a) a linker that lets people with similar needs and interests convene and shapes their interactions, (b) a prerequisite to building an online, "third place" for social interactions, and (c) an apparatus for ubiquitously seeking, searching, sharing, and storing information in multiple formats and controlling its flow on the VBAC group. This paper fills in six gaps in the ICT4D research. [ABSTRACT FROM AUTHOR]

Exposure to intimate partner violence (IPV) during early childhood is associated with self-regulation difficulties. Caregivers can facilitate children's self-regulation through emotion-focused conversations about past experiences, buffering downstream effects. However, caregivers experiencing violence may avoid distressing emotions activated by such conversations. This paper explores two different models of relational stress responses, one involving indirect effects (i.e. spillover effects) and the other moderation (i.e. buffering effects). Mothers (n = 117), oversampled for violence exposure, self-reported on IPV and participated in an emotional reminiscing task with children (aged 3–5 years); narratives were coded for maternal sensitive guidance. Maternal sensitive guidance was related to children's self-regulation. Sensitive guidance did not have indirect effects in the association between IPV exposure and children's self-regulation, but did buffer the association between physical IPV and self-regulation; this pattern did not hold for psychological IPV. Results suggest sensitive guidance during reminiscing may promote self-regulation in contexts of high IPV. [ABSTRACT FROM AUTHOR]

This paper analyzes how Trump uses metadiscourse as a strategy for denying accusations of racism. We conduct a discourse analysis of press event interactions where Trump denies journalists' accusations of racism or where Trump himself voices others' accusations of racism and then denies these accusations. Analysis of 8 excerpts illustrates how Trump a) uses metadiscourse to reframe his own talk as "accurate" instead of "racist," b) uses "fake news" as humor to delegitimize media and display amicable relationships with his African American supporters and c) labels questions from journalists who ask about his racist actions as "racist" or "nasty." These metadiscursive strategies reproduce racist ideologies that position Trump as well intentioned, not racist, and thus not blame-worthy for racist actions and those who question Trump as unreasonable and sometimes, racist themselves. Thus, Trump uses his authority to control definitions of what counts as racism and is able to perpetuate racism while attempting to maintain a "not-racist" identity. Overall, we highlight how close analysis of forms of metadiscourse as used in particular interactional and relational contexts is consequential for understanding ways that racism is justified and maintained more broadly. [ABSTRACT FROM AUTHOR]

The vulnerability of deafblind people is considered axiomatic; they are seen not only as a vulnerable group but also as one of the most vulnerable. This paper aims to synthesise existing knowledge to determine what is known about such vulnerability. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. An approach based on a 'hierarchy of evidence' would have reduced the amount of literature reviewed significantly, to the point where synthesis would not be possible. Included material was appraised and an interpretative rather than aggregative approach to synthesis adopted. Drawing on principles of critical interpretive synthesis, rather than being a determiner of whether material should be included or excluded, a critique of the literature is offered within the synthesis. Twenty-eight references were identified for inclusion, originating from the UK, USA, Australia, Continental Europe and the Nordic Countries. No empirical studies specifically examining the experience of vulnerability of deafblind people were found. However, deafblind people describe feelings of vulnerability in studies exploring their experiences more generally, and in personal accounts of living with the impairment. Literature produced by practitioners and specialist organisations also explores the topic. Deafblind people are identified as a population 'at risk' of various adverse outcomes, particularly when compared to the non-deafblind majority, and deafblind people describe being and feeling vulnerable in various situations. The literature largely relates to negative outcomes and includes significantly less exploration of positive risk taking, coping capacity and resilience. Deafblind people do not appear to describe themselves as being vulnerable as a permanent state, suggesting a need for greater exploration of the experience among all sections of this heterogeneous population, with consideration of the concepts of resilience and coping capacity. [ABSTRACT FROM AUTHOR]

Rationale: Little is known about vulnerable patients' perceptions and understanding of, and preferences for, lung cancer screening decision aids.Objectives: To determine, in a low-income, racially diverse population, (1) participants' experience, preferences, and reactions to web-based and paper decision aids, and (2) their understanding of harms and benefits of lung cancer screening.Methods: We enrolled outpatients at an urban county hospital in six focus group discussions that included review of a web-based and a paper-based lung-cancer screening decision aid. Participants completed surveys before and after the focus groups.Measurements and Main Results: Forty-five patients participated (mean age, 61 yr; 76% current smokers; 24% former smokers); 27% had not completed high school; 50% had an annual income not exceeding $15,000; 42% were nonwhite; and 96% reported chronic illness requiring at least three health care visits yearly. Comparing the proportion with correct answers on pre- and postsurveys, participants' understanding of lung cancer screening increased, particularly of the harms of screening including the potential for false positives, extra testing, and complications. However, after conclusion of the focus groups, more than 50% believed that screening lowered the chance of getting lung cancer. Five major themes emerged from qualitative analyses. Participants (1) were not aware of the purpose of lung cancer screening; (2) wanted to know about the benefits and harms; (3) believed physicians need to communicate more effectively; (4) found decision aids helpful and influential for decision-making about screening; and (5) wanted the discussion to be personalized and tailored. Participants expressed surprise that the magnitude of their lung cancer risk and benefits of screening were lower than anticipated.Conclusions: Vulnerable patients find lung cancer screening decision aids helpful and generally show increased knowledge after reviewing decision aids, particularly of harms. Our results can inform future implementation efforts. [ABSTRACT FROM AUTHOR]

Online platforms can support health and educational professionals in their daily work; however, it is challenging to keep online platforms sustainable. This paper aims to indicate the most important factors of platform sustainability from the perspective of professionals involved in online platforms. Further, it aims to understand how these factors operate. A mixed methods study was carried out among professionals from Europe, Australia, the USA and Canada. In the first phase, the importance of 54 factors from the literature was assessed with a questionnaire among 17 professionals. The relative importance of the factors and the consensus regarding this importance were calculated using median scores and interquartile deviations. In total, 19 factors were selected representing general characteristics, characteristics related to the platform, communication, visitor and context. In the second phase, insight was gained regarding the experiences with those factors through 12 individual Skype interviews. The most frequently mentioned important factors of platform sustainability were (i) having sufficient time, resources and expertise, (ii) user friendliness and (iii) creating a sense of belonging. Platforms should use a planned approach to address a combination of factors directly from platform development. Gaining long-term resources is challenging and should be considered from the start of a project by building partnerships. To promote user friendliness, platforms should be simple, have a clear set-up and provide high-quality tools. Finally, establishing a sense of belonging could be supported by branding and face-to-face networking activities. For all aspects, involving visitors and stakeholders is essential. [ABSTRACT FROM AUTHOR]