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This paper investigates the potential of the Gamified Metaverse as a platform for promoting library services. The study compares the effectiveness of a traditional library program with a Metaverse- based library program in terms of knowledge acquisition and library anxiety. The research also examines students' perceptions of implementing gamification within the context of the Gamified Metaverse platform. A mixed-methods approach was adopted, including pre- and post-test analysis, statistical analysis, and qualitative data collection. The results indicate that both the traditional and Metaverse-based library programs effectively increased the participants' knowledge, with no significant difference between the two approaches. However, the Metaverse-based program was found to be less effective in facilitating interaction with librarians and reducing library anxiety. Additionally, students expressed positive perceptions of implementing gamification in the Gamified Metaverse platform, finding it engaging and motivating. These findings contribute to the understanding of the effect of the Metaverse as a tool for promoting library services and enhancing knowledge acquisition. However, it is not as effective in reducing library anxiety, particularly in terms of interaction with librarians and staff. It should be noted that the platform may have limitations such as high costs and potential side effects of virtual reality, making it more suitable as an additional tool for promoting library services, taking into account its feasibility and potential benefits for specific student populations and larger libraries. [ABSTRACT FROM AUTHOR]

Background: Despite research that has shown that the presence of support persons during maternity care is associated with more respectful care, support persons are frequently excluded due to facility practices or negative attitudes of providers. Little quantitative research has examined how integrating support persons in maternity care has implications for the quality of care received by women, a potential pathway for improving maternal and neonatal health outcomes. This study aimed to investigate how integrating support persons in maternity care is associated with multiple dimensions of the quality of maternity care. Methods: We used facility-based cross-sectional survey data from women (n = 1,138) who gave birth at six high-volume facilities in Nairobi and Kiambu counties in Kenya and their support persons (n = 606) present during the immediate postpartum period. Integration was measured by the Person-Centered Integration of Support Persons (PC-ISP) items. We investigated quality of care outcomes including person-centered care outcomes (i.e., Person-Centered Maternity Care (PCMC) and Satisfaction with care) and clinical outcomes (i.e., Implementation of WHO-recommended clinical practices). We used fractional regression with robust standard errors to estimate associations between PC-ISP and care outcomes. Results: Compared to low integration, high integration (≥four woman-reported PC-ISP experiences vs. <4) was associated with multiple dimensions of quality care: 3.71%-point (95% CI: 2.95%, 4.46%) higher PCMC scores, 2.76%-point higher (95% CI: 1.86%, 3.65%) satisfaction with care scores, and 4.43%-point (95% CI: 3.52%, 5.34%) higher key clinical practices, controlling for covariates. PC-ISP indicators related to communication with providers showed stronger associations with quality of care compared to other PC-ISP sub-constructs. Some support person-reported PC-ISP experiences were positively associated with women's satisfaction and key practices. Conclusions: Integrating support persons, as key advocates for women, is important for respectful maternity care. Practices to better integrate support persons, especially improving communication between support persons with providers, can potentially improve the person-centered and clinical quality of maternity care in Kenya and other low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Retaining participants in randomised controlled trials (RCTs) is challenging and trial teams are often required to use strategies to ensure retention or improve it. Other than monetary incentives, there is no requirement to disclose the use of retention strategies to the participant. Additionally, not all retention strategies are developed at the planning stage, i.e. post-funding during protocol development, but some protocols include strategies for participant retention as retention is considered and planned for early in the trial planning stage. It is yet unknown if these plans are communicated in the corresponding participant information leaflets (PILs). The purpose of our study was to determine if PILs communicate plans to promote participant retention and, if so, are these outlined in the corresponding trial protocol. Methods: Ninety-two adult PILs and their 90 corresponding protocols from Clinical Trial Units (CTUs) in the UK were analysed. Directed (deductive) content analysis was used to analyse the participant retention text from the PILs. Data were presented using a narrative summary and frequencies where appropriate. Results: Plans to promote participant retention were communicated in 81.5% (n = 75/92) of PILs. Fifty-seven percent (n = 43/75) of PILs communicated plans to use "combined strategies" to promote participant retention. The most common individual retention strategy was telling the participants that data collection for the trial would be scheduled during routine care visits (16%; n = 12/75 PILs). The importance of retention and the impact that missing or deleted data (deleting data collected prior to withdrawal) has on the ability to answer the research question were explained in 6.5% (n = 6/92) and 5.4% (n = 5/92) of PILs respectively. Out of the 59 PILs and 58 matching protocols that both communicated plans to use strategies to promote participant retention, 18.6% (n = 11/59) communicated the same information, the remaining 81.4% (n = 48/59) of PILs either only partially communicated (45.8%; n = 27/59) the same information or did not communicate the same information (35.6%; n = 21/59) as the protocol with regard to the retention strategy(ies). Conclusion: Retention strategies are frequently communicated to potential trial participants in PILs; however, the information provided often differs from the content in the corresponding protocol. Participant retention considerations are best done at the planning stage of the trial and we encourage trial teams to be consistent in the communication of these strategies in both the protocol and PIL. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether the surgical process information sharing system could alleviate the parental anxiety during a pediatric selective operation. Design: Randomized controlled trial. Methods: A questionnaire survey was conducted one day before surgery for the enrolled participants. Family members assigned to the intervention group received real-time process information sharing through service reminders during the surgical period, while the control group received standard perioperative education. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality during the perioperative period, and the State of Cohesion-13 Scale (SOC-13) and Self-rating Anxiety Scale (SAS) were used to assess anxiety levels. Satisfaction levels during the perioperative period were assessed through a follow-up survey conducted one day after surgery. Results: The intervention group showed better scores in terms of PSQI, SOC-13, SAS, and postoperative satisfaction levels at various time points compared to the control group, with statistically significant differences observed (P < 0.05). Conclusion: Real-time process information sharing is effective in reducing perioperative sleep disorders and anxiety among family members of pediatric patients, as well as improving satisfaction levels. This approach not only establishes a process and mechanism for effective doctor-patient communication but also helps implement continuous perioperative care, thereby optimizing internet healthcare services. [ABSTRACT FROM AUTHOR]

Background: The intensive care unit presents structural complexities, and the prevailing power imbalance between patients and staff can lead to health disparities. Hence, unveiling the underlying factors that give rise to and reinforce these disparities can contribute to their prevention. This study aims to shed light on the stereotypes linked to ageism and lookism, which perpetuate health disparities within the intensive care unit setting in Iran. Methods: This critical ethnographic study employed Carsepkan's approach and was carried out in intensive care units in the west of Iran from 2022 to 2023. The data collection and analysis were conducted through three interconnected stages. In the initial stage, more than 300 h of observations were made at the research site. In the subsequent stage, a horizon analysis was performed. Conversations with 14 informants were conducted in the final stage to enrich the dataset further. Then the analysis process was carried out as in the previous step to uncover an implicit culture of health disparity. To verify the validity and reliability of the study, credibility, conformability, dependability, and transferability were all taken into account. Findings: The ageism and lookism stereotypes emerged from seven main themes; youth-centric; negative ageism; age-friendliness; age-related priority; centered care for pediatric patients and families; appearance-centeredness; and a contradiction between belief and behavior. Conclusion: This critical study showed that ageism and lookism stereotypes permeated the intensive care unit's culture. These stereotypes have the potential to influence equality dynamics, as well as to foster and support health disparity in the intensive care unit. [ABSTRACT FROM AUTHOR]

Simple Summary: Family communication in the cancer context has gained attention as a crucial factor related to the quality of life of children and adolescents. The aim of this review was to examine therapeutic parent–child communication and its impact on health outcomes in children and adolescents with cancer. This review identified an emerging body of evidence that therapeutic parent–child communication contributes to better psychological health outcomes at both the individual and family levels in the childhood cancer context. A comprehensive understanding of the impact of family communication may provide knowledge for developing interventions to improve family communication and health outcomes. Family communication has been thought to be an important area to support children's adjustment to a cancer diagnosis. However, the characteristics of therapeutic parent–child communication that contribute to better patient outcomes and the specific patient health outcomes have been less explored. This current review explored the characteristics of therapeutic parent–child communication and its physical and psychological health outcomes. A total of 5034 articles were initially identified, and only 10 articles remained for inclusion in this review after application of the exclusion criteria. Most studies used a cross-sectional design and measured verbal communication characteristics and its psychological outcomes, but no physical outcomes. The characteristics of therapeutic verbal communication (openness, maternal validation, quality of information shared, etc.) and nonverbal communication (eye contact, close physical distance, and acknowledging behaviors) were identified. The psychological health outcomes included less distress, a lower level of PTSS, less internalizing and externalizing of symptoms, increased levels of social emotional competencies, better peer relationships, and more cooperation during the procedure at the individual level. Increased family cohesion and family adaptation were family-level outcomes. Longitudinal studies are needed to identify what qualities of communication predict better psychological outcomes so that interventions can be developed and tested. In addition, physical outcomes should be evaluated. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the importance of using patient and public involvement (PPI) in doctoral and dementia research • To become aware of the opportunities and challenges associated with including patients with dementia in PPI advisory groups • To gain insight into the practicalities of establishing PPI. Background: There is increasing recognition of the need to include patients and the public in the research process. There is extensive literature about patient and public involvement (PPI) in research, but fewer articles report on PPI in doctoral research. Aim: To reflect on establishing an advisory group for a doctoral study, exploring the opportunities and challenges associated with including patients with dementia in the research process. Discussion: The authors discuss the practicalities of establishing an advisory group, the challenges of being a novice researcher, long-term commitment to PPI, the overall approach to PPI and ethical considerations. Conclusion: Establishing an advisory group for a doctoral study can facilitate mutual learning and enhance the study’s quality. Implications for practice: Achieving high-quality PPI in health and social care research can ultimately improve its quality and relevance. An important aspect of the doctoral journey is developing knowledge and skills to facilitate PPI as part of a researcher’s apprenticeship. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to clarify the concept of pediatric hospice and palliative care through conceptual analysis. It also sought to identify the differences between related concepts such as pediatric death care and pediatric spiritual care, in order to provide foundational data for the development of nursing theory and knowledge. Methods: A conceptual analysis of pediatric hospice and palliative care was conducted using Rodgers’ evolutionary method. Out of 5,013 papers identified, 28 were selected for detailed reading and analysis. Results: Pediatric hospice and palliative care encompasses physical, psychological, social, mental, spiritual, and family care for children with acute and chronic diseases with uncertain prognoses ahead of death, as well as their families. Effective pediatric hospice and palliative care will require multidisciplinary team nursing, effective communication, and supportive policies. Conclusion: The findings of this study suggest that providing pediatric hospice and palliative care will lead to improvements in pain relief for children and families, the efficiency of responses to death in children, and the quality of life for children and families. The significance of this study is that it clearly clarifies the concept by analyzing pediatric hospice and palliative care using an evolutionary method. [ABSTRACT FROM AUTHOR]

In February 2022, the Food, Pools, and Lodging Services Section at the Minnesota Department of Health sent out a 29-question, anonymous electronic survey to food workers across Minnesota. The goals of the survey were to 1) identify the most e. ective methods for distributing food safety information to operators; 2) understand operator behaviors pertaining to illness reporting and other Minnesota-specifi c code requirements; and 3) understand how operators view health department inspections, their perceptions of the inspection process, and interactions with their inspector. A total of 1,535 food workers participated in the survey. The feedback and fi ndings from the survey will be used to inform how the Minnesota Department of Health conducts future training and outreach and will help identify gaps in food safety training. [ABSTRACT FROM AUTHOR]

Introduction: Psoriatic arthritis (PsA) is a complex, progressive, and often debilitating disease. Despite recent advances in treatment, numerous unmet needs in patient care persist. Rheumacensus is a multistakeholder, pan-European initiative designed to identify ways to elevate the standard of care (SoC) and treatment ambition for patients with PsA, using the perspectives of three key stakeholder groups: patients, healthcare professionals (HCPs) and payors. Methods: Rheumacensus followed three phases: an insights-gathering workshop to identify current unmet needs in PsA and an area of focus for the project, a modified Delphi process to gain consensus on improvements within the agreed area of focus, and a Consensus Council (CC) meeting which used consensus statements as inspiration to generate 'Calls to Action' (CTA)—practical measures which, if implemented, could elevate the SoC for patients with PsA. Results: The Rheumacensus CC consisted of four patient representatives, four HCPs and four payors. All 12 members completed all three Delphi e-consultations. The shared area of focus that informed the Delphi process was "patient empowerment through education on the disease and treatment options available, to enable patient involvement in management". Four key themes emerged from the Delphi process: patient empowerment, patient knowledge and sources of education, patient–HCP consultations, and optimal initial treatment. Statements within these themes informed 12 overarching CTA, which focus on the need for a multistakeholder approach to implementing a paradigm shift towards patient-centred care and improved outcomes for patients with PsA. Conclusion: Rheumacensus has identified shortcomings in the current SoC for patients with PsA and provides a foundation for change through practical CTA. It is hoped that all stakeholders will now take practical steps towards implementing these CTA across Europe to elevate the SoC for patients with PsA. Plain Language Summary: Inequalities in the care patients with psoriatic arthritis (PsA) receive can be mainly explained by poorly coordinated management due to a lack of disease and treatment knowledge. This report is about a programme called Rheumacensus which has the overall aim of improving the standard of care (SoC) for patients with PsA. Rheumacensus brings together the points of view of three key groups involved in the care of people with PsA: patients, payors and healthcare professionals (HCPs) from across Europe. Together, these three groups agreed to focus on patient empowerment through education on the disease and treatment options as a way to raise the SoC. Through a series of exercises—to agree on the current SoC and what needs to be improved—and group discussions, four themes were established which were used by the groups to help them suggest 'Calls to action' (CTA). The CTAs were ideas of how improvements could be made or what needs to be done to improve the care patients receive. The four themes were (1) patient empowerment, (2) patient knowledge, (3) patient–HCP consultation and (4) optimal initial treatment. In total, 12 CTAs were developed across these themes that provide direction and practical next steps which patients, payors and HCPs could take to drive change and make a real difference to patients by improving their care. [ABSTRACT FROM AUTHOR]

This study introduces the concept of pandemic safety climate (SC), employees' perceptions of an organization's policies, procedures and practices aiming to deal with the COVID‐19 pandemic. Based on the theory of planned behaviour, we expected that the pandemic SC would be the base of employees' subjective norms, attitudes and perceived control in dealing with the COVID‐19 pandemic‐related challenges. We hypothesized that pandemic SC would be associated with a series of attitudinal and behavioural criteria that aim to prevent the spread of COVID‐19 as well as promote other health and well‐being outcomes. Using both prospective and cross‐sectional datasets, we developed and validated a measure of pandemic SC which consisted of two scales. Organization pandemic SC refers to the employees' perceptions of the strategies and efforts at the organization level and consists of four dimensions: management commitment and proactivity, workplace flexibility and capacity, equipment and sanitization for COVID‐19 prevention and COVID‐19‐related communication and training programmes. Group pandemic SC refers to the employees' perceptions of the intermediate support and care from supervisors and consists of three dimensions: supervisor commitment and proactivity, safety monitoring and COVID‐19‐related supervisory communication. Construct validity and criterion‐related validity were supported. Theoretical and practical implications of the newly developed pandemic SC scales are discussed. [ABSTRACT FROM AUTHOR]

Background: Nursing presence depends on an individual's belief system, truths, sensory experience, professional skills, and active listening. Thus, one may assume that presence occurs when nurses care for patients in a kind and compassionate way. This study aimed to explore and describe presence practices amongst unit managers in a selected provincial hospital in Free State Province. Methods: A qualitative research approach with an exploratory descriptive contextual research design was employed in this study. A purposive nonprobability sampling technique was utilised to select participants. Data were collected through semi-structured interviews and analysed using the six steps of thematic qualitative data analysis. The study's trustworthiness was ensured through ascertaining credibility, dependability, confirmability, transferability, and authenticity. Approval to conduct the study was obtained from the North-West University Health Research Ethics Committee (NWU-HREC), DoH in the Free State Province, and the CEO (the gatekeeper) of the selected hospital. Results: Four themes were generated, namely, presence practices amongst unit managers in a selected provincial hospital in Free State, the impact of presence practices on hospital dynamics in a selected provincial hospital in Free State, unit managers' practices of relational care and human connectedness in the unit, and the perceptions of unit managers on barriers to presence practices in a selected provincial hospital in Free State. Each of these themes presents categories and sub-categories. Unit managers actively foster supportive work cultures, effective management, human connectedness and relational care, and effective communication to yield team cohesion and positive impacts on patient care. Unit managers also display resilience and highlight the need for ongoing support from colleagues and top management. Conclusion: Unit managers exhibit diverse presence practices which emphasise their commitment through visibility and accessibility despite staff shortages and resource constraints. [ABSTRACT FROM AUTHOR]

Background: Personalised Care and Support Planning (PCSP) replaces conventional annual reviews for people with long-term conditions. It is designed to help healthcare professionals (HCPs) and patients engage in conversations as equals and collaboratively plan actions oriented to each patient's priorities, alongside biomedical concerns. Little is known about how the shift to remote consulting initiated with COVID-19 restrictions has impacted PCSP. Aim: To investigate HCPs' experiences of conducting PCSP conversations remotely and consider implications for the fulfilment of PCSP ambitions as remote consulting continues beyond COVID-19 restrictions. Methods: 19 semi-structured interviews with HCPs in England and Scotland; interpretive analysis. Results: HCPs' accounts made clear that COVID-19 restrictions impacted multiple aspects of PCSP delivery, not just the mode of conversation. Broader disruption to general practice systems for gathering and sharing information ahead of PCSP conversations, and moves to 'wide window' appointment times, made it harder for patients to be prepared for PCSP conversations. This constrained scope to achieve PCSP ambitions even with the best professional communication skills. Most remote PCSP conversations were conducted by telephone. In the absence of visual communication with patients, it was sometimes harder to achieve the ambitions of PCSP conversations, including to balance patient and professional agendas, fulfil key planning activities, and foster a relational ethos of equal, collaborative partnership. The challenges were particularly severe when working with new patients and people with complex clinical and social problems. Although options for telephone appointments now offer valued flexibility, sustained experience of struggling to achieve PCSP ambitions via remote consulting led some HCPs to lower their standards for judging a "good" PCSP conversation, and to diminished professional satisfaction. Conclusions: There are significant challenges to fulfilling the ambitions of PCSP via telephone, especially when preparatory support is limited. This study provides grounds for scepticism about how compatible telephone appointments can be with this person-centred model of working, especially for people who are socially disadvantaged and live with complex health conditions. These threats to the provision of person-centred support for people with long-term conditions warrant careful attention going forward if the PCSP model and its benefits are to be sustained. [ABSTRACT FROM AUTHOR]

Background: Person-centred medicine is recommended in the care of older patients. Yet, involvement of care home residents and relatives in medication processes remains limited in routine care. Therefore, we aimed to develop a complex intervention focusing on resident and relative involvement and interprofessional communication to support person-centred medicine in the care home setting. Methods: The development took place from October 2021 to March 2022 in the Municipality of Aarhus, Denmark. The study followed the Medical Research Council guidance on complex intervention development using a combination of theoretical, evidence-based, and partnership approaches. The patient involvement tool, the PREparation of Patients for Active Involvement in medication Review (PREPAIR), was included in a preliminary intervention model. Study activities included developing programme theory, engaging stakeholders, and exploring key uncertainties through interviews, co-producing workshops, and testing with end-users to develop the intervention and an implementation strategy. The Consolidated Framework for Implementation Research and the Interprofessional Shared Decision Making Model were used. Data were analysed using a rapid analysis approach. Results: Before the workshops, six residents and four relatives were interviewed. Based on their feedback, PREPAIR was modified to the PREPAIR care home to fit the care home population. In total, ten persons participated in the co-producing workshops, including health care professionals and municipal managerial and quality improvement staff. The developed intervention prototype was tested for three residents and subsequently refined to the final intervention, including two fixed components (PREPAIR care home and an interprofessional medication communication template) delivered in a flexible three-stage workflow. Additionally, a multi-component implementation strategy was formed. In line with the developed programme theory, the intervention supported health care professionals´ awareness about resident and relative involvement. It provided a structure for involvement, empowered the residents to speak, and brought new insights through dialogue, thereby supporting involvement in medication-related decisions. The final intervention was perceived to be relevant, acceptable, and feasible in the care home setting. Conclusion: Our results indicate that the final intervention may be a viable approach to facilitate person-centred medicine through resident and relative involvement. This will be further explored in a planned feasibility study. [ABSTRACT FROM AUTHOR]

Background: Chronic disease (CD) accounts for more than half of the overall global disease burden and physical activity (PA) is an established evidence-based strategy for the prevention and management of CD. Global policy emphasises the value of embedding PA into primary healthcare, highlighting the positive effects on PA behaviour. However, there is limited implementation of PA protocols in primary care, and research is needed to guide its integration into routine practice. The voice of the patient is underrepresented in the literature, resulting in the absence of critical insights into determinants of PA promotion in primary care. The purpose of the research was to identify the perspectives of people at risk of or living with CD on the determinants of PA promotion in primary care and to map these determinants across the six COM-B constructs. Methods: Semi-structured interviews (n = 22), guided by the COM-B model were conducted with people aged 35–60 years, at risk of or living with CD and not meeting the PA guidelines. A hybrid analytic approach of thematic inductive and deductive analysis was applied to the participant transcripts guided by a COM-B informed coding framework. Results: In total, 37 determinants across constructs related to capability, opportunity and motivation were prominent, examples include; physical capability constraints, the conflation of exercise with weight management, credibility of the health services in PA advice, communication styles in PA promotion, expectations of tailored support for PA, social support, accessibility, and integration of PA into routine habits. Conclusion: Exploring the determinants of PA promotion through the lens of the COM-B model facilitated a systematic approach to understanding the primary care user perspective of the healthcare professional (HCP) broaching the topic of PA. Findings emphasise the value of HCPs being supported to broach the issue of PA in a therapeutic and patient-centred manner using diverse and flexible approaches, while highlighting the importance of tailored, accessible PA opportunities that build self-efficacy and foster social support. The research provides valuable learnings to support PA promotion and the development of strategies in primary care through encompassing the perspective of those living with or at risk of CD. [ABSTRACT FROM AUTHOR]

Background: Social media are immensely popular among adolescents. Thus, concerns have been raised about the threats adolescents encounter on social media and the possible negative health consequences, such as depressive symptoms and anxiety. This study investigated the prevalence of nine social media threats: (1) cyberbullying, (2) sexual harassment, (3) racism, (4) unauthorized distribution of sensitive material, (5) phishing attempts, (6) misinformation, (7) the sale or distribution of drugs, (8) harmful or dangerous social media challenges, (9) content causing appearance pressures. The study also investigated how individual and social factors, problematic social media use (PSMU), and online communication with strangers are associated with social media threat exposure, as well as the association between social media threats and self-rated health, depressive feelings, and anxiety symptoms. Methods and findings: Nationally representative Health Behaviour in School-aged Children (HBSC) data from Finland were obtained from 2288 respondents aged 11, 13, and 15 years. Fixed effects regression models were applied. The most common threat, encountered daily and weekly, was misinformation. Regression models showed that individual and social factors, PSMU, and online communication with strangers explained adolescent exposure to social media threats in differing ways. Furthermore, certain factors (e.g., emotional intelligence, family support) were associated with encountering social media threats less frequently, whereas other factors (e.g., PSMU, online communication with strangers) were associated with more frequent encounters. Daily and weekly exposure to social media threats was systematically associated with poor self-rated health, frequent depressive feelings, and anxiety symptoms. Conclusions: Our study highlights the need for intervention and health promotion efforts to mitigate adolescent exposure to social media threats and ensuing negative health consequences. [ABSTRACT FROM AUTHOR]

Background: A growing share of male nurses in the nursing profession in Tanzania has changed the trend of diversity of nursing gender. This might have created a divergent perspective within the communities. Therefore, the current study aimed to explore the perspective, encounters, and choices of nursing gender among licensed nurses, non-nurse healthcare providers, and clients in Tanzania. Methods: The study employed a qualitative descriptive design. The data were collected between August 2022 to January 2023 by the principal investigator and one research assistant. Twelve Focus Group Discussions (FGDs) were carried out in four different hospitals in Dar es Salaam comprised of total participants (n = 59). The participants were nurses, clients, and non-nurse healthcare providers. The data was collected through an interview guide developed by the principal investigator and validated by nurse experts. The data was analyzed using qualitative content analysis to generate themes and subthemes. Results: Eight themes and twenty-seven subthemes emerged from the study. The following are themes; ① Variations of male and female nurses in communication ② Differences of male and female nurses in carrying out leadership roles ③ Divergent clinical qualities and outcomes across nursing gender ④ Positive value of male nurses in clinical facilities from colleagues and patients ⑤ Different cooperation of male and female nurses at the clinical settings ⑥ Mixed perspective towards clinical competencies across nursing gender ⑦ Perspective towards gender diversity in nursing ⑧ Preferences of nurse's gender, reasons, and opinion towards gender preferences. Conclusion: Male nurses and female nurses differ in how they communicate, execute leadership roles, and clinical qualities. However, their variations don't mean one gender is underrated than the other, but every gender has unique communication styles, leadership styles, and clinical qualities that both lead to effective outcomes. Diversity in nursing gender is very important and should be strategized. Since preferences of nursing gender seems to enhance somebody's freedom and creates an environment where a person can discuss sensitive issues, nursing bodies and healthcare stakeholders might initiate a discussion about approaches to promote the implementation of nursing preference and perform the feasibility studies. [ABSTRACT FROM AUTHOR]

Background: To overcome of patients with COVID-19 over the capacity of hospitals and mild to moderate severity of the disease in most cases, the World Health Organization and the Centers for Disease Control and Prevention in the United States, recommend home care for these patients. Receiving care at home will face challenges that can be context-based, especially in crises like the Coronavirus pandemic. The present study aimed to describe the experiences of patients with COVID-19 and their relatives from receiving professional home care nursing. Methods: This study was conducted using a qualitative content analysis method. Nine participants with COVID-19 who were receiving home care nursing in Semnan participated in this study. The purposive sampling method was used. Sampling continued until no new categories appeared, meaning the category's theoretical saturation. Deep and semi-structured interviews were used to collect data based on the research question. Data was analyzed using the conventional content analysis method using Graneheim and Lundman's approach. Results: After analyzing the interviews and comparing codes based on similarities and differences, three main themes, 11 categories, and 30 subcategories were identified. The main themes included "The value of home care" (personalization of care, being economical, providing intellectual security, and reducing the concern of family), "Comprehensive care" (professional commitment, empathy, mastery in care, and patronage), and "Care challenges" (cultural barriers, inadequate services, and lack of information about costs and conditions). Conclusion: The patients with COVID-19 who received professional nursing care at home mentioned some challenges, such as the caregiver not being of the same sex as the patient, delay in receiving the service, the inadequacy of the centers, the limitation of the right to choose the care provider, and insufficient information about the cost of services received before receiving each care. [ABSTRACT FROM AUTHOR]

Background: By incorporating socio-cognitive mindfulness which has been under-examined in the nursing field, this study investigated the relationships between socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance of nurses in long-term care hospitals. This study also examined the factors influencing nurses' dementia nursing performance. Methods: A cross-sectional study was conducted with 209 nurses from long-term care hospitals in Korea. Data were collected between August 1 and August 31, 2022. Participants completed the questionnaire assessing their socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance. Pearson's correlation and hierarchical multiple regression analysis were performed for data analysis. Results: Dementia nursing performance of the nurses in long-term care hospitals was positively related to their socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors. Furthermore, nurses' dementia communication behaviors, moral sensitivity, and total clinical career, in that order, were found to be the factors influencing their dementia nursing performance. Conclusion: The findings indicate that the higher socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors, the higher dementia nursing performance, and that higher dementia nursing performance is associated with better dementia communication behaviors, greater moral sensitivity, and more extensive clinical experiences. This study provides a foundation for developing effective interventions to enhance dementia nursing performance in the future. To improve dementia nursing performance of nurses in long-term care hospitals, it is necessary to improve dementia communication behaviors and moral sensitivity, and prepare multilateral countermeasures to maintain nurses' clinical careers. [ABSTRACT FROM AUTHOR]

Background: Values are broadly understood to have implications for how individuals make decisions and cope with serious illness stressors, yet it remains uncertain how patients and their family and friend caregivers discuss, reflect upon, and act on their values in the post-left ventricular assist device (LVAD) implantation context. This study aimed to explore the values elicitation experiences of patients with an LVAD in the post-implantation period. Methods: Qualitative descriptive study of LVAD recipients. Socio-demographics and patient resource use were analyzed using descriptive statistics and semi-structured interview data using thematic analysis. Adult (> 18 years) patients with an LVAD receiving care at an outpatient clinic in the Southeastern United States. Results: Interviewed patients (n = 27) were 30–76 years, 59% male, 67% non-Hispanic Black, 70% married/living with a partner, and 70% urban-dwelling. Three broad themes of patient values elicitation experiences emerged: 1) LVAD implantation prompts deep reflection about life and what is important, 2) patient values are communicated in various circumstances to convey personal goals and priorities to caregivers and clinicians, and 3) patients leverage their values for strength and guidance in navigating life post-LVAD implantation. LVAD implantation was an impactful experience often leading to reevaluation of patients' values; these values became instrumental to making health decisions and coping with stressors during the post-LVAD implantation period. Patient values arose within broad, informal exchanges and focused, decision-making conversations with their caregiver and the healthcare team. Conclusions: Clinicians should consider assessing the values of patients post-implantation to facilitate shared understanding of their goals/priorities and identify potential changes in their coping. [ABSTRACT FROM AUTHOR]

Background: Nursing homes and other long-term care services account for a disparate share of COVID-19 cases and casualties worldwide. During COVID-19 there is a distinct need to preserve a holistic view of the wellbeing of residents of nursing homes, be mindful of their rights as citizens, and to be aware of protecting residents from infection. The delivery of health and social care throughout a pandemic must remain person-centred and adhere to a human rights-based approach. Methods: This study aimed to capture nursing home residents, their families and staff's perspective of the nursing homes residents experience, approaches of staff and the nursing home environment. An online survey was distributed via stakeholder networks and online platforms across Ireland. This study was performed and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Results: 25 residents, 42 family members and 51 staff completed the survey (n = 118). Across the domains measured all but one aspect scored above 50% (residents get up and go to bed when they want 41.5%) with the highest score of 89.1% scored for the nursing home is comfortable and well-kept. Results highlight evidence of positive experiences and endeavours to preserve social connections, residents were in a safe place cared for by staff who did their best in a difficult position and who went above and beyond their duty of care. However, some families reported poor communication, no internet connections, not enough phones or tablets, and that staff were busy and unable at times to assist residents who needed help using phones/tablets. Conclusion: This study highlights the importance of human rights and how they ought to inform and shape the advancement of public health advice and policy documents. Overall, nursing home residents, their families and staff reported favourably on the study measures. However, issues pertaining to communication are essential and there is a need to address issues such as the provision of accurate timely information, communication infrastructure and resources, and inconsistencies in communications. Of note is that while healthcare professionals have a duty to uphold the rights of nursing home residents, they themselves have human rights which must also be protected and supported. [ABSTRACT FROM AUTHOR]

Background: For years politics and healthcare, faced with the progressive increase in the prevalence of overweight and obesity in childhood, have wondered how to stem it and reduce its consequences on health without finding a valid, effective and applicable solution. Many studies have been written initially on what to prescribe, then on why not to prescribe and how to approach people in a new and more effective way to improve their behaviors, considered the main cause of excess weight. Over the last twenty years it has been highlighted that no diet or physical exercise is truly effective and not even global changes in lifestyle guarantee the large weight reductions traditionally expected, despite offering significant health advantages. A new approach is necessary and we must begin by working on ourselves. Main body: We examined literature on weight stigma and considered expert opinions, as well as feedback from parents/caregivers and patients. Literature on stigma has grown enormously in recent years, and finally considers the opinion of parents and patients. By interviewing patients with obesity, it was discovered that very often healthcare workers do not communicate the diagnosis and, if they do, they have a blaming attitude, holding patients responsible for their weight. Furthermore, when these people become aware of their obesity and seek treatment, they do not find adequate professionals and centers. Failure was mostly due to the enormous burden of obesity stigma and discrimination which, especially in children and young people, encourages internalization of the problem and takes away their self-efficacy, desire and ability to take care of themselves. Conclusions: New actions are needed to change all this. We propose "Training, Networking and Contrasting Weight Stigma". Now that we've figured out where to start, we should get going. And yet, nothing is changing! [ABSTRACT FROM AUTHOR]

Background: It is well known that patient satisfaction with medical communication in the emergency department (ED) improves patient experience. Investing in good communication practices is highly desirable in the emergency setting. In the literature, very few studies offer evidence of effective interventions to achieve this outcome. Aim of the study is to evaluate whether encouraging emergency physicians to ask if patients have questions at the end of the visit would improve patient satisfaction with medical communication. Methods: The physicians of two EDs in Lugano, Switzerland, were invited by various methods (mailing, newsletter, memo pens and posters, coloured bracelets etc.) to implement the new practice of asking patients if they had questions before the end of the visit. Patients discharged were consecutively enrolled. Participants completed the modified CAT-T questionnaire rating their satisfaction with medical communication from 1 (very poor) to 5 (excellent). Data such as age, means of arrival, seniority of the physician etc. were also collected. Statistical analysis was performed with Bayesian methodology. The results were compared with those of a similar study conducted one year earlier. Results: 517 patients returned the questionnaire. Overall, patients' satisfaction with communication in the ED was very good and improved from the previous year (percentage of fully satisfied patients: 68% vs. 57%). The result is statistically significant (C: I: 51.8 − 61.3% vs. 63.9 − 71.8% p = 0.000). Younger patients (< 30 ye22ars old) were slightly less satisfied. Waiting time did not affect perception of communication. Conclusion: This study implements a concrete way to improve patients' satisfaction with medical communication in the ED. The intervention targeted only one item of the CAT-T ("Encouraged me to ask questions") but it generated an overall perception of better communication from patients discharged from the ED. The study also confirms that there are some objective elements that can alter perception of quality of medical communication by patients (age, seniority of the physician), in agreement with the literature. In conclusion, focusing physicians' attention on asking patients whether they have questions before discharge helps improving overall patient satisfaction with medical communication in the ED. This may lead to changes in physicians' clinical practice. [ABSTRACT FROM AUTHOR]

Background: Stress is a pervasive occurrence within certain professions, including nurses working in emergency and intensive care unit environments. Nurses in these settings often confront various stress-inducing factors, such as unsupportive management and distressing events like patient mortality, and experience notably higher levels of stress. Nevertheless, information is scarce regarding the precise level of stress in Ethiopia, particularly within southern hospitals. Objective: To assess stress levels and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in southern Ethiopia, 2023. Methods: A facility-based cross-sectional explanatory sequential mixed-method study was undertaken, involving a total of 239 nurses. For the quantitative component, all nurses working in intensive care units and emergency rooms were included as participants, while a purposive sampling technique was employed to select participants for the qualitative aspect. Data for the quantitative study were gathered through the utilization of self-administered questionnaires, while interviews were conducted using a structured interview guide for the qualitative portion. Quantitative data entry and analysis were performed using EpiDataV4.6 and the Statistical Package for the Social Sciences software, respectively. Thematic analysis of the qualitative data was conducted using the OpenCode software. Results: The level of stress among nurses in the emergency and intensive care units was low (19.3%), moderate (55.9%), and high (24.8%). Workload (Adjusted odds ratio (AOR) = 3.51, 95% confidence interval (CI) (1.17–10.56) and time constraints (AOR = 2.5, 95% CI (1.03–6.07) were significantly associated with moderate stress level, while duty demands (AOR = 3.03, 95% CI (1.17–7.14), availability of medical equipment and supplies (AOR = 1.42, 95% CI (1.18–4.97), and witnessing death and dying (AOR = 2.34, 95% CI (1.13–5.88) were significantly associated with high-stress level. The qualitative data analysis revealed that the participants underscored the significant impact of organizational factors, individual factors, and profession-related factors on the stress levels experienced by nurses in emergency and critical care settings. Conclusion and recommendation: Based on the findings, the participants in this study experienced some level of stress, to varying degrees. Therefore, it is crucial to implement effective strategies such as optimizing staffing and workflow, improving communication and collaboration, providing adequate support and resources, leveraging technology and innovation, emphasizing patient-centered care, and implementing data-driven quality improvement to alleviate the burden. [ABSTRACT FROM AUTHOR]

Background: Indigenous palliative persons and their families often have different values, spiritual traditions, and practices from Western culture and Canadian health systems. Additionally, many healthcare policies and practices have been established without adequate consultation of the Indigenous populations they are meant to serve. This can result in barriers to Innu receiving culturally safe end-of-life care. Innu community leaders from Sheshatshiu, Labrador, have identified a need for further research in this area. The purpose of this study is to: (1) describe the cultural and spiritual practices related to death and dying of the Innu in Sheshatshiu; (2) identify aspects of current end-of-life care delivery that serve and/or fail to meet the cultural and spiritual needs of the Innu in Sheshatshiu; and (3) explore ways to integrate current end-of-life care delivery practices with Innu cultural and spiritual practices to achieve culturally safer care delivery for the Innu. Methods: This qualitative patient-oriented research study was co-led by Innu investigators and an Innu advisory committee to conduct semi-structured interviews of 5 healthcare providers and 6 decision-makers serving the community of Sheshatshiu and a focus group of 5 Innu Elders in Sheshatshiu. Data was analyzed thematically from verbatim transcripts. The codebook, preliminary themes, and final themes were all reviewed by Innu community members, and any further input from them was then incorporated. Quotations in this article are attributed to Innu Elders by name at the Elders' request. Results: The findings are described using eight themes, which describe the following: relationships and visitation support a "peaceful death"; traditional locations of death and dying; the important role of friends and community in providing care; flexibility and communication regarding cultural practices; adequate and appropriate supports and services; culturally-informed policies and leadership; and Innu care providers and patient navigators. Conclusions: The Innu in Sheshatshiu have a rich culture that contributes to the health, care, and overall well-being of Innu people approaching end of life. Western medicine is often beneficial in the care that it provides; however, it becomes culturally unsafe when it fails to take Innu cultural and spiritual knowledge and traditions into account. [ABSTRACT FROM AUTHOR]

Background: In order to mitigate the distress associated with life limiting conditions it is essential for all health professionals not just palliative care specialists to identify people with deteriorating health and unmet palliative care needs and to plan care. The SPICT™ tool was designed to assist with this. Aim: The aim was to examine the impact of the SPICT™ on advance care planning conversations and the extent of its use in advance care planning for adults with chronic life-limiting illness. Methods: In this scoping review records published between 2010 and 2024 reporting the use of the SPICT™, were included unless the study aim was to evaluate the tool for prognostication purposes. Databases searched were EBSCO Medline, PubMed, EBSCO CINAHL, APA Psych Info, ProQuest One Theses and Dissertations Global. Results: From the search results 26 records were reviewed, including two systematic review, two theses and 22 primary research studies. Much of the research was derived from primary care settings. There was evidence that the SPICT™ assists conversations about advance care planning specifically discussion and documentation of advance care directives, resuscitation plans and preferred place of death. The SPICT™ is available in at least eight languages (many versions have been validated) and used in many countries. Conclusions: Use of the SPICT™ appears to assist advance care planning. It has yet to be widely used in acute care settings and has had limited use in countries beyond Europe. There is a need for further research to validate the tool in different languages. Key message: What is already known on this topic? • The SPICT™ was developed to assist clinicians to screen patients for palliative care needs. What this review found. • The SPICT™ assists conversations about advance care planning and facilitates changes in documented goals of care. • The SPICT™ is available in at least eight languages (and used in many countries. How the findings of this review may affect practice and research. • Evidence suggests that formalising screening for palliative care needs using the SPICT™ is advantageous for advance care planning; clinicians should consider using the SPICT™ to initiate discussions with people with life limiting conditions. • Further research is required to validate the tool in different languages and extend its use in acute care settings and with other patient cohorts. [ABSTRACT FROM AUTHOR]

Students with autism spectrum disorder (ASD) are included in the general education classroom more often than ever before. Despite mathematical strengths and early success, these students experience poor outcomes (academic and employment) compared to their typically developing peers. The language of mathematics increases in complexity, use, and expectations as students age. To facilitate the development of mathematical proficiency for students with ASD, teachers can incorporate instructional strategies to support language processing and use in mathematics. This manuscript provides practical advice for teachers who want to support math language for students with ASD in the general education environment including (a) the importance of these supports, (b) specific recommendations, (c) visual and descriptive examples, and (d) additional resources. [ABSTRACT FROM AUTHOR]

Background: Patients with palliative care needs live with the reality of limited time due to illness or age, eliciting emotional and existential responses. A failure to address their existential needs can lead to significant suffering. A person-centred approach is paramount to effectively address these needs, emphasising holistic care and effective communication. Although existing communication models focus on predefined frameworks, a need exists to explore more spontaneous and confidential conversations between patients and nurses. Confidential conversations have the potential to build therapeutic relationships and provide vital emotional support, highlighting the need for further research and integration into palliative care practice. This study aims to more deeply understand the meaning of confidential conversations for patients with palliative care needs. Methods: In-depth interviews were conducted with 10 patients in the context of specialised palliative care. A hermeneutic analysis was used to gain a deeper understanding of the meanings of the conversations. Results: The patients had varying experiences and wishes concerning confidential conversations. They strived for self-determination in finding confidants, seeking trust and comfort in their interactions with nurses. Trust was crucial for creating a safe space where patients could express themselves authentically. In shared belonging, confidential conversations with a nurse provided validation and relief from life's challenges. Experiences of feeling unheard or rejected by a nurse could intensify loneliness, prompting individuals to withdraw and remain silent. Regardless of the motives behind their choices, it was crucial that patients felt respect and validation in their decisions. Their autonomy could thus be recognised, and they felt empowered to make decisions based on their unique preferences. Conclusions: Patients value trust and understanding, particularly in confidential conversations with nurses, which offer solace, validation and empowerment. However, indifference can increase patients' suffering, fostering self-doubt and reluctance to engage further. To address this, health care can prioritise empathic communication skills, offer ongoing support to nurses, and promote continuity in care through investment in training and resources. Additionally, adopting a person-centred approach in confidential conversations is crucial, considering patients' varying preferences. [ABSTRACT FROM AUTHOR]

Febrile seizures (FS) are commonly perceived by healthcare professionals as a self-limited condition with a generally 'benign' nature. Nonetheless, they frequently lead to pediatric consultations, and their management can vary depending on the clinical context. For parents and caregivers, witnessing a seizure can be a distressing experience, significantly impacting their quality of life. In this review, we offer an in-depth exploration of FS management, therapeutic interventions, and prognostic factors, with the aim of providing support for physicians and enhancing communication with families. We conducted a comprehensive literature search using the PubMed and Web of Science databases, spanning the past 50 years. The search terms utilized included "febrile seizure," "complex febrile seizure," "simple febrile seizure," in conjunction with "children" or "infant." Only studies published in English or those presenting evidence-based data were included in our assessment. Additionally, we conducted a cross-reference search to identify any additional relevant data sources. Our thorough literature search resulted in a compilation of references, with carefully selected papers thoughtfully integrated into this review. [ABSTRACT FROM AUTHOR]

Introduction: Almost one third of people affected by leprosy in Colombia suffer from disability, which often results from delayed diagnosis and treatment. We aimed to explore the experience of people affected by leprosy during the process of diagnosis and treatment and if and how this experience was influenced by peers. Methods: A qualitative study using body map stories was conducted from October 2019 to February 2020 in Colombia. Adult people affected by leprosy were recruited through patient associations in different cities. We conducted three sessions with an average duration of 2–3 h per participant, during which the participants created a painted map of their body and chose symbols to represent their experience, while being engaged in an informal interview. The sessions were audio recorded, transcribed verbatim and analyzed thematically by an interdisciplinary team, consisting of physicians, social workers and a person affected by leprosy. Results: The 17 study participants (11 female) were aged 20 to 70 years. Leprosy-related manifestations ranged from no to advanced disability. Some participants were active members of associations for people affected by leprosy. Three main themes were identified during analysis: (1) A long pathway to diagnosis, (2) Therapy as a double-edged sword and (3) The influence of other people affected by leprosy. The participants described an often years-long process until being diagnosed, which was marked by insecurities, repeated misdiagnosis, and worsening mental and physical health. Delayed diagnosis was related to late health care seeking, but also to inadequate health communication, lack of leprosy-related knowledge and negligence among health care workers. A high desire to cure motivated the participants to take their medication rigorously, despite the high treatment burden. Support from peers, either within the own social environment or provided from associations, contributed to a faster diagnosis and increased therapy adherence. Peers helped to recognize the symptoms, urged patients to seek care, recommended physicians with leprosy-related knowledge and provided a realistic example of both disease severity and curability. Conclusion: People affected by leprosy experience a significant burden during the process of diagnosis and treatment. Involving well-trained peers could foster early diagnosis, treatment compliance and prevention of disability. [ABSTRACT FROM AUTHOR]

Background: Interprofessional primary care teams (IPCTs) work together to enhance care. Despite evidence on the benefits of IPCTs, implementation remains challenging. This research aims to 1) identify and prioritize barriers and enablers, and 2) co-develop team-level strategies to support IPCT implementation in Nova Scotia, Canada. Methods: Healthcare providers and staff of IPCTs were invited to complete an online survey to identify barriers and enablers, and the degree to which each item impacted the functioning of their team. Top ranked items were identified using the sum of frequency x impact for each response. A virtual knowledge sharing event was held to identify strategies to address local barriers and enablers that impact team functioning. Results: IPCT members (n = 117), with a mix of clinic roles and experience, completed the survey. The top three enablers identified were access to technological tools to support their role, standardized processes for using the technological tools, and having a team manager to coordinate collaboration. The top three barriers were limited opportunity for daily team communication, lack of conflict resolution strategies, and lack of capacity building opportunities. IPCT members, administrators, and patients attended the knowledge sharing event (n = 33). Five strategies were identified including: 1) balancing patient needs and provider scope of practice, 2) holding regular and accessible meetings, 3) supporting team development opportunities, 4) supporting professional development, and 5) supporting involvement in non-clinical activities. Interpretation: This research contextualized evidence to further understand local perspectives and experiences of barriers and enablers to the implementation of IPCTs. The knowledge exchange event identified actionable strategies that IPCTs and healthcare administrators can tailor to support teams and care for patients. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions 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.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.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.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]

Background: Australian government strategies and frameworks have been developed in recent years to encourage the integration and coordination of primary care delivery; including patient-centred approaches to clinical and preventative care, and health promotion. This study aims to explore patient experiences of information-sharing and patient-centred care across various primary care clinical settings, with a particular focus on clinical encounters with GPs, naturopaths, osteopaths and acupuncturists. Methods: Data about healthcare utilisation and experiences from a 63-item cross-sectional survey obtained from a nationally representative sample of Australian adults aged ≥ 18 years were analysed. Chi-square and Kruskal-Wallis H tests were used to explore differences in the experiences of knowledge and information sharing during GP consultations among those who also consulted with a naturopath, osteopath or acupuncturist, compared those who had not. Logistic regression was used to investigate correlations between participants perceptions about GP consultation outcomes, and the GP's information-sharing behaviour or perceived experience of patient-centredness. Results: Across 2354 participants, verbal explanation (76.3%) and/or individualised handouts (16.8%) were the most common type of information shared in GP consultations. Individuals who consulted with a GP and a naturopath, an osteopath, or an acupuncturist reported a lower rate of receiving a verbal explanation from their GP but higher rate of receiving other types of information sources including handouts. Over one quarter of study participants who visited a GP did not discuss any of their health information with their GP. Information sharing was lower for individuals who also visited a naturopath, osteopath or acupuncturist. Participants scored their consultations with a GP as patient-centred, but these scores were lower among participants who also consulted with at least one other primary care practitioner type included in the study. Conclusions: Public health and health services researchers, policymakers and leaders of primary care professions have a role and responsibility to ensure practitioners are confident and competent in sharing health information with their patients that considers their health literacy needs, and the importance of patient-centred care. Research focussed on a more in-depth understanding of the differences and relationships observed across the primary care landscape in this study is recommended. [ABSTRACT FROM AUTHOR]

Background: Crisis Resolution Teams (CRTs) offer home-based care for people in mental health crisis, as an alternative to hospital admission. The success of CRTs in England has been variable. In response to this, the CRT Optimization and RElapse prevention (CORE) study developed and trialled a 12-month Service Improvement Programme (SIP) based on a fidelity model. This paper describes a qualitative evaluation of the perspectives of CRT staff, managers, and programme facilitators. We identify barriers and facilitators to implementation, and mechanisms by which service improvements took place. Methods: Managers and staff from six purposively sampled CRTs were interviewed, as well as six facilitators who were employed to support the implementation of service improvement plans. Semi-structured focus groups and individual interviews were conducted and analysed using thematic analysis. Findings: A majority of participants viewed all components of the SIP as helpful in improving practice, although online resources were under-used. Perceived barriers to implementation centred principally around lack of staff time and ownership. Support from both senior staff and facilitators was essential in enabling teams to undertake the work associated with the SIP. All participating stakeholder groups reported that using the fidelity model to benchmark their CRT work to best practice and feel part of a 'bigger whole' was valuable. Conclusion: CRT staff, managers and programme facilitators thought that a structured service improvement programme helped to increase fidelity to a best practice model. Flexibility (from all stakeholders) was key to enable service improvement actions to be manageable within time- and resource-poor teams. [ABSTRACT FROM AUTHOR]

This is Part IV in the series Nursing Power through Advocacy. Its purpose is to help advocates develop a strong voice for children's safety in relation to gun violence in schools while talking with legislators and other stakeholders. The advocate must understand the facts surrounding an issue, both positive and negative, to provide effective evidence supporting their thoughts. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study is to determine the tobacco use status of first and fifth grade students studying at Dokuz Eylül University Faculty of Medicine in the 2022-2023 academic year and to evaluate the factors affecting tobacco use. MATERIAL AND METHODS: The data of the cross-sectional study were obtained by sending a form prepared in electronic environment to the students after a brief information was given in the unit/classroom where they did their internship, and the students responded on their mobile phones. In research, 539 of 790 students answered the form. RESULTS: The prevalance of tobacco use was 34.1% (first: 29.8%, fifth: 40.8%) (female: 26.7%, male: 40.4%). According to multivariate analysis, tobacco use in first grades increases 1.8 times (95% CI: 1.1-3.3) if the general health perception is moderate/poor, 2.9 times (95% CI: 1.2-6.8) to be exposed to insistence of friends for tobacco use, 2.4 times (95% CI: 1.3-4.3) for at least one of the family members to use tobacco, 29.7 times (95% CI: 3.9-224.1) for at least one of the close friends to use tobacco, and 3.9 times (95% CI: 2.2-7.1) not to think that physicians should set an example for the society by not using tobacco; in fifth grade, tobacco use by at least one of the close friends increases 9.6 times (95% CI: 2.1-43.6), and not thinking that physicians should set an example for the society by not using tobacco increases 4.9 times (95% CI: 2.7-9.2). CONCLUSION: In research, it is seen that tobacco use is common among medical faculty students, and the prevalance of use increases as they get higher classes. [ABSTRACT FROM AUTHOR]

Analyze the gender stereotypes present in the leaders of the Hospital Physiotherapy Units, determine the level of acceptance of female leadership and identify which factors influence these perceptions. Observational, descriptive, exploratory and cross-sectional study. The study subjects are the census of leaders of the Physiotherapy Units of public hospitals. The measurement instruments used are the Acceptance of Female Leadership Questionnaire (ACT-LM), and the sociodemographic and job-related variables. Most of the leaders of the hospital physiotherapy units were women (69.4%) physiotherapists. Gender stereotypes emerge in the dimension of Instrumental Characteristics, with respondents not fully agreeing that women were sufficiently competitive (18.7%) or ambitious (20.8%) to be successful in the world of work. These data were influenced by gender, showing that men have a higher regard for female leadership abilities than women themselves. In the dimension of Acceptance of Female Leadership, 17.4% of those surveyed did not fully agree that women can rise to the same extent as men. Most of the leaders of the physiotherapy units in public hospitals in Spain are women, this is reversed in favor of men in highly complex hospitals. The stereotype persists, especially among women, that they do not have enough ambition and competitiveness to succeed in the world of work. [ABSTRACT FROM AUTHOR]

Vocalisations are widely used to signal behavioural intention in animal communication, but may also carry acoustic signatures unique to the calling individual. Here, we used acoustic analysis to confirm that Manx shearwater Puffinus puffinus calls carry individual signatures, and discerned which features made the calls individual. Manx shearwater are nocturnal seabirds that breed in dense colonies, where they must recognize and locate mates among thousands of conspecifics calling in the dark. There is evidence for mate vocal recognition in two shearwater species, but quantitative data on the vocalisations are lacking. We elicited vocal responses to playback of conspecific calls in Manx shearwaters, and measured spectral and temporal parameters of the calls. We then applied linear discriminant analysis with leave‐one‐out cross‐validation and could confirm the presence of individual vocal signatures. We then calculated among‐individual repeatability of 34 features describing the vocalisation to determine the extent to which these features may contribute to individual signature coding. We found that calls cluster by individual in both temporal and spectral characteristics, suggesting these traits are contributing to Manx shearwaters' unique call signatures. [ABSTRACT FROM AUTHOR]

Subsurface exploration of ice-covered planets and moons presents communications challenges because of the need to communicate through kilometers of ice. The objective of this task is to develop the capability to wirelessly communicate through kilometers of ice and thus complement the potentially failure-prone tethers deployed behind an ice-penetrating probe on Ocean Worlds. In this paper, the preliminary work on the development of wireless deep-ice communication is presented and discussed. The communication test and acoustic attenuation measurements in ice have been made by embedding acoustic transceivers in glacial ice at the Matanuska Glacier, Anchorage, Alaska. Field test results show that acoustic communication is viable through ice, demonstrating the transmission of data and image files in the 13–18 kHz band over 100 m. The results suggest that communication over many kilometers of ice thickness could be feasible by employing reduced transmitting frequencies around 1 kHz, though future work is needed to better constrain the likely acoustic attenuation properties through a refrozen borehole. [ABSTRACT FROM AUTHOR]

Parents experience a lot of stress in the neonatal intensive care unit (NICU). Then effective communication between parents and members of the care team is an essential component of improving the quality of care. The present study was conducted by qualitative exploratory research method for explaining parents and health care teams' perceptions of communication in NICU. We selected 39 participants by purposive sampling. We collected data through in- depth semi-structured, face-to-face interviews. The transcripts were analysed using the conventional content analysis approach. Three themes were obtained by analyzing the data included, the nature of communication, the theme of factors affecting successful communication, the theme of factor affecting continuity communication. All members of the care team should be involved in parent communication. But according to our results, nurses are more responsible for communicating with parents. Finding from the study indicates the key role of nurses in communicating in the NICU. It is necessary to teach physicians and nurses, especially physicians, how to communicate with parents. Also, health system authorities have an important role in continuing education on communication methods in the NICU. [ABSTRACT FROM AUTHOR]

Introduction: Existing approaches in cancer survivorship care delivery have proven to be insufficient to engage primary care. This study aimed to identify stakeholder‐informed priorities to improve primary care engagement in breast cancer survivorship care. Methods: Experts in U.S. cancer survivorship care delivery were invited to participate in a 4‐round online Delphi panel to identify and evaluate priorities for defining and fostering primary care's engagement in breast cancer survivorship. Panelists were asked to identify and then assess (ratings of 1–9) the importance and feasibility of priority items to support primary care engagement in survivorship. Panelists were asked to review the group results and reevaluate the importance and feasibility of each item, aiming to reach consensus. Results: Respondent panelists (n = 23, response rate 57.5%) identified 31 priority items to support survivorship care. Panelists consistently rated three items most important (scored 9) but with uncertain feasibility (scored 5–6). These items emphasized the need to foster connections and improve communication between primary care and oncology. Panelists reached consensus on four items evaluated as important and feasible: (1) educating patients on survivorship, (2) enabling screening reminders and monitoring alerts in the electronic medical record, (3) identifying patient resources for clinicians to recommend, and (4) distributing accessible reference guides of common breast cancer drugs. Conclusion: Role clarity and communication between oncology and primary care were rated as most important; however, uncertainty about feasibility remains. These findings indicate that cross‐disciplinary capacity building to address feasibility issues may be needed to make the most important priority items actionable in primary care. [ABSTRACT FROM AUTHOR]

Limited research exists regarding athletic trainers' (ATs') perceptions of professionalism. To explore the lived experiences of ATs and their perceptions of professionalism. Qualitative study. Participants were ATs who completed a semistructured interview protocol via audio-only recording conferencing. Seventeen participants (age = 33 ± 8 years; range = 25–56 years) who were certified ATs with an average of 10 years of experience (SD = ±8; range = 1–33 years) were interviewed. Individuals self-identified their interest in participating in a follow-up interview recruitment located within a survey. Interviews occurred until saturation was met and included a variety of participants. Demographic information was gathered from the survey for each person. All transcripts were audio recorded, transcribed verbatim, and coded using a 3-person coding team following the consensual qualitative research protocol. Member checking, auditing, and triangulation established trustworthiness and credibility in the data-analysis process. A total of 4 domains with supporting categories were identified. Athletic trainers spoke of the employee environment that affected perceptions of what was determined to be professional, specifically in various settings or situations. They shared their personal determination of outward appearance and expression when differentiating what was deemed professional, including references to cleanliness, judgment of self-expression, and implicit bias. Whether intentional or unintentional, participants made comments that demonstrated a bias toward sex or race and ethnicity when determining outward appearance appropriateness. They noted various cultural awareness situations, including progression of perceptions over time, external pressure, and internal dialog. Respondents shared discourse regarding an internal struggle of what was right and wrong in their responses. They discussed professionalism based on the provider's conduct, mainly in terms of communication and patient care. Participants shared that communication occurring through both verbal and nonverbal means is vital to the perceptions of professionalism for ATs. Current views of professionalism in athletic training were shaped by various lived experiences. With the movement toward athletic training becoming more diverse, equitable, and inclusive, antiquated professionalism ideals need to shift to provide a better work environment for all. [ABSTRACT FROM AUTHOR]

Health literacy is defined as "the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others."1 Individuals with health disparities are more likely to have poor health outcomes and misuse health care services due to low health literacy. This connection between health literacy and health disparities demonstrates the need for clinicians to provide health literate care. Athletic trainers serve as essential points of contact for diverse patient populations in a variety of health care settings. The 2023 Practice Analysis 8 recognizes health literacy as an essential responsibility; however, few practical resources exist, and research specific to athletic training is lacking. In this manuscript, we aim to provide a primer on health literacy definitions, concepts, and best practices adapted from public health to support implementation into athletic training clinical practice. [ABSTRACT FROM AUTHOR]

Simple Summary: Facial expressions are important for many animals when communicating with other individuals both within and outside of their own species or group. The canid family includes several species that are highly social. Dogs, in particular, have adapted, through domestication, facial expressions that aid in their social interactions with people. The presence of certain facial muscles facilitates these interactions, however it does not seem that these muscles are unique to dogs, but also present in other canids. The evolution of facial muscles in dogs has been linked to human preferential selection of dogs whose faces appear to communicate information and emotion. Dogs who convey, especially with their eyes, a sense of perceived helplessness can elicit a caregiving response from humans. However, the facial muscles used to generate such expressions may not be uniquely present in all dogs, but rather specifically cultivated among various taxa and individuals. In a preliminary, qualitative gross anatomical evaluation of 10 canid specimens of various species, we find that the presence of two facial muscles previously implicated in human-directed canine communication, the levator anguli occuli medialis (LAOM) and the retractor anguli occuli lateralis (RAOL), was not unique to domesticated dogs (Canis familiaris). Our results suggest that these aspects of facial musculature do not necessarily reflect selection via human domestication and breeding. In addition to quantitatively evaluating more and other members of the Canidae family, future directions should include analyses of the impact of superficial facial features on canine communication and interspecies communication between dogs and humans. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: Seagrass ecosystems are of fundamental importance to our planet and wellbeing. Seagrasses are marine flowering plants, which engineer ecosystems that provide a multitude of ecosystem services, for example, blue foods and carbon sequestration. Seagrass ecosystems have largely been degraded across much of their global range. There is now increasing interest in the conservation and restoration of these systems, particularly in the context of the climate emergency and the biodiversity crisis. The collation of 100 questions from experts across Europe could, if answered, improve our ability to conserve and restore these systems by facilitating a fundamental shift in the success of such work. Summary: Seagrass meadows provide numerous ecosystem services including biodiversity, coastal protection, and carbon sequestration. In Europe, seagrasses can be found in shallow sheltered waters along coastlines, in estuaries & lagoons, and around islands, but their distribution has declined. Factors such as poor water quality, coastal modification, mechanical damage, overfishing, land‐sea interactions, climate change and disease have reduced the coverage of Europe's seagrasses necessitating their recovery. Research, monitoring and conservation efforts on seagrass ecosystems in Europe are mostly uncoordinated and biased towards certain species and regions, resulting in inadequate delivery of critical information for their management. Here, we aim to identify the 100 priority questions, that if addressed would strongly advance seagrass monitoring, research and conservation in Europe. Using a Delphi method, researchers, practitioners, and policymakers with seagrass experience from across Europe and with diverse seagrass expertise participated in the process that involved the formulation of research questions, a voting process and an online workshop to identify the final list of the 100 questions. The final list of questions covers areas across nine themes: Biodiversity & Ecology; Ecosystem services; Blue carbon; Fishery support; Drivers, Threats, Resilience & Response; Monitoring & Assessment; Conservation & Restoration; Governance, Policy & Management; and Communication. Answering these questions will fill current knowledge gaps and place European seagrass onto a positive trajectory of recovery. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: The societal debate on the use of genome‐edited crops has been polarised from the start. While policymakers struggle to democratically resolve this dilemma, plant scientists have been criticised for taking up advocative roles and thereby risking further polarisation. This study demonstrates how plant scientists themselves perceive their roles and responsibilities. Indeed, those scientists active in the debate were found to fulfil advocative roles, and there seems to be an underlying, persistent—and very traditional—view on roles and responsibilities of scientists within the community. Critical reflection on this view is required for better democratic dialogue and decision‐making. More interdisciplinary interaction could facilitate this reflection. Summary: In this paper, we examine how plant scientists from Wageningen University and Research (WUR) demarcate their roles and responsibilities in relation to the societal impact of their research, in response to calls for public legitimacy of their research, and within the societal debate on the governance of genome‐edited crops (GE crops) in Europe.We analysed 16 semi‐structured interviews, 5‐day journals, and (social) media contributions of plant scientists at WUR.Our study demonstrates that the perceived roles and responsibilities of the interviewees were aligned with the ideal of the scientist as value‐free, as separate from society, and as producing knowledge that leads to unproblematic societal benefits through industry. When confronted with the polarised debate on the governance of genome editing (GE) technology, the reflexivity that our respondents had demonstrated in general, tended to be dispersed. Respondents rarely considered the GE crop debate, or their own position, to be value‐based. Those respondents active in the debate were found to fulfil advocative roles, and they struggled to recognise the validity of viewpoints other than their own.We hypothesise that this decreased reflexive capacity is a product of the long‐term polarisation of the GM/GE debate, mediated by both their conceptual alignment with the linear model of innovation and their limited interactions outside of their field. In order to better align the perspectives of social and natural scientists on the topic of science‐responsibility, and to constructively contribute to the debate on GE crops, we argue for more interaction between the these two communities. The societal debate on the use of genome‐edited crops has been polarised from the start. While policymakers struggle to democratically resolve this dilemma, plant scientists have been criticised for taking up advocative roles and thereby risking further polarisation. This study demonstrates how plant scientists themselves perceive their roles and responsibilities. Indeed, those scientists active in the debate were found to fulfil advocative roles, and there seems to be an underlying, persistent—and very traditional—view on roles and responsibilities of scientists within the community. Critical reflection on this view is required for better democratic dialogue and decision‐making. More interdisciplinary interaction could facilitate this reflection. [ABSTRACT FROM AUTHOR]

This article builds a case for raising occupational consciousness by critically questioning ahistorical and apolitical uses of battle language, especially when referring to infectious diseases. Words such as invasion, colonization, and resistance are particularly ethically troubling, and this article considers why the social practices our language brings about matter in health care. Dynamic relationships among humans and microbes, as well as metaphor, are considered here in historical context and through the lens of Derrida’s portmanteau hostipitality, which invites reconsideration of an infectious disease notion of host and how conceptions of hospitality have been institutionalized and commodified. This article argues that language used in infectious disease care settings should be informed by coexistence as a guiding value of clinical and ethical relevance. [ABSTRACT FROM AUTHOR]

Simple Summary: Genetic testing for BRCA1/2 is recommended for individuals at high risk of hereditary breast and ovarian cancer, yet racial and ethnic disparities persist. Diverse and mutually influencing factors contribute to BRCA health disparities, including socially constructed identities (e.g., gender, race, and ethnicity), sociodemographic factors (e.g., income and education), and societal factors (discrimination). Such factors can be additive and multiplicative. Viewing BRCA health disparities through an intersectional lens may provide a more nuanced, comprehensive understanding of lived experience by considering individuals' unique, intersecting identities. A deeper understanding of the individual can inform more person-centered approaches to genomic healthcare and help bridge BRCA health disparities. Significant health disparities exist in relation to pathogenic variants in BRCA1/2. This study aimed to better understand the barriers and facilitators to BRCA1/2 genetic testing and intrafamilial communication of risk in racially and ethnically diverse individuals. We conducted qualitative interviews with non-Hispanic White (n = 11) and Black, Indigenous, People of Color (BIPOC) individuals (n = 14) who underwent testing for pathogenic BRCA1/2 variants. We employed template analysis, case study analysis, and comparative case study analysis to examine healthcare experiences related to genetic testing as well as intrafamilial communication of risk. Applying an intersectional lens, we sought to inform more person-centered approaches to precision healthcare and help dismantle disparities in genomic healthcare. Template analysis revealed salient factors at the individual (psychosocial well-being), interpersonal/familial, and healthcare system levels. A two-part case study analysis provided insights into how race/ethnicity, cultural norms, and socioeconomic status interact with systemic and structural inequities to compound disparities. These findings underscore the need for person-centered, tailored, and culturally sensitive approaches to understanding and addressing the complexities surrounding testing and the communication of BRCA risk. Applying an intersectional lens can inform more person-centered approaches to precision healthcare and may help to surmount existing disparities. [ABSTRACT FROM AUTHOR]

Background: It is not known how much information clients retrieve from discharge instructions. Objective: To investigate client's understanding of discharge instructions and influencing factors. Animals: Dogs and cats being hospitalized for neurological diseases. Methods: Clients were presented questionnaires regarding their pet's disease, diagnostics, treatments, prognosis and discharge instructions at time of discharge and 2 weeks later. The same questions were answered by discharging veterinarians at time of discharge. Clients answered additional questions regarding the subjective feelings during discharge conversation. Data collected included: data describing discharging veterinarian (age, gender, years of clinical experience, specialist status), data describing the client (age, gender, educational status). Raw percentage of agreement (RPA) between answers of clinicians and clients as well as factors potentially influencing the RPA were evaluated. Results: Of 230 clients being approached 151 (65.7%) and 70 (30.4%) clients responded to the first and second questionnaire, respectively (130 dog and 30 cat owners). The general RPA between clinician's and client's responses over all questions together was 68.9% and 66.8% at the 2 time points. Questions regarding adverse effects of medication (29.0%), residual clinical signs (35.8%), and confinement instructions (36.8%) had the lowest RPAs at the first time point. The age of clients (P =.008) negatively influenced RPAs, with clients older than 50 years having lower RPA. Conclusions and Clinical Importance: Clients can only partially reproduce information provided at discharge. Only clients' increasing age influenced recall of information. Instructions deemed to be important should be specifically stressed during discharge. [ABSTRACT FROM AUTHOR]

Introduction: The term 'patient feedback' can be measured through various formal reactions, including levels of patient comfort, experience, perspectives, and assessments of care in terms of convenience, continuity, and quality. By recording the patient's viewpoint on the quality of care provided by a tertiary healthcare facility, it can be acknowledged through patient feedback. This data can then be utilised to improve health services and enhance the overall patient experience. Aim: To assess patient satisfaction with the services provided at a tertiary care hospital in Banda. Materials and Methods: This descriptive cross-sectional study was conducted at the government medical college in Banda, a district in the Bundelkhand region of Uttar Pradesh, a northern state of India. The study took place from December 2022 to February 2023 at the medical college and its associated hospital. A total of 400 participants who consented to be part of the study were included. Purposive sampling technique was employed for data collection. Outpatients were interviewed upon exiting the clinics, while inpatients were interviewed in the wards. Results: In the questionnaire, there was a question asking, about patient's overall satisfaction during the visit to the hospital. Since everyone's score was higher than the 'poor' category, all categories were merged into one word, 'satisfied,' except for the 'poor' category to facilitate better understanding. The majority of patients from the Outpatient Department (OPD) (91, 45.5%) and Inpatient Department (IPD) (198, 99%) were satisfied with the attitude and communication of the doctor. Additionally, 98.5% of IPD patients were satisfied with the doctor's knowledge. A total of 99% of participants responded "yes" when questioned about their preference to return to the hospital for treatment. Conclusion: Overall, it was observed that the behaviour and care provided by hospital staff satisfied the majority of patients, who also expressed satisfaction with the indoor and outdoor services of the hospital. [ABSTRACT FROM AUTHOR]