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Aim s : The objective of this study was to examine the relationship between caregiving burden and pre‐death grief, with a specific focus on adult‐child caregivers in mainland China. Additionally, the study explored whether coping strategies played a mediating role in this correlation. Methods: A convenience sample of 320 adult‐child caregivers of older parents with dementia from Kunming, mainland China, was recruited for the study. Data were collected using the Chinese version of the Marwit‐Meuser Caregiver Grief Inventory‐Short Form, the Burden Scale for Family Caregivers, and the Ways of Coping Checklist‐Revised. Results: Results using linear regression and multiple mediation analysis with Hayes' process model indicated that caregiving burden was positively related to pre‐death grief and that active coping mediated the relationship between them. In the female group, active coping partially mediated the association between caregiving burden and pre‐death grief, but in the male group, this mediating effect did not exist. Conclusion: The study found evidence supporting the link between caregiving burden and pre‐death grief among adult‐child caregivers of older parents with dementia in mainland China. Furthermore, the caregiving burden prevented the use of active coping, and this decrease in coping increased the perception of pre‐death grief. These associations only existed in the female group. Implications: This paper presented the importance of active coping skills in the dementia caregiving process. Impact: The findings of this study emphasize the necessity for health practitioners to provide targeted interventions regarding pre‐death grief among dementia caregivers and strengthen caregivers' active coping strategies to reduce their pre‐death grief. Community‐based and personal care support services should be promoted to alleviate their caregiving burden. Reporting Method: We have adhered to the transparent reporting of evaluations with quantitative design statements and the corresponding checklist was followed. Patient or Public Contribution: 'No patient or public involvement'. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Loneliness is common among young and middle‐aged stroke survivors. It not only hinders the recovery of their neurological and physical functions but also increases the risk of stroke recurrence, disability, and even death.Improving the mental health of young and middle‐aged stroke survivors is of utmost importance. However, previous research has not yet investigated the impact of interpersonal sensitivity and resilience on the relationship between stigma and feelings of loneliness. What the paper adds to existing knowledge?: This study confirms that stigma has a positive impact on loneliness among young and middle‐aged stroke survivors.Interpersonal sensitivity partially mediates the relationship between stigma and loneliness, and resilience plays a moderating role in the mediating mechanism. What are the implications for practice?: Mental health nurses can formulate nursing interventions to reduce loneliness of young and middle‐aged stroke survivors with the goals of improving stigma, reducing interpersonal sensitivity and cultivating resilience. Introduction: Previous studies have not explored the impact of interpersonal sensitivity and resilience on the relationship between stigma and loneliness. However, improving the resilience of young and middle‐aged stroke survivors and increasing their social participation is of great significance for reducing patients' loneliness of patients and promoting their physical and mental rehabilitation. Aims: To investigate the influence of stigma, interpersonal sensitivity and resilience on loneliness among young and middle‐aged stroke survivors. Methods: A cross‐sectional design was used to collect data. A total of 330 participants completed measures of stigma, resilience, interpersonal sensitivity and loneliness. The descriptive statistical approach, Pearson's correlation analysis and Hayes' PROCESS Macro Model 4 and 7 in regression analysis were used to analyse the available data. Results: The results revealed that young and middle‐aged stroke survivors' stigma, resilience, interpersonal sensitivity and loneliness were significantly correlated between every two variables, with coefficients ranging between −0.157 and 0.682. Interpersonal sensitivity played a partial mediating role in stigma and loneliness, accounting for 63.27% of the total effect; This process was moderated by resilience. Discussion: Stigma positively predicts participants' loneliness. As a mediating mechanism with moderating, interpersonal sensitivity and resilience further explain how stigma affects loneliness. Implications for Practice: Understanding this mechanism is of guiding significance to reduce loneliness of young and middle‐aged stroke patients and promote their physical and mental rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: Building on social exchange and leader-member exchange theories, this paper aims to propose a model of the impact of coronavirus-induced anxiety on health-care professionals' burnout and turnover intention through the mediation role of servant leadership. Design/methodology/approach: This model was examined by adopting partial least square-based structural equation modeling using data collected from 271 health professionals (doctors, nurses, midwives and analysts) from Turkey. Findings: The findings of the research illustrate that coronavirus-induced anxiety is positively associated with burnout and turnover intention. Furthermore, servant leadership mediates the relationship between coronavirus-induced anxiety, burnout and turnover intention. Yet, according to factor loadings, the mediating role of servant leadership is not strong (β : 0.035 and 0.053, respectively). Research limitations/implications: First, this study targeted the health-care professionals from Turkey. Therefore, this population may not be able to provide general information on the topic. Thus, this study suggests that the subject be addressed in other populations as well. Second, the data were self-reported by the participants. Although common method bias and social desirability bias were not an issue in this study, it should be known that the results are based on the subjective judgments of the participants. Third, this study was limited to investigating the mediating role of servant leadership only. Practical implications: This study gives much beneficial information to both administrators and organizations by mirroring highly stressed workers' inside throughout statistically results. Hence, it is assumed that the findings will help leaders to cope with several difficult situations, especially in crisis moments. As the chaotic circumstances occurred, achieving organizational goals became more and more difficult. To do this, some leaders play critical roles for members like servant leaders by contributing uniquely spiritual dimensions. Social implications: Struggling with the COVID-19 pandemic has aggravated the health-care professionals' existing mental health and has loaded more agitation on them. According to Mozes (2021), suicide cases among nurses have doubled the number of women in the general population. Thus, leaders should do something to lower those ratios. This study points out that servant leaders could break down those unwanted issues by decreasing burnout and turnover intention rates of health workers. Barbuto and Wheeler (2006) highlighted this situation by creating a dimension called "The Natural Desire to Serve Others." Originality/value: To the best of the authors' knowledge, to date, this study is the first to examine the mediating role of servant leadership in the effect of coronavirus-induced anxiety on burnout and turnover intention. Furthermore, this research reveals that servant leadership may play a role in avoiding burnout and turnover intention in the health sector. [ABSTRACT FROM AUTHOR]

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

Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

Objectives: Cardiac rehabilitation (CR) provides evidence-based secondary prevention for people with heart disease (HD) (clients). Despite HD being the leading cause of mortality and morbidity, CR is under-utilised in Australia. This research investigated healthcare systems required to improve access to CR in rural and remote areas of North Queensland (NQ). Methods: A qualitatively dominant case study series to review management systems for CR in rural and remote areas of NQ was undertaken. Data collection was via semi-structured interviews in four tertiary hospitals and four rural or remote communities. An audit of discharge planning and CR referral, plus a review of community-based health services, was completed. An iterative and co-design process including consultation with healthcare staff and community members culminated in a systems-based model for improving access to CR in rural and remote areas. Results: Poorly organised CR systems, poor client/staff understanding of discharge planning and low referral rates for secondary prevention, resulted in the majority of clients not accessing secondary prevention, despite resources being available. Revised health systems and management processes were recommended for the proposed Heart: Road to health model, and given common chronic diseases risk factors it was recommended to be broadened into Chronic disease: Road to health. Conclusion: A Chronic disease: Road to health model could provide effective and efficient secondary prevention for people with chronic diseases in rural and remote areas. It is proposed that this approach could reduce gaps and duplication in current healthcare services and provide flexible, client-centred, holistic, culturally responsive services, and improve client outcomes. What is known about the topic? Cardiac rehabilitation is known to improve health outcomes and reduce hospitalisations, but referrals and attendance are low (30%). What does this paper add? A revised systems-based model for improved access to secondary prevention for people with heart and related chronic diseases in rural and remote areas of North Queensland is proposed: Chronic disease: Road to health. What are the implications for practitioners? A functional system from hospitalisation to local healthcare services has been designed to improve access to secondary prevention. Staff require support and education to improve skills, better manage care and improve job satisfaction. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article is to describe data collection considerations, methods, and response rates for a survey available both online and on paper. Methodological issues in the design of online data collection, and advantages and disadvantages of different data collection methods are discussed. Method: A survey was compiled that included 9 full or partial clinical questionnaires designed to measure different components relevant to tinnitus distress. It was completed once by 342 members of the public with tinnitus. Respondents could choose whether to complete the survey online or on paper. Results: Ninety-five percent of participants chose to complete the survey online. The advantages of an online self-administered questionnaire include low numbers of unanswered questions, convenience (particularly in a longer survey such as this), a fast return rate, and reduced expense. Age emerged as an important variable, with those opting to complete the paper-based version of the survey being older. Conclusions: Online data collection has several advantages to both participants and researchers. However, cross-sectional studies such as that presented here should also offer paper questionnaires to avoid excluding certain subgroups of the population. Ethics and reporting guidelines for Internet-delivered questionnaire studies are available. These can usefully inform study design and guide high-quality reporting. [ABSTRACT FROM AUTHOR]

This paper investigates alcohol consumption within cultures of football fandom through the innovative combination of theories of the carnivalesque and Bourdieu's concepts of habitus, field, and capital. Focus groups (n = 79) were conducted with football supporters in England and Scotland. Semi-structured interviews (n = 15) were also conducted with key organizational stakeholders. Research explored the importance and role of alcohol consumption for supporters when watching or attending matches.. Participants confirmed the cultural significance, perceived normalcy and historical links between football and alcohol consumption. Supporters highlighted the importance of the sociability, friendship, and social capital aspects of alcohol consumption. Participants believed football supporters are perceived differently in comparison with supporters of other sports, arguing that legislation surrounding alcohol consumption at other sports allowed supporters to enhance the carnivalesque by drinking alcohol, whereas football fans were more restricted. Participants agreed the habitus of excessive drinking and violence associated with football supporters led to a bad reputation, however, this view was outdated. Participants also recognized a growing drug culture in football. The findings draw attention to the alcohol-sport relationship and the contested relations, and diverging interests and influences, within the social field of football. [ABSTRACT FROM AUTHOR]

Background: Despite the significant emphasis on self‐determination in special education and the crucial role of mobile learning, there is a notable absence of path modelling studies that explore the effect of self‐determination on the usage of mobile learning by students with special needs. Objectives: This study sought to investigate the intentions of mobile learning usage among students with special needs by proposing a model rooted in the technology acceptance model, complemented by extraneous constructs from self‐determination theory (competence, autonomy and relatedness). Methods: The data of the study was obtained online from 1298 special needs university students with eight different types of disabilities. Data were analysed with descriptive statistics, confirmatory factor analysis, structural equation modelling and bootstrapping. Results and Conclusions: The proposed model explained 78.4% of ease of use, 85.2% of usefulness, and 76.5% of intention. 11 of the 12 hypotheses tested within the scope of the model were supported. All hypotheses examining the impacts of self‐determination theory constructs on ease of use, usefulness, and intention were validated (8 hypotheses), with the exception of the autonomy → intention relationship. Substantial empirical evidence has been acquired to support the role of the self‐determination theory in exploring the intention toward mobile learning among university students with special needs. Concurrently, a robust theoretical framework has been introduced to the field of special education to elucidate the acceptance and utilization of technology by university students with special needs. Lay Description: What is already known about this topic: Numerous studies have demonstrated the significance of mobile tools and mobile learning in the realm of special education.Self‐determination holds immense importance in fostering independence and social engagement by empowering individuals with special needs to gain confidence, assume control and accountability for their own choices and actions.Self‐determination theory underscores the importance of providing individuals with support for three fundamental psychological needs—autonomy, competence, and relatedness—to foster healthy development. What this paper adds: To the best of the authors' knowledge, this study stands as a unique contribution within its field due to its distinctive characteristics. The model, supported by exceptionally successful outcomes and its ability to elucidate technology acceptance constructs at remarkably high levels, offers a robust theoretical framework for enabling students with special needs to engage effectively with mobile learning in both special and inclusive educational settings.Investigating how self‐determination theory enhances the explanatory power of the technology acceptance model in special education.Illuminating the significance of basic psychological needs in the adoption of mobile learning, employing advanced statistical methods with a substantial participant base, and delivering valuable insights to advance the utilization of mobile learning in special education. Implications for practice and/or policy: Special education settings should encourage students to take initiative, make choices, and exercise autonomy, and curriculum design should include opportunities for students to make choices.Making students part of the design processes and emphasizing usability through the prioritization of customizable, user‐friendly designs should be an inherent aspect of educational technology.Educators and support staff must have training and professional development opportunities to effectively use mobile learning tools and create inclusive learning environments. [ABSTRACT FROM AUTHOR]

This paper advances the Future Ready Talent Framework (FRTF), a conceptual model of talents that are relevant to stakeholders of work-integrated learning (WIL) programs. The paper is organized into three sections. The first section provides background on the development of the FRTF, including a brief review of talent frameworks and the future of work literature as they relate to WIL. The second section presents the method through which the FRTF was extended and validated. This involved soliciting behavioral examples of talents from WIL stakeholders. The third section of the paper discusses implications of the FRTF for WIL, such as its application to student assessment. It also situates the FRTF in a broader discussion of WIL and the future of work. The goal of the paper is to position the FRTF as a tool that WIL stakeholders can use to create "common ground" as they communicate with each other about talent. [ABSTRACT FROM AUTHOR]

Ageing with a disability increases the risk of hospitalization and nursing home admission. Ageing in place interventions aiming to reduce disability are often not sufficiently effective and inadequately theory-based. There are many models available on disability, but it is unclear how they define disability, what their differences are, and how they evolved throughout the years. This paper aims to provide an overview of the evolution of these models and to elaborate on the causal mechanisms of disability. A literature review was conducted as part of the TRANS-SENIOR international training and research network. PubMed and Google Scholar were searched, and snowball sampling was applied to eligible publications. Data were extracted from the included publications, and a thematic analysis was performed on the retrieved data. Overall, 29 publications were included in the final sample. All included models arose from three original models and could be divided into two types: linear models and models on the interaction between the person and the environment. Thematic analysis led to three distinct evolutionary trends: (1) from a unidirectional linear path to a multidirectional nonlinear path, (2) from the consequences of disease towards the consequences of person–environment interaction, and (3) from disability towards health and functioning. Our findings suggest that by optimizing the use of personal as well as environmental resources, and focusing on health and functioning, rather than disability, an older person's independence and wellbeing can be improved, especially while performing meaningful daily activities in accordance with the person's needs and preferences. [ABSTRACT FROM AUTHOR]

Background: Considerable evidence suggests that students' achievement emotions are important contributors to their learning and success online. It is, therefore, essential to understand and support students' emotional experiences to enhance online education, especially under the COVID‐19 context. However, to date, very few studies have investigated how students' achievement emotions might be affected by teaching and learning factors in online learning environments. Objectives: Based on Pekrun's (2006) control‐value theory of achievement emotions, this study examined the influence of students' perceived online teaching quality and appraisals of control and value on their achievement emotions in an online second language (L2) learning context instigated by the COVID‐19. Methods: Data were collected using an online survey of 1503 undergraduates from ten universities across different regions of China. Confirmatory factor analyses (CFA) were performed to test the validity of the instruments and structural equation modelling were conducted to examine the relations between L2 teaching and learning variables. Results and Conclusions: Results revealed that perceived teacher internet and communication technology competence had positive effects on enjoyment, but negative effects on anxiety and boredom, and these effects were fully mediated by perceived control and/or value. Perceived chaotic teaching structure (CTS) had reverse effects for the three emotions. Perceived CTS effects on enjoyment and anxiety were fully and partially mediated by perceived control, respectively. Takeaways: Online teaching quality is critical for students' appraisals and emotions towards L2 learning. Teachers should strive to improve online teaching quality and design interventions targeting students' perceived control and value to temper their affective experiences associated with the crisis‐prompted online teaching practices. Lay Description: What is already known about this topic: Teachers' internet and communication technology (ICT) competence and pedagogical design can enhance students' e‐learning efficacy, motivation and interests.Students' perceived control and value can influence their achievement emotions in online learning.Teacher's ICT competence and pedagogical design can impact students' emotions in online learning. What this paper adds: Perceived teacher ICT competence and chaotic teaching structures can have differential impact on students' perceived control and value for e‐learning.Perceived control and intrinsic value differently mediated the effects of the two teaching factors on students' emotions for e‐learning.Perceived teacher ICT competence and chaotic teaching structures can have both direct and indirect effects on students' e‐learning emotions via perceived control and value. Implications for practice and/or policy: Teacher training and development programs should prepare teachers for varying teaching formats including unplanned online teaching due to a forced switch to remote teaching.Teachers should acquaint themselves with using various online platforms and software to communicate the goals, expectations, structures and requirements of their language lessons to students' in a clear manner.Online language teaching interventions aiming to increase or decrease a specific emotion could directly target specific combinations of teaching characteristics and appraisals. [ABSTRACT FROM AUTHOR]

Purpose: The importance of effective public messages has been widely recognized during the coronavirus disease 2019 (COVID-19) pandemic. In particular, the role of news items and interpersonal conversations for the acceptance of public health measures has been highlighted. The authors propose a conceptual model based on the existing literature on how to measure the degree of persuasion of news narratives in the context of the COVID-19 pandemic. Design/methodology/approach: The authors adopted a whole population approach, where the unit of analysis was the population of the media news about the COVID-19 pandemic. The authors selected a sample to develop and test their conceptual model. The sample size was n = 248. The questionnaire was distributed online using a non-probability convenience sampling plan. The authors used a pre-post pseudo-experimental design. Respondents answered questions about their attitude toward the COVID-19 pandemic. After watching a narrative news report on the same subject, they then answered questions designed to measure changes in their attitude. A structural equation model, the Sobel test and a paired samples t-test were used to test hypotheses. Findings: The results showed that there is a significant relationship between narrative with transportation and empathy. There was also a positive and significant relationship between transportation and empathy with attitude and interpersonal talk. The relationship between transportation and self-referencing was also supported. Further, transportation and attitude mediated the relationships between narrative and interpersonal talk, self-referencing as well as empathy. A paired samples t-test revealed that attitudes were changed or reinforced before and after watching the narrative news report. Originality/value: This paper contributes to the body of knowledge by identifying the outcomes of narrative persuasion during public health crises such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Electroencephalogram (EEG) analysis has been widely used in the diagnosis of stroke diseases for its low cost and noninvasive characteristics. In order to classify the EEG signals of stroke patients with cerebral infarction and cerebral hemorrhage, this paper proposes a novel EEG stroke signal classification method. This method has two highlights. The first is that a multi-feature fusion method is given by combining wavelet packet energy, fuzzy entropy and hierarchical theory. The second highlight is that a suitable classification model based on ensemble classifier is constructed for perfectly classification stroke signals. Entropy is an accessible way to measure information and uncertainty of time series. Many entropy-based methods have been developed these years. By comparing with the performances of permutation entropy, sample entropy, approximate entropy in measuring the characteristic of stroke patient's EEG signals, it can be found that fuzzy entropy has best performance in characterization stroke EEG signal. By combining hierarchical theory, wavelet packet energy and fuzzy entropy, a multi-feature fusion method is proposed. The method first calculates wavelet packet energy of EEG stroke signal, then extracts hierarchical fuzzy entropy feature by combining hierarchical theory and fuzzy entropy. The experimental results show that, compared with the fuzzy entropy feature, the classification accuracy based on the fusion feature of wavelet packet energy and hierarchical fuzzy entropy is much higher than benchmark methods. It means that the proposed multi-feature fusion method based on stroke EEG signal is an efficient measure in classifying ischemic and hemorrhagic stroke. Support vector machine (SVM), decision tree and random forest are further used as the stroke signal classification models for classifying ischemic stroke and hemorrhagic stroke. Experimental results show that, based on the proposed multi-feature fusion method, the ensemble method of random forest can get the best classification performance in accuracy among three models. [ABSTRACT FROM AUTHOR]

To date, at least 2.41 billion people with Non-Communicable Diseases (NCDs) are in need of rehabilitation. Rehabilitation care through innovative technologies is the ideal candidate to reach all people with NCDs in need. To obtain these innovative solutions available in the public health system calls for a rigorous multidimensional evaluation that, with an articulated approach, is carried out through the Health Technology Assessment (HTA) methodology. In this context, the aim of the present paper is to illustrate how the Smart&TouchID (STID) model addresses the need to incorporate patients' evaluations into a multidimensional technology assessment framework by presenting a feasibility study of model application with regard to the rehabilitation experiences of people living with NCDs. After sketching out the STID model's vision and operational process, preliminary evidence on the experiences and attitudes of patients and citizens on rehabilitation care will be described and discussed, showing how they operate, enabling the co-design of technological solutions with a multi-stakeholder approach. Implications for public health are discussed including the view on the STID model as a tool to be integrated into public health governance strategies aimed at tuning the agenda-setting of innovation in rehabilitation care through a participatory methodology. [ABSTRACT FROM AUTHOR]

Online medical consultation (OMC) is generating considerable interest among researchers and practitioners due to the mandatory quarantine measures implemented during the COVID-19 pandemic in China. However, the acceptance rate of OMC has declined over time. This paper aims to empirically investigate OMC acceptance using a proposed research model by integrating the technology acceptance model (TAM) with trust and its antecedent variables. A quantitative self-administered cross-sectional survey was conducted to collect data from 260 healthcare consumers. A partial least squares structural equation modeling method was used to examine the data. Results revealed that healthcare consumers' behavioral intention was influenced by attitudes, while perceived usefulness and trust significantly influenced behavioral intention through attitude as a mediator. In addition, perceived risk, perceived privacy protection, network externalities, cognitive reputation, and interactivity directly influenced trust. Overall, the research model explained 50% of the variance in attitude and 71% of the variance in behavioral intention. The study's findings should provide useful insights into making effective design, development, and implementation decisions for OMC services. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based practice involves the synthesis of multiple forms of evidence to inform clinical decision‐making and treatment evaluation. Practice‐ and patient‐based evidence are two forms of evidence that are under‐represented in the stuttering literature. The collection of such knowledge is essential to support the design and delivery of effective stuttering interventions for adults. Aims: To build stakeholder consensus on the core components of intervention for adults who stutter, and to establish a guiding framework for the design and development of evidence‐based interventions for adults who stutter. Methods & Procedures: Adults who stutter and speech and language therapists (SLTs) with experience in providing stuttering intervention participated in the three‐round e‐Delphi Survey focused on: (1) identifying key stuttering intervention components, including principles, practices, and structural and contextual elements; and (2) obtaining group consensus on stuttering intervention components. Statements were categorized using the International Classification of Functioning, Disability and Health (ICF) model adapted to the study of stuttering. Outcomes & Results: A total of 48 individuals agreed to participate: 48/48 (100%) completed the Round 1 questionnaire, 40/48 (83%) responded to Round 2 and 36/40 (90%) participated in Round 3. Following content analysis of Round 1, 101 statements were developed, and consensus was achieved on 89 statements perceived as representing the core components of stuttering intervention for adults. Categorization of these statements reflected the key stuttering intervention components relating to personal reactions to stuttering, limitations in life participation and environmental factors. Conclusions & Implications: Consensus on the core components of stuttering intervention was reached through engagement with key stakeholders. The evidence‐based framework presented highlights the range of key intervention components a clinician should consider when designing interventions for adults who stutter. What this paper adds: What is already known on the subject: Evidence‐based practice endorses the synthesis of multiple knowledge forms including research, practice and patient evidence to support clinical decision‐making and treatment evaluation. The stuttering literature is characterized by an over‐representation of efficacy evidence, with significantly less practice and patient evidence to guide clinical practice. What this paper adds to existing knowledge: This study adds valuable practice‐ and patient‐based evidence for effective stuttering intervention components for adults who stutter. These relate to personal reactions to stuttering, limitations in life participation and environmental factors. What are the potential or actual clinical implications of this work?: This research presents a stakeholder‐informed framework for stuttering intervention to guide SLTs working with adults who stutter in designing evidence‐based interventions. The framework supports the adoption of a person‐centred approach to intervention to ensure each client's unique needs, preferences, values and desired outcomes are explored and integrated into therapy. [ABSTRACT FROM AUTHOR]

Multiple external representations (MERs) play an important role in the learning field of mathematics. Whereas the cognitive theory of multimedia learning and the integrative text and picture comprehension model assume that the heterogeneous combination of symbolic and analogous representations fosters learning; the design, functions, and tasks framework holds that learning benefits depend on the specific functions of MERs. The current paper describes a conceptual replication study of one of the few studies comparing single representations, heterogeneous, and homogeneous MERs in the context of mathematics learning. In a balanced incomplete block design, the participants were provided single representations (a graphic, text, or formula) or a heterogeneous (e.g., text + graphic) or homogeneous (text + formula) combination of these to solve linear system of equations problems. In accordance with previous research, performance was superior in conditions providing MERs compared to single‐representation conditions. Moreover, heterogeneous MERs led to time savings over homogeneous MERs which triggered an increase in cognitive load. Contrary to previous research, text was the least fixated representation whereas the graphical representation proved to be most beneficial. With regard to practical implications, experts should be fostered through more challenging homogeneous MERs whereas novices should be supported through the accessible graphic contained in heterogeneous MERs. Lay Description: What is already known about this topic: Providing multiple instead of single representations can foster mathematics learning.However, some combinations of representations hamper the performance of novice learners.The classical multimedia view explains the positive effect of combining text with picture.Recent research suggests the combination of multiple symbolic representations (text and formula). What this paper adds: The study replicated the effect of multiple symbolic representations for equation solving.In contrast to former research, each representation (text, formula, and graphic) was functionally equivalent.Tasks with differently coded representations were solved faster and with less mental effort.Gaze behavior indicated that students mostly used the graphical representation. Implications for practice and/or policy: Beginners should be supported with a graphic when solving equations.Experts should be challenged with a combination of symbolic representations to benefit the most. [ABSTRACT FROM AUTHOR]

Background: Medicines are often suboptimally managed for heart failure patients across the transition from hospital to home, potentially leading to poor patient outcomes. The Improving the Safety and Continuity Of Medicines management at Transitions of care programme included: understanding the problems faced by patients and healthcare professionals; developing and co‐designing the Medicines at Transitions of care Intervention (MaTI); a cluster randomized controlled trial testing the effectiveness of a complex behavioural MaTI aimed at improving medicines management at the interface between hospitals discharge and community care for patients with heart failure; and a process evaluation. The MaTI included a patient‐held My Medicines Toolkit; enhanced communication between the hospital and the patient's community pharmacist and increased engagement of the community pharmacist postdischarge. This paper reports on the patients' experiences of the MaTI and its implementation from the process evaluation. Design: Twenty one‐to‐one semi‐structured patient interviews from six intervention sites were conducted between November 2018 and January 2020. Data were analysed using the Framework method, involving patients as co‐analysts. Interview data were triangulated with routine trial data, the Consolidated Framework for Implementation Research and a logic model. Results: Within the hospital setting patients engaged with the toolkit according to whether staff raised awareness of the My Medicines Toolkit's importance and the time and place of its introduction. Patients' engagement with community pharmacy depended on their awareness of the community pharmacist's role, support sources and perceptions of involvement in medicines management. The toolkit's impact on patients' medicines management at home included reassurance during gaps in care, increased knowledge of medicines, enhanced ability to monitor health and seek support and supporting sharing medicines management between formal and informal care networks. Conclusion: Many patients perceived that the MaTI offered them support in their medicines management when transitioning from hospital into the community. Importantly, it can be incorporated into and built upon patients' lived experiences of heart failure. Key to its successful implementation is the quality of engagement of healthcare professionals in introducing the intervention. Patient or Public Contribution: Patients were involved in the study design, as qualitative data co‐analysts and as co‐authors. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, all women aged 30–60 years are invited to participate in the national cervical cancer screening programme, which is aimed at early detection and treatment of precancerous lesions. One fourth of the Dutch population has a migration background, with Turkish and Moroccan immigrants being the largest immigrant populations. Turkish‐ and Moroccan‐Dutch women show lower screening participation rates and a higher incidence of cervical cancer, compared to native Dutch women. Since current information materials are not tailored to these women's needs, we developed a short culturally sensitive educational video to facilitate informed decision‐making for cervical cancer screening among Turkish‐ and Moroccan‐Dutch women. This article describes the development process of this video and the lessons learned. Methods: Using the Entertainment–Education communication strategy, we collaborated with an interdisciplinary team of Turkish‐ and Moroccan‐Dutch women, researchers, public health experts, and creative media professionals. We developed the video following the different stages of the Media Mapping model: Orientation, Crystallization, Design/Production, Implementation, and Dissemination. Each stage is described in the paper. Results: The video was developed in Moroccan‐Arabic, ‐Berber and Turkish, and emphasized three main themes: (1) more certainty about having cervical (pre)cancer and the possibility to prevent treatment, surgery, or premature death, and because of this, being there for the children, (2) according to the Islam, a woman should take good care of her health, and (3) anxiety, shame, and privacy. Conclusions: A short culturally sensitive educational video, delivered as part of a larger intervention together with the current information brochure, was developed based on theory and grounded in the needs of Turkish‐ and Moroccan‐Dutch women. The value and effectiveness of this intervention to facilitate informed cervical cancer screening decisions are evaluated in a randomised controlled trial. Patient or Public Contribution: We collaborated with Turkish‐ and Moroccan‐Dutch women during the development process of a short culturally sensitive educational video. Turkish‐ and Moroccan‐Dutch women were also invited to watch the raw footage to verify whether the content and presentation matched their needs and requirements. [ABSTRACT FROM AUTHOR]

Aims: To explore the feasibility and effects of the programme based on information‐motivation‐behavioural skills (IMB) model (IMB programme) on adherence to inhalation therapy and other health outcomes in chronic obstructive pulmonary disease (COPD) patients. Background: Poor adherence to inhalation therapy is common among COPD patients. The IMB model is supported by previous studies as useful in promoting adherence to health behaviours. Methods: This pilot randomized controlled trial randomized 35 COPD patients to receive either the IMB‐based programme or usual care. The 4‐week IMB programme consisted of a face‐to‐face and two telephone sessions to empower patients with skills and knowledge on using inhalation therapy and support their goal attainment for treatment compliance. Outcome evaluation including adherence to inhalation therapy, inhalation techniques, disease impact, and quality of life was conducted at baseline and at 6 weeks after randomization. Feasibility of the IMB programme was evaluated by a satisfaction survey and implementation experience. Results: Thirty patients completed the study, with an attrition rate of 14.3%. The intervention group (n = 15) had significant improvements in inhalation adherence, inhalation techniques, and quality of life than the control group over the evaluation period. Patient satisfaction survey results and observations on programme implementation suggested the feasibility of the IMB programme. Conclusion: A IMB model is a feasible and potentially effective intervention for improving COPD patients' adherence to inhalation therapy. SUMMARY STATEMENT: What is already known about this topic? Information‐motivation‐behavioural skills (IMB) models have produced positive effects on adherence behaviour in patients with acquired immune deficiency syndrome, coronary heart disease, and diabetes. What this paper adds? No study has evaluated the effects of the IMB model on an intervention for adherence behaviour in patients with chronic obstructive pulmonary disease (COPD).The pilot randomized controlled trial (RCT) showed that the IMB model used in the intervention was effective in improving COPD patients' adherence to inhalation regimen and techniques.The pilot study found that the IMB intervention programme was feasible for implementation in outpatient settings and was highly accepted by COPD patients. The implications of this paper: This programme may be effective in improving COPD patients' adherence to inhalation regimen and inhalation techniques.The programme is feasible and acceptable.There is need to conduct an adequately powered multisite RCT to provide stringent outcome evaluation of the IMB intervention programme. [Correction added on 28 January 2020: 'The implications of this paper' section has been amended.] [ABSTRACT FROM AUTHOR]

Purpose: The reduction of the violence and child abuse requires the cooperation of national and international health-related organizations. The purpose of this paper is to investigate the role of NGOs in health and peace development through administrating supportive programs for child abuse and violence victims. Design/methodology/approach: The present research was a mixed method research, and the type of research was a descriptive-analytic study. To collect data, library and field methods were used. The research sample included 137 staff members of the NGOs supporting children in Tehran. Data analysis was performed using SPSS software. Findings: According to authorities and members of the NGOs supporting children, networking and affective factors played a significant role in the development of health and peace (P<0.01). This was feasible by controlling the factors affecting violence and child abuse. Practical implications: Given the fact that NGOs are contributing to the development and establishment of peace through effective participation and networking, trying to support the victims of child abuse and violence, the need for more attention from governments is recommended in order to support these organizations, especially legislative and financial support is needed to expand the activities of such organizations. Originality/value: This paper is original in its method, topic and findings. The first is mixed method research, which has studied the role of networking of NGOs for peace development through implementing support programs for victims of child abuse and violence. [ABSTRACT FROM AUTHOR]

U.S. organizations seek to provide interns with positive socialization experiences such that their internships may lead to job offer acceptances. This study presents a process model examining how developmental relationships shape interns' experiences and outcomes. Utilizing a sample of 6,802 recent graduates from across 200 U.S. colleges and universities who completed an internship, the study found that supervisor support indirectly influences an intern's decision to accept a job offer through learning and intern satisfaction. Findings further show that interns benefit from developmental relationships such as mentors since mentor status buffered the decrements in learning when supervisor support was low. This study contributes to the growing internship literature that draws upon early socialization and newcomer adaptation by examining the critical role developmental relationships play in the experiences of interns. [ABSTRACT FROM AUTHOR]

This paper aims to provide a comprehensive insight into the role of mindfulness in organizational settings. A daily experience sampling method was used to explore the mechanism through which state mindfulness influences employees' work attentiveness. By collecting data from 153 full-time Chinese employees over 5 consecutive days, we used 765 matched cases to conduct a multilevel structural equation model with random slopes to test the conceptual model. The results showed that: 1) daily state mindfulness is positively related to employee work attentiveness; 2) employee moral self-efficacy mediates the indirect relationship between daily state mindfulness and work attentiveness; and 3) moral disengagement moderates the indirect relationship between state mindfulness and work attentiveness through moral self-efficacy, such that the indirect relationship will be weaker in the condition of low moral disengagement than in the condition of high moral disengagement. This research contributes to the work attentiveness literature by incorporating state mindfulness as a critical antecedent. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case. Design/methodology/approach: The paper is based on the Reassure, Explain, Listen, Answer, Take Action and Express Appreciation (RELATE) model and the Four Habits models of Clinical Communication. Findings: The results of the study indicate that leadership conducted staff meetings with some of the components of the RELATE model. These include staff meetings, employee rounding and communication/notice boards. The results of the study also suggest that much as some parts of the Four Habits model was used in provider–patient communication, certain aspects of the model were absent. The study identified some communication challenges including poor dissemination, lack of unity among some health workers, poor attendance in meetings and, with respect to patients, language barrier, patients' reluctance to disclose their actual health problems to health providers, lack of privacy and lack of a friendly environment. Practical implications: Providers, especially physicians, should be given training on the local languages in areas where they perform their services. Health service providers should receive as part of their learning in-depth training on the Four Habits model of Clinical Communication, especially the Medical Officers. Originality/value: It is imperative to embrace evidence-based practices/models aimed at securing proper communication in all hospitals but most especially teaching hospitals. [ABSTRACT FROM AUTHOR]

Purpose This paper aims to focus on the role of hospital business models by examining the innovative business model of Moheb Hospitals, which have successfully achieved the goal of reducing costs and delivering high-quality health-care services in Iran by encouraging public–private partnership.Design/methodology/approach This paper is a single case study.Findings The study results illustrate the hospital's current business model and its underlying elements. After presenting the findings, this paper is concluded by presenting the standing issues that should also be addressed and how improvements and adjustments can be made.Originality/value This study offers new insight to identify and analyze the shortcomings of health-care sector in Iran and introduces new methods to efficiently use current competencies. [ABSTRACT FROM AUTHOR]

Background: This paper compares the relationship between theoretically-driven mechanisms of change and clinical outcomes across two different interventions to improve oral hygiene of older adults participating in a group randomized trial. Methods: Six low-income senior residences were paired and randomized into two groups. The first received a face to face counseling intervention (AMI) and the second, a peer-facilitated health campaign (three oral health fairs). Both were based on Fishbein's Integrated Model. 331 participants were recruited at baseline and 306 completed the post-assessment one month after intervention. Clinical outcomes were Gingival Index (GI) and Plaque score (PS), collected by calibrated dental hygienists. Surveys obtained data on patient background characteristics and ten mechanisms of change including oral health beliefs, attitudes, norms and behaviors. GLMM was used to assess the effects of time, intervention arm, participant characteristics, intervention mechanisms and differences between the two interventions over time in relation to outcomes. Results: At baseline, both groups had similar background characteristics. Both groups improved significantly in outcomes. Overall GI scores changed from baseline mean of 0.38 (SD =.032) to.26 (SD =.025) and PS scores changed from baseline mean of 71.4 (SD = 18%) to 59.1% (SD = 21%). T-tests showed that fears of oral disease, oral health intentionality, oral health norms, worries about self-management of oral health, flossing frequency and sugar control improved significantly in both interventions from baseline to post intervention. Oral health self-efficacy, perceived risk of oral health problems, oral health locus of control and brushing frequency improved significantly only in the counseling intervention. GLMM models showed that the significant predictors of GI improvement were intentionality to perform oral hygiene, locus of control, and improvement in frequency of brushing and flossing in association with the counseling intervention. Predictors of PS improvement were worries about oral hygiene self-management and fear of oral diseases, in association with the counseling intervention. In the reduced final models, only oral health locus of control (predicting GI) and fears of oral diseases (predicting PS) were significant in association with the counseling intervention. Locus of control, a key concept in oral hygiene interventions including the IM was the main contributing mechanism for GI improvement. Fear, an emotional response, drove improvement in PS, reinforcing the importance of cognitive/emotional mechanisms in oral hygiene interventions. Conclusions: Though both groups improved in outcomes, GI and PS outcomes improved more in response to the counseling intervention than the campaign. The counseling intervention had an impact on more mechanisms of change than the campaign. Improvements in intervention mechanisms across both interventions however, suggest a closer examination of the campaign intervention impact on outcomes over time. Trial Registration: Clinicaltrials.gov NCT02419144, first posted April 17, 2015. [ABSTRACT FROM AUTHOR]

Purpose: The study's purpose is to argue from a theoretical perspective, the importance of an ethical foundation or ontology in rehabilitation. The study aims to create a theoretical model where ethics and rehabilitation form a synthesis. Method: The study is theoretical in the fields of rehabilitation and Caring Science. It follows a hermeneutic approach where the text is interpreted and analysed concerning context. Findings: A common opinion, based on our material, is that rehabilitation is a relationship rather than a separate activity area. No professional group can invoke a monopoly on rehabilitation. Who formulates clinical practice goals and determines the patients' needs? How is the rehabilitation process tailored to the theme of "what is right "and "what is best for the patient"? Conclusion: The theoretical model as it describes in this paper has opportunities to guide the ReHabilitering team against excellent ethical rehabilitation independent of clinical context. [ABSTRACT FROM AUTHOR]

Continual course correction during implementation of nutrition programmes is critical to address factors that might limit coverage and potential for impact. Programme improvement requires rigorous scientific inquiry to identify and address implementation pathways and the factors that affect them. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powder (MNP) interventions for young children. This paper focuses on how MNP interventions undertook key elements of programme improvement, specifically, the use of programme theory, monitoring, process evaluation, and supportive supervision. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that although much has been written and published about the use of monitoring and process evaluation to inform MNP interventions at small scale, there has been little formal documentation of lessons for the transition from pilot to scaled implementation. Supervision processes and experiences are not documented, and to our knowledge, there is no evidence of whether they have been effective to improve implementation. Improving the efficiency and effectiveness of interventions requires identification of critical indicators for detecting implementation challenges and drivers of impact, integration with existing programmes and systems, strengthened technical capacity, and financing for implementation of effective monitoring systems. Our understanding of programme improvement for MNP interventions is still incomplete, especially outside of the pilot stage, and we propose a set of implementation research questions that require further investigation. [ABSTRACT FROM AUTHOR]

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience-based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. [ABSTRACT FROM AUTHOR]

Background: African American men have poorer health outcomes compared to their white counterparts despite medical advancements and early detection of diseases. The purpose of this study was to determine to what extent the constructs of the multi theory model (MTM) explain the intention for initiation and sustenance of the consumption of fruits and vegetables among African American adult men in Mississippi. Methods: Using a cross-sectional design a valid and reliable paper survey was administered during November and December of 2019. The target population for the study consisted of African American adult men (18 or older) that had not consumed recommended levels of fruits and vegetables within 24 hours of taking the questionnaire. A convenience quota sample of African American men from select barbershops in Jackson, Mississippi, were asked to complete the 40-item questionnaire on preventive health screening behavior (n = 134). Results: The mean total number of fruits and vegetables consumed by participants within 24 hours of the taking the survey was 1.63 (SD =1.47). The mean intention to initiate consuming 5 or more cups of fruits and vegetables per day score was 2.13 (SD=1.17) as measured on a 5-point scale (0-4). Behavioral confidence (β = 0.495, P < 0.0001), and changes in physical environment (β = 0.230, P < 0.0001) accounted for 40.8% of the variance in predicting the intention to initiate behavioral change regarding the daily consumption of fruits and vegetables. Practice for change (β = 0.462, P< 0.001) and emotional transformation (β = 0.215, P< 0.0001) accounted for 37.5% of the variance in the intention to sustain fruits and vegetables consumption behavior. Conclusion: Based on data found in the study, MTM appears to predict the intention to initiate and sustain fruit and vegetable intake of African American men. Further research studies of suitable interventions to target African American men are needed. [ABSTRACT FROM AUTHOR]

This study explores care practices of older people outside formal care and without appealing to predefined relationships. We conducted interviews with 30 independent‐living men and women aged 67–93 in three municipalities in Sweden. The interviews explored how they cared for themselves and other older people who were not family. Interviews were conducted between December 2017 and May 2018 and later transcribed and analysed using grounded theory. Our paper presents one of the first studies on informal care practices among older people that looks beyond the definition of formal care to understand how such care complements formal care services. The findings show that older people participate in several care arrangements to care for themselves as well as for others. The arrangements feature different types of mutuality and include distant relations to other older people and larger more or less formalised groups. The findings highlight the importance of looking beyond conceptualisations of care based on understandings of formal care and specific relationships as a frame for understanding informal care. To promote older people's health by cultivating and supporting older people's care for themselves and others, research and healthcare practitioners need to explore and acknowledge the significance and complexity of older people's everyday care practices. [ABSTRACT FROM AUTHOR]

Abstact This paper revisited the vulnerability hypothesis to explain the greater level of psychological distress among working women compared to working men. A comprehensive vulnerability model was tested in which work and family stressors and psychosocial resources are directly related to psychological distress and indirectly through work‐to‐family (WFC) and family‐to‐work (FWC) conflicts. Data came from a random sample of 989 women and 1,037 men working in 63 Canadian establishments. Multilevel path analyses were performed separately for men and for women. The results show that many work/family stressors and resources are linked to men's or women's psychological distress directly and indirectly through WFC and FWC. However, the z‐test used to assess whether the relationships differed significantly between women and men indicated that only two relationships differ significantly between the two groups: experimenting problems with children and a low self‐esteem are associated positively to psychological distress through FWC only for women. In addition to showing the specific involvement of work–family conflict in the psychological distress inequality, this study contributes to revealing that testing the differences in the magnitude of the relation offer a more suitable appraisal of the vulnerability mechanism involved in the psychological distress inequality between men and women. [ABSTRACT FROM AUTHOR]

Purpose: Using the PRECEDE model, the purpose of this paper is to determine the predictors of mothers' performance in daily consumption of fruit and vegetables (FV) in rural preschoolers. Design/methodology/approach: This study was carried out on 350 mothers of preschool children who had health records in the rural health-care centers of Iran. To collect data, a researcher-made questionnaire based on the PRECEDE model was used. The data were analyzed using the SPSS 19 software. Findings: The results showed that 11.42 percent of the mothers observed the FV intake for their children recommended by WHO. The independent t-test showed a significant difference between the mean scores of predisposing, enabling and reinforcing factors. Originality/value: This study showed that the rate of FV intake by preschool children in rural areas was much lower than the recommended WHO rate. To promote behavior, attention to the predisposing, enabling and reinforcing factors seems to be necessary. [ABSTRACT FROM AUTHOR]

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This paper examines the ways in which older people's residential and nursing homes can constitute heteronormative environments – social spaces in which the same-sex attractions and desires of residents are disregarded in the provision of everyday care. The aim of this discussion is to examine the synergies and differences between older lesbian, gay and bisexual (LGB) adults' expectations for future care home provision and the expectations of care staff and managers in providing residential services to older people with diverse sexual backgrounds. We present qualitative evidence from research into the provision of care environments in Wales. In this paper, we present findings from two cohorts: first, from five focus groups with care and nursing staff and managers; and second, from 29 semi-structured interviews with older LGB adults (50–76 years) residing in urban and rural locations across Wales. We argue that residential care environments can constitute heterosexualised spaces in which LGB identities are neglected in comparison to the needs and preferences of other residents. To this extent, we discuss how care staff and managers can be more attentive and responsive to the sexual biographies of all residents and argue against the separation of care and sexual orientation in practice. [ABSTRACT FROM PUBLISHER]

Objective: This study aims to examine the impact of nurses' nursing information competence on their creative self-efficacy and innovation behavior, and to investigate its role as a mediating factor between these two elements. Methods: A survey was conducted from July to September 2023 involving 1,200 nurses from two tertiary-level oncology specialty hospitals in Beijing, selected through convenience sampling. Instruments used included the Creative Self-Efficacy Scale, Nursing Information Competence Assessment Scale, and Nurses' Innovative Behavior Scale. Data analysis was conducted using SPSS 25.0 and R 4.1.2; AMOS26 was used to construct structural equation models and Bootstrap method was used to test the mediating hypotheses. Results: Out of the distributed questionnaires, 1,166 were valid, yielding an effective response rate of 97.16%. Pearson correlation analysis revealed significant correlations between innovation self-efficacy, nursing information competence, and nurses' innovative behaviors (P < 0.001). The Bootstrap method indicated that nursing information competence serves as a mediating factor in the relationship between creative self-efficacy and innovative behaviors, contributing to 24.5% of the observed effect. Additionally, regression analysis suggested that nursing information competence moderates the relationship between creative self-efficacy and innovation behavior. Conclusion: The findings suggest that nursing information competence not only mediates but also moderates the relationship between creative self-efficacy and innovative behavior. Enhancing nurses' information competence could therefore foster creative self-efficacy, leading to an increase in innovative behavior and, subsequently, improvements in the quality of oncology nursing care. [ABSTRACT FROM AUTHOR]

The subjective orgasm experience (SOE) refers to the perception, sensation and/or evaluation of orgasm from a psychological point of view, representing an important construct of sexual functioning rarely studied under a dyadic approach. This study analyzed SOE in the contexts of sexual relationships and solitary masturbation in 179 different-sex and same-sex couples. The results indicated the absence of differences in intradyadic discrepancies in SOE dimensions in both sexual contexts, varying according to the type of couple. Besides, the study also highlights the influence of some of these discrepancies of SOE in solitary masturbation on SOE discrepancies in sexual relationships among the members of male-female and female-female couples. Furthermore, the study revealed that the intensity of partners' orgasm experience during solitary masturbation influences the intensity of SOE during sexual relationships, with variations observed based on the type of couple. These findings highlight the importance of considering SOE from a dyadic approach, with the association of orgasmic experience in both sexual contexts gaining relevance, differing according to the couple type. The results also point to the clinical implications of the dyadic effects of such an individual practice as solitary masturbation on shared sexual experiences. [ABSTRACT FROM AUTHOR]

Low-stakes test performance commonly reflects examinee ability and effort. Examinees exhibiting low effort may be identified through rapid guessing behavior throughout an assessment. There has been a plethora of methods proposed to adjust scores once rapid guesses have been identified, but these have been plagued by strong assumptions or the removal of examinees. In this study, we illustrate how an IRTree model can be used to adjust examinee ability for rapid guessing behavior. Our approach is flexible as it does not assume independence between rapid guessing behavior and the trait of interest (e.g., ability) nor does it necessitate the removal of examinees who engage in rapid guessing. In addition, our method uniquely allows for the simultaneous modeling of a disengagement latent trait in addition to the trait of interest. The results indicate the model is quite useful for estimating individual differences among examinees in the disengagement latent trait and in providing more precise measurement of examinee ability relative to models ignoring rapid guesses or accommodating it in different ways. A simulation study reveals that our model results in less biased estimates of the trait of interest for individuals with rapid responses, regardless of sample size and rapid response rate in the sample. We conclude with a discussion of extensions of the model and directions for future research. [ABSTRACT FROM AUTHOR]

Purpose: In this paper, we present an exploratory, qualitative strand of a multiphase program evaluation of the Canadian-based SNAP® Youth Justice (SNAP YJ) model for males involved with the youth criminal justice system. SNAP YJ's therapeutic approach is founded on the evidence-based SNAP (Stop Now And Plan) model which focuses on strategies to enhance emotion regulation, self-control, and problem-solving for latency-aged children and their families. Integrating best practices from the literature, the SNAP YJ intervention uses technology (digital modules) to convey the manualized strategies and program sessions, engaging youth in an interactive manner. This systemic, cognitive behavioral intervention is designed to reduce further contact with the law and/or gang affiliation. The objectives of this study are to understand youth experiences of programing, enrich and contextualize preliminary outcome findings, and further develop programing through the inclusion of the youth perspective and feedback. Methods: A thematic analysis of 15 interviews with program participants from diverse backgrounds was conducted. Results: The results revealed a continuum of learning related to self-understanding and awareness of feelings; thinking and consequences; and prosocial skills and behavior. Discussion: Refinements to the program to target increased program effectiveness as a result of youth experiences are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Feedback is a tool that informs students about their learning process and facilitates necessary changes. It looks for the students' own perceptions of their performance and how to improve it, developing permanent learning skills vital for autonomous practice. It is useful for improving one's performance, clinical skills, communication and treatment of patients. If carried out improperly, it causes a lack of motivation and a collapse in the teacher–student relationship. The purpose of this paper is to analyze the perceptions and experiences of the residents and graduates of the psychiatry specialty at the Universidad of Concepción with respect to the feedback received on their performance during their training. Design/methodology/approach: The study was conducted using a qualitative approach of an exploratory, descriptive and interpretative nature that was also based on Grounded Theory. Ten in-depth voluntary interviews were conducted with residents-in-training and graduates from within the last two years of the Adult Psychiatry specialty at the Universidad of Concepción. Subsequently, the data were codified to create a theoretical model. Findings: The interpersonal teacher–resident relationship, when based on collaboration and an openness to dialogue, is fundamental in producing effective feedback. Research limitations/implications: The limitations of this study were based mainly on the qualitative methodology used, so it is not possible to generalize the results. Although the above limitation, this study seems to reaffirm the importance of feedback for residents in training, so it would be advisable to reproduce it in various training contexts and extend it to the perception of the teachers involved. On the other hand, to follow this research line, it is essential to create instruments that facilitate the use of quantitative research methodology, which allows the generalization and comparison of results in different areas. Social implications: This research opens a first line of research regarding subjective experience when receiving feedback, which will allow the creation of instruments to objectify how it is being developed in different educational contexts and to propose strategies to standardize its realization. Originality/value: There are no other studies of this type published. The originality of this research was that beyond the mention made about the known characteristics that a feedback must have to be effective, the participants gave special emphasis to the fact that it is a social relationship, which should be based on a horizontal interaction between two actors, in addition to promoting dialogue and mutual involvement in the task that brings them together. Thus it is an effective teaching strategy, fulfilling the objective of motivating the learning and autonomy of the resident. [ABSTRACT FROM AUTHOR]

Purpose Health Sector Evolution Plan (HSEP) is known as the biggest and most comprehensive reform in Iran's health system. One of the goals of HSEP is to reduce inequity in the healthcare financing. The purpose of this paper is to demonstrate HSEP agenda setting from the perspective of equity in healthcare financing (EHCF) using the multiple streams model.Design/methodology/approach This qualitative study was conducted by 26 documents review and analysis, and 30 semi-structured interview with Iranian key informants in the field of HSEP that were selected based on purposeful and snowball sampling method. Data were collected using a researcher-made checklist based on the goals. All audio-taped interviews were transcribed and analyzed thematically. Data management and analysis were performed using the framework analysis in MAXQDA software.Findings The framework analysis identified 12 complementary sub-themes totally. Problem stream included four sub-themes (high share of Out Of Pocket, high index of catastrophic health expenditures, low EHCF index, and inappropriate economic state and sanctions). Focus on EHCF in general policies of the Iran World Health Organization's report in 2000, the Targeted Subsidies Law and emphasis on equalizing healthcare financing in the Fourth and Fifth Development Plan were considered as policy stream sub-themes. Finally, political stream showed four sub-themes including strong support from the Minister of Health for HSEP, mass media, the pressure of WHO and people's request to reduce health costs.Research limitations/implications The limitations of the present study included paying attention to one package (evolution in the treatment sector) of three health packages to assess EHCF, as well as the lack of similar national and international evidence in implementation framework.Practical implications The results of this study can be used to analyze other health sector reforms around the word and can help the formulation and implementation of most practical reforms, especially in field of health system financing.Social implications This study gives a holistic view about health system policy setting that can be used for understanding policy-making streams to population.Originality/value This is the first study that has examined HSEP (the biggest health sector reform in Iran) from the perspective of agenda setting. In addition, using the popular and well-known Kingdon's model to explain HSEP agenda setting is one of the strengths of this study. Furthermore, taking advantage of a wide range of related views by including highly informed people increased the strength of the results of the study. In addition, the short interval between the interview and reviewing the results on reforms reduced the recall bias of the participants in the study. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the relationship between the age-friendliness of local environments and self-reported loneliness for a representative sample of community-dwelling adults aged 55+ in Ireland. Design/methodology/approach: Data were from the Healthy and Positive Ageing Initiative Age friendly Cities and Counties Survey (n=10,540) (2016). Several age friendly indicators, as proposed by World Health Organisation, were included in this study: outdoor spaces and buildings; access to social services; social participation; respect and social inclusion; and transport. Loneliness was measured using five items from the UCLA Loneliness Scale. Informed by an ecological approach to ageing, multi-level negative binomial regression models were used to investigate the association between each age friendly indicator and social loneliness. Models were adjusted for known demographic, socio-economic and health correlates of loneliness. Findings: Average loneliness scores were significantly higher for those in poorer health, who lived alone, were materially deprived and those never or formerly married. Lower ratings and poorer outcomes for several interrelated age friendly place-based factors were significantly associated with higher loneliness scores: difficulty with transport, difficulty accessing social services, barriers to community activities, lower social engagement, and experiences and perceptions of ageism in the community; however, the effect sizes were small. Originality/value: This study identified several modifiable age friendly features of local environments that are associated with loneliness in this older population. The results of this study can inform coordinated local and national efforts to enhance the age-friendliness of local environments and reduce the risk and experience of loneliness among the ageing population in Ireland. [ABSTRACT FROM AUTHOR]

Research on recovery from work stress has emphasized the importance of within‐day work breaks. However, prior research has not been designed and analysed in a way that fully aligns with the processes described by the underlying theoretical framework (i.e., the effort‐recovery model). The current paper examines the effects of within‐day work breaks on recovery using an event‐based pre‐/post (EBPP)‐design, in a way that more fully captures the recovery process as described by the effort‐recovery model. We also included designs used in previous studies (i.e., an interval‐based design and an event‐based design without pre‐break strain measures) to demonstrate the differences between the EBPP design and previous designs. The results of the EBPP model using a sample of Chinese white‐collar employees showed that within‐day work breaks are significantly associated with reduced fatigue and negative affect and increased positive affect, supporting the predicted recovery effects of within‐day work breaks. However, mixed results were found in the interval‐based design, and non‐significant results were found in the event‐based design without pre‐break measurements. We discuss methodological implications and explain how the EBPP design could be applied to study other episodic phenomena. Practitioner points: An event‐based pre‐/post‐design (EBPP) can be used to study recovery and other momentary, episodic events at work.Within‐day work breaks can help employees reduce fatigue and negative affect and increase positive affect.Relaxation break activities, nutrition‐intake activities, social activities, and cognitive activities help recovery. [ABSTRACT FROM AUTHOR]

A standard approach to analysis of case-cohort data involves fitting log-linear models. In this paper, we describe how standard statistical software can be used to fit a broad class of general relative rate models to case-cohort data and derive confidence intervals. We focus on a case-cohort design in which a roster has been assembled and events ascertained but additional information needs to be collected on explanatory variables. The additional information is ascertained just for persons who experience the event of interest and for a sample of the cohort members enumerated at study entry. One appeal of such a case-cohort design is that this sample of the cohort may be used to support analyses of several outcomes. The ability to fit general relative rate models to case-cohort data may allow an investigator to reduce model misspecification in exposure-response analyses, fit models in which some factors have effects that are additive and others multiplicative, and facilitate estimation of relative excess risk due to interaction. We address model fitting for simple random sampling study designs as well as stratified designs. Data on lung cancer among radon-exposed men (Colorado Plateau uranium miners, 1950–1990) are used to illustrate these methods. [ABSTRACT FROM AUTHOR]

Biomarkers are playing an increasingly important role in disease screening, early detection, and risk prediction. The two-phase case-control sampling study design is widely used for the evaluation of candidate biomarkers. The sampling probabilities for cases and controls in the second phase can often depend on other covariates (sampling strata). This biased sampling can lead to invalid inference on a biomarker's classification accuracy if not properly accounted for. In this paper, we adopt the idea of inverse probability weighting and develop inverse probability weighting-based estimators for various measures of a biomarker's classification performance, including the points on the receiver operating characteristics (ROCs) curve, the area under the ROC curve (area under the curve), and the partial area under the curve. In particular, we consider classification accuracy estimators using sampling weights estimated conditionally on sampling strata and further improve their efficiency through the use of estimated weights that additionally take into account the auxiliary variables available from the phase-one cohort. We develop asymptotic properties of the proposed estimators and provide analytical variance for making inference. Extensive simulation studies demonstrate excellent performance of the proposed weighted estimators, while the traditional empirical estimator can be severely biased. We also investigate the advantages in efficiency gain for estimating various classification accuracy estimators through the use of auxiliary variables in addition to sampling strata and apply the proposed method to examples from a renal artery stenosis study and a prostate cancer study. [ABSTRACT FROM AUTHOR]

The mental health care environment is a stressful environment, especially among student nurses. The purpose of the study was to develop a model of emotional support for student nurses working in the mental health care environment. The objectives were set in two phases: Phase one -- identification of concepts; Phase two -- development of a model of emotional support for student nurses. A theory-generating design, based on a qualitative, explorative and descriptive research approach, was used to meet the aim of the study. Data was purposively collected from 40 nursing students using (n=6) focus group discussions and eight educators and nine clinical staff by way of semi-structured interviews. Data was analysed by means of Tesch's method of data analysis. The model was developed by means of the four steps of which the first two are discussed in this paper as step three and four will be discussed elsewhere. Step one is the concept development consisting of concept identification and concept definition. A total of 22 concepts were identified, which were synthesised into six main concepts, namely, positive self-concept, positive work environment, academic and professional development, effective communication, formal and informal supportive interventions, and collaboration between the higher education institution and the mental health care setting. Step two is the model development during which the main concepts were placed in relation to one another, which formed an emotional support model for students working in mental health care settings. This paper gives an account of the methodological processes that were utilised to meet the aim and objectives of the study. [ABSTRACT FROM AUTHOR]

Consumer-directed care (CDC) is increasingly widespread among aged care service options in Organisation for Economic Co-operation and Development (OECD) countries. However, the evidence base regarding the programmatic and contextual factors that affect the outcome of CDC interventions is surprisingly small. This paper reports on a self-directed care approach for older Australians with complex care needs. A multimethods longitudinal comparative cohort study was employed comprising 4 survey tools and 56 semi-structured interviews. Participation rates were around 20%. A total of 185 (98 in the intervention and 87 in the control group) older people and carers were recruited at baseline. Eleven months later, 109 participants (59 in the intervention and 50 in the control group) completed the repeat measure. Attrition rates were around 40%. Data collection occurred between July 2010 and April 2012. The data suggest that intervention group participants were likely to be more satisfied with the way they were treated (P = 0.013), their care options (P = 0.014), the 'say' they had in their care (P < 0.001), the information they received regarding their care (P = 0.012), what they were achieving in life (P = 0.031), that the services changed their view on what could be achieved in life (P = 0.020) and with their standard of living (P = 0.008). The evaluation suggests that while only a very small segment of older people is interested in a voucher or cash option, a substantially larger group would like to have greater say over and more direct access to their care, without, however, assuming administrative and financial responsibilities. The paper concludes that a stepped capacity-building approach to CDC may improve the acceptability of CDC to older people and generate synergies that improve older people's care outcomes. [ABSTRACT FROM AUTHOR]

This paper describes the process a wound care team used to develop a protocol to standardise the care of skin tears in an orthopaedic specialty hospital. The aims of the project were to: 1) find a classification tool to implement standardisation and 2) develop and implement a treatment algorithm and guidelines according to current evidence. A protocol and algorithm were developed to deal with skin tears in a standardised format. Knowledge increased 36% after an educational intervention targeting skin tear aetiology and implementation of the newly developed protocol. [ABSTRACT FROM AUTHOR]

This introduction to the Special Issue Indigenous Youth Resilience in the Arctic reviews relevant resilience theory and research, with particular attention to Arctic Indigenous youth. Current perspectives on resilience, as well as the role of social determinants, and community resilience processes in understanding resilience in Indigenous circumpolar settings are reviewed. The distinctive role for qualitative inquiry in understanding these frameworks is emphasized, as is the uniquely informative lens youth narratives can offer in understanding Indigenous, cultural, and community resilience processes during times of social transition. We then describe key shared cross-site methodological elements of the Circumpolar Indigenous Pathways to Adulthood study, including sampling, research design, procedures, and analytic strategies. The site-specific papers further elaborate on methods, focusing on those elements unique to each site, and describe in considerable detail locally salient stressors and culturally patterned resilience strategies operating in each community. The concluding paper considers these across sites, exploring continuities and discontinuities, and the influence of cross-national social policies. [ABSTRACT FROM AUTHOR]