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With science and digitalisation emphasised further in the new Swedish preschool curriculum, there is a need to clarify teachers' role in educating children in and about these areas. With research pointing out the importance of a conscious language use in STEM teaching, we here focus on words used by teachers and children during inquiry-based STEM activities in five different preschools. Bers' powerful ideas about early childhood computational thinking (Bers 2018. Coding as a Playground. New York: Routledge.) were used for analysis and results highlight how digital programming and use of robots can promote a more versatile use of robotic words, compared to analogue, 'unplugged', programming without robots. Furthermore, it is also found that use of precise decontextualised language by the teacher seems to stimulate children's use of words related to STEM and the object of learning. The findings add to the discussion about how teachers can scaffold children's learning by inquiry teaching of STEM supported by robotics. [ABSTRACT FROM AUTHOR]

Clinicians and researchers have traditionally worked in independent silos, with limited collaboration to rapidly translate discovery into clinical practice. At institutional level, hospitals and universities have also tended to work independently with limited success in leveraging each other's strengths with a view to improving population health. The consequences include fragmentation of clinical services, poor communication between researchers and clinicians, lengthy delays in identification of clinical problems requiring innovative solutions through research and a generation of clinicians who are not well equipped with all the skills to address future health needs. Academic Health Science Systems (AHSS) have been proposed as a mechanism for driving effective collaboration between academia and clinical services. There are examples of well established AHSS and the benefits have been articulated. In Singapore, three AHSS have been established over the past 15 years. National dental specialty centres and one dental school have been embedded in AHSS and have well established multi‐disciplinary collaboration across clinical and academic domains. The aim of this commentary is to describe the concept of an AHSS and some of the areas where dentistry in Singapore has been transformed by having key dental institutions embedded in an AHSS. [ABSTRACT FROM AUTHOR]

In recent years, the number of autistic people entering university has increased in Australia and worldwide. While an encouraging trend, autistic students' completion rates remain much lower than non-autistic students in Australia. Perhaps unsurprisingly, numerous studies investigating autistic people's experiences at universities have identified stigma and discrimination as a significant barrier facing autistic people in higher education. In this study, our team of autistic co-researchers and non-autistic researchers co-produced an in-depth qualitative study to understand the contexts and circumstances in which autistic people felt stigmatised or experienced discrimination at universities in Australia. We interviewed 21 autistic people who either had completed at least one university course, or were studying a university course, or had enrolled in but discontinued at least one university course in Australia. Using reflexive thematic analysis, we identified four themes: (1) 'My disability is something that people just don't have a clue about', (2) 'the system is really stacked against you', (3) the onus is on autistic students, and (4) 'grit and stubbornness'. Based on these findings, we suggested implementing Universal Design for Learning, neurodiversity-affirming and trauma-informed practices, together with a participatory approach to better design university curricula, processes, and support services for autistic students. Autistic students experience many challenges at university. One significant barrier identified in past research was autistic students' experiences of discrimination (i.e. being treat differently) and stigma (being judged differently). Our research team included both autistic and non-autistic researchers who designed a project to help explore autistic students' experiences of stigma and discrimination at Australian universities. We interviewed 21 autistic students who went to a university – some had completed qualifications, and some had not. From our interviews, we identified four themes: (1) 'My disability is something that people just don't have a clue about', (2) 'the system is really stacked against you', (3) the onus is on autistic students, and (4) 'grit and stubbornness'. As a result, we recommended changes in the way courses are written and taught so that autistic people have opportunities that meet their ways of learning. It is also important for university staff to understand the impact of trauma experienced by autistic people and that universities work together with autistic people to design courses and supports that include autistic ways of learning, accessible university processes and identify support needs. [ABSTRACT FROM AUTHOR]

The experiences of autistic parents when interacting with statutory services for their autistic children is not well understood. This study investigates the experiences of autistic parents' interactions with statutory services, including education and healthcare, in relation to their autistic children. Interpretative Phenomenological Analysis was used to investigate their experiences. Ten autistic mothers of autistic children in mainstream education completed semi-structured interviews, which were co-developed with autistic parents. Two superordinate themes were developed: (1) The wider system is the problem and (2) Feeling judged and stigmatised. While Theme 1 demonstrates some similarities in the experiences of autistic parents to that of non-autistic parents in previous studies, theme 2 is unique to autistic parents who may feel that they are being treated differently. These themes indicate the importance of training encouraging a strength-based rather than deficit-based understanding of autism. Participants highlighted the wider system is the problem rather than individual professionals, and that it places some families at a disadvantage. Becoming a parent is an important part of adult life for many people, including autistic people. Many parents of autistic children can find getting the right support for their children difficult. Knowledge is currently poor about how this is experienced by parents who are also autistic themselves. The main researcher is also an autistic parent to an autistic child and other experts by experience were consulted in the development of the study. Ten autistic mothers with autistic children in mainstream education were interviewed about their experiences of seeking support for their autistic children from services such as healthcare and education. Participants talked about finding the overall system being the main problem, rather than the individuals working in it, and about needing to fight to get the right support for their children. These are points that non-autistic parents have also raised before. Participants also talked about feeling judged and stigmatised for being autistic, and about struggling to manage sensory and communication difficulties, which is something that has not been talked about by non-autistic parents. Improving services to offer better support to autistic families is important and can be achieved through better training. This training should be developed and run by autistic adults and focus on positive aspects of autism, rather than negative. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the views of autistic adults on randomised controlled trials, specifically on processes such as randomisation and blinding, to understand the barriers and facilitators for recruiting autistic people to randomised controlled trials involving medications. We conducted one-to-one interviews with 49 autistic adults. Interviews were audio-recorded and analysed thematically. The participants found randomised controlled trial processes acceptable and linked positive attitudes towards randomised controlled trial participation to autistic peoples' heightened sense of fairness and preference for evidence-driven knowledge. However, randomised controlled trial designs may be incompatible with a (1) preference for a controlled predictable world, (2) perceived vulnerability at physical and mental health levels and (3) history of misunderstanding and exclusion, crucially from healthcare professionals. Suggestions that emerged from our findings include efforts to co-produce research to nurture trust and adapting communication practices to improve access to trials. Autistic people are a highly motivated group to work with research teams to mitigate barriers to randomised controlled trial participation. We explored what psychosocial determinants play a role in the acceptability of randomised controlled trials to test interventions to improve quality of life and mental health in autistic adults. The study provides useful information that may help the design and conduct of more accessible trials with and for the autistic community. Large randomised controlled trials are used to test healthcare treatments. Yet there are no large randomised controlled trials on effective treatments for common mental health issues affecting autistic adults. The purpose of this study was to learn what autistic adults think about randomised controlled trials in preparation for a randomised controlled trial testing a medication for anxiety. This means we wanted to know their opinions about the way randomised controlled trials are done, such as how people are chosen to be in the study and how the study is carried out. We did this by talking to 49 autistic adults individually and asking them questions. We found that most of the people we talked to were okay with the way randomised controlled trials are done. They thought it was fair and they liked that it was based on evidence. However, some autistic people might find it hard to take part in randomised controlled trials. Some people did not like the uncertainty of not knowing what treatment they would receive in a randomised controlled trial. Others felt too vulnerable and may have had bad experiences with healthcare in the past. We found that it is important to involve autistic people early on and at every stage when designing a clinical trial. Care about how clear and precise the study communication is will build trust and improve access to research. Our study indicates that it is possible to conduct large randomised controlled trials with and for autistic people. This can ultimately contribute to the improvement of healthcare outcomes for this population. [ABSTRACT FROM AUTHOR]

Naturalistic developmental behavioral interventions are an empirically supported intervention approach for young autistic children. Despite the prevalence of disruptive behaviors among autistic children, most manualized caregiver-mediated naturalistic developmental behavioral interventions include limited formal guidance on when and how to manage disruptive behavior. The present study sought to characterize how clinicians address disruptive behaviors within the caregiver-mediated naturalistic developmental behavioral intervention, Project ImPACT, the effect of disruptive behavior on Project ImPACT delivery, and the extent to which disruptive behavior impacts social communication outcomes. Data collection was embedded within outpatient early intervention services and included clinicians' report of adaptations to address behavior within the electronic medical record, child social communication outcomes from 124 children and their caregivers, and interviews with certified Project ImPACT coaches and trainers. Results indicate that close to one-third of Project ImPACT sessions included adaptations made to address behavior and regulation. Furthermore, adaptations made to address disruptive behavior were associated with more adaptations to Project ImPACT overall, although behavior adaptations were not associated with child social communication outcomes. Qualitatively, clinicians described using a flexible approach to integrate content and coaching related to behavior and regulation. The present study indicates several future directions for supporting clinicians in addressing behavior and regulation within the naturalistic developmental behavioral intervention framework. Naturalistic developmental behavioral interventions are a common and well-researched type of intervention for young autistic children that focus on supporting social communication. These interventions often do not include formal guidelines on how to address disruptive behaviors, even though they are common among autistic children. This study measured how often clinicians delivering a specific naturalistic developmental behavioral intervention, Project ImPACT, adapted how they delivered the program to address disruptive behavior, and how these adaptations related to children's social communication outcomes at the end of their participation in the intervention. We also spoke with clinicians about how they address disruptive behavior and emotion regulation during their sessions. In this study, clinicians adapted Project ImPACT to address disruptive behaviors in about one-third of all sessions. These adaptations did not affect children's social communication outcomes. Clinicians discussed how they felt social communication, disruptive behavior, and emotion regulation are linked to one another and that they often try to integrate intervention strategies to address each of these areas. However, they note that a clinicians' approach to addressing disruptive behavior might vary depending on their level of training and experience. These results indicate several future directions for supporting clinicians in addressing behavior and regulation effectively within these types of interventions. [ABSTRACT FROM AUTHOR]

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

To verify the factor structure of the LIFE-H 3.1-Brasil in a sample of independent older adults, and to analyze their responses to the instrument. Cross-sectional study with175 older adults assisted by the Family Health Strategy in the interior of the State of São Paulo/Brazil. We used Cronbach's alpha to assess internal consistency, Pearson's correlation coefficient for retained dimensions, and exploratory factor analysis to examine the factor structure. Among participants, 62.3 per cent were women, 49.2 per cent were aged between 60–69 years, 54.3 per cent had 0–3 years of schooling and 67.4 per cent were retired. Based on our factor analysis, four factors were identified that explained 43.5 per cent of the variance: personal care, community, recreation, and communication. Cronbach's alphas ranged from.76 to.93. We demonstrated that a 4-dimensional model for the LIFE-H 3.1-Brasil was valid and reliable to measure the quality of social participation of independents older adults living in the community. Findings support its use in clinical practice and research. Nonetheless, future research is warranted to confirm the proposed factorial structure. This study supports the importance of identifying older adults' social participation through a valid instrument such as the LIFE-H, which has been widely used internationally. [ABSTRACT FROM AUTHOR]

Objective: To explore the treatment experiences of those diagnosed with large to massive rotator cuff tears and the perspectives of healthcare practitioners providing their care. Design: A qualitative descriptive study using reflexive thematic analysis. Setting: In-person focus groups were undertaken in a clinical setting (private practice [ n = 1]; public outpatient [ n = 2]). Semi-structured interviews were conducted online via Microsoft Teams. Participants: Patients diagnosed with these tears (n = 12) and healthcare practitioners (n = 11). Results: Two interlinking themes were identified based on the care received and provided for patients with symptomatic large to massive rotator cuff tears: 1) Positive treatment experiences and management: Education, clear communication and reassurance around prognosis were the foundation of positive patient–clinician care. Sub-themes of pain relief, exercise prescription and confidence in their pathway underpinned this experience. This proficiency in care was affirmed by some healthcare practitioners who spoke about the importance of confidence and experience in their management plan even in times of poor progress. 2) Negative treatment experiences and management: Uncertainty, delays and exacerbation of pain flawed the patient–clinician care. Sub-themes of inappropriate pain relief, inappropriate exercise prescription and uncertainty impacted their care. Some healthcare practitioners acknowledged knowledge gaps led to uncertainty especially when choosing the next step of care and were quick to escalate care to deflect this uncertainty. Conclusions: The findings suggest discordance exists between the patient's experiences and expectations when the delivery of care was by less experienced and confident healthcare practitioners in the management of this condition. This highlights the need for improved education and support for healthcare practitioners. [ABSTRACT FROM AUTHOR]

In today's society, one will find a variety of parenting practices that might be imbedded in the parent's religious beliefs. However, little research has been done on the influences of religious beliefs on parenting practices. The aim of this paper was to systematically examine whether religion or religious beliefs influence parenting practices. The study engaged in a systematic review methodology that objectively analysed the studies dealing with the issue. The findings of the study revealed that the influence of religious beliefs on parenting practices has both a positive and negative impact on the children and the family as a whole. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges ICU (Intensive care unit) clinicians face in conducting end-of-life care conversations, highlighting barriers such as system issues, variability in conversation quality, goal misalignment, and clinician moral distress.

The article highlights ongoing misconceptions about the Physician Payments Sunshine Act and reveals high rates of undisclosed financial conflicts among guideline authors in radiology journals, prompting discussions about the need for clearer disclosure policies.

Background: There are numerous publications on inpatient medication errors. However, little focus is given to medication errors that occur at home. Aims: To describe and analyse the types of medication errors among community-dwelling patients following their discharge from an acute care hospital in Singapore. Method: This is a retrospective review of a 'good catch' reporting system from December 2018 to March 2022. Medication-related errors were extracted and analysed. Findings: A total of 73 reported medication-related error incidents were reviewed. The mean age of the patients was 78 years old (SD=9). Most patients managed their medications independently at home (45.2%, n=33). The majority of medications involved were cardiovascular medications (51.5%, n=50). Incorrect dosing (41.1%, n=39) was the most common medication error reported. Poor understanding of medication usage (35.6%, n=26) and lack of awareness of medication changes after discharge (24.7%, n=18) were the primary causes of the errors. Conclusion: This study's findings provide valuable insights into reducing medication errors at home. More attention must be given to post-discharge care, especially to preventable medication errors. Medication administration and management education can be emphasised using teach-back methods. [ABSTRACT FROM AUTHOR]

The field of arts and health has been growing rapidly in the Republic of Korea (ROK) as a means to solve social problems with the development of arts and health government programs to prevent mental disorders and improve quality of life. This study addresses the history, policy and funding scale, practices, and challenges of the arts and health in the ROK and provides a global overview of different countries to guide development procedures and communicate directions to relevant stakeholders. Data were collected using various methods, including policy reports, grey literature, peer-reviewed articles, and open data provided by Statistics Korea. Progress has been made in identifying specific opportunities for the arts to address mental health concerns in the Korean society. Specialty and digital arts are emerging as new professional practices in the arts and health fields. Establishing new government agencies is the next challenge toward identifying and reaching a consensus among relevant stakeholders for the future development of arts and health in the ROK. [ABSTRACT FROM AUTHOR]

COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress. Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered. Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety. Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing. [ABSTRACT FROM AUTHOR]

This study explores siblings' experiences of family relations before their siblings' drug-related death. A qualitative approach inspired by reflexive thematic analysis was chosen for the analysis. Four men and ten women, aged 23–61 and representing all regions of Norway, were interviewed. Three themes were identified: (1) A changed view of both their sibling and personal relationship, (2) Changed patterns of communication in the family and (3) Coping strategies. The results are discussed through the lens of family systems theory and salutogenesis. [ABSTRACT FROM AUTHOR]

Family relations are essential for the bereaved in terms of healing and adjusting to life, especially after experiencing a traumatic death. Although 500 000 people die in drug-related deaths each year, few works focus on family interactions and the help needs of those bereaved by such losses. In this qualitative study, we interviewed 14 parents who had lost their child through a drug-related death. Through a reflexive thematic analysis, we generated three themes: (I) considerable needs in the family become our responsibility, capturing how parents try to mend the disrupted family system and provide adequate care for those who struggle after death, (II) conversations that are important for family connections are obstructed, encompassing how family members sometimes seem afraid of grief emotions and try to protect each other by not talking, and (III) as parents, we can strengthen family connections, encapsulating how parents create space to talk and listen to each other in the family and navigate relational challenges in maintaining relationships. The findings are discussed through the Dual Process Model of Coping with Bereavement as well as family resilience theory. Based on the results, we propose that professional family-oriented help efforts for drug death-bereaved families in two main domains should be considered. The first includes those related to the family's need and ability to adapt roles and relationships to the new reality, and the second involves those connected to creating a space and environment for emotional sharing and joint meaning-making processes in the family. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To understand frontline ICU clinician's perceptions of end-of-life care delivery in the ICU. DESIGN: Qualitative observational cross-sectional study. SETTING: Seven ICUs across three hospitals in an integrated academic health system. SUBJECTS: ICU clinicians (physicians [critical care, palliative care], advanced practice providers, nurses, social workers, chaplains). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In total, 27 semi-structured interviews were conducted, recorded, and transcribed. The research team reviewed all transcripts inductively to develop a codebook. Thematic analysis was conducted through coding, category formulation, and sorting for data reduction to identify central themes. Deductive reasoning facilitated data category formulation and thematic structuring anchored on the Systems Engineering Initiative for Patient Safety model identified that work systems (people, environment, tools, tasks) lead to processes and outcomes. Four themes were barriers or facilitators to endof- life care. First, work system barriers delayed end-of-life care communication among clinicians as well as between clinicians and families. For example, overreliance on palliative care people in handling end-of-life discussions prevented timely end-of-life care discussions with families. Second, clinician-level variability existed in end-of-life communication tasks. For example, end-of-life care discussions varied greatly in process and outcomes depending on the clinician leading the conversation. Third, clinician-family-patient priorities or treatment goals were misaligned. Conversely, regular discussion and joint decisions facilitated higher familial confidence in end-of-life care delivery process. These detailed discussions between care teams aligned priorities and led to fewer situations where patients/families received conflicting information. Fourth, clinician moral distress occurred from providing nonbeneficial care. Interviewees reported standardized end-of-life care discussion process incorporated by the people in the work system including patient, family, and clinicians were foundational to delivering end-of-life care that reduced both patient and family suffering, as well as clinician moral distress. CONCLUSIONS: Standardized work system communication tasks may improve end-of life discussion processes between clinicians and families. [ABSTRACT FROM AUTHOR]

Background: Studies delving into the personal and professional experiences of psychotherapists working with children and adolescents who have been sexually abused are scarce and mostly cross‐sectional. Aim: The present qualitative longitudinal study aimed to describe the narratives that therapists construct about their personal and professional experiences of working with children and/or adolescents who have been victims of sexual aggression during different moments of the psychotherapeutic process. Method: Eight psychologists were interviewed and asked about the psychotherapy of 12 cases they were developing. These cases were of children and adolescents who had been sexually abused. Each participant was interviewed at different moments of the cases' psychotherapy (6 months into the process, 12 months into the process and once more at the end of therapy for those who received therapy for longer than 12 months). A total of 34 interviews were conducted and studied through narrative analysis. Results: Three major themes involving the personal and professional experiences of psychotherapists emerged: regarding the patient and their family; regarding the institutional context; and regarding the personal/professional experience. Also, identified and analysed convergences and divergences that appear within these themes at different points in the participants' interviews are highlighted. Discussion: The findings suggest that therapists manage to navigate the most complex and distressing aspects of each intervention case in the earlier moments of the psychotherapeutic process and later are likely to have an emotional connection with pleasant or satisfactory elements in their work and are likely to end treatment with an appreciation for the learning experiences they have had working with challenging cases and a sense of amazement at the resources and resilience of the children and adolescents they work with. [ABSTRACT FROM AUTHOR]

Purpose: For children with advanced cancer and their families, communication about prognosis is critical. Unfortunately, data demonstrate that prognostic communication occurs infrequently and inconsistently across advancing illness. Prior to developing an intervention to improve prognostic communication, we aimed to (1) characterize parent and oncologist perspectives on “best” approaches for prognostic communication, and (2) explore similarities and differences between parent and oncologist perspectives. Methods: Children with poor-prognosis solid tumors, their parents, and oncologists were followed prospectively for 24 months or until death. Matched semi-structured interviews were conducted with parents and oncologists 0–7 days after medical encounters at timepoints of disease progression or relapse. Reflexive thematic analysis was conducted to describe parent and oncologist impressions of communication quality. Results: A total of 68 interviews were conducted following serial disease reevaluation encounters involving 13 parents and five oncologists. Nine main themes were identified as “best” approaches: (1) speaking with honesty and clarity, (2) leaving room for hope, (3) leaning into a long-standing relationship, (4) personalizing language, (5) empowering the patient and family, (6) collaborating with the multidisciplinary team, (7) providing anticipatory guidance, (8) setting the scene, and (9) creating a therapeutic space. Parents and oncologists generally agreed on themes related to helpful communication approaches, while parents more explicitly described communication pitfalls. Conclusion: Parents and oncologists described clear recommendations for helpful communication strategies and pitfalls to avoid during difficult prognostic disclosure. Future work should integrate patient perspectives in the design and testing of an intervention to improve prognostic communication in advanced childhood cancer. [ABSTRACT FROM AUTHOR]

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

Aims: To investigate the ways that nurses engage with referral letters and discharge summaries, and the qualities of these documents they find valuable for safe and effective practice. Design: This study comprised a qualitative, case‐study design within a constructivist paradigm using convenience sampling. Methods: Interviews were conducted with nurses to investigate their practices relating to referral letters and discharge summaries. Data collection also involved nurses' examination and evaluation of a diverse range of 10 referral letters and discharge summaries from medical records at two Australian hospitals through focus‐group sessions. The data were transcribed and analysed inductively. Results: In all, 67 nurses participated in interviews or focus groups. Nurses indicated they used referral letters and discharge summaries to inform their work when caring for patients at different times throughout their hospitalisation. These documents assisted them with verbal handovers, to enable them to educate patients about their condition and treatment and to provide a high standard of care. The qualities of referral letters and discharge summaries that they most valued were language and communication, an awareness of audience and clinical knowledge, as well as balancing conciseness with comprehensiveness of information. Conclusion: Nurses relied on referral letters and discharge summaries to ensure safe and effective patient care. They used these documents to enhance their verbal handovers, contribute to patient care and to educate the patient about their condition and treatment. They identified several qualities of these documents that assisted them in maintaining patient safety including clarity and conciseness of information. Implications for the Profession and Patient Care: It is important that referral letters and discharge summaries are written clearly, concisely and comprehensively because nurses use them as key sources of evidence in planning and delivering care, and in communicating with other health professionals in relaying goals of care and implementing treatment plans. Impact: Nurses reported that they regularly used referral letters and discharge summaries as valuable sources of evidence throughout their patients' hospitalisation. The qualities of these documents which they most valued were language and communication styles, awareness of audience and clinical knowledge, as well as balancing conciseness with comprehensiveness of information. This research has important impact on the patient experience in relation to encouraging effective referral letter and discharge summary writing. Reporting Method: We have adhered to the relevant EQUATOR guidelines through the SRQR reporting method. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives. Design: An exploratory, descriptive qualitative study was conducted with a theoretical‐methodological orientation of phenomenology. Methods: In‐depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis. Results: Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non‐punitive culture and superior feedback. Conclusion: The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety. Implications: It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture. Impact: This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety. Reporting Method: The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines. Patients or Public Contribution: No patients or public contribution. [ABSTRACT FROM AUTHOR]

Objective: This article intends to reveal the long-term effects of physical maltreatment in childhood on depressive symptoms in later life in China. Methods: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). 8676 respondents aged 45 and older were included in the study. In this study, we use ordinary least squares (OLS) regression models to estimate the long-term impact on children of physical punishment from their parents. Results: We found that individuals who recalled being hit by their mother in early life reported more depressive symptoms than those who recalled being punished by their father. Difficult family contexts (e.g., comparative poverty, family violence, and parent's poor mental health) had a weak association with higher risk of reporting physical maltreatment and more depressive symptoms among respondents in later life. Conclusion: This article extended the exploration of the long-term impact of child physical maltreatment beyond adolescence and into until later adult life. Effective policies to protect children from maltreatment in the form of physical punishment require further attention to the challenges posed by tradition and culture. [ABSTRACT FROM AUTHOR]

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

The ongoing COVID‐19 pandemic has brought profound change to many areas of our lives, and perhaps most of all in terms of how we communicate. A testament to our vital need for social connection, millions of people have sought to shed the physical constraints of isolation and restricted mobility by using online video calling to reaffirm relations with friends, colleagues and wider communities. Drawing on qualitative in‐depth interviews with users of online video call platforms, this paper explores the social and subjective impacts of video calling, and how they are transforming habitual modes of relating to ourselves and others. The paper argues that grasping the impact of such technological encounters requires new modes of thinking attuned to the less conscious and more material processes though which technologies come to shape how we think and behave. In theorising these unconscious and non‐representational potentials, the paper engages with Félix Ravaisson's innovative theorisation of habit. In contrast to those thinkers who would reduce habit to the unthinking and automatic repetition of the same, we explore how Ravaisson's theorisation of habit offers a dynamic ontology for understanding how bodies change and how change comes to be registered in bodies through encounters with technology. We argue that this conceptualisation of habit opens a powerful way of thinking about how the repeated use of online video calls has become bound with the production of new habits of attention, transforming the embodied ways in which we perceive and relate to our own subjectivities, other people, and the spaces in which we live and work. [ABSTRACT FROM AUTHOR]

In line with the urgency of problems related to climate change, studies on the framing of this issue have flourished in recent years. However, as in framing research overall, a lack of definitions complicates the synthesis of theoretical/empirical insights. This systematic review contrasts trends of framing in climate change communication to those observed in reviews of communication research overall and harnesses framing's power to bridge perspectives by comparing frames across different frame locations (i.e., frame production, frame content, audience frames, and framing effects), as part of the wider cultural framing repository. Combining quantitative and qualitative approaches of content analysis, this review draws on 25 years of peer-reviewed literature on the framing of climate change (n = 275). Among the findings, we observe that research has not made use of framing's bridging potential. Hence, the conceptual (mis)fit between frame locations will be discussed, and directions for future research will be given. [ABSTRACT FROM AUTHOR]

Background: In health policy, much attention has been paid to collaboration between the primary and secondary health care sectors, especially in relation to hospitalisation and discharge. Despite ideal plans for collaboration, the research literature shows that inadequate communication is a well‐known problem that can be a barrier to a safe trajectory for the citizen. Based on the assumption that better knowledge of each other's work will lead to better collaboration, a cross‐sectoral exchange program with nurses was initiated. Aim: The aim was to investigate which barriers to good patient trajectories the involved nurses attributed to cross‐sectoral collaboration and what impact the exchange to the opposite sector had for them. Methods: Twenty‐eight nurses were exchanged: 14 from a cardiology department and 14 from municipal home care. The nurses shadowed a colleague from the opposite sector in their daily work. Subsequently, six focus group interviews were conducted. The transcribed material was analysed based on Ricoeur's interpretation theory. Results: Two main themes, including sub‐themes emerged: (1) Challenging communicative conditions: (a) Inadequate digital communication, (b) Inadequate care plans and discharge reports, (c) Conversation promotes understanding, and (d) Challenging collaboration and communication with the discharge coordinators. (2) Perceived importance of the exchange: (a) Cross‐sectoral relationship, prejudice and gaining respect for each other and (b) Working in two different worlds. Conclusion: Electronic communication is inadequate, and the IT systems do not support sufficient cross‐sectoral communication. The organisational model in the municipal care sector is inflexible in terms of allocations for the current needs of citizens, and professionals feel that their professional judgements are not recognised. The nurses gained insight into each other's work and working conditions and respect for each other's professionalism. The exchange has the potential to both improve the relationship and communication between the sectors for the benefit of a better and more coherent patient course. [ABSTRACT FROM AUTHOR]

Background: Worldwide visitor restrictions forced nurses to separate patients from their relatives. However, the experience of implementing shifting restrictions from the frontline nurses' perspectives in a Danish context has yet to be assessed. Aim: The aim of this descriptive qualitative study was to explore frontline nurses' experiences of managing shifting visitor restrictions in a Danish somatic university hospital during the COVID‐19 pandemic. Methods: An online questionnaire, including open‐ended questions, was developed. Data were analysed using descriptive statistics and content analysis. Findings: 116 nurses from 29 departments participated; they were informed about restrictions primarily by their charge nurses and hospital intranet. Shifting visitor restrictions compelled the nurses to constantly adjust and negotiate their practices. When deciding to suggest deviating from the restrictions, they shared their decision‐making with colleagues. Visitor restrictions left the hospital environment quieter, but they also created a lack of overview and predictability, an emotional burden, and a negative impact on the quality of care. Conclusion: Restricting relatives' access challenged the nurses' professional values, and it seems to have affirmed their appreciation of relatives' role as important partners in contemporary hospital‐based health care. [ABSTRACT FROM AUTHOR]

Background: Effective self‐management of type 2 diabetes requires adequate health literacy (HL) and a supportive network. Diabetes self‐management education and support programmes play a crucial role in improving these factors. However, limited research exists on how such programmes can support health literacy among migrants and facilitate the dissemination of knowledge within their social networks. Aim: This study aimed to investigate the perspectives of Arabic‐speaking informants with a migrant background in relation to how their type 2 diabetes‐related health literacy was acquired, applied and distributed within social networks through participation in a culturally sensitive diabetes self‐management education and support (DSMES) programme. Methods: Semi‐structured interviews were conducted with 12 informants during the programme and three to 7 months later, from September 2019 to May 2020. Abductive analysis was applied using HL and distributed health literacy (DHL) theory as frameworks. Results: The analysis generated three themes: (1) sources of health information and the development of health literacy; (2) changes towards active self‐management; and (3) distributed health literacy. Prior to programme participation, informants faced challenges in navigating conflicting information from family, friends and social media. After participating in the programme, they reported improvements in HL, particularly in knowledge acquisition. Many became more actively engaged in decision‐making and exhibited improved health behaviours, such as dietary choices. Nonetheless, some informants continued to struggle with choosing appropriate prevention and treatment strategies. Notably, certain informants acted as HL mediators, sharing their newly acquired knowledge within their social networks in Denmark and abroad. Conclusion: Culturally sensitive diabetes self‐management education programmes have the potential to enhance HL among migrants, leading to the distribution of relevant diabetes knowledge within their social networks. Future studies should explore how members of migrants' social networks perceive their supportive role in type 2 diabetes management. Programmes can benefit from emphasising critical HL and exploring how participant‐informants effectively communicate diabetes‐related knowledge within their networks to address misinformation and conflicting information. [ABSTRACT FROM AUTHOR]

Aim: Dignity in older persons is a goal of palliative care. This study aimed to perform a process evaluation of the Swedish Dignity Care Intervention (DCI‐SWE) in municipal palliative care in Sweden, focusing on implementation, context, and mechanism of impact. Methods: This study had a process evaluation design. The Knowledge to Action framework supported the implementation of the DCI‐SWE. The intervention was used by community nurses with older persons (n = 18) in home healthcare and nursing homes. Data were collected by focus groups‐ and individual interviews with community nurses (n = 11), health care professionals (n = 5) and managers (n = 5), reflective diaries, and field notes. Results: Grasping the DCI‐SWE was challenging for some community nurses. Enhanced communication training and increased engagement from managers were requested. However, the DCI‐SWE was perceived to enhance professional pride in nursing. In terms of fidelity, dose and reach the project was not fully achieved. Regarding mechanism of impact the DCI‐SWE contributes to address older persons' loneliness and existential life issues, as it put conversations with older persons on community nurses' agenda. Conclusions: The DCI‐SWE provided opportunities to maintain older persons' dignity and quality of life. However, with refinements of design and the DCI‐SWE, the sustainability in the context may increase. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to contribute to an understanding of the role deployment of advanced practice nurses (APNs) in French healthcare settings. Introduction: The introduction of APNs was formalised in France by the decrees issued on 18 July 2018, which described the areas, activities and training of APNs. Background: A qualitative study on the role implementation of APNs was conducted between July 2021 and May 2022 following a call for projects launched by the Île‐de‐France Regional Health Agency to evaluate the deployment of APNs in the area. Methods: Data were collected through field observations and semi‐structured interviews in order to explore both the APNs deployment processes in nine healthcare structures and the roles played by APN networks and associations with regard to the deployment of APN activities in their working environments. Results: The projects proved to be evolutionary, and their development was marked by various forms of APN isolation and multiple obstacles that were specific to their professional practice settings. Some APNs relied on a variety of forms of mutual assistance and advocacy deployed throughout APN networks and associations. Discussion: The deployment of APNs' role was impacted by diverse configurations of professional power relations and the nature of the obstacles that were structural for APNs in primary care. Their experience of isolation derived from the novelty of their role, the challenge they posed to the cohesion of the nursing profession and a lack of supportive policies for their deployment. Their participation in APN networks and associations enabled them to access advocacy and manage the uncertainties and unknowns related to the deployment of their activities. Conclusion: The results suggest that the formalisation of schemes for mutual assistance among APNs and advocacy should be integrated into the guidelines for the implementation of their role. Implications for nursing policy: APN policy should strengthen a bottom‐up approach, relying in particular on the development of different forms of collaboration and communication between APN networks and associations on the one hand and the public authorities on the other. [ABSTRACT FROM AUTHOR]

A majority of children's language learning experiences occur in inclusive early child care and education settings. Few evidence-based professional development (PD) programs exist to empower early childhood education providers to use language instruction practices with children in inclusive classrooms. There is little research on providers' implementation of naturalistic developmental behavioral intervention (NDBI) strategies to improve children's language outcomes in whole-group inclusive instruction. We conducted a pilot cluster randomized controlled trial to test the hypothesis that providers in the Early Achievements for Child Care Providers (EA-CP) PD program would show greater gains in NDBI implementation fidelity during shared book reading relative to business-as-usual (BAU) providers. This hypothesis was confirmed. Compared to BAU providers, EA-CP providers exhibited significantly greater fidelity gains from pre-training to mid-training, post-training, and 12-week maintenance assessments. A secondary hypothesis was that toddlers with and without developmental delays in the EA-CP condition would exhibit greater vocabulary and communication gains than toddlers in the BAU condition. Analyses of children with and without delays showed significantly greater expressive vocabulary and story-related engagement and communication in the EA-CP group. For children with delays, positive effects favoring the EA-CP group but not statistically significant were found. Implications for research, practice, and policy are discussed. [ABSTRACT FROM AUTHOR]

Younger siblings of autistic children are at a high likelihood (HL) of autism, language, and/or cognitive delays. Vocal complexity, a continuous measure of the developmental maturity of vocal communication, is facilitated by parent-child interaction and predicts language outcomes. This study examined whether parents' intervention fidelity to Project ImPACT, a 12-week, parent-mediated, naturalistic developmental behavioral intervention (NDBI), mediated the effect of Project ImPACT on parents' verbal responsiveness (post-intervention) and children's vocal complexity (3 months post-intervention). Participants were 54 12- to 24-month-old HL child-parent dyads who received 12 weeks of Project ImPACT (n = 28) or business-as-usual (n = 26). Project ImPACT indirectly improved both parents' verbal responsiveness and children's vocal complexity by improving parents' use of the intervention techniques. The efficacy of Project ImPACT in supporting early social communication might be attributed to how Project ImPACT helps parents improve the quality and frequency of their use of the intervention strategies across children's everyday settings. [ABSTRACT FROM AUTHOR]

This article describes the development and use of a first of its kind statewide implementation of an adapted Early Start Denver Model (ESDM). Supported by a collaborative partnership between stakeholders that included families, state agencies, and a state university, the intervention was implemented within the existing framework of a northeastern state's relationship-based Individuals with Disabilities Education Act (IDEA) Part C early intervention program. Participants were 194 families. The study examined the effectiveness and implementation costs of an adaptation of the ESDM using a coaching model to inform statewide implementation to improve outcomes for young children with autism spectrum disorder (ASD) in rural and low-resource states. Results indicated 194 children who received a monthly average of 10.90 hr of adapted ESDM for an average of 12 months demonstrated an improvement in the frequency of ASD symptomology for a total cost of US$2,511/child. Intervention intensity and child factors demonstrated varying influence on outcomes. This study contributes to the literature by demonstrating the potential for positive impact of an evidence-based practice scaled to a statewide model of early intervention for young children with ASD. [ABSTRACT FROM AUTHOR]

Background: A culture centered on relationships and communication is necessary to improve the quality of life of older adults living in nursing homes. Objectives: To examine the effects of a storytelling program by examining the cognitive, emotional, and psychosocial changes in older adults in facilities and explore staff experience of changes in care. Methods: This mixed method study delivered a 6-week storytelling program based on relationship-centered care for residents of nursing homes (aged >65 years). Changes in emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and the person-centered environment as perceived by older adults were quantitatively analyzed using pre-intervention and post-intervention surveys. Qualitative data were collected through weekly stories created by residents, followed by focus group interviews with nursing home staff, analyzed using reflexive thematic analysis to enhance understanding of the program's outcomes. Results: The 42 residents reported significant changes in their emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and person-centered environment scores after the 6-week intervention. Analysis of the residents' stories identified 5 themes. The staff focus group interviews identified 2 themes and 7 subthemes. Intervention group residents were more likely to initiate conversations, express themselves, carefully observe themselves and others, and actively participate in social activities. Conclusions: The storytelling program was useful in reducing older adults' negative emotions by allowing them to express their thoughts and feelings and improve their relationships, creating opportunities for social interaction. These effects could help foster relationship- and communication-centered facility cultures. [ABSTRACT FROM AUTHOR]

Rooted in sexual script and gender minority stress and resilience (GMSR) theories, the present study investigated how a nationally recruited sample of 169 transgender and gender diverse (TGD) undergraduates perceived a typical sexual encounter involving a TGD undergraduate (i.e., their sexual scripts), as well as the extent to which various forms of distal stress, proximal stress, and resilience factors were embedded within and affected these scripts. Using thematic analysis, 12 themes were identified within three overarching categories: types of sexual/romantic relationships, gender minority stress experiences, and resilience factors. TGD undergraduates' scripts in some ways mirrored those of their heterosexual and cisgender peers (i.e., enacting gendered roles in sex initiation, differing emotional responses following sex by gender identity), but scripts also differed in many notable ways. In their scripts, TGD students frequently described how distal (i.e., enacted stigma, trauma history) and proximal (i.e., gender dysphoria, self-stigma) stressors affected the sexual experiences of TGD undergraduates. However, resilience themes such as open communication and discussing one's gender identity were also commonly included and presented as providing protection against minority stress. Results demonstrate how GMSR experiences inform TGD undergraduates' sexual scripts and suggest several critical potential points of intervention for this population. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/doi/suppl/10.1177/03616843231218699. [ABSTRACT FROM AUTHOR]

Inspired by research in language play and linguistic ethnography, this article examines children's language play in early childhood education and care (ECEC) as a locally situated generic practice created through children's semiotic repertoires. The article is based on video-recorded linguistic ethnographic fieldwork in a Danish day care centre. By analysing two play sequences with 3–4 year old children, we examine how the children align to each other in an improvised way while co-creating social worlds. The multimodal micro-ethnographic analysis reveals how an assemblage of chunks of language, musicality, movements, affect and materiality is constitutive of children's language play, and how language play appears as an integral part of children's local language practices. The children's use of a broad range of semiotic repertoires in language play represents a unique practice that might enhance our theoretical and empirical understanding of child language. We argue that empirical insight into children's language play has the potential for developing paths to language and literacy that challenge the often highly prioritised 'precursors to literacy' strategy as the central aim for language learning in ECEC. [ABSTRACT FROM AUTHOR]

To describe the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) staff experiences, perceptions, and training needs surrounding the provision of infant feeding support for parents with intellectual and developmental disabilities (IDD). We conducted in-depth semistructured interviews between October and November 2021 with Maryland WIC staff (N = 10) who provide infant feeding counseling and support. We analyzed interviews using conventional content analysis. Three themes were identified: identifying and documenting IDD, facilitating effective communication and infant feeding education, and assessing WIC staff competence and readiness. The interviews suggested the need to explore the risks and benefits of routine and compassionate processes for identifying and documenting disability, create accessible teaching materials that facilitate understanding and engagement, and educate and train staff to provide tailored support in WIC. Engaging parents with IDD to better understand their perspectives and experiences should guide future efforts to improve inclusivity and accessibility. [ABSTRACT FROM AUTHOR]

'Structural characteristics' are gambling product design features which contribute to the amount of time or money that gamblers spend using them, such as the short pay-out intervals of electronic gaming machines (EGMs). However, it is important to also understand the structural characteristics of current online sports betting products, and how these products may continue to evolve via a forward-looking analysis of utility patents, given the increasing international popularity of this gambling mode. A scoping review of the emergent structural characteristics associated with online sports betting was conducted upon the literature (2015–2022), and of sports betting utility patents. A total of 26 literature records and 8 utility patents were included. Results indicated that online sports betting is instantly accessible, provides rapid and continuous betting opportunities, and offers user-interactivity via features such as 'cash-out' and the ability to instantly deposit funds. Additionally, the online sports betting market has expanded into adjacent industries such as esports. The included utility patents suggest that online sports betting may evolve by incorporating peer-to-peer competitive elements, augmented reality, and highly specific statistics/notifications. Overall, the online environment has transformed sports betting into a faster and more harmful gambling mode that provides a diverse range of features and betting opportunities. It is important that this area of research develops in order to encourage appropriate policy and the more ethical redesign of online sports betting products. [ABSTRACT FROM AUTHOR]

Background: Communicating with people with severe/profound intellectual disabilities is essential for person‐centred, rights‐based support. Despite a proliferation of research around COVID‐19, there is a dearth of evidence exploring its impact on communication with people with severe/profound intellectual disabilities. This study aimed to explore disability support staff experiences of communicating with people with severe/profound intellectual disabilities through the COVID‐19 pandemic. Methods: A qualitative descriptive study was undertaken. A purposive sample of six disability support staff who supported people with severe/profound intellectual disabilities through the pandemic in four Irish residential services participated in online, semistructured interviews. Data were analysed thematically. Findings: Six themes were generated including unwavering commitment; running on empty; being a safe haven; empathic understanding; heightened sensitivity and new insights. Participants discussed the impact of COVID‐19 on communicating with people they support, the contextual challenges, how these were managed/overcome and new learning that emerged. Although communication challenges did present because of COVID‐19 restrictions, communication remained a priority. Conclusions: Despite the challenges experienced by disability support workers, their unwavering commitment to ensuring the well‐being of people with severe/profound intellectual disabilities was identified. This was a small‐scale qualitative study but highlights areas warranting further research and makes recommendations for practice and service planning. Accessible Summaries: The restrictions during the COVID‐19 pandemic made it very hard to interact with people.This study looked at disability support workers' experience of interacting with people with severe/profound intellectual disabilities who live in residential services.The study participants talked about how important it was to be there for a person with severe/profound intellectual disability because visitors were not allowed, and they might not understand why.It is important that we use what we learned through this challenging time to provide better support in the future. [ABSTRACT FROM AUTHOR]

Background: Quality early childhood interactions, especially quality adult–child interactions, are known to form the foundation of future skills associated with social, academic and communicative development. Speech-language therapists (SLTs) can engage with educators in professional development to improve communication environments for children. Understanding the perspectives of early childhood directors and educators in relation to the feasibility, sustainability and impact of professional development is needed. Aim(s): This study investigated the experiences of early childhood educators and directors who participated in a SLT-led professional development training program. Method: Participants were four directors and six early childhood educators. Directors participated in one focus group; educators participated in individual semi-structured interviews. All participants were female and had between 5 and 38 years of experience. They were interviewed following the completion of an eight-week training program. Verbatim transcripts of the director focus group and educator interviews were thematically analysed using NVivo12. Result(s): Three overarching themes were developed. These were the appropriateness and acceptability of the training, impact and professional engagement with eight subsequent themes also identified. Although participants reported positive experiences participating in the training, several practical and translational challenges were identified. Conclusion: The professional development training implemented by SLTs was influenced by a number of factors that assisted or hindered educator and director experience of the program. The appropriateness, acceptability and feasibility of a professional development (PD) program should carefully consider participants' learning needs and workplace environments. [ABSTRACT FROM AUTHOR]

This study investigated the feasibility of a vocabulary-based teacher intervention to increase preschool teachers' production of complement clauses (e.g. I wonder if we can put the monkey in the tree) in teacher–children play interactions. Using a multiple baseline across participants design we measured the impact of an intervention that promoted preschool teachers' production of four complement clause verbs (CCVs)— figure out, notice, remember, wonder. Based on visual analysis we established a functional relation between the teacher intervention and the teachers' production of the target CCVs produced with a complement clause. Asking teachers to increase their use of CCVs in verbal interactions with children is a promising approach to increase teacher complex syntax input in the preschool classroom. [ABSTRACT FROM AUTHOR]

Companions (i.e., friends, family members, and other accompanying persons) play an important role in seizure clinic consultations, providing information that patients cannot. The COVID-19 pandemic has seen an increase in these consultations being conducted via telephone. Little is known, however, about how this shift might affect companion participation. Using conversation analysis applied to a set of recorded telephone neurologist-patient-companion consultations (n = 9) and comparable moments drawn from a set of face-to-face consultations (n = 37) (both collected in the UK), we aimed to explore this impact and to identify communication methods that clinicians can use to manage companion participation during telephone consultations. We identified four ways in which participation was observably affected by the telephone. Telephone consultations could make it unclear whether a companion was present and make it difficult for the companion to communicate directly with the neurologist. Passing the floor from one speaker to another was more complex remotely, which could also restrict the patient's own participation once the companion had the floor. These issues are rooted in the limitations of the telephone as a communication medium. Based on the issues identified, we conclude our analysis by highlighting some of the ways in which neurologists and other health professionals can manage companion participation in telephone consultations. These include encouraging the use of speakerphone, checking whether a companion is present throughout the call, keeping track of who can hear what throughout the call, and directing questions using given names to avoid ambiguity. [ABSTRACT FROM AUTHOR]

Based on previous work, we developed the comic "A healthy liver will always deliver!" to raise awareness about Non-Alcoholic Fatty Liver Disease (NAFLD) and promote healthy lifestyles. An online pre-post questionnaire design demonstrated an increase in health-threat beliefs regarding NAFLD among the general public, as well as response efficacy and self-efficacy beliefs, normative and control beliefs regarding the maintenance of preventive strategies involving healthy diets and active lifestyles, after interaction with the comic's narrative. This effect was more evident in women. Furthermore, although we could not perform all the ideal controls during the COVID-19 pandemic, and the online strategy attracted mostly university education-level subjects, the comic seemed relatable and engaging. However, more work will have to be performed to ensure its usefulness in terms of acquired knowledge and behavior changes, especially in at-risk segments of the population. [ABSTRACT FROM AUTHOR]

Social norms are common in persuasive messaging. For norms trending in a positive direction, it may be beneficial to emphasize change (i.e. dynamic norm) rather than the status quo (i.e. static norm). To test this proposition, we examined college students' responses to social norm messages encouraging moderate alcohol use. Undergraduates (N = 842) were randomly assigned to view a dynamic norm ("More college students drinking in moderation"), a static descriptive norm ("Most college students drink in moderation"), or a no message control. Four mechanisms were examined as potential mediators, three of which have been examined in previous work (preconformity, perceived importance, self-efficacy) and one of which was novel (psychological reactance). Results revealed that exposure to either social norm message (dynamic or static descriptive) was associated with more favorable attitude relative to a no message control. Attitude did not differ between the dynamic norm and static descriptive norm conditions. Only psychological reactance mediated the relationship between message condition (dynamic vs. static descriptive norm) and favorable attitude. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

Guided by Brashers's uncertainty management theory, the purpose of this study was to better understand the experience of family caregivers utilizing Medicaid waivers to subsidize health care for children with disabilities. Specifically, the focus of this study was to explore caregivers' experience with Kentucky's Michelle P. Waiver (MPW), a Medicaid waiver that provides robust benefit offerings to children with disabilities. Little is known about how parents come to know about the waiver, and the communication challenges they experience when applying for and navigating their child's health care through Medicaid. Data were gathered by narratively interviewing 31 parents of children who are currently receiving services through the MPW. Data were analyzed using narrative thematic analysis. The analysis focused on the community-level communication that contributes to parent caregivers' uncertainty about the MPW system. Findings show that parents experience unique personal, social, and medical uncertainties related to the MPW when navigating care for their child in the community. This project contributes to the health communication literature theoretically by expanding the conceptualization of the uncertainty in illness framework to include the means of health care (i.e. Medicaid) as a consequential element of an individual's illness experience. [ABSTRACT FROM AUTHOR]

This study employs the media system dependency theory to explore both macro- and micro-level dependencies between South Korean sojourners and Chinese media during the COVID-19 pandemic. Through semi-structured interviews with 25 South Korean sojourners in Beijing, we find that under the influence of Confucianism and collectivistic culture, South Korean sojourners are hard to identify with China's media environment and rely on Chinese media. Apart from Chinese television meeting South Korean sojourners' goal of play, other traditional media outlets, new media, and interpersonal communication with Chinese people fail to fulfill their goals of understanding, orientation, and play. These findings suggest that future research should take cultural factors into account to understand media dependency theory. [ABSTRACT FROM AUTHOR]

Recognizing the need for more evidence-based interventions and the potential of well-crafted messages in communicating the opioid epidemic, this study investigates the effectiveness of two messaging strategies (i.e., victim vividness and external attribution) that have the potential to mitigate stigmatization and influence a wide range of public policies concerning the opioid epidemic. Building upon the attribution theory of interpersonal behavior, an experiment with a 2 (victim vividness: high vs. low) × 2 (external attribution: present vs. absent) between-subjects factorial design was conducted among a national sample of U.S. adults (N = 995). The findings show that the messages with greater victim vividness reduced support for victim-oriented punitive policies, whereas the messages that mentioned external attribution increased support for perpetrator-oriented punitive policies. In addition, the two messaging strategies also worked indirectly through various emotions to influence policy support. Discussions on this study's contributions to both theory and practice are provided. [ABSTRACT FROM AUTHOR]

This manuscript focuses on the communication factors that affect the willingness of African Americans and Black Caribbean patients to participate in clinical trials and research studies. Low rates of research participation by members of communities of color have long been linked to health disparities. While there are many factors that contribute to low rates of accrual of African American and Black patients to clinical trials, a lack of attention to communication factors that enhance or inhibit the recruitment process is central to the problem. In this study, we describe results from the analysis of six focus groups (N = 31) consisting of African American (k = 3) and Black Caribbean (k = 3) participants. Our analyses focus on verbal and nonverbal communication behaviors and how they affect participants' willingness to participate in clinical trials. Specifically, when clinical research coordinators (CRCs) had a professional appearance, made the effort to explain a study in detail, made eye contact, took the time to listen and answer questions patiently, and gave the sense that the CRC was being truthful and transparent, patients felt respected and valued. Additionally, participants emphasized the importance of the process of developing and maintaining a trusting relationship between study participants and CRCs. The results of this study will be used to develop a clinical trial communication training program designed to enhance the communication skills of clinical research coordinators who discuss research participation with African American and Caribbean Black patients. [ABSTRACT FROM AUTHOR]