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In this article we explore how digital play as conducted through various social media and online meeting platforms facilitated resiliency and confidence building in children during the COVID-19 pandemic. Using day-in-the-life methodology and narrative inquiry, we disseminate and examine observations collected on children aged 2-10 during lockdown in a Newfoundland neighbourhood. Children utilized platforms such as TikTok, YouTube, and Zoom to embrace their agentic digital play in ways that repurposed the platforms to fulfil life milestones and social needs otherwise impacted and disrupted by pandemic restrictions. Through a series of vignettes and interviews, our research not only examines how such digital play benefits children and their healthy development, but how parents reacted to and assisted with their children's agentic digital platform manipulation and how this provided positive benefits and enriching experiences to the entire family. We additionally explore the conflicts and tensions both children and parents encountered in securely implementing free play via digital platforms, including fears of excess screen-time, digital dependency, and online threats, all of which risk limiting children's ability to independently explore their creativity and identities through digital play if not handled sensitively. Despite the hurdles to implementing digital play, this study exposes why it is essential for families to navigate this online terrain; this study ultimately poses that digital play and online platforms not only were beneficial to maintaining and building family resilience during the pandemic but will be vital assets in sustaining resiliency and positive mindsets moving forward with pandemic recovery.

This paper explores the use and impact of experiential learning initiatives in an entrepreneurial university. Data are taken from two sources: interviews with eight academic managers and six focus groups with learners. A mix of narrative structuring and thematic analysis is used to explore the design, delivery and assessment of experiential learning. The authors apply Kolb's Experiential Learning Theory as their theoretical lens. Experiential learning evokes a mixed reaction from academic managers and students. The paper identifies three key themes (design, delivery and outcomes) which help to capture the complex mix of direct and indirect effects that experiential learning initiatives can have at both individual and institutional levels. The authors conclude that embedding experiential learning is a valuable part of the development of an entrepreneurial university.

BackgroundThe most widely used copper intrauterine device (IUD) in the world (the TCu380A), and the only product available in many countries, causes side effects and early removals for many users. These problems are exacerbated in nulliparous women, who have smaller uterine cavities compared to parous women. We compared first-year continuation rates and reasons/probabilities for early removal of the TCu380A versus a smaller Belgian copper IUD among nulliparous users.MethodsThis 12-month interim report is derived from a pre-planned interim analysis of a sub population and focused on key secondary comparative endpoints. In this participant-blinded trial at 16 centres in the USA, we randomised participants aged 17-40 in a 4:1 ratio to the NT380-Mini or the TCu380A. In the first year, participants had follow-up visits at 6-weeks and 3, 6, and 12-months, and a phone contact at 9 months; we documented continued use, expulsions, and reasons for removal. Among participants with successful IUD placement, we compared probabilities of IUD continuation and specific reasons for discontinuation using log-rank tests. This trial is registered with ClinicalTrials.gov number NCT03124160 and is closed to recruitment.FindingsBetween June 1, 2017, and February 25, 2019, we assigned 927 nulliparous women to either the NT380-Mini (n = 744) or the TCu380A (n = 183); the analysis population was 732 (NT380-Mini) and 176 (TCu380A). Participants using the NT380-Mini, compared to the TCu380A, had higher 12-month continuation rates (78·7% [95% CI: 72·9-84·5%] vs. 70·2% [95% CI: 59·7-80·7], p = 0·014), lower rates of removal for bleeding and/or pain (8·1% vs. 16·2%, p = 0·003) and lower IUD expulsion rates (4·8% vs. 8·9%, p = 0·023), respectively.InterpretationThe NT380-Mini offers important benefits for a nulliparous population compared to the TCu380A in the first twelve months, when pivotal experiences typically occur. Higher continuation rates with the NT380-Mini may avert disruptions in contraceptive use and help users avoid unintended pregnancy.FundingBill & Melinda Gates Foundation, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Mona Lisa, N.V. (Belgium).

In a world that grows increasingly aware of ecological problems such as global warming, rising sea levels, and pollution, we need to reconsider how we connect ourselves to the natural world around us. In this paper, we view makerspaces as ideal locations to shape children's emotional, sociocultural, and educational consciousnesses about the environment and our multi-layered roles undertaken to live in, and conserve, it. We apply third space, makerspace, and relational value theories in the analysis of a research project conducted with children at an early childhood centre. This project invited children to discuss ocean conservation prompted by the picturebook Flotsam (2006) and create three-dimensional exhibits that express how they visualize ocean conservation. Our research shows that children develop strong emotional connections to tangible representations of conservation when they are given the time to invest in making them, and that these emotional connections are driving forces for relational values that create conservation-oriented mindsets. It also shows how important context is for shaping the ways children learn, and that providing opportunities to examine conservation through makerspaces as a third space encourages children to create empathetic and personal relationships with the natural world.

ObjectivesTo evaluate safety outcomes from clinical studies of a 12-month contraceptive vaginal system (CVS) releasing an average of segesterone acetate (SA) 150 mcg and ethinyl estradiol (EE) 13 mcg daily.Study designWe integrated clinical safety data from nine studies in which women used the CVS for 21 consecutive days and removed it for 7 days of each 28-day cycle. Four studies used the final manufactured CVS, including a 1-year pharmacokinetic study, two 1-year phase 3 trials and a second-year treatment extension study. We assessed safety by evaluating adverse events women reported in a daily diary. We also included data from focused safety studies evaluating endometrial biopsies, vaginal microbiology and liver proteins from one of the phase 3 studies.ResultsThe combined studies included 3052 women; 2308 women [mean age 26.7±5.1 years; mean body mass index (BMI) 24.1±3.7 kg/m2] received the final manufactured CVS, of whom 999 (43.3%) completed 13 cycles of use. Women using the final CVS most commonly reported adverse events of headache (n=601, 26%), nausea (n=420, 18%), vaginal discharge/vulvovaginal mycotic infection (n=242, 10%) and abdominal pain (n=225, 10%). Few (29 kg/m2 (n=2)]. During 21,482 treatment cycles in the phase 3 studies evaluable for expulsion, women reported partial expulsions in 4259 (19.5%) cycles and complete expulsions in 1509 (7%) cycles, most frequently in the initial cycle [499/2050 (24.3%) and 190/2050 (9.3%), respectively]. Safety-focused studies revealed no safety concerns.ConclusionThe 1-year SA/EE CVS has an acceptable safety profile. Additional studies are warranted in obese women at higher risk of VTE.ImplicationsThis 1-year contraceptive vaginal system represents a new long-term, user-controlled and procedure-free option with a safety profile similar to other combination hormonal contraceptives. The same precautions currently used for combination hormonal contraceptive prescriptions apply to this new contraceptive vaginal system.

Introduction: This article aims to characterise hospital admissions involving opioid toxicity across South Australia to guide future implementation and evaluation of risk mitigation strategies. Methods: International Classification of Diseases, 10th Edition codes (T40.0–T40.4) were used to identify admissions involving pre‐hospital opioid toxicity in public hospitals across South Australia from 1 June 2017 to 30 August 2020. Demographic and episode of care data were extracted and summarised using descriptive statistics. Admission cost estimates were calculated using Independent Hospital Pricing Authority data. Results: A total of 2046 cases met the criteria for inclusion; over half (56%) were female and median age on admission was 44 years (interquartile range 27 years). Where opioid toxicity was the primary diagnosis, 70% of admissions did not specify the responsible opioid and 23% were related to heroin use. One‐fifth of admissions occurred outside of metropolitan Adelaide. Individuals living in an area of relative socio‐economic disadvantage were over‐represented. Over half of admissions required a stay >24 h; 19% were admitted for ≥5 days, 22% required intensive care and ~10% required mechanical ventilation. The total estimated cost of admissions involving opioid toxicity in South Australia over the 3‐year period was $18,230,546.50, equating to $5.6 million per annum. Discussions and Conclusions: These findings highlight the significant personal, fiscal, and systemic impacts of opioid toxicity‐related hospital admissions in South Australia and provide a baseline to evaluate the effectiveness of initiatives to reduce opioid‐related harm, including real‐time prescription monitoring and take‐home naloxone supply. [ABSTRACT FROM AUTHOR]

Background: A key skill of nephrology nursing is cannulation of patients receiving haemodialysis. Traumatic and unsuccessful cannulation experiences, particularly in the initial weeks of haemodialysis, may contribute to the onset of needle distress for patients. Objectives: To identify the key knowledge, skills and attitudes of nephrology nurses working with haemodialysis patients and the competencies relevant to nephrology nursing working with patients with needle‐related distress. Design: A qualitative study involving semistructured interviews. Interviews were audio‐recorded, transcribed and deductive, and inductive thematic analysis applied. Participants: Nephrology nurses (n = 17) were interviewed from a tertiary kidney service in South Australia. Nurses had varying roles and years of experience (range 1–30 years) working with dialysis patients within the service. Results: Two overarching themes, (1) Flexibility in Practice and Care and (2) Responsibility of Nephrology Nursing, were identified as relevant across all knowledge, skills and attitudes of nephrology nurses working with patients with needle‐related distress. Thirty‐six knowledge, skills and attitudes were identified; 12 related to knowledge, 14 related to skills and 10 were identified as attitudes and were summarised under seven broad competencies. Conclusion: This study identifies potential knowledge, skills and attitudes and competencies required for nephrology nurses working with patients with needle‐related distress. It highlights strategies that may prevent the onset and worsening of needle‐related distress, as well as reduce it. It also brings to light that nurses desire additional education regarding strategies to improve the patient experience of cannulation and nurse confidence and skill in this area. [ABSTRACT FROM AUTHOR]

Summary: Access to bariatric surgery is limited, and the factors related to undergoing or not undergoing the procedure are poorly understood. To this end, a systematic review of PubMed, Embase, PsycINFO, and CINAHL was conducted to deduce the factors associated with progression or non‐progression to bariatric surgery. Quantitative and qualitative English‐language articles ranging in date from database conception to September 2023 were included. Eligible studies employed adult participants (18 years of age or above) who had been referred for bariatric surgery. A total of 57 studies were identified. Fifteen key factors were found, alongside six less frequently studied factors: age, sex, BMI, race and ethnicity, distance to clinic, socio‐economic status, insurance coverage, physical health, psychological health, eating history and habits, substance use and smoking, social influence and relationships, pre‐surgery process and requirements, surgery‐related concerns, choice of surgery, and others (emergency room visitation, COVID‐19 virus, health literacy, appearance perceptions, time‐off work, and stigma related to surgery). No factors were found to be reliably associated with progression or non‐progression to bariatric surgery; however, the nature of these findings is tentative considering methodological flaws and limited research. Further studies are required to elucidate potential inequities in bariatric surgery access and educate policymakers and health professionals. [ABSTRACT FROM AUTHOR]

As technology becomes a larger part of people's everyday lives, it is logical to think that it should also become a part of the learning process. The use of tablets in classrooms is becoming an area of interest as researchers are trying to understand what the benefits are--if any--to using these devices. This article gives an overview of some of the recent literature related to the benefits and challenges associated with the use of tablets with students in middle schools. Prevalent themes include the benefits of using tablets with students who have learning disabilities, and the challenges that can arise in the classroom, specifically issues of safety and security, access to apps and disruptive behaviours when using these devices. The authors share qualitative case studies of two teachers who have used tablets extensively with their students and discuss how their experiences resonate with the literature. The authors conclude with a summary of the affordances and constraints of using tablets with students who have special needs and offer workable solutions for some of the challenges educators face when using these devices.

This paper is located within a larger study of children's voice and storytelling. The focus is on how children use artifacts, such as special objects and photographs, to tell stories about their lives. We studied the collaborative learning of educators, in two schools in Eastern Canada, as they used sharing circles and multimodal pedagogies, and worked to elevate and listen to children's voices during a period of pandemic teaching. This study examines children's things/artifacts as material culture and relates things/artifacts to artifactual literacies. The action research design included a consideration of children's voice in early years research alongside the collaborative professional development inquiry undertaken by educators in the study. An analysis of key findings as they relate to evolving pedagogies, including how artifacts were used to tell stories, and how voice can be viewed through this artifact sharing is presented. We argue that building voice and collaboration can result from pedagogies of classroom sharing and listening. Educators' challenges in this research and their classroom teaching during a constantly shifting set of teaching conditions are fore fronted. Insights from children's particular artifacts and their stories enhanced educator and peer awareness of difference, and of cultural practices in families. Finally, implications for practice, and future research possibilities are presented, along with an argument for viewing children's voice as emergent alongside classroom multimodal pedagogical practices that augment children's voices. [ABSTRACT FROM AUTHOR]

This article shares teachers' conversations within teacher inquiry groups and considers how this reflective approach has potential for transforming teachers' practices. Conversations took place at the early stages of a longer teacher inquiry project and centred on the critical interrogation of social justice-oriented children's literature. These conversations served as a forum to help teacher professional learning communities and to reconcile understandings about social justice, action and agency within larger political and cultural forums of teaching. The teacher inquiry sessions shared in this paper explore teachers' beginning struggles with conceptualizations of social justice, and the teacher's role in imparting values to students. Teacher participants imparted their experience and practice as they negotiated their own understanding and implementation of social justice education in their schools. The teacher inquiry groups provided a needed supportive space where classroom teachers' struggles were shared alongside their beliefs and pedagogical approaches so that a social justice agenda could be achieved.