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AbstractIntroductionMethodsResultsConclusionsAccreditation of medical education programs can be observed from different perspectives. Regulatory/accreditation agencies consider it vital to assure a certain level of quality. Other stakeholders may perceive the accreditation process as a negative experience, draining resources, and efforts. Although accreditation may improve the program’s governance and administration, its direct or indirect impact on students must be further investigated. This study explores the relationship between the occurrence of accreditation site visits and student satisfaction rates at Avalon University School of Medicine.A comparison study was conducted with retrospective satisfaction data from two accreditation cycles at AUSOM. We used the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) student surveys for data collection, and data from 2017, 2019, and 2022 were used. The response rate was 70% (n = 71), 72% (n = 47), and 60% (n = 56) for basic science students and 80% (n = 111), 82% (n = 115), and 70% (n = 76) for clinical students in 2017, 2019, and 2022, respectively. The survey for basic sciences students included 37 questions/items, and the survey for clinical students included 39 questions/items. The responses for the questionnaire were on the five-point Likert scale. The retrospective data were evaluated using the unpaired Wilcoxon-rank sum test.The ratings for the basic science students’ survey increased from 2017 to 2019 (first accreditation cycle) only for 11 items/questions and they were increased from 2019 to 2022 for all items/questions. The ratings for clinical science students’ surveys increased from 2017 to 2019 (the first accreditation cycle) for all items/questions with a statistically significant p-value. They increased for 28 questions/items from 2019 to 2022, and two items (availability and adequacy of career counseling) showed statistically significant p-values.The pre-accreditation preparation and the self-evaluation process while correcting the program’s deficiencies are essential triggers for the quality improvement process associated with accreditation. [ABSTRACT FROM AUTHOR]

Background Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking. Method Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set. Results The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health. Conclusion The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare. [ABSTRACT FROM AUTHOR]

Objectives The fourth age is considered a life stage with a high likelihood of age-related losses. However, very old age extends over decades, and little is known about how transitions that may happen during this age period (e.g. developing support needs or adopting caregiving roles) or lack thereof might change perceptions of age-related gains or losses. Many subjective age scales assume implicitly that they work across advanced old age, but data to support this assumption are scarce. This study reports findings on (1) diverging, age-specific understandings of age-related change and (2) whether very old adults' functional health, received social support, and caregiving roles, rather than chronological age, account for such differences. Methods Data came from the nationally representative survey "Old Age in Germany D80+" conducted in 2020/2021, comprising 10,578 individuals aged 80–106 years. Results At equivalent levels of perceived gains and losses, adults in the early fourth age reported more "freedom in daily life," less "dependency on others," and fewer "needs to reduce activities," whereas adults in the late fourth age reported more "appreciation of others." Chronological age, as such, was not the primary source of this response shift. Rather, functional health, social support, and caregiving responsibilities accounted for the differences in how older adults interpreted and reported specific age-related gains and losses. Discussion Findings underscore that across the multiple decades of the fourth age, interpretations of aging experiences vary and depend on a person's own late-life health and functioning and on that of significant others. [ABSTRACT FROM AUTHOR]

Aim: This study examines whether changes in physical activity (PA) during the first year after the Great East Japan Earthquake and Tsunami (2011–2012) contributed to preventing the onset of future frailty among older survivors of the disaster. Methods: This study tracked 2561 physically active Japanese survivors aged ≥ 65 years (43.6% men; mean age 72.9 years) who had completed self‐administered questionnaires in 2011 and 2012. PA levels for participants were classified into four categories based on ≥23 and <23 metabolic equivalent hours/week in 2011 and 2012: "consistently low," "decreasing," "increasing," and "consistently high." Frailty was defined as a Kihon Checklist score ≥ 5, which is used in the long‐term care insurance system in Japan. Hazard ratios were calculated for the onset of frailty using a Cox proportional hazards model that fitted the proportional sub‐distribution hazards regression model with weights for competing risks of death. Results: From 2012 to 2018, 283 men and 490 women developed frailty. Men with consistently high or increasing PA during the first year after the disaster had a lower risk of frailty. Furthermore, even increasing PA by walking for just 30 min/day prevented future frailty in men; however, this association between a change in PA and the decreased risk of frailty was not observed in women. Conclusions: Older men who remained physically active or resumed PA at an early stage and at a low intensity, even after being physically inactive owing to the disaster, were able to prevent future frailty. Geriatr Gerontol Int 2024; 24: 563–570. [ABSTRACT FROM AUTHOR]

Introduction: Cell population data (CPD) parameters may be putative biomarkers for the screening of various diseases including some infections and myelodysplastic syndrome. This study aimed to establish the age‐ and sex‐specific reference intervals (RIs) for the CPD parameters in the Korean population. Methods: The reference population for the RIs of CPD parameters comprised 124 856 subjects aged 20–99 years. CPD parameters were obtained from Sysmex XN‐2000 (Kobe, Japan) datasets from 17 health promotion centers in 13 South Korean cities. We determined significant partitions for age and sex, and calculated RIs according to Clinical and Laboratory Standards Institute C28‐A3 guidelines. Results: The side scattered light intensity in the neutrophil area and the lymphocyte area did not require sex‐related partitioning except in those over the age of 50, among whom the lower limit (LL) and upper limit (UL) were lower in females. However, the side scattered light distribution width in the lymphocyte area required age‐ and sex‐related partitioning, in which LL and UL were higher in females. The LL and UL of the fluorescent light distribution width were higher in males in the neutrophil area and higher in females in the lymphocyte area, but age‐related partitioning was not required. The forward scattered light intensity in the neutrophil area, lymphocyte area, and monocyte area did not require age‐related partitioning in males. Conclusion: This study has determined comprehensive age‐ and sex‐specific RIs for CPD parameters, which could help to prove the clinical significance of these parameters in the Sysmex XN‐2000. [ABSTRACT FROM AUTHOR]

To examine the applicability and process of change of Cognitive Functional Therapy (CFT) in the management of pain and disability in people with knee osteoarthritis who were offered knee replacement surgery and had risk factors for poor response to surgery. Single-case experimental design with a mixed-methods, repeated measures approach was used to investigate the process of change through CFT in four participants. Qualitative interviews investigated beliefs, behaviours and coping responses, and self-reported measures assessed pain, disability, psychological factors, and function at 25 timepoints. Study registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12619001491156). Qualitative data indicate that CFT promoted helpful changes in all participants, with two responses observed. One reflected a clear shift to a biopsychosocial conceptualisation of osteoarthritis, behavioural re-engagement and the view that a knee replacement was no longer necessary. The other response reflected a mixed conceptualisation with dissonant beliefs about osteoarthritis and its management. Psychological and social factors were identified as potential treatment barriers. Overall, quantitative measures supported the qualitative findings. The process of change varies between and within individuals over time. Psychological and social barriers to treatment have implications for future intervention studies for the management of knee osteoarthritis. Cognitive Functional Therapy is applicable in the management of knee osteoarthritis. Reconceptualisation of osteoarthritis reflected a helpful change. Psychological and social factors emerged as barriers to recovery. [ABSTRACT FROM AUTHOR]

We responded to the need for replication in psychotherapy research by extending a prior naturalistic study documenting the effectiveness of long‐term psychodynamic treatment. We employed three novel analytic strategies and evaluated their influence on substantive interpretations offered in the prior study. The sample consisted of clients (N = 387; Mage = 31.61; SD = 11.13; 58.9% female; 79.1% Caucasian/White) receiving outpatient treatment at a psychodynamic training clinic. Results replicated the original two‐class solutions for social functioning, depression and life satisfaction. Novel to the replication analyses, each trajectory for social functioning and depression exhibited nonlinear change and results advanced research on a theorised mechanism of effective psychodynamic treatment. Results showed that change in experiential avoidance was a possible mechanism between early‐treatment change in social functioning and later‐treatment changes in depression symptoms and life satisfaction. Clinical implications focus on the influence that initial levels of symptoms and well‐being may have on early and later phases of treatment, monitoring progress throughout treatment, and how to promote symptom and well‐being improvement. [ABSTRACT FROM AUTHOR]

Limited research has examined the active ingredients and mechanisms of change of naturalistic developmental behavioral interventions (NDBIs). The present study used an exploratory sequential mixed-methods design to develop a comprehensive Theory of Change of Project ImPACT, an empirically supported NDBI. We used qualitative data from interviews with intervention experts (n = 10), community providers (n = 22), and caregivers (n = 12) to develop a comprehensive causal model of the intervention process. We then tested select paths of the causal model using path analyses with an archival dataset (n = 92). The causal model described how developmental techniques aimed at supporting children's attention and engagement lay the foundation for more adult-directed learning opportunities and subsequent child skill growth. However, hypothesized causal relationships were not supported by our quantitative analyses. In the future, this research can be used to develop and prioritize nuanced research questions related to the timing, optimization, and mechanistic process underlying NDBIs. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic face-to-face activities were suspended, boosting the delivery of online teaching. As students returned to campuses, the delivery of active learning teaching methods followed a blended learning style. The flipped classroom, which is a student-centred approach, appears to be an effective teaching method, generating improved learning outcomes. No systematic review has so far explored students' experiences of this teaching method – a knowledge gap that this review aims to address. Methods: Studies published between 2012 and 2023 were identified from seven databases. The JBI critical appraisal tool was adopted to select high-quality studies and add credibility. Following extraction of qualitative data, meta-aggregation was used to identify synthesised findings. Results: The findings were aggregated into seven categories. Based on meaning similarity, three synthesised findings were identified to answer the research question on how nursing students experience the flipped classroom method. Conclusion: Several factors affect the student experience. Although variables are interrelated and complex to analyse, this approach is a valuable teaching method, positively experienced by students with the potential to improve engagement and learning outcomes. The group activities used as a feature of the flipped classroom can be seen as an instrument to deliver a safer and high quality of care. [ABSTRACT FROM AUTHOR]

In light of economic, social and discursive changes, old-industrial towns and regions increasingly apply entrepreneurial strategies to actively shape discourses as part of place-making processes. Foundational narratives play an important role in this regard. They are used by agents to foster cohesion in a local community, to legitimize and anchor their actions and goals and to make sense of complex development processes. Applying the methodology of Critical Narrative Analysis, the present study zooms in such processes of narrative building in Lauchhammer (Germany). Despite having experienced the decline of the most important parts of its industry, local actors still mobilize the industrial past in order to strengthen local identity and attract new businesses and manufacturers. Yet, the paper shows that different agents foreground different aspects of the industrial past and narratives may be contested. At the same time, local, regional and national development strategies are closely interlinked offering ‘opportunity spaces’ for local actors but raising also questions about a potential (de)legitimization of local narratives. [ABSTRACT FROM AUTHOR]

When studies use different scales to measure continuous outcomes, standardised mean differences (SMD) are required to meta‐analyse the data. However, outcomes are often reported as endpoint or change from baseline scores. Combining corresponding SMDs can be problematic and available guidance advises against this practice. We aimed to examine the impact of combining the two types of SMD in meta‐analyses of depression severity. We used individual participant data on pharmacological interventions (89 studies, 27,409 participants) and internet‐delivered cognitive behavioural therapy (iCBT; 61 studies, 13,687 participants) for depression to compare endpoint and change from baseline SMDs at the study level. Next, we performed pairwise (PWMA) and network meta‐analyses (NMA) using endpoint SMDs, change from baseline SMDs, or a mixture of the two. Study‐specific SMDs calculated from endpoint and change from baseline data were largely similar, although for iCBT interventions 25% of the studies at 3 months were associated with important differences between study‐specific SMDs (median 0.01, IQR −0.10, 0.13) especially in smaller trials with baseline imbalances. However, when pooled, the differences between endpoint and change SMDs were negligible. Pooling only the more favourable of the two SMDs did not materially affect meta‐analyses, resulting in differences of pooled SMDs up to 0.05 and 0.13 in the pharmacological and iCBT datasets, respectively. Our findings have implications for meta‐analyses in depression, where we showed that the choice between endpoint and change scores for estimating SMDs had immaterial impact on summary meta‐analytic estimates. Future studies should replicate and extend our analyses to fields other than depression. [ABSTRACT FROM AUTHOR]

We examined the interrelationships between psychopathy, changes in general criminal attitudes, and community recidivism in a sample of 212 men who attended an institutional sexual offense treatment program (SOTP) and were followed for an average of 12.73 years post‐release. The men completed a self‐report measure of general criminal attitudes, the Criminal Sentiments Scale, as part of routine SOTP service delivery, Psychopathy Checklist‐Revised (PCL‐R) ratings were completed via file review, and recidivism data were obtained from official criminal records. Criminal attitude endorsement and criminal attitude change had clinically meaningful, but differential, associations with the antisocial and interpersonal features of psychopathy. Further, positive changes in criminal attitudes—particularly tolerance of law violations (i.e., rationalizations for criminal behavior)—were significantly predictive of reductions in community violent and general recidivism after controlling for PCL‐R score. Results demonstrate that general criminal attitude change has risk relevance in the treatment of high psychopathy persons with sexual offense histories. [ABSTRACT FROM AUTHOR]

This qualitative study was informed by critical race feminism and sought to examine Canadian Black women's motivations for participating in the research study that explored their experiences with the police in the context of intimate partner violence (IPV), and the key factors that complicated their decisions. Semistructured interviews were conducted with 25 self-identified women over the age of 18. Findings indicated that Black women's experiences of anti-Black racism and various forms of systemic barriers influenced their decisions to disclose their experiences of IPV. Key themes included the invisibility of Black women's narratives, fostering political change, and the impact of racialized and gendered insider positionality. Given these findings, positioning Black women's narratives at the centre of IPV research creates opportunities for Black women to share their experiences of IPV, recognizes them as experts of their own experiences, identifies their differential experiences accessing services and supports and the barriers that impact their participation in research studies. The study provides strategies on how to increase Black women's participation and engagement in IPV research. [ABSTRACT FROM AUTHOR]

Aim(s): To understand the experiences of HIV nurses in the context of ambivalence between biomedical treatment advancements and the continuing burden for people living with HIV and negative representations of HIV. Design: An interpretative phenomenological study was conducted using in‐depth interviews. Methods: Twenty‐one interviews with nurses were conducted between November 2021 and March 2022. A thematic analysis was performed. Results: Six themes related to the nurses' experiences emerged. Despite effective treatment for most people with HIV, nurses identify patient populations that require additional care. Nurses are flexible in making extra appointments to accommodate complex issues in these patients. Nurses develop a unique relationship with their patients based on trust and empathy, linked to patient's experiences with stigma and discrimination for people with HIV. Nurses perceive their tasks as becoming increasingly complex. There is explicit awareness about the changes in HIV care from acute to chronic care and how this affects nurses' tasks. Nurses continue to differentiate HIV from other chronic conditions. Conclusion: Biomedical advancements change the organization of HIV care while public health concerns remain and patient population has particular needs due to negative social representations of HIV. Nurses navigate these issues in their everyday care. Implications for the Profession and/or Patient Care: A potential re‐evaluation of the role of nurses in providing chronic HIV care. Impact: Our study addresses the roles of HIV nurses as care is shifting towards chronic care models. The unique relationship between nurses and patients is key in understanding the importance of nurses in the care trajectory. These findings impact the institutional role of nurses in HIV treatment centres and the institutional organization of HIV care. Report Method: The COREQ guideline was used. Patient or Public Contribution: Amsterdam UMC (AMC) staff, the national organization of HIV Nurses and patient organizations contributed to the study design. [ABSTRACT FROM AUTHOR]

Stability and change in students' achievement goals (AGs) are of great relevance for educational research and practice. In two separate meta-analyses, we investigated the rank-order stability (93 studies, 569 effect sizes, 54,736 students), as well as the mean-level change (157 studies, 1,170 effect sizes, 81,464 students) in AGs throughout students' academic careers (K-12 to university). We found that the average rank-order stability of AGs (ρ =.51) was in the approximate range of rank-order stability reported for personality traits and other motivational constructs. Stability increased with students' grade level and decreased with increasing interval duration between measurement points. Overall, the mean levels of all AGs declined throughout K-12 (Glass's Δ ranged from −.15 to −.06 per year), indicating a quantitative decrease in AGs throughout this academic stage. During the university years, only mastery-approach goals significantly declined (Δ = −.22 per year), indicating a qualitative decrease in AGs. Educational Impact and Implications Statement: This meta-analytic research investigates how consistent students' achievement goals (AGs) remain and how they change from K-12 to university. We found that while students' AGs are generally moderately stable, the level of these goals tends to decline over time, particularly during K-12 education; certain goals, such as striving for mastery and personal growth, continue to decline at university. These findings highlight the importance of educational strategies that maintain students' motivation and engagement throughout their academic careers. The findings are crucial for educators, policymakers, and parents seeking to foster consistent and motivated learning in their students. [ABSTRACT FROM AUTHOR]

Background To remain effective in the dynamic health care landscape, the laboratory must embrace the continuous improvement mindset to support a culture of change, and leadership must facilitate the change process, mitigating perceived barriers of change readiness in followers. Methods This quantitative study was designed to determine whether there is an association between leadership style (Multifactor Leadership Questionnaire [MLQ]) and change readiness (3-component model [TCM] commitment to change/Employee Commitment Survey, and whether leadership style predicts change readiness. Laboratory professionals (n = 718) were recruited through national societies to complete a combined MLQ-TCM survey instrument. Multivariate analysis of variance, Pearson correlations, and multiple regression analyses were performed. Results A significant correlation between leadership style and change readiness (transformational leadership [TL] and affective commitment to change, r (716) =.12, P =.002; passive-avoidant behavior and continuance commitment to change, r (716) =.25, P <.001) and between leadership style and leadership outcomes (TL and effectiveness, r (716) =.90, P <.001) was identified. Transformational leadership was a significant predictor of change readiness (β =.17, P <.05). Conclusion It is recommended that laboratory leaders use transformational leadership or situational leadership to improve followers' affective commitment to change and reduce followers' continuance commitment to change, thus improving commitment to continuous improvement. Leaders should also limit passive-avoidant behavior. [ABSTRACT FROM AUTHOR]

I propose the concept of public futurity as a framework for studying how communities renegotiate collective identity in times of crisis. Public futurity, which I define as the process by which groups imagine and deliberate about their shared future, demonstrates how collective identity is maintained, negotiated, and transformed over time. I theorize how futurity is experienced collectively, drawing from scholarship on Black, queer, and disability futurity to show that appeals to futurity recognize not only the possibility of change, but the impossibility of sustaining an untenable present. I apply the concept of public futurity to an analysis of public deliberation about the fate of the former Philadelphia Energy Solutions (PES) oil refinery. A series of meetings organized by Philadelphia's Refinery Advisory Committee became highly contested, with mostly Black residents arguing that the site should benefit the local public and mostly white former workers fighting to keep the refinery open. Tracking how residents and former workers leveraged futurity differently in their arguments, I demonstrate how residents revealed the impossibility of the refinery's continued survival. I argue that a key process of public futurity is contending with the liminality of collective identity, and that undoing is necessary for transformation. [ABSTRACT FROM AUTHOR]

Objective: Motivation to change has been suggested to significantly impact treatment outcomes in eating disorders (EDs). This review will investigate factors associated with motivation to change in EDs with the aim of supporting clinicians to be aware and sensitive to factors that might obstruct recovery and to inform motivation‐based interventions. Method: Using PRISMA guidelines, this article identified 24 studies through database searches meeting eligibility criteria. Only correlates of motivation were identified, limiting the ability of this review to identify causal relationships. Factors that changed alongside changes in motivation were identified from longitudinal studies. Results: This review identified factors such as individual characteristics, co‐morbid psychopathology, lack of treatment autonomy and relationships with others to be associated with motivation to change in individuals with EDs. In addition, motivation to change significantly increased alongside self‐esteem and identity re‐negotiation when measured longitudinally. Discussion: Motivational interviewing can typically focus on exploring ambivalence to treatment, identifying goals and values, and increasing self‐efficacy. However, this review identifies individual and relational factors to be particularly significant and may obstruct recovery from an ED. As such, evidence‐based targets have been identified to inform clinicians and motivation‐based interventions. Public significance: Knowledge of factors associated with motivation to change in EDs is important to understand those who may have poorer treatment outcomes. Motivation may be improved by supporting individuals' relationship with others and tailoring interventions according to temperament and personality traits. Utilizing an individual's social support as they enter ED treatment may be effective in maximizing motivation to recover. [ABSTRACT FROM AUTHOR]

To investigate the predictive value of baseline platelet count and its short-term dynamic changes in the prognosis of patients with acute heart failure (AHF) in the intensive care unit. Patients diagnosed with AHF in the medical information mart for intensive care III and their clinical data were retrospectively filtered. Patients were divided into survivor and non-survivor groups based on their prognosis during hospitalization, and differences in baseline data between groups were compared. Logistic regression models and restricted cubic spline (RCS) plots were performed to evaluate the relationship between baseline platelet counts and in-hospital mortality. Changes and trends in platelet counts were compared between the survivor and non-survivor groups after adjusting for confounders with the generalized additive mixing model (GAMM). A total of 2930 critical patients with acute heart failure were included, of which 2720 were survivors and 210 were non-survivors. Multiple logistic regression models revealed that baseline platelet count was an independent factor in hospital mortality (OR 0.997, 95% CI 0.994–0.999, P-value = 0.018). The RCS plot demonstrated a U-shaped dose–response relationship between baseline platelet count and in-hospital mortality. GAMM analysis suggested that the platelet counts decreased and then increased in the survivor group and gradually decreased in the non-survivor group, with a gradual increase of difference between two groups. After adjusting for confounders, the mean daily increase was −6.014 (95% CI −7.076–4.953, P-value < 0.001). Baseline platelet demonstrated a U-shaped dose–response relationship with adverse outcomes in critical patients with AHF. Early elevation of platelet was correlated with higher in-hospital mortality, indicating that tracking early changes in platelet might help determine the short-term prognosis of critical patients with AHF. [ABSTRACT FROM AUTHOR]

While change is a constant in libraries, this article will explore the changes that have occurred and may yet be discovered following the COVID pandemic. 2020 has been referred to as the year the Earth stood still. Yet for libraries, it was a year of tremendous change with quick adaptations in order to support our student and faculty populations while seeking to preserve the safety and health of library colleagues. The authors will explore what external factors are driving the post-pandemic changes, the practices that were standard that no longer work, and emerging changes in practices. While the authors work in a North American context as well as in academic and research library context, they will explore literature from around the world. The authors bring their experience as library leaders and subject expertise to the consideration of the impact of the pandemic on library efforts and operations. [ABSTRACT FROM AUTHOR]

The current Lebanese crisis, with its accumulated historical complexities, has transformed into a national catastrophe, turning the Lebanese state into a failed and fragmented entity. What remains of its formal unity is only the structures of paralyzed constitutional institutions and authorities. Rational solutions for extrication seem to vanish, given the tangible decline in the production of intellectual elites and the political unity movement's inertia in the face of anything nonnational in thought or action. Opportunities for a dignified life within the framework of a fair civil state governed by law have been lost. This study is an attempt to rethink the causes and realities that led to the failed state, and to envision the aspirations for building a successful state in fulfilling its duties towards its people and its Arab environment. [ABSTRACT FROM AUTHOR]

Introduction: Engaging adolescents with chronic pain in physical activities is challenging. Motivational interviewing (MI) combined with activity promotion may encourage teens to make behavioural changes. This research aimed to assess the feasibility and acceptability of our MI‐based physical activity promotion programme, the M3 training. Methods: In our exploratory study with 35 adolescent–parent dyads, we evaluated the feasibility by enrolment, drop‐out and retention rates. Acceptability of the M3 training was examined by adherence rates and participation experiences through open‐ended questions. We also assessed changes in pain self‐efficacy and readiness to change after the M3 training intervention. Results: The M3 training was feasible with an adequate enrolment (77.8%) and retention (85.7%) rate. Both teens and parents found the M3 training acceptable and considered exercise and physical activity the most helpful elements of the programme (36% and 37%, respectively). While self‐efficacy remained unchanged, we identified a significant increase in the readiness to change for adolescents and parents. Conclusion: M3 training improved physical activity engagement while prioritising adolescents' autonomy. Furthermore, it appears to be a clinically relevant approach and could result in a positive shift in readiness to change within a shorter timeframe. Patient or Public Contribution: The preliminary version of the M3 training was reviewed and commented upon by the public (adolescents and adults). Adolescents who participated in this study were designing their own movement programme, considering their lived experiences. Participants' feedback was used to create the online version of the M3 training (which will be published elsewhere). [ABSTRACT FROM AUTHOR]

Throughout the literature, there are assertions that those endorsing conservative ideologies reject the science and solutions of climate change due to perceived threat. That is, they fear that accepting climate change means accepting problems with a favoured socioeconomic system and supporting action on climate change threatens to disrupt these systems. We draw together lines of research and reasoning on this topic to outline three key predictions this perspective makes about the drivers of conservative denial of climate change and opposition to climate policy. The first is that an asymmetry exists in climate‐related threat perceptions, whereby greater endorsement of conservative ideology predicts lower perceived threat from climate change and greater perceived threat from climate reform. Second, climate‐related threat perceptions are multifaceted, such that threats to economic and cultural well‐being can be experienced, at personal or collective levels. Third, the asymmetry in threat perceptions explains conservatives' lower support for pro‐climate reforms. We then specify a new integrated threat model of climate change attitudes, review the current evidence for and against each prediction in this model and outline ways to interrogate these theoretical predictions with empirical research. Doing so will advance understanding of the underpinnings of ideological disagreement on climate change. [ABSTRACT FROM AUTHOR]

A rapidly aging population, combined with technological advancement, is creating strong latent motivators for older women to learn and use technology. While many past studies have provided insights into older women's perceptions and impacts of their technology adoption, the psychological capabilities underpinning their motivation to learn are often overlooked. This study draws on interview data from 16 older women in a less developed country to explore the psychological capabilities of older women that drive them to learn and use technology. Our analysis reveals five themes (i.e. sense of purpose, self-efficacy, continuous learning, self-care, and social support seeking) that reflect the psychological capabilities of older women in relation to their technology learning and adoption. As our findings provide new evidence of the importance of fusing the elements of psychological capabilities with content delivery in education and training for older women in less developed countries, this study has practical and theoretical implications for gerontechnology. [ABSTRACT FROM AUTHOR]

Value-based healthcare has been described as the sustainable, equitable and transparent use of healthcare resources to achieve improved experiences and outcomes for people and communities. It is supported by all levels of government in Australia, with recent initiatives championing a shift away from traditional, clinician-centric care delivery to a more contemporary, value-based approach. To date, however, efforts in Queensland have focused on smaller scale siloed models of care and have not extended to the transformational change required to create equitable and sustainable healthcare delivery. The Queensland Health Allied Health Framework for Value-Based Health Care (the Framework) builds on contemporary frameworks with reference to the local context in Queensland and provides a structure and starting point for clinicians and managers to work together with consumers to transform services to focus on preventative health and wellbeing, shifting the focus of care to the community and sustainably improving the quality of care delivered. The Framework outlines key considerations for the design and implementation of new services, including understanding the care pathway, supporting an outcome driven workplace culture, measuring what matters and designing for outcomes. Several key lessons were learnt during the development of the Framework, including the importance of early and sustained consumer partnerships, of establishing a shared definition of value-based healthcare that enables integration across the care pathway and the need for leadership at all levels to actively support the change management process. While developed for Queensland public allied health services, the Framework is intended to be a system-wide tool relevant to all health professionals and services. What is known about the topic? Value-based healthcare provides an approach to restructure healthcare systems to improve health outcomes and the holistic experience of care for people and communities. What does this paper add? This paper details the development of a framework to support health services to transition to a value-based approach. What are the implications for practitioners? By reflecting on the diversity of health practitioners, managers and consumer experiences and the unique opportunities and challenges of individual healthcare services, the framework provides a structure and starting point for services to transition to value-based healthcare. This article belongs to the Special Issue: Value-Based Healthcare. [ABSTRACT FROM AUTHOR]

I dissent from the standard assertion of a "Two-Times Problem," in which physical time is taken as being at odds with the human sense of a "flow of time." I provide a brief overview of the case to be made for the contrary view: namely, that physical theory is indeed consistent with a genuine temporal dynamism that takes into account the quantum level in connection with spacetime emergence, the latter being supervenient on specific quantum processes. [ABSTRACT FROM AUTHOR]

We argue that the problem of the flow of time is a special problem, one unlike many other challenges in reconciling temporal phenomena with time in physics. After clarifying this point, we develop a Humean account of the flow of time according to which the psychological stream of experience explains why we think the world is tensed. On our account, the flow of time is not all inferential, as the invitation to think time flows comes from the deepest aspects of human experience, making it an offer we cannot refuse. [ABSTRACT FROM AUTHOR]

Despite the fact that age is associated with higher religiosity, the aging European population has experienced a noticeable religiosity decline over recent decades. This study aimed to explain this paradox and to link it to an intergenerational shift in the pattern of values (as conceptualized by Shalom Schwartz). We conducted extended mediation analyses on the relationships between generational affiliation and the level of personal religiosity via human values in two studies (European Social Survey round 7, N = 29,775; and European Social Survey rounds 1–9, N = 224,314). Our results confirm a pronounced trend of religiosity decline and explain this process by changes in personal values. In particular, Europe's generational increase in openness to change values explains religiosity decline above and beyond the effect of people's developmental age. We conclude that the perspective of human values provides a significant rationale for further research on religiosity, in relation to both past and future generations of Europeans. [ABSTRACT FROM AUTHOR]

From the perspective of the historical development of the command of maritime operations, it is found that the flow of command information gradually increases, the flow direction gradually increases, and the flow velocity gradually increases. Under the influence of the change of the command information flow, the command structure of maritime operations has undergone a process of change from simple to complex, and its internal structure is constantly optimized, and the external structure is constantly expanded and the operation mode is constantly sensitive. [ABSTRACT FROM AUTHOR]

The article highlights the transformative journey of a nurse-turned-activist who founded a not-for-profit organization, Her Heart, dedicated to addressing the alarming statistics and barriers faced by women in heart health. Topics include her diverse career trajectory, challenges in setting up the organization, and innovative solutions such as an online directory to connect women with female cardiologists and Australia's first online risk assessment tool tailored for women.

Research from the perspective of parents, educators and mental health professionals has documented the negative impacts of pandemic isolation on children, but few studies have sought children's own perspectives on this difficult year. The current study aims to provide a first‐person perspective on children's psychological health by asking children directly about their experiences of isolating at home. We interviewed 28 seven‐ to eleven‐year‐olds in early days of lockdowns with follow‐ups 6 months later. Children answered questions about family, school, friendships and feelings about the changes in their lives during lockdown. Children's reflections showed resilience, adaptability, positive appraisals and an ability to maintain meaningful social connections. This data underscores the value of including children's narratives to better understand the pandemic's lasting effects on their lives. [ABSTRACT FROM AUTHOR]

This study examined how and when employee perceptions of change fairness increase their engagement in innovative behavior during organizational change. Drawing upon fairness heuristic theory, we suggest that change fairness plays a pivotal role as a key heuristic about trustworthiness of leaders and managers in motivating employees to engage in innovative behavior. We also suggest that this change fairness effect becomes stronger or weaker depending on social contexts (change norms, change norm strength, and status differentiation) within a group. Our findings from survey data (N = 318; 35 teams) supported our hypotheses, showing that change fairness is positively related to innovative behavior and that this relationship becomes weaker when (a) group members demonstrate supportive behaviors for the planned change on average (positive change norms), (b) all group members uniformly demonstrate change‐supportive behaviors (strong change norms), and (c) group members' social status perceptions are similar (low status differentiation). We provide insights into theory development and change implementation in practice by highlighting the crucial role of fairness as a key decision heuristic about the trustworthiness of management and demonstrating how social contexts substitute the fairness effect on innovative behavior. [ABSTRACT FROM AUTHOR]

Background: Studies on the changes of extracellular matrix (ECM) in pelvic organ prolapse (POP) are still controversial. Objective: To identify the changes in the ECM in POP patients. Search strategy: Comprehensive searching in Embase, PubMed, Web of Science and the Cochrane Library was carried out until 23 February 2023. Selection criteria: Studies comparing the protein levels of ECM‐related components between women with and without POP. Data collection and analysis: Quality and risk of bias were assessed using the Agency for Healthcare Research and Quality assessment. Indicators were pooled with random or fixed effect meta‐analysis based on heterogeneity and sub‐grouped analysed by the biopsy site. Main results: Thirty cross‐sectional studies were included, comprising 840 POP cases and 755 controls. Overall results showed that the expression of type III collagen (COLIII) and several matrix metalloproteinases (MMP‐1, ‐2 and ‐9) were increased, whereas those of type I collagen (COLI), and tissue inhibitor of matrix metalloproteinase‐1 (TIMP‐1) were decreased in patients with POP. Subgroup analysis showed that the expression of COLIII in the anterior vaginal wall (AVW) and COLIII, MMP‐2 and ‐9 in the uterosacral ligament (USL) were consistent with the overall results. However, the expression of COLI and MMP‐1 in the AVW showed no difference and the expression of COLI and MMP‐1 in the USL is still controversial based on current studies. Conclusions: Patients with POP have lower expression of COLI and TIMP‐1 and higher expression of COLIII and MMPs compared with non‐POP cases, but further studies are required to investigate in specified anatomical sites. [ABSTRACT FROM AUTHOR]

In recent years, increasing attention has been devoted to electoral turmoil associated with the emergence of new political actors or the crisis of established parties at national level. However, in multi-level systems, transformations have also affected sub-national politics. This article seeks to understand some hitherto unexplored aspects of political change in regional party systems. Change is linked to the concept of instability and operationalized in terms of electoral volatility. To account for the fact that instability may be driven by distinct regional and national pressures coexisting in regional elections, a new measure of volatility has been developed. It is disaggregated into two territorial components: 'Region-specific volatility' (RSV) and 'Region-transcending volatility' (RTV). RSV refers to changes in electoral support for political parties competing exclusively in one region, while RTV is calculated for parties that 'transcend' regional boundaries – i.e. they are electorally active in several/all regions of a country or are part of institutionalized inter-regional networks. By applying this new measure to 385 elections in 58 European regions, this article shows that levels and types of instability have varied significantly over time, across regions and across countries. This may also account for different developments in territorial politics observed in Western Europe. [ABSTRACT FROM AUTHOR]

Restorative justice practices are an increasingly popular approach to behavioral management, rooted in relationships rather than the behaviorist approach of many traditional forms of schooling. Research on restorative practice implementation demonstrates that schools rarely have time to consider cultural change, as they rush to reduce suspensions and discipline gaps. Presumably, this mismatch between culture and practice would be even more pronounced in a no-excuses charter, but this presumption warrants inquiry. Framed by theories of institutional logics, the current study examines an historically no-excuses charter school's shift toward restorative justice. We find that a behaviorist, "no-excuses" logic inhibits teachers and administrators from embracing the cultural and ideological foundations of restorative justice, even as they express ideological and intellectual commitment to the shift in practices. We close with implications for school leadership and restorative justice implementation. [ABSTRACT FROM AUTHOR]

This theoretical paper provides valuable insights into the ongoing debates on OfSTED’s fitness for purpose and effectiveness. It critically examines the current education inspection system in England through the lens of complexity theory. The paper begins with a review of significant changes in the system from 2019 to the present, explaining that education inspection, as a complex system, is characterised by path-dependence, self-organisation, co-evolution, emergence, interdependence and adaptability. This is followed by a comprehensive discussion concerning the underlying power dynamics contributing to the gradual lock-in of the inspection system over the past three decades. Furthermore, it evaluates whether the system has reached a tipping point, potentially transitioning towards a new era. The complexity theory equips change agents, policymakers, policy implementers and school practitioners with a useful theoretical framework to navigate the landscape of educational inspection and facilitate meaningful changes. For change agents to embrace complexity thinking when envisioning a new inspection system, this paper presents several recommendations: surveying the evolving landscape and collecting new evidence, benchmarking against other inspection systems, balancing the power dynamic between OfSTED and schools and paying switching costs while incentivising change adopters. [ABSTRACT FROM AUTHOR]

As the higher education landscape has shifted and calls for change and improvements have grown louder, researchers have turned to empirical investigations of what makes change possible in higher education. Recent studies on the impact of informal interactions for promoting change have given impetus to social network analysis as an approach to studying higher education change. However, the relationship between teachers’ social network characteristics and their disposition to adopt changes remains largely unknown. In this study, we describe the characteristics of teaching networks and explain the network characteristics of the most innovative teaching staff. By capturing whole teaching and research networks within a STEM discipline department at a Norwegian university, we show that teachers tend to speak to the same colleagues about both research and teaching, and that teaching communities are constrained by departmental sub-units (i.e. research groups). Furthermore, by combining the network data with a survey on diffusion of innovation, we find that the most innovative teachers (1) are central in the network, having the largest personal networks, (2) have a substantial reach to the rest of the network, and (3) are highly interconnected. This paper contributes to the understanding of change theories in higher education and discusses how these results can inform the practice of change agents and educational developers. In addition to confirming the presence of a research-teaching nexus, we discuss why leveraging the networks of the most innovative teaching staff would be a promising strategy for facilitating change in higher education. [ABSTRACT FROM AUTHOR]

Reducing the prevalence of acute kidney injury (AKI) is an important patient safety objective set forth by the National Quality Forum. Despite international guidelines to prevent AKI, there continues to be an inconsistent uptake of these interventions by cardiac teams across practice settings. The IMPROVE-AKI study was designed to test the effectiveness and implementation of AKI preventive strategies delivered through team-based coaching activities. Qualitative methods were used to identify factors that shaped sites' implementation of AKI prevention strategies. Semi-structured interviews were conducted with staff in a range of roles within the cardiac catheterization laboratories, including nurses, laboratory managers, and interventional cardiologists (N = 50) at multiple time points over the course of the study. Interview transcripts were qualitatively coded, and aggregated code reports were reviewed to construct main themes through memoing. In this paper, we report insights from semi-structured interviews regarding workflow, organizational culture, and leadership factors that impacted implementation of AKI prevention strategies. [ABSTRACT FROM AUTHOR]

As a result of the defeats of Muslims against the West, different approaches to religion have emerged in the Islamic world. In this context, some people saw religion as the main reason for the defeat of the Islamic world. Some people said that the reason for this was to turn away from religion. Some people explained the reason for this as the intertwining of religion and tradition. Some of those who saw the reason for the defeat as the intertwining of religion and tradition argued that religion should be completely refined from tradition, while others thought that some opportunities in tradition should be utilized. It is seen that the idea that stands out among the opportunities that should be utilized in the tradition is maqasid-maslahat. Those who think that the idea of maqasid-maslahat, which is an important subject of the tradition, should be utilized, have interpreted that some of the provisions about which there are verses may change in line with the needs of modern period. In this study, ın the context of this thought of Muhammed Tahir b. Ashur, it is aimed to reveal his approach on whether the provisions of the Qur’an can be changed or not. In the study, first of all, Ibn Ashur’s idea of maqasid-maslahat was discussed. Then, some Qur’anic provisions that are thought to be changed in the contemporary period were touched upon and Ibn Ashur’s approach to these provisions was tried to be revealed. [ABSTRACT FROM AUTHOR]

Introduction: To examine gender differences in drinking habits among Swedish ninth graders over the period 1989–2021. Methods: Annual school surveys with nationally representative samples of ninth‐grade students in Sweden covering the period 1989–2021, total sample of 180,538 students. Drinking habits were measured with self‐reports of frequency and quantity of use and frequency of heavy episodic drinking. Differences between genders were compared annually and differences were tested using logistic and ordinary least square regression models with cluster robust standard errors. Results: Small gender differences in the prevalence of alcohol use during the first part of the study period were followed by an increasing gap over the past decade with girls being more likely to drink alcohol than boys. Boys consumed larger amounts of alcohol than girls during the first three decades of the studied period but no gender differences were found in later years. Binge drinking was more prevalent among boys during 1989 to 2000 but no systematic gender difference was found during the past 15 years. Discussion and Conclusions: There used to be clear gender differences in drinking habits among ninth graders in Sweden with boys drinking more than girls. This gap has narrowed over the past three decades and among contemporary adolescents, no gender differences are found neither in binge drinking nor volume of drinking and the prevalence of drinking is even higher among girls. [ABSTRACT FROM AUTHOR]

A type 2 diabetes remission project, Remission in Diabetes (REMI.D), funded by Sport England, was developed by stakeholders based in the North East of England and begun in early 2020. This local delivery pilot sought to tackle health inequalities by working with multiple organisations to demonstrate a way of scaling up an effective type 2 diabetes remission strategy which included both physical activity and dietary components. The intended delivery of the original project was impacted by the COVID‐19 pandemic and changes were made to the project delivery in 2022. The aim of this process evaluation was to learn from the reactive decisions taken by stakeholders which altered the REMI.D project in response to the COVID‐19 pandemic. Twelve stakeholders (from local authorities, secondary care, universities, NHS England commissioning, Diabetes UK, Sport England, Everyone Active and Active Partnerships) involved in the design and delivery of the intervention took part in a semi‐structured interview lasting up to 60 min. Interviews were recorded and transcribed verbatim. Thematic analysis used the pre‐determined 'core content' themes from the Medical Research Council and National Institute for Health Research framework for developing and evaluating complex interventions. Three topics for discussion emerged as follows: (a) lack of effective collaboration, (b) perception of change and (c) scalability of the intervention. Hierarchy within the stakeholder group initially hampered collaboration. Change was reactive as a result of the COVID‐19 pandemic. Project changes reduced project sustainability and scalability but offered valuable learning about the need for explicit project theory for partnership working, co‐production with service users and project flexibility for long‐term health behaviour change. [ABSTRACT FROM AUTHOR]

An essential component of the academic knowledge infrastructure is the services provided by the library to its community of students, staff, and stakeholders. The University of Queensland library recently transitioned from a service model of individual discipline focused librarians to one where Outreach Librarians and Learning & Research Librarians deliver services with an explicit team approach, enabling the future vision of the Library to be seen as an essential component of the academic knowledge infrastructure of UQ. The transition took place over an extended 18-month period, with ten project groups formed from the librarian group to focus on service review and to reconsider the operational processes to implement the required changes. This paper is about the whole approach of transition to change, and the intention of sharing so others will find practical help, as methodical management of the transition was a key factor to enable the change. [ABSTRACT FROM AUTHOR]

Marriage is a social institution that maintains the basic structure of a society. However, when this basic structure gets shaken by different knowledge systems encountered by the society during its course of history, a conflicting situation develops. This paper attempts to understand the nature of the marriage system of the Kom tribe of Manipur, who, of late, have been faced with a situation when conflicting wisdoms, namely, traditional, Christianity, and modern logicorational scientific knowledge, come into play with almost equal emphasis. With the advent of Christianity and modern lifestyle, the Kom people have been increasingly exposed to complex and conflicting developments arising from direct encounters between custom-oriented pre-Christian (traditional) and Christian systems, and taking a liberal outlook toward marriage as an influence of modernity. This article makes an attempt to throw light on how society deals with the marriage system with all the changes revealed by it. [ABSTRACT FROM AUTHOR]

In 2022, an international conference was held focusing on 'participation'. We shared current evidence, identified knowledge gaps and worked together to understand what new knowledge and community and practice changes were needed. This brief communication is a summary of the conference delegates' discussions. We present the key assumptions we make about participation and propose what is needed to create change for societies, communities, families and individuals. While we have some robust evidence to support participation approaches, more is needed, and it is everyone's responsibility to build an inclusive society where participation for all is the reality. [ABSTRACT FROM AUTHOR]

Alice’s adventures in Wonderlands, is the story of growth and transformation. A continuous oscillation between what we were, what we are, what we could be and what we will become. It is the story of questions and answers that generate other questions. The tale of fear, truth and courage. Of everything and the opposite of everything. The story that tells of the uncanny of every change. The tale of the truth inscribed in every dream. [ABSTRACT FROM AUTHOR]

The effectiveness of perpetrators' intervention programs (PIPs) remains controversial. Readiness and motivation for change are associated with treatment success among intimate partner violence (IPV) perpetrators. In this study, we aimed to verify whether adding Motivational Interviewing Techniques (MIT) during the intake phase of a standard PIP (SPIP) increases treatment adherence. We also sought to evaluate the effectiveness of the MIT plus SPIP concerning an SPIP alone. In this non-randomized clinical trial, 50 participants were assigned to one of the two conditions SPIP alone or MIT plus SPIP. Data were collected at baseline and the end of the intervention. Proximal outcomes (dropout, intervention dose, motivation, attitudes toward IPV, problem-solving skills) and final outcomes (IPV perpetration, risk of IPV) were assessed. The Reliable Change Index (RCI) was also computed. Results indicated that SPIP plus MIT participants concluded the curriculum in a more advanced stage of change, revealed more readiness to change, evidenced greater clinical improvements, and displayed higher reductions in attitudes toward IPV, IPV perpetration, and recidivism risk than SPIP participants. These findings point to MIT's ability to promote readiness to change and progression into the stages of change, enhancing intervention efficacy with IPV perpetrators. (NCT05484440) [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to explore (1) cognitive analytic therapy (CAT) practitioners' experiences of receiving their own reformulation letter as part of their training and (2) CAT practitioners' perceptions about how receiving their own reformulation letter altered their clinical practice. Design: Semistructured interviews were used to elicit participants' (N = 9) experiences of having received their personal CAT, with a particular focus on the reformulation letter, and their perceptions of its impact on them as clinicians and their clinical practice. Methods: Inductive "bottom up" thematic analysis was used to analyse the interview transcripts and extract overarching themes and subthemes across all participants. Results: Four overarching themes emerged from the data: the power of the reformulation letter; inhabiting the client's role; absorbing thinking as a CAT practitioner; and evolving the therapist's technique. Conclusions: Cognitive analytic therapy practitioners report experiences of the reformulation letter that indicate a positive impact on their self‐awareness, learning about CAT and consciousness about how their own clients experience therapy. This was also the case when the reformulation letter did not resonate with them to the desired extent as learning from their therapist's limitations was experienced as having an impact on their learning and subsequent practice. [ABSTRACT FROM AUTHOR]

Background: Despite the urban myth of "the divorce course," there is little research to support this perception of counselling training programmes. Studies exploring the lived experiences of counsellors in training have referred to relationship changes, but none have made these their primary focus. Research is needed to enhance our understanding of this formative stage for counsellors. Aims: The purpose of this ideographic study is to gain new perspectives on the perceived impact of counselling training on trainees' personal relationships by exploring the lived experiences of five counsellors who completed their training in the last 18 months. Method: Through a process of volunteer and snowball sampling, qualified counsellors were invited to participate in individual semistructured interviews, which were recorded and transcribed. Due to the small sample size and the emphasis on how each participant made meaning of their own experience, interpretative phenomenological analysis was chosen to interpret the findings. Findings: Detailed analysis and interpretation of the data filtered into two superordinate themes: permission to change; andthe challenge of integration. Conclusion: The data revealed that training had a significant multifaceted impact on the personal relationships of all participants. Participants' experience of their training group and of personal therapy was found to be an important factor in this change, as were themes of agency and identity. The majority of ruptures in extant relationships took place early in training. Further research is needed, perhaps into the experiences of loved ones in relationships with student counsellors. [ABSTRACT FROM AUTHOR]

Aim: To investigate the correlation between organizational agility and nurses' readiness for change. Background: The paradigm of agility in a healthcare organization is a novel concept that embodies the most advantageous organizational status. However, assessing the effects of organizational agility on nurses' readiness for change has not been previously studied. Methods: This cross‐sectional study was conducted on 270 nurses working in a university hospital in Egypt. The study took place between January ‐ March 2022, and participation was voluntary. Data were collected using the organizational agility scale and individual readiness for change scales. Data analysis was conducted using descriptive statistics, Pearson correlation, and structured equation modeling (SEM). Results: The results indicated that nurses in the hospital exhibited a moderate level of agility. Nurses' readiness for change is high. The SEM showed that organizational agility accounted for 64% of the variance in nurses' readiness for change. Conclusions: Organizational agility is a significant predictor of nurses' readiness for change. Implications for nursing policymaking: As a means of ensuring that nurses are prepared for changes, nursing institutions should foster agility by instilling a vision for the future, enhancing staff capabilities, encouraging teamwork and open communication, and implementing total quality management, strategic planning, advanced nursing practice, participatory management, shared decision‐making, and policy development. [ABSTRACT FROM AUTHOR]