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Context: Patellofemoral pain (PFP) is a prevalent chronic condition characterized by retropatellar or peripatellar pain exacerbated by various knee flexion-based activities. Previous research has highlighted the impact of psychological constructs on pain and function in chronic musculoskeletal pain conditions, yet their influence on physical activity in PFP cohorts remains unexplored. We aimed to evaluate whether pain self-efficacy and pain catastrophizing predict variations in steps per day and moderate to vigorous physical activity (MVPA) among individuals with PFP. Design: Cross-sectional observational study. Methods: Thirty-nine participants (11 males) with PFP were included. Dependent variables were steps per day and minutes of MVPA. Independent variables were pain self-efficacy and pain catastrophizing, measured by the pain self-efficacy questionnaire and the pain catastrophizing scale. Participants were given an ActiGraph wGT3X-BT for 7 days to assess physical activity. Correlations were assessed between psychological measures and physical activity, and a simple linear regression was performed on psychological variables that correlated with physical activity. Alpha was set a priori at P <.05. Results: Pain self-efficacy scores displayed a moderate association with steps per day (rho =.45, P =.004) and a weak association with MVPA (rho =.38, P =.014). Pain catastrophizing scores exhibited no significant associations with physical activity (P <.05). Regression models affirmed pain self-efficacy scores as significant predictors of both steps per day (F1,37 = 10.30, P =.002) and MVPA (F1,37 = 8.98, P =.004). Conclusions: Psychological measures continue to demonstrate value to clinicians treating PFP. Pain self-efficacy scores were moderately associated with steps per day and weakly associated with MVPA, explaining nearly a fifth of the variation in physical activity. Clinicians should prioritize the assessment of pain self-efficacy when treating individuals with PFP, potentially employing psychological interventions to improve physical activity in the PFP population. [ABSTRACT FROM AUTHOR]

Looking back at 50 years of Journal of Consumer Research methods and interviewing some of the field's most respected methodologists, this article seeks to craft a core set of best practices for scholars in consumer research. From perennial issues like conceptual validity to emerging issues like data integrity and replicability, the advice offered by our experts can help scholars improve the way they approach their research questions, provide empirical evidence that instills confidence, use new tools to make research more inclusive or descriptive of the "real world," and seek to become thought leaders. [ABSTRACT FROM AUTHOR]

Humans are immensely curious and motivated to reduce uncertainty, but little is known about the neural mechanisms that generate curiosity. Curiosity is inversely associated with confidence, suggesting that it is triggered by states of low confidence (subjective uncertainty), but the neural mechanisms of this link, have been little investigated. Inspired by studies of sensory uncertainty, we hypothesized that visual areas provide multivariate representations of uncertainty, which are read out by higher-order structures to generate signals of confidence and, ultimately, curiosity. We scanned participants (17 female, 15 male) using fMRI while they performed a new task in which they rated their confidence in identifying distorted images of animals and objects and their curiosity to see the clear image. We measured the activity evoked by each image in the occipitotemporal cortex (OTC) and devised a new metric of "OTC Certainty" indicating the strength of evidence this activity conveys about the animal versus object categories. We show that, perceptual curiosity peaked at low confidence and OTC Certainty negatively correlated with curiosity, establishing a link between curiosity and a multivariate representation of sensory uncertainty. Moreover, univariate (average) activity in two frontal areas-vmPFC and ACC-correlated positively with confidence and negatively with curiosity, and the vmPFC mediated the relationship between OTC Certainty and curiosity. The results reveal novel mechanisms through which uncertainty about an event generates curiosity about that event.

Moral decision-making typically involves trade-offs between moral values and self-interest. While previous research on the psychological mechanisms underlying moral decision-making has primarily focused on what people choose, less is known about how an individual consciously evaluates the choices they make. This sense of having made the right decision is known as subjective confidence. We investigated how subjective confidence is constructed across two moral contexts. In Study 1 (240 U.S. participants from Amazon Mechanical Turk, 81 female), participants made hypothetical decisions between choices with monetary profits for themselves and physical harm for either themselves or another person. In Study 2 (369 U.S. participants from Prolific, 176 female), participants made incentive-compatible decisions between choices with monetary profits for themselves and monetary harm for either themselves or another person. In both studies, each choice was followed by a subjective confidence rating. We used a computational model to obtain a trial-by-trial measure of participant-specific subjective value in decision-making and related this to subjective confidence ratings. Across all types of decisions, confidence was positively associated with the absolute difference in subjective value between the two options. Specific to the moral decision-making context, choices that are typically seen as more blameworthy – i.e., causing more harm to an innocent person to benefit oneself – suppressed the effects of increasing profit on confidence, while amplifying the dampening effect of harm on confidence. These results illustrate some potential cognitive mechanisms underlying subjective confidence in moral decision-making and highlighted both shared and distinct cognitive features relative to non-moral value-based decision-making.

How much should an entrepreneur experiment and when should they pivot? Do the answers to these questions change if the entrepreneur is subject to behavioral biases, such as overconfidence? In this paper, we develop a conceptual logic to address these questions. We focus on the design of a "program of experimentation," which we define as a sequentially interdependent set of experiments and pivot decisions an entrepreneur undertakes to develop a viable business idea. This conceptualization highlights two dimensions of program design: the number of experiments to run and the pivot threshold for evaluating experimental outcomes. Our computational model suggests that while experimenting and pivoting can improve new venture performance, it can also be taken too far. Programs of experimentation that generate frequent and early pivots may impede learning and underperform more conservative programs that generate fewer pivots. We also show that an effectively designed program of experimentation can partially remedy an entrepreneur's behavioral biases. Our work informs ongoing scholarly efforts to more fully understand the Lean Startup's strengths and limitations and advances the theoretical apparatus underlying a scientific approach to venturing. [ABSTRACT FROM AUTHOR]

The purpose of this article is to examine the content of previously published empirical literature utilizing self-efficacy theory with regard to physical education teachers' perceived self-confidence to teach students with disabilities in general physical education. Keyword searches were used to identify relevant literature from electronic databases published from 2000 to 2022. Twenty-four articles, from 11 countries, met all inclusion criteria, and relevant data regarding participants, theory, measurement, research design, and dependent variables were extracted. Of the 24 studies, nine were survey validation, eight were experimental, six were cross-sectional, and one was mixed-methods design. Major findings across the examined studies indicate that teachers' perceptions of training, amount of experience, and support from personnel significantly influence their self-efficacy toward teaching students with disabilities. [ABSTRACT FROM AUTHOR]

While masters sport aligns with the holistic concept of active aging, related research has focused predominantly on the physical domain, and less is known about the psychological, cognitive, and social benefits of older adults' participation. This study examined, in combination, the perceived psychological, social, cognitive, and physical benefits of training and competing as a masters athlete, while considering age and gender differences. Forty masters athletes residing in Canada were interviewed (21 men and 19 women; 15 who were 50–64 years and 25 who were 65–79 years), representing 15 different sports. Interviews were coded both deductively and inductively, revealing several subthemes of benefits for the broader perceived psychological, social, cognitive, and physical benefits, with few but notable differences between women and men, and those younger than 65 years and those 65+ years. Our findings provide new insights into the positive experiences of active aging associated with high levels of physical activity among older adults, such as greater self-confidence, especially for women, comradery, and feeling mentally sharper, especially for the older age group. [ABSTRACT FROM AUTHOR]

Sentiment analysis has fundamentally changed marketers' ability to assess consumer opinion. Indeed, the measurement of attitudes via natural language has influenced how marketing is practiced on a day-to-day basis. Yet recent findings suggest that sentiment analysis's current emphasis on measuring valence (i.e., positivity or negativity) can produce incomplete, inaccurate, and even misleading insights. Conceptually, the current work challenges sentiment analysis to move beyond valence. The authors identify the certainty or confidence of consumers' sentiment as a particularly potent facet to assess. Empirically, they develop a new computational measure of certainty in language—the Certainty Lexicon—and validate its use with sentiment analysis. To construct and validate this measure, the authors use text from 11.6 million people who generated billions of words, millions of online reviews, and hundreds of thousands of entries in an online prediction market. Across social media data sets, in-lab experiments, and online reviews, the authors find that the Certainty Lexicon is more comprehensive, generalizable, and accurate in its measurement compared with other tools. The authors also demonstrate the value of measuring sentiment certainty for marketers: certainty predicted the real-world success of commercials where traditional sentiment analysis did not. The Certainty Lexicon is available at www.CertaintyLexicon.com. [ABSTRACT FROM AUTHOR]

This study examines the impact of shared decision-making on investor overconfidence. Data from 2,000 investors, 6,394 consumers, and 657 experimental participants shed light on whether consumers who engage in joint financial decision-making are less affected by investor overconfidence than those who decide on their own. The findings show that investors who jointly decide are substantially less overconfident. However, family- or friend-inclined interactions are more effective in reducing overconfidence than relying on a financial advisor. The current research theoretically argues and empirically shows that shared metaknowledge drives this diminishing effect by highlighting unknown aspects of a financial decision. Compared to providing investors with solutions, problem reformulation, validation, or legitimation, only metaknowledge consistently decreases overconfidence in joint financial decision-making. It is argued that the process of highlighting unknowns can explain why interactions with family and friends have a more pronounced impact on investor overconfidence than consulting a professional advisor. The study provides a feasible debiasing tool to consumers, financial institutions, and other financial service providers to decrease overconfidence by emphasizing unknown aspects of an investment toward improving the quality of a consumer's financial decisions under uncertainty. [ABSTRACT FROM AUTHOR]

BackgroundDelivering methadone treatment in community health facilities by primary care providers is a task-shifting strategy to expand access to drug use treatment, especially in rural mountainous areas. This study aims to investigate factors related to confidence in providing methadone treatment among primary care providers in Vietnam to inform good practice development.MethodsWe conducted a cross-sectional survey with 276 primary care providers who were physicians, physician assistants, nurses, pharmacists or dispensing staff from 67 communes in a mountainous province in Northern Vietnam. Using self-report scales, we measured providers' confidence in providing methadone treatment, beliefs in harm reduction, perceived work-related support, perceived stigma and risk in working with drug-using patients, and empathy towards this population. We used multiple linear regression analyses to explore factors associated with providers' confidence in providing methadone treatment in the whole sample and to compare two groups of providers who did and did not have experience providing methadone. Potential associated factors were measured at facility and provider levels.Result114 (41.3%) participants had previously experience in providing methadone treatment. Providers with methadone treatment experiences had higher confidence in and more accurate knowledge of methadone treatment, perceived less stigma of working with drug-using patients, and reported more work-related support than those without experiences. Higher medical education is associated with lower confidence in providing methadone treatment among providers without methadone experiences, but higher confidence among providers with methadone experiences. Better methadone knowledge was associated with greater confidence in providing methadone treatment among inexperienced providers but not among those with experiences. Receiving work-related support was associated with greater confidence in providing treatment in both groups, regardless of their past methadone experiences.ConclusionIn rural provinces where methadone treatment has been expanded to primary care clinics, interventions to improve primary care providers' confidence should benefit professionals with diverse experiences in providing methadone treatment. Continued training and support at work for providers is essential to ensuring quality in decentralized methadone treatment.

Most Siamese trackers use the first frame tracked object as a fixed template. To adapt to the changes in object appearances, some trackers have explored "how to update" templates. Meanwhile, to suppress negative samples from contaminating templates, some trackers utilize fixed thresholds to determine "updating or not". To further improve the decision adaptability of "updating or not", we first propose an online Siamese tracking framework with an adaptive updating decision (SiamAUDT). The decision module (AUD) can adaptively determine "updating or not" according to the confidence evaluation of the current tracking result. Second, we define a metric to assess the peak deviation degree (PDD) in the current response map. Then, we design the confidence evaluation method via the fluctuation amplitude of the PDD. The evaluation does not need any additional parameters or any training costs. Furthermore, the proposed framework can be easily migrated to existing tracking algorithms. Finally, we evaluated the effectiveness of our proposed SiamAUDT on several benchmarks and verified the generalization ability of the framework under several Siamese trackers. [ABSTRACT FROM AUTHOR]

During the analysis of a commingled human remains assemblage, pair‐matching is often conducted as part of the inventory to inform the DNA sampling strategy and to calculate the minimum or most likely number of individuals. As commingled assemblages become larger, pair‐matching becomes more difficult, and it is unknown whether accuracy declines. Therefore, a study to determine the accuracy rates of visual pair‐matching for multiple observers was conducted on a large, commingled human assemblage. The sample consisted of 580 left and right humeri (n = 287 and n = 293, respectively) from the commingled remains of the USS Oklahoma, which were undergoing analysis at the Defense POW/MIA Accounting Agency. Five anthropologists completed this study, determining humeri pairs with varying degrees of confidence and non‐pairs. The overall precision was 81.0% and ranged from 74.1% to 95.9% for participants, including all confidence levels. When considering only confident matches, the overall precision for all participants increased to 91.4%. [ABSTRACT FROM AUTHOR]

Single pixel imaging (SPI) shows great potential in encryption by its indirect imaging mechanism. However, there appears to be room for further exploration in the corresponding cryptanalysis. Current studies primarily rely on straightforward end‐to‐end cryptanalysis of plain‐ciphertext pairs, ignoring the fundamental SPI optical path. As a result, the effectiveness of most attacks depends on the training data and the design of network, triggering low certainty and confidence. In this study, an alternative model is proposed to attack multiple SPI encrypting methods based on chosen plaintext attack framework, where arbitrary plaintexts can be encrypted as ciphertexts for cryptanalysis. In terms of the basic SPI setup, it is found that no matter how complicated the patterns are encrypted, the linear relationship between encrypted patterns and intensity always maintain. Thus, specifically, the ciphertext is first differentialized to derive encrypted patterns. By further reconstructing the pixel correlation of these derived patterns, deep learning is employed to correct them. Ultimately, the cracked patterns are used to decrypt plaintexts by conventional correlation. The experiments demonstrate that this method possesses a certain degree of reusability in the SPI encryption with linear propagating characteristic, like pattern‐encrypting class, demonstrating potential for the indirect optical encryption. [ABSTRACT FROM AUTHOR]

Introduction: With the goal of patient engagement, an initiative was formulated to equip each patient in the general wards with a tablet whereby they can access their health information and patient education materials and communicate with their healthcare team. This paper presented the methodology of the implementation efforts as well as an evaluation of the preliminary outcomes. Methods: The process of hospital-wide implementation was shared using the implementation research logic model. The bedside tablets were rolled out hospital-wide in a step-wedge manner over 12 months. Barriers and facilitators to this implementation were discussed together with strategies to optimize the situation. Preliminary outcomes of the implementation were evaluated using the RE-AIM framework. Results: The initial adoption rate for the bedside tablet was low. Additional strategies, such as survey audits and provision of feedback, development of education materials for patients, facilitation, and purposefully re-examining the implementation strategies, were used to improve adoption. The trend of adoption increased over the course of 2 years from the start of implementation. Discussion: The initial lower adoption rates may reflect Singapore's paternalistic healthcare culture. While this implementation was driven by the need to move away from paternalism and toward patient engagement, more time is required for significant cultural change. [ABSTRACT FROM AUTHOR]

We consider multipartite quantum state discrimination and provide a specific relation between the properties of entanglement witness and quantum nonlocality inherent in the confidence of measurement. We first provide the definition of the confidence of measurement as well as its useful properties for various types of multipartite measurement. We show that globally-maximum confidence that cannot be achieved by local operations and classical communication strongly depends on the existence of a certain type of entanglement witness. We also provide conditions for an upper bound on maximum of locally-achievable confidence. Finally, we establish a method in terms of entanglement witness to construct quantum state ensembles with nonlocal maximum confidence. [ABSTRACT FROM AUTHOR]

Background: Assessing the clinical level of competency in nursing students is crucial as it represents the ultimate goal of nursing education. Poor competency result in low performance and can be affected by various factors. Thus, the aim of this study was to identify level of clinical competency and associated factors of nursing students in Ethiopia. Methods: systematic review and meta-analysis was employed. Searching strategy was conducted from January up to march 2024 from Web of Science, PubMed and Google Scholar. The quality of studies was assessed using PRISMA checklist. A meta-analysis was performed using R Studio with the meta package Version 1.4.1106. Results: in total, 145 studies were identified through database search, and only 7 studies were included in the meta-analysis representing 1937 nursing students. The pooled effect size of clinical competency of nursing students was 28%. Three factors were found to be associated with clinical competency: a positive clinical learning environment, student confidence in performing procedures, and effective staff-student interaction. The effect sizes of these factors were 6.30, 2.23, and 7.76, respectively. Conclusion and recommendation: The clinical competency of nursing students was 28%, and it was associated with clinical learning environment, student confidence in performing procedures, and staff-student interaction. Nursing education programs should focus on enhancing students' competency levels by addressing specific factors. (PROSPERO) International prospective register of systematic reviews: CRD42022367057. [ABSTRACT FROM AUTHOR]

Background: Previous studies have established a positive link between nurse managers' caring leadership and nurses' work engagement, but the processes and conditions through which this leadership style influences positive work behaviors remain largely unexplored. To address this gap and contribute to the existing body of knowledge, we developed a chain-mediated effects model to elucidate the impact of caring leadership on nurses' work engagement and the underlying mechanisms. In this model, we identified professional mission and affective organizational commitment as the mediating variables, offering a novel perspective on the relationship between caring leadership and work engagement. Methods: A robust multi-center and large-sample cross-sectional survey was conducted, involving 2502 first-line nurses from six general tertiary hospitals across the eastern, central, and western regions of China. The data collection instruments included a comprehensive questionnaire covering demographic information, the caring leadership scale, the Chinese calling scale, the affective organizational commitment scale, and the Utrecht work engagement scale. Data were meticulously screened and analyzed, employing descriptive analysis to summarize the demographic information, correlation analysis to test the relationship among the variables, stepwise regression analysis to explore the mediating role of calling and affective organization commitment, and the bootstrap method to test the chain mediating effect. This rigorous methodology not only ensures the reliability and validity of research findings but also instills confidence in the robustness of this research. Results: The results indicated a positive relationship among caring leadership, calling, affective organizational commitment, and nurses' work engagement (p < 0.001). Specifically, caring leadership was significantly associated with nurses' calling (β = 0.55, p < 0.001), affective organizational commitment (β = 0.21, p < 0.001), and work engagement (β = 0.05, p < 0.001). And the analysis further revealed that calling and affective organizational commitment mediate the process between caring leadership and work engagement(Effect: 0.17, 0.03, 0.05), with a relative effect size of 89.3% for the total indirect effect. These findings highlight the crucial role of these factors in enhancing nurses' work engagement, providing valuable insights for healthcare leaders and policymakers. Conclusion: Caring leadership positively predicts nurses' work engagement and indirectly mediates calling and affective organizational commitment. The results of this study revealed that the mechanisms of caring leadership influence nurses' work engagement, which provides a new approach to strengthening nurses' work engagement and improving patient healthcare outcomes and organizational performance. Healthcare organizations face continuous challenges; this study embodies the significance of caring leadership in improving nurses' work experience and increasing their work engagement. Nursing managers should enhance their knowledge of caring leadership and receive caring leadership training, thus actively improving their leadership behaviors in nurse management, enhancing leadership effectiveness, and creating more possibilities for developing healthcare organizations. [ABSTRACT FROM AUTHOR]

Presently, multi-label classification algorithms are mainly based on positive and negative logical labels, which have achieved good results. However, logical labeling inevitably leads to the label misclassification problem. In addition, missing labels are common in multi-label datasets. Recovering missing labels and constructing soft labels that reflect the mapping relationship between instances and labels is a difficult task. Most existing algorithms can only solve one of these problems. Based on this, this paper proposes a soft-label recover based label-specific features learning (SLR-LSF) to solve the above problems simultaneously. Firstly, the information entropy is used to calculate the confidence matrix between labels, and the membership degree of soft labels is obtained by combining the label density information. Secondly, the membership degree and confidence matrix are combined to construct soft labels, and this process not only solves the problem of missing labels but also obtains soft labels with richer semantic information. Finally, in the process of learning specific label features for soft labels. The local smoothness of the labels learned through stream regularization is complemented by the global label correlation, thus improving the classification performance of the algorithm. To demonstrate the effectiveness of the proposed algorithm, we conduct comprehensive experiments on several datasets. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Adults with food insecurity (FI) face barriers to hypertension management, including difficulty adhering to diet recommendations. Few community health worker (CHW) interventions focus on diet to improve blood pressure. This qualitative study elicited patient and CHW perspectives on healthy eating and a future CHW nutrition intervention for patients with hypertension. Methods: Twenty-five patients with hypertension and FI and 5 CHWs participating in a hypertension health coaching program from 5 Boston-area health centers participated in semi-structured interviews from July to September 2023. Interviews were audio recorded, transcribed, and analyzed using the Framework Method. Results: Themes included: 1) Variable patient knowledge about dietary patterns for hypertension management and low confidence in interpreting nutrition labels; 2) Culture influenced healthy food perception; and 3) Barriers to healthy eating included cost, limited cooking abilities/supplies, and competing demands. Patients and CHWs favored simple nutrition education materials (e.g., traffic light nutrition ranking, healthy meals on a budget). Patients had mixed opinions about CHW-accompanied supermarket visits. Conclusions: This study identified culture, knowledge gaps, and budget constraints as factors influencing diet among patients with hypertension and FI. A CHW-delivered intervention could include simplified nutrition education, strategies for healthy eating on a budget, and linkage to community-based food programs. [ABSTRACT FROM AUTHOR]

Increased automation transparency can improve the accuracy of automation use but can lead to increased bias towards agreeing with advice. Information about the automation's confidence in its advice may also increase the predictability of automation errors. We examined the effects of providing automation transparency, automation confidence information, and their potential interacting effect on the accuracy of automation use and other outcomes. An uninhabited vehicle (UV) management task was completed where participants selected the optimal UV to complete missions. Low or high automation transparency was provided, and participants agreed/disagreed with automated advice on each mission. We manipulated between participants whether automated advice was accompanied by confidence information. This information indicated on each trial whether automation was "somewhat" or "highly" confident in its advice. Higher transparency improved the accuracy of automation use, led to faster decisions, lower perceived workload, and increased trust and perceived usability. Providing participant automation confidence information, as compared with not, did not have an overall impact on any outcome variable and did not interact with transparency. Despite no benefit, participants who were provided confidence information did use it. For trials where lower compared to higher confidence information was presented, hit rates decreased, correct rejection rates increased, decision times slowed, and perceived workload increased, all suggestive of decreased reliance on automated advice. Such trial-by-trial shifts in automation use bias and other outcomes were not moderated by transparency. These findings can potentially inform the design of automated decision-support systems that are more understandable by humans in order to optimise human-automation interaction. [ABSTRACT FROM AUTHOR]

Purpose: To explore the attitudes and experiences of clinicians and individuals with chronic stroke on the use of shared decision-making (SDM) during upper extremity rehabilitation to improve daily arm use in the home environment. Specifically, we aimed to describe clinician and client perspectives regarding the facilitators and barriers to using SDM within the context of a self-directed upper extremity intervention for individuals living in the community with chronic stroke. Methods: Data were collected within the context of an interventional study examining the feasibility of the Use My Arm-Remote intervention. Focus group interviews were conducted with the clinicians (n = 3) providing the intervention and individual semi-structured interviews with the participants (n = 15) of the study. All interview data were collected after the end of the intervention period. Data were analyzed using thematic analysis. Results: The following themes were identified: (1) Equal partnership; (2) Enhancing clinician confidence; and (3) This is different. Facilitators and barriers were identified within each theme. Key facilitators for clinicians were competence with SDM and patient characteristics; while facilitators for patients were open and trusting relationships with clinicians and personalized experience. Key barriers to SDM for clinicians were lack of expertise in SDM and participant buy in; while patients identified a lack of foundational knowledge of stroke rehabilitation as a potential barrier. Conclusions: Key barriers were analyzed using the consolidated framework for advancing implementation science to interpret results and identify strategies for enhancing the implementation of SDM in a virtual setting. The CFIR-ERIC tool highlighted the need for targeted educational meetings and materials to address the training and educational needs of both clinicians and patients for future iterations of this intervention. [ABSTRACT FROM AUTHOR]

Health care professionals can enhance conversations about serious illness and medical decision-making by adopting a transparent, standardized approach. This article critiques established communication strategies, which often emphasize patient values and goals without providing the necessary medical information to align these goals with a shared understanding of prognosis. We propose an alternate strategy that (1) provides detailed explanations of medical conditions at the beginning of the conversation, (2) includes support persons in discussions, (3) considers capacity, and (4) offers tailored advice by clinicians. The proposed framework aims to provide patients (or their delegates) with the information they need to integrate their values in pursuit of well-informed medical decisions. This strategy builds trust by providing honest information about medical conditions and their trajectories. It empowers decision makers to consider realistic outcomes, allowing them to accept or reject treatments in accordance with their preferences. This article presents a thorough step-by-step guide on how to conduct a serious illness conversation and facilitate medical decision-making, including a supplement that provides example phrases for use in clinical practice. [ABSTRACT FROM AUTHOR]

Background: The factors informing decisions to fund health services for Aboriginal and Torres Strait Islander children are unclear. This study's objective aimed to describe decision-makers' perspectives on factors informing decisions to fund health services for Aboriginal and Torres Strait Islander children. Methods: We conducted semi-structured interviews with 13 participants experienced in making funding decisions at organisational, state, territory and national levels. Decision-makers were from New South Wales, Northern Territory, Queensland, Victoria and Western Australia. Transcripts were analysed thematically following the principles of grounded theory. Results: We identified five themes, each with subthemes. First, prioritising engagement for authentic partnerships (opportunities to build relationships and mutual understanding, co-design and co-evaluation for implementation). Second, valuing participant experiences to secure receptiveness (cultivating culturally safe environments to facilitate acceptability, empowering for self-determination and sustainability, strengthening connectedness and collaboration for holistic care, restoring confidence and generational trust through long-term commitments). Third, comprehensive approaches to promote health and wellbeing (linking impacts to developmental milestones, maintaining access to health care, broadening conceptualisations of child health). Fourth, threats to optimal service delivery (fractured and outdated technology systems amplify data access difficulties, failure to 'truly listen' fuelling redundant policy, rigid funding models undermining innovation). Fifth, navigating political and ideological hurdles to advance community priorities (negotiating politicians' willingness to support community-driven objectives, pressure to satisfy economic and policy considerations, countering entrenched hesitancy to community-controlled governance). Conclusion: Decision-makers viewed participation, engagement, trust, empowerment and community acceptance as important indicators of service performance. This study highlights factors that influence decisions to fund health services for Aboriginal and Torres Strait Islander children. Making decisions to fund health services requires evidence that decision-makers consider relevant. This study identifies and defines factors of health services for Aboriginal and Torres Strait Islander children that influence funding decisions from the perspectives of decision-makers. Knowing the factors that decision-makers find useful when making decisions to fund health services can inform the types of measures that health services include in reports used to support applications for funding. [ABSTRACT FROM AUTHOR]

Background: Chronic pelvic pain (CPP) is a common and debilitating condition, and sufferers present to healthcare professionals with variable complex symptoms and co-morbidities. This study aimed to investigate the current beliefs and practice behaviours of healthcare professionals towards the management of CPP in Australian females. Methods: We distributed an online survey to Australian healthcare professionals. Participants were questioned regarding their beliefs, the importance of various contributing factors and assessment variables, and their management preferences for two CPP vignettes. Demographic information and responses were analysed with descriptive statistics. Results: Complete data were obtained and analysed from 446 respondents including gynaecologists (n = 75), general practitioners (GPs) (n = 184) and physiotherapists (n = 187). Most of the respondents were female (88.1%), with male (11.7%) and other (0.2%) making up a smaller representation. Physiotherapists rated themselves higher in understanding mechanisms of CPP (64.7% very good to excellent) compared to gynaecologists (41.3%) and GPs (22.8%). Physiotherapists also reported higher levels of confidence in managing patients with CPP (57.8% quite or extremely confident) compared to 41.3% of gynaecologists and 22.3% of GPs who reported being quite or extremely confident. All three professions rated patient's beliefs (89.8%), nervous system sensitisation (85.7%), stress/anxiety/depression (91.9%), fear avoidance (83.3%), history of sexual/emotional/physical abuse (94.1%) and pelvic floor muscle function (85.0%) as very/extremely important factors in the development of chronic pelvic pain. Most gynaecologists (71.0%) and GPs (70.2%) always referred for pelvic ultrasound during assessment. Physiotherapists assessed goal setting (88.8%) and screened for patients' beliefs (80.9%) more often than gynaecologists (30.4% and 39.1% respectively) and GPs (46.5% and 29.0% respectively). Conclusions: All three groups of healthcare professionals demonstrated a good understanding of pain mechanisms and incorporated a biopsychosocial and multidisciplinary approach to management of females with chronic pelvic pain. However, both gynaecologists and GPs were less confident in their understanding of and management of CPP, and less likely to consider patient beliefs and goals. The findings of this online survey may assist in the provision of more targeted education to further improve management of this condition. Chronic pelvic pain (CPP) is a common, debilitating condition. Sufferers present to healthcare professionals with variable complex symptoms and co-morbidities. This online survey demonstrated that Australian healthcare professionals (HCPs) demonstrated good knowledge of pain mechanisms, largely followed guideline recommended care, but lacked confidence treating patients with CPP. Patient experiences suggest discrepancy exists between HCPs beliefs and actual practice behaviours. A collaborative approach is needed to help guide targeted research and education to further improve confidence in the management of CPP. [ABSTRACT FROM AUTHOR]

Background: Patient Assessment of Care in Chronic Conditions (PACIC+), included in some Australian guidelines, has been shown reliable for measuring patient engagement and perception of their care in primary care settings. Various studies have focussed on PACIC+ use in specific conditions. This study aims to expand PACIC+ to measure patient empowerment to self-manage their chronic condition and validate it in the broader Australian primary care population. This study aims to evaluate internal consistency and reliability of PACIC+ and six new supplementary items proposed to assess patient wellbeing and empowerment to self-manage their chronic condition. Methods: A repeated-measures correlation design study assessed the expanded PACIC+ over three time-points. Particpants were patients with at least one chronic disease, referred by consultant physician, or recruited by advertisement posters in hospital clinic areas. Results: PACIC+ (26-item) had acceptable internal consitency (Cronbach's alpha 0.96). Test–retest reliability (Time-1 and 2, P < 0.01) was acceptable: Total score r (48) = 0.43; and New supplementary items: Confidence r (48) = 0.54; Understanding r (48) = 0.62; Support r (48) = 0.43; Overall Health r (48) = 0.42; Overall Health Change r (48) = −0.31, P = 0.03; and Acute Episodes of Care in 1-month r (48) = 0.42, P < 0.01. Four factors from the original PACIC+ accounted for 66.5% of the variance. Conclusions: The expanded PACIC+ is an improved psychometric tool providing for the patient's voice in a shared health journey. It is a valid, reliable tool to monitor and measure self-management of chronic conditions in Australian population clinic and primary healthcare settings. Six new supplementary patient empowerment and health status measures proved reliable and, in combination with the PACIC+ psychometric tool, could offer a method to monitor and measure the self-management of chronic conditions in the Australian clinic setting and for future research. [ABSTRACT FROM AUTHOR]

Purpose: School-based telefacilitators are critical yet underresearched members of telepractice programs. They are the face of the telepractice program and are often telepractice champions in their communities. However, we have little research explaining the typical profile of telefacilitators, making it more difficult to identify personnel characteristics that contribute to the implementation of sustainable telepractice programs. The purpose of this study was to describe the typical profile and preparation of school-based telefacilitators for physical, occupational, and speech therapy in the United States. Method: A cross-sectional survey gathered 21 telefacilitator responses about their primary job title, preparation, confidence, and basic demographics. Survey recruitment followed an adaptive sampling method with three phases: stratified random sampling, purposive sampling, and targeted convenience sampling. Results were analyzed using frequency counts and descriptive statistics where appropriate. Results: Most respondents held the primary job title of paraprofessional, but a diverse range of titles were reported, including superintendents and directors of special education. Half of the respondents received various methods of formal training for the role, whereas the other half were self-taught. Overall levels of confidence in job performance were high, yet self-taught telefacilitators felt that lack of training negatively impacted their performance. Most respondents had a bachelor's degree or higher. Conclusions: There is a high degree of variability in the profile and preparation of telefacilitators. Inconsistency in terminology and lack of agreed-upon job responsibilities are significant barriers to studying the role of telefacilitators and the ability to plan telepractice staffing needs adequately. Clinical implications and opportunities for future investigation are highlighted. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic was a far-reaching disruptor in K-12 education beginning in the spring of 2020 when nearly all schools pivoted to remote instruction. Although the pandemic was officially declared over by the World Health Organization in May 2023, many questions remain about the long-term impact of the pandemic on K-12 education. The purpose of this study was to gain a deeper understanding of the continued impact of the pandemic among school-based speech-language pathologists (SLPs) at the onset of the 2023-2024 school year. Method: This study involved a survey of 193 school-based SLPs between September and December 2023. The results of the survey were analyzed both qualitatively and quantitatively to identify key themes and trends related to how the pandemic influences both their direct work with students and how they approach and reflect on their own careers. Multiple efforts were made to ensure the credibility and trustworthiness of the analysis. Results: This survey found that although many SLPs in public schools have largely returned to prepandemic practices, most perceived that the pandemic continues to influence their work in key ways. Specifically, survey responses highlighted the altered needs of students (e.g., social-emotional needs and academic gaps) as well as changes to how SLPs reflect on their careers as professionals serving communities. Conclusion: The results of this study indicate that although the most obvious effects of the pandemic are no longer visible in schools (e.g., masking, distancing, relying on virtual services), the pandemic continues to make the work of school-based SLPs more challenging as they navigate the disconnect between the postpandemic demands of their work and prepandemic expectations, policies, and regulations. [ABSTRACT FROM AUTHOR]

Background: Every advanced cancer diagnosis brings enormous challenges to patients and their relatives on numerous levels: be it physical, practical, social challenges, or on a more personal level. While specific aspects have been researched before, an overarching approach is lacking. Aim: To understand the lived experiences of people with advanced cancer, to identify gaps along the cancer care continuum, to identify potential opportunities for meaningful interventions and to develop a theoretical framework for practitioners and researchers. Design: A qualitative study using in-depth interviews with patients, relatives, and care professionals. Interviews were transcribed verbatim and analysed using a conventional content analysis. Setting/participants: Fifty-four interviews with 17 patients from a university oncology department and palliative care service, 15 relatives and 22 care professionals from physicians to funeral directors. All interviewees were recruited by a German university hospital. Results: We developed a novel model describing the diagnosis with advanced cancer as a highly disruptive experience that threatens to challenge the integrity of personhood in cancer patients through four areas: communication, knowledge, relationships, and confidence. We were able to identify factors leading to disintegration in these areas and factors supporting a restoration of integrity of personhood. Conclusions: The developed model provides a more thorough understanding of patients lived experiences. It can help to develop new interventions along the cancer care continuum to support patients in the complex challenges they face. These interventions should focus on supporting the integrity of personhood. [ABSTRACT FROM AUTHOR]

Objective: The article reports on an assessment of the effectiveness of the MLA Research Training Institute (RTI) for the years 2018 and 2019. The RTI is a year-long continuing education research methods training and support program for health sciences librarians. The study focuses on assessing RTI participants' research confidence after program completion and compares these results with their perceptions of workshop/program performance and learning outcomes. In addition, the authors discuss how the findings were applied to inform and improve the program. Methods: The study used a 26-item questionnaire, RTI Research Confidence Questionnaire, to gather information on participants' self-reported research confidence before the workshop, immediately after the workshop, and one year after the workshop to determine statistically significant differences. Differences in research confidence were identified by using three nonparametric statistical tests. Additional workshop and program surveys were used to corroborate the research confidence findings. Results: Post-workshop and one-year-after-workshop research confidence ratings were significantly higher than preworkshop levels for years 1 and 2. A comparison of median ratings between years 1 and 2 showed significant increases in research confidence for nine items in year 2. Participants' positive perceptions of workshop/program effectiveness and learning outcomes corroborated these findings. Conclusion: Overall assessment findings indicated that RTI training helped participants understand, use, and apply research skills to conduct research. Findings also revealed that participants' heightened research confidence persisted at least 12 months postintervention. The RTI Research Confidence Questionnaire proved effective for rigorously assessing and improving the RTI program. This study enhances the currently limited evidence on evidence-based approaches for assessing and improving research instruction for librarians. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is diagnosed in 2.3 million women each year and kills 685,000 (~30% of patients) worldwide. The most dangerous breast cancer is triple-negative breast cancer (TNBC). TNBC is very diverse, with 12 underlying subtypes. This great deal of patient diversity, along with the lack of broad-application targetable mechanistic markers (such as ER, PR, and HER2, which are present in other breast cancer subtypes but missing in TNBC), gives TNBC patients the worst outcomes of any breast cancer type. We aim to remedy this by exploring the molecular mechanisms across TNBC samples and subtypes. Molecular mechanisms are potentially targetable for treatment. We explore these options as part of our RNA-sequencing analysis. Our novel findings include highly accurate mechanistic markers identified using machine learning methods, including CIDEC (97.1% accuracy alone). Additionally, we found TNBC subtype-differentiating mechanistic markers, including PDE3B, CFD, IFNG, and ADM, which are targets with known therapeutics and potential for drug repurposing. Background/Objectives: Breast cancer is diagnosed in 2.3 million women each year and kills 685,000 (~30% of patients) worldwide. The prognosis for many breast cancer subtypes has improved due to treatments targeting the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). In contrast, patients with triple-negative breast cancer (TNBC) tumors, which lack all three commonly targeted membrane markers, more frequently relapse and have lower survival rates due to a lack of tumor-selective TNBC treatments. We aim to investigate TNBC mechanistic markers that could be targeted for treatment. Methods: We performed a secondary TNBC analysis of 196 samples across 10 publicly available bulk RNA-sequencing studies to better understand the molecular mechanism(s) of disease and predict robust mechanistic markers that could be used to improve the mechanistic understanding of and diagnostic capabilities for TNBC. Results: Our analysis identified ~12,500 significant differentially expressed genes (FDR-adjusted p-value < 0.05), including KIF14 and ELMOD3, and two significantly modulated pathways. Additionally, our novel findings include highly accurate mechanistic markers identified using machine learning methods, including CIDEC (97.1% accuracy alone), CD300LG, ASPM, and RGS1 (98.9% combined accuracy), as well as TNBC subtype-differentiating mechanistic markers, including the targets PDE3B, CFD, IFNG, and ADM, which have associated therapeutics that can potentially be repurposed to improve treatment options. We then experimentally and computationally validated a subset of these findings. Conclusions: The results of our analyses can be used to better understand the mechanism(s) of disease and contribute to the development of improved diagnostics and/or treatments for TNBC. [ABSTRACT FROM AUTHOR]

The calibration problem in machine learning classification tasks arises when a model's output score does not align with the ground truth observed probability of the target class. There exist several parametric and non-parametric post-processing methods that can help to calibrate an existing classifier. In this work, we focus on binary classification cases where the dataset is imbalanced, meaning that the negative target class significantly outnumbers the positive one. We propose new parametric calibration methods designed to this specific case and a new calibration measure focusing on the primary objective in imbalanced problems: detecting infrequent positive cases. Experiments on several datasets show that, for imbalanced problems, our approaches outperform state-of-the-art methods in many cases. [ABSTRACT FROM AUTHOR]

Pre-interview planning is vital in interviews with suspects. Via a questionnaire administered to 596 police investigators in Singapore, the current study examined potential associations between pre-interview planning, interviewing behaviours and interview outcomes. Interviewing behaviours were hypothesised to mediate the relationship between pre-interview planning and interview outcomes. It is posited that pre-interview planning fosters an investigative mindset, which in turn, influences the nature of interviewing behaviours employed by investigators. The study also sought to provide insights into police interviews with suspects in Singapore, given the limited research from Singapore on the topic. Rapport-based interviewing behaviours were found to mediate the relationship between pre-interview planning and positive interview outcomes, contributing empirical support to the importance of pre-interview planning. In addition, accusatorial interviewing behaviours were associated with negative interview outcomes. This study also found that police investigators in Singapore reported frequent planning prior to their interviews and used rapport-based interviewing behaviours with suspects. These behaviours are in line with the interviewing model adopted in Singapore. Regression analyses showed that participants' endorsement of rapport-based approaches was predicted by investigator experience, confidence, and interview length. Endorsement of pre-planning of interviews was also predicted by investigator confidence and interview length. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Aims: Explore perspectives of steering group members and external clinical supervision facilitators of developing and establishing peer group clinical supervision. Background: The climate of healthcare is complex which can lead to staff burnout and challenges to practice. Clinical supervision is suggested as an approach to managing and leadership of such complexities. Design: Qualitative descriptive. Methods: Focus group interviews with 19 members of the peer group clinical supervision steering groups and individual interviews with five external clinical supervision facilitators from the Western region of Ireland were conducted. Data analysis followed Elo and Kyngäs' content analysis method, involving preparation, organising and reporting, to extract meaning and identify patterns from the qualitative data collected. Results: Developing peer group clinical supervision practice requires, clarity of purpose and function that address the pros and cons of clinical supervision. Organisational leadership is required to support and release staff for peer group clinical supervision and peer group clinical supervisors need to be credible and have a level of expertise in practice. When prepared and supported, the aspects of confidence, leadership, personal development and resilience develop. Conclusion: Peer group clinical supervisors need training and ongoing continual professional development for their role, scope of practice and responsibilities. Sustainability rests on staff awareness and familiarity with the purpose and format of peer group clinical supervision and the regularity of sessions. Implications for the profession and/or patient care: Peer group clinical supervision is a means of supporting improvement of patient care delivery while in parallel supporting personal and professional development of staff, building resilience in the workplace. Impact: This study explored the implementation of peer group clinical supervision for staff across nursing and midwifery disciplines. It found that implementing peer group clinical supervision had a positive impact on staff well‐being and morality and on patient care delivery. These findings influence healthcare service providers in implementing peer group clinical supervision in a sustainable way enabling nurses to continue working in complex healthcare environments delivering safe person‐centred care. Reporting method: The qualitative reporting guidelines Standards for Reporting Qualitative Research (SRQR) were followed. Patient or public contribution: Patient/public involvement was addressed in this study by staff, managers, planners, directors, leaders and educationalists being involved at all stages of the study (concept, design, analysis and reporting). [ABSTRACT FROM AUTHOR]

Rapport is generally considered an essential component of successful interviewing, where participants are willing to share and divulge information. The present paper contributes to the research on rapport in qualitative interviewing by exploring ethical tensions that researchers may experience when conducting qualitative interviews with vulnerable participants. The analysis is based on semi-structured interviews with nine researchers from various fields within social sciences who had extensive experience in doing research with diverse vulnerable groups. We identified six ethical tensions related to building rapport with people in vulnerable life situations that cover issues concerning both too little and too much rapport. Findings illustrate that rapport as the 'ideal' for the researcher-participant relationship may need nuancing. The study concludes that researchers undertaking qualitative interviews on sensitive topics need to have a conscious awareness of ethical tensions that may arise when building rapport with their participants [ABSTRACT FROM AUTHOR]

The demand for alternative methods of providing informed consent is increasing, especially in research with marginalised (or illiterate) research participants. This article discusses the co-creation of a visual informed consent (VIC), in collaboration with an artist. The VIC was inspired by the experience of obtaining informed consent from a group of migrant women with limited English proficiency, in empirical research undertaken on agroecology and health in Coventry, UK. Reflecting further on its creation and wider utility, this article explores the inner values that might guide researchers and lead to the co-creation of care-full tools that meet the needs of research participants. Specifically, this includes, reflecting on the iterative process of developing a VIC and using an ethics of care as a primary conceptual framework. Findings reveal that participants' understanding of ethical issues is facilitated using visual illustrations. It is argued that the creation of a VIC requires the researcher to be attentive to the embodied nature of research practice and guided by an ethics of care. A conceptual framework that integrates care and embodiment is presented, with the intention that it may further support the development of care-full research by others. [ABSTRACT FROM AUTHOR]

Background: The population of people living with dementia (PLwD) continues to grow in Japan where advance care planning (ACP) for PLwD is relatively new. Our aim was to evaluate the feasibility and cultural acceptability of a dementia‐specific ACP communication skills toolkit for Japanese primary care clinicians. Methods: We delivered 13 training sessions in primary care clinics across central Japan and conducted a post‐training survey to assess whether the toolkit increased confidence in dementia‐specific ACP communication skills and the acceptability of the toolkit with the following four statements: (1) The language in the sessions was clear, (2) The sessions took an appropriate amount of time to complete, (3) The design of the sessions was an effective educational method, and (4) The sessions were culturally appropriate for communication with Japanese patients with dementia and their family members. We asked participants to respond using a 5‐point Likert scale from strongly agree to strongly disagree. Results: All participants were Japanese and included 80 physicians (mean age 39.8 years), 33 nurses (mean age 45.7 years), and 58 other participants (mean age 42.9 years), who were 30.0%, 87.9%, and 55.2% female, respectively. Most participants practiced in rural settings. In pre‐ post‐comparisons, participant confidence increased in determining capacity, understanding dementia prognosis, goals of care, eliciting surrogates, recommending self‐care practices to families, and leading family meetings (all p < 0.001). Most participants strongly agreed or agreed that the toolkit was an effective method (96.9%), took an appropriate amount of time (94.5%), contained clear language (89.8%), and was culturally appropriate (73.6%). Conclusions: Dementia‐specific ACP communication skills toolkit can be delivered in Japan. Japanese primary care clinicians generally felt the dementia‐specific ACP toolkit increased their confidence in ACP communication skills and was acceptable. The language, time, and design were well received, though further work is needed to improve the cultural appropriateness of the toolkit. [ABSTRACT FROM AUTHOR]

Objective This study aimed to explore the impact of high-fidelity simulator (HFS) training on the bronchoscopy operation skills, confidence, stress, and learning satisfaction of trainees who further their training at endoscopy center in our hospital. The study also investigated the practical application effects of HFS training and provided a reference for the development of clinical teaching and training programs in hospitals. Methods The 18 trainees who furthered their training at the endoscopy center were evaluated for their bronchoscopy operation skills, confidence, and stress levels before and after HFS training. A survey on learning satisfaction was conducted after the completion of HFS training. The scores of all evaluations were collected for comparison of differences before and after HFS training. Results HFS training improved the clinical operation skill levels and confidence of trainees who further their training at the endoscopy center, reduced their stress, and achieved 100% satisfaction from this training. Education level and department had no significant impact on trainees' operational skills and confidence improvement, and stress reduction (p > 0.05). The results of this study supported the influence of the history of endoscopy operations on the improvement of trainees' improved operational skills after HFS training, but it had no relation to the improvement of confidence and stress reduction. Trainees with a history of endoscopy operations had higher operation skill scores before and after HFS training (n = 5, 94.80 ± 2.95 and 97.60 ± 1.82, respectively) than those without a history of endoscopy operations (n = 13, 80.62 ± 2.53 and 86.38 ± 2.82, respectively), and the difference was significant (p < 0.05). Conclusion HFS training is an effective clinical teaching method that can significantly improve trainees' bronchoscopy operation skills and confidence, reduce stress, and achieve high levels of satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: The current study aimed to examine the longitudinal associations among basic psychological need satisfaction at school (BPNSS), self‐esteem, and suicidal ideation (SI), including whether self‐esteem functioned as a mediator of the relations between BPNSS and SI at the within‐person level after disentangling between‐ and within‐person associations encompassing middle childhood to early adolescence. Methods: A total of 650 Chinese students (53.54% boys, Mage = 9.95, SD = 0.75 at Time 1) completed measures on four occasions across 1.5 years, using 6‐month intervals. Random intercept cross‐lagged panel models were applied to disaggregate between‐ and within‐person effects, thus providing greater confidence in elucidating the causal relations among study variables. Results: The results showed that at the within‐person level: (a) BPNSS negatively predicted SI; (b) BPNSS positively predicted self‐esteem; (c) Self‐esteem negatively predicted SI; and (d) BPNSS indirectly predicted SI via self‐esteem. Conclusion: These findings advanced the literature by demonstrating longitudinal associations among BPNSS, self‐esteem, and SI at the within‐person level, and highlighting the significance of distinguishing between‐ and within‐person effects in developing prevention and intervention programs aimed at reducing SI over time from middle childhood to early adolescence. [ABSTRACT FROM AUTHOR]

I compare the discussion on exclusivism in religion to the discussion on exclusivism in general. With defenders of religious exclusivism, such as Plantinga, I argue that it is a subset of general exclusivism and is as little blameworthy as the latter is. This explains why defenders of religious exclusivism are right in assuming that the burden of proof is on the shoulders of the critics of exclusivism. Yet, this answer solves only part of the problem. It answers only the first order question of whether it is legitimate to hold exclusivist truth claims in religion. It does not answer the second order question of how, in what spirit, they should be held. I argue that there are contexts in which exclusivist truth claims should be held in a humble fashion, for example contexts in which (cognitive) ambiguity reigns. If they are held in those contexts in an overconfident fashion, they are epistemically and/or morally blameworthy. Since religion is characterized by a measure of (cognitive) ambiguity, exclusivist religious truth claims should be held in a humble fashion. They are thus blameworthy if held in an overconfident fashion. Yet, if held in a modest spirit, there is nothing wrong with religious exclusivism. [ABSTRACT FROM AUTHOR]

Background: Clinician bias contributes to health disparities; therefore, educational standards and professional expectations incorporate cultural humility. Vague standards and numerous pedagogical methods make implementing an effective and uniform curriculum challenging. Classroom and clinical faculty's attitudes and behaviors are pivotal; however, evidence on roles beyond instruction is lacking. Purpose: This study explored physical therapy (PT) students' perceptions of faculty's role in improving their cultural humility. Methods: This study was rooted in a phenomenological approach that incorporated elements of both descriptive and interpretive phenomenology. Thirteen first-year PT students participated in one-on-one interviews which underwent reflexive thematic analysis. Results: Reflexive thematic analysis generated two hundred-ninety codes, six categories, and one overarching theme. Dissonance emerged between students' perceptions of faculty's role and the explicit and implicit curriculum. Conclusion: Explicit messaging from classroom instruction and implicit messaging from clinical encounters and unspoken attitudes, values, and behaviors were disparate. Faculty role modeling, diversity, cultural awareness, and perceived comfort interacting with a diverse patient population improved students' self-confidence and cultural humility. Professional development including field experience with a cognitive apprenticeship approach, and standardized, discipline-specific cultural humility competencies may provide uniform and clear guidelines. [ABSTRACT FROM AUTHOR]

Background: With increased emphasis on self-management in healthcare, clinicians need outstanding skills in offering advice and empowering patients to attain an optimal outcome. Objectives: This study explores how undergraduate physiotherapists acquire knowledge, skills, and confidence to offer advice to patients in clinical practice. Methods: Convenience sampling was used to recruit 50 BSc and MSc pre-registration physiotherapy students across all years of study in one university in southern England, UK. Semi-structured interviews were conducted for first year BSc students (n = 13). Six focus groups of mixed BSc and MSc students were conducted, three groups (n = 15 students) were mid-training, and three groups (n = 22 students) were in their final year. Results: Thematic analysis identified 6 themes: advice content; a patient-centered approach; delivery; acquisitions; perceptions; and uptake of advice. Students placed high value on advice-giving, drawing upon multiple learning opportunities, however they felt under-prepared to deliver this skill in practice. Furthermore, perceptions of their student status, and pressures to perform on graded placements were reported to influence the advice they offered to patients. Conclusions: Developing high-level skills in promoting self-management is essential in physiotherapy, this study highlights the challenges for students to develop these skills. Academic and practice educators must explicitly enable and support students to develop the knowledge and skills to confidently offer high-quality advice to patients. [ABSTRACT FROM AUTHOR]

Background: Integrating nutrition care into physiotherapy can address modifiable risk factors contributing to chronic diseases, providing comprehensive and effective patient care, and supporting a wellness-oriented approach to healthcare. Objective: To investigate physiotherapists' self-perceived confidence in their competence in nutrition care in Ireland. Methods: Cross-sectional study using data from a validated online survey tool. Four constructs of competence in nutrition care were assessed: knowledge, skill, communication and counseling, and attitude. Open-ended responses were collected to gather opinions on nutrition knowledge requirements. Participants were chartered physiotherapists representing public and private workplaces across geographical settings in Ireland. Results: 447 physiotherapists completed the survey. Most were female (n = 364, 81%), in private practice (n = 136, 31%), and located in a city (n = 215, 48%) with a mean 17 years post-qualification experience. Participants' self-perceived confidence in nutrition care competence was positive (mean score of 107.2/175). However, knowledge (mean score of 18.5/35) and skills (mean score of 27.2/55) related to nutrition care received lower ratings. Age and years of practice were positively associated with higher confidence in providing nutrition care. Most participants (n = 314, 71%) agreed that additional nutrition education is needed. Three overarching themes were identified regarding nutrition knowledge requirements: importance of providing nutrition advice, stated knowledge needs for nutrition education and training, and feasibility of nutrition care within physiotherapy practice. Conclusions: Physiotherapists in Ireland have confidence in provision of nutrition care but rated their knowledge and skills in nutrition as relatively low. Nutrition knowledge and skill are essential for physiotherapist practice as they can significantly impact patients' outcomes. [ABSTRACT FROM AUTHOR]