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There are millions of street-connected children worldwide, with thousands estimated in Kenya. Many child-serving organizations, including Agape Children's Ministry in Kenya, aim to remove children from the streets, and provide rehabilitation and family reintegration. This study aims to elucidate barriers and facilitators of Agape's Family Strengthening Program (FSP) and elicit feedback. Twelve children, 12 caregivers, and 11 staff participated in interviews. Salient child/caregiver themes include: (1) spirituality/religion, (2) reflections on the FSP, (3) reflections on Agape, and (4) family functioning. Staff themes were similar. Results amplify the voices of the participants regarding provision of and participation in the FSP. [ABSTRACT FROM AUTHOR]

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

Low- and middle-income countries (LMIC) are experiencing a surge in non-communicable diseases, with a resultant increase in the demand for palliative care. However, there is a wide gap between the demand for palliative care and its availability in LMIC. On the pretext of bridging this gap, the present study aims to explore factors that facilitate or hinder palliative care provision in the healthcare system in West Bengal, India. The study employed a qualitative focus group discussion to explore the perspectives of Chief Medical Officers of Health (CMOH), medical officers, nurses, and epidemiologists. The participants were responsible for making health care and policy decisions in their organisation. The data were analysed using Charmaz's constructivist grounded theory. A total of six focus group discussions were undertaken, two each at two sites and one each at two other sites. Three themes and subthemes were generated inductively from the study: 1. clinical teams' disposition was further influenced by self-actualisation needs, emotionally burdensome care, and perceived patient and family expectations; 2. organisational factors included interprofessional collaboration, reassurance from administration, the need for better infrastructure, community outreach, and the scarcity of opioids; 3. palliative care training and awareness impacting palliative care delivery. Factors that could facilitate better implementation of the programme include good interprofessional collaboration, comprehensive care, continuing education, an uninterrupted supply of essential medications, and engaging patients, their families, and the community in palliative care. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorders (ASD) present deficits in regulation of their emotions which have a great impact on their mental health and well-being. There are several studies showing the connection between executive functions deficits and emotion dysregulation in the context of an ASD diagnosis. Our study aims to investigate which among the executive functions can predict the emotional dysregulation in children with ASD, if there is an association between the ASD specific characteristics and their ability to regulate their emotions and to identify if there are possible mediators of this relationship. To reach our objective, we enrolled 60 children with ASD (mean age 8.5 years) whose parents completed standardised measurements for executive functions, emotional dysregulation, and ASD characteristics. We found a positive association between ASD characteristics' severity and emotional dysregulation, as well as some significant predictors among specific executive functions and emotional dysregulation. Moreover, executive functioning mediates the relationship between the ASD characteristics and emotion regulation. Our research provides a better understanding of the relationship between ASD characteristics, executive functions, and emotion regulation. [ABSTRACT FROM AUTHOR]

The importance of play is well established in early childhood development; however the importance of play appears to diminish in more advanced levels of education. Despite this, the demand for experiential, engaging learning experiences that seek to differentiate graduate-level programs in a fiercely competitive market continues to increase. This research sought to explore the phenomenon of bringing play and playfulness to the graduate-level classroom as a means through which to enhance creativity, student engagement, and teamwork. The LEGO® Serious Play (LSP) activity was originally created to be used as a facilitation strategy for business executives seeking to enhance innovation and business performance. This research sought to develop a protocol to adapt the LSP activity for masters' students completing a mandatory marketing course. The primary aim of the research considered whether LSP would provide a valuable learning activity for future graduate-level marketing classes. As such, feedback was collected on the activity from students following engagement with LSP. The results of the study provide guidelines for marketing educators to seamlessly incorporate novel activities, such as LSP, into their teaching practice. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we expand on the existing work on daily performance by focusing on (1) within‐person fluctuation in perceived manager effectiveness in relation to daily positive affective experiences and daily performance and (2) between‐person fluctuations in uncertainty as a relevant boundary condition of these relationships. Methods: Multilevel data from 101 managers (1,010 measurement occasions) were used to test the hypotheses. Results: The results showed that fluctuations in the perception of a manager's effectiveness related positively to daily positive affective experiences, and this relationship was moderated by the team member's uncertainty levels in such a way that perceived uncertainty buffered the positive effect of leadership effectiveness on positive affective experiences. Further, the findings evidenced a positive association between daily positive affective experiences and daily performance. Finally, results showed a significant indirect effect from perceived manager's effectiveness to daily fluctuations in performance via daily fluctuations in positive affective experiences. Conclusions: Perceived manager's effectiveness made employees feel more positive affective experiences, which contributed to their daily performance. However, uncertainty overshadows the influence of a manager's effectiveness on their workers' positive affective experiences. We discuss implications for theory and practice. [ABSTRACT FROM AUTHOR]

Nonprofit organizations operating in civil society have become the main channel for social service provision in most neoliberal welfare economies. Social service nonprofits (SSNs) deliver essential services mainly to vulnerable and marginalized populations. Since the outbreak of COVID-19, SSNs have been at the frontline of dealing with its socioeconomic consequences. This paper focuses on the activities and responses to the crisis of SSNs in Israel. Interviews with SSN directors (N = 17) show that they dealt with growing demands for services due to the social implications of the pandemic, along with operational difficulties, such as deterioration in clients' condition, disruption in service continuity, and reduced funding and staff. Next to these difficulties, the findings highlighted the social innovations adopted by SSNs to maintain service provision, such as implementing remote service technologies, forming collaborations, and recruiting volunteers. Implications for the social services and policies are presented and discussed. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disabilities are living longer and are increasingly diverse, with health and care needs that are varied and complex. Without changes to funding, services have found it difficult to respond to needs and wishes. Method: A descriptive mixed methods design study, data were collected through questionnaire, focus groups and individual interviews from intellectual disability service managers, direct care staff and older people with intellectual disabilities and family members. Results: Continued reticence on the part of some community healthcare providers to treat people with intellectual disability was noted. Although some service innovations were noted, housing, staffing levels, staff mix and the timely provision of equipment were all reported to impact the ability of services to respond to changing needs. Current per‐capita funding practices were reported as unresponsive to growing age‐related complexity and fundamentally unsustainable. Conclusions: The health inequalities experienced by people with intellectual disabilities are compounded as they age with complex age‐related health needs. There is an urgent need for revision of the service model in Ireland and instigation of flexible and responsive approaches to funding. Accessible summary: More people with intellectual disabilities are living into old age and may experience age related ill health.In this study, we interviewed older people with intellectual disability, family members and staff and managers in intellectual disability services. We also surveyed staff from the services.We found that there is a concern that as people with intellectual disability age and have different health and social needs, the way that services are provided and staffed may no longer suit the needs of the individuals.Most intellectual disability services are now based in the community and most staff are social care rather than healthcare staff and may not have the skills and experience to provide care to older adults with healthcare needs. Accommodation in the community may not be suitable for older adults with healthcare needs.A new model of care and different model of funding intellectual disability services is needed to meet the needs of older people with intellectual disability. [ABSTRACT FROM AUTHOR]

Introduction: Early in COVID‐19, continuing professional development (CPD) providers quickly made decisions about program content, design, funding and technology. Although experiences during an earlier pandemic cautioned providers to make disaster plans, CPD was not entirely prepared for this event. We sought to better understand how CPD organisations make decisions about CPD strategy and operations during a crisis. Methods: This is a descriptive qualitative research study of decision making in two organisations: CPD at the University of Toronto (UofT) and the US‐based Society for Academic Continuing Medical Education (SACME). In March 2021, using purposive and snowball sampling, we invited faculty and staff who held leadership positions to participate in semi‐structured interviews. The interview focused on the individual's role and organisation, their decision‐making process and reflections on how their units had changed because of COVID‐19. Transcripts were reviewed, coded and analysed using thematic analysis. We used Mazmanian et al.'s Ecological Framework as a further conceptual tool. Results: We conducted eight interviews from UofT and five from SACME. We identified that decision making during the pandemic occurred over four phases of reactions and impact from COVID‐19, including shutdown, pivot, transition and the 'new reality'. The decision‐making ability of CPD organisations changed throughout the pandemic, ranging from having little or no independent decision‐making ability early on to having considerable control over choosing appropriate pathways forward. Decision making was strongly influenced by the creativity, adaptability and flexibility of the CPD community and the need for social connection. Conclusions: This adds to literature on the changes CPD organisations faced due to COVID‐19, emphasising CPD organisations' adaptability in making decisions. Applying the Ecological Framework further demonstrates the importance of time to decision‐making processes and the relational aspect of CPD. To face future crises, CPD will need to embrace creative, flexible and socially connected solutions. Future scholarship could explore an organisation's ability to rapidly adapt to better prepare for future crises. Using CPD organizations's response to the covid crisis, Paton et al. demonstrate the importance of time and relations as a means to embrace creative, flexible, and socially connected solutions in future. [ABSTRACT FROM AUTHOR]

Background: Life skills development among youth in foster care is critical in helping them overcome the barriers they face when leaving care. While foster care agencies, child welfare professionals, and caregivers play important roles in life skills development, little research has examined the topic from their perspectives. Objective: This study examined the barriers and supports Florida foster care agencies, child welfare professionals, and caregivers face related to life skills development of youth in foster care. Methods: Foster care agency representatives (n = 11) completed interviews or questionnaires and identified agency-level challenges, agency-level supports, and caregiver-focused supports for life skills development. In surveys, child welfare professionals (n = 24) and caregivers (n = 23) identified the challenges and supports they experience, as well as additional supports they needed. Semi-structured interviews with three child welfare professionals and seven caregivers gathered in-depth information on the topics covered in the survey. Thematic analysis was employed to identify themes within the data. Results: While a number of challenges (i.e., lack of youth-focused resources, staff turnover) emerged across all three groups, supports were more varied across and within groups. Notably, caregivers received minimal support from the foster care system in helping youth develop life skills. Despite this, caregivers and child welfare professionals mainly identified youth-focused resources and services as needed additional supports. Conclusions: More training, support, and funding are required to address the challenges identified in this study. Broader child welfare issues, such as staff retention and turnover, must also be addressed to support the youths' development of independent living skills. [ABSTRACT FROM AUTHOR]

Economic empowerment (EE) services promote survivors' economic stability and well-being. A target for intervention and prevention, then, is to offer more effective EE services. The study purpose was to develop a clearer picture of what EE services agencies offer, and how prepared staff are to provide these services. We collected data from 154 providers. Survivors most requested, and agencies most frequently provided, housing services. EE services offered did not differ by agency location, staff size, or number of clients. Providers' confidence was greater if they completed high school; their agency offered more EE services; and they completed voluntary training. [ABSTRACT FROM AUTHOR]

This research is centred in the specialty of early phase cancer research – the branch of clinical research that focuses on phase one and phase two clinical trials. The aim was to gain an understanding of the complexity of work involved in implementing an educational intervention within the clinical pathway for newly referred early phase cancer clinical trial patients. The May and Finch Normalisation Process Theory (NPT) was used to understand, develop and evaluate the process of embedding an educational resource at referral hospital sites. Elements emerged from the evaluation that provide insights into the complexity of the implementation work that took place. The main elements were: pandemic-related challenges, change management, leadership, shared purpose, teamwork, workforce capacity and patient outcomes. The findings shed light on the barriers to or facilitators of the implementation of the educational resource [ABSTRACT FROM AUTHOR]

Background: Stress is a pervasive occurrence within certain professions, including nurses working in emergency and intensive care unit environments. Nurses in these settings often confront various stress-inducing factors, such as unsupportive management and distressing events like patient mortality, and experience notably higher levels of stress. Nevertheless, information is scarce regarding the precise level of stress in Ethiopia, particularly within southern hospitals. Objective: To assess stress levels and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in southern Ethiopia, 2023. Methods: A facility-based cross-sectional explanatory sequential mixed-method study was undertaken, involving a total of 239 nurses. For the quantitative component, all nurses working in intensive care units and emergency rooms were included as participants, while a purposive sampling technique was employed to select participants for the qualitative aspect. Data for the quantitative study were gathered through the utilization of self-administered questionnaires, while interviews were conducted using a structured interview guide for the qualitative portion. Quantitative data entry and analysis were performed using EpiDataV4.6 and the Statistical Package for the Social Sciences software, respectively. Thematic analysis of the qualitative data was conducted using the OpenCode software. Results: The level of stress among nurses in the emergency and intensive care units was low (19.3%), moderate (55.9%), and high (24.8%). Workload (Adjusted odds ratio (AOR) = 3.51, 95% confidence interval (CI) (1.17–10.56) and time constraints (AOR = 2.5, 95% CI (1.03–6.07) were significantly associated with moderate stress level, while duty demands (AOR = 3.03, 95% CI (1.17–7.14), availability of medical equipment and supplies (AOR = 1.42, 95% CI (1.18–4.97), and witnessing death and dying (AOR = 2.34, 95% CI (1.13–5.88) were significantly associated with high-stress level. The qualitative data analysis revealed that the participants underscored the significant impact of organizational factors, individual factors, and profession-related factors on the stress levels experienced by nurses in emergency and critical care settings. Conclusion and recommendation: Based on the findings, the participants in this study experienced some level of stress, to varying degrees. Therefore, it is crucial to implement effective strategies such as optimizing staffing and workflow, improving communication and collaboration, providing adequate support and resources, leveraging technology and innovation, emphasizing patient-centered care, and implementing data-driven quality improvement to alleviate the burden. [ABSTRACT FROM AUTHOR]

Background: Community health workers (CHW) are an integral part of primary health care re-engineering in South Africa. Cape Town is developing community-orientated primary care, with a central role for CHWs. Their role in human immunodeficiency virus, tuberculosis, maternal and child health has been articulated, but is less clear for non-communicable diseases (NCDs). Non-communicable diseases are now a major contributor to the burden of disease. The aim was to explore the current role of CHWs regarding NCDs in the Eastern sub-district of Cape Town, South Africa. Methods: An exploratory descriptive qualitative study made use of non-participant observation and qualitative interviews with CHWs, their managers, and nurse coordinators. Data from nine semi-structured interviews and ten observations were analysed with the framework method and Atlas-ti. Results: The CHWs were embedded in their communities and provided services via support groups, household visits and delivery of medication. They linked people to care with assistance of nurse coordinators. They could also provide physical care in the home. They lacked the ability to counsel people on the risk factors for NCDs and their role in rehabilitation and palliative care was unclear. More nurse coordinators were needed to provide supportive supervision. Inter-sectoral collaboration was weak and hindered CHWs from addressing social issues. More standardised and comprehensive training should equip CHWs for health promotion and disease prevention during household visits. Data collected in the community needed to be analysed, reported on and integrated with data from the primary care facility. This should also contribute to a community diagnosis. Their relationship with facility-based members of the primary health care team needed to be improved. Attention needed to be given to the requirements for and conditions of employment, as well as working hours and remuneration. Some equipment was absent and hindered their services for NCDs. Conclusions: CHWs have the potential to provide a comprehensive approach to NCDs, but community-orientated primary care needs to be strengthened in many of the key areas to support their activities. In relation to NCDs, they need training in basic and brief behaviour change counselling and risk factors as well as in the areas of rehabilitation and palliative care. [ABSTRACT FROM AUTHOR]

The article reflects on the transformative impact of the COVID-19 pandemic on clinical laboratories, emphasizing their indispensable role in patient care. It discusses institutional, operational, and early pandemic perspectives, highlighting challenges faced, such as logistical hurdles in testing, staff shortages, and supply chain disruptions, while also acknowledging the resilience and collaborative efforts that emerged amidst the crisis.

Objective: Localized Upper Urinary Tract Urothelial Carcinoma (UTUC) is an uncommon cancer typically detected at an advanced stage. Currently, radical nephroureterectomy (RNU) with bladder cuff excision is the standard treatment for high-risk UTUC. This meta-analysis aims to evaluate the 5-year overall and cancer-specific survival and bladder recurrence rates in studies comparing endoscopic kidney-sparing surgeries (E-KSS) with RNU in localized UTUC. Evidence acquisition: We performed a literature search on 20th April 2023 through PubMed, Web of Science, and Scopus. The PICOS model was used for study inclusion: P: adult patients with localized UTUC; I: E-KSS. C: RNU; O: primary: overall survival (OS); secondary: cancer-specific survival (CSS), bladder recurrence rate, and metastasis-free survival (MFS). S: retrospective, prospective, and randomized studies. Evidence synthesis: Overall, 11 studies involving 2284 patients were eligible for this meta-analysis, 737 in the E-KSS group and 1547 in the RNU group. E-KSS showed a similar overall 5-year OS between E-KSS and RNU, and for low-grade tumors, while 5-year OS favored RNU for high-grade tumors (RR 1.84, 95% CI 1.26–2.69, p = 0.002). No difference emerged for 5-year CSS between the two groups, even when the results were stratified for low- and high grade tumors. Bladder recurrence rate and 5-year MFS were also similar between the two groups. Conclusions: Our review showed that E-KSS is a viable option for patients with localized UTUC with non-inferior oncological outcomes as compared with RNU, except for 5-year OS in high-grade tumors which favoured RNU. [ABSTRACT FROM AUTHOR]

Background: Primary Health Care (PHC) has been key element in detection, monitoring and treatment of COVID-19 cases in Spain. We describe how PHC practices (PCPs) organized healthcare to guarantee quality and safety and, if there were differences among the 17 Spanish regions according to the COVID-19 prevalence. Methods: Cross-sectional study through the PRICOV-19 European Online Survey in PCPs in Spain. The questionnaire included structure and process items per PCP. Data collection was due from January to May 2021. A descriptive and comparative analysis and a logistic regression model were performed to identify differences among regions by COVID-19 prevalence (low < 5% or high ≥5%). Results: Two hundred sixty-six PCPs answered. 83.8% of PCPs were in high prevalence regions. Over 70% PCPs were multi-professional teams. PCPs attended mainly elderly (60.9%) and chronic patients (53.0%). Regarding structure indicators, no differences by prevalence detected. In 77.1% of PCPs administrative staff were more involved in providing recommendations. Only 53% of PCPs had a phone protocol although 73% of administrative staff participated in phone triage. High prevalence regions offered remote assessment (20.4% vs 2.3%, p 0.004) and online platforms to download administrative documents more frequently than low prevalence (30% vs 4.7%, p < 0.001). More backup staff members were hired by health authorities in high prevalence regions, especially nurses (63.9% vs 37.8%, p < 0.001. OR:4.20 (1.01-8.71)). 63.5% of PCPs provided proactive care for chronic patients. 41.0% of PCPs recognized that patients with serious conditions did not know to get an appointment. Urgent conditions suffered delayed care in 79.1% of PCPs in low prevalence compared to 65.9% in high prevalence regions (p 0.240). A 68% of PCPs agreed on having inadequate support from the government to provide proper functioning. 61% of high prevalence PCPs and 69.5% of low ones (p: 0.036) perceived as positive the role of governmental guidelines for management of COVID-19. Conclusions: Spanish PCPs shared a basic standardized PCPs' structure and common clinical procedures due to the centralization of public health authority in the pandemic. Therefore, no relevant differences in safety and quality of care between regions with high and low prevalence were detected. Nurses and administrative staff were hired efficiently in response to the pandemic. Delay in care happened in patients with serious conditions and little follow-up for mental health and intimate partner violence affected patients was identified. Nevertheless, proactive care was offered for chronic patients in most of the PCPs. [ABSTRACT FROM AUTHOR]

Background: Interprofessional primary care teams (IPCTs) work together to enhance care. Despite evidence on the benefits of IPCTs, implementation remains challenging. This research aims to 1) identify and prioritize barriers and enablers, and 2) co-develop team-level strategies to support IPCT implementation in Nova Scotia, Canada. Methods: Healthcare providers and staff of IPCTs were invited to complete an online survey to identify barriers and enablers, and the degree to which each item impacted the functioning of their team. Top ranked items were identified using the sum of frequency x impact for each response. A virtual knowledge sharing event was held to identify strategies to address local barriers and enablers that impact team functioning. Results: IPCT members (n = 117), with a mix of clinic roles and experience, completed the survey. The top three enablers identified were access to technological tools to support their role, standardized processes for using the technological tools, and having a team manager to coordinate collaboration. The top three barriers were limited opportunity for daily team communication, lack of conflict resolution strategies, and lack of capacity building opportunities. IPCT members, administrators, and patients attended the knowledge sharing event (n = 33). Five strategies were identified including: 1) balancing patient needs and provider scope of practice, 2) holding regular and accessible meetings, 3) supporting team development opportunities, 4) supporting professional development, and 5) supporting involvement in non-clinical activities. Interpretation: This research contextualized evidence to further understand local perspectives and experiences of barriers and enablers to the implementation of IPCTs. The knowledge exchange event identified actionable strategies that IPCTs and healthcare administrators can tailor to support teams and care for patients. [ABSTRACT FROM AUTHOR]

Emergency departments (ED) in the United States serve a dual role in public health: a portal of entry to the health system and a safety net for the community at large. Public health officials often target the ED for public health interventions due to the perception that it is uniquely able to reach underserved populations. However, under time and resource constraints, emergency physicians and public health officials must make calculated decisions in choosing which interventions in their local context could provide maximal impact to achieve public health benefit. We identify how decisions regarding public health interventions are affected by considerations of cost, time, and available personnel, and further consider the role of local community needs, health department goals, and political environment. We describe a sample of ED-based public health interventions and demonstrate how to use a proposed framework to assess interventions. We posit a series of questions and variables to consider: local disease prevalence; ability of the ED to perform the intervention; relative efficacy of the ED vs community partnerships as the primary intervention location; and expected outcomes. In using this framework, clinicians should be empowered to improve the public health in their communities. [ABSTRACT FROM AUTHOR]

This document is a letter from the Executive Director of the journal Military Medicine, Dr. John Cho. The letter is dedicated to Vice Admiral (VADM) Michael L. Cowan, who served as the 34th Surgeon General of the US Navy and Chief, Bureau of Medicine and Surgery (BUMED), and as the AMSUS Executive Director and Chief Executive Officer (CEO). The letter highlights the impact that Admiral Cowan had on AMSUS and discusses the growth and success of the organization. It also shares some of the initiatives and pearls of wisdom that Admiral Cowan shared with Dr. Cho. The letter concludes with a tribute to Admiral Cowan and an invitation to read a forthcoming edition of the journal that will include a tribute to him. [Extracted from the article]

SUMMARY: Goal: Growing numbers of hospitals and payers are using call centers to answer patients' clinical and administrative questions, schedule appointments, address billing issues, and offer supplementary care during public health emergencies and national disasters. In 2020, the Veterans Health Administration (VA) implemented VA Health Connect, an enterprise-wide initiative to modernize call centers. VA Health Connect is designed to improve the care experience with the convenience, flexibility, and simplicity of a single toll-free number connected to a range of 24/7 virtual services. The services are organized into four areas: administrative guidance for scheduling and general inquiries; pharmacy support for medication matters; clinical triage for evaluation of symptoms and recommended care; and virtual visits with providers for urgent and episodic care. Through a qualitative evaluation of VA Health Connect, we sought to identify the factors that affected the development of this program and to compile considerations to support the implementation of other enterprise-wide initiatives. Methods: The evaluation team interviewed 29 clinical and administrative leads from across the VA. These leads were responsible for the modernization of their local service networks. PhD-level qualitative methodologists conducted the interviews, asking participants to reflect on barriers and facilitators to modernization and implementation. The team employed a rapid qualitative analytic approach commonly used in healthcare research to distill robust results. Principal Findings: A review of the early implementation of VA Health Connect found: (1) deadlines proved challenging but provided momentum for the initiative; (2) a balance between standardized processes and local adaptations facilitated implementation; (3) attention to staffing, hiring, and training of call center staff before implementation expedited workflows; (4) establishing national and local leadership commitment to the innovation from the onset increased team cohesion and efficacy; and (5) anticipating information technology infrastructure needs prevented delays to modernization and implementation. Practical Applications: Our findings suggest that healthcare systems would benefit from anticipating likely obstacles (e.g., delays in software implementations and negotiations with unions), thus providing ample time to secure leadership buy-in and identify local champions, communicating early and often, and supporting flexible implementation to meet local needs. VA leadership can use this evaluation to refine implementation, and it could also have important implications for regulators, federal health exchanges, insurers, and other healthcare systems when determining resource levels for call centers. [ABSTRACT FROM AUTHOR]

The 2023 United Auto Workers (UAW) strike, led by Shawn Fain and his reformist team, aimed to address corruption, concessions, and wage tiers within the union. The strike resulted in agreements with General Motors and Stellantis that new battery plants would be covered by the UAW contract, and Ford agreed to unionize its new electric vehicle facilities. The UAW's success in this strike has implications for the re-unionization of the automobile industry and the potential for organizing workers at non-union companies. The UAW is now focusing on a broad-front organizing strategy to target workers at multiple factories simultaneously. [Extracted from the article]

Against the background of increasingly severe environmental problems, green development has gained widespread attention, and green innovation has thus become crucial for enterprises. This study used 2007–2019 data from listed A-share companies in China to evaluate the effect of senior executives' overseas experience on corporate green innovation. The results showed that senior executives' overseas experience could promote green innovation in companies. This positive effect was more significant for private enterprises and high-tech enterprises, especially in eastern China. The CEO pay regulation have a significant negative moderating effect on this positive effect. This study enriches upper echelons theory and provides theoretical support for government agencies to accelerate innovative green development strategies. The results can also provide a decision-making basis for governments to formulate policies to promote enterprises' green development. [ABSTRACT FROM AUTHOR]

To explore the experiences of the Namaste Care intervention for persons with advanced dementia (ie, moderate and late-stage) in long-term care (LTC). A qualitative descriptive design was used. Staff Carers (eg, personal support worker, nurse, or activity aide) delivered Namaste Care with the support of volunteers in a small group. Activities provided during the Namaste Care sessions to enhance quality of life included massages, aromatherapy, music, and snacks/beverages. Family carers of residents with advanced dementia, LTC staff, administrators, and volunteers from 2 Canadian LTC homes, located in a midsize metropolitan area, were included. Experiences and acceptability of Namaste Care was assessed through semistructured interviews ranging from 30 to 60 minutes following the 6-month study duration period with family carers, LTC staff, administrators, and volunteers. Thematic analysis was used for interview transcripts. A total of 16 family carers and 21 LTC staff, administrators, and volunteers participated in the study. Namaste Care was found to be acceptable and successful in enhancing the quality of life of residents due to collaborative efforts of all group of participants. Families, volunteers, and staff noted positive responses in residents, such as smiling and laughing. The program environment supported the development of relationships within the LTC community, which included families, residents, staff, and volunteers. Namaste Care was perceived by the LTC community as an acceptable intervention for persons with advanced dementia. It was perceived as offering multiple benefits for residents with advanced dementia such as improved communication and mood. [ABSTRACT FROM AUTHOR]

Background: Health professions education curricula are undergoing reform towards social accountability (SA), defined as an academic institution's obligation to orient its education, service and research to respond to societal needs. However, little is known about how or which educational experiences transform learners and the processes behind such action. For example, those responsible for the development and implementation of undergraduate medical education (UGME) programs can benefit from a deeper understanding of educational approaches that foster the development of competencies related to SA. The purpose of this paper was to learn from the perspectives of the various partners involved in a program's delivery about what curricular aspects related to SA are expressed in a UGME program. Methods: We undertook a qualitative descriptive study at a francophone Canadian university. Through purposive convenience and snowball sampling, we conducted 16 focus groups (virtual) with the following partners: (a) third‐ and fourth‐year medical students, (b) medical teachers, (c) program administrators (e.g., program leadership), (d) community members (e.g., community organisations) and (e) patient partners. We used inductive thematic analysis to interpret the data. Results: The participants' perspectives organised around four key themes including (a) the definition of a future socially accountable physician, (b) socially accountable educational activities and experiences, (c) characteristics of a socially accountable MD program and (d) suggestions for curriculum improvement and implementation. Conclusions: We extend scholarship about curricular activities related to SA from the perspectives of those involved in teaching and learning. We highlight the relevance of experiential learning, engagement with community members and patient partners and collaborative approaches to curriculum development. Our study provides a snapshot of what are the sequential pathways in fostering SA among medical students and therefore addresses a gap between knowledge and practice regarding what contributes to the implementation of educational approaches related to SA. We emphasise the need for educational innovation and research to develop and align assessment methods with teaching and learning related to SA. This study delves into how a medical training fosters socially accountable physicians. Findings underscore the importance of experiential learning, community engagement, and collaborative curriculum development. #MedEd #SocialAccountability [ABSTRACT FROM AUTHOR]

Objectives. To document state Medicaid pre- and postrelease initiatives for individuals in the criminal legal system with substance use disorder (SUD). Methods. An Internet-based survey was sent in 2021 to Medicaid directors in all 50 US states and the District of Columbia to determine whether they were pursuing initiatives for persons with SUD across 3 criminal legal settings: jails, prisons, and community corrections. A 90% response rate was obtained. Results. In 2021, the majority of states did not report any targeted Medicaid initiatives for persons with SUD residing in criminal legal settings. Eighteen states and the District of Columbia adopted at least 1 Medicaid initiative for persons with SUD across the 3 criminal legal settings. The most commonly adopted initiatives were in the areas of medication for opioid use disorder treatment and Medicaid enrollment. Out of 24 possible initiatives for each state (8 initiatives across 3 criminal legal settings), the 2 most commonly adopted were (1) provision of medication treatment of opioid use disorder before release from criminal legal settings (16 states) and (2) facilitation of Medicaid enrollment through suspension rather than termination of Medicaid enrollment upon entry to a criminal legal setting (14 states). Initiatives pertaining to Medicaid SUD care coordination were adopted by the fewest (9) states. Conclusions. In 2021, states' involvement in Medicaid SUD initiatives for criminal legal populations remained low. Increased adoption of Medicaid SUD initiatives across criminal legal settings is needed, especially knowing the high rate of overdose mortality among this group. (Am J Public Health. 2024;114(5):527–530. https://doi.org/10.2105/AJPH.2024.307604) [ABSTRACT FROM AUTHOR]

Community health worker (CHW) models have been shown to improve health behaviors and health outcomes and reduce cost, particularly among low-income underserved populations. Consequently, health systems are increasingly employing CHWs to provide health services in clinical environments. A growing body of the literature suggests that effective integration of CHWs within the healthcare system is important to achieve the desired outcomes, but the question of how to achieve effective integration is less clear. This study seeks to explore the integration of CHWs within a large state university health system to identify factors critical to the effective integration of CHWs into the clinical care environment. We conducted a qualitative descriptive multiple embedded case study of the University of Illinois at Chicago's Hospital and Health Science System (UI Health). The embedded subunits of analysis were teams within the UI Health System that currently employ CHWs to assist with the provision of clinical care or services to patients. Data were collected via semi-structured interviews and document review. In total, six sub-units were enrolled, and 17 interviews were conducted with CHWs (n = 9), and administrators or healthcare providers (n = 8). Fourteen factors related to effective CHW integration were identified and organized in four categories: individual, team, organization, and community. Findings suggest that in addition to commonly recognized elements of effective CHW models including training, supervision, and the presence of a champion, programs must consider the organizational context in which the program is positioned as well as the ways in which both CHWs and the organization engage with communities served. This research can serve as a roadmap for health systems that seek to integrate CHWs within healthcare services and can be used to promote best practice in CHW integration. [ABSTRACT FROM AUTHOR]

This exploratory, descriptive study sought to determine the perceptions of special education (SPED) directors and their respective SPED teachers regarding self-efficacy in meeting the diverse needs of students who have English learning challenges and have been identified as having special learning needs. Also, general information regarding the various programs used and ideas concerning the work and interventions with English learners (Els) who receive SPED services were reviewed for possible discussion. Researchers utilised content analysis procedures to review and code the narrative responses from 24 SPED educators and 3 SPED directors. Peer-debriefing sessions occurred and allowed researchers to collapse categories and form themes from the narrative responses. Two themes derived from SPED teachers' responses and one theme from SPED directors' responses. Theme 1 (T1)-SPED Teachers Valued Research-Based Practices, and Theme 2 (T2)-SPED Teachers Expressed Frustration or Lack of Knowledge with the District's ELs Curricular Program's Connection with SPED Services. Researchers determined one viable theme, after two debriefing sessions, from SPED directors' responses, Theme 3 (T3): SPED Directors Providing Outsourced Training Resources to Special Educators was a Source of Self-Efficacy. Researchers concluded more communication and the sharing of research-based instructional resources and coordinating cross curricular trainings were needed. [ABSTRACT FROM AUTHOR]

International recognition of Special Educational Needs Coordinators (SENCos) as agents of change for students with special educational needs calls for a deeper understanding of SENCo agency. However, literature on teacher agency for inclusion has paid little attention to SENCos. Taking a sociocultural view of agency, this qualitative case study collected rich data from five primary school SENCos in New Zealand via semi-structured individual interviews, work-shadowing and relevant documents. The findings showed that the SENCos exercised agency for inclusion through advocacy for students with SEN, commitment to the SENCo role, professional competence, self-efficacy, participation in decision-making, and collaboration with a wide range of people. The findings point to the need to conceptualise SENCo agency as a temporal, ecological process that involves engagement with culture, structure and resources in specific contexts. [ABSTRACT FROM AUTHOR]

Sexual violence is prevalent on university campuses globally. In this article, we report a qualitative insider research study examining practices for addressing sexual violence at four universities across Australia and Aotearoa New Zealand. We collected, analysed, and synthesised descriptive information about the practices at each institution. We found unique institutional approaches that nonetheless share some commonalities, yieldingseveral themes that are central to practice. In reflecting on our findings, we conclude with an outline of critical considerations and a call to action for future efforts to address campus-based sexual violence, particularly as this field remains underdeveloped across Australia and Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

According to the literature, the success of deinstitutionalization (DI) practices in low‐ and middle‐income countries (LMICs) is dependent on key factors including, a well‐functioning family‐based alternative care and social protection system, adequate funding and resources, and professional and other stakeholders' engagement and support. Following a practice research qualitative method, the study explored practitioner's experiences and perceptions on the status of Ghana's ongoing DI efforts and their recommendations for improving implementation. The study's main themes were establishing the need for residential homes for children (RHCs), RHCs not being an ideal family environment and RHCs as respite. Family marital problems, poor financial situation, stigma attached to some children in care, abusive parents and a lack of suitable alternatives when families have a crisis were identified as key factors that impede DI implementation in Ghana. The findings suggest the need for a progressive approach towards DI implementation in LMICs, with the first step being the re‐positioning of RHCs as respite care centres while progressively developing other alternative family‐based care options (such as kinship care) for children. [ABSTRACT FROM AUTHOR]

Introduction: Safe and nutritious food is the key to sustaining life and promoting good health. Unsafe food creates a vicious cycle of disease and malnutrition, particularly affecting infants, young children, the elderly, and the sick. Methods: The study consisted of two phases, a descriptive cross-sectional study, and an intervention study. Both studies were conducted in the Regional Director of Health Services area, Kalutara, Sri Lanka. The descriptive cross-sectional study [food handlers (n = 904), food establishments (n = 421)] was conducted with the objective of determining factors associated with food handling practices among food handlers and in food establishments. The interventional study was a three-arm non-randomized controlled community trial (n = 50 per arm) with interventions of a participatory consumer group, educational package group, and control group. Results: The food establishments assessment tool (FEAT) contained 11 domains including 75 items with more than a hundred assessment points with a guide to conduct an assessment of food handling. The descriptive cross-sectional study found that food handlers' knowledge of food handling practices of storing milk, fish, and meat and fast-food items containing fish and meat was very poor (96.6%). Visibility of the last place of processing inside the food establishments to consumers was inadequate (19.2%) and the absence of the above-mentioned factor was significantly associated with an unsatisfactory level of food handling score in food establishments (p = 0.03). The unsatisfactory level of food handling was significantly higher among food establishments with non-personal ownership (p = 0.005), a low number of notices issued by legal authorities (p = 0.02), dereliction of duty by owners/managers on supervising (p < 0.001) and lack of medical certification to food handlers (p < 0.0001). Participatory consumer group intervention and educational package interventions were effective in improving food handling practices in food establishments and among food handlers (p < 0.0001). Two independent sample analysis using the Mann–Whitney U test showed, the best improvement in food handling practices was by participatory consumer group intervention (p < 0.0001) and the second was educational package intervention (p < 0.0001). Conclusions: Knowledge and practices of food handling among participants were poor. A participatory consumer group is more effective than an educational package on improving food handling practices both among food handlers and in food establishments. [ABSTRACT FROM AUTHOR]

In implementing the equity incentive system, this paper delves into the listed enterprises' selection of equity incentive models. While previous research has extensively covered the effects, models, and influencing factors of equity incentives, there needs to be more in-depth literature focusing on the diverse incentive models and their impact on corporate performance. Notably, there needs to be more literature on considering entrepreneurial spirit as a mechanism. It aims to explore the relationship between executives' choices under different incentive models, the entrepreneurial spirit fostered by these models, and their combined impact on corporate performance. The findings reveal that adopting the restricted stock incentive model by listed enterprises implementing the equity incentive system significantly positively affects enterprise performance. Mechanistic tests show that when a company implements the restricted stock incentive model, executives prioritize maximizing their interests, leading them to embrace more risk in their investment decisions. This behavior, in turn, stimulates the adventurous spirit of executives, positively impacting enterprise performance, particularly pronounced in companies with more concentrated executive power. Moreover, executives may be more inclined to invest in high-risk, high-reward innovative projects, a behavior indicative of innovation and more prevalent in firms with higher research and development (R&D) investment. However, the limitation of this paper is that the study evaluates the operation of the equity incentive system in China by taking listed companies in China as an example, which is not necessarily suitable for foreign developed capitalist countries. This study contributes to the study of principal-agent problems by exploring the relationship between executives, entrepreneurship and firm performance. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the 123rd Annual Meeting held by the Medical Library Association, Inc. in Detroit, Michigan on May 16-19, 2023. It presents the sponsors and exhibitors who have demonstrated their outstanding support for the conference and for the value they see in information professionals, a conference overview, and the annual business meeting and outgoing presidential address.

Background: Non-variceal upper gastrointestinal bleeding (UGIB) is a common case of emergency in daily clinical practice with a fairly high mortality rate. The use of tranexamic acid, which has been recommended in managing trauma bleeding, may serve as an alternative pharmacological therapy to manage bleeding in nonvariceal UGIB. This evidence-based case report aims to evaluate the impact of tranexamic acid on managing bleeding, risk of mortality, and thromboembolic event in non-variceal UGIB patients. Methods: A systematic literature search was conducted on 4 databases: CDSR, EMBASE, PubMed, and Scopus for meta-analyses. Studies were selected based on inclusion and exclusion criteria formulated a-priori with subsequent critical appraisal according to the OCEBM critical appraisal tools. Result: Meta analyses by Kamal, et al (2020) and Twum-Barimah, et al (2020) were included in our report. Kamal, et al shows no significant difference in mortality in tranexamic acid use compared to placebo (RR 0.84; 95%CI 0.63--1.11; I2=2%). Similarly, although Twum-Barimah reported tranexamic acid reduced risk of mortality compared to placebo (RR 0.45; 95%CI 0.23--0.88; p=0.02; I2 = 0%), none of the RCTs included shows significant result when observed individually. In addition, Kamal, et al also reported increased risk of vein thromboembolic events in high-dose tranexamic acid administration (RR 2.21; 95%CI 1.32--3.69; I2=0%) compared to low-dose administration, in UGIB patients. Conclusion: Tranexamic acid is not recommended to be used in managing bleeding in patients non-variceal UGIB patients and may increase the risk of thromboembolic event. [ABSTRACT FROM AUTHOR]

El articulo discute un evento conmemorativo realizado en 2023 por el IESA y la AVE en Venezuela. también se enfoca un seminario celebrado en 1963 en Maracay, donde líderes empresariales, gubernamentales y sociales debatieron sobre el papel social de las empresas. Otros teams relacionados son la evolución de la responsabilidad social empresarial y la necesidad actual de que los gerentes venezolanos.

Residential aged care managers play an important role which can influence outcomes for their staff, their residents, and the organisations they work for. Burnout in residential aged care employees has been researched however burnout in residential aged care managers has received little attention. This scoping review sought to identify literature examining burnout in residential aged care managers. To investigate the literature currently available on what stressors were experienced by residential aged care managers that led to burnout. This scoping review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist. Five databases were searched, including CINAHL, MEDLINE, EMCARE, SCOPUS, and INFORMIT using primo search. The first review of title and abstracts was conducted by three authors to determine eligibility, using the program JBI SUMARI. Two authors were involved in the final screening of each full-text article. Where disagreement occurred, a collaborative discussion took place until consensus was reached. The review included peer-reviewed journal articles focusing on burnout, stress, fatigue, moral distress, exhaustion, or resilience in residential aged care managers or leaders published after 2012 in English. An initial search of the databases found 275 articles, of which 5 articles met the inclusion criteria for final review. Articles were categorised into the following groups Responsibilities, Reaction, and Regulation. These groups encapsulated risk factors for burnout in residential aged care managers. As a result of the scoping review, it is suggested that burnout in residential aged care managers can be attributed to environmental stressors, those being situational and organisational (Maslach, 2003), which are outside the control of the individual. Strategies that support residential aged care managers to manage and lessen the phenomenon of burnout require further exploration. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to extend safety climate research by considering perceptions across the following three hierarchical levels within a workplace: (1) senior leaders/executives, (2) field leaders/supervisors, and (3) front-line employees. Methods: We conducted a quantitative survey study at a US utility company where we collected data related to safety climate perceptions and employee-reported safety behaviors across the different levels of organizational hierarchy. Results: The findings revealed the highest safety climate scores among senior leaders/executives, followed by field leaders/supervisors, and then employees, suggesting potential discrepancies between espoused and enacted safety values in the workplace. Conclusions: These results suggest that supervisors and top managers may have different mental models of workplace safety compared with employees. Consequently, assessing perceptions at different organizational levels provides a fuller picture of safety in the workplace. [ABSTRACT FROM AUTHOR]

Introduction: To increase the likelihood of research responding to societal needs, intermediary structures such as Science Shops are being created. Science Shops respond to research needs identified and prioritized through participatory processes involving civil society. However, these are not mainstream structures, and most research needs addressed by the scientific community are not defined by a diversity of stakeholders (including citizens) but are mostly prioritized by researchers and funders. Literature shows this often leads to bias between the research topics investigated and the research needs of other relevant stakeholders. This study analyses how 14 Science Shops contribute to decreasing bias in health research agenda setting. Methodology: We compare the research priorities identified through participatory processes by the Science Shops, which participated in the European Union‐funded project InSPIRES (2017–2021), to the available research addressed in the literature (identified in Web of Science), which we use as a proxy for current research priorities. Results: Science Shop projects contributed to decreasing the existing bias in health research agenda setting: (1) between drug and nondrug treatments and (2) between clinical trials of treatments for illnesses affecting high‐income versus middle‐ and low‐income countries, which leads to a lack of local strategies for high disease burdens in nonhigh‐income regions. Conclusion: This study provides the first evidence of Science Shops' effectiveness in addressing current biases in health research agenda setting. We conclude they could play a key role in shaping local, national and international research policies. [ABSTRACT FROM AUTHOR]

Introduction and Aim: Small fibre neuropathy (SFN) is a peripheral neuropathy, leading to neuropathic pain and autonomic dysfunction. An evidence‐based standardized patient diagnostic SFN service has been implemented in the Netherlands for improving patient‐centred SFN care. However, the quality of care of this diagnostic SFN service has never been assessed from a patient perspective. The aim of this study was to develop and validate an SFN‐Patient Satisfaction Questionnaire (SFN‐PSQ) to measure the quality performance of a standardized diagnostic SFN service. Methods: A descriptive qualitative study to create the SFN‐PSQ was performed using the (COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. For item generation and content development, domains and/or items from validated PSQs were selected. The content development and content validity were performed using a Delphi method with SFN expert caregivers with different backgrounds. By using the three‐step‐test method in individual cognitive interviews, the content validity by patients was finalized. Results: In one online Delphi panel round, the content of the first concept of the SFN‐PSQ was validated, which resulted in the second concept of the SFN‐PSQ. From July 2019 till March 2020, nine patients consented to participate in the individual cognitive interviews. The most significant changes of the new questionnaire were adding domains and items concerning the waiting list, the diagnostic services and consultation by the hospital psychiatrist. Also, a differentiation was made for both an inpatient and outpatient diagnostic SFN service. Furthermore, the clarity and intelligibility of the domains/items were improved, resulting in an increased comprehension of the SFN‐PSQ. Ultimately, the new developed SFN‐PSQ consisted of 10 domains and 51 items, suitable for measuring patient satisfaction of the neurological analysis in patients with SFN. Conclusion: Through item generation, expert opinions and interviews with patients, the SFN‐PSQ was developed and validated, and feasibility was confirmed. The structure of the questionnaire, based on the logistic and diagnostic SFN pathway, could be used as a model in other hospitals to improve the quality, continuity and access of SFN care and other chronic diseases taking into account potential cross‐cultural differences. Patient or Public Contribution: Caregivers were involved in the item generation and content development of the questionnaire. Patients were directly involved in testing the content validity and feasibility of the SFN‐PSQ. Clinical Trial Registration: Not applicable. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic. Design: Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders. Methods: Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust. Results: Participants continued to deliver a significant proportion of patient care inperson. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks. Conclusion: The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice. Impact: The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward. Reporting method: Standards for Reporting Qualitative Research (O'Brien et al., 2014). Patient or public contribution: This was a workforce study so there was no patient or public contribution. Implications for the profession and patient care: The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic strained the U.S. health care system, posing logistical challenges for community-based programs. This study surveyed 11 program directors in sexually transmitted infection (STI) clinics and syringe services programs (SSPs) that served people who use substances and are at risk for HIV in five southeastern U.S. states. Brief survey questions asked about programs' use of in-person and telehealth services. Results indicated widespread reduction of in-person services and concomitant adoption of telehealth services. In STI clinics, telehealth replaced in-person visits for all but urgent treatment of active symptoms. In SSPs, in-person contact continued or increased from pre-pandemic volumes. In both programs, the most salient telehealth use barrier was limited device or internet access and limited technological ease. Services were sustained through innovative adaptations. This snapshot of response to the early COVID-19 lockdown phase offers actionable guidance about service preparedness for future public health catastrophes in community-based programs serving vulnerable populations. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated score reliability of the Professional Quality of Life Scale (ProQoL) when contextualizing help to a relevant derivative. Method: The researchers evaluated score reliability across three datasets among school-based professionals (n = 122), teachers (n = 216), and mental health professionals (n = 543) using Cronbach's alpha, McDonald's omega, inter-item correlations and visual analysis. Results: Score reliability was acceptable across samples. However, item analysis indicated variability in responses indicating participants' extracting different meaning or relevance to the items. Terminology changes may extract different meaning based on profession resulting in measurement error. Conclusions: Findings highlight use of one-word derivative changes to items may impact score reliability based on the professional activities represented. Researchers should adjust item terminology for clarity and relevance to all the professions represented in the sample. Evidence of the nature of professional activities with client or student trauma to secondary traumatic stress is presented. This study evaluates score reliability of the ProQoL when contextualizing help to a derivative relevant to the profession. Internal consistency may differ across professions as participants extract different item meaning, directly impacting score reliability. Researchers and practitioners using the ProQoL should review items for clarity and relevance to the professionals represented. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the association between the onset of the COVID-19 pandemic and change in low-value cancer services. STUDY DESIGN: In this retrospective cohort study, we used administrative claims from the HealthCore Integrated Research Environment, a repository of medical and pharmacy data from US health plans representing more than 80 million members, between January 1, 2016, and March 31, 2021. METHODS: We used linear probability models to investigate the relation between the onset of the COVID-19 pandemic and 4 guideline-based metrics of low-value cancer care: (1) conventional fractionation radiotherapy instead of hypofractionated radiotherapy for early-stage breast cancer; (2) non--guideline-based antiemetic use for minimal-, low-, or moderate- to high-risk chemotherapies; (3) off-pathway systemic therapy; and (4) aggressive end-of-life care. We identified patients with new diagnoses of breast, colorectal, and/or lung cancer. We excluded members who did not have at least 6 months of continuous insurance coverage and members with prevalent cancers. RESULTS: Among 117,116 members (median [IQR] age, 60 [53-69] years; 72.4% women), 59,729 (51.0%) had breast cancer, 25,751 (22.0%) had colorectal cancer, and 31,862 (27.2%) had lung cancer. The payer mix was 18.7% Medicare Advantage or Medicare supplemental and 81.2% commercial non-Medicare. Rates of low-value cancer services exhibited minimal changes during the pandemic, as adjusted percentage-point differences were 3.93 (95% CI, 1.50-6.36) for conventional radiotherapy, 0.82 (95% CI, -0.62 to 2.25) for off-pathway systemic therapy, -3.62 (95% CI, -4.97 to -2.27) for non--guideline-based antiemetics, and 2.71 (95% CI, -0.59 to 6.02) for aggressive end-of-life care. CONCLUSIONS: Low-value cancer care remained prevalent throughout the pandemic. Policy makers should consider changes to payment and incentive design to turn the tide against low-value cancer care. [ABSTRACT FROM AUTHOR]

The aim of this study is to identify whether there are substantive differences in the career development of men and women who have held the presidency in a Latin America country. To do this, we reconstruct the trajectory of the 162 men and women that have, under democracy, been the chief executives of their government in the region between 1978 and 2022. From the reconstruction of their political careers, we propose a classification of career profiles based on three dimensions: capital of origin, entry channel into politics, and capitalisation after leaving the presidency. The data show differentiated patterns by gender. [ABSTRACT FROM AUTHOR]

Top managers' past experiences (e.g., foreign experience) significantly impact their decision-making behavior, which may influence firms' sustainable development. The available literature, focusing on the role of the increase in the number of top executives with foreign experience in corporate social responsibility (CSR), yields mixed results. In order to clarify the ambiguous relationship between executive foreign experience and CSR, we empirically examine the effect of the geographic diversity of top executives' foreign experience on CSR. Based on a hand-collected dataset of the top management team's (TMT's) foreign experience, we demonstrate the positive impact of the geographic diversity of returnee executives' foreign experience on firms' CSR using Chinese A-share listed firms from 2009 to 2018. Moreover, this impact is stronger in firms with political connections with the central government and in regions with good market development. Furthermore, the mechanism analysis shows that returnee executives drive firms' CSR by promoting corporate donations and green innovation. This paper offers clear policy implications by suggesting that hiring returnees with a broad geographic scope of foreign experience as corporate executives is an efficient way to enhance firms' CSR. [ABSTRACT FROM AUTHOR]