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BACKGROUND: By enabling individuals with hearing loss to collect their own hearing data in their personal real-world settings, there is scope to improve clinical care, empower consumers, and support shared clinical decision-making and problem-solving. Clinician support for this approach has been established in a separate study. OBJECTIVE: This study aims to explore, for consumers with hearing loss, their (1) experiences of listening difficulties, to identify the data an app could usefully collect; (2) preferences regarding the features of mobile apps in general; and (3) opinions on the potential value and desirable features of a yet-to-be designed app for documenting listening difficulties in real-world settings. METHODS: A total of 3 focus groups involved 27 adults who self-reported hearing loss. Most were fitted with hearing devices. A facilitator used a topic guide to generate discussion, which was video- and audio-recorded. Verbatim transcriptions were analyzed using inductive content analysis. RESULTS: Consumers supported the concept of a mobile app that would facilitate the documenting of listening difficulties in real-world settings important to the individual. Consumers shared valuable insights about their listening difficulties, which will help determine the data that should be collected through an app designed to document these challenges. This information included early indicators of hearing loss (eg, mishearing, difficulty communicating in groups and on the phone, and speaking overly loudly) and prompts to seek hearing devices (eg, spousal pressure and the advice or example provided by others, and needing to rely on lipreading or to constantly request others to repeat themselves). It also included the well-known factors that influence listening difficulties (eg, reverberation, background noise, group conversations) and the impacts and consequences of their difficulties (eg, negative impacts on relationships and employment, social isolation and withdrawal

The need for education research to explore ‘real world’ learning impact for stakeholders is now more pressing than ever as we navigate perpetual shifting educational experience in situational contexts driven by rapid technology changes and environmental change. Design-based research (DBR) is a pragmatic methodology that promotes a proactive educational enquiry to implement theories of learning and teaching. To address a pedagogical problem or innovation, the DBR methodological framework incorporates four research phases including 1) analysis of a practical problem, 2) development of an innovative solution, 3) implementation of iterative research action cycles, and 4) final analysis and reflection. These phases enable the possibility of growth and evolution of both education theory and knowledge contribution using a practical approach. The ultimate aim of DBR is to generate useful knowledge by applying cycles of both action and inquiry in a situated context. Outputs of DBR commonly fall into two categories including a) tangible practical outcomes such as a design artefact to improve learning, and b) non-tangible outputs in the form of final design principles and progressive societal contributions. In this sense, local knowledge can still contribute to social learning practices more broadly. The flexible ethos of DBR extends to the generation of outputs, as there is potential to use quantitative, qualitative, or mixed methods when using DBR. The DBR framework allows a malleable way to problem solve changing educational issues. While progressively drawing upon current literature to improve iterative learning outputs, the process of DBR integrates ‘design thinking’ to understand what stakeholders need in specific contexts by fostering empathy and cultural awareness. DBR invites the ‘messiness and complexity’ of educational settings by not shying away from giving attention to the uncontrollable variables that stakeholders may bring to research action cycles. Thus DBR has

BACKGROUND: Children living in out-of-home care (OOHC) have significant unmet health care needs and use more tertiary and specialist health care services compared with children from similar social and economic backgrounds. Allied health professionals and nurses have a central role in health care; however, very little is known about the engagement of children in OOHC with nursing and allied health professionals. This scoping review addresses this knowledge gap. METHODS: A scoping review methodology framework was used to search for relevant articles published between January 1970 and November 2019, identified using three databases: MEDLINE, CINAHL and ProQuest. Selection of studies was based on empirical research about the health of children in OOHC and their engagement with nursing or allied health services. A total of 37 relevant articles met the eligibility criteria for inclusion in this review. RESULTS: Findings could be summarized under five broad themes: (1) nursing and allied health professionals engaging with children in OOHC to support their health and development, (2) opportunities and challenges for nursing and allied health professionals to engage children in OOHC in healthcare, (3) identification and complexity of healthcare needs, (4) access to healthcare services and (5) coordination of healthcare. CONCLUSIONS: Children in OOHC have multiple healthcare needs that require monitoring and treatment by allied health professionals and the health and development of these children is best supported through comprehensive health screening on entry into OOHC, and community-based, multidisciplinary healthcare while children are living in OOHC. While nurses in hospitals and community settings were found to play a role in health assessment and care coordination targeted at children in OOHC, the literature was silent on the role of allied health professionals in this healthcare approach.

Summary Pastoralism is globally significant in social, environmental, and economic terms. However, it experiences crises rooted in misconceptions and poor interdisciplinary understanding, while being largely overlooked in international sustainability forums and agendas. Here, we propose a transdisciplinary research approach to understand pastoralist transitions using (1) social, economic, and environmental dimensions, (2) diverse geographic contexts and scales to capture emerging properties, allowing for cross-system comparisons, and (3) timescales from the distant past to the present. We provide specific guidelines to develop indicators for this approach, within a social-ecological resilience analytical framework to understand change. Distinct systems undergo similar transitions over time, crossing critical thresholds and then either collapsing or recovering. Such an integrated view of multidimensional interactions improves understanding of possible tipping points, thereby supporting better-informed decision making. The need for a paradigm shift in pastoralism science and policy is pressing. This research approach, including participatory methods, can provide the solutions urgently needed.

Objectives: ‘Dementia Friends’ is a programme used to raise awareness of dementia, developed by the Alzheimer’s Society, which has been delivered across the UK to diverse populations, including adolescents. However, there is little evidence available with regards to adolescents’ perceptions of the programme and its impact. This study aims to explore this in a group of adolescents from the south of England. Design: Four focus group discussions Methods: 30 adolescents aged between 11 and 16 were recruited from two schools in East Sussex, England. All had participated in a Dementia Friends session in the past month. Focus group discussions were transcribed, coded and themes were created using inductive thematic analysis. Results: Four themes were identified: 1) perceptions and experiences of dementia, 2) outcomes and learning from Dementia Friends session, 3) reactions to the Dementia Friends session, and 4) identified future learning needs. Discussion: Adolescents had generally positive opinions about Dementia Friends, particularly the interactive nature of the session. Whilst they felt participating in Dementia Friends improved their attitudes and knowledge, they were often left wanting to learn more. Future research needs to empirically evaluate the extent to which Dementia Friends may improve attitudes and knowledge of dementia.

Background Current evidence suggests that negative and stigmatising attitudes towards dementia may develop at a young age. There are a number of dementia education and awareness initiatives aimed at reducing stigma, though they have not been robustly evaluated to establish the impact on dementia attitudes or suitability in adolescent populations. This study explored the efficacy and satisfaction of one such initiative (Dementia Friends) in a British adolescent sample. Methods 301 adolescents (M = 12.6 years old, SD = 0.73) were assigned to either receive Dementia Friends (a 60-min interactive class that teaches about dementia and its effects on people’s lives) or education as usual. All participants completed a series of validated questionnaires pre- and post-intervention, related to dementia attitudes (Brief A-ADS and KIDS). Results Adolescents in the dementia awareness group showed little to no improvements between time-points. The change scores in the dementia awareness group did not significantly differ to the control group based on both KIDS (d = − 0.003, p = 0.98) and Brief A-ADS (d = 0.14, p = 0.13) measures. There was no Group x Time effect after controlling for confounding variables. Conclusions Dementia Friends is successful in terms of reach and impact, though this study suggests that it may fall short of achieving its goal of improving attitudes towards dementia. Importantly, Dementia Friends did not have a negative effect on attitudes, and the majority of adolescents enjoyed the sessions. It is important that these findings are replicated in a larger randomised-controlled study.

Purpose: This systematic review synthesized evidence supporting interventions aimed at mitigating cognitive bias associated with the decision-making of social work professionals. Methods: A systematic search was conducted within 10 social services and health-care databases. Review authors independently screened studies in duplicate against prespecified inclusion criteria, and two review authors undertook data extraction and quality assessment. Results: Four relevant studies were identified. Because these studies were too heterogeneous to conduct meta-analyses, results are reported narratively. Three studies focused on diagnostic decisions within mental health and one considered family reunification decisions. Two strategies were reportedly effective in mitigating error: a nomogram tool and a specially designed online training course. One study assessing a consider-the-opposite approach reported no effect on decision outcomes. Conclusions: Cognitive bias can impact the accuracy of clinical reasoning. This review highlights the need for research into cognitive bias mitigation within the context of social work practice decision-making.

OBJECTIVE: The aim of this study was to explore the nature, potential usefulness and meaning of complaints lodged by patients and their relatives. DESIGN: A retrospective, descriptive design was used. SETTING: The study was based on a sample of formal patient complaints made through a patient complaint reporting system for publicly funded healthcare services in Sweden. PARTICIPANTS: A systematic random sample of 170 patient complaints was yielded from a total of 5689 patient complaints made in a Swedish county in 2015. MAIN OUTCOME MEASURE: Themes emerging from patient complaints analysed using a qualitative thematic method. RESULTS: The patient complaints reported patients' or their relatives' experiences of disadvantages and problems faced when seeking healthcare services. The meanings of the complaints reflected six themes regarding access to healthcare services, continuity and follow-up, incidents and patient harm, communication, attitudes and approaches, and healthcare options pursued against the patient's wishes. CONCLUSIONS: The patient complaints analysed in this study clearly indicate a number of specific areas that commonly give rise to dissatisfaction; however, the key findings point to the significance of patients' exposure and vulnerability. The findings suggest that communication needs to be improved overall and that patient vulnerability could be successfully reduced with a strong interpersonal focus. Prerequisites for meeting patients' needs include accounting for patients' preferences and views both at the individual and organizational levels.

Density-based separators have been used as a preferred method of concentrating minerals and upgrading coal for several centuries. However, significant technological advances continue to be developed and introduced into commercial practice. The main focus of development has been the improvement in separation efficiency over a larger particle size range and the ability to achieve effective density-based separations for particles as small as 10 microns. The success of enhanced gravity separators in the recovery of ultrafine particles has resulted in their implementation into grinding circuits in an effort to prevent overgrinding and reduce circulating loads while also reducing the consumption of the chemicals used in conventional recovery processes and circuits. A review of recent innovations in density-based separations is provided in this publication along with the impact on the strategies and circuits used to process a wide range of minerals and coal.