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Purpose: To evaluate the use, acceptability, and experience of a seven-item palliative care referral screening tool in an outpatient oncology setting. Methods: A two-phase convergent parallel mixed-methods study. Patient participants who met any of the “Royal Marsden Triggers Tool” criteria were compared with those who did not in terms of demographic data, palliative care needs (Integrated Palliative Outcome Scale, IPOS) and quality of life indicators (EORTC-QLQ-C30). In-depth interviews were carried out with patients and oncology staff about their views and experience of the “Royal Marsden Triggers Tool”. Qualitative and quantitative data were triangulated at data interpretation. Results: Three hundred forty-eight patients were recruited to the quantitative phase of the study of whom 53% met at least one of the Triggers tool palliative care referral criteria. When compared with patients who were negative using the Triggers tool, “Royal Marsden Triggers Tool” positive patients had a lower quality of life (EORTC QLQ-C30 Global Health Status scale (p < 0.01)) and a higher proportion had severe or overwhelming physical needs on IPOS (38% versus 20%, p < 0.001). Median survival of “Royal Marsden Triggers Tool” positive patients was 11.7 months. Sixteen staff and 19 patients participated in qualitative interviews. The use of the tool normalised palliative care involvement, supporting individualised care and access to appropriate expertise. Conclusion: The use of a palliative care referral tool streamlines palliative care within oncology outpatient services and supports teams working together to provide an early holistic patient-centred service. Further research is needed to evaluate the effectiveness and feasibility of this approach. [ABSTRACT FROM AUTHOR]

Abstract There is limited research on the experiences of people in working to embed, integrate and sustain simulation programmes. This interview-based study explored leaders’ experiences of normalising a simulation-based education programme in a teaching hospital. Fourteen known simulation leaders across Australia and North America were interviewed. Semi-structured interviews were analysed using reflexive thematic analysis sensitised by normalisation process theory, an implementation science theory which defines ‘normal’ as something being embedded, integrated and sustained. We used a combined social and experiential constructivist approach. Four themes were generated from the data: (1) Leadership, (2) business startup mindset, (3) poor understanding of simulation undermines normalisation and (4) tension of competing objectives. These themes were interlinked and represented how leaders experienced the process of normalising simulation. There was a focus on the relationships that influence decision-making of simulation leaders and organisational buy-in, such that what started as a discrete programme becomes part of normal hospital operations. The discourse of ‘survival’ was strong, and this indicated that simulation being normal or embedded and sustained was still more a goal than a reality. The concept of being like a ‘business startup’ was regarded as significant as was the feature of leadership and how simulation leaders influenced organisational change. Participants spoke of trying to normalise simulation for patient safety, but there was also a strong sense that they needed to be agile and innovative and that this status is implied when simulation is not yet ‘normal’. Leadership, change management and entrepreneurship in addition to implementation science may all contribute towards understanding how to embed, integrate and sustain simulation in teaching hospitals without losing responsiveness. Further research on how all stakeholders view simulation as a normal part of a teaching hospital is warranted, including simulation participants, quality and safety teams and hospital executives. This study has highlighted that a shared understanding of the purpose and breadth of simulation is a prerequisite for embedding and sustaining simulation. An approach of marketing simulation beyond simulation-based education as a patient safety and systems improvement mindset, not just a technique nor technology, may assist towards simulation being sustainably embedded within teaching hospitals.

Abstract Background During the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred. Methods In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 – February 2022. The data was analysed using inductive qualitative content analysis. Results Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women’s difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a ‘key person’ in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered. Conclusions Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.

Gambling patterns among young people are diverse, yet factors that affect changes in their gambling behaviour as they mature remain poorly understood. This study explores gambling trajectories and related sources of influence during childhood, early adolescence and later adolescence, and amongst adolescents at different levels of gambling risk. Qualitative interviews and online communities with 89 Australians aged 12–17 years explored their gambling experiences, from childhood to the present. Reflexive thematic narrative analysis revealed that children often learn how to gamble through their parents. Parents, peers, sports interests, advertising and simulated gambling continue to transfer gambling knowledge and skills throughout adolescence. Gambling is further reinforced through social rewards and is highly normalised through advertising. At-risk/problem gambling adolescents tended to report positive early memories of gambling, but also harmful parental gambling. They reported having friendship groups where betting is highly normalised. They purposefully honed their betting knowledge to demonstrate skill, and also gambled with in-game items (skins). Conversely, non-gamblers reported very little exposure to parental gambling, mirrored their parents’ negative attitudes to gambling, were unlikely to have friends who gambled, and reported less interest in professional sport. Reducing youth gambling and gambling harm requires measures to tackle multiple layers of influence. [ABSTRACT FROM AUTHOR]

Objective: To examine patient‐described experiences of endometriosis diagnosis. Design: Mixed‐methods study. Setting: Online patient‐led endometriosis support groups. Population or Sample: People with endometriosis aged over 18. Methods: A survey with qualitative and quantitative questions was distributed through online patient‐led endometriosis support groups. Descriptive statistics were used to analyse quantitative data, and thematic analysis was used for qualitative responses. Quantitative and qualitative data were triangulated to examine patient experiences of endometriosis diagnosis across age groups. Main outcome measures: Experiences of endometriosis diagnosis among people with endometriosis. Results: A total of 2017 people with endometriosis from 63 countries responded to the questionnaire. Patients experienced an average delay of 3.7 years between symptom onset and first presentation of symptoms to a physician (the care‐seeking delay) and an average delay of 5.8 years between first presentation of symptoms to a physician and diagnosis of endometriosis (the healthcare‐related delay). Patients experienced an average total diagnostic delay of 9.6 years. Participants aged over 35 at the time of the study reported significantly longer times to receive an endometriosis diagnosis (mean 10.7, 95% confidence interval [CI] 10.2–11.2) compared with participants age 18–24 (6.8, 95% CI 6.1–7.5 years). The qualitative analysis identified the following themes: physicians normalised endometriosis symptoms, patients felt their symptoms were ignored by physicians because they were considered unreliable, and participant character attributes (e.g. age, appearance, weight or physical ability) led to clinician dismissal. Conclusions: People with endometriosis of all age groups reported pervasive negative healthcare experiences during their adolescence. Patients experience delays in seeking care and in receiving a diagnosis once presenting for care. [ABSTRACT FROM AUTHOR]

The article explores key trajectories of Swedish press discourse on immigration in the period 2010–2022 which covers a variety of socio-economic and political developments including parliamentary entry and growth of the immigration-critical Swedish far-right. Analysing the press across its key variants (liberal/conservative, nationwide/regional, broadsheet/tabloid), the article points to how dynamics of the press discourse on immigration locates within the key “discursive shifts” in the wider Swedish public sphere, including those related to regular political events such as national-parliamentary elections (of 2010, 2014, 2018, and 2022) as well as those marked by other, pivotal contextual factors such as the 2015–2016 European “Refugee Crisis.” Deploying a systematic, multi-method approach from within critical discourse studies, the article leads to a number of findings, including on the gradual change and the apparent negativisation of the analysed press discourse over time. It highlights that the increasing hybridity and ambivalence of discursive constructions of immigration in the press are among the key factors underlying their alignment with the wider logic of the public sphere in Sweden, and especially with developments in Swedish political discourse in recent years. [ABSTRACT FROM AUTHOR]

Over the past two decades, recognition of same-sex relationships and non-normative families has increased alongside greater access to reproductive technologies. Despite this progress, surrogacy, a potential path to parenthood for gay couples, remains banned in many countries. Research indicates that gay couples, facing legal restrictions, often seek reproductive services abroad, navigating complex legal, political and sociocultural contexts in both their home and destination countries. However, existing research lacks cross-country comparisons that explore how different contexts shape gay couples' reproductive practices. This study enhances our theoretical understanding of the intricate interplay between social structure and social interactions. It explores how normative family conceptions, ingrained in legal frameworks, societal norms and cultural values at the macro level, profoundly influence the (normalising) practices of couples at the micro level. Empirically, this study compares Germany and Israel, where gay couples face starkly different challenges. Germany universally prohibits surrogacy, while Israel permits it, although not for gay men during my interviews. Drawing on interviews with couples from both countries who engaged surrogates abroad, this study analyses their struggles for legal recognition and social visibility as 'gay father families'. In both countries, couples navigate legal, political and sociocultural contexts differently, encapsulated in a process termed 'becoming a gay father family', involving concealing surrogacy and appropriating heteronormative family narratives. The data indicate that the couples' social interactions reflect and reinforce a discernible normative shift from heteronormativity to repronormativity in the context of assisted reproduction. [ABSTRACT FROM AUTHOR]

Migration is a risk factor for gambling-related harms. Little research has been conducted on gambling and gambling harms among migrant groups in Finland, but there are indications that gambling participation is high among migrants also in this context. Russian speakers constitute the largest migrant group in Finland. This study focuses on the experiences and views of Russian speakers in Finland on the Finnish gambling system and its relationship to gambling harms. The study is based on the results of qualitative data collected on gambling experiences among Russian-speaking residents of Finland. The data consist of an online survey directed at individuals who gamble (N = 26) and interviews conducted among family members of those gambling (N = 3). Russian speakers in Finland view gambling as highly normalised in the Finnish society. This normalisation reinforced by availability, accessibility, and state involvement. Russian speakers also have perspective on how to better prevent and treat gambling harms in Finland. Involving migrants with experience of different gambling systems can provide critical insight on established practices in gambling systems. [ABSTRACT FROM AUTHOR]

Inquiries into organisational scandals repeatedly attribute wrongdoing to the normalisation of deviance. From this perspective, the cause of harm lies not in the actions of any individual but rather in the institutionalised practices of organisations or sectors. Although an important corrective to dramatic tales of bad apples, the normalisation thesis underplays the role of management in the emergence of deviance. Drawing on literatures exploring ideas of amoral (Carroll in Bus Horiz 30(2):7–15, 1987) or ethically neutral leadership (Treviño et al. in Calif Manag Rev 42(4):128–142, 2000) we seek to bring management back into the explanation of organisational wrongdoing. Amoral theorists point to management's ethical silence, but they also describe the way in which that silence is sustained by a series of organisational characteristics. We build on this work in arguing that it is management's deliberate focus on bottom line performance, the diffusion of responsibility and high levels of organisational identification that explain the emergence of wrongdoing. We apply these ideas to the case of the UK's Stafford hospital which hit the headlines in 2009 when it was reported that poor standards of care had led to a mortality rate markedly above that expected for a hospital of its type. We conclude with a discussion of the circumstances which translate amoral management into unethical outcomes. [ABSTRACT FROM AUTHOR]

To identify if and how the age of in vitro potato plantlets at planting affects the later tuber formation, an extensive pot experiment was performed under controlled conditions. In vitro-derived plantlets of different ages (14, 28, 42 and 56 days old at planting) and cultivars varying in maturity type (Gloria, very early; Bintje, mid-early; Elkana, late) were grown after planting for 10 weeks at photo/thermoperiods of 16 h (standard conditions) or 12 h (short-day conditions). Plants raised from older in vitro plantlets produced higher total dry weights, harvest index and tuber dry and fresh weights than plants from younger in vitro plantlets when grown under standard conditions after planting. By contrast, total and tuber dry weights were not affected by plantlet age when grown under short-day conditions. The number of tubers per plant increased with increase in in vitro plantlet age in the later cultivars and in the oldest age classes of the very early cultivar when plants were grown under standard conditions. Short-day conditions resulted in fewer, but larger tubers than standard conditions. Results support the ideas that (1) plants from older in vitro plantlets and earlier maturing cultivars are more advanced in the tuber formation process; however, this may benefit tuber yield only when plants are grown under conditions that are not strongly inducing tuberization, and (2) higher tuber numbers can be achieved by more below-ground nodes—as in older in vitro plantlets—and/or by later or less strong tuber induction—as in less inducing conditions (16-h vs. 12-h), later cultivars or younger in vitro plantlets. [ABSTRACT FROM AUTHOR]

In vitro-propagated potato plantlets are commonly used in potato seed tuber production. Four experiments were carried out to identify how the duration of the last in vitro phase ('age') before planting of in vitro-produced plantlets affects the early growth and development ex vitro, assessed 10–14 days after planting. Experiments included varying ranges in age of the in vitro plantlets at planting (10–40, 15–45, 14–28 and 14–56 days old at the moment of planting in the respective experiments) and different cultivars. Because in vitro plantlet size increases with age, the first experiment studied interactions between age and planting method. Planting 'deep' (the upper four visible leaves above the ground) seemed more robust than planting 'shallow' (all nodes/leaves above ground except the lowest two), and in later experiments, only deep planting was applied. Across experiments, plants grown from younger in vitro plantlets had smaller leaf areas 10–14 days after planting than those from older in vitro plantlets. The increase in leaf area levelled off with increasing age of the in vitro plantlets used, especially when plantlets were older than c. 28 days. Larger leaf areas 10–14 days after planting were related to the older in vitro plantlets having higher absolute growth rates after planting and a larger above-ground leaf area at planting, even though four leaves were kept above ground in all treatments. Below ground, plants from older in vitro plantlets had more stem nodes, initiated stolons earlier after planting and initiated more stolons per plant. Tuber initiation rarely occurred within 14 days after planting, but was observed in some plants from 42- and especially 56-day-old in vitro plantlets of the very early cultivar Gloria and a single plant from 56-day-old in vitro plantlets of the mid-early cultivar Bintje. The data show that planting older in vitro plantlets can enhance early leaf area growth. Plants from older in vitro plantlets also more readily initiate stolons below ground and may be more advanced in the tuber formation process, especially when from early cultivars. [ABSTRACT FROM AUTHOR]

Body-worn cameras (BWCs) are increasingly permeating policing worldwide. Through a survey of all federal, provincial, municipal, and First Nations police services across Canada, we find that 36 of 172 Canadian police services reported using BWCs as of 2022. We also present a scorecard-style assessment of all available Canadian BWC procedures in use (N = 27), documenting the extent to which the procedures address core issues related to BWC regulation. Key themes of the procedures fall into six general categories: expectations of the BWC program, expectations of BWC users, expectations of BWC supervisors, data retention and storage expectations, video disclosure expectations, and additional considerations. The procedures conveyed a good deal of consistency. Almost all procedures provided activation instructions, required subject notification as soon as reasonably possible, did not allow BWC footage to substitute for other forms of evidence, and permitted users to view BWC footage. However, some topics are broached far less consistently, with a minority of procedures commenting on camera buffering, victim-sensitive practices, and making disclosures in the public interest. We advocate for the continued standardization of BWC procedures across Canada (and mechanisms of police governance more generally) to support consistent, high-quality policing across the country. [ABSTRACT FROM AUTHOR]

qRT-PCR is one of the widely used methods for analysing the expression levels of specific genes, which requires reliable experimental results with the aid of stably-expressed reference genes. Although there are some common housekeeping genes, many experiments have proved that the expression of these genes can change under different experimental conditions. Heat stress is one of the key factors affecting rice yield and quality, and there are relatively few reports of reference genes that can be used for heat stress research. To find the reference genes that can be stably expressed under heat stress, this experiment analysed 10 common reference genes and 10 new candidate genes by qRT-PCR to explore their expression patterns in rice heat-tolerant variety HT54 and heat-sensitive variety HT13 under heat stress conditions, and used GeNorm, NormFinder, BestKeeper, ΔCT and RefFinder to evaluate the expression stability of these genes. The results showed that LOC_Os06g23160, b-TUB and eIF-4a were the most stably expressed genes in HT13 and combined analysis of these three reference genes are recommended to be used for qRT-PCR normalisation. Our results also showed that LOC_Os06g23160 was an excellent reference gene more stable than common reference genes such as 18S RNA in both HT13 and HT54. [ABSTRACT FROM AUTHOR]

This article discusses online harassment against women journalists exploring self-reported incidents, effects, and trust in safety mechanisms. Drawing on twenty-five semi-structured interviews of women journalists in Portugal, we use a feminist and critical realist framework to explore the causal structures and generative mechanisms that explain their vulnerability to online abuse. We identify three overarching themes: increasing visibility in a context of higher hostility towards journalism and insufficient safety mechanisms; intersectional gender inequality and cultural mores that foster it; and (individual) responses to harassment. These themes show that women journalists' actions are both constrained and enabled by existing structures and cultural attitudes. While they tend to deny harassment is caused by their gender, seeing it mainly because of their job, they admit the sexualised and gendered nature of the insults, seeing this as an added offence not experienced by their male counterparts. They also see harassment as a continuation of inequality and prevailing sexism and find the protection mechanisms insufficient and ineffective. As a result, they assume an extra burden of emotional labour to deal with online bullying, admitting self-censoring and the need to develop resilience strategies. [ABSTRACT FROM AUTHOR]

Rapid urbanisation and water resource depletion have compelled regions worldwide to consider reverse osmosis desalination as a solution for securing a sustainable water supply. However, the sustainability of reverse osmosis desalination plants, especially in the Gaza Strip, remains a critical concern. So, a comprehensive evaluation of the sustainability of these facilities is essential. This paper presents a framework for assessing the sustainability of reverse osmosis desalination plants in the Gaza Strip, aiming to promote informed decision-making and address the multifaceted challenges associated with water resource management in this area. As a case study, the generated framework was applied to the southern desalination plant in Gaza. The framework integrates technical, environmental, economic, social, and institutional setup categories utilising various multi-criteria decision analysis methods such as the analytical hierarchy process, weighted summation, and swing methods. The framework was built depending on a list of sustainability indicators that were carefully selected and attributed to each sustainability category. Then, a group of local specialists in the desalination field were involved to determine the relative weight of the sustainability categories and their indicators. Finally, multi-criteria analysis was applied to find the global sustainability index that reflects the desalination plant's sustainability status. The southern desalination plant was found to be partially sustainable, with a global sustainability index value of 65%. Finally, this research promotes sustainable water management in regions like the Gaza Strip by guiding informed decisions on reverse osmosis desalination plants, emphasising the need for ongoing sustainability efforts. [ABSTRACT FROM AUTHOR]

Normalization indicates that states have opened a new page in their bilateral relations, and while it does not cover some problematic areas in relations and does not offer a final solution, it serves to create a reasonable basis for dialogue. The concept of normalisation includes the capacity to transform not only the political but also the economic dimension of Turkish-Israeli relations. This article contends that before the normalisation process in the bilateral relationship, the economic and especially the commercial dimension of the relations remained at a certain level and maintained its strong position even during tense diplomatic and political periods. In this context, the article draws attention to the fact that the normalization of Israel-Turkey relations is an ongoing process and aims to indicate that despite the existence of some disagreements, the search for cooperation on specific issues of common interest may continue. [ABSTRACT FROM AUTHOR]

This article examines the tensions in Turkish–Israeli relations during the 2010s as well as prospects and challenges of normalisation from an ontological security perspective. Emphasising the role of conflicts in the provision of ontological security, it illustrates how frictions with Israel and attachment to the Palestinian issue serve the identity needs of Turkey's political elites and provides additional avenues for responding to legitimacy challenges. The article suggests that comprehensive normalisation of relations remains elusive and uncertain despite recent positive steps as this may engender ontological insecurity for both countries and can lead to a backlash towards hostile identities. [ABSTRACT FROM AUTHOR]

Electronic drug markets enable calculative, impersonal trade between faceless strangers, but also intimate interaction between pseudonymous users. In this space, do people treat banned drugs as ordinary consumer products that can be purchased from anyone? Or do drug-takers frame their consumption as a counter-cultural activity? To answer these questions, I use qualitative and computational research methods to analyse 3788 electronically published consumer reports of cannabis and psychedelic drugs from the period 2011–2017. I find that report writers emphasise product quality, customer service and transaction value, and devote less attention to the social and political sides of drug-taking. Discussions about legality, morality and counter-cultural ideas are completely absent from the texts, even in psychedelic reports, which detail profound effects. These findings suggest that drug e-commerce is primarily a normalising force, and that widening access to banned drugs is unlikely to disseminate counter-cultural perspectives. [ABSTRACT FROM AUTHOR]

The article discusses the National Engagement in Canadian Bioethics workshop and community forum organized by the Canadian Bioethics Society in 2023. The forum aimed to share knowledge and reflections on various topics in bioethics and provide opportunities for ongoing discussion and community-building. The workshops covered areas such as standardization in the field, embedding ethics into policy and decision-making, and addressing the moral impact of working in health systems. The article concludes by highlighting the importance of ongoing discussion and collaboration in Canadian bioethics. [Extracted from the article]

The article will focus on a critical re-evaluation of approaches to the city in the period of late normalization; especially on the new ethos that took place in the professional community as a result of postmodern ideas coming from Western Europe, but also thanks to the extremely negative experience of the highly modernist industrialization of architecture, abused by the socialist regime. The core of the text will compare the three areas of the normalization city – housing estates, core and historic districts. At the housing estate it is going to describe efforts to introduce city-forming features in the parameters of newly established public spaces, their equipment and requirements for public buildings. In the case of historic cores, intentions were primarily related to rehabilitation of the city’s main streets and squares or to fill inappropriate empty plots. And in connection with the historic (industrial) districts, the text will describe the program of modernization of apartment buildings from 19th and early 20th century. The text is based on a research project – Architecture of the Eighties – completed last year.

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Schools in rural places in European societies generally teach the same content and perform as well as other national schools do on national tests and international comparison assessments such as PISA. However, by doing this they may also marginalise local rural knowledge and expose rural populations to a (for them) culturally insensitive curriculum. Using a meta-ethnographic analysis this article identifies how rural educational ethnographic researchers working in Sweden have depicted this situation and the social and cultural interests in which it operates. It identifies how research articles often describe rural schools as fulfiling a local community function, but it also questions exactly what kind of function this is and whether we can really talk about rural schools operating in local community interests generally or even at all. Instead, it is rather more the case that schools in rural places contribute to some individual educational interests and possibilities along with a general cultural domination and marginalisation of rural consciousness and interests. [ABSTRACT FROM AUTHOR]

This paper examines emerging discourses and practices of quality assurance in English Further Education (FE), a sector currently undergoing significant change. Using a broadly ethnographic approach and Foucauldian theories of power, we discuss how ‘documentisation’ contributes to governance techniques in a specific institutional context. Documentisation, the transformation of concrete practice into discourse, reverses a common-sense view of the role of policy documentation and exemplifies a wide range of practices in both FE and the wider post-16 sector and includes the gamification of quality systems. Our analysis of the conditions and practices out of which the phenomenon appears identifies processes that are shaping present-day experiences and redefining the discourse of quality itself. Moreover, rather than situating compliance and/or resistance in practice per se, we argue that it is within the conditions of possibility expressed by such processes that the intertwining of compliance and resistance can best be appreciated. [ABSTRACT FROM AUTHOR]

Who is opposed to “innovation”? For most newsroom publishers, managers, editors, and reporters, the word connotes progress; it implies a strategy for achieving success—and dodging failure. But innovation inescapably entails change: Doing and thinking about things differently means giving up the old as well as embracing the new. This commentary recaps journalists’ response over 30 years of digital news. It suggests that calls for change meet with initial resistance, typically on normative grounds; only over time do practitioners normalise the innovation, incorporating it into their perceptions and routines.

Abstract Background The implementation science literature acknowledges a need for engagement of key stakeholders when designing, delivering and evaluating implementation work. To date, the literature reports minimal or focused stakeholder engagement, where stakeholders are engaged in either barrier identification and/or barrier prioritisation. This paper begins to answer calls from the literature for the development of tools and guidance to support comprehensive stakeholder engagement in implementation research and practice. The paper describes the systematic development of the Implementation‐STakeholder Engagement Model (I‐STEM) in the context of an international, large‐scale empirical implementation study (ImpleMentAll) aimed at evaluating the effectiveness of a tailored implementation toolkit. The I‐STEM is a sensitising tool that defines key considerations and activities for undertaking stakeholder engagement activities across an implementation process. Methods In‐depth, semistructured interviews and observations were conducted with implementers who were tailoring implementation strategies to integrate and embed internet‐based cognitive behavioural therapy (iCBT) services in 12 routine mental health care organisations in nine countries in Europe and Australia. The analytical process was informed by principles of first‐ and third‐generation Grounded Theory, including constant comparative method. Results We conducted 55 interviews and observed 19 implementation‐related activities (e.g., team meetings and technical support calls). The final outcome of our analysis is expressed in an initial version of the I‐STEM, consisting of five interrelated concepts: engagement objectives, stakeholder mapping, engagement approaches, engagement qualities and engagement outcomes. Engagement objectives are goals that implementers plan to achieve by working with stakeholders in the implementation process. Stakeholder mapping involves identifying a range of organisations, groups or people who may be instrumental in achieving the engagement objectives. Engagement approaches define the type of work that is undertaken with stakeholders to achieve the engagement objectives. Engagement qualities define the logistics of the engagement approach. Lastly, every engagement activity may result in a range of engagement outcomes. Conclusion The I‐STEM represents potential avenues for substantial stakeholder engagement activity across key phases of an implementation process. It provides a conceptual model for the planning, delivery, evaluation and reporting of stakeholder engagement activities. The I‐STEM is nonprescriptive and highlights the importance of a flexible, iterative approach to stakeholder engagement. It is developmental and will require application and validation across a range of implementation activities. Patient or Public Contribution Patient contribution to ImpleMentAll trial was facilitated by GAMIAN‐Europe at all stages—from grant development to dissemination. GAMIAN‐Europe brings together a wide variety of patient representation organisations (local, regional and national) from almost all European countries. GAMIAN‐Europe was involved in pilot testing the ItFits‐toolkit and provided their views on the various aspects, including stakeholder engagement. Patients were also represented in the external advisory board providing support and advice on the design, conduct and interpretation of the wider project, including the development of the ItFits‐toolkit. Trial registration ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018.

The overall aim of this study is to explore the authoritarian dimension in the far-right discourse of online forums. The study argues for a focus on the articulations of authoritarianism to understand the dynamics of far-right discourse. Four central features of authoritarianism are identified and explored: 1) the authoritarian values underlying articulated opinions on diverse issues; 2) the emotional dimension of authoritarianism; 3) the coexistence of civil and uncivil articulations of authoritarianism; and 4) the role of mainstream news as reference for and trigger of authoritarian responses. The qualitative study is based on data from two Swedish forums, Flashback and Familjeliv [Family life], and consists of 79 threads related to three issues on the agenda: disorder in school, gang crime, and transgender. The results show expressions of authoritarian–liberal value conflicts, and, most significantly, the vigour of an authoritarian culture on the forums, with implications for the normalisation of far-right discourse.

In a recent paper del Valle-Inclan and Schlöder argue that bilateral calculi call for their own notion of proof-theoretic harmony, distinct from the usual (or ‘unilateral’) ones. They then put forward a specifically bilateral criterion of harmony, and present a harmonious bilateral calculus for classical logic. In this paper, I show how del Valle-Inclan and Schlöder’s criterion of harmony suggests a notion of normal form for bilateral systems, and prove normalisation for two (harmonious) bilateral calculi for classical logic, HB1 and HB2. The resulting normal derivations have the usual desirable features, like the separation and subformula properties. HB1-normal form turns out to be strictly stronger that the notion of normal form proposed by Nils Kürbis, and HB2-normal form is neither stronger nor weaker than a similar proposal by Marcello D’Agostino, Dov Gabbay, and Sanjay Modgyl.

Wastewater-based epidemiology (WBE) is a valuable tool for monitoring the circulation of COVID-19. However, while variations in population size are recognised as major sources of uncertainty, wastewater SARS-CoV-2 measurements are not routinely population-normalised. This paper aims to determine whether dynamic population normalisation significantly alters SARS-CoV-2 dynamics observed through wastewater monitoring, and whether it is beneficial or necessary to provide an understanding of COVID-19 epidemiology. Data from 394 sites in England are used, and normalisation is implemented based on ammoniacal nitrogen and orthophosphate concentrations. Raw and normalised wastewater SARS-CoV-2 metrics are evaluated at the site and spatially aggregated levels are compared against indicators of prevalence based on the Coronavirus Infection Survey and Test and Trace polymerase chain reaction test results. Normalisation is shown, on average, to have a limited impact on overall temporal trends. However, significant variability in the degree to which it affects local-level trends is observed. This is not evident from previous WBE studies focused on single sites and, critically, demonstrates that while the impact of normalisation on SARS-CoV-2 trends is small on average, this may not always be the case. When averaged across many sites, normalisation strengthens the correlation between wastewater SARS-CoV-2 data and prevalence indicators; however, confidence in the improvement is low. HIGHLIGHTS 394 sites were analysed to determine the impact of population normalisation on SARS-CoV-2 trends.; Comparison made with the Coronavirus Infection Survey and NHS Test and Trace polymerase chain reaction test results.; Significant variability between sites in the impact of normalisation was revealed.; On average, population normalisation strengthens the correlation between wastewater SARS-CoV-2 data and prevalence indicators.;

Background: The implementation science literature acknowledges a need for engagement of key stakeholders when designing, delivering and evaluating implementation work. To date, the literature reports minimal or focused stakeholder engagement, where stakeholders are engaged in either barrier identification and/or barrier prioritisation. This paper begins to answer calls from the literature for the development of tools and guidance to support comprehensive stakeholder engagement in implementation research and practice. The paper describes the systematic development of the Implementation‐STakeholder Engagement Model (I‐STEM) in the context of an international, large‐scale empirical implementation study (ImpleMentAll) aimed at evaluating the effectiveness of a tailored implementation toolkit. The I‐STEM is a sensitising tool that defines key considerations and activities for undertaking stakeholder engagement activities across an implementation process. Methods: In‐depth, semistructured interviews and observations were conducted with implementers who were tailoring implementation strategies to integrate and embed internet‐based cognitive behavioural therapy (iCBT) services in 12 routine mental health care organisations in nine countries in Europe and Australia. The analytical process was informed by principles of first‐ and third‐generation Grounded Theory, including constant comparative method. Results: We conducted 55 interviews and observed 19 implementation‐related activities (e.g., team meetings and technical support calls). The final outcome of our analysis is expressed in an initial version of the I‐STEM, consisting of five interrelated concepts: engagement objectives, stakeholder mapping, engagement approaches, engagement qualities and engagement outcomes. Engagement objectives are goals that implementers plan to achieve by working with stakeholders in the implementation process. Stakeholder mapping involves identifying a range of organisations, groups or people who may be instrumental in achieving the engagement objectives. Engagement approaches define the type of work that is undertaken with stakeholders to achieve the engagement objectives. Engagement qualities define the logistics of the engagement approach. Lastly, every engagement activity may result in a range of engagement outcomes. Conclusion: The I‐STEM represents potential avenues for substantial stakeholder engagement activity across key phases of an implementation process. It provides a conceptual model for the planning, delivery, evaluation and reporting of stakeholder engagement activities. The I‐STEM is nonprescriptive and highlights the importance of a flexible, iterative approach to stakeholder engagement. It is developmental and will require application and validation across a range of implementation activities. Patient or Public Contribution: Patient contribution to ImpleMentAll trial was facilitated by GAMIAN‐Europe at all stages—from grant development to dissemination. GAMIAN‐Europe brings together a wide variety of patient representation organisations (local, regional and national) from almost all European countries. GAMIAN‐Europe was involved in pilot testing the ItFits‐toolkit and provided their views on the various aspects, including stakeholder engagement. Patients were also represented in the external advisory board providing support and advice on the design, conduct and interpretation of the wider project, including the development of the ItFits‐toolkit. Trial registration: ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018. [ABSTRACT FROM AUTHOR]

This paper is theoretically driven by doctoral research data. The corresponding doctoral research involved fifteen participants who live in Brazil: immigrants and parents of immigrant students from Haiti and Venezuela and mathematics teachers in schools with immigrant students in São Paulo (Brazil). The research aims to consider socially and racially structured exclusions, to discuss perspectives and approaches, and to challenge mathematics education with immigrant students towards inclusive actions. Thinking about what inclusion and inclusive mathematics education with immigrant students could mean goes toward glimpsing the roots of what can obstruct such a process, which means taking the path towards unwrapping the processes of exclusion and violence against the immigrant population. Immigrants’ and teachers’ voices will be heard in this article to support discussions about the issues around inclusive mathematics education. I present situations that illustrate that microexclusions may accompany the inclusive context in subtle practices. Microexclusions tend to isolate people in a given environment, even if that environment is considered inclusive. This paper aims to discuss a crucial situation: the barriers to including immigrant students have to do with various levels of oppressive social structures. I identify four types of microexclusion related to immigrants having to do with exoticization, misleading identification, second-class citizen treatment, assimilation, and misprise. [ABSTRACT FROM AUTHOR]

One of the achievements of the Prague Spring was the establishment of the Nationalities Committee of the Slovak National Council. Although, contrary to the aspirations of the national minorities, the Committee, which was established in October 1968, was not set up as a representative body of the nationalities but as a simple parliamentary committee, its formation was attached high hopes to. Its primary task was to draft a proposal for a nationality law. This paper reviews the Committee's activities in this field and its work during the two and a half years of its existence. The political reconstruction and the normalisation regime under the name of Gustáv Husák not only prevented the drafting and adoption of the Nationality Act, but also the Nationality Committee itself was dissolved in March 1971. Thus, for 55 years now, ethnic minorities in Slovakia have been waiting in vain for the adoption of the Law on the Status of Nationalities. [ABSTRACT FROM AUTHOR]

In a recent paper del Valle-Inclan and Schloder argue that bilateral calculi call for their own notion of proof-theoretic harmony, distinct from the usual (or 'unilateral') ones. They then put forward a specifically bilateral criterion of harmony, and present a harmonious bilateral calculus for classical logic. In this paper, I show how del Valle-Inclan and Schlöder's criterion of harmony suggests a notion of normal form for bilateral systems, and prove normalisation for two (harmonious) bilateral calculi for classical logic, HB1 and HB2. The resulting normal derivations have the usual desirable features, like the separation and subformula properties. HB1-normal form turns out to be strictly stronger that the notion of normal form proposed by Nils Kurbis, and HB2-normal form is neither stronger nor weaker than a similar proposal by Marcello D'Agostino, Dov Gabbay, and Sanjay Modgyl. [ABSTRACT FROM AUTHOR]

Modern health‐care systems have customarily approached hepatitis C in ways that resemble the public health approach to HIV/AIDS known as 'HIV exceptionalism'. HIV exceptionalism describes the unusual emphasis on privacy, confidentiality and consent in approaches to HIV and was partly developed to address HIV/AIDS‐related stigma. In the case of hepatitis C, exceptionalist approaches have included diagnosis and treatment by specialist physicians and other 'boutique' public health strategies. The recent availability of highly effective, direct‐acting antivirals alongside goals to eliminate hepatitis C have heralded dramatic changes to hepatitis C health care, including calls for its 'normalisation'. The corollary to exceptionalism, normalisation aims to bring hepatitis C into routine, mainstream health care. This article draws on interviews with stakeholders (n = 30) who work with hepatitis C‐affected communities in policy, community, legal and advocacy settings in Australia, alongside Fraser et al.'s (2017, International Journal of Drug Policy, 44, 192–201) theorisation of stigma, and Rosenbrock et al.'s (1999, The AIDS policy cycle in Western Europe: from exceptionalism to normalisation. WZB Discussion Paper, No. P 99‐202) critique of normalisation to consider the perceived effects of hepatitis C normalisation. Stakeholders described normalisation as a stigma‐reducing process. However, they also expressed concerns about the ongoing stigma and discrimination that is not ameliorated by normalisation. We suggest that in centring normalisation, changes in health care may exaggerate the power of technological solutions to transform the meanings of hepatitis C. [ABSTRACT FROM AUTHOR]