Communication Support Research Articles

Circle time in preschool as a practice for developing language support between teachers and children using the structured ELSA model

ABSTRACT This paper focuses on how early childhood teachers developed deeper understandings of their communication support for children in everyday practice through professional learning conversations by introducing the Early Language Support Activity (ELSA) model. With this model, communication patterns were studied using a proven observation tool based on language research and developed by Dockrell et al. (2015). This protocol was used in a process of action research focused on communication patterns in circle time, which gave the early childhood teachers data to discuss and reflect on what happens in their conversations with children. The theory of practice architectures was used as a theoretical lens to understand the conditions of possibility that action research might provide for learners and leaders of professional learning .In conclusion, through changed practice architectures, participants developed awareness of themselves as educators and learned that communication with children can be supported and developed by circle time. Moreover, the interaction and communication practices among members of the teacher team were enhanced through realization of the importance of a structure in developing their communication patterns.

Organization of Vaccination Sites in Quebec: Perception of Users, Employees and managers

Abstract Since late 2020, vaccination sites have emerged rapidly in order to protect the population against COVID-19. Health services in Montérégie (Québec) are provided by three organizations. Each adopted a different approach to immunization. The Regional Public Health Department took this opportunity to describe, compare, and explain these three approaches. A mixed methods design through a multiple case study was conducted. Users, employees and managers were interviewed at the end of 2021 on several performance-related topics. Individual interviews with employees and managers in mid-2022 further explored these topics. 38 managers, 360 employees, and 946 users participated in the survey. 9 managers and 10 employees were interviewed. Most participants were satisfied with vaccination organization regardless of the model used, mainly because of high geographic and temporal accessibility of the sites. Further signage to indicate directions could optimize accessibility. High adaptability was essential for managers and employees. Training strategies such as people to refer to and pairing allowed to better deal with frequent changes and staff rotation. The addition of ongoing training could be beneficial. Rapid changes in employee schedules were identified as a challenge. The use of technology-based scheduling tools, accessible to all, brought added flexibility, which was appreciated. Several ideas were used to communicate updates on a daily basis. However, timely implementation of new recommendations remained an ongoing challenge. Dedicated clinics for specific clienteles were successful. Community partnerships were generally beneficial, although establishing more of them could potentially reach other vulnerable communities. To improve accessibility and minimize health social inequities, a greater investment in local partnerships might reach more vulnerable clienteles. Regular communication and innovative employee support are key elements to improve fluidity of operations. Key messages • Reaching out for vulnerable clienteles is essential to minimize health social inequities. • Rapid changes in services needs underlign fluidity communication importance.

Global health

Abstract Global health emphasizes the importance of addressing health challenges that transcend national borders and require strong international collaboration and governance. This concept is grounded in collaborative transnational actions aimed at promoting health for all, reducing disparities, and protecting against threats. Strengthening health systems, public health infrastructure, improving health service delivery, and ensuring equal access to healthcare for all are key focus areas in global health. This plenary will address several major health challenges and critical issues, such as the rising burden of non-communicable diseases, re-emerging pandemics, environmental threats, and the suboptimal responses of national healthcare systems to manage these challenges. The need to focus on vulnerable and marginalized populations, particularly those affected by migration and ethnicity, will be highlighted. The discussion will also showcase the importance of including ethnic minority and Indigenous people’s perspectives in health policy and decision-making processes, as well as addressing the social determinants of health that disproportionately affect these communities. Central to the discussion on global health is the role of global health policy and diplomacy, focusing on how countries can collaborate to address health threats and challenges, shaping international strategies and frameworks. Innovation, including reverse innovation and the development of evidence-informed policies and effective public health strategies that can be implemented globally and is relevant also in resource-constrained contexts, is another critical aspect in addressing the intersection of health and development. Finally, strong public health leadership is needed to shape practices and policies, as well as fostering the next generation of global health leaders. The multifaceted nature of global health calls for a comprehensive approach to health—one that integrates policy, leadership, and equity into the core of public health strategies. The integration of health into all policies at the global level is vital for creating supportive environments, policies, services, and communications that promote better health for all. Moderators Iveta Nagyova President EUPHA Henrique Barros President ASPHER Speakers/Panellists Emma Rawson Te Patu President World Federation of Public Health Associations Charles Agyemang Professor of Global Migration, Ethnicity & Health, University of Amsterdam, Netherlands Agnès Buzyn Former Minister of Health and Social Affairs, France Moredreck Chibi Public Health Innovation Lead, WHO Regional Office for Europe

Romantic Functioning in the Aftermath of Adult Sexual Assault: A Scoping Review.

This scoping review investigates the influence of Adult Sexual Assault (ASA) on romantic functioning through an analysis of 16 studies. Four databases were searched (Google Scholar, PsycINFO, Taylor & Francis Online, and ProQuest) in June 2023 for relevant published and grey literature. Emphasis was placed on conducting analyses solely among individuals who had experienced ASA, defined in this context as non-consensual sexual contact occurring at or after the age of 18 years. The review highlighted several factors explored in existing literature, encompassing relationship satisfaction, sexual functioning, partner effects, risk assessment, and protective factors. Results yielded mixed findings on the effects of ASA on relationships and sexual functioning. Insights from the partners of individuals who have experienced ASA illuminate emotional repercussions and communication disruptions, highlighting the intricate relationship dynamics affected by ASA within romantic relationships. Moreover, the review identifies protective factors, such as enhanced relationship communication and partner support, potentially mitigating adverse romantic outcomes. The review also revealed shortcomings in the existing literature, including sparse research on ASA, limited demographic representation, and inadequate control between adult and child sexual assault. These insights inform evidence-based interventions, policy development, and future research directions, highlighting the need for tailored approaches to address ASA's multifaceted impact on survivors' romantic well-being.

Participation in medication safety of older-adult patients with chronic disease during the transition from hospital to home: a descriptive qualitative study

BackgroundMedication safety issues occur frequently among older-adult patients with chronic diseases during the transition from the hospital to their homes. Patient participation in medication safety has been found to be an effective measure for improving patient safety. However, few studies have been conducted on the safety of older-adult patients with chronic disease during the hospital to family transition period. This study aimed to understand the experiences and perceptions of such patients regarding participation in medication safety during the hospital to family transition period and to explore the actual situation and obstacles during this period in the Chinese context.MethodsA descriptive, qualitative research approach was adopted using purposive sampling. Eighteen patients with chronic disease (aged 61–84 years) participated, all of whom were in the period of transition from hospital to home. Data were collected through semi-structured face-to-face interviews and analysed using directed qualitative content analysis.ResultsFour themes and 12 sub-themes were identified in this study. The four themes were participation in medication decision-making, participation in medication self-management, participation support, and barriers to patient participation.ConclusionsPatient participation is important in ensuring medication safety during the hospital to family transition period. This study highlights that older-adult patients’ participation in medication safety includes three aspects: participation in medication decision-making, participation in medication self-management, and participation support. Health literacy, medical communication, and family care support are the key factors affecting patient participation in medication safety. Effective intervention strategies for this patient group during the transition period would target improving patients’ cognition, health literacy, doctor-prescription communication, and family care support to encourage patients to be more actively involved in the process of drug treatment.

PRevention Intervention and Support in Mental health for people with aphasia (Aphasia PRISM): protocol and mixed methods analysis plan for two feasibility studies

BackgroundPeople with aphasia commonly experience depression and anxiety. The individual therapy program, Aphasia PRevention Intervention and Support in Mental health (Aphasia PRISM) offers low intensity psychotherapeutic interventions using communication supports. Trained stroke clinicians from disciplines other than psychology (e.g., allied health professional, nurse, doctor) can deliver such interventions. The aim of the planned studies is to test the acceptability, feasibility and preliminary effectiveness of Aphasia PRISM for preventing depression and anxiety and supporting wellbeing in people with aphasia after stroke.MethodThis protocol describes two feasibility studies of the Aphasia PRISM using parallel, convergent, mixed methods designs. Participants will be adults with aphasia after stroke from a metropolitan healthcare site (Study A, pre-post case series, approximate n = 6) and two regional/rural sites (Study B, randomised controlled trial, n = 30; random allocation to either: treatment arm Aphasia PRISM + usual care; or attention control of secondary stroke prevention information + usual care) in Victoria, Australia. Eligible participants will be offered 7 weekly intervention sessions (via telehealth or in person). Other participant groups include stroke clinicians / site managers and family members. Feasibility will be assessed with treatment acceptability ratings (primary outcome) and secondary outcomes such as recruitment rate and participant clinical response. Participant clinical responses to intervention will be collected pre-intervention (baseline), concurrently (4 week acceptability measure), immediately post (8 weeks), follow-up (3 months) and follow-up at 6 months (Study B only). Descriptive statistics will be used to analyse quantitative data based on the type and distribution of data. Reflexive thematic analysis, an inductive approach will be used to analyse qualitative data.DiscussionAphasia PRISM offers the potential for trained stroke clinicians to deliver low intensity psychotherapeutic interventions with communication supports to people with aphasia. Studies A and B were registered with the Australian New Zealand Clinical Trials registry under one registration (ACTRN12620000209998) 20th February 2020.

The burden of sustaining communication: communication breakdowns experienced by deaf students and their communication support workers in a further education college

ABSTRACT The educational inclusion of deaf students in England is usually interpreted as placement in mainstream settings alongside hearing students, creating unintended pressure for assimilation to the communicative needs of hearing people. In this context, it is deaf students and their communication support staff who are left to deal with communicative disparities found in educational settings. This ethnographic study explored episodes of communication breakdown in communicative interactions of 5 deaf college students in a further education college in Northern England. Analysis coded what was the source of breakdown, who noticed it, who repaired communication and what strategy was used. Findings were organised into three themes, reflecting how breakdowns were dealt with either by deaf students or their Communication Support Workers, or as a shared concern with teaching staff. Overall, deaf students were noted to deal with miscommunication through translanguaging, deploying their multilingual and multimodal repertoires to engage with multiple audiences and repair communication. Findings reflect how deaf students are overburdened with responsibility for ensuring communication is sustained, which opens further questions regarding the pressure to assimilate to hearing normative ways of communicating. Restricting deaf students’ communication to English may limit their development as bi/multilinguals and their learning experiences.

Best Practices in Supporting Inpatient Communication With Technology During Visitor Restrictions: An Integrative Review.

Since the onset of the COVID-19 pandemic, healthcare workers around the world have experimented with technologies to facilitate communication and care for patients and their care partners. Our team reviewed the literature to examine best practices in utilizing technology to support communication between nurses, patients, and care partners while visitation is limited. We searched four major databases for recent articles on this topic, conducted a systematic screening and review of 1902 articles, and used the Johns Hopkins Nursing Evidence-Based Practice for Nurses and Healthcare Professionals Model & Guidelines to appraise and translate the results of 23 relevant articles. Our evaluation yielded three main findings from the current literature: (1) Virtual contact by any technological means, especially video visitation, improves satisfaction, reduces anxiety, and is well-received by the target populations. (2) Structured video rounding provides effective communication among healthcare workers, patients, and offsite care partners. (3) Institutional preparation, such as a standardized checklist and dedicating staff to roles focused on facilitating communication, can help healthcare workers create environments conducive to therapeutic virtual communication. In situations that require healthcare facilities to limit visitation between patients and their care partners, the benefits of virtual visitation are evident. There is variance in the types of technologies used to facilitate virtual visits, but across all of them, there are consistent themes demonstrating the benefits of virtual visits and virtual rounding. Healthcare institutions can prepare for future limited-visitation scenarios by reviewing the current evidence and integrating virtual visitation into modern healthcare delivery.

Beyond Treatment: A Narrative Review of Humanization Practices, Empathetic Communication, and Comprehensive Support in Oncology Patient Care in Brazil Over the Last Two Decades (2003-2023).

Humanization in oncology patient care represents a significant innovation in health care practice, shifting the traditional focus solely on treating physical conditions to encompass the emotional and psychosocial dimensions of patient experience. This study aimed to explore the importance of humanization in oncology and the application of practices that promote a patient-centered approach. Through a narrative review of the past 2 decades, the objective was to analyze the practices, benefits, and challenges of humanization in the oncology context. The methodology involved reviewing the relevant literature on empathetic communication, psychological support, and the integration of these aspects into oncology care. The results indicated that humanization significantly contributes to improving patients' quality of life, increasing treatment adherence, and fostering a more satisfying work environment for health care teams. However, effective implementation faces challenges, such as the need for ongoing training, resource limitations, and resistance to change. Despite these obstacles, humanization is essential to provide more comprehensive and patient-centered care. The adoption of humanized practices transforms the oncology care experience, making it more empathetic and holistic.

Flourishing With Flexibility: Leader Communicative Support of Flexible Work Arrangements Enhances Employee Engagement and Well-Being

In the wake of the COVID-19 pandemic, more than half of U.S. employees whose work is capable of being done remotely report they use a hybrid work arrangement that includes some remote work and some work in the office. This poses a challenge for leaders because research shows that employee use of flexible work arrangements (FWA) can negatively affect employee outcomes. The current study, a cross-sectional survey of 1,258 employees who work full time in the U.S., uses the theory of communicative leadership to understand the influence of leader communicative support of FWA on the relationship between employee use of FWA and two employee outcomes: flourishing at work (a measure of well-being) and job engagement. Results show that higher levels of employee use of FWA is associated with less flourishing at work and job engagement; however, leader communicative support of FWA moderates this relationship, with high-quality leader communicative support associated with higher levels of flourishing at work and job engagement. The results have implications for leadership and work-life scholarship and provide practices that leaders can implement to help support employee engagement and well-being.

Write here write now. What can we learn from the writing goals of people with aphasia?

ABSTRACT Background People with aphasia commonly have difficulties with producing written language (dysgraphia). Greater understanding of people with aphasia’s rehabilitation goals for writing can inform development of evidence-based assessment and management tools. Aims This qualitative study aimed to explore the nature of writing goals of people with aphasia who attended an intensive speech and language therapy (SLT) centre. Methods and Procedures Qualitative data was obtained from five years-worth of client SLT reports from an intensive aphasia centre. Using qualitative content analysis, a deductive coding framework was used to identify any description of writing goals; coding incorporated iterative refinement and agreement among authors. Themes were then constructed to reflect clients’ goals to inform writing assessment and therapies. Outcomes and Results Qualitative analysis focused on content describing 66 goals on writing from 87 reports. There were two dominant interrelated themes: Supporting Communication (33 goals) and Technology (25 goals). Technology included subthemes on Emailing, Texting, Social Media, and Assistive Technology. Two smaller themes were Impairment Focused (4 goals), where goals did not have a clear functional direction, and Other (4 goals), where goals targeted specific writing activities, e.g. crosswords. Conclusions These thematic findings demonstrate the varied real-life goals for writing among attendees at an aphasia centre. They highlight the nature of relatively early-stage rehabilitation goals for individuals with aphasia, focusing on supporting communication and returning to valued activities. The results provide a context within which we can scrutinise the adequacy of current clinical tools to support goal setting, assess functional writing and design interventions for acquired writing difficulties. Further guidance is needed on assessment of writing as a supportive communication strategy and therapy towards improving this skill. There are also gaps in supporting the personal goals of people with aphasia who wish to produce written language via technology or in online environments. Future research should recognise these priorities and work together with people with aphasia, clinicians, and technology specialists to address an area of clinical need.

Communication, Socialization, and Literacy for Adults With Developmental Disabilities: An Interview Study of Parents' Perspectives and Experiences.

The study highlights the significance of continuous support and services in communication, socialization, and literacy skills for adults with developmental disabilities (DDs). The aim of the study was to gather in-depth information on the individualized needs, lived experiences, and expectations of adults with DD by interviewing their parents. A total of 14 parents of adults with DD participated in one-on-one semistructured interviews. During the interviews, parents were asked to describe (a) their children's current communication, socialization, reading and writing skills; (b) the types of communication, socialization, and literacy support their children were receiving; and (c) the types of support that their children needed. Interviews were video- and audio-recorded, transcribed, and analyzed qualitatively using thematic analysis. Thematic analysis revealed three main themes and eight subthemes: (1) insufficient support and services for adults with DD (i.e., lack of competent professionals and lack of literacy support), (2) approaches that the parents attempted for their children with DD (i.e., parents' responsibilities, technologies, and pseudoscience), and (3) recommendations for ongoing support and services (i.e., novel technologies, social media, and motivation). The study highlights crucial gaps between the participating parents' desire for individualized, consistent, and innovative support and services for their adult children with DD and scarcity of resources in communication, socialization, and literacy. The dearth of evidence-based support and resources leads to easy access to pseudoscience. Future research is warranted to develop innovative, customized, and highly motivating programs in communication, socialization, and literacy for adults with DD. https://doi.org/10.23641/asha.27214407.

The experience of surrogate decision-making and deciphering critically ill patient values: A qualitative study.

Surrogate decision-makers (SDMs) who make decisions for critically ill patients often face great challenges. Although shared decision-making has been advocated, its implementation has been less than satisfactory. To explore the experience of the surrogate decision-making process and determine how SDMs understand the values and preferences of critically ill patients. A constructivist qualitative study was used. The data were collected using semistructured interviews with four questions conducted between January and February 2023. The audio recordings were transcribed verbatim and analysed via thematic analysis. Fourteen SDMs (all family members) of 10 critically ill patients were recruited according to the inclusion criteria. We identified eight sub-themes that were classified into three themes: (a) the unbalanced act: no respite for the surrogates, conflict between rationality and emotion, and sacrifice in surrogate decision-making; (b) unclear values and preferences: ignored values, intentional silence and substituted values; and (c) unsatisfying surrogate decisions: decision regret and decreased surrogate decision-making self-efficacy. These findings underscore the urgent need for enhanced communication strategies and support systems to better assist SDMs in navigating their roles. Effective interventions could help clarify patients' values and preferences, thereby improving the decision-making process and outcomes for both SDMs and patients. Misalignment between patient values and those of SDMs can potentially degrade the quality of decision-making. Clinicians should be skilled in stimulating SDMs to think about patient values and preferences.

Online examinations: Factors that impact student experience and perceptions of academic performance

Online examinations are an increasingly common feature of higher education. Research in this area often focuses on academic integrity without exploring student experience in online examinations more broadly. With increasing use of online examinations and associated security measures, there is a plausible risk that the platform, examination conditions and measures to achieve assessment security may have a negative impact on student experience, well-being and performance. This paper reports on a large-scale survey conducted in 2021 and 2022 at a large metropolitan university in Australia. Analysis of 13,751 completed surveys revealed that the majority of students perceived their overall online exam experience positively. However, a thematic analysis of 5,213 optional open-ended responses provided a more detailed understanding of the range of positive and negative influencing factors and their consequences. Many of the issues negatively impacting student experience were related to the assessment design, rather than the assessment platform or exam security. The findings also revealed implications relating to platform functionality, personal technology and exam conditions, including location of exam, and preparation and support. Implications for practice or policy: Academics need to consider the quality and appropriateness of assessment design, as these affect the extent to which students experience online exams positively and are largely independent of the exam and security systems. Institutions can reduce the wide range of negative impacts through improved communication and in-exam support. System developers can iteratively ameliorate negative impacts through investigating student experience and involvement of students in the co-design of assessment platforms.

Sharing for Caring? A Patients' and Clinicians' View on Handling Personal Medical Data in the Context of Digitization: An Exploratory Study.

The healthcare sector is currently undergoing a significant transformation, driven by an increased utilization of data. In this evolving landscape, surveys are of pivotal importance to the comprehension of patient needs and preferences. Moreover, the digital affinity of patients and physicians within the healthcare system is reforming the manner in which healthcare services are accessed and delivered. The utilization and donation of data are influencing the future of medical research and treatment, while artificial intelligence (AI) is empowering patients and physicians with knowledge and improving healthcare delivery. In order to evaluate the opinions of patients and physicians regarding the management of personal health data and the functionality of upcoming data management devices in the context of healthcare digitization, we conducted an exploratory study and designed a survey. The survey focused on a number of key areas, including demographics, experience with digitization, data handling, the identification of needs for upcoming digitization, and AI in healthcare. A total of 40 patients and 15 physicians participated in the survey. The results indicate that data security, timesaving/administrative support, and digital communication are aspects that patients associate with patient-friendly digitization. Based on the responses provided by physicians, it might be concluded that future digital platforms should prioritize usability, time efficacy, data security, and interoperability. In terms of expectations for future digital platforms, there is a notable overlap between the needs expressed by patients and those identified by physicians, particularly in relation to usability, time management, data security, and digital communication. This suggests that the requirements of different stakeholders can be combined in a future system, although individual issues may still require attention.

The Associations Between COVID-19-related Stigma of School-age Children and Communicative Support from Parents and Teachers

The Associations Between COVID-19-related Stigma of School-age Children and Communicative Support from Parents and Teachers

Patient motivation: A concept analysis.

Patient motivation is crucial in maintaining health-improving activities and helping patients recover from illnesses. Despite extensive research on patient motivation, this concept has not been clearly defined and remains ambiguous. The latest analysis of patient motivation was over two decades ago, thus necessitating the need to reexamine it in more updated literature. This study aims to explore the concept of patient motivation. The eight-step approach of Walker and Avant was used: concept selection, determining analysis aim, identifying concept use, defining attributes, model case identification, borderline and contrary case identification, antecedents and consequences identification, and empirical referent identification. Five databases, CINAHL, Cochrane, Medline, PubMed, ProQuest, and ScienceDirect, were searched for published works between 2014 and 2024 using the keywords "patient" and "motivation." The identified attributes of patient motivation are a psychological drive, a desire to adopt healthy behaviors, and goal-directed action. Antecedents of patient motivation are self-efficacy, provider-patient communication, and social support. Patient motivation leads to consequences, including healthier lifestyles and greater adherence and compliance. The present concept analysis draws upon current literature to suggest the antecedents, attributes, and consequences of patient motivation. Nurses can promote healthier lifestyles and greater adherence and compliance among patients by employing techniques to raise self-efficacy and provide social support while enhancing patient-centered interactions.

Promoting Health for a vulnerable Family with Relationship Challenges. Exploring the Community Nurse's Role

Background: In today's dynamic social landscape, families often encounter a myriad of challenges that can impact their overall health and well-being. Among these challenges, relationship difficulties within the family unit stand out as a significant concern, with potential repercussions for the physical, emotional, and psychological health of its members. Aim: This case study article delves into the intricate dynamics of promoting health within a vulnerable family facing significant relationship challenges. The focus of this study is to explore the pivotal role of the community nurse in addressing the unique needs of such families. Materials and Methods: A qualitative research approach was employed to comprehensively investigate the experiences of a vulnerable family navigating relationship challenges. Data collection involved in-depth interviews, direct observations, and document analysis. Thematic analysis was used to extract meaningful patterns and insights from the collected data. Results: The findings underscored the crucial influence of the community nurse in fostering the health and well-being of the vulnerable family. Through tailored interventions, collaborative support, and sensitive communication, the community nurse played a pivotal role in addressing the family's relationship challenges and promoting their overall health. Conclusions: This study sheds light on the significance of the community nurse's involvement in enhancing the health outcomes of families facing relationship challenges. The role of the community nurse emerges as an essential component in fostering resilience and facilitating positive changes within the family unit.

The Canadian VirusSeq Data Portal and Duotang: open resources for SARS-CoV-2 viral sequences and genomic epidemiology.

The COVID-19 pandemic led to a large global effort to sequence SARS-CoV-2 genomes from patient samples to track viral evolution and inform the public health response. Millions of SARS-CoV-2 genome sequences have been deposited in global public repositories. The Canadian COVID-19 Genomics Network (CanCOGeN - VirusSeq), a consortium tasked with coordinating expanded sequencing of SARS-CoV-2 genomes across Canada early in the pandemic, created the Canadian VirusSeq Data Portal, with associated data pipelines and procedures, to support these efforts. The goal of VirusSeq was to allow open access to Canadian SARS-CoV-2 genomic sequences and enhanced, standardized contextual data that were unavailable in other repositories and that meet FAIR standards (Findable, Accessible, Interoperable and Reusable). In addition, the portal data submission pipeline contains data quality checking procedures and appropriate acknowledgement of data generators that encourages collaboration. From inception to execution, the portal was developed with a conscientious focus on strong data governance principles and practices. Extensive efforts ensured a commitment to Canadian privacy laws, data security standards, and organizational processes. This portal has been coupled with other resources, such as Viral AI, and was further leveraged by the Coronavirus Variants Rapid Response Network (CoVaRR-Net) to produce a suite of continually updated analytical tools and notebooks. Here we highlight this portal (https://virusseq-dataportal.ca/), including its contextual data not available elsewhere, and the Duotang (https://covarr-net.github.io/duotang/duotang.html), a web platform that presents key genomic epidemiology and modelling analyses on circulating and emerging SARS-CoV-2 variants in Canada. Duotang presents dynamic changes in variant composition of SARS-CoV-2 in Canada and by province, estimates variant growth, and displays complementary interactive visualizations, with a text overview of the current situation. The VirusSeq Data Portal and Duotang resources, alongside additional analyses and resources computed from the portal (COVID-MVP, CoVizu), are all open source and freely available. Together, they provide an updated picture of SARS-CoV-2 evolution to spur scientific discussions, inform public discourse, and support communication with and within public health authorities. They also serve as a framework for other jurisdictions interested in open, collaborative sequence data sharing and analyses.

Exploring children's preferences for graphic symbols to represent pain‐related words

AbstractChildren who are hospitalized may sometimes not be able to communicate verbally to self‐report their pain or other symptoms due to medical conditions, medical interventions, or communication difficulties. As such, these children may need other means, such as augmentative and alternative communication (AAC) strategies, in this case, graphic symbols, to express their pain‐related experiences and receive applicable treatment. Choosing suitable graphic symbols to represent pain‐related words contributes to the effective use and implementation of visual support. This study explored the preferences of 6.0–9.11‐year‐old (years; months) children with typical development regarding graphic symbols to represent pain‐related words. These symbols were selected from two commonly used and widespread symbol resources: Picture Communication Symbols (PCS®) and Aragonese Portal of Augmentative and Alternative Communication (ARASAAC) symbols. A descriptive, quantitative study design was employed, including a total of 30 typically developed South African children. Data were collected by means of an electronic questionnaire and analyzed using descriptive and inferential statistics. Probability values were determined and predictions, as well as inferences, were implemented. The results showed that the children preferred ARASAAC symbols to represent most pain‐related words (p < 0.001). It is important to consider stakeholders' (in this case, children's) input on their preferences in designing communication support to enable participation during the clinical decision‐making process.