Core Priorities Research Articles

Teachers as first responders in marginalized, urban communities: Stress and coping during unprecedented times for public education

The present study examines workplace priorities, challenges, and experiences of burnout and coping among teachers in marginalized urban communities, where structural barriers elevate job demands and minimize job resources. Specifically, we amplify the voices of public elementary school teachers in an urban hub of Florida during a time of unprecedented stressors (COVID-19, staff shortages, racial injustice, school shootings) to identify possible avenues of support. Participants (N = 12) were teachers in grades 3 through 5 from one large urban district; six participants served predominately Black or African American students, and six participants served predominately Hispanic students. All teachers self-identified as female and from a racially and/or ethnically minoritized background themselves. Semi-structured interviews (conducted remotely by the first author) were organized around five questions. Qualitative content analysis highlighted two core priorities (support students holistically and address interconnecting social emotional skills and academic success) and two core challenges (mismatch between administration expectations/supports and teacher needs/values, and difficulty managing student behavior). Teachers attributed the ubiquitous experience of burnout to factors at levels of work (e.g., responding to student stressors and traumas on top of curriculum demands), organization (e.g., poor compensation, excessive work demands), and society (e.g., school shootings, COVID-19), and they offered concrete recommendations for improving their work conditions. Altogether findings inspire opportunities to reevaluate supports for teachers serving as first responders for youth in marginalized urban communities.

National biodiversity data infrastructures: ten essential functions for science, policy, and practice

Abstract Today, at the international level, powerful data portals are available to biodiversity researchers and policymakers, offering increasingly robust computing and network capacities and capable data services for internationally agreed-on standards. These accelerate individual and complex workflows to map data-driven research processes or even to make them possible for the first time. At the national level, however, and alongside these international developments, national infrastructures are needed to take on tasks that cannot be easily funded or addressed internationally. To avoid gaps, as well as redundancies in the research landscape, national tasks and responsibilities must be clearly defined to align efforts with core priorities. In the present article, we outline 10 essential functions of national biodiversity data infrastructures. They serve as key providers, facilitators, mediators, and platforms for effective biodiversity data management, integration, and analysis that require national efforts to foster biodiversity science, policy, and practice.

Development of a HIV Prevention Program to Promote Condom Use Among Iranian Female Sex Workers: Application of An Intervention Mapping Approach.

We used an Intervention Mapping Approach (IMA) to derive multi-level HIV prevention strategies aiming to develop an HIV prevention intervention program among female sex workers (FSWs). We also aimed at pilot testing the effects of the IMA-based "HIV Prevention and Awareness Program (HIV-PAP)" on safe sex behaviors and its determinants among FSWs in Tabriz, Iran. To develop HIV-PAP, we conducted the six-step process of IMA. At Step 1, in a cross-sectional study, 140 FSWs were face-to-face interviewed. At Step 2, the program matrix was provided based on the importance and variability for identifying priority factors. At Steps 3 and 4, the methods and strategies for behavioral change were selected, and the HIV-PAP program components and materials were developed. At Steps 5 and 6, evaluation (as a pilot testing with Static-Group Comparison design) was conducted applying a pre-experimental study, in which 30 FSWs were assigned to intervention (n = 15) and control (n = 15) groups. The intervention group participated in a two-month long program, and one month later, the initial questionnaires were completed by both groups. The respondents (M age: 33.4 years, SD: 9.7) acquired low score (less than 50%) in negotiating for condom use (49.8%) only, and moderate scores (50-65%) in perceived social support (61.6%) and knowledge (60.5%). Adjusted for other variables, the factors (R2 = 32.0%) associated with safe sex behaviors among FSWs were predisposing factors [self-efficacy (β = 0.331), perceived norms (β = 0.945), and perceived barriers (β = 0.258)], condom use negotiation (β = 1.386), and environmental factors (β = 0.333). Our IM-based framework had an adequate fit index (χ2 = 130.8, CFI = 0.78). Looking for inter-group comparison after intervention, we found significant mean difference (MD) for knowledge (MD: 2.18; 95% Confidence Interval (CI) -.38 to 4.74, p < 0.05), self-efficacy to use condom (MD: 6.71; 95% CI -1.85 to 9.29, p < 0.05), perceived risk (MD: 2.03; 95% CI 0.58, to 3.49, p < 0.05), perceived social support (MD: 4.64; 95% CI -5.37 to 11.31, p < 0.01), and safe sexual behaviors (MD: 7.75; 95% CI -4.19 to 9.71, p < 0.05). The HIV-PAP showed effectiveness in promoting safe sexual behaviors and their determinants among FSWs. Healthcare providers should better understand the determinants of safe sexual behaviors among FSWs in the settings with legal prohibitions for sex work. In such communities, they should try to either develop or adapt such stage-specific interventions, within which promoting the above-mentioned factors is the core priorities of the program.

Graduate medical education well-being directors in the United States: who are they, and what does the role entail?

BackgroundInstitutional Graduate Medical Education (GME) Well-being Director (WBD) roles have recently emerged in the United States to support resident and fellow well-being. However, with a standard position description lacking, the current scope and responsibilities of such roles is unknown. This study describes the scope of work, salary support, and opportunities for role definition for those holding institutional leadership positions for GME well-being.MethodsIn November 2021, 43 members of a national network of GME WBDs in the United States were invited to complete a cross-sectional survey that included questions about job responsibilities, percent effort, and dedicated budget, and a free text response question about unique leadership challenges for GME WBDs. The survey was analyzed using descriptive statistics for quantitative data and thematic analysis for qualitative data.Results26 members (60%) responded. Most were physicians, and the majority identified as female and White. Median percent effort salary support was 40%. A small minority reported overseeing an allocated budget. Most respondents worked to improve access to mental health services, oversaw institution-wide well-being programs, designed or delivered well-being content, provided consultations to individual programs, met with trainees, and partnered with diversity, equity, and inclusion (DEI) efforts. GME WBDs described unique challenges that had implications for perceived effectiveness related to resources, culture, institutional structure, and regulatory requirements in GME.DiscussionThere was high concordance for several key responsibilities, which may represent a set of core priorities for this role. Other reported responsibilities may reflect institution-specific needs or opportunities for role definition. A wide scope of responsibilities, coupled with limited defined budgetary support described by many GME Well-being Directors, could limit effective role execution. Future efforts to better define the role, optimize organizational reporting structures and provide funding commensurate with the scope of work may allow the GME Well-being Director to more effectively develop and execute strategic interventions.

IMPLEMENTING A STAKEHOLDER AND POLICY MAP TO TRACK FEDERAL CAREGIVER POLICY ACTIVITY

Abstract A top priority for family caregiver policy should be a focus on accountability and transparency regarding federal actions identified within the National Strategy to Support Family Caregivers. It is crucial to have accountability and transparency as the National Strategy is being updated and refined over the course of time that occurs between the release of the initial strategy and the publishing of the next version of the strategy. Increased accountability and transparency are especially important as stakeholders continue to champion and build on the foundation that has been established in the process of creating the 2022 National Strategy to Support Family Caregivers. Establishing outcomes measures will also inform how the stakeholder community may shift their priorities and operations to align with successes and challenges outlined in an updated National Strategy. To ensure that accountability and transparency are at the forefront of public interest, and as agency leadership communicates the intended outcomes of their critical contributions to America’s family caregivers, it is essential to establish a process to communicate the meaningful impact regarding federal actions on this population. As the National Strategy is being examined for future updates, NAC has facilitated a systematic process to map the actions that federal agencies have identified as core priorities and track their progress toward implementation. That mapping process will be revealed and analyzed during this presentation.

Developing a mission statement to reflect the diversity, equity, and inclusion values and priorities of a College of Nursing.

A mission statement represents an organization's values, expectations, and priorities and guides its strategic decision-making. This article describes an innovative and iterative process for developing mission statements to reflect and guide the diversity, equity, and inclusion values of schools and colleges of nursing. The process began with extensive input from the faculty during the fall 2021 faculty retreat using a World Café approach. Following the retreat, members of the Equity and Inclusion Committee reviewed the information from the faculty about the college's values, goals, and vision for our tripartite mission. In drafting the mission statement, the Equity, and Inclusion Committee, which includes faculty, staff, and student representation from the college's multiple regional campuses, units, and departments, met to craft an initial draft collaboratively. The initial draft of the mission statement was then circulated to the Faculty Leadership Team, the Faculty Executive Committee, and individual departments within the college for feedback. Committee members used the input and suggested revisions to refine and finalize a proposed new mission statement. A survey was distributed to faculty, staff, and students to provide quantitative and qualitative feedback about the proposed mission statement (N=125). Mean scores suggested agreement that the new mission statement reflected the values and future direction of the college (M=7.91), aligned with personal values and career goals (M=8.25), and its achievement would advance the discipline of nursing (M=8.30). The level of support for adopting the new mission statement was strong (M=7.83). Most of the faculty voted to adopt the new mission statement at a faculty meeting (N=98, 85%). The strategies described have implications for guiding the development of mission statements to speak to the issues of diversity, equity, and inclusion as core values and priorities of schools and colleges of nursing.

DANISH GRANT AND SCHOLARSHIP POLICIES TOWARDS RUSSIA IN 2011–2021

The paper deals with issues of cooperation between Denmark and Russia in Arctic research and academic mobility projects, making an emphasis on scholarship and grant policy. Despite the fact, that international cooperation in research and education is one of the core priorities in both Arctic strategies, before the year 2022 it was functioning in specific conditions. Scholarship and grant policy appeared to be a «soft power» tool for Copenhagen due to research topics, concentration of project management in Danish hands and disproportions in student mobility scholarship programmes. Interaction between Russian and Danish researchers has not been a subject to special attention from Danish authorities and foundations. On the contrary, researchers from both countries interacted within investigating the issues of the Arctic region actively. Even international turbulence after 2014 did not affect it: both countries stated that the «Arctic vector» is to stay aside from any turbulence. Expanding the scholarship programmes for Russian researchers in order to support their mobility to Denmark, Greenland and Faroe Islands enforced this idea. So did formal prioritization of cooperation with Russian research and educational institutions in Arctic research in 2021 for grant support. Though turbulent situation in 2022 led to suspending the interaction, it is clear that there are formal and informal grounds to restore it upon normalization. That fact will require revisiting the previous cooperation experience and implementation of the best grant and scholarship practices by Russian relevant agencies.

Priorities and Progress in Complex Care Education.

Pediatricians routinely care for children with medical complexity (CMC), yet complex care is not a standard part of their training. In “Core curricular priorities in the care of children with medical complexity: A North American modified Delphi study,” we reported on a consensus development process that identified essential topics to include in a formal complex care curriculum for pediatric residents.1 We described 11 curricular priorities related to multisystem clinical issues, as well as medical technology care, safety/emergency planning, care coordination, and advocacy.

Influence and behaviour of the new standard setters in the sustainability reporting arena: implications for the Global Reporting Initiative’s current position

PurposeThis study aims to examine the influence and behaviour of the European Financial Reporting Advisory Group (EFRAG)/European Commission, and the International Financial Reporting Standards (IFRS) Foundation/International Sustainability Standards Board in the standardisation of sustainability reporting arena and their implications for the Global Reporting Initiative’s (GRI) current position.Design/methodology/approachThis paper draws on the arena concept, particularly the work of Renn (1992) and Georgakopoulous and Thomson (2008), to explore the EFRAG and the IFRS Foundation’s behaviour towards the standardisation of the sustainability reporting arena and their implications for the GRI’s current position. Further, the documents and public releases pertinent to the activities and output of the GRI, the EFRAG/European Commission and the IFRS Foundation are used. The documents are screened and analysed based on the key elements of arena concept that emerged, which includes “agenda, claims, network of bodies and group engaged, interaction and behaviour with arena issues (audience, materiality, scope and core priorities, purpose of reporting and relevance to sustainable development)”.FindingsThis study reveals the source of motivation and influence of the new standard setters in the sustainability reporting arena and documents the relevance of their behaviour as an actionable strategy to change the arena rule. Particularly, this paper demonstrates the perceived fall away from driving business behaviour towards the pursuit of sustainable development if the GRI and its standards cease to exist.Practical implicationsThe pathway to achieve sustainable development and improve sustainability impact disclosure remains a debatable issue among policymakers and users of sustainability reporting standards. This study reconstructs the awareness of different dynamics at play inhibiting the harmonisation of sustainability reporting standardisation and the importance of the GRI in pursuing global sustainable development.Social implicationsThe pattern of behaviour and agenda of sustainability institutions and influential standard setters harnessed in this paper are aimed at enabling the existence of the rules that can uphold the primary focus of the sustainability reporting arena, particularly in achieving global sustainable development.Originality/valueThis paper furthers the understanding of the importance of the GRI in upholding the key tenets and traditional agenda of sustainability reporting and sustainable development.

Characterisation and tribological testing of recycled crushed glass as an alternative rail sand

In the UK Network Rail Environmental Sustainability Strategy 2020–2050, minimal waste and the sustainable use of materials are highlighted as core priorities. The ambition is to reuse, repurpose or redeploy all resources. In low adhesion conditions, sand particles are used to enhance traction throughout the network. However, sand is in danger of becoming scarce as many applications demand it. In this study, an alternative adhesion enhancing particle system made of recycled crushed glass is examined in terms of density, size, shape distribution, mineralogy, mechanical properties, and bulk behaviour to better understand their characteristics in comparison with the typical Great British rail sand currently in use and reported in the literature. Their effects on tribological behaviour and surface damage are also investigated using the High-Pressure Torsion test in dry, wet, and leaf-contaminated conditions. Both particle characterisation and tribological testing show promising results. Recycled glass particles provide an acceptable level of traction with a similar level of rail damage as typical rail sand. It is suggested to perform full-scale laboratory and field tests to further confirm the suitability of this material.

THE COVID-19 PANDEMIC AND OFFICE SPACE DEMAND DYNAMICS

The COVID-19 pandemic led to the mass adoption of remote working and other office market dynamics. As firms continue to adapt to the changes caused by the pandemic through various work patterns, the potential implications for the office market are unclear. Using data from Knight Frank’s (Y)OUR SPACE (2021) survey, this paper employs probit and multinomial models to examine the relationship between COVID-19 related remote working and changes to firms’ office space strategies. The study confirms that the pandemic has significantly influenced firms’ medium-term office space use strategies, and the results show that firms’ perception of their employees’ work-from-home experience has influenced their strategy review. The results specifically show that a positive WFH experience increases the likelihood that firms will reduce their total space quantity, reduce their density of occupation, and negotiate shorter leases in the medium term. We further observe that the pandemic is likely to have weaker effects on space quality than on space quantity, implying that economic factors remain core priorities in future office space use strategies, while social and environmental factors may remain secondary. These insights extend the literature beyond the economic determinants of office space demand to other social factors.

Patient priority setting in HIV ageing research: exploring the feasibility of community engagement and involvement in Tanzania

ObjectiveThe chronic complications of ageing with HIV are not well studied in sub-Saharan Africa (SSA) where general healthcare resources are limited. We aimed to collaborate with individuals living with HIV aged ≥ 50 years, and community elders (aged ≥ 60 years) living with non-communicable diseases in the Kilimanjaro region of Tanzania in a health research priority-setting exercise.MethodsWe conducted structured workshops based on broad questions to aid discussion and group-based patient priority setting, alongside discussion of the feasibility of future community research engagement. Participant priorities were tallied and ranked to arrive at core priorities from consensus discussion.ResultsThirty older people living with HIV and 30 community elders attended separate priority setting workshops. Both groups reported motivation to participate in, conduct, and oversee future studies. In this resource-limited setting, basic needs such as healthcare access were prioritised much higher than specific HIV-complications or chronic disease. Stigma and social isolation were highly prioritised in those living with HIV.ConclusionsCommunity engagement and involvement in HIV and ageing research appears feasible in Tanzania. Ageing and non-communicable disease research should consider the wider context, and lack of basic needs in low-income settings. A greater impact may be achieved with community involvement.

The WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022-2030.

There are approximately 135 million persons with disabilities in the WHO European Region. In order to address health inequities experienced by this population, Member States and WHO/Europe developed the 'WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022-2030', in close cooperation with organisations of persons with disabilities. The Framework, with its accompanying Resolution, was adopted by all 53 Member States in September 2022. The Framework is aligned with the core priorities of the WHO European Programme of Work 2020-2025, that is, achieving universal health coverage, protecting against health emergencies, and promoting health and well-being. It consists of four objectives, 13 targets, and 20 indicators that act as measures of progress and success, and as drivers for policy action and a roadmap for Member States towards a disability-inclusive health sector. The Framework is expected to have a significant impact on the health and well-being of all in the Region, and especially persons with disabilities, as it will advance inclusive health systems across the Region. Inclusive health sectors will aid towards the achievement of the Sustainable Development Goals, the protection of the human rights of persons with disabilities, and the promotion of their health.

Aducanumab, Accelerated Approvals & the Agency: Why the FDA Needs Structural Reform.

The US Food and Drug Administration's controversial decision to grant accelerated approval to aducanumab (Aduhelm), a therapy for Alzheimer's disease, has motivated multiple policy reforms. Drawing a case series of other drugs granted accelerated approval and interviews of senior FDA officials, I argue that reform should be informed but not defined by aducanumab. Rather, structural reforms are needed to reshape FDA's core priorities and restore the regulatory system's commitment to scientific rigor.

Identifying opportunities to optimise the electronic medical record for allied health professionals: a concept mapping study.

Objective To utilise a concept mapping process to identify key opportunities for electronic medical record (EMR) optimisation for allied health professionals (AHPs). Methods A total of 26 participants (allied health managers, clinicians and healthcare consumers) completed the concept mapping process, which included generating statements, and then subsequently sorting all statements into groups, and also ranking each statement for importance and changeability (0 = not important/changeable, 4 extremely important/changeable). Multivariate analysis and multidimensional scaling were then used to identify core priorities for digital optimisation. Results Participants generated 98 discrete statements that were grouped into 13 conceptual clusters. Of these, 36 statements were subsequently determined to fall within the 'green zone' on the Go-Zone plot of importance and changeability (changeability ≥2.44, importance ≥2.79), and formed the set of key optimisation priorities. Clusters with the most items in the Go-Zone plot were 'training and business rules ' and 'service statistics .' Conclusion Concept mapping facilitated identification of 36 key optimisation priorities considered both changeable and important to assist EMR optimisation for AHPs. Addressing these priorities requires action related to end-user skills and training, EMR system capacity, and streamlining of governance and collaboration for the optimisation process.

Variation in medical humanities program mission statements in United States and Canadian Medical Schools

Purpose In 2019, the American Association of Medical Colleges (AAMC) identified the discipline of medical humanities as a priority in medical education. Although medical humanities programs have existed in medical and osteopathic schools in the U.S. and Canada since the late 1960’s, this interdisciplinary field remains difficult to define. We studied the mission statements of medical humanities programs to identify core themes and priorities. Materials and methods We conducted a content analysis of U.S. and Canada medical humanities MD and DO mission statements and associated descriptions (n = 56). We compared themes across programs whose directors had a clinical degree versus a terminal research degree, conducted comparisons between medical humanities programs housed in medical schools ranked in Top 20 U.S. News and World Report for Research or Primary Care, and conducted a word frequency analysis. Results Content analysis revealed five themes: improving patient care, improving the provider experience, generating scholarship, cultivating community relationships, and promoting diversity/sociocultural awareness. 70% of programs emphasized patient care and provider experience. Only 34% included the promotion of diversity/sociocultural awareness as a theme. Word frequency analysis corroborated our findings. Conclusions U.S. and Canada medical humanities programs focus primarily on improving patient care and provider wellness.

Main findings of the European Health Report 2021

Abstract The EHR2021 examines the WHO European Region's progress towards the health-related SDGs, the impact of the COVID-19 pandemic on population health, and approaches to build back better from 2022 onwards. It provides insight into the main challenges related to the 3 core priorities of the EPW, which are moving towards UHC, protecting people better against health emergencies, and ensuring healthy lives and well-being for all at all ages. In this presentation, we will have look at these 3 core priorities in more detail. Although the European Region is making good progress for some of the SDG targets, challenges and delays exist across the core priorities. For example, the incidence of catastrophic health spending ranges from 1% to 19% across countries, and the European Region is one of two global regions where the overall number of new HIV infections is increasing. One year into the pandemic, 29% of health services were still at least partially disrupted in the Region. The impact of the pandemic aggravates the effort Member States will have to make to reach the health-related SDGs by 2030. Furthermore, there are large and persistent differences between Member States. The COVID-19 pandemic has exacerbated existing health inequalities by impacting vulnerable groups most severely. To build back after the COVID-19 crisis, the EPW will be the leading policy framework for the coming years to take on the challenges identified. The report shows that the evidence base for supporting the policy efforts that Member States will have to make for reaching the SDGs and working on the EPW core priorities is suboptimal. While the COVID-19 pandemic has emphasized the importance of health information and sparked innovative ways of data collection and processing, there are still data gaps for key indicators and operational challenges in HISs. Overcoming these issues in health information is critical for improving the health of the people in the WHO European Region.

3.C. Workshop: The WHO European Health Report 2021: overcoming gaps in data and health information systems

Abstract The publication of the European Health Report every three years gives readers a vital snapshot of health in the WHO European Region and progress towards health and well-being for all. The European Health Report 2021 (EHR2021) shows trends in and progress towards the health-related Sustainable Development Goals (SDGs) and the goals of the European Programme of Work 2020-2025 (EPW). It reveals gaps in progress, persistent health inequalities and other areas of concern and uncertainty, where action must be taken. The Report also lays bare, and not for the first time, considerable data gaps for key indicators, as well as operational problems in Member States’ (MS) health information systems (HISs). As strong HIS are a prerequisite for evidence-informed policy-making, overcoming these issues is critical. In this workshop, we will first present the main findings of the EHR2021, showing which challenges the European Region is facing related to the three core priorities of the EPW: moving towards universal health coverage (UHC), protecting people better against health emergencies and ensuring healthy lives and well-being. Although from the EHR2021 it shows that data for many SDG indicators can be reported, there are also many areas that we cannot monitor well due a lack of data. Such data gaps are not stand-alone problems but relate to wider issues with the functioning of HISs. In the second presentation we will present an overview of the most important data gaps for key indicators and common issues in national HISs in the European Region, providing insight into where concretely action needs to be taken to ensure a stronger evidence-base for policy-making. Supporting MS in strengthening their HIS has traditionally been an important focus in WHO Regional Office for Europe's (WHO-Euro's) work and continues to be so under the EPW. One important tool that WHO-Euro uses for this purpose is a HIS assessment. Such an assessment provides insight into the strengths and weaknesses of the HIS and is the starting point for an evidence-informed process of HIS strengthening. In the third presentation, we will present WHO-Euro's HIS assessment approach. Lacking or incomplete digitalisation is a common issue in HISs in the Region, and the COVID-19 pandemic has emphasized the need for implementing digital solutions to improve the efficiency of HISs. Therefore, supporting Member States in the further digitalisation of their HIS is an important focus of WHO-Euros HIS strengthening work for the coming years. In the final presentation, we will present WHO-Euro's existing tools and planned activities related to this. Participants of this workshop will get a comprehensive overview of current challenges related to achieving the health-related SDGs in Europe, with a specific focus on challenges related to health information. They will learn about WHO-Euro's approaches and plans for how to tackle these challenges. Key messages • Although the European Health Report 2021 shows data for many health-related SDGs, there are important areas that we cannot monitor well due to a lack of data and issues in health information systems. • Overcoming these issues is crucial for a strong evidence-base for health policy, and therefore WHO Regional Office for Europe has a series of tools and activities to support Member States in this.

Using Simulation to Test Validity and Reliability of I-BIDS: A New Handoff Tool

Background Patient safety and improved outcomes are core priorities in healthcare, and effective handoffs are essential to these priorities. Validating handoff tools using simulation is a novel approach. Methods The construct validity and instrument reliability of the I-BIDS© tool were tested. In Phase I, construct validity was substantiated with a convenience sample of 21 healthcare providers through an electronic survey. Content Validity Ratio (CVR) was tabulated using Lawshe’s CVR. Interrater reliability was tested in a simulated handoff scenario, in Phase II, with graduate nursing students and two raters, and simulation effectiveness was assessed by students. Results Construct validity was evaluated, and 17 of the 25 items were found significant at the critical level (0.42). Items scoring below were removed, and the tool was reduced by one category. Weighted kappa (Kw) with quadratic weights was run from the scenario data to determine if there was an agreement between raters of handoff performance. There was a statistically significant agreement between the two raters, Kw = .627 (95% CI: .549–.705), p &lt; .001) with good strength of the agreement. SET-M Total mean was 55.64 ( SD = 2.46). Discussion The tool showed beginning validity and interrater reliability. The SET-M Learning subscale showed the widest range of scores which suggests the most opportunity for improvement. Use of the tool in simulated scenarios may be one way to test the items further. Conclusions Simulation was effective in facilitating the evaluation of the tool.

Mapping theme trends and knowledge structures of dignity in nursing: A quantitative and co-word biclustering analysis.

The present study aims to explore the research hot spots, development trends and knowledge structure of dignity in the nursing field. Quantitative and co-word biclustering analysis were used. Articles on dignity care published from 01 Jan 2011 to 31 Dec 2020, were retrieved from PubMed. The extracted Medical Subject Headings (MeSH) terms were quantitatively analysed using Bibliographic Item Co-occurrence Matrix Builder software. To determine the hot spots, a biclustering analysis was completed using gCluto1.0 software. A strategic diagram and a social network analysis (SNA) were used to reveal trends in the theme and knowledge structure. In the parameters of the retrieval strategy, a total of 1977 papers were included in the present study. Amongst all the extracted MeSH terms, 27 high-frequency MeSH terms were identified, and the hot spots were grouped into five categories. These were namely dignity in: (1) dementia care, (2) palliative care, (3) older people care, (4) healthcare and (5) clinical nursing. In the strategic diagram, the study of dignity in clinical nursing was active and should become an emerging field of research in the near future. Based on the co-word biclustering of dignity care over the past 10years, five hot spots were identified, and it was predicted that research on dignity in clinical nursing would be the main trend in future studies. Amongst the five themes it was interesting to note that dignity in dementia and palliative care are core priorities to which scholars should pay more attention. In recent years, dignity-conserving care has been highly valued, however, there are few relevant bibliometric articles that can be referenced on this topic. The present study was considered to offer novel insights into research on dignity in nursing and could be a reliable reference point for researchers when launching new projects.