Support Action Research Articles

The co-design of a digitally supported intervention for selecting implementation tools and actions for standards (SITAS)

BackgroundHealth and social care standards are multi-faceted interventions that promote quality and safe care in health systems. There is a need to apply evidence-based, rigorous and transparent methods when selecting strategies to support the implementation of standards. We aimed to develop an evidence- and theory-informed intervention to guide researchers in identifying appropriate implementation strategies and then selecting tailored support tools and actions for use when implementing a set of standards.MethodsOur intervention is a digital tool entitled ‘Selecting Implementation Tools and Actions for Standards (SITAS).’ The Medical Research Council Framework for Developing and Evaluating Complex Interventions guided the design of SITAS. Co-design of SITAS, using a multi-stage and multi-methods approach included developing programme theory; identifying and prioritising enablers and barriers to implementing standards; identifying the best fit implementation framework using the Theory Comparison and Selection Tool; mapping enablers and barriers to the Consolidated Framework for Implementation Research (CFIR); identifying matching implementation strategies using the CFIR-ERIC (Expert Recommendations for Implementing Change) matching tool; mapping enablers and barriers to the Behaviour Change Wheel (BCW). The enablers and barriers, outputs from the CFIR-ERIC matching tool and the BCW were used to develop a prototype of the content and interactive logic within a digital tool. The prototype was refined following feedback from intended users (n = 7) at three design workshops.ResultsProgramme theory was developed and refined following feedback from intended users of SITAS. Twenty-three enablers and barriers were prioritised. CFIR was identified as the best fit framework with the majority of enablers and barriers (n = 15) mapped to the ‘Inner Setting’ domain. ‘Conduct educational meetings’ was the most common strategy retrieved using the CFIR-ERIC matching tool. ‘Physical opportunity’ was the component of the BCW with the most enablers and barriers (n = 8). A prototype of SITAS was designed in Microsoft Excel based on the aforementioned steps. Workshops with intended users provided key insights about the content, functionality and user experience for SITAS which resulted in refinements to SITAS.ConclusionWe developed a practical intervention enhanced by user involvement. SITAS guides users through the process of selecting and tailoring implementation strategies to specific contexts, using core concepts of implementation science. SITAS will need to undergo formal piloting before spread and scale-up.

The Relationship Between Happiness and Caring Behaviors in Nurses: A Descriptive-Analytical Study

Background: Caring behaviors encompass the supportive actions undertaken by nurses to assist patients, with the primary aim of reducing the duration of illness. Enhanced happiness may positively influence these behaviors, which are essential for nurses in maintaining and promoting patient health. Objectives: This study investigates the factors affecting the happiness of Iranian nurses and examines whether increased happiness correlates with improved caring behaviors. Methods: This descriptive-correlational study employed random sampling to survey 220 nurses in Isfahan, Iran, in 2024. Data were collected through questionnaires evaluating demographics, happiness (measured by the Oxford Happiness Questionnaire-Short Form), and caring behaviors. Data analysis was performed using descriptive statistics, independent t-tests, ANOVA, and Pearson correlation coefficients in SPSS V.23. Results: The Iranian nurses in this study demonstrated above-average happiness (mean score: 34.48 ± 5.82). Happiness showed a significant correlation with caring behaviors (P < 0.05) and was also significantly associated with gender, work experience, and income level. No significant associations were found between happiness and age, marital status, education, employment type, or department (P > 0.05). Conclusions: Higher levels of nurse happiness are associated with improved caring behaviors, suggesting that initiatives aimed at enhancing nurse happiness can lead to better quality of patient care. It is imperative for government and healthcare organizations to prioritize programs and policies that focus on increasing nurse satisfaction to improve healthcare outcomes.

Institutional courage attenuates the association between institutional betrayal and trauma symptoms among campus sexual assault survivors.

When an institution fails to fulfill its obligations to prevent violence from occurring or to respond adequately to violence, it commits institutional betrayal, which can compound a survivor's distress. One proposed strategy to reduce the harm caused by institutional betrayal is institutional courage, which involves supportive and transparent institutional actions that prioritize the needs of institutional members. The objective of the present study is to examine the unique relationships between the theoretical constructs of institutional betrayal, institutional courage, and trauma-related mental health outcomes among campus sexual assault survivors within one university institution. Self-report questionnaire data were collected from a sample of campus sexual assault survivors enrolled at a large, public university in the Pacific Northwest (N = 85). There were no statistically significant bivariate relationships among institutional betrayal, institutional courage, and trauma symptoms. Consistent with hypotheses, institutional courage moderated the relationship between institutional betrayal and trauma symptoms. Institutional betrayal was positively related to trauma symptoms among students who reported low and moderate levels of institutional courage, but institutional betrayal was no longer linked to trauma symptoms among students who reported high levels of institutional courage. This finding suggests that institutional courage may attenuate the negative influence of institutional betrayal. Overall, institutional courage may be a helpful approach to combat the harms of both sexual violence and institutional betrayal. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Visegrad Countries and Africa

The scenario of great international uncertainty and insecurity reconfigures a new and necessary focus on the dynamics between the Visegrad countries and Africa. Through an evolutionary historical perspective and a focus on the complex and delicate contemporary situation, this contribution aims to explore and deepen the type of relations that have been established over the years between the Visegrad countries and Africa. Specifically, the paper considers the policies developed by Visegrad countries with particular attention to three issues: security, resilience, cultural diplomacy, and cooperation. In accordance with these issues, security is a common ground for both Visegrad countries and Africa as the latter geopolitical reality is in different ways affected by political and economic instability that could be adapted through actions of social resilience and support to the communities involved. The aim of this paper is therefore to understand how the issue of resilience is and has been addressed in the relationship between the Visegrad countries and Africa. In this complex framework influenced by the major events of the Covid-19 pandemic and the conflict between Ukraine and Russia, the instruments of cooperation and cultural diplomacy will be considered to better understand the relationship between the Visegrad countries and Africa.

A Study to Evaluate the Effectiveness of Computer-assisted Teaching on Attitudes of Fathers Regarding Toddler-rearing Practices in Selected Tertiary Care Center of Dadra and Nagar Haveli

In India, while women and motherhood have traditionally been emphasized, the role of fathers in child development is gaining recognition. Fathering involves nurturing and supportive actions crucial for a child’s growth. The toddler stage, often referred to as the "Terrible Twos," requires effective parental guidance to foster autonomy and social-emotional regulation. However, many fathers lack adequate attitudes toward toddler-rearing, highlighting the need for structured educational interventions

WebGIS map for smart city development and decision support system: A case study of Dehradun Smart City, Uttarakhand, India

India is one of the countries in the world which has made continuous progress in the technological revolution. The development of Smart Cities has led to a revolution in e-governance and the citizen-centric approach. The Geographical Indicators and Location-based assets can provide quick action and decision-making approaches to City Administrators. All Smart City GIS Layers on a single platform are beneficial for Smart City and Urban Planners and Administrators to find common solutions for retrofitting the environment. The common GIS Layer helps in utility services planning and drainage mapping which allows for the underground laying of all utility pipes and cables. This research is about the mapping of the common GIS Layer of a Smart City of India on a single WebGIS map to its core. The common GIS Layer will help in decision support and quick action redressal in emergency scenarios as well.

Evaluation of a teacher pipeline program: Choosing teacher education based on self-confidence and support

This study evaluated the outcomes of implementing courses and student support actions within a pipeline program in Chile called the Teacher Education Access and Training Program (Spanish acronym PAP). The program's purpose is to attract high school students to teaching careers by offering them academic and support activities. A mixed-methods design was employed. Descriptive and crosstab analysis of students' retention rates revealed that students who graduated from these programs demonstrated higher rates than those accessing teacher education through other admission pathways. Qualitative content analysis of interviewees stated that PAP helped them feel more motivated and confident to enter teacher education.

Does Ovariectomy Affect the Mechanics of the Mandibular Alveolar Bone Structure of Wistar Rats Subjected to Tooth Loss and Modified Diet?-A FEA Study.

The aim of this study was to evaluate the mechanical effect of ovariectomy, diet, and tooth extraction on the bone structure of the mandible of Wistar rats. Mandibles from 40 female Wistar rats were used, divided into rats with ovariectomy surgery or surgical simulation. Half of the rats had the right upper incisor extracted and a soft diet was introduced for half of the animals for 30 days. After euthanasia, microtomography of the mandibles was performed for bone segmentation to construct three-dimensional models. Each mandible was subjected to a three-point bending test. The simulation by finite element method was configured according to the protocol for positioning the part on the support and force action by the load cell defined in the mechanical tests. Stress dissipation was described qualitatively on a color scale distributed in ranges of stress values. All models showed a higher concentration of stresses in the regions of force action and in the support regions, with differences in stress values and locations. Diet and dental condition interfered in the distribution of stresses, with the lateral surface of the mandible being more influenced by diet and the medial surface of the mandible by diet and dental condition.

Pedagogical principles for encouraging (socially just) youth climate action: A schema for citizenship education curriculum analysis

This article synthesizes pedagogical principles for supporting youth climate action from across local (Ontario) and global literature. It also seeks out stories of Indigenous youth engaging in climate action in distinct ways—highlighting examples from Sioux (of Standing Rock) and Inuit youth. The authors propose the Pedagogical Principles for Supporting Climate Action curriculum analysis schema before using it to examine the Ontario citizenship framework. The findings reveal how the curriculum segment in its current form is incongruent with the pedagogical principles of supporting youth climate action. The authors articulate both immediate and urgent curriculum revisions that are necessary for supporting youth in socially just climate action—with a call for immediate revisions that include a shift toward centering Indigenous knowledges, integrating climate justice and upholding relationality to the land and all that it sustains.

Numerical Investigation with Failure Characteristic Analysis and Support Effect Evaluation of Deep-Turning Roadways

In recent years, tunnel-boring machines (TBMs) have been widely applied in deep coal mining. Turning is an inevitable challenge in TBM tunneling, and a TBM turning roadway exhibits greater instability than a straight roadway, as engineering experience has indicated. This study aimed to explore the failure mechanism and evaluate the support performance of a deep-turning roadway. Several numerical models were established to investigate the deformation of the roadway, the stress distribution, and the failure zone of the surrounding rocks under different tunneling conditions. The results show that the tunneling depth influences the failure pattern of the turning roadway: deep tunneling with high in situ stress can cause asymmetric failure of the turning roadway, while shallow tunneling with low in situ stress does not. Moreover, the change in turning radius, namely the change in roadway geometry, does not influence the stability of the turning roadway. In addition, the support actions for both the straight and turning roadways do not differ significantly, and the amount of controlled deformation of the surrounding rocks is proportional to their natural deformation.

Determinant of Rural and Urban Student Performance in Ghana

Despite the large number of remedial students entering tertiary institutions in Ghana, very little empirical research has examined the impact of geographical and socio-economic variables on student performance. This study uses microdata on 360 urban and rural remedial students to examine the differences in educational outcomes between those attending remedial schools in rural areas and those enrolled in urban remedial schools. The study further analyzes the determinants of educational outcomes, with a focus on the relevance of geographical location. The descriptive analysis shows that the academic outcomes of urban remedial students are generally better than those of rural students. In contrast, the results from the student’s t-test indicate a statistically significant difference in the performance of urban and rural remedial students. The determinants of these performances include age, gender, number of papers written, parental education, and, most importantly, the location of the remedial student. From a policy perspective, the findings of this paper support actions aimed at improving educational conditions in rural areas.

The Impact of Exclusion Reasons and Trait Empathy on Third-Party Compensatory Behavior in Vicarious Exclusion

Social exclusion is a widespread phenomenon that not only negatively impacts the individuals directly excluded but also deeply affects bystanders who witness such exclusion. This study aims to investigate how bystanders' levels of trait empathy and their perception of the reasons for exclusion shape their third-party compensatory behaviors. Specifically, we examined whether bystanders with higher empathy levels are more likely to engage in compensatory actions when they perceive the exclusion as unjust. Using a 2x2 between-subjects experimental design, participants were divided into groups based on trait empathy (high vs. low) and the perceived appropriateness of the exclusion (appropriate vs. inappropriate). An online experiment was conducted to simulate social exclusion scenarios, and participants' responses were analyzed to understand how these factors influenced their behavior. The results demonstrated that bystanders with higher trait empathy were significantly more likely to offer compensation when the exclusion was perceived as inappropriate, highlighting the role of empathy in driving supportive actions. Conversely, bystanders with lower empathy showed less variation in their responses, regardless of the exclusion reason. These findings provide new insights into the interaction between personal traits and contextual factors in shaping bystander behavior during social exclusion. This study also offers practical implications for designing interventions aimed at reducing the negative effects of exclusion, promoting empathy, and creating a more inclusive and supportive social environment.

Inclusive Life Projects for people with Serious Mental Disorder and/or addictions

Abstract Project “Inclusive Life Projects” offers comprehensive and community care to people with SMD/A within projects of autonomous living, which provide a concrete and real response to their needs, with the ultimate objective of avoiding the risk of institutionalization. Currently, 26 actions have been designed and are being implemented within JA ImpleMENTAL pilot in five municipalities in the Region of Murcia: Caravaca, Cartagena, Lorca. Molina de Segura and Yecla with a participation of 50 people with SMD/A. The following elements are selected from the Belgian good practice: • Creation of local intersectoral networks promoting person-centered care process; • Personalization of care through the Individualized Care Plan, responding to the needs, and desires of people with SMI/A, activating the appropriate support; • Professional case manager. It generates the well-being of people on an empathy and trust basis and articulates coordination so that the agreed Plan can be developed as planned. A strategic and support coordination tool for action and facilitation of institutional support, the Social and Health Coordination Protocol for people with SMI/A, has been developed. The protocol facilitates the creation of coordination structures, among them the Socio-Health Coordination Base Teams stand out, teams made up of professionals from the different agents involved, multi-professional and intersectoral, (Mental Health, Primary Health Care, Social Services, Social Initiative) taking into account the needs of the person. It also serves to share information, detect training needs, influence resources, etc. PETRA, a computer platform, has been developed for sharing information between the systems involved, especially the health system and the social services system, both primary care, hospital care and specialized care. It allows the exchange of information, in real time, between professionals, the planning of actions, and the design of indicators and control and evaluation processes.

The KMT versus the CCP: Dueling Chinese Nationalisms and the Politics of Colonial Rule During Hong Kong’s 1956 Riots

During October 10–12, 1956, British Hong Kong was engulfed in a downward spiral of violence that pitted Kuomintang (KMT) supporters against men and women affiliated with the Chinese Communist Party (CCP), forcing the People’s Republic of China (PRC), the Republic of China (ROC), and Great Britain to engage in a series of tense diplomatic exchanges that could have escalated into a wider geopolitical conflict. The actions of KMT supporters precipitated the 1956 riots, thereby granting opportunities to the PRC to repeatedly and strongly criticize the colonial government for allegedly failing to protect Chinese who were loyal to Beijing. While the PRC did not intervene militarily to protect its supporters, the 1956 riots revealed to London the precarious nature of colonial rule and underscored the fact that the colony’s very existence was dependent upon the acquiescence of Beijing.

The state-of-the-art and barriers for the adoption of personalised prevention in Europe and beyond

Abstract Personalized prevention is a priority of the European Commission’s research agenda, exemplified by the EU-funded project ‘a PeRsonalised Prevention roadmap for the future HEalThcare’ (PROPHET), a coordination and support action of the International Consortium for Personalized Medicine. It aims to bolster health systems in implementing innovative, sustainable, and high-quality personalized strategies to prevent chronic diseases. In this context, a scoping review was conducted to map personalized preventive approaches (PPA) for chronic diseases and obstacles to their adoption worldwide. The review followed the Arksey-O’Malley guidelines and was conducted from January 2017 to December 2023, on PubMed, Web of Science, Scopus, and grey literature. Eligible studies were primary reports and guidelines, while for the barriers to their adoption we included literature reviews. We included 120 documents on approaches and 34 reviews on barriers. Among the former, 251 PPA were identified: 69% on cancer, 21% on cardiovascular diseases, and 10% on neurological, psychiatric, and metabolic diseases. Furthermore, 27% were on primary prevention, using omic biomarkers to predict disease risk and guide preventive strategies; 27% on secondary prevention, using genomics to guide screening programs; 46% on tertiary prevention, using pharmacogenomics or targeted therapies to prevent disease complications. Among the 34 reviews on barriers, the majority were about the lack of clinical utility evidence and research needs, ethical and legal issues, and limited knowledge among health professionals, citizens, and patients. The majority of the barriers (76%) were referred to primary and secondary prevention, consistent with the low rates of existing approaches in these areas. Ongoing efforts show promise for tailoring prevention strategies, but further research and integration are needed to maximize their potential in improving population health and reducing chronic disease burdens on health systems.

Cybernic robot hand-arm that realizes cooperative work as a new hand-arm for people with a single upper-limb dysfunction.

A robot hand-arm that can perform various tasks with the unaffected arm could ease the daily lives of patients with a single upper-limb dysfunction. A smooth interaction between robot and patient is desirable since their other arm functions normally. If the robot can move in response to the user's intentions and cooperate with the unaffected arm, even without detailed operation, it can effectively assist with daily tasks. This study aims to propose and develop a cybernic robot hand-arm with the following features: 1) input of user intention via bioelectrical signals from the paralyzed arm, the unaffected arm's motion, and voice; 2) autonomous control of support movements; 3) a control system that integrates voluntary and autonomous control by combining 1) and 2) to thus allow smooth work support in cooperation with the unaffected arm, reflecting intention as a part of the body; and 4) a learning function to provide work support across various tasks in daily use. We confirmed the feasibility and usefulness of the proposed system through a pilot study involving three patients. The system learned to support new tasks by working with the user through an operating function that does not require the involvement of the unaffected arm. The system divides the support actions into movement phases and learns the phase-shift conditions from the sensor information about the user's intention. After learning, the system autonomously performs learned support actions through voluntary phase shifts based on input about the user's intention via bioelectrical signals, the unaffected arm's motion, and by voice, enabling smooth collaborative movement with the unaffected arm. Experiments with patients demonstrated that the system could learn and provide smooth work support in cooperation with the unaffected arm to successfully complete tasks they find difficult. Additionally, the questionnaire subjectively confirmed that cooperative work according to the user's intention was achieved and that work time was within a feasible range for daily life. Furthermore, it was observed that participants who used bioelectrical signals from their paralyzed arm perceived the system as part of their body. We thus confirmed the feasibility and usefulness of various cooperative task supports using the proposed method.

From passenger to driver: an interview study on person-centeredness in clinical reasoning during stroke rehabilitation

Purpose To explore how stroke survivors experience and prefer to participate in clinical reasoning processes in the subacute phase of stroke rehabilitation. Methods An explorative qualitative design was used. Individual interviews were conducted with 10 stroke survivors (4 women and 6 men, mean age 68 years) 4 weeks after their stroke, and follow-up interviews were conducted with 6 of them after 10 weeks. The interview settings were the patient’s home during their home rehabilitation, an inpatient and an outpatient rehabilitation unit. A reflexive thematic analysis was performed. Results Four themes were identified: discharge as a critical point for participation, describing a stressful time with varying involvement; supportive actions and context as crucial for participation, describing collaboration with the stroke team, the team’s consideration of the stroke survivor’s resources and needs, and a supportive home environment; the importance of goals and follow-up, describing goals as motivational and an unstructured use of goals; and difficulties in participation, describing a lack of dialogue with the stroke team and undetected resources and needs. Conclusions The stroke survivors experienced changes in their participation in the clinical reasoning process as their rehabilitation progressed. They moved from perceiving themselves as passengers at the time of their hospital discharge to gradually seeing themselves as the driver of their rehabilitation process. Some person-centered attributes, such as respectful relationships and a health focus, were incorporated into the clinical reasoning, while others, such as a holistic view and shared goal-setting, required further emphasis for improved person-centeredness in stroke rehabilitation.

White NIMBYism and diversity close to home

AbstractObjectiveWe use a survey experiment to study what explains white “not in my backyard” opposition (NIMBYism) to dense and affordable housing—racial threat, material self‐interest, or both.MethodsIn a survey experiment on white U.S. respondents, we vary the presence of a racial prime about black and Latinx community organizations and the proximity of the housing development to the subject's home. We then measure levels of support for a proposed hypothetical housing development, willingness to take political action in support of or opposition to the development, and support for a number of housing‐related and redistributive policies.ResultsWe find that a racial threat, a material self‐interest threat, and a combined racial and material self‐interest threat decrease support for a proposed housing development. These effects are moderated by racial resentment, ideology, and partisanship such that the effects of the treatments are primarily driven by Republicans, conservatives, and the highly racially resentful. These groups are more threatened than others by either Latinx and black people moving in, the development being in their own neighborhood, or both.ConclusionThese findings indicate that racial and material perceived threats play important and interlocking roles in white Americans’ resistance to multifamily housing being built. In a context where local political institutions empower an unrepresentative group of disproportionately white, economically privileged neighbors to mount opposition to dense housing, it is important to understand how white opposition to new dense housing is shaped by racial and financial concerns.

Reporting to audiences in crisis: Disruption, criticism and absent hope in TV journalisms’ rendering of the impactful UK energy price rises

How does journalism communicate to audiences who are experiencing crisis? Existing literature suggests that journalists use reporting templates and related practices to report crises with elite narratives and myths (and some ‘disruptive factors’, on occasion). Their news audiences, it follows, are understood as observers of abstracted crisis rather than as those who are experiencing crisis impacts as immediate and affecting. Such thinking becomes challenged by the emerging UK energy crisis. Analysing the corresponding TV journalism shows its reporting responds to several unique disruptive aspects of the crisis (i.e. its ‘seriality’, ‘unpredictability’ and ‘impacts’) rather than reproduce expected myths and authority skew. Additionally, it forms potentially transformative coverage with an included critical commentary on elite inaction and profiteering. Still, omitted at the same time is any relevant explanation and assistance for those audiences affected by the soaring energy costs. The paper argues, subsequently, that this journalism is producing a crisis subjectivity that serves only to reflect back accounts of ‘close suffering’ and uncertainty to audiences, without any sense of hope, support or meaningful action.

Participants in a peer-based nutrition and health program in Zimbabwe value dialogue, peer support, and tangible action: A qualitative exploration of peer group experiences.

Peer support groups are implemented globally, and viewed as cost-effective, scalable platforms for delivering health and nutrition programming. Quality is important for participation and achieving social and behavior change goals. Little research has explored the perspectives of peer group participants on quality. This manuscript describes community-based implementation research, and associated findings, which was conducted to learn how participants of a nutrition and health program define quality peer groups and how they suggest improving peer groups. In-depth interviews on experiences, benefits, and challenges were conducted with participants of health and nutrition peer groups, including group members (n = 64) and facilitators (n = 30), in three districts in Zimbabwe. Qualitative data were analyzed thematically and preliminary results were presented in six follow-up focus group discussions with interviewees to provide input on results and interpretation. Peer groups met some of participants' needs for knowledge, social support, and visible improvements in their lives and homes. Participants described generally positive experiences that sustained participation and motivated behavior change. They highlighted group dynamics, interactive facilitation, and community recognition which support the credibility and motivation of group facilitators. Implementation could be improved by strengthening family engagement and more hands-on learning for encouraging participation. Local adaptation of group activities can address influences on behavior change and increase relevance to participants' needs. The perspectives of core stakeholders are essential to understand what aspects of peer groups are most important to implement the approach with quality across contexts. Implementation research and continued monitoring to understand participant perspectives should be an integral part of all programs to ensure the application of adult learning principles and an appropriate balance between fidelity and adaptation for local relevance and engagement.