The European Grief Conference, Copenhagen 2022: An effort to unite the field of bereavement care in Europe.

Bereavement care in Europe varies in quality and availability. Through greater collaboration across Europe, there could potentially be an opportunity to improve care. This article discusses the inaugural European Grief Conference held in Denmark in 2022: "Bereavement and Grief in Europe - Emerging Perspectives & Collaborations". The conference was structured around a 4-tiered public health model of bereavement care needs. It included practice, research, policy, and educational perspectives. A total of 250 people from 27 different countries participated. To determine if the conference had appealed to a broad European audience of grief professionals and to assess how the conference was received by participants, we examined registration/submission data, the results of a one-word real-time feedback exercise, and the answers to an online satisfaction survey. The results indicated wide interest in greater information sharing and collaboration across Europe among bereavement care, research, and education professionals.

'Getting control of Corona takes many angles': COVID-19 vaccine knowledge, attitudes and beliefs among refugee/immigrant/migrant communities in four US cities.

The objectives of the study were to (i) document refugee, immigrant and migrant (RIM) communities' knowledge, attitudes and beliefs (KABs) related to the Coronavirus disease (COVID-19) vaccine and (ii) identify best practices for developing and disseminating culturally and linguistically responsive health messaging addressing those KABs. Thirteen online focus groups (OFGs) in 10 languages were conducted. Each OFG was conducted in the participants' native language. OFGs were recorded, transcribed, translated and uploaded to qualitative software for coding. A thematic analysis was conducted. Results suggest that while there was some variation between different language groups (e.g. whether religious leaders were seen as trusted sources of information about COVID), there were also important commonalities. Most language groups (i) alluded to hearing about or having gaps in knowledge about COVID-19/the COVID-19 vaccine, (ii) reported hearing negative or conflicting stories about the vaccine and (iii) shared concerns about the negative side effects of the vaccine. There continues to be a need for health messaging in RIM communities that is culturally and linguistically concordant and follows health literacy guidelines. Message content about the COVID-19 vaccine should focus on vaccine importance, effectiveness and safety, should be multimodal and should be primarily delivered by healthcare professionals and community members who have already been vaccinated.

Risk factors for prolonged grief symptoms: A systematic review and meta-analysis.

BACKGROUND: The diagnosis Prolonged Grief Disorder (PGD) has recently been included in ICD-11 and DSM-5-TR. To identify individuals who need help coping with grief, knowledge is needed about who is at risk of developing PGD. We, therefore, conducted a comprehensive systematic review and meta-analysis of the available literature on risk factors for prolonged grief symptoms (PGS). METHODS: Based on a literature search in PsycInfo, PubMed, Web of Science, and CINAHL, we included the most frequently investigated risk factors in a meta-analysis. The effect size correlation was used as the standardized measure of the strength of the association between the risk factor and PGS. RESULTS: Based on 120 studies of 61.580 participants published between 1989 and 2023, 19 risk factors were included in the meta-analysis. For the adjusted associations, the strongest associations with PGS were pre-loss grief symptoms (ESr = 0.39, 95%CI[0.24-0.53]) and depression (ESr = 0.30, 95%CI[0.13-0.44]). Small, but statistically significant associations were observed for unexpected death, violent/unnatural death, low educational level, low income, female gender, anxious attachment style, and death of a child or partner. CONCLUSIONS: An updated overview of risk factors for PGS is presented, including their predictive strength. The results offer knowledge that can aid prevention and early identification of people at risk of PGD.

Radiography students' viewpoints of the clinical learning environment: A cross-sectional study.

INTRODUCTION: The quality of clinical learning environments (CLEs) impact learners' experience and competence development. Objective instruments have been developed to evaluate CLEs from the perspective of medical and nursing students. No such instruments have been used in Radiography. METHODS: Radiography students' perspectives of CLEs were investigated using the validated Undergraduate Clinical Education Environment Measure (UCEEM). Undergraduate (UG) (n = 365) and graduate entry (GE) radiography students (n = 45) from an Irish university were invited to participate. CLEs consisted of 25 public and 10 private hospitals. The UCEEM contains 26 items under two overarching dimensions, experiential learning and social participation, with four subscales: opportunities to learn in and through work and quality of supervision; preparedness for student entry; workplace interaction patterns and student inclusion; and equal treatment. RESULTS: Two hundred and ten students participated (response rate 52.4%; n = 185 UG, n = 30 GE), most of whom were based in public hospitals (87.4%). The mean UCEEM score was 107.5 ± 17.7 (optimal range: 90-125). Experiential learning and social participation were scored 74.2 ± 12.5 (optimal range: 60-85) and 33.37 ± 6.29 (optimal range: 30-40), respectively. Private hospitals ranked slightly higher than public hospitals for 'opportunities to learn in and through work and quality of supervision' (p = 0.018). Items ranked highest related to 'equal treatment' and 'opportunity to put theory into practice'. Clinical supervision-related items were scored highest by first-year students. CONCLUSION: High UCEEM scores indicate radiography students' positive perceptions of their CLEs, particularly regarding equality and experiential learning. Findings support the expansion of radiography placement to include public and private hospitals. IMPLICATIONS FOR PRACTICE: The UCEEM is a theoretically robust, validated tool which appears suitable for evaluating radiography CLEs. This study provides valuable baseline data for comparison of Radiography CLEs.

Operationalization, implications and correlates of the cultural deviance criterion for ICD-11 and DSM-5 prolonged grief disorder.

Prolonged Grief Disorder (PGD) is included in ICD-11 and DSM-5-TR and includes a requirement of cultural deviance. This study examined endorsement rates and factors associated with endorsement of this criterion among Danish bereaved spouses (n = 425) and their adult children (n = 159) four years post-loss. In total, 7.5% (n = 44) participants endorsed this criterion. Both including and excluding the criterion, the prevalence rates for probable DSM-5-TR PGD were 1.4% (n = 8) and 1.7% (n = 10), respectively and for probable ICD-11 PGD were 1.4% (n = 8) and 2.2% (n = 13), respectively. Age and gender of the deceased, age of the bereaved, greater grief severity, and comorbid psychopathology were positively associated with endorsement of the criterion. Findings demonstrate low endorsement of the cultural deviation criterion, that its inclusion excludes several potential PGD cases, and unanticipated associations with several factors raise questions about the criterion's validity.

Radiographers' experiences and educational needs in relation to caring for suicidal patients during radiology examinations.

INTRODUCTION: Researchers have explored the experiences, attitudes, and educational needs of several healthcare professional groups in relation to caring for suicidal patients. However, radiographers have not been included in these studies. Radiographers are likely to encounter these patients when they present for diagnostic imaging following suicide attempts. METHODS: An online questionnaire exploring radiographers' experiences and educational needs in caring for suicidal patients was circulated to radiographers working in 23 acute hospitals across Ireland and posted to a Facebook page targeting Irish-based radiographers. Closed-ended questions were used to capture respondents' demographics and five-point Likert scale questions to establish their confidence levels in imaging suicidal patients. Open-ended questions were used to explore their experiences and educational needs. Quantitative data was analysed using descriptives statistics, and qualitative data thematically analysed. RESULTS: One hundred and four radiographers responded to the questionnaire, 96% of whom had imaged suicidal patients. Radiographers were confident in justifying and optimising these radiographic examinations, however, less confident in communicating with and caring for these patients. Radiographers reported insufficient patient history on imaging referrals and challenges in communicating with suicidal patients, which many attributed to lack of training. Radiographers expressed interest in further education related to caring for patients who've attempted suicide, which they felt should include an introduction to psychiatry, strategies for communicating with suicidal patients and building resilience. CONCLUSION: Radiographers' experiences of imaging suicidal patients have been reported along with several challenges which could be addressed through further education. IMPLICATIONS FOR PRACTICE: Further education in caring for suicidal patients should be offered to radiographers which aligns with their educational needs. Referring clinicians should be reminded of the importance of informing radiographers of patients' suicide attempt when referring them for diagnostic imaging.

Radiographers' organisational commitment and occupational stress: First Covid-19 wave.

INTRODUCTION: Radiographers, like many health professionals, are in a high-risk group for succumbing to workplace demands beyond their ability to cope, particularly in the context of the COVID-19 pandemic resulting in occupational stress. Occupational stress has been linked to poor organisational commitment. Therefore, the purpose of this research was to evaluate radiographers' organisational commitment and occupational stress after the first wave of the COVID-19 pandemic. METHODS: A mixed method approach entailed data collected from purposively sampled Australian radiographers working during the first COVID-19 wave. The quantitative phase used an online commitment questionnaire, and 21 semi-structured individual virtual interviews were conducted in the qualitative phase. Data interpretation and analysis used statistical and thematic approaches. RESULTS: The quantitative data revealed a higher level of continuance than affective and normative commitment. Whereas the qualitative findings showed participants high levels of affective commitment to their occupation and, together with leadership support, working collectively towards a positive outcome. CONCLUSION: Despite the variety of occupational stressors that arose during the COVID-19 crisis, Australian radiographers enjoy a high level of occupational and organisational commitment. IMPLICATIONS FOR PRACTICE: Radiographers' organisational commitment represents their emotional and psychological attachment to their workplace, and radiographers experiencing occupational stress represent high levels of psychosomatic distress and burnout. Therefore, considering radiographers' organisational commitment and occupational stress is essential in the delivery of services, quality of patient care and radiographers well-being.

An investigation into academic career pathways across Radiography education centres internationally.

INTRODUCTION: Robust academic pathways are critical to support of radiography faculty within third level education. As the profession of Radiography grows its' research activity, it is important that academic opportunities meet the needs of the profession. The purpose of this research was to investigate current academic career pathways across radiography education centres internationally. METHODS: An online survey was developed and administered to radiography academics and clinical/academic staff members internationally. The survey questions (n = 28) include demographic data; teaching and research requirements; academic promotion criteria; identification of the challenges and benefits of being an academic, including equality, diversity and inclusion (EDI) matters. RESULTS: A total of 175 responses were obtained (6 continents and 39 countries), with a variety of experience levels amongst academics that primarily held permanent work contracts. Regarding the highest qualifications held, 31.4% (n = 55) had a Doctorate and 45.7% (n = 80) a Master's degree, and most respondents were employed as academic lecturers (40.6%; n = 71), with 17.7% (n = 31) employed at professorial level. The minimum time requirement to achieve a permanent contract was variable, ranging from no delay (5.7%; n = 10) to more than 10 years (12.6%; n = 22). Doctorate qualification is currently not necessary in order to career progression for 126 (72%) respondents, while 52% (n = 91) provided specific research requirements. 106 (60.6%) respondents indicated that their institution has EDI policy. CONCLUSION: This study has captured details related to academic pathways across international radiography education centres. Whilst some heterogeneity exists, there are numerous differences impacting standardised academic career opportunities for Radiography academics. These may challenge academic career opportunities and discourage those interested in an academic career. IMPLICATIONS FOR PRACTICE: The profile and educational background of these academics has been highlighted as well as the perceived barriers and advantages of a career in academic.

Grief is a family affair: examining longitudinal associations between prolonged grief in parents and their adult children using four-wave cross-lagged panel models.

BACKGROUND: Losing a parent or spouse in adulthood may result in prolonged grief disorder (PGD) symptoms. PGD levels in parents may affect PGD levels in their adult offspring and the other way around. However, research on transmission of PGD in parent-child dyads is lacking. Consequently, we aimed to examine temporal associations between PGD levels in parent and adult children. METHODS: In doing so, we analyzed longitudinal self-report data on PGD levels (using the PG-13) assessed at 2, 11, 18, and 26 months after loss in 257 adult parent-child dyads from Denmark. Cross-lagged panel modeling was used for data-analyses. RESULTS: Changes in PGD levels in parents significantly predicted PGD levels in adult children, but not vice versa. Small through moderate cross-lagged effects (ß = 0.05 through 0.07) were found for PGD levels in parents predicting PGD levels in adult children at a subsequent time-point. These cross-lagged effects were found while taking into account the association between PGD levels in parents and adult children at the same time-point as well as the associations between the same construct over time and relevant covariates. CONCLUSIONS: Pending replication of these findings in clinical samples and younger families, our findings offer tentative support for expanding our focus in research and treatment of PGD from the individual to the family level.

Student perceptions of the use of three-dimensional (3-D) virtual reality (VR) simulation in the delivery of radiation protection training for radiography and medical students.

BACKGROUND: VR simulation-based learning is increasingly used in healthcare education to prepare students for clinical practice. This study investigates healthcare students' experience of learning radiation safety in a simulated interventional radiology (IR) suite. METHOD: Radiography students (n = 35) and medical students (n = 100) were introduced to 3D VR radiation dosimetry software designed to improve the learners' understanding of radiation safety in IR. Radiography students underwent formal VR training and assessment, which was complemented with clinical placement. Medical students practiced similar 3D VR activities informally without assessment. An online questionnaire containing Likert questions and open-ended questions was used to gather student feedback on the perceived value of VR-based radiation safety education. Descriptive statistics and Mann-Whitney U tests were used to analyse Likert-questions. Open-ended question responses were thematically analysed. RESULTS: A survey response rate of 49% (n = 49) and 77% (n = 27) was obtained from radiography and medical students respectively. Most respondents (80%) enjoyed their 3D VR learning experience, favouring the in-person VR experience to online VR. 73% felt that VR learning enhanced their confidence across all relevant learning outcomes. Whilst confidence was enhanced across both cohorts, VR learning had a greater impact on confidence levels amongst medical students with respect to their understanding of radiation safety matters (U = 375.5, p < 0.01). 3D VR was deemed a valuable assessment tool. CONCLUSION: Radiation dosimetry simulation-based learning in the 3D VR IR suite is perceived to be a valuable pedagogical tool by radiography and medical students and enhances curricula content.

Recruitment and retention of radiography clinical practice educators.

INTRODUCTION: Clinical Practice Educators (CPEs) play a vital role in radiography education, fostering the development of students' clinical competence and creating positive learning experiences. In recent years, there has been a high turnover and difficulties recruiting radiography CPEs in Ireland. This is the first study to explore issues surrounding recruitment and retention of radiography CPEs. METHOD: A cross-sectional, mixed-method study was conducted to gain a better understanding of the issues surrounding recruitment and retention of radiography CPEs. Current and former CPEs affiliated with undergraduate radiography training in Ireland were recruited. CPEs completed an online questionnaire detailing demographics and career background. Online semi-structured focus groups were conducted with current CPEs and interviews with former CPEs. RESULTS: Nineteen current CPEs completed the questionnaire and participated in focus groups (95% response rate). Ten CPEs who had resigned within the last five years were interviewed. The main motivators for CPEs were an interest in teaching, inspiration from role models, personal learning goals and the appeal of part-time employment. Job satisfaction was influenced by efficacy in the role, professional growth, autonomy, and relationships with stakeholders. The main disincentives were the CPE grade not being commensurate with work involved, lack of protected time and lack of support from colleagues. A variety of reasons for resignation were provided, many of which related to grading of the CPE post and lack of career progression opportunities in the role. CONCLUSION: The findings outline the key motivators for radiography CPEs and disincentives relative to recruitment and retention of radiography CPEs in Ireland. IMPLICATIONS FOR PRACTICE: By understanding the disincentives relative to CPE recruitment and retention, along with the motivators, employers can devise initiatives that reduce turnover and increase CPE retention.

Clinical portfolios as a tool to develop competence in radiography education.

INTRODUCTION: Clinical portfolios are used in healthcare programmes to prepare students for their professional careers by promoting reflective practice and critical thinking. There is a paucity of research related to students' and educators' perceptions of the effectiveness of clinical portfolios in radiography education. METHODS: A cross-sectional, questionnaire-based study was conducted to explore radiography students' and educators' opinions on the contribution of portfolios to students' personal and professional development. Optimal portfolio content and administration was investigated. Questionnaires were distributed to a stratified sample of second-, third- and fourth-year undergraduate radiography students and recent graduates from a 4-year BSc Radiography program in Ireland. A second questionnaire was sent to academic staff involved in clinical education. Participation was on a voluntary basis and data anonymous. RESULTS: Sixty participants provided the student perspective and seven provided the educator perspective. All educators and most radiography students (58-83%) agreed that the portfolio contributed effectively to personal and professional development. Tutor feedback and competency assessments were ranked the most valuable elements of the portfolio by both students and educators. The remainder content ranked from most to least beneficial were; image appraisal assignments, self-reflection, training needs analysis and modality objective lists. Final-year students and new graduates valued self-reflections more than novice students. Online portfolio administration was preferred over paper administration (5:3) due to greater efficiency, accessibility, and interactivity. CONCLUSION: The clinical portfolio was perceived to be an effective tool for developing competence in radiography education. Study findings may be used to optimise radiography clinical portfolio design and administration. IMPLICATIONS FOR PRACTICE: This study is the first to highlight elements of a clinical portfolio deemed most effective in competence development from the perspective of radiography students and educators.

A qualitative analysis of radiography students' reflective essays regarding their experience of clinical placement during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic significantly impacted healthcare services and clinical placement for healthcare students. There is a paucity of qualitative research into radiography students' experiences of clinical placement during the pandemic. METHOD: Students in stages three and four of a 4-year BSc Radiography degree in Ireland wrote reflective essays regarding their experience of clinical placement during the COVID-19 healthcare crisis. Permission was granted by 108 radiography students and recent graduates for their reflections to be analysed as part of this study. A thematic approach to data analysis was used, allowing themes to emerge from the reflective essays. Two researchers independently coded each reflective essay using the Braun and Clarke model. RESULTS: Four themes were highlighted; 1) Challenges associated with undertaking clinical placement during the pandemic, such as reduced patient throughput and PPE-related communication barriers; 2) Benefits of clinical placement during the pandemic, in terms of personal and professional development and completing degree requirements to graduate without delay; 3) Emotional impact and 4) Supporting students in clinical practice. Students recognised their resilience and felt proud of their contribution during this healthcare crisis but feared transmitting COVID-19 to family. Educational and emotional support provided by tutors, clinical staff and the university was deemed essential by students during this placement. CONCLUSIONS: Despite the pressure hospitals were under during the pandemic, students had positive clinical placement experiences and perceived these experiences to have contributed to their professional and personal growth. IMPLICATIONS FOR PRACTICE: This study supports the argument for clinical placements to continue throughout healthcare crisis periods, albeit with additional learning and emotional support in place. Clinical placement experiences during the pandemic prompted a deep sense of pride amongst radiography students in their profession and contributed to the development of professional identity.

Supporting radiography clinical placements in Ireland during the COVID-19 pandemic: The practice educators perspective.

INTRODUCTION: The COVID-19 pandemic has significantly impacted healthcare services and the clinical learning environment. Several studies have investigated radiography students' experiences of clinical placement during the pandemic; however, few have investigated the Clinical Practice Educator's (CPEs) perspective. CPEs play a pivotal role in supporting clinical education. METHOD: A qualitative study was conducted using a purposeful sample of twenty-two CPEs, each working in a different Irish hospital. Four semi-structured focus groups were used to gather data. To maintain reasonable homogeneity, CPEs who were new to the role (n = 8) were assigned a separate focus group from experienced CPEs (n = 14). Inductive thematic analysis was applied. RESULTS: CPEs experienced role expansion, particularly in managerial and administrative aspects of the role. They described arranging COVID-19 vaccinations locally for radiography students and the complexities of student rostering during the pandemic. CPEs perceived the pandemic to have impacted students' emotional wellbeing with 'high anxiety levels' and 'loneliness' being reported. They also perceived issues with clinical readiness and the student transition to clinical practice. Many challenges were faced by CPEs including arranging clinical recovery time for numerous students when sites were already at full capacity, fewer learning opportunities due to decreased patient throughput and range of imaging examinations, social distancing constraints, resistance from staff to student placements, and a shortage of staff for student supervision. Flexibility, communication, and multi-level support helped CPEs to fulfil their role. CONCLUSION: The results provide insight into how CPEs supported radiography clinical placements during the pandemic and into the challenges faced by CPEs in their role. CPEs supported student placement through multi-level communication, teamwork, flexibility, and student advocacy. IMPLICATIONS FOR PRACTICE: This will aid understanding of the support mechanisms needed by CPEs to provide quality clinical placements.

Research recruitment through the patient portal: perspectives of community focus groups in Seattle and Atlanta.

Objective: Research recruitment through patient portals (ie, patient-facing, web-based clinical interfaces) has the potential to be effective, efficient, and inclusive, but best practices remain undefined. We sought to better understand how patients view this recruitment approach. Materials and Methods: We conducted 6 focus groups in Atlanta, GA and Seattle, WA with members of patient advisory committees and the general public. Discussions addressed acceptability of patient portal recruitment and communication preferences. Focus groups were audio-recorded, transcribed, and analyzed using deductive and inductive codes. Iterative team discussions identified major themes. Results: Of 49 total participants, 20 were patient advisory committee members. Participants' mean age was 49 (range 18-74); 59% identified as non-Hispanic White and 31% as Black/African American. Participants were supportive of patient portal recruitment and confident that messages were private and legitimate. Participants identified transparency and patient control over whether and how to participate as essential features. Concerns included the frequency of research messages and the ability to distinguish between research and clinical messages. Participants also discussed how patient portal recruitment might affect diversity and inclusion. Discussion: Focus group participants generally found patient portal recruitment acceptable and perceived it as secure and trustworthy. Transparency, control, and attention to inclusiveness were identified as key considerations for developing best practices. Conclusion: For institutions implementing patient portal recruitment programs, continued engagement with patient populations can help facilitate translation of these findings into best practices and ensure that implemented strategies accomplish intended goals.

School Nurses' Diabetes-Related Attitudes and Self-efficacy in Diabetes Education and Management.

This study explored relationships between school nurses' diabetes-related attitudes, self-efficacy in diabetes management and education, and care practices. One-hundred fourteen school nurses who have taken care of students with type 1 diabetes in public schools comprised this descriptive study sample. Participants completed online surveys. School nurses' diabetes-related attitudes were not related to their self-efficacy in diabetes education, but nurses' attitudes towards the psychosocial impact of diabetes were significantly related to their self-efficacy in diabetes management, and the number of students with diabetes was a significant contributor to this relationship. Nurses' full-time status and the type of school they worked in were significantly related to their self-efficacy in providing diabetes education. School nurses' positive attitudes about providing care for students with diabetes were related to having a higher level of self-efficacy in providing diabetes management. Based on the findings, recommendations are made for health consolidated schools and full-time school nurses.

An exploration of gender and prolonged grief symptoms using network analysis.

BACKGROUND: Gender has been proposed as a potentially important predictor of bereavement outcomes. The majority of research in the field has explored this issue by examining gender differences in global grief severity. Findings have been mixed. In this study, we explore potential gender differences in grief using network analysis. This approach examines how individual symptoms relate to and reinforce each other, and so offers potential to shed light on novel aspects of grief expression across genders. METHOD: Graphical lasso networks were constructed using self-report data from 839 spousally bereaved older participants (584 female, 255 male) collected at 2- and 11- months post-bereavement. Edge strength, node strength and global network strength were compared to identify similarities and differences between gender networks across time. RESULTS: At both time points, the strongest connection for both genders was from yearning to pangs of grief. Yearning, pangs of grief, acceptance, bitterness and shock were prominent nodes at time 1. Numbness and meaninglessness emerged as prominent nodes at time 2. Males and females differed in the relative importance of shock at time 1, and the female network had greater overall strength than the male network at time 2. CONCLUSIONS: This study identified many similarities and few differences in the relationships between prolonged grief symptoms for males and females. Findings suggest that future studies should examine alternate sources of variation in grief outcomes. Limitations are discussed.