The semiconscious choice of food as a potential obesogenity marker

The semiconscious choice of unhealthy foods is investigated to provide a transferable branding-like method to quantify obesogenity in terms of consumers’ propensities to habituation. Some triggers of unhealthy food consumption and all the food choices associated to such cues were found as statistically independent from consumers’ motivations, particularly for two-thirds of consumers

Wicked problems in a post-truth political economy: a dilemma for knowledge translation

The discipline of knowledge translation (KT) emerged as a way of systematically understanding and addressing the challenges of applying health and medical research in practice. In light of ongoing and emerging critique of KT from the medical humanities and social sciences disciplines, KT researchers have become increasingly aware of the complexity of the translational process, particularly the significance of culture, tradition and values in how scientific evidence is understood and received, and thus increasingly receptive to pluralistic notions of knowledge. Hence, there is now an emerging view of KT as a highly complex, dynamic, and integrated sociological phenomenon, which neither assumes nor creates knowledge hierarchies and neither prescribes nor privileges scientific evidence. Such a view, however, does not guarantee that scientific evidence will be applied in practice and thus poses a significant dilemma for KT regarding its status as a scientific and practice-oriented discipline, particularly within the current sociopolitical climate. Therefore, in response to the ongoing and emerging critique of KT, we argue that KT must provide scope for relevant scientific evidence to occupy an appropriate position of epistemic primacy in public discourse. Such a view is not intended to uphold the privileged status of science nor affirm the “scientific logos” per se. It is proffered as a counterbalance to powerful social, cultural, political and market forces that are able to challenge scientific evidence and promote disinformation to the detriment of democratic outcomes and the public good

Health System Enablers and Barriers to Continuity of Care for First Nations Peoples Living with Chronic Disease

Introduction: Failings in providing continuity of care following an acute event for a chronic disease contribute to care inequities for First Nations Peoples in Australia, Canada, and Aotearoa (New Zealand). Methods: A rapid narrative review, including primary studies published in English from Medline, Embase, PsycINFO, and Cochrane Central, concerning chronic diseases (cancer, cardiovascular disease, chronic kidney disease, diabetes, and related complications), was conducted. Barriers and enablers to continuity of care for First Nations Peoples were explored considering an empirical lens from the World Health Organization framework on integrated person-centred health services. Results: Barriers included a need for more community initiatives, health and social care networks, and coaching and peer support. Enabling strategies included care adapted to patients’ cultural beliefs and behavioural, personal, and family influences; continued and trusting relationships among providers, patients, and caregivers; and provision of flexible, consistent, adaptable care along the continuum. Discussion: The support and co-creation of care solutions must be a dialogical participatory process adapted to each community. Conclusions: Health and social care should be harmonised with First Nations Peoples’ cultural beliefs and family influences. Sustainable strategies require a co-design commitment for well-funded flexible care plans considering coaching and peer support across the lifespan

The integrated and adaptable dynamics of the Caring Life Course Theory and its constructs

The integrated and adaptable dynamics of the Caring Life Course Theory and its constructsThe Caring Life Course Theory (CLCT) is an emerging interdisciplinary approach to understanding caring and self-care throughout a person's life course.[1] It proposes 14 theoretical constructs that work together in an integrated and adaptable way based on a person's context, health status, and circumstances (shown in Figure 1).[2-8] In this theory, ‘Fundamental Care’ is an essential construct, which refers to the care required by all people for health, development, well-being, welfare, and survival (illustrated in detail in Figure 2).[1, 9, 10] The CLCT examines care needs and provision over time, emphasising the combination of ‘self-care’ and ‘care networks’ as the support needed to meet a person's holistic care requirements in a coordinated way. Such networks involve formal and informal carers via natural or technological means, all crucial in addressing the evolving aspects of ‘Fundamental Care’ and the interplay of its elements across time (Figure 2).[1-8, 10]References[1] Kitson A, Feo R, Lawless M, Arciuli J, Clark R, Golley R, Lange B, Ratcliffe J and Robinson S 2022 Towards a unifying caring life‐course theory for better self‐care and caring solutions: A discussion paper Journal of Advanced Nursing 78 e6-e20[2] Barbabella F, Melchiorre M G, Quattrini S, Papa R, Lamura G, Richardson E and van Ginneken E 2017 How can eHealth improve care for people with multimorbidity in Europe?: World Health Organization, Regional Office for Europe Copenhagen)[3] Pinero De Plaza MA, Beleigoli A, Mudd A, Tieu M, McMillan P, Lawless M, Feo R, Archibald M, Kitson A. Not Well Enough to Attend Appointments: Telehealth Versus Health Marginalisation. InHealthier Lives, Digitally Enabled 2021 (pp. 72-79). IOS Press. doi:10.3233/SHTI210013[4] Pinero de Plaza M A, Beleigoli A, Brown S, Bulto L N, Gebremichael L G, Nesbitt K, Tieu M, Pearson V, Noonan S, McMillan P, Clark R A, Hines S, Kitson A, Champion S, Dafny H and Hendriks J M 2022 Effectiveness of telehealth versus standard care on health care utilization, health-related quality of life, and well-being in homebound populations: a systematic review protocol JBI Evid Synth 20 2734-42[5] Pinero De Plaza MA, Conroy T, Mudd A, Kitson A. Using a Complex Network Methodology to Track, Evaluate, and Transform Fundamental Care. Stud Health Technol Inform. 2021 Dec 15;284:31-35. doi: 10.3233/SHTI210656. PMID: 34920462.[6] WHO 2018 Continuity and coordination of care: a practice brief to support implementation of the WHO Framework on integrated people-centred health services[7] Pinero de Plaza M A 2023 The network of interactions between the elements of the fundamentals of care framework across the life course. figshare.[8] Pinero de Plaza M A, Yadav L and Kitson A 2023 Co-designing, measuring, and optimizing innovations and solutions within complex adaptive health systems Frontiers in Health Services 3. https://doi.org/10.3389/frhs.2023.1154614[9] Feo R, Conroy T, Jangland E, Muntlin Athlin Å, Brovall M, Parr J, Blomberg K and Kitson A 2018 Towards a standardised definition for fundamental care: A modified Delphi study Journal of clinical nursing 27 2285-99[10] Lawless M T, Tieu M, Golley R. and Kitson A. 2023 How and where does “care” fit within seminal life‐course approaches? A narrative review and critical analysis Journal of Advanced Nursing A.</p

Measuring fundamental care using complexity science: A descriptive case study of a methodological innovation.

This paper presents an exploratory account of an innovative methodology to record and evaluate fundamental care. Fundamental care is defined as the care required by everyone for survival, health and welfare. Fundamental care has been informed by the development and testing of the Fundamentals of Care Framework, which describes how fundamental care is complex and multidimensional, and consists of three interrelated dimensions and 38 elements. This accords with a broader re-examination of care provision as part of a complex adaptive system in which existing linear models of cause and effect are inadequate to describe the totality of activity. Informed by graph theory and complexity science, this paper presents a novel methodological innovation. It uses the Fundamentals of Care Framework to create a Matrix to quantify the relationships between different elements within the Framework. We use a Matrix methodology to process care recipient narratives to generate three outputs: a heat map, a summary table and a network analysis. The three outputs serve to quantify and evaluate fundamental care in a multidimensional manner. They capture different perspectives (care recipients and their families, direct care providers and care managers) to improve care outcomes. The future aim is to advance this exploration into digitalising and operationalising the Matrix in a user-friendly manner for it to become a real-time mechanism to evaluate and potentially predict patterns of fundamental care

My Wellbeing Journal: Development of a communication and goal‐setting tool to improve care for older adults with chronic conditions and multimorbidity

Abstract Background Chronic conditions and multimorbidity, the presence of two or more chronic conditions, are increasingly common in older adults. Effective management of chronic conditions and multimorbidity in older adults requires a collaborative and person‐centred approach that considers the individual's goals, preferences and priorities. However, ensuring high‐quality personalised care for older adults with multimorbidity can be challenging due to the complexity of their care needs, limited time and a lack of patient preparation to discuss their personal goals and preferences with their healthcare team. Objective To codesign a communication and goal‐setting tool, My Wellbeing Journal, to support personalised care planning for older adults with chronic conditions and multimorbidity. Design We drew on an experience‐based codesign approach to develop My Wellbeing Journal. This article reports on the final end‐user feedback, which was collected via an online survey with older adults and their carers. Setting and Participants Older adults with chronic conditions, multimorbidity and informal carers living in Australia. Personalised care planning was considered in the context of primary care. Results A total of 88 participants completed the online survey. The survey focused on participants' feedback on the tool in terms of effectiveness, efficiency, satisfaction and errors encountered. This feedback resulted in modifications to My Wellbeing Journal, which can be used during clinical encounters to facilitate communication, goal setting and progress tracking. Discussion and Conclusions Clinicians and carers can use the tool to guide discussions with older adults about their care planning and help them set realistic goals that are meaningful to them. The findings of this study could be used to inform the development of recommendations for healthcare providers to implement person‐centred, goal‐oriented care for older adults with chronic conditions and multimorbidity. Patient or Public Contribution Older adults living with chronic conditions and multimorbidity and their carers have contributed to the development of a tool that has the potential to significantly enhance the experience of personalised care planning. Their direct involvement as collaborators has ensured that the tool is optimised to meet the standards of effectiveness and usability

Care biography: A concept analysis

In this article, we investigate how the concept of Care Biography and related concepts are understood and operationalised and describe how it can be applied to advancing our understanding and practice of holistic and person-centred care. Walker and Avant's eight-step concept analysis method was conducted involving multiple database searches, with potential or actual applications of Care Biography identified based on multiple discussions among all authors. Our findings demonstrate Care Biography to be a novel overarching concept derived from the conjunction of multiple other concepts and applicable across multiple care settings. Concepts related to Care Biography exist but were more narrowly defined and mainly applied in intensive care, aged care, and palliative care settings. They are associated with the themes of Meaningfulness and Existential Coping, Empathy and Understanding, Promoting Positive Relationships, Social and Cultural Contexts, and Self-Care, which we used to inform and refine our concept analysis of Care Biography. In Conclusion, the concept of Care Biography, can provide a deeper understanding of a person and their care needs, facilitate integrated and personalised care, empower people to be in control of their care throughout their life, and help promote ethical standards of care

Supplemental Material - From Promise to Practice: How Health Researchers Understand and Promote Transdisciplinary Collaboration

Supplemental Material for From Promise to Practice: How Health Researchers Understand and Promote Transdisciplinary Collaboration by Michael T. Lawless, Matthew Tieu, Mandy M. Archibald, Maria Alejandra Pinero De Plaza, and Alison L. Kitson in Qualitative Health Research</p

The Caring Life Course Theory: Opening new frontiers in care—A cardiac rehabilitation example

Aim(s): To operationalize the Caring Life Course Theory (CLCT) as a framework for improving cardiac rehabilitation (CR) engagement and informing ways to address dis- parities in rural, low socio-economic areas. Methods: A secondary analysis of data collected from 15 CR programmes to identify CR patterns through the CLCT lens using a mixed-methods approach. All analytical processes were conducted in NVivo, coding qualitative data through thematic analy- sis based on CLCT constructs. Relationships among these constructs were quantita- tively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters. Results: A strong interconnectedness among constructs: ‘care from others’, ‘capabil- ity’, ‘care network’ and ‘care provision’ (coefficient = 1) highlights their entangled cru- cial role in CR. However, significant conceptual disparities between ‘care biography’ and ‘fundamental care’ (coefficient = 0.4) and between ‘self-care’ and ‘care biography’ (coefficient = 0.384615) indicate a need for more aligned and personalized care ap- proaches within CR. Conclusion: The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engage- ment in rural and underserved regions. Implications: Integrating CLCT into CR programme designs could effectively address participation challenges, demonstrating the theory's utility in developing targeted, accessible care interventions/solutions. Impact: • Explored the challenge of low CR engagement in rural, low socio-economic settings. • Uncovered care provision, transitions and individual care biographies' relevance for CR engagement. Demonstrated the potential of CLCT to inform/transform CR services for under- served populations, impacting practices and outcomes. Reporting Method: EQUATOR—MMR-RHS. Patient Contribution: A consumer co-researcher contributed to all study phase