High levels of dissolved inorganic nitrogen (DIN) in groundwater pose challenges for regions like northern Anhui Province, China, where groundwater is a crucial domestic resource. This study utilized modern geostatistics to explore the spatial and temporal dynamics of DIN in groundwater. Significant seasonal influences on DIN concentrations were identified: ammonium peaks during wet season driven by agricultural activities, while nitrate peaks during the dry season primarily influenced by municipal inputs. This study established a Bayesian Maximum Entropy - Random Forest (BME-RF) model based on Land Use/Land Cover data to infer the spatio-temporal performance of DIN, achieving an interpretation rate above 90 %. It also highlighted the role of hydrogeological conditions and aquifer types in the evolution of DIN. By employing a DIN environmental interaction model, it further analyzed the eco-hydrological drivers and seasonal trends affecting DIN variability, enhancing the understanding of groundwater nitrogen dynamics and their link to environmental factors with low consumption. SYNOPSIS: This study reveals seasonal shifts in groundwater DIN, links them to human activity, and uses the BME model to guide targeted nitrogen reduction.

Purpose: This concept analysis aims to address the gap in knowledge regarding the concept of successful refugee cohabitation with host families. It seeks to develop a conceptual model that integrates holistic nursing and healthcare practices into refugee cohabitation settings to enhance refugee well-being. Methods: A comprehensive literature search was conducted using Walker and Avant\'s methodology for concept analysis. Findings: Successful refugee cohabitation with host families concept characterized by peaceful coexistence, power dynamics, hospitality, and cultural tolerance. Antecedents include refugee shelter needs, societal acceptance, humanitarian solidarity, and legal support. Consequences include refugee inclusion and integration, societal cohesion, psychological well-being, and refugee-host acceptance. Conclusions: Successful refugee cohabitation is defined as a private hosting arrangement that embodies shared living spaces and peaceful coexistence amid conflict or crises, fostering resilience and support for displaced individuals by local citizens. It combines hospitality, balanced power, and cultural tolerance, driven by refugee needs for shelter and a commitment to successful refugee settlement and integration. This hosting arrangement promotes societal development and cohesion, economic growth, psychological well-being, and foster inclusion and intergroup tolerance. The integration of holistic nursing principles into refugee cohabitation practices can foster more inclusive and healthy communities.

BACKGROUND: A conceptual model of effective symptom management was previously developed from interviews with multidisciplinary healthcare professionals (HCP) working in English hospices. Here we aimed to answer the question; does a HCP data-derived model represent the experience of patients and carers of people with advanced cancer?
METHODS: Semi-structured interviews were undertaken with six patients with advanced cancer and six carers to gain an in-depth understanding of their experience of symptom management. Analysis was based on the framework method; transcription, familiarisation, coding, applying analytical framework (conceptual model), charting, interpretation. Inductive framework analysis was used to align data with themes in the existing model. A deductive approach was also used to identify new themes.
RESULTS: The experience of patients and carers aligned with key steps of engagement, decision making, partnership and delivery in the HCP-based model. The data aligned with 18 of 23 themes. These were; Role definition and boundaries, Multidisciplinary team decision making, Availability of services/staff, Clinician-Patient relationship/rapport, Patient preferences, Patient characteristics, Quality of life versus treatment need, Staff time/burden, Psychological support -informal, Appropriate understanding, expectations, acceptance and goals- patients, Appropriate understanding, expectations, acceptance and goals-HCPs, Appropriate understanding, expectations, acceptance and goals- family friends, carers, Professional, service and referral factors, Continuity of care, Multidisciplinary team working, Palliative care philosophy and culture, Physical environment and facilities, Referral process and delays. Four additional patient and carer-derived themes were identified: Carer Burden, Communication, Medicines management and COVID-19. Constructs that did not align were Experience (of staff), Training (of staff), Guidelines and evidence, Psychological support (for staff) and Formal psychological support (for patients).
CONCLUSIONS: A healthcare professional-based conceptual model of effective symptom management aligned well with the experience of patients with advanced cancer and their carers. Additional domains were identified. We make four recommendations for change arising from this research. Routine appraisal and acknowledgement of carer burden, medicine management tasks and previous experience in healthcare roles; improved access to communication skills training for staff and review of patient communication needs. Further research should explore the symptom management experience of those living alone and how these people can be better supported.

BACKGROUND: Total joint arthroplasty (TJA) for osteoarthritis is one of several treatment options with benefits and harms that patients value differently. However, the process for determining TJA appropriateness does not sufficiently acknowledge patient perspectives. The aim of this paper is to propose an evidence-informed patient-centred conceptual model for elective TJA appropriateness for hip and knee osteoarthritis.
METHODS: Our interprofessional team developed a conceptual model for determining the appropriateness of adults considering elective TJA. The model was informed by a review of the evidence, a qualitative study we conducted with adults who underwent TJA for osteoarthritis to determine barriers and facilitators to the use of appropriateness criteria, and the research and clinical experience of team members.
RESULTS: Appropriateness is providing health services (e.g., TJA) with net benefits to the right patient at the right time. The proposed Patient-centred Elective TJA Appropriateness Conceptual Model involves three key steps. First, assess adults with osteoarthritis to determine eligibility for TJA. Second, acknowledge the patient\'s informed preferences including their expectations and goals. Third, explore and support their mental and physical readiness for TJA. Given that osteoarthritis is a chronic condition, these steps can be revisited over time with patients.
CONCLUSIONS: Our proposed conceptual model reconceptualises the appropriateness of TJA to be more patient-centred. Hence, this approach has the potential to be a more inclusive approach and ensure patients undergoing TJA are eligible, ready to proceed, and achieve what matters most to them. Future research is needed to test and validate the model.

BACKGROUND: More than half of those who die by suicide do not communicate about suicide prior to their death. This project describes the emotional state and decision-making among \"unplanned\" attempt survivors to inform a conceptual model and suicide prevention interventions.
METHODS: This qualitative study purposefully sampled patients who reported having no suicidal thoughts on a standardized mental health questionnaire within 60 days (about 2 months) prior to a nonfatal suicide attempt documented in the health record. Participants verbally consented to telephone interview participation. Semistructured audio-recorded interviews elicited suicide attempt survivor descriptions of their emotional state and experiences in the days, hours, and minutes leading up to their suicide attempt. Interviews were transcribed and analyzed using grounded theory. The biopsychosocial theory of emotion regulation informed conceptual model development.
RESULTS: Participants (N = 26) described 2 distinct \"phases\" prior to the attempt. First, a phase of increasing life stressors, transitory and nonspecific suicidal thoughts, and a reluctance to disclose experiences. Second, an overwhelming emotional state led to a sudden suicide attempt and nondisclosure due to the rapidity and intensity of the experience. These results informed the conceptual model and intervention development to manage unplanned and overwhelming urges to attempt suicide.
CONCLUSIONS: Qualitative analysis informed the development of an intervention for the high-intensity \"hot\" period preceding an attempt, including specific steps to manage a highly intense emotional state in combination with overwhelming urges to kill oneself.
CONCLUSIONS: Future research is needed to evaluate whether and how this intervention helps support people with a chance of \"unplanned\" suicide attempts.

Efficient information management is pivotal for the effective execution of spatial planning projects, yet many encounter hurdles stemming from disjointed information systems and processes. In this article, authors consider the intricacies of information management within the realm of spatial planning, leveraging insights from the multifaceted MAKING-CITY project to elucidate common challenges and propose innovative solutions. The proposed conceptual model for an integrated information management system offers a holistic approach, aiming to eliminate weaknesses inherent in existing information landscapes by seamlessly integrating diverse information components into a unified framework. By facilitating robust communication channels and synchronizing the actions of all project participants and stakeholders, this model enhances collaboration, streamlines workflows, and fosters informed decision-making. Importantly, the adaptability and versatility of developed model ensure its applicability across various spatial planning initiatives, offering a scalable solution to address the evolving demands of urban development projects. Through a meticulous examination of real-world challenges and practical solutions, this article contributes to the advancement of information management practices in spatial planning, laying the groundwork for more efficient, sustainable, and inclusive urban development processes in today\'s dynamic landscape.

This article examines the integration of a Clinical Nurse Reasoning (CNR) model into advanced nursing practice training to develop the clinical reasoning skills of advanced practice nurses. The article explores the contribution of Callista Roy\'s conceptual model of adaptation and presents a global analysis of a complex care situation that justifies the introduction of an CNR model paired with nursing knowledge to ensure comprehensive, quality nursing care.

BACKGROUND: Youth violence, victimization, and bullying are pervasive in schools across the United States and are detrimental for learning and healthy development. K-12 school safety is an increasingly urgent issue to research and understand from multiple perspectives. Physical and psychological safety in school is linked to better student and school outcomes and is fundamental to fostering well-being and prosocial behavior.
METHODS: Despite research demonstrating positive outcomes associated with school safety, there is no comprehensive conceptual model in the literature that considers precursors, strategies, mechanisms, and outcomes of school safety together. The current paper presents an equity-centered comprehensive model of school safety, which is intended as a holistic representation of the multiple factors and pathways that contribute to school safety and positive youth development.
RESULTS: This model can guide research and practice through an equity-centered and comprehensive approach. This model can enable practitioners, researchers, and policymakers to make informed decisions and reach consensus regarding planning and decisions related to reducing violence and establishing supportive school environments.
CONCLUSIONS: Our model suggests that a comprehensive approach can ensure the safety and well-being of students and staff. By thinking ecologically, schools, communities, and stakeholders can ensure that all aspects of the school context are included in school safety.

The arsenic (As) content of seaweed has been extensively studied due to its toxicological concerns. As a primary producer, seaweed plays a vital role in the biochemical cycling of As in marine environments. Several studies have focused on the growth and behavior of seaweed under a salinity gradient; however, information related to the impact of salinity on As uptake, biotransformation mechanism, and time-dependent speciation patterns of these plants is limited. This study aimed to investigate the temporal effects of salinity on these factors in seaweed. Three seaweed species, Sargassum fusiforme, Sargassum thunbergii, and Sargassum horneri, were maintained in a 1% Provasoli-enriched seawater medium for 14 d under 5‰, 15‰, 25‰, and 34‰ salinities. The results revealed that the high salinity media promoted a rapid uptake of As by all three species. Arsenic accumulation inside the cell approached 100% within seven days of culture for S. thunbergii, irrespective of the salinity content of the media. In addition, As(V) biotransformation and release by S. fusiforme and S. thunbergii were time-dependent, while S. horneri released dimethylarsinic acid (DMAA) from day 3 of the culture. All seaweed species showed methylation of As(V) to DMAA during the culture period. Furthermore, S. thunbergii released DMAA when As(V) was completely depleted from the culture media, whereas the release by S. fusiforme and S. horneri was relatively earlier than that of S. thunbergii. S. horneri showed minimal tolerance to low salinity, as the cells revealed significant damage. Based on the results of this study, a conceptual model was developed that demonstrated the effects of salinity on As uptake and the biotransformation mechanism of seaweed.

The presence of pharmaceuticals and personal care products (PPCPs) in reclaimed water introduces an ongoing challenge as they infiltrate green space soils during irrigation, leading to a gradual buildup that poses considerable ecological risks. The simulation and forecasting of PPCPs accumulation in soil are pivotal for proactive ecological risk management. However, the majority of research efforts have predominantly concentrated on the vertical transport mechanisms of PPCPs in the soil, neglecting a holistic perspective that integrates both vertical and lateral transport phenomena, alongside accumulation dynamics. To address this gap, this study introduces a comprehensive conceptual model that encapsulates the dual processes of vertical and lateral transport, coupled with accumulation of PPCPs in the soil environment. Grounded in the distinctive properties of green space soils, we delve into the determinants governing the vertical and lateral migration of PPCPs. Furthermore, we consolidate existing simulation methodologies for contaminant transport, aiming to establish a comprehensive model that accurately predicts PPCPs accumulation in green space soils. This insight is critical for deducing the emission threshold of reclaimed water necessary for the protection of green space soils, informing the formulation of rational irrigation strategies, and anticipating future environmental risks. It provides a critical theoretical basis for more informed decision-making in the realm of urban water reuse and pollution control.