Background/PurposeNurses, as the largest health workforce, play a crucial role in shaping health outcomes through policy engagement. Measuring their policy involvement is essential. This study aimed to translate and culturally adapt the Waddell Spectrum of Policy Participation Influence and Research (WSPPIR) instrument into Chinese for use in Taiwan.MethodsBrislin's translation model (forward translation, reconciliation, and back-translation) was applied. To address cultural and systemic differences, the Delphi method was conducted with experts in nursing practice, management, and policy. Across three rounds, experts assessed item simplicity, relevance, and clarity, and Content Validity Index (CVI) scores were calculated. Of 38 items, one test question was excluded, leaving 37 items for translation. Reliability was tested among 222 nurses from the medical centers in Taiwan.ResultsThirty-three items were revised and modified to reflect Taiwan's political and nursing systems. Four items were deleted as they were not suitable for Taiwan's political and nursing system. By Round 3, 33 items had reached consensus, with S-CVI/UA and S-CVI/Ave scores of 0.97. The Chinese version demonstrated good reliability (Cronbach's α = 0.86), compared with acceptable reliability in the English version (α = 0.78).ConclusionsIntegrating Brislin's model with the Delphi method and CVI ensured semantic, cultural, and functional equivalence. The validated Chinese WSPPIR instrument is a reliable and valid tool for evaluating nurses' participation in health policy in Taiwan and provides a rigorous framework for the cross-cultural adaptation of policy-related instruments.
Alternative organizations are commonly understood as antidotes to cynicism; that is, as collectives who always act in accordance with ‘better knowledge’ and seek to challenge hegemonic orders through utopian visions of a ‘perfect world’. Problematizing this assumption, we propose that cynicism might be an indispensable virtue for organizations that seek to advance counter-hegemonic principles and practices in a viable manner. To that end, we reinterpret Sloterdijk’s famous definition of cynical reason and coin the term ‘metamodern cynicism’, characterized by ‘productive false consciousness’, as a way of explaining how alternative organizations can switch between sincere belief in moral ideals and reflexive critique of those very ideals. In doing so, we draw on a theoretical perspective known as ‘metamodernism’, which helps us unfold how such oscillations between construction and deconstruction occur in practice. Empirically, the paper draws on an ethnographic study of a partially worker-owned consultancy to show how the organization oscillates between alternativity and necessity, while its members act as if it is more alternative than current circumstances allow. In conclusion, we argue that the productive false consciousness of metamodern cynicism opens new strategic avenues for alternatives, extends the vocabulary of processual approaches to alternativity and points to the progressive potential of cynicism in, but not limited to, alternative organization.
Background Chronic kidney disease (CKD) affects more than 674 million people worldwide and remains insufficiently prioritized in the global noncommunicable disease (NCD) agenda. Although nurses comprise a substantial share of the global health workforce, their roles in implementing global kidney health commitments remain unclear. Purpose Drawing on the Walt and Gilson policy analysis framework, this study critically examines the opportunities and challenges posed by the 2025 United Nations Political Declaration on NCDs (A/80/L.34) for nephrology nursing governance, workforce roles, and integration into primary and community-based kidney care. Methods A qualitative policy analysis examined the declaration through four interrelated dimensions (policy context, content, actors, and process), anchored in the official text adopted by the United Nations General Assembly on December 15, 2025. Findings The declaration explicitly recognizes CKD in the global NCD agenda and reinforces primary healthcare and community-based services as central strategies. However, it provides limited operational guidance on workforce role delineation, particularly regarding nursing leadership. Governance and accountability mechanisms for implementing kidney health commitments are underdeveloped. Although nephrology nursing is implicitly positioned as a strategic workforce, its formal integration into health system planning has not been articulated explicitly. Conclusions Translating the declaration into effective and equitable kidney care requires explicit recognition of nephrology nursing in governance arrangements, workforce planning, and policy implementation. Without such integration, global commitments risk being merely aspirational. Strengthening nursing leadership, advanced education, and expanded scopes of practice are critical policy levers for advancing equitable and sustainable kidney care across diverse health-system contexts.
Purpose: Recently there has been an increase in political hostility toward LGBTQ+ communities within the United States, as well as globally. The intersection of LGBTQ+ issues in education and educational leadership remains an area that has relatively little scholarship. This study seeks to understand LGBTQ+ educational leaders experiences over the course of their careers, as well as during the current political climate of increased hostility. Research Methods: This study was conducted qualitatively and utilized semi-structured interviews with 23 educational leaders across the United States. We leverage the history of LGBTQ+ educators in the United States as the conceptual framing to underpin our findings and situate the current moment within the rich—and often underexamined—histories of LGBTQ+ communities. We utilized an inductive analytic approach including initial coding and axial coding. Findings: We present three conceptual findings from our study. First, we discuss how LGBTQ+ educational leaders navigate heteronormative schools. Second, we examined the interplay of local politics and federal political pressure. Third, we present the concept of identity consciousness as a means by which LGBTQ+ educational leaders navigate identity in the workplace. Conclusions: This study adds to the relative dearth of scholarship on LGBTQ+ educators—and specifically educational leaders. It provides important insight for the field of educational leadership as we consider the lived experiences of leaders and how they navigate increased political hostility and anti-LGBTQ+ sentiment. Additionally, it questions dominant narratives surrounding progress by situating the current experiences of leaders within a historical framework.
Detecting careless responding in self-report questionnaires has gained considerable attention. Different detection methods have been proposed, with implicit methods offering clear advantages over explicit ones. Mahalanobis distance (MD) and person-total correlation ( r pbis ) are among the most promising implicit detection methods. However, previous research has suggested that MD and r pbis are less accurate indicators of careless responding when the percentage of careless respondents in the sample is high and that norm group-based (NGB) MD and r pbis might be more accurate alternatives under that condition. In two simulation studies and a reanalysis of real data, we examined whether NGB MD and NGB r pbis indeed outperform their sample-based (SB) counterparts in a variety of careless responding patterns. The three main findings were as follows: (1) NGB MD outperformed SB MD in most conditions in three studies, (2) both MD indices (but not r pbis indices) were ineffective when simulated scale-midpoint invariant and full straightlining careless responding had to be detected, and (3) NGB r pbis almost never outperformed SB r pbis . We therefore recommend using NGB MD instead of SB MD, and using SB r pbis instead of NGB r pbis when screening data for careless responding.
