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Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming. [ABSTRACT FROM AUTHOR]

Although widely acknowledged as an important social determinant of health, until recently researchers and policymakers have primarily approached housing insecurity as an urban issue, obscuring the visibility of its impacts in rural contexts, including the ways in which housing insecurity intersects with other health and structural inequities facing rural populations. Working to address this gap in the existing literature, this paper explores the experiences of housing insecurity in a rural context by reporting on an analysis of 210 in-depth interviews with 153 adults between the ages of 18–35, living in California's rural North State, a relatively overlooked far northern region of the state comprised of 12 north central and north eastern counties. Using in-depth qualitative interview data, we conducted an exploratory pattern-level analysis of participants' narratives structured by four dimensions of housing insecurity defined in the literature (housing affordability, housing stability, housing conditions, and neighborhood context). Drawing attention to the pervasiveness of rural housing insecurity within our sample, this analysis highlights the unique ways in which rurality creates distinct experiences not currently captured in the existing literature. Further research is needed across different types of rural communities to better understand the various ways that housing insecurity affects the everyday lives and health of rural residents. By grounding research within the experiences of rural residents, we are better able to respond to the crisis of rural housing insecurity and develop solutions that are tailored to rural residents' unique needs. [ABSTRACT FROM AUTHOR]

People from refugee and asylum seeker backgrounds resettling in Australia often experience intersecting risks for poor mental and physical health. Physical activity can promote better health outcomes, however there are limited programs tailored for this population. Therefore, understanding how to support refugees and asylum seekers to engage in physical activity is crucial. This paper aims to describe how the experience-based co-design (EBCD) process was used to identify priorities for a new physical activity service for refugees and asylum seekers. Using an EBCD framework we conducted qualitative interviews and co-design workshops with service users (refugees and asylum seekers living in the community) and service providers at a community Centre in Sydney, Australia. Sixteen participants, including eight service users and eight service providers engaged in the EBCD process over 12-months. The interviews revealed common themes or 'touchpoints' including barriers and enablers to physical activity participation such as access, safety and competing stressors. Subsequent co-design focus groups resulted in the establishment of five fundamental priorities and actionable strategies; ensuring cultural and psychological safety, promoting accessibility, facilitating support to access basic needs, enhancing physical activity literacy and fostering social connection. Using EBCD methodology, this study used the insights and lived experiences of both service users and providers to co-design a physical activity service for refugees and asylum seekers which is safe, supportive, social and accessible. The results of the implementation and evaluation of the program are ongoing. [ABSTRACT FROM AUTHOR]

Measurement based care (MBC), a practice that uses patient reported outcome measures (PROMs), is not widely used in behavioral health settings and little is known about the patient experience with MBC in safety-net settings. This study aimed to understand patient experiences completing PROMs on paper when presenting to an outpatient, behavioral health setting within a public safety-net hospital. Semi-structured interviews were conducted with 22 participants in English and Spanish. Participants were 42 years old (SD = 12.7), mostly white (36.4%) and Black (31.8%). Thematic analysis was used to analyze findings. Overall, participants were engaged with PROMs and described them as helpful for themselves and their clinicians. Participants also expressed themes focused on PROMs user-friendliness, including formatting, time to complete measures, and participant characteristics such as attention and literacy. These findings are important to consider to ensure equitable access to MBC when implemented in behavioral health in the health safety-net setting. [ABSTRACT FROM AUTHOR]

The integration of normative analysis with empirical data often remains unclear despite the availability of many empirical bioethics methodologies. This paper sought bioethics scholars' experiences and reflections of doing empirical bioethics research to feed these practical insights into the debate on methods. We interviewed twenty-six participants who revealed their process of integrating the normative and the empirical. From the analysis of the data, we first used the themes to identify the methodological content. That is, we show participants' use of familiar methods explained as "back-and-forth" methods (reflective equilibrium), followed by dialogical methods where collaboration was seen as a better way of doing integration. Thereafter, we highlight methods that were deemed as inherent integration approaches, where the normative and the empirical were intertwined from the start of the research project. Second, we used the themes to express not only how we interpreted what was said but also how things were said. In this, we describe an air of uncertainty and overall vagueness that surrounded the above methods. We conclude that the indeterminacy of integration methods is a double-edged sword. It allows for flexibility but also risks obscuring a lack of understanding of the theoretical-methodological underpinnings of empirical bioethics research methods. [ABSTRACT FROM AUTHOR]

Access to social protection in old age is crucial and yet contingent upon negotiations between the social structures of the welfare states and the personal networks within which individuals are embedded. International migration, changing family dynamics, and the transformation of care and other welfare policies in the global North make it challenging for older migrants to negotiate social protection. Drawing on 45 semi-structured interviews with first-generation older Turkish migrants in London and 13 semi-structured interviews with professional service providers for the community, the paper aims to investigate the assemblages of formal and informal social protection in the lives of older migrants. Findings indicate the complexity in accessing informal social protection and the navigation of formal care support in the UK for first generation older Turkish migrants and the contingency of access to formal care services on informal support networks for participants. It has been demonstrated that built infrastructure and policies aimed at older adults have great influence on assemblages of care, highlighting the need for more age-friendly and integrated policies to facilitate access to social protection for diverse groups of older adults. [ABSTRACT FROM AUTHOR]

Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions. [ABSTRACT FROM AUTHOR]

Purpose: Although batterers' intervention programs (BIPs) constitute an important part of the coordinated response to intimate partner violence (IPV) and contribute to increasing the perpetrators' accountability and keeping victims safe, the effectiveness of these programs is still debated. Only recently has the focus of these debates shifted away from researching outcomes by measuring overall program effectiveness toward specific qualities of interventions across program models that may be effective for the distinct client (Babcock et al., Clinical Psychology Review,23(8), 1023–1053, 2004; Zarling et al., Psychology of Violence,9(3), 257–266, 2019). The discussion on the practical implementation of BIPs was supplemented by various significant concepts emerging from new empirical findings, such as differential treatment, motivational interviewing, and effective facilitator–client alliances (Hamel et al., Partner Abuse,11(4), 387–414, 2020; Holtrop et al., Journal of Interpersonal Violence,32(8), 1267–1290, 2017). This paper aimed to address some of the abovementioned concepts by identifying challenges that arise during the implementation of BIPs in Lithuania. Methods: Using qualitative data from semi-structured interviews and focus group discussions with BIPs facilitators, BIPs attendees, and various stakeholders, the paper discusses how to contribute to more effective BIPs outcomes. Results: According to this study, the process of implementing BIPs in Lithuania should be systematized by incorporating existing instruments, such as motivational interviewing, risk-based assessment, and differential treatment, evidence-based programs focused on different theoretical approaches, and forms of implementation. Conclusion: The study found that the consistency and integrity of the entire BIP implementation process should be prioritized, and institutional cooperation in Lithuania needs to be improved to achieve a successful coordinated response to intimate partner violence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to add to the research literature and begin to fill the gap in knowledge about shared parenting arrangements for women with young children and who have experienced domestic violence (DV), in three Canadian provinces; Alberta, Manitoba and Ontario. Method: This paper reports on the qualitative findings from a mixed methods study on shared parenting from women with children ages 4 and under. Twenty women participated in one-on-one individual interviews through electronic platform utilizing Zoom. Thematic analysis is used to analyze the data. Results: Despite efforts to not exclusively recruit women who had experienced domestic violence (DV) from their former partner, all participants identified as survivors of DV and ongoing survivors of DV, specifically, coercive controlling behaviours. Five themes describe the women's experiences of shared parenting with young children: 1) walking a tight-rope; 2) navigating post-separation relationships; 3) emotional realities of shared parenting; 4) shared parenting outcomes; and, 5) structural challenges. Conclusions: This paper not only adds to the significant and longstanding gap in knowledge directly from women with children ages 4 and under in shared parenting relationships, and who have experienced DV, and also helps to inform social service and legal actors. It is timely with the amendments to the Divorce Act in Canada which now includes DV as a factor in determining the best interests of the child. [ABSTRACT FROM AUTHOR]

Purpose: Maternal substance use and deaths due to overdoses are increasing nationwide. Evidence suggests that the rate of resumed substance use, and fatal and non-fatal overdose is greatest in the first year after birth, particularly around six months postpartum, compared to other parts of the perinatal period. Doula care has been linked to improvements in perinatal health and outcomes. Description: In response to the opioid epidemic, the Philadelphia Department of Public Health developed and implemented the Doula Support Program (DSP), with a focus on one year of postpartum care for birthing people with a substance use disorder (SUD). In this paper, we describe the program and its formation and report on the early challenges and successes of the program implementation, based on information we received from program founders and managers in a group interview. Assessment: Early successes of the program include partnering with local community-based programs to recruit and retain doulas, supplementing traditional doula education with perinatal SUD-specific trainings, and maximizing client referrals by collaborating with local organizations and treatment centers that serve birthing people with SUD. Client retention, however, has proven to be challenging, especially during the COVID-19 pandemic. Conclusion: The DSP continues to grow, and lessons learned will facilitate program improvements. The goal of this paper is to outline the development and launch of the DSP and to act as a model for other state and local health departments interested in providing doula care for birthing people with SUD. Significance: Maternal substance use and fatal overdoses are increasing in Philadelphia, Pennsylvania. In response to this crisis, the Philadelphia Department of Public Health's Division of Maternal, Child and Family Health developed the Doula Support Program (DSP), offering doula care to pregnant people with a current or past SUD history up to one-year postpartum. To our knowledge, this is the only doula program in Pennsylvania offering one-year postpartum support to birthing people affected by SUD. [ABSTRACT FROM AUTHOR]

In recent years, Hunza has seen a surge of suicide cases among youth. This paper attempts to decipher the multiple layers of meanings entailed in suicide cases. The dominant perception among the natives is the attribution of influence to supernatural beings. This paper attempts to provide insights into the supernatural cosmology and its relationship to youth suicide among the Burushaski speakers of Hunza. Using qualitative research methodology, this paper describes the local perception of supernatural beings, and their classifications as well as the role of local shamans, known in Burushaski as bitan. In this scenario, suicide is not seen as a self-destruction, but is rather a punishment by the supernatural beings owing to the violation of the sacred supernatural social order imposed by the spirits connected to the supernatural world. For the natives, both the terrestrial and supernatural spheres share common habitats and mountain ecology; however, the latter is perceived to have more powers than the former. Therefore, breach of this order is highly discouraged and bears dire consequences. What appears as mere supernatural and human conflict actually carries deeper references to social and ecological disruptions. [ABSTRACT FROM AUTHOR]

Purpose: To compare (1) fluid, food and nutrient intake obtained with a paper versus an online version of a 7-day food record and (2) user's acceptability of both versions of the food record. Methods: A cross-over study was carried out in 2010 in France. A total of 246 participants aged 18-60 years reported their food and fluid intake using both versions of the 7-day food record, separated by a 7- to 14-day washout period. To help participants in estimating consumed portions, both versions of the food record were supported by a photographic booklet of standard portions and containers. At the end of the study protocol, participants completed a questionnaire designed to assess the acceptability of the two questionnaires. Results: The reported water intake of fluids was significantly higher with the online version compared with the paper version (respectively 1348 ± 36 and 1219 ± 34 mL/day, p < 0.0001). No difference was found between methods in terms of energy intake and the consumption of most food categories, macro- and micronutrients. Furthermore, 77 % of the participants preferred the online method to the paper version. Conclusions: Fluid intake, but not food intake, reported with the online 7-day food record was higher in comparison with the paper version. In addition, the online version was preferred by users. In population surveys, the online record is therefore a relevant alternative, and even a preferred alternative in the case of fluid intake, to the paper record. [ABSTRACT FROM AUTHOR]

Purpose: In England and Wales, Domestic Homicide Reviews (DHRs) are conducted into domestic abuse-related killings. In 2016, deaths by suicide were brought into the scope of this review system and, to distinguish them from reviews into domestic homicides, we describe these as 'Suicide Domestic Abuse-Related Death Reviews' (S-DARDR). To date, S-DARDRs have been little considered and, in response, this empirical paper seeks to unpack this process. Method: In a larger study, 40 DHR participants were interviewed, and a reflexive thematic analysis was undertaken. 18 participants discussed S-DARDRs. These interviews were re-read, with relevant extracts identified and re-analysed thematically. Through a shared critical reflection, we drew on our practice experience to interrogate the themes generated from the interviews and offer insight into the underlying challenges. Results: From the interviews, we generated four themes relating to commissioning and delivery; the involvement of stakeholders; intersections with other statutory processes; and purpose. Based on our shared critical reflection, we identified the underlying challenges as an under conceptualisation of S-DARDRs, alongside their de-mooring from the criminal justice system. Taken together, these challenges have implications for the conduct of S-DARDRs. We identify recommendations for policy and practice to address these challenges. Conclusion: The development of S-DARDRs has been little considered and challenges arise around when and how they should be undertaken. A shared understanding of key concepts and expectations around delivery is necessary if S-DARDRs are to enable robust learning and be a driver for systems change while also being accessible and understood by all stakeholders. [ABSTRACT FROM AUTHOR]

This paper describes a case study of an Outreach and Drop-in Centre (ODIC) established under the National Action Plan for Drug Demand Reduction, Ministry of Social Justice and Empowerment, Government of India. In the quantitative part, data were gathered from the ODIC office documents and analysed using MS Excel. Linear regression analysis demonstrated a relationship between the number of in-centre clients and the number of Community Outreach Programmes (COPs). Similarly, this study examined the relationship between the number of networks established and the number of participants in COPs. Hence, two regression lines were derived accordingly. In addition, qualitative data collected through key informant interviews corroborated the quantitative results. This case study highlights the importance of networks and COPs in increasing the reach of ODIC and ensuring the quality of services. Finally, in partnership with other government agencies, this ODIC sets a model for engaging marginalised adolescents in reducing substance abuse. [ABSTRACT FROM AUTHOR]

For over 70 years, studies have reported lower rates of completed suicide in Muslim-majority countries and individuals who identify as Muslim. To this point, the mechanisms underlying the relationship between Islam and lower risk of suicide remain understudied. In an effort to advance our understanding, we convened a bilingual international interdisciplinary panel of experts for a discussion of the current state and future directions of the field. In this paper, we present an exploratory qualitative analysis of the core themes that emerged from the group interviews. We also derive a general theoretical model of the association between Islam and suicide risk. [ABSTRACT FROM AUTHOR]

Background: Various professional groups are involved in the daily work of the central operating room with the aim of providing the best possible treatment for each individual using modern medical technology (sociotechnical system) in a cost-effective manner. Ensuring perioperative patient safety is of particular importance. At the same time, the efficient use of the central operating room is essential for the economic success of a hospital. Preoperative preparation is a complex process with many substeps that are often difficult to manage. Historically, the focus has been on retrospective learning from errors and incidents. More recent approaches take a systemic view. A central idea is to consider the mostly positive course of treatment and the adjustments to daily work that are currently required by the people involved (Safety-II). By taking greater account of how the many components of the system interact, processes can be better understood and specific measures derived. This strengthens the system's ability to adapt to changes and disturbances, thus ensuring that goals are achieved. The functional resonance analysis method (FRAM) is an internationally recognized method for modelling work as done compared to work as imagined. This paper presents the application of FRAM to preoperative preparation in a major regional hospital. Objective: Is FRAM suitable for improving process understanding in preoperative preparation? Material and methods: An interdisciplinary project team identified relevant functions of preoperative preparation through document analysis and walkthroughs. Based on this, more than 30 guided interviews were conducted with functionaries. The results were presented graphically and specific information, such as safety-related statements or reasons for the variability of functions, were also presented textually. In the next phase, statements were evaluated and compared with the target model and the job descriptions. Results: The FRAM revealed the process as a complex network of relationships. During the modelling process, a varying degree of centrality and variability of certain functions became apparent. From the observations, the project team selected those with high relevance for patient safety and for the efficiency of the overall process in order to prioritize starting points for deriving measures to increase resilience. These starting points relate either to single functions, such as surgical site marking or to multiple functions that are variable in their execution, such as delays due to nonsynchronized duty times. Conclusion: The FRAM conducted provides valuable new insights into the functioning of complex sociotechnical systems that go far beyond classical linear methods. The awareness of operational processes gained and the resulting dynamic view of interactions within the system enable specific measures to be derived that promote resilient behavior and reduce critical variability, thus contributing to increased patient safety and efficiency. [ABSTRACT FROM AUTHOR]

Schools and districts nationwide have heavily emphasized supporting students' health and wellbeing by engaging families and caregivers to truly support the "whole child," as outlined in the Whole School, Whole Community, Whole Child (WSCC) model. The COVID-19 pandemic only heightened the important role of school and family partnerships in supporting children's health. The Chicago Public Schools (CPS) Healthy CPS initiative is designed to support schools in their compliance with existing health and wellness policies to support child health. This study aimed to explore parents' primary health concerns for their children, characterize these views, explore any alignment with WSCC, and identify recommendations for family engagement in school health promotion. Eleven semi-structured focus groups (seven English, four Spanish) were conducted with CPS parents/caregivers. Groups were conducted in spring 2021 on Chicago's West Side, one of the more historically disinvested communities in the city. Focus groups were recorded, transcribed, and analyzed using constant comparison, incorporating both inductive and deductive approaches. Key themes emerged related to parents' perceptions of schools' role in promoting health including: (1) parents see child health as a shared responsibility between families and schools; and (2) parents identify significant structural barriers and inequities that impede child health, such as racism, community violence, and a lack of community resources in their neighborhoods, and believe schools can do more to address them. Parents' viewed child health and wellbeing as multidimensional and stated that these dimensions must be considered holistically. Their views aligned with WSCC family engagement-related components. Parents recommended that schools employ a variety of strategies to engage families. Findings from this paper have implications for engaging families in school health policy and program development as well as implementation, particularly those in lower income, urban communities that have faced a history of structural inequities. Highlights: Chicago Public Schools parents in in this sample see child health as a shared responsibility between families and schools. Consistent with the long-standing evidence documenting historic disinvestment on the West Side of Chicago, participating parents identify significant structural barriers and inequities, such as racism, community violence, and a lack of community resources in their neighborhoods, and believe schools can do more to address them. Parents recommend schools take a variety of strategies to engage families and recommend more leadership opportunities for parents. [ABSTRACT FROM AUTHOR]

A significant body of research has investigated potential correlates of deception and bodily behavior. The vast majority of these studies consider discrete, subjectively coded bodily movements such as specific hand or head gestures. Such studies fail to consider quantitative aspects of body movement such as the precise movement direction, magnitude and timing. In this paper, we employ an innovative data mining approach to systematically study bodily correlates of deception. We re-analyze motion capture data from a previously published deception study, and experiment with different data coding options. We report how deception detection rates are affected by variables such as body part, the coding of the pose and movement, the length of the observation, and the amount of measurement noise. Our results demonstrate the feasibility of a data mining approach, with detection rates above 65%, significantly outperforming human judgement (52.80%). Owing to the systematic analysis, our analyses allow for an understanding of the importance of various coding factor. Moreover, we can reconcile seemingly discrepant findings in previous research. Our approach highlights the merits of data-driven research to support the validation and development of deception theory. [ABSTRACT FROM AUTHOR]

We aim to verify the equivalence between the paper and electronic version of Chinese SF-36 administered using the Quality-of-Life-Recorder. A crossover trial of the electronic and paper versions of the Chinese SF-36 was performed as follows: the interviewees were asked to fill out either an electronic version or a paper version firstly according to their own willingness. After at least 30 min interval, interviewees were required to complete the other version. This study used a convenience sample of medical college freshman participating in courses at the College of Medicine of Zhejiang University (China). About 100 subjects were eventually recruited and the response rate was 90.9%. The mean difference of completion time between the two versions was caused by an impact of order sequence and advantages of the electronic version over the paper version were eventually verified. At both the level of eight subscales and the level of 36 items, score equivalence was achieved between two versions. Thereby this study provided an empirical basis for the identification of the equivalence between the paper version and electronic version of the Chinese SF-36 and can be regarded as a pilot towards further investigations on how to facilitate widespread deployment of the Quality-of-Life-Recorder in Asian populations. [ABSTRACT FROM AUTHOR]

Over a third of individuals diagnosed with a psychotic disorder are also a parent. The symptoms of psychosis and side effects of antipsychotic medication can impact on parents' awareness of the needs of their children and, at times, the parent may be emotionally and practically unavailable to their child. This study assessed the expressed emotion of parents with psychosis and used qualitative methods to investigate their needs and experience in order to identify how best to support this parent group. Twelve parents with a diagnosed psychotic disorder and with a child aged between 3 and 11 years took part in semi-structured interviews. The majority of parents displayed high levels of warmth and low levels of negativity towards their child. Four themes were generated using reflexive thematic analysis: (1) the impact of psychosis on parenting, (2) the need to protect their child, (3) the need to feel normal, and (4) the impact of parenting stress on psychosis. These results showed how parents want to protect their children and feel normal despite experiencing psychosis. They also highlighted the cyclical relationship between parenting stress and psychotic symptoms, whereby psychotic symptoms can impact on a parent's capacity to care for their child and parenting stress can exacerbate psychotic symptoms. Highlights: This paper investigated the expressed emotion of parents with psychosis, and found that, generally, parents displayed high levels of warmth. This paper also investigated the needs and experiences of parents with psychosis using qualitative methods. Psychosis can impact on the parent's capacity to parent, and many parents were reluctant to talk about psychosis with their children. The stress from parenting was described by some parents as a trigger for their psychosis. Participants described a need to feel normal, and suggested that peer support would be beneficial. [ABSTRACT FROM AUTHOR]

This paper presents the results of a survey conducted among people walking the pilgrimage route to the shrine of St James in Santiago de Compostela. The aim of the research was to investigate how a pilgrimage on the Camino de Santiago among a married couple or family affects marital or familial relationships, whether walking the trail to Compostela together influences the behaviour of family members towards each other and whether it forms positive attitudes and behaviour. The empirical basis of the study is the results of a survey among respondents who made the Camino de Santiago pilgrimage, as well as in-depth interviews conducted with 24 spouses of pilgrims along the Way of St James. The study revealed that doing the pilgrimage as a married couple or family had a positive impact on intra-family relationships. According to the interviewees, going on the pilgrimage together helped to strengthen marital bonds and trust, improve communication and mutual connection, show care and affection and improve contact with children. [ABSTRACT FROM AUTHOR]

Using a mixed-method approach, this present study examined the roles of calling and the relation between life goals and spiritual values among early childhood professionals in New Zealand. Among the 102 participants who completed the surveys, 24 participated in the follow-up individual interviews. In line with previous research, results showed that the five spiritual values—conformity, universalism, tradition, benevolence, and security—positively correlated with at least three intrinsic life goals, but showed a negative correlation with at least three of the four extrinsic goals. In addition, all non-spiritual values—self-direction, stimulation, hedonism, achievement, and power—correlated negatively with at least three of the intrinsic life goals. A similar pattern was found between the correlation between all non-spiritual values and extrinsic life goals. Interview data showed that participants who self-identified as having experienced a call to work with young children actively engaged with their calling. They also affirmed that their calling was experienced at a deeply personal and emotional level. Participants also recognized the important impact of life goals, personal and spiritual values on their work. This paper concludes with implications for future research and practice. [ABSTRACT FROM AUTHOR]

Purpose: Within this paper we evaluate the inclusion of the family voice in the domestic homicide review process. We use an Indigenous rubric (Te Pou) developed to ensure a culturally appropriate framework for conducting fatality reviews. We further draw on the creative potential of Indigenous knowledge systems, applying them alongside Western understandings of the engagement of family in homicide reviews, to seed new knowledge. This review has been undertaken early in the process of implementing family interviews to learn from current practices, seeking to improve them and, thereby, be better hosts for those invited to be part of a review. Methods: The process of including family input into the in-depth reviews of family violence homicide reviews, conducted between October 2019 and November 2021, was reviewed against the guidelines specified within Te Pou. Results: While there were strengths within the current process, the review established that further work is required to fully embed cultural understandings and processes within homicide reviews. Indeed, the current process and legislative framework in which it is based, works against relational obligations of reciprocity and a duty to care. Conclusions: Using indigenous frameworks and research methods, it is possible to determine how homicide review processes have the potential to embed trauma rather than providing an opportunity for critical reflection and healing. Repositioning homicide reviews will require a reconceptualization of the legislative framework and support system requirements for review panels. [ABSTRACT FROM AUTHOR]

Objectives: The COVID-19 pandemic has had significant impacts on maternal mental health. We explored the lived experiences of women with perinatal depression and anxiety to elucidate their perceptions of how the pandemic influenced their mental health and access to care. Methods: We conducted a qualitative descriptive study using semi-structured interviews. From March to October 2021, purposive sampling was used to recruit a socio-demographically diverse sample of women with self-reported perinatal depression or anxiety who were pregnant or within one year postpartum between March 2020 and October 2021. Interviews were conducted remotely and thematically analyzed. Results: Fourteen women were interviewed. Three major themes arose. Theme 1, Negative impacts of COVID-19 on symptoms of depression and anxiety, described how the pandemic magnified underlying symptoms of depression and anxiety, increased social isolation, generated anxiety due to fears of COVID-19 infection, and caused economic stress. In theme 2, Negative impacts of COVID-19 on access to and quality of health care, women described stressful and isolating delivery experiences, negative psychological impact of partners not being able to participate in their perinatal health care, interruptions and barriers to mental health treatment, and challenges in using telehealth services for mental health care. Theme 3, Positive impacts of COVID-19 on mental health, identified advantages of increased telehealth access and ability to work and study from home. Conclusions for Practice: The COVID-19 pandemic negatively affected women with perinatal depression and anxiety by magnifying underlying symptoms, increasing stress and social isolation, and disrupting access to mental health care. Findings provide support for policies and interventions to prevent and address social isolation, as well as optimization of telehealth services to prevent and address gaps in perinatal mental health treatment. Significance: What is Already Known on this Subject? Quantitative data suggest that the pandemic increased rates of perinatal mental illness. Yet the perspectives of women with perinatal depression and anxiety on how the pandemic affected their mental health and access to care remain underreported. What this Study adds? This paper offers new insight from the lived experience of women with perinatal depression and anxiety on ways the pandemic negatively and positively affected their mental health and access to mental health care. Implications for interventions, policies, and clinical practice are discussed. [ABSTRACT FROM AUTHOR]

In this paper, we contend that urban middle-class older Indians engaged in "serious leisure" as a way to reimagine and reconfigure the structure of everyday life during the pandemic-led epochal downtime. In particular, we heuristically show that leisure activity patterns and constraint negotiation strategies among older Indians followed conceptual semblances with the dominant leisure-based typology of Serious Leisure Perspective. By thematically analysing household surveys (n = 71), time-use diaries and in-depth interviews (n = 15) of middle to upper middle-class individuals (55–80 years), we show how both men and women distinguished between serious leisure that is marked by motivation, agency and perseverance with that of unstructured, routinized free-time (or causal leisure). Time-use diaries suggested that despite the changed realities of heightened domestic time available to both genders due to the pandemic, women recorded higher proportion of their daily hours in household management and caregiving. Although women were governed by moral-cultural self-descriptions in their engagement with leisure, it was often associated with an enhanced sense of self-actualisation, self-management and identity. Overall, we show how the social codes of age and gender were inextricably linked with the practice of leisure during the pandemic. [ABSTRACT FROM AUTHOR]

Objectives: To characterize pregnant women admitted to Irene Neto Maternity Hospital, Lubango city, Huíla province, and their pregnancy outcomes. Methods: We conducted a descriptive cross-sectional facility-based survey between October 2016 and September 2017, involving 500 pregnant women, followed from admission in labor until the end of delivery. Mean (SD) was computed for quantitative variables, while relative and absolute frequencies were determined for categorical variables. Additionally, confidence intervals were estimated. Results: Among pregnant women 18.3% were adolescents (≤ 19 years) and 14.5% had advanced maternal age (≥ 35 years). Illiteracy was reported by 8.2%. One in three (33.6%) had a short stature (< 1.55 m). Malaria was the most frequent infection during pregnancy (16.3%). Upon admission, 18.1% were anemic (Hb < 11 g/dl) and 36.0% had hypertension (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg), contrasting with the few cases reported of chronic hypertension and pregnancy-induced hypertension. There were 15 twin pregnancies. Cesarean section was performed in 25.2% of the women, although there was no medical indication for 23.0% of women having cesareans. Two maternal deaths occurred in our sample. Among live births from singleton pregnancies (97.1%), birth asphyxia (Apgar < 7 at 5 min) was observed in 22.7% and 10.3% had low birth weight (< 2.5 kg). Conclusions: There are very few studies reporting pregnancy outcomes in Angola. This analysis presents data from Huíla province, the second most populous province. We identified characteristics for higher risk of adverse pregnancy outcomes: adolescence, illiteracy, and short stature. Among newborn outcomes, birth asphyxia and low birth weight demand special attention. Further research is needed to explore the non-medical indications for cesarean section and to better understand the twinning rate in Lubango. Significance: The significance of this paper is that it is one of the very few reports contributing for the knowledge of detailed maternal, obstetric and newborn outcomes in Angolan women. Although our study only addresses the outcomes descriptively, it can be used as a first step in monitoring and improving outcomes of Angolan women. Maternal and child health is a key issue to address sustainable development in Angola. [ABSTRACT FROM AUTHOR]

As the world's population rapidly ages, older people are increasingly placed in long-term care institutions. Although this global trend is supposed to protect older people, it is unclear whether they have any voice in decisions about such placements. The aim of this paper is to report a qualitative study into whether and to what degree social workers involve older people in these decisions. The study employed in-depth semi-structured interviews, focused group discussion, sociograms, and the daily and weekly schedules of 17 respondents (7 social workers and 10 older people in long-term care) in Warsaw, Poland. The findings show that social workers did involve older people, but only in minor decisions after their placement to help them adapt to the new situation. This practice seems to be attributable to neoliberal and managerial tendencies in the policy guidelines that social workers must follow in performing inherently relational tasks. The paper concludes by outlining the implications of these findings for social work. [ABSTRACT FROM AUTHOR]

The military lifestyle can be defined by a triad of unique stressors: frequent relocation, parental absence, and risk of injury, illness and/or death of a serving member. Research has suggested that this unique triad of stressors can impact the mental health of children and youth living in military families. However, research focusing on the mental health of children and youth living in military families overwhelmingly focuses on the American context. Due to key contextual differences, it is unclear to what extent the American findings are representative of military-connected children and youth living in other geographical contexts, such as Canada. A large qualitative study was conducted to explore the mental health of military-connected children in Canada from three perspectives: child, parent, and service provider. This paper reports on the service provider findings. Using individual semi-structured interviews, data were collected from 11 service providers. Data analysis was guided by qualitative content analysis. Two main themes emerged: (1) the mental health of children living in military families may be impacted by the military lifestyle stressors, and (2) the mental health of children living in military families can be impacted by the accessibility and availability of mental health services. While this qualitative study builds upon recent Canadian work that has considered the service provider perspective, additional research is needed to better understand the experiences of service providers who support military-connected children and youth. Highlights: American research shows that the military lifestyle factors can impact the mental health of military-connected children. The mental health of military-connected children has yet to be extensively explored in Canada. The mental health of children living in Canadian military families may be impacted by the military lifestyle stressors. The mental health of Canadian military-connected children can be impacted by the accessibility and availability of mental health services. Our findings can help build capacity and knowledge for service providers who support Canadian military-connected children. [ABSTRACT FROM AUTHOR]

Corporal punishment (CP) is a widely spread disciplining practice among parents and caregivers globally. Our paper aimed to explore the relationship between the parental attitudes towards CP, expected outcomes of CP, and parenting practices on one hand, with the reported dysfunctions of their children, on the other. Additionally, we aimed to explore the relationship between the use of CP and the reported academic, developmental, and psychological–emotional dysfunctions of their children. The present study involved a nationally representative sample of 1186 parents in Serbia, who had at least one child aged 0–18 years at the moment of interviewing. The parents filled out a series of questionnaires on their attitudes towards CP, expectations of CP outcomes, and their parental practices. Findings indicate that parents that report having a child with dysfunctions have positive attitudes towards CP and expect positive outcomes of CP. These parents also report using more CP as a disciplining method, as well as other harsh disciplining practices. We also identified parental positive expectations of CP, use of physical assault, psychological aggression, neglect as significant predictors of reported child dysfunctions severity. Having all the results in mind, we can assume that children with health-related and school-related issues might be at potential risk of further maltreatment. [ABSTRACT FROM AUTHOR]

From the early years of the internet, its key importance was recognized as a site for sexual minorities to explore and express their identity and sexuality. Gay men were quick to connect online, first in chat rooms and subsequently on an ever-expanding array of sites and apps, culminating in geolocation apps such as Grindr. Although a lot of research has investigated the uses of these services, the focus is mostly on younger users, disregarding the experiences of older people. Moreover, the life stage of users is not sufficiently addressed, nor are their evolving uses throughout the life course. The current paper aims to contribute to this knowledge by reporting on a study involving four generations of Belgian men who have sex with men (MSM), combining insights gained in an exploratory survey (N = 684) with in-depth interviews (N = 80). The results show how men from different generations got access to dating sites and apps at different times in their lives, in a shifting balance with offline dating practices. Moreover, at the time of the research, participants were in different stages of their lives, which led to a variety of online dating practices. The end picture is one of dating "in motion", both shifting between generations and changing with the life course of individuals. This paper contributes to the literature on MSM online dating by adding a non-Anglophone perspective, studying a broad age range including older users, disclosing clear intergenerational differences, and transcending a static view of online dating among a single age cohort. [ABSTRACT FROM AUTHOR]

Hope is essential to mental health recovery, yet little is known about how mental health services can foster hope. This paper addresses the question: How can mental health services influence the sense of hope experienced by people who access their services? Sixty-one people who accessed a new mental health service were interviewed about their experiences, including about how the service had influenced their sense of hope. Interviews were analysed using constant comparative analysis. The data revealed that hope increased when people perceived positive changes in themselves and their circumstances: developing new understandings and perspectives; having effective strategies to manage challenges; seeing progress or having plans; and having support. Changes were attributed to three major features of the service: accessibility; staff competence and wisdom; and caring interactions. The findings highlight that, while individual clinicians are important, other interactions with services and the wider service context are also critical for facilitating hope. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) and substance use disorder (SUD) frequently co-occur and are rarely addressed together despite evidence indicating benefits of combined interventions. Both are linked to trauma. Scholars have theorized attention to trauma may facilitate engagement with IPV and SUD but have not studied this potential empirically. Methods: Using service system level quantitative data on organizations focused on IPV or SUD (n = 281) in a midwestern city in the United States and semi-structured interviews with policymakers, funders, and practitioners in both areas (n = 27), this paper uses grounded theory to explore whether attention to trauma facilitates attention to IPV and SUD. Results: While quantitative data suggest addressing trauma and both IPV and SUD are associated at the service system level, analysis of interview data indicates greater complexity. Despite consensus on trauma-informed care's potential, competing understandings of temporality (when trauma occurs in relation to IPV or SUD), different liabilities associated with addressing trauma, and different intervention approaches combine to limit engagement by both IPV and SUD organizations. Rather than adopting trauma-informed care, both types of organizations more typically engage trauma selectively, offering discrete services rather than holistic intervention. Findings have implications for addressing co-occurring IPV, SUD, and trauma and for practice, policy, education, and research. Conclusions: There is need for greater consensus about what it means to address trauma, increased investments in practitioner education and training around intersections of IPV, SUD, and trauma, and additional supports to incentivize movement from a trauma services approach towards meaningful implementation of trauma-informed care. [ABSTRACT FROM AUTHOR]

Rural areas are becoming more and more concerned about their aging population and perceived loss of youth. Analysts see the older members of communities as a burden, and focus their development strategies on attracting and retaining the young. In doing so, they may be missing the value that elders' civic engagement can provide to rural community development. This qualitative study, based on interviews with 40 elders in mostly rural areas of Wisconsin, in the United States, shows the benefits that their civic engagement brings to rural areas. They have biographical availability, political and economic freedom, and life-long experience to offer. They do face some challenges, including occasional health issues, lack of technological agility, and change-resistant peers. The paper concludes by considering how communities can better access and honour elder civic engagement, including understanding elders' motivations and skills for civic engagement. [ABSTRACT FROM AUTHOR]

This paper explores the perception of African, Caribbean, and Black (ACB) religious leaders on HIV vulnerability and their role in HIV prevention among ACB communities in Windsor, Ontario. We conducted one semi-structured focus group discussion with nine Black religious leaders, most of whose congregants are members of the ACB community. Most religious leaders in the focus group had a negative perception of the transmission of HIV, but they acknowledged their own important role in HIV prevention strategies. This role is collaborative in nature, from the stage of designing HIV prevention strategies to implementing prevention messages. The religious leaders noted, however, that some challenges, such as church doctrine and congregational culture, are likely to impede their HIV prevention efforts. [ABSTRACT FROM AUTHOR]

The family setting can be an opportunistic environment for parents and children to engage in physical activity (PA) together; however, there is still much to learn from families about their participation in family PA interventions. The findings presented in this paper are from an analysis of exit interviews with families (parents and children) who participated in a randomized controlled trial which explored planning as a strategy to increase PA. A rigorous inductive and deductive coding reliability thematic analysis taking a constructive realist perspective was used to code the interviews and determine themes. The major themes were benefits to family PA, barriers to family PA, and perspectives on research participation. Families identified many benefits to family PA including bonding and enjoyment. Barriers to family PA included complex family schedules and family differences. Important concerns with accelerometers, as well as perspectives on planning as a strategy and secondary fitness measurements were shared by families with respect to their research participation. Parents' awareness of their influence on their children's PA was noteworthy in this study. Planning was also perceived by the majority of families as beneficial, despite also voicing ongoing challenges with logistics. These findings support researchers who have previously suggested leveraging family-based tools and supports for enhanced PA engagement and adherence. Participants' perceptions of weight-related benefits and secondary fitness measures may have both distracted and detracted from family PA uptake and potential maintenance. Future research could benefit from family system approaches, targeted protocols and more seamless technology to better engage families. Registered Trial: clinicaltrials.gov # NCT01882192 Highlights: This study included the perspectives of children and parents together to provide greater insight. Planning as a strategy was most frequently perceived as helpful. Participants identified many benefits, such as family bonding, enjoyment, and educational benefits. Perceived barriers included family scheduling logistics, lack of time, and family differences. Complex impacts related to weight and accelerometer monitoring, and fitness testing were found. [ABSTRACT FROM AUTHOR]

Qualitative studies on assisted reproductive technology commonly focus on the perspectives of participants living in major metropolises. In doing so, the experiences of those living outside major cities, and the unique way conditions of spatiality shape access to treatment, are elided. In this paper, we examine how location and regionality in Australia impact upon access and experience of reproductive services. We conducted twelve qualitative interviews with participants residing in regional areas across Australia. We asked participants to discuss their experience with assisted reproduction services and the impacts of location on access, service choice, and experience of care, and analysed the data using reflexive thematic analysis, as outlined by Braun and Clarke (2006, 2019). Participants in this study reported that their location impacted the services available to them, required considerable time in travel, and reduced continuity of care. We draw on these responses to examine the ethical implications of uneven distribution of reproductive services in commercial healthcare settings which rely on market-based mechanisms. [ABSTRACT FROM AUTHOR]

Drawing from previous research on domestic violence and stalking, this study addresses children's experiences of their family relations in post-separation parental stalking contexts from the perspective of stalking as a form of violence against women and children. Despite the fact that violence perpetrated by a parent fundamentally changes family dynamics and children's perceptions of family security, research on children's family relations in the course of domestic violence or stalking has rarely addressed children's sense of belonging. The aim of this paper is to augment our understanding of children's experiences of family relations in connection with parental stalking. The research question is: How do children experience their belonging in family relations in the context of post-separation parental stalking? A total of 31 children and young people aged 2–21 participated in the study. The data were collected through interviews and therapeutic action group sessions with the children. The qualitative data analysis was content-oriented. Four dimensions of children's sense of belonging were identified: (1) Varying belonging, (2) distancing belonging, (3) non-belonging and (4) holding belonging. The first three dimensions are constructed in relation to the child's stalking father, while the fourth one includes the mother, siblings and other relationships that provide safety and comfort. The dimensions are parallel and not mutually exclusive. The study indicates that a finer-grained understanding of children's sense of belonging in family relations is needed when social and health care and law enforcement professionals evaluate the child's safety and best interest. [ABSTRACT FROM AUTHOR]

Although scholars have noted the detrimental nature of the various changes in higher education prompted by neoliberalism, its impact on the experiences of international Higher Degree by Research (HDR) students has yet to be adequately studied. Informed by Bourdieu's concepts of doxa, field, habitus, and capital, this paper examines the ways in which neoliberalism as doxa in the Australian higher education field has colonised the perception and practice of Chinese international HDR students whilst some students were able to demonstrate resilience to the pervasive neoliberal practices. The paper draws on a larger qualitative research project including interviews with 18 Chinese HDR students from four Australian universities. Data suggest that Chinese HDR research students gradually developed intensified dispositions of self-reliance and self-exploitation in response to neoliberal academic practices whilst others were enculturated into a floating habitus (or vulnerable position) in relation to academic publishing as they attempted to negotiate the tensions across fields and over time. Data further reveal that some participants demonstrated resilience to neoliberalism when empowered by their supervisors with less utilitarian and more critically reflexive supervisory practices. The paper argues that the embrace of neoliberalism in the Australian higher education field has become widespread yet controversial, and that thinking and enacting resilience sociologically may de-neoliberalise the higher education field in Australia and beyond. [ABSTRACT FROM AUTHOR]

Becoming a parent creates a new phase in adult development where the creation of a family brings new meanings and relational dimensions to one's life. For people who are involuntarily childless, however, the absence of children can have a multifaceted impact on their everyday lives. Although extensive studies concerning childlessness have been conducted, past work has tended to have a clinical focus on women's infertility and fertility treatments and much less attention has been paid to how involuntarily childless people live beyond the phase of trying for a child while contemporaries pursue their lives with children. This study explores the experience of 11 White, heterosexual British women in midlife living with involuntary childlessness. To gain experiential insights, semi-structured interviews were conducted and transcripts analyzed using interpretive phenomenological analysis. Analysis reveals two interrelated key patterns exemplifying intrapersonal and interpersonal features. This paper focuses on the latter. The findings bring to light not only layers of complex relational issues caused by being involuntarily childless, but also different ways of reconstructing meaning in relational reconnections that impacted positively on developing generativity. The paper presents the dynamics unique to each woman and offers micro-level understandings helpful for health professionals, family therapists, life coaches, and researchers looking into childlessness and midlife/adult development. [ABSTRACT FROM AUTHOR]

Purpose: The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life-Core Questionnaire (QLQ-C30) is a widely used generic self-report measure of health-related quality of life (HRQOL) for cancer patients. However, no validated voice script for interviewer-led telephone administration was previously available. The aim of this study was to develop a voice script for interviewer administration via telephone. Methods: Following guidelines from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Mixed Modes Good Research Practices Task Force, a randomised cross-over equivalence study, including cognitive debriefing, was conducted to assess equivalence between paper and telephone administration modes. Assuming an expected intraclass correlation coefficient (ICC) of 0.70 and a minimally acceptable level of 0.50, a sample size of 63 was required. Results: Cognitive interviews with five cancer patients found the voice script to be clear and understandable. Due to a protocol deviation in the first wave of testing, only 26 patients were available for analyses. A second wave of recruitment was conducted, adding 37 patients (n = 63; mean age 55.48; 65.1% female). Total ICCs for mode comparison ranged from 0.72 (nausea and vomiting, 95% CI 0.48–0.86) to 0.90 (global health status/QoL, 95% CI 0.80–0.95; pain, 95% CI 0.79–0.95; constipation, 95% CI 0.80–0.95). For paper first administration, all ICCs were above 0.70, except nausea and vomiting (ICC 0.55; 95% CI 0.24–0.76) and financial difficulties (ICC 0.60; 95% CI 0.31–0.79). For phone first administration, all ICCs were above 0.70. Conclusions: The equivalence testing results support the voice script's validity for administration of the QLQ-C30 via telephone. [ABSTRACT FROM AUTHOR]

While Extended Reality (XR) autism research, ranging from Augmented to Virtual Reality, focuses on socio-emotional abilities and autistic children requiring low support, common interventions address the entire spectrum and focus on other abilities, including perceptual abilities. Based on these observations, this paper first addresses common practitioners' interventions, and then suggests XR use cases and guidelines to better support them. To do so, 34 interviews were conducted with stakeholders, mainly including practitioners, and then analyzed. Emerging XR use cases were compared with the findings from two former systematic literature reviews, and emerging design guidelines were compared with the findings from a literature survey that we conducted. Findings suggest that collaborative XR sensory-based and mediation approaches could benefit the entire spectrum. [ABSTRACT FROM AUTHOR]

In Uganda, low resources for mental health provision combine with disadvantage and inadequate supports for family and community-based care. Catalysed by the need to reduce overcrowded psychiatric hospital wards and frequent readmissions at Butabika National Referral Mental Hospital (BNRMH) in Kampala, the nongovernment organisation YouBelong Uganda (YBU) developed the YouBelong Home (YBH) intervention. YBH is a theoretically eclectic pre and post hospital discharge intervention. This paper reports on qualitative findings of the project Curtailing Hospital Readmissions for Patients with Severe Mental Illness in Africa (CHaRISMA), which explored how to refine the YBH intervention. The project was funded by a UK Joint Global Health Trials (JGHT) Development Grant. Data was collected through structured interviews with service users and caregivers, reflective practice by the YBH implementing team and a stakeholder focus group. A summary of refinements to the YBH intervention follows the TIDieR format (Template for Intervention Description and Replication). [ABSTRACT FROM AUTHOR]

To include people with disabilities as equal citizens, CRPD (Convention on the Rights of Persons with Disabilities) promotes direct or supported decision-making by people with disabilities. However, involuntary psychiatry admission is considered in many countries to be necessary for people with psychosocial disabilities. To overcome the tension and implement CRPD, it is essential to understand the experiences and concerns of service users, family members, and medical professionals in each country. To understand the process and the factors that make psychiatrists decide involuntary psychiatric admission in Japan, and explore their attitudes toward direct or supported decision-making by people with psychosocial disabilities. Psychiatrists who had authorized involuntary admission and who were in charge of the service users were recruited at hospitals in Japan. The interviews were individual, peer to peer, and semi-structured. The interviews were audio-recorded, transcribed verbatim, and the analysis followed reflexive thematic analysis using NVIVO 12. Six psychiatrists (five designated psychiatrists and one psychiatric resident) participated in the study at two hospitals in urban Japan. The study found that the psychiatrists assessed symptoms, behaviors, and perceptions of the service users together with supports and wishes of their families. The psychiatrists decided on involuntary admission when they saw self-harm or violence, weak insights and judgment abilities, family's wishes, or when they wanted to avoid the service users leaving the hospital with incomplete treatment. The psychiatrists felt that the service users would not understand any explanations, which made their communications minimal. The psychiatrists thought it was hard to imagine a system other than the current involuntary admission mechanism. If it was to change, they felt the essential things were to avoid abuse, clarify who is responsible, make plans medically valid and feasible, and assess and plan through everyday life, not just in crisis. During a crisis, the psychiatrists were most careful about complying with the Mental Health Act and responded to the family's wish. The psychiatrists justified involuntary admission as they believed that people in a psychiatric crisis cannot decide or understand and need protection. Related protocols, laws, and expectations from family members shapes the values and practices of psychiatrists in Japan. The paper concludes with several recommendations to regard people with psychosocial disabilities as equal citizens, and promoting the aim of reducing or ending involuntary admission. [ABSTRACT FROM AUTHOR]

The Sequential Intercept Model has helped conceptualize interventions for people with serious mental illness in the criminal/legal system. This paper operationalizes the Sequential Intercept Model into a 35-item scorecard of behavioral health and legal practices. Using interviews, survey, and observational methods, the scorecard assesses an exploratory sample of 19 counties over 27 independent data collections. A series of ordinary least squares regression models assessed the predictor scores on four jail outcomes: prevalence of serious mental illness, length of stay, connections to treatment, and recidivism. Increases in pre-booking scores showed significant decreases in jail prevalence of serious mental illness at the p < 0.05 level, and post-booking scores and overall scores showed significant positive associations with connections to treatment at the p < 0.05 level, though these were non-significant after correcting for multiple comparisons. Preliminary findings suggest a combination of practices across the Sequential Intercept Model could have synergistic impacts on key jail diversion outcomes. [ABSTRACT FROM AUTHOR]

This paper analyses community knowledge, perceptions, and experiences of effectiveness of healthcare service provision on malaria prevention/treatment in two disease-endemic villages of the Okavango Delta panhandle in northern Botswana. A stratified random sampling of 355 households was conducted in October–November 2015. Follow-up retrospective cohort interviews were undertaken in August 2016 from 79 households that reported malaria incidences during the household survey. Data were also collected from 16 key informant interviews and 2 focus group discussions participants. Descriptive statistics and content analyses were used to summarise quantitative and qualitative data, respectively. Results indicate that communities in the study sites had positive perceptions about efficiency of health services based on availability, accessibility and utilization, adequacy of prevention and treatment interventions. Local health clinics were crucial information channels used by respondents. Additionally, factors related to acceptability, availability and accessibility are likely to contribute to perceived effectiveness of the interventions provided by healthcare service providers. Affirmation of efficiency health service provision against malaria has public health implications for adherence to treatment/prevention and participation in community health education campaigns and program implementation in the Okavango Delta region. [ABSTRACT FROM AUTHOR]

Research has repeatedly shown the positive effects of early diagnosis and intervention in improving the quality of life and symptom trajectory of individuals with autism spectrum disorder (ASD). Immigrant and racial/ethnic minority children are diagnosed with ASD at significantly older ages, and have access to interventions later than their White peers. Recent efforts to address diagnostic disparities have focused on universal ASD screening in pediatric primary care. However, little is known about immigrant families' experiences with ASD screening and with navigating subsequent referrals after receiving a positive ASD screen. In the current study, we explored cultural influences on: mothers' perceptions of child development and disability, communication with pediatric healthcare providers, and perceived benefits of Early Intervention services. We interviewed 26 mothers (14 US-born and 12 immigrant—representing twelve different nationalities) of children who screened positively for ASD in primary care but did not receive an ASD diagnosis after a formal evaluation (i.e., false positive ASD screen). Mothers completed semi-structured qualitative interviews that explored their perceptions of child development, experiences with the ASD screening and developmental evaluation process, and experiences with developmental services. Data were stratified by U.S. nativity and analyzed using applied thematic analysis. Immigrant mothers described different ways of monitoring child development than US-born mothers, and described a mismatch between their own views and the child development frameworks used in the U.S. Due to this mismatch, immigrant parents may be less likely to raise concerns to their pediatricians, and therefore may particularly benefit from routine screening. This paper uses data from a supplemental study to a larger clinical trial. The clinical trial registration number is NCT02359084. Highlights: Immigrant families view child development as a process that unfolds uniquely for each child, therefore, monitoring development through milestones can be a new idea for culturally diverse families. Immigrant children with elevated risk for ASD may be at higher risk for later identification of developmental delays if they are not screened at their well-child visits. Culturally and linguistically accessible explanations of child development and disabilities can help immigrant families throughout the ASD screening process. Immigrant families emphasize benefiting from family navigation and logistical support during the developmental evaluation process. [ABSTRACT FROM AUTHOR]

The paper examines gendered experiences of established adulthood with reference to role-related responsibilities in urban Indian families. In-depth interviews were conducted with 30 married adults aged between 35 and 45 years, from educated, high socioeconomic class families of Vadodara, India. The aim was to examine participants' reasoning about similarities and differences in potentials of men and women; and gender differences in responsibilities. Qualitative analyses revealed that both men and women attributed equal potentials for both genders, in fulfilling a range of adult roles within and outside the family. All participants also agreed that even if responsibilities were 'shared', women's involvement in different roles was much more intense than men's. Women were critical of patriarchal norms that hindered participation in the workforce and led to role overload. However, they navigated diverse roles with increased efficiency and multitasking. Men, on the other hand, showed passive acceptance and reinforced traditional gender norms in spite of complete awareness of demands generated from a rapidly changing socioeconomic milieu. However, in what may seem like a push and pull between the two genders, decisions of balancing work and family were always contextualized and embedded in an ethos of maintaining strong social and familial networks, indicating a clear preference for doing what was in everyone's best interest. Overall, results suggested that navigating traditional gender role expectations in marriage and parenthood, without compromising social and familial harmony, was a significant cultural marker of maturity in established adulthood in India. [ABSTRACT FROM AUTHOR]

Adolescents in out-of-home care generally have poor prospects for reunification with their birth families. However, for some adolescents in care, with deliberate support and intervention, there may opportunities for successful reunification. The Adolescent Reunification Program (ARP) is an Australian program designed to assist young people aged 12–17 years return home to their families. The program focuses on supporting families, mentoring young people so as to meet their developmental and educational needs, and providing a safe home environment. It also included an innovative therapeutic component which focused on addressing the consequences of intergenerational trauma in order to help repair relationships between parents and children. The purpose of this paper is to describe the therapeutic component of the program and to examine the potential value of therapy in a family reunification context with a particular focus on client receptivity and preliminary evidence on outcomes. Using case illustrations, this paper describes the therapeutic component of the ARP and provides a preliminary evaluation of these components using a mixed methods approach, including standardised psychological assessments, qualitative interviews with parents and young people, and reflections from the program workers. The therapeutic component of the ARP may have helped to break the cycle of intergenerational trauma by bringing focus to the interrelationships between how people feel and how they act. This was done through the work of therapists attempting to combine non-judgmental exploration and positive therapeutic framing with practical support within the context of the environment where the family reunification occurred. Therapy in conjunction with practical supports within a multidisciplinary collaborative approach may help to facilitate better outcomes for reunification when working with complex families. [ABSTRACT FROM AUTHOR]

Chaplains are embedded in several ambulance services across Australia, however as Australia's religiosity is currently in decline and questions are being asked about retaining chaplains, little is actually known about their role and value within Ambulance services. The aim of this paper is to present the key findings from interviews with chaplains about their role and value of being ambulance chaplains. These findings are then compared with those of paramedics derived from an earlier phase of this study. Thirteen chaplains participated in semi-structured interviews, and data were analysed using framework analysis. The results indicated that ambulance chaplains provided paramedic-centred emotional and spiritual care through proactively and reactively supporting paramedics in their work. Chaplains saw value in their relational approach which facilitated trust and access, did not seek to 'fix' or diagnose but instead offered physical and emotional presence, and promoted supportive conversations. Chaplains and paramedics valued operationally trained and equipped ambulance chaplains who provided a relational, around the clock, 'frontline' staff support presence in paramedic workplaces, regardless of the paramedic's personal religious/spiritual beliefs. [ABSTRACT FROM AUTHOR]

This paper aims to explore young people's perspectives of a real-life scenario of child language brokering in a healthcare setting (the doctor's office), when the topic of discussion is sensitive and potentially conflictual. Child Language brokers are migrant young people who translate and interpret for family members, peers and the local community. Often the spaces in which children broker (e.g., healthcare, banks), referred to here as a 'contact zone', are dominated by adults in positions of authority and unequal power differentials. The language broker and those for whom they are brokering may be in a less powerful position because of their migration status and/or age status. Existing research has focused mainly from the view of adults and young people's perspectives on the practice are underexplored. We draw the existing literature to explore how brokers understand the wider societal context and the strategies they employ to manage conflict. Findings are presented from 29 individual qualitative vignette-based interviews with language brokers (aged 13–16) in the United Kingdom which were qualitatively analysed. Findings show how these children play a vital role in protecting those for whom they broker, often navigating sophisticated social interactions and tactics (such as delay and selective modification). Equally, they carry a weight of responsibility trying to manage complicated, perhaps morally questionable, situations. By asking brokers to reflect on a real-life healthcare scenario, we are advancing understanding of migrant youth brokers and the families they support in their day to day lives. Highlights: Child language brokers find themselves brokering in health care settings with unequal power relations. Vignette methodology is a useful way of capturing complex sensitive and conflictual accounts of healthcare brokering in children. Brokering in the doctor's office required children to have knowledge of tri-interactional actors, institutional factors and wider societal norms. Young people used different strategies for managing conflict (e.g., delay tactics and selective modification). Clearer guidelines are needed around child language brokering in medical settings and spaces with contentious power inequalities. [ABSTRACT FROM AUTHOR]