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Background: Methamphetamine use disorder (MUD) is associated with poor health outcomes. Pharmacists play a role in delivery of substance use treatment, with several studies having examined their attitudes to people with opioid use disorder, but little is known about their attitude towards people with MUD. This study aimed to explore pharmacists' perspectives on the provision of services to clients with MUD. Methods: A convenience sampling strategy was used to recruit community pharmacists across Sydney, Australia. Semi structured interviews examined views and ideas of pharmacists surrounding the treatment and management of MUD, followed by coding of transcribed interview data by all members of the research team. Results: Nineteen pharmacists completed the interviews. The main theme identified was stigma held by healthcare professionals. The almost unanimous perception amongst pharmacists was fear and apprehension towards people with MUD, including underlying assumptions of criminality, misinformation regarding people with MUD, and lack of education and knowledge surrounding MUD. Conclusion: A substantial amount of stigma towards people with MUD was found in this study. Negative attitudes by healthcare professionals can perpetuate healthcare disparities and impede the accessibility of future treatment programs for people with MUD. Appropriate educational interventions on MUD for pharmacists are needed. [ABSTRACT FROM AUTHOR]

Purpose: It is well-documented that people with inflammatory arthritis (IA) exhibit a high prevalence of symptoms related to anxiety and depression. Less is known about what contributes to good mental health in people with IA. Therefore, this study aims to explore how some patients maintain good mental health despite living with IA. Methods: Explorative qualitative interview study (one focus group, 12 individual interviews, n = 18) utilizing purposeful sampling. All interviews were audiotaped, transcribed, and managed using NVivo14 and employed a reflexive thematical analysis approach. Results: We identified four main themes: 1) Assisted by a positive outlook on life—how participants' inherent positivity helped them cope with arthritis; 2) Moving towards acceptance of life with arthritis—how participants embraced the reality of living with IA; 3) Counteracting letting arthritis dictate one's life how the participants structured their lives in terms of physical activity and social connections; and 4) Taking responsibility for the trajectory—how the participants were mindful of their bodies and took the initiative to explore new treatments. Conclusion: People living with IA maintain good mental health by engaging in structured physical activity, fostering social connections, and cultivating a positive outlook on life. These insights can inform the development of future treatment and support strategies. [ABSTRACT FROM AUTHOR]

To understand how the perinatal care experiences among adolescents were impacted during the early years of the COVID-19 pandemic. Integrative review. We performed a search in the literature focusing on qualitative studies regarding the perceptions of pregnant adolescents during the pandemic (2020–2023). We described the most frequent thematic axes observed in the included studies, and we synthesized the results. The selection involved 69 articles, resulting in 9 studies from 7 countries (Indonesia, Kenya, the United Kingdom, South Africa, the United States, Malawi, and India). The studies highlight six main thematic axes: 1. Economic impact: the pandemic adversely influenced personal and family conditions, leading to early marriages and violence and exacerbating pre-existing economic inequalities. 2. Mental health: increased anxiety, depression, isolation, and fear among pregnant adolescents, with a focus on concerns related to contamination and perinatal uncertainties. 3. Compromised perinatal care: restrictions during prenatal and delivery care and lack of emotional and professional support lead to negative impacts on care for pregnant adolescents. 4. Breakdown of family Support network: school closures, family losses, and increased domestic violence affected family dynamics, influencing the occurrence of early pregnancies. 5. Impact on sexual education: school closures hindered access to contraceptives, contributing to unplanned pregnancies. 6. Vaccine hesitancy: misinformation led to hesitancy among pregnant women, highlighting the need for better communication to increase confidence in vaccination. The review emphasizes the wide geographic variety of the studies and highlights the interconnection between economic, social, and mental health factors. The pandemic intensified preexisting challenges, underscoring the importance of comprehensive support for pregnant adolescents, including emotional and psychological support. The COVID-19 pandemic exacerbated social and economic inequalities, negatively impacting the perinatal experiences of pregnant adolescents. The emphasis is on the need for comprehensive support, considering psychosocial factors, highlights the importance of more inclusive and sensitive health policies addressing the specific needs of this group during public health crises. The identified thematic axes, spanning economic, mental health, perinatal care, family support networks, sexual education, and vaccine hesitancy, illuminate the intricate challenges faced by adolescents during the pandemic. The identification of these axes provided a comprehensive analysis of the diverse consequences experienced by adolescents during the COVID-19 pandemic. It also allows the proposition of tailored interventions to mitigate the adverse effects on adolescent well-being and inform public health strategies for future pandemics or crises. [ABSTRACT FROM AUTHOR]

Aim: This article presents the findings of a qualitative study focusing on the experiences of people aged over 70 years in the interpersonal nurse–patient care relationship in hospital settings during and after the COVID‐19 pandemic. The aim was to analyse different aspects of this relationship, including nurses' behaviour and caring attitudes, the person‐centred model of care, patients' involvement in their own care and communication in the hospital context. Design: An exploratory qualitative study was conducted on the basis of an interpretative framework. Methods: Six focus groups were conducted. A total of 34 participants were purposively recruited from three nursing homes in Spain, Italy and Portugal. Specific inclusion criteria were used to select participants. Results: Five main categories were identified. Analysis revealed the importance of empathy and sensitivity in caring relationships, as well as the need for personalized and patient‐centred care. The importance of effective communication and recognition of ageist behaviour by professionals was highlighted. In addition, independent of the pandemic, situational factors in the hospital environment were identified that influence the interpersonal care relationship. Conclusions: The study highlights the need to promote a person‐centred model of care that takes into account the specific preferences and needs of older people. This is achieved by identifying elements of the interpersonal nurse–patient relationship. In addition to highlighting the disparity of opinion regarding an active or passive role in self‐care and decision making, the importance of addressing ageism and improving communication is emphasized. What problem did the study address?: The importance of the patient–nurse relationship in hospital care has been highlighted in previous studies.Critical elements of the patient care experience have been identified as empathy and effective communication.Ageism in healthcare has been recognized as a potential barrier to patient‐centred care. What were the key findings?: The main findings highlight the importance of empathy and personalized care, emphasize the importance of effective communication and address ageist behaviours in the nurse–patient relationship. Where and who will the research impact?: By highlighting the need for person‐centred care and improved communication strategies, particularly in the context of caring for older patients during and after the COVID‐19 pandemic, this research will have an impact on healthcare professionals, policy makers and carers. Reporting Method: The COREQ guideline was used. Patient or public contribution: This study adopted a collaborative approach to ensure that patient perspectives were integrated into the research process. We organized regular focus groups. Patients were actively involved in shaping the research questions, refining the study design and interpreting the emerging findings. Their valuable input helped us to understand the nuances of their experience and to prioritize the aspects that were critical to their well‐being. In addition, their insights guided the development of practical recommendations aimed at improving the interpersonal care relationship between nurses and patients in hospital settings, ensuring that their voices were heard and reflected in the proposed interventions. This patient‐centred approach fostered a sense of empowerment among the participants. It reinforced the notion that their experiences and opinions are integral to shaping healthcare practice. [ABSTRACT FROM AUTHOR]

Autonomy is a fundamental requirement for the professional practice of journalism. However, while its role in ensuring well-informed audiences is widely acknowledged, the way in which audiences make sense of journalists’ autonomy remains unexplored. Similarly, the understanding of how audience perceptions of journalists’ autonomy, their attributed professionalism and authority, and the resulting impact on journalism practice remains incomplete. To address these gaps, this study conducts a qualitative analysis involving semi-structured interviews with 64 news users in Chile. Results show that journalists’ autonomy, from audiences’ view, is limited by labor forces and organizational influences. Journalists’ working conditions are perceived to be connected to high levels of editorial control, yielding a deficiency of autonomy that relegates journalists to a subservient role, compromising their professionalism, undermining their authority, and eroding the quality of the information they provide. Also, findings show that autonomy assumes a prominent role as a distinct form of authority when journalists diverge from conventional news norms, establishing a closer connection with their audience. Furthermore, independent journalists frequently garner recognition for their autonomy and credibility, attributed to their detachment from specific media outlets. The article delves into the implications of these findings for journalism studies and practice. [ABSTRACT FROM AUTHOR]

Background: The treatment of multiple sclerosis, an autoimmune disease that predominantly affects women of reproductive age, has undergone considerable advancements. Nevertheless, their unique needs, particularly those related to motherhood, continue to be disregarded. This study aims to ascertain the needs of women diagnosed with MS about motherhood. Methods: Using the Noblit and Hare methods, meta-synthesis research was conducted on 10 qualitative studies. The relevant studies were obtained by conducting a comprehensive search using keywords in the PubMed, Scopus, Web of Science (ISI), and ProQuest databases without any time limitations until June 2023. The CASP checklist was used to assess the quality of the articles, while the technique of Brown and Clark (2006) was utilized for data synthesis. Results: Four key themes emerged from this meta-synthesis, highlighting the significance of a support system, psychoeducational counseling, knowledge promotion, and continuous, comprehensive, and unique care. Conclusion: Identifying the needs of women diagnosed with MS and addressing these needs concerning motherhood can enhance the quality of services rendered and enhance women's contentment with their choice to embark on motherhood. Furthermore, recognizing these needs during subsequent stages can be utilized in formulating tailored programs catering to this specific cohort of women. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Method Results Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To explore the lived experience of donors and recipients involved in peer‐to‐peer human milk donation.An exploratory descriptive qualitative study.Semi‐structured interviews were conducted between November 2022 and April 2023. A total of 50 women consisting of 34 donors and 16 recipients were recruited using purposive sampling from specific social media groups in Hong Kong that focus on breast milk donation and sharing. Data were analysed based on thematic analysis.Five key themes were identified in this study: Motivation; Milk sharing as a social act; Not a Norm; Recommendation to formal milk banks; and Formal donation as the preferred route.The findings indicate informal milk sharing is seen as an inferior alternative to formal milk donation systems. The establishment of formal milk banks is viewed as a way to address the shortcomings of informal sharing.The findings have implications for the healthcare field, particularly in improving the experiences of those involved in informal milk sharing. The insights gained from the experiences of informal milk sharers can directly inform and enhance the services provided by formal milk banks.Given the growing prevalence of online informal milk sharing, healthcare professionals should enhance their understanding of this practice. However, the practice has remained understudied, particularly in Asian region. This study brings together the experiences of both milk donors and recipients, providing a comprehensive view on the phenomenon.The Standards for Reporting Qualitative Research (SRQR).No patient or public contribution. [ABSTRACT FROM AUTHOR]

In the 1970s, the movie Kramer versus Kramer dramatized the destructiveness of child custody disputes. It helped inspire family law reform and careers. The central problem identified was an adversarial system and hostile litigation. The proposed solution was alternative dispute resolution (ADR). Over time, these alternatives became an integral part of the family law response to child custody cases, except in cases of vulnerable parties. Today's parents are under greater legal and social pressure to resolve disputes without resorting to court. This can be welcomed and resisted by parents. This article focuses on parental resistance to dispute resolution over litigation through a return to Hollywood. The movie Marriage Story is used to show how parents might feel alienated rather than relieved by opportunity to cooperatively problem‐solve differences. Implications are explored in part through drawing from ethnographic research on parents who engaged in mediation through a U.S. family court program and through two Australian Family Relationship Centres (FRC). Key points for the family court community: Popular culture, such as movies, can be used by professionals to consider why parents may not perceive services and systems according to professional expectations.Comparing two divorce movies, produced 40 years apart, helps to consider how evolving societal expectations about custody and disputing may impact parent perceptions and behaviors.This article uses the author's past research to examine the depiction of a custody dispute in the movie, Marriage Story (2019).The movie portrayal of contemporary divorce and research outcomes presented in this article help explain how and why some parents may feel more alienated than empowered under today's family dispute resolution paradigm.An example of conflict for some parents in both the movie Marriage Story and in research study results was how they felt when advised to avoid court while considering implications of court oversight and judgment. In the movie, this is framed as, "Court or No Court." [ABSTRACT FROM AUTHOR]

Background: Given the growing population of older adults globally, e-Health plays an indispensable role in the chronic disease management of multimorbidity. However, qualitative evidence that synthesizes the experiences of older adults with multimorbidity using e-Health service is currently lacking. The objective was to explore the experiences and perceptions of e-Health care in community-based settings among the older adults with multimorbidity. Methods: Seven electronic databases including PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, China National Knowledge Infrastructure, and Chinese BioMedical Literature were searched, and the search was limited to studies from inception to September 1, 2023. Screening, data extraction, and quality appraisal were conducted independently by two reviewers. Thomas and Harden's thematic synthesis methodology was applied to synthesize the original themes. The methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the confidence of synthesized themes was evaluated by the Confidence in the Evidence from Reviews of Qualitative Research approaches. Results: Ten studies with moderate methodological quality met eligibility criteria and were included finally. Studies were conducted in four countries with 235 participants who were living with multiple chronic conditions. Among the 10 included studies, 37 credible findings were extracted and interpreted into 3 synthesized themes and 12 subthemes: (1) advantages and benefits perceived during e-Health service, (2) multidimensional challenges and negative experience posed by e-Health service, and (3) preferences, suggestions, and expectations for future e-Health improvement. The confidence in the majority of the three final synthesized themes was rated between "low" and "moderate" scales. Conclusions: The findings of this study provide new insights into implementing tailored e-Health care for older adults with multimorbidity. Further research should emphasize on realizing the potential value of e-Health service based on users' needs and perspectives to promote age-friendliness in geriatric practice. [ABSTRACT FROM AUTHOR]

Purpose: The Wheelchair Skills Training Program (WSTP) is underutilized in pediatrics for training manual wheelchair skills because the voluminous manual lacks pediatric specificity and no materials adapted for pediatric manual wheelchair users (PMWUs) are available. A set of resources (storybook, posters, training workbook) based on the WSTP has previously been developed for training basic indoor wheelchair skills with five to 15-year-old PMWUs. Occupational therapists (OTs) and PMWUs expressed a need for additional resources addressing higher-level skills. Two new sets of resources teaching indoor and community wheelchair skills were developed. Objective: Describe OTs' and PMWUs' satisfaction and perceptions regarding usability, relevance and feasibility in pediatrics with the new resources. Methods: A descriptive qualitative study was conducted. A focus group and interviews were respectively conducted with a convenience sample of OTs and a criterion sample of PMWUs to document perceptions regarding satisfaction, usability, relevance and feasibility. A deductive approach to data analyses was used following the Framework Method. Results: Six OTs expressed satisfaction regarding both sets of resources feeling more confident using the WSTP (relevance) and perceiving potential time efficiencies when planning training interventions (feasibility). They provided suggestions to improve the usability of the second set. Six PMWUs participated in the interviews, two of which provided feedback on both sets. They were satisfied with the resources recommending them to novice and temporary PMWUs aged from three to 11 years. Conclusion: Participants' suggested the resources may contribute to reducing the gap between the evidence supporting the WSTP and its utilization in pediatrics. IMPLICATIONS FOR REHABILITATION: Two sets of knowledge transfer resources based on the Wheelchair Skills Training Program (WSTP) are pediatric-friendly materials that could be used in rehabilitation settings to train wheelchair skills among novice and temporary manual wheelchair users. Both sets of knowledge transfer resources may help bridge the gap between the evidence supporting the WSTP and its utilization in pediatrics by responding to clinicians' needs for playful, easy-to-use and condensed materials to use in their interventions. The perspectives of occupational therapists and pediatric manual wheelchair users are important to improve the wheelchair skills training resources so that they align with both knowledge users' needs and preferences. [ABSTRACT FROM AUTHOR]

This study was conducted to analyze the results of using generative artificial intelligence (AI) in the analysis of data in studies employing qualitative methodologies. The researchers sought to investigate the question: Can a human qualitative evaluator uncover the same themes as a generative AI bot from semi-structured interviews? A non-evaluator researcher was used to select the topic, exclusionary criteria, source of transcripts, and the transcripts to be analyzed. Two evaluator researchers then analyzed the data using Quirkos software to produce themed discoveries. A bot was used to complete the same task. The results obtained from the two evaluator researchers and the generative AI were then compared with the study conducted by Morgan (2023). The researchers concluded that a generative AI bot is a good starting point for theme analysis, but humans are still needed for nuanced analysis and emotional understanding in analysis. [ABSTRACT FROM AUTHOR]

Abstract Background The treatment of multiple sclerosis, an autoimmune disease that predominantly affects women of reproductive age, has undergone considerable advancements. Nevertheless, their unique needs, particularly those related to motherhood, continue to be disregarded. This study aims to ascertain the needs of women diagnosed with MS about motherhood. Methods Using the Noblit and Hare methods, meta-synthesis research was conducted on 10 qualitative studies. The relevant studies were obtained by conducting a comprehensive search using keywords in the PubMed, Scopus, Web of Science (ISI), and ProQuest databases without any time limitations until June 2023. The CASP checklist was used to assess the quality of the articles, while the technique of Brown and Clark (2006) was utilized for data synthesis. Results Four key themes emerged from this meta-synthesis, highlighting the significance of a support system, psychoeducational counseling, knowledge promotion, and continuous, comprehensive, and unique care. Conclusion Identifying the needs of women diagnosed with MS and addressing these needs concerning motherhood can enhance the quality of services rendered and enhance women’s contentment with their choice to embark on motherhood. Furthermore, recognizing these needs during subsequent stages can be utilized in formulating tailored programs catering to this specific cohort of women.

The use of e-cigarettes has been rapidly expanding in recent years. The reasons people in Slovenia chose to use electronic cigarettes have not been studied to date. This study examines e-cigarette users' attitudes regarding their health risks.

Background In the face of the serious challenges posed by the high prevalence of chronic diseases among the elderly and the coexistence of multiple chronic diseases, the health problems of community-dwelling elderly people' with multimorbidity require urgent attention. The comorbidity management model is being explored and practiced. Disease experience, as self-reported health information from patients, is expected to become a key component of the patient-centered community multimorbidity management model. Objective This study aimed to gain a deeper understanding of the real disease experience of community-dwelling elderly people with multimorbidity and provide a basis for personalized health management and supportive strategies of the group. Methods This study used purposive sampling and maximum difference sampling to select eligible interviewees from four communities under the jurisdiction of a community health service center in Zhengzhou City from August to September in 2022. Based on the principle of information saturation, 20 subjects were ultimately included. Based on the research objective, literature review, and expert consultation results, the preliminary interview outline was formulated, and the final interview outline was determined after interviewing 2 patients. Semi-structured interviews were conducted with the study participants, guided by the phenomenological research methodology. Golaizzi analysis was used to analyse the data. Results Four themes and eleven sub-themes had been extracted from this study, including mainly long-standing symptomatic distress (physical dysfunction, fatigue, sleep disorders, and pain), negative psychological experiences (feelings of helplessness and worry about future life, reduced sense of social value and self-identity, and loneliness with altered social activities), positive mindset of coexisting harmoniously with multimorbidity (being grateful for being satisfied, and positively adapting), and aspirations in times of adversity (hoping for improvement in functioning, and seeking multi-directional social support) . Conclusion Physical dysfunction, sleep disturbances, fatigue, and pain are the most concerning health disturbances for community-dwelling elderly people with multimorbidity. The symptom management and multiple social support of the multimorbidity need to be strengthened. In the future, it is expected that multidimensional data would be used for dynamic health assessment to explore the common and individual patterns of multimorbidity, and to achieve precise management and intervention of elderly multimorbidity in the community.

Background: CAR-T therapy has emerged as a potentially effective treatment for individuals diagnosed with hematologic malignancies. Understanding patients’ unique experiences with this therapeutic approach is essential. This knowledge will enable the development of tailored nursing interventions that align with the increasing importance of patient-centered care. Objective: To examine and synthesize qualitative data on patients and their family caregivers’ experiences during the treatment journey. Design: We conducted a systematic review and qualitative meta-synthesis. Eligible studies contained adult patient or family caregiver quotes about experiences of CAR-T therapy, published in English or Chinese in a peer-reviewed journal since 2015. Data sources included MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Scopus, Cochrane Library, CNKI, and WanFang. Methods: Systematic search yielded 6373 identified articles. Of these, 12 reports were included in the analysis, which covered 11 separate studies. Two reviewers independently extracted data into NVIVO 12.0. Qualitative meta-synthesis was performed through line-by-line coding of full text, organization of codes into descriptive themes, and development themes. Results: The qualitative meta-synthesis yielded eight primary themes. Noteworthy revelations from patients and their family caregivers regarding the CAR-T therapy journey encompassed various aspects. Prior to CAR-T therapy, patients experienced a lack of actual choice, struggled with expectations for treatment outcomes, and encountered intricate emotional experiences. During or immediately after CAR-T therapy, patients reported both comfortable and uncomfortable experiences. Additionally, patients emphasized that concerns regarding treatment efficacy and adverse reactions intensified treatment-related distress. After CAR-T therapy, significant changes were observed, and the burden of home-based rehabilitation. Additionally, we found factors contributed to the high CAR-T therapy cost. Conclusions: To ensure the safety and sustainability of CAR-T therapy, it is crucial to address the physical and psychological aspects of the patient's experience. Effective communication and comprehensive management are highly valued by patients and their caregivers. Further research should investigate ways to reduce burdens and develop self-management education programs for patients and their families. [ABSTRACT FROM AUTHOR]

Copyright of TEC Empresarial is the property of Instituto Tecnologico de Costa Rica, Escuela de Administracion de Empresas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Early referral to palliative care has been viewed as providing opportunity for accomplishing end‐of‐life care goals of life closure, comfortable dying and effective grieving. However, previous studies have shown that palliative care referrals are being made too late. Healthcare providers play important role in helping terminally ill patients to early access and being referred to palliative care. It is necessary to understand healthcare providers' attitudes on palliative care referral and associated factors regarding referrals. Objectives: This review aimed to identify and synthesise healthcare providers' attitudes and associated factors on palliative care referrals systematically. Design: A systematic review of qualitative evidence and meta‐aggregation was conducted and guided according to PRISMA guideline. Data sources: PubMed, CINAHL, PsycINFO, EMBASE, Web of Science and Cochrane databases from inception to 24 October 2022. Results: Database searches yielded 5856 references. Twenty‐two studies met eligibility criteria and of moderate to high methodological quality were included. Studies occurred in USA, UK, Australia and France with 716 healthcare providers participants were included. A total of 378 codings were finally extracted and integrated into 41 categories, forming three synthesised findings: (1) Healthcare providers' attitudes towards palliative care referrals, (2) the influence of subjective norms on palliative care referral behaviour and (3) perceived behavioural control on palliative care referral behaviour. Conclusion: This review demonstrates a series of factors that affect the palliative care referrals, including the attitudes of healthcare providers, the participation of patients and families, the support of colleagues and supervisors, inter‐professional collaboration, the availability of hospice resource, disease trajectory and socio‐economic factors. Further research that addresses these factors and design relevant trainings on improving healthcare providers' attitudes, enhancing patient and family engagement, strengthening support networks and optimising resource allocation may aid to meet increasing demands of patients. Relevance to Clinical Practice: This review not only guides healthcare providers in making better decisions about patient referrals by identifying and addressing barriers but also aids in the development of effective interventions that facilitate the early initiation of referrals. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Most of the women from the B40 groups have been involved in informal business. Many mumpreneurs need higher knowledge, education, motivation, imbalance between work and household roles, and financial restraint in developing a business. Therefore, the objective of this study is determined based on the level of bankability status among B40 managers and to assess the issue of financial management, which could affect their bankability and business expansion. This study uses a qualitative method, and the research instrument used is a semistructured interview. The data were analyzed using descriptive and inductive techniques. The study involved 23 respondents who are B40 mumprenuers who live in PPR Kerinchi Lembah Pantai. Thematic analysis is employed to analyze, identify, and report themes and patterns in the research data. The analysis is done by combining approaches: 1) descriptive approach and 2) inductive (data-driven) approach. The findings revealed that the level of bankability among mumprenuers is low. Second, the results of the inductive approach revealed that most of the mumpreneurs practicing poor financial management could affect their business's sustainability. The implication is that mumpreneurs still need continuous disclosure and awareness in managing their finances, especially in cash inflow and outflow, budgeting, and decision-making. [ABSTRACT FROM AUTHOR]

The “Emergency Department Pathology Order Support Tool” (EDPOST) is an electronic laboratory test ordering decision support tool that aims to decrease variation in test ordering practices. As part of a larger project on the codesign, development, and evaluation of ED-POST, this study aimed to explore the workflow nuances that might affect the intended use of the digital decision support tool. Semi-structured, in-depth interviews were conducted with 15 ED clinicians involved in the laboratory test ordering process across the development and evaluation phases of ED-POST. Participants identified the expanded role of registered nurses in test ordering and the practice of ordering tests that are outside the ED’s scope as contextual characteristics that can affect the use and perceived utility of the proposed ED-POST tool. Reconciling “work-as-imagined” with “work-as-done” in the design and development of electronic interventions is important in achieving interventions to improve the safe and effective use of pathology tests. [ABSTRACT FROM AUTHOR]

Purpose It is well-documented that people with inflammatory arthritis (IA) exhibit a high prevalence of symptoms related to anxiety and depression. Less is known about what contributes to good mental health in people with IA. Therefore, this study aims to explore how some patients maintain good mental health despite living with IA. Methods Explorative qualitative interview study (one focus group, 12 individual interviews, n = 18) utilizing purposeful sampling. All interviews were audiotaped, transcribed, and managed using NVivo14 and employed a reflexive thematical analysis approach. Results We identified four main themes: 1) Assisted by a positive outlook on life—how participants’ inherent positivity helped them cope with arthritis; 2) Moving towards acceptance of life with arthritis—how participants embraced the reality of living with IA; 3) Counteracting letting arthritis dictate one’s life how the participants structured their lives in terms of physical activity and social connections; and 4) Taking responsibility for the trajectory—how the participants were mindful of their bodies and took the initiative to explore new treatments. Conclusion People living with IA maintain good mental health by engaging in structured physical activity, fostering social connections, and cultivating a positive outlook on life. These insights can inform the development of future treatment and support strategies.

ABSTRACTBackground: Methamphetamine use disorder (MUD) is associated with poor health outcomes. Pharmacists play a role in delivery of substance use treatment, with several studies having examined their attitudes to people with opioid use disorder, but little is known about their attitude towards people with MUD. This study aimed to explore pharmacists’ perspectives on the provision of services to clients with MUD.Methods: A convenience sampling strategy was used to recruit community pharmacists across Sydney, Australia. Semi structured interviews examined views and ideas of pharmacists surrounding the treatment and management of MUD, followed by coding of transcribed interview data by all members of the research team.Results: Nineteen pharmacists completed the interviews. The main theme identified was stigma held by healthcare professionals. The almost unanimous perception amongst pharmacists was fear and apprehension towards people with MUD, including underlying assumptions of criminality, misinformation regarding people with MUD, and lack of education and knowledge surrounding MUD.Conclusion: A substantial amount of stigma towards people with MUD was found in this study. Negative attitudes by healthcare professionals can perpetuate healthcare disparities and impede the accessibility of future treatment programs for people with MUD. Appropriate educational interventions on MUD for pharmacists are needed.

Background On 15 March 2019, a white supremacist gunman sequentially attacked two mosques in Christchurch, New Zealand, killing 51 people aged from 3 to 77 years and bullet-injuring 40 more. Approximately 250 people survived the atrocity, and many more family and community members have been directly or indirectly affected. Aim To develop an understanding of the personal experiences of some of those affected, including effects on daily life and well-being, in the 18–30 months following the attacks. Method Qualitative thematic analysis of semi-structured interviews with 21 men and women from September 2020 to August 2021 was performed. Participants were drawn from a larger quantitative study and included injured, bereaved, witnesses, family members and those from the wider Muslim community in Christchurch. Results Four superordinate themes were identified: being overwhelmed in the midst of chaos; experiencing silent and enduring impact; living similarly, but differently; and gaining meaning and growth. These themes captured ongoing distress inclusive of physical symptoms, family and community relationship dynamics and connectedness, secondary stressors, and diversity in coping and growth. For most, the centrality of Islam as a faith tradition was woven throughout. Conclusion Consistent with previous literature, post-trauma reactions were pervasive and varied. This appeared to be compounded by secondary stressors in this cohort, such as sociopolitical circumstances, demographic diversity, the COVID-19 pandemic and justice processes. Findings also revealed a strong spiritual thread in the experiences of this minority faith community, shedding light on a complex interaction between recovery and post-traumatic growth.

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States of America (USA). Cervical cancer is the most common HPV-related cancer, which leads to approximately 4000 deaths yearly in women. Despite the nationwide availability of the HPV vaccine, the coverage and series-completion rates have been historically low due to multiple barriers. Previous systematic literature reviews emphasize global quantitative studies regarding parents of pediatric populations. This study aimed to evaluate qualitative studies conducted in the USA to characterize the facilitators and barriers to HPV uptake among eligible women. Four databases, including PubMed/MEDLINE, Embase, Scopus, and the Cumulative Index for Nursing and Allied Health Literature (CINAHL), were utilized to search the literature for comprehensive qualitative studies from 2014 to 2023 with pre-selected inclusion criteria. This review was conducted in compliance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After detailed full-text extraction, 26 studies met the inclusion criteria, and two authors extracted the data. Three themes emerged from the data: (1) facilitators perceived by women to uptake the HPV vaccine, (2) barriers perceived by women to uptake the HPV vaccine, and (3) barriers and facilitators perceived by women to uptake the HPV vaccine. These themes highlighted different barriers and facilitators to HPV vaccines uptake, such as the lack of healthcare provider recommendation, cost, and safety concerns as barriers to receiving the vaccine. To change the norms towards HPV vaccine hesitancy, the healthcare team has a important opportunity to impart the knowledge and skills known to elicit behavior change.

Background: Patients receiving a brain cancer diagnosis may face cognitive decline and a poor prognosis. In addition, they suffer from a high symptom burden in a complex cancer pathway. The aim of this study was to investigate the early hospital experiences of brain tumour patients during the diagnostic and surgical treatment phase. Methods: A descriptive longitudinal single‐case study design was used, and data were analysed via systematic text condensation. Results: The patients' experiences of being diagnosed with and treated for brain cancer were interpreted in terms of the central theme: a fast transition into an unknown journey. This theme consisted of the following subthemes: emotionally overwhelmed, putting life on hold and an unfamiliar dependency. Conclusions: Patients diagnosed with brain cancer struggle with overwhelming emotions due to this sudden life‐threatening diagnosis, their fear of brain surgery and their progressing dependence. Patients did not voice their feelings, fears or needs, so these may easily be overlooked and unmet. A proactive and continuous care approach throughout the diagnostic phase is needed to support these patients. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States of America (USA). Cervical cancer is the most common HPV-related cancer, which leads to approximately 4000 deaths yearly in women. Despite the nationwide availability of the HPV vaccine, the coverage and series-completion rates have been historically low due to multiple barriers. Previous systematic literature reviews emphasize global quantitative studies regarding parents of pediatric populations. This study aimed to evaluate qualitative studies conducted in the USA to characterize the facilitators and barriers to HPV uptake among eligible women. Four databases, including PubMed/MEDLINE, Embase, Scopus, and the Cumulative Index for Nursing and Allied Health Literature (CINAHL), were utilized to search the literature for comprehensive qualitative studies from 2014 to 2023 with pre-selected inclusion criteria. This review was conducted in compliance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After detailed full-text extraction, 26 studies met the inclusion criteria, and two authors extracted the data. Three themes emerged from the data: (1) facilitators perceived by women to uptake the HPV vaccine, (2) barriers perceived by women to uptake the HPV vaccine, and (3) barriers and facilitators perceived by women to uptake the HPV vaccine. These themes highlighted different barriers and facilitators to HPV vaccines uptake, such as the lack of healthcare provider recommendation, cost, and safety concerns as barriers to receiving the vaccine. To change the norms towards HPV vaccine hesitancy, the healthcare team has a important opportunity to impart the knowledge and skills known to elicit behavior change. [ABSTRACT FROM AUTHOR]

The purpose of this article was to explore, from the perspective of students and graduates with disabilities, the skills that are necessary to be self-determined at university, why these are important, and how they can be developed to remain in university and graduate successfully. A systematic review, including 16 qualitative studies with a total of 303 participants, was carried out. The results provide information on: essential skills to facilitate self-determination and successful completion of university studies (problem-solving skills, learning about oneself, goal setting, self-management, self-advocacy) and attributes (autonomy, resilience, and empowerment); the reasons for being self-determined at university (achieving academic goals, overcoming barriers, demonstrating abilities, self-confidence, and academic success); and how self-determination can be learned at university (trial and error; family, faculty and peers; disability services; peers; specific programmes; and information technology communication). The conclusions are encouraging and show that self-determination can be learned in universities with the necessary supports. [ABSTRACT FROM AUTHOR]

Human-driven changes threaten environmental and economic stability, prompting the formulation of sustainability objectives and innovation efforts to mitigate the negative impacts of economic activities. However, the pace of this transition is often seen as slow, and businesses' commitment to sustainable development is frequently deemed insufficient. In this context, the current study explores the motivational factors that drive businesses to adopt and implement sustainable practices. The findings reveal significant differences in how companies approach social and environmental sustainability and balance it with economic goals. To capture the diversity of motivations behind sustainability initiatives, investments, and related preparatory planning, we propose a model of three types of existing development mindsets in companies, distinguishing between "a spreadsheet mindset", "a mindset of strategic capabilities" and "a value-driven mindset". This typology serves as a tool for companies to self-assess their motivations as well as for governments to fine-tune sustainability regulations and support mechanisms accordingly. [ABSTRACT FROM AUTHOR]

Laboratory tests play an integral role in the delivery of quality health care. However, evidence indicates variations in diagnostic testing, which can lead to patient safety risks. Electronic decision support systems are often identified as key to reducing diagnostic error. However, such tools are often introduced into a clinical setting with little understanding of clinician workflow and how tools are likely to impact this. This study reports a qualitative co-design methodology and results from the first phase in the design and development of an analytics-driven, dashboard approach to supporting clinician test ordering in the Emergency Department. [ABSTRACT FROM AUTHOR]

Objectives: Refugee studies require extra attention due to ethical concerns and language-cultural differences. We aimed to compare the challenges and opportunities of online focus group discussions (FGDs) conducted with Syrian refugee mothers. Materials and Methods: We used data from face-to-face and online FGDs of a study investigating the breastfeeding characteristics of Syrian mothers. FGDs were carried out with Syrian mothers and grandmothers (Group I-II), and Syrian healthcare workers (Group III) in Turkey. A total of 7 focus group discussions (FGDs) were performed face to face. 47 Syrian mothers and grandmothers and 16 Syrian HCWs attended these meetings. In two different provinces, a total of 7 FGDs were conducted online with 30 Syrian refugees, and 15 Syrian HCWs. All face-to-face FGDs were performed in Refugee Health Centres (RHCs). Online FGDs with Group I-II were performed using the technical equipment-facilities of RHCs. Group III attended the FGDs with their own devices from wherever they wanted. Thematic analysis of the transcripts in a deductive-inductive fashion was carried out with MAXQDA 11. Results: Online FGDs were more favorable than face-to-face FGDs in terms of planning, selection of participants, cost, moderation, providing a heterogeneous group, equal participation, ease of recording and transcribing, privacy and anonymity, and comfort of participating. On the other hand, internet interruption and not focusing on the meeting were disadvantages of online FGDs with Group III. Conclusion: Providing technological and technical support and utilizing facilitators and interpreters of the same nationality as the refugees at every stage of the study eliminated many disadvantages of online FGDs. [ABSTRACT FROM AUTHOR]

Background Community First Responders are trained volunteers dispatched by ambulance services to potentially life-threatening emergencies such as cardiac arrest in the first vital minutes to provide care until highly skilled ambulance staff arrive. Community First Responder schemes were first introduced to support ambulance services in rural communities, where access to prehospital emergency care is more likely to be delayed. Evidence is lacking on their contribution to rural healthcare provision, how care is provided and how this might be improved. Objectives We aimed to describe Community First Responder activities, organisation, costs of provision and outcomes of care together with perceptions and views of patients, public, Community First Responders, ambulance service staff and commissioners of their current and future role including innovations in the rural health and care workforce. Design We used a mixed-methods design, using a lens of pragmatism and the ‘actor’, ‘behaviour change’ and ‘causal pathway’ framework to integrate quantitative routine and qualitative (policy, guideline and protocol documents with stakeholder interview) data from 6 of 10 English ambulance services. We identified potential innovations in Community First Responder provision and prioritised these using a modified nominal group technique. Patients and public were involved throughout the study. Results In 4.5 million incidents from six English regional ambulance services during 2019, pre COVID-19 pandemic, Community First Responders attended first a higher proportion of calls in rural areas (almost 4% of calls) than in urban areas (around 1.5%). They were significantly more likely to be called out to rural (vs. urban) areas and to attend older (vs. younger), white (vs. minority ethnic) people in more affluent (vs. deprived) areas with cardiorespiratory and neurological (vs. other emergency) conditions for higher-priority emergency or urgent (category 1 and 2 compared with category 3, 4 or 5) calls but did also attend lower-category calls for conditions such as falls. We examined 10 documents from seven ambulance services. Ambulance policies and protocols integrated Community First Responders into ambulance service structures to achieve the safe and effective operation of volunteers. Costs, mainly for training, equipment and support, varied widely but were not always clearly delineated. Community First Responders enabled a faster prehospital response time. There was no clear benefit in out-of-hospital cardiac arrest outcomes. A specific Community First Responder falls response reduced ambulance attendances and was potentially cost saving. We conducted semistructured interviews with 47 different stakeholders engaged in Community First Responder functions. This showed the trajectory of becoming a Community First Responder, the Community First Responder role, governance and practice, and the positive views of Community First Responders from stakeholders despite public lack of understanding of their role. Community First Responders’ scope of practice varied between ambulance services and had developed into new areas. Innovations prioritised at the consensus workshop were changes in processes and structures and an expanded scope of practice supported by training, which included counselling, peer support, better communication with the control room, navigation and communication technology, and specific mandatory and standardised training for Community First Responders. Limitations Missing data and small numbers of interviews in some stakeholder groups (patients, commissioners) are sources of bias. Future research Future research should include a robust evaluation of innovations involving Community First Responders. Trial registration This trial is registered as ClinicalTrials.gov, NCT04279262. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR127920) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 18. See the NIHR Funding and Awards website for further award information. Plain language summary Background Community First Responders are volunteers who attend emergencies, particularly in rural areas, and provide help until the ambulance arrives. Research aims We aimed to describe Community First Responder activities, costs and effects and get the views of the public, Community First Responders, ambulance staff and commissioners on the current and future role of Community First Responders. Research design Our study design combined different approaches. We examined routine ambulance patient information, reviewed ambulance policies and guidelines, and gathered information from interviews to make sense of our findings. Through interviews we learned about ways that the work of Community First Responders had been enhanced or could be improved. In a 1-day workshop, a group of lay and professional experts ranked in order of importance ideas about future developments involving Community First Responders. Research findings Community First Responders arrived before ambulance staff for a higher proportion of calls in rural than in urban areas. They attended people with various conditions, including breathing problems, chest pain, stroke, drowsiness, diabetes and falls, and usually the highest-priority emergencies but also lower-priority calls. Policies aimed to ensure that Community First Responders provided safe, effective care. Costs, mainly used for management, training and equipment, were sometimes incomplete or inaccurate and varied widely between services. Community First Responders attending meant faster responses and positive experiences for those patients and relatives interviewed. A Community First Responder scheme responding to people who had fallen at home led to fewer ambulances attending and possible financial savings. Survival among people attended because their heart had stopped was no better when Community First Responders arrived early. Interviews revealed why and how Community First Responders volunteered and were trained, what they did and how they felt. Interviewees were largely positive about Community First Responders. Improvements suggested included support from colleagues or counsellors, better communication with ambulance services, technology for communication and locating patients, and better training. Conclusions Community First Responders have benefits in terms of response times and patient care. Future improvements should be evaluated. Scientific summary Text in this section is reproduced from Botan V, Asghar Z, Rowan E, et al. What Is the Contribution of Community First Responders to Rural Emergency Medical Service Provision in the UK? Paper presented at: Society for Academic Primary Care Annual Scientific Meeting: Recovery and Innovation; 4–6 July 2022; University of Central Lancashire, Preston, England, which is an open access article distributed under the terms of the Creative Commons CC BY-NC licence, which permits unrestricted use, distribution, and reproduction in any medium, for non-commercial use, provided the original work is properly cited. See http://creativecommons.org/licenses/by-nc/4.0/. Background Community First Responders (CFRs) are trained lay (and sometimes health professional) volunteers dispatched by Emergency Medical Services (EMS) to potentially life-threatening emergencies such as cardiac arrest in the first vital minutes to provide care until ambulance staff arrive. CFR schemes were first introduced to support ambulance services to rural communities where access to prehospital emergency care is more likely to be delayed. Apart from a few small-scale evaluations, surveys and qualitative studies of CFRs, evidence is lacking for their contribution to rural EMS provision, how care is provided and how this might be improved. We sought to provide evidence for the contribution and costs of CFR schemes to rural healthcare delivery and outcomes and to identify ways that these services can be improved, innovated or developed further to benefit rural communities. Objectives We aimed to investigate current activities, costs of provision and outcomes of CFR schemes, and explore views of patients, public, CFRs, CFR leads and primary care commissioners on CFRs, working with our stakeholders to develop recommendations for future innovations in rural CFR provision. Our objectives were to: 1. Describe the contribution of CFRs to rural healthcare provision in terms of the numbers and timing of calls attended, together with the types of conditions and characteristics of people attended. 2. Evaluate the costs, funding sources and consequences [response time, out-of-hospital cardiac arrest (OHCA) outcomes, response to falls] of CFR schemes. 3a. Explore ambulance policies, guidelines and protocols for CFRs. 3b. Explore stakeholder (patients, relatives, ambulance staff, primary care, commissioners, CFRs and CFR scheme organisers) experiences and perceptions of CFRs’ current role and the potential for future developments and innovations. We also aimed to ask CFRs and CFR scheme organisers about challenges in and solutions to recruiting, training and retaining CFRs in rural areas and how to ensure governance and accountability for safe, high-quality care. 4. Assimilate and integrate data derived from objectives 1–3, synthesising these to develop a list of recommendations for future innovations. 5. Prioritise recommendations for future developments/innovations in rural CFR provision through a consensus stakeholder workshop. Methods We used a mixed-methods design, using a lens of pragmatism and the ‘actor’, ‘behaviour change’ and ‘causal pathway’ (ABC) framework to integrate quantitative (cross-sectional) and qualitative (policy, guideline and protocol document together with stakeholder interview) data using the ‘following the thread’ approach to triangulation. For the cross-sectional study of calls attended by CFRs, we used a retrospective observational study design, analysing routine electronic clinical records data from 6 of 10 regional ambulance services in England between 1 January 2019 and 31 December 2019. For the survey of CFR costs and resource use, we used a bespoke self-administered questionnaire e-mailed to ambulance trust directors of research and heads of research requesting information on the workforce of volunteer CFRs, the budget allocated to CFRs and the actual expenditure for the financial years 2017–8, 2018–9 and 2019–20. For the counterfactual analysis of the impact of CFR attendance on response times, we compared incidents that CFRs attended with those where ambulance staff attended in close geographical locations to derive response time distributions for each, adjusting by severity category and urban–rural classification, to estimate difference in attendance times and meeting of response target thresholds. For the analysis of OHCA outcomes related to CFR attendance, we derived Utstein-style templates for cardiac arrest incidents presenting to East Midlands Ambulance Service attended by both CFRs and ambulance staff. We compared outcomes for return of spontaneous circulation (ROSC) and 30-day survival using multivariable regressions models comparing CFR arrival before EMS with EMS alone for both. For the evaluation of the CFR response to falls provided by LIVES (Lincolnshire Integrated Voluntary Emergency Service), the falls response programme (FRP), introduced in Lincolnshire in 2019 and recommissioned after an initial pilot, we examined its operation, effects and cost-effectiveness during the period April 2020 to December 2021 using a cross-sectional design that linked falls episode data involving the programme from the ambulance service and the CFR scheme involved. We identified potential innovations in CFR provision that were prioritised using a modified nominal group technique in a consensus meeting. Patients and public were involved throughout the study. Results In 4.5 million incidents from six English regional ambulance services during 2019, pre COVID-19 pandemic, CFRs attended first a higher proportion of calls in rural areas (almost 4% of calls) than in urban areas (around 1.5% of calls). Community First Responders attended first in more than 9% of category 1 calls and almost 5% of category 2 calls. They first attended 6.5% of the total number of neurological (e.g. loss of consciousness, convulsions, collapse) or endocrine (e.g. hypo- or hyperglycaemia) conditions and 5.9% of the total number of cardiorespiratory conditions (including breathing problems, chest pain and stroke). In a multivariable model, the main predictors of CFR attendance were rurality [odds ratio (OR) 2.05, 95% confidence interval (CI) 1.99 to 2.11; p

Background: Chronic cough, defined as a cough lasting 8 or more weeks, affects up to 10% of adults. Refractory chronic cough (RCC) is a cough that is uncontrolled despite comprehensive investigation and treatment of comorbid conditions while unexplained chronic cough (UCC) is a cough with no identifiable cause despite extensive evaluation of comorbid conditions. RCC and UCC are often poorly controlled. Understanding individuals' lived experience of the symptoms and impacts of these conditions may guide therapeutic strategies. Objectives: The primary objectives of this study were to assess respondents' perceptions of the key symptoms of RCC and UCC and the impacts of RCC and UCC and their symptoms on well-being, health-related quality of life, work productivity, and social relationships. Design: Qualitative study. Methods: This study enrolled 30 adults with physician-diagnosed RCC or UCC. Two trained qualitative researchers conducted individual, in-depth telephone interviews using a semi-structured interview guide. Interviews were audio-recorded, transcribed, coded, and systematically analyzed to identify content themes. Results: A total of 15 respondents with RCC and 15 with UCC were included in the study. Many respondents had RCC or UCC for a long duration (median 9 years, range: 0–24). Half of the respondents reported having a coughing episode at least once daily. Only 40% of respondents reported that medication had improved their symptoms. In over half of the respondents, RCC or UCC hindered communication, caused embarrassment, frustration, and worry, and lowered quality of life. Perceptions of meaningful treatment benefits in RCC or UCC varied widely across respondents. Conclusion: RCC and UCC remained poorly managed in many individuals and were associated with a wide range of symptoms and cough triggers that hindered daily activities and reduced emotional well-being. Understanding individuals' lived experiences may inform the development of RCC and UCC therapeutic strategies. Plain language summary: Patient-reported experiences with refractory or unexplained chronic cough: a qualitative analysis Chronic cough, particularly refractory and unexplained chronic cough, remain poorly managed in many individuals and are associated with a wide range of symptoms and cough triggers that hinder daily activities and reduce emotional well-being. Currently there are no US Food and Drug Administration-approved treatments for refractory or unexplained chronic cough. Understanding the experience and treatment preferences of individuals with these conditions may help inform the development of new therapies and clarify the potential impact of such therapies on the lives of individuals with chronic cough. Using in-depth interviews, the present study comprehensively evaluated individuals' experience with refractory or unexplained chronic cough and treatment priorities, a research area that has not been well-studied. This study detailed broad-ranging physical, behavioral, and emotional impacts of chronic cough, which hindered individuals' social well-being. [ABSTRACT FROM AUTHOR]

Introduction: Professional challenges play a significant role in the formation of nursing students' professionalism in the internship stage, and their in-depth investigation can be very effective in improving the quality of learning and improving the skills of these students. This study was conducted with the aim of explaining nursing students' views on the organizational challenges of the internship program. Methods & Materials: This qualitative study was of analytic-content type, in which 12 nursing students of the internship program from different universities of medical sciences in Iran were purposefully selected (2021). Data were collected through semi-structured interviews and analyzed through conventional content analysis using MAXQDA version 10 software. Also, for the accuracy of the study, the four criteria suggested by Guba and Lincoln were observed. Results: The professional challenges of students were extracted in two main categories of "Professional misconduct" with three subcategories of "exploitation", "inappropriate behavior" and "verbal harassment" and "college-clinic gap" with two subcategories of "lack of support" and " low coordination of training and clinic". Conclusion: Nursing internship students face two professional challenges, which investigation and identification can provide the basis for improving the clinical education environment of nursing internship students. [ABSTRACT FROM AUTHOR]

Adequate glycemic control is key to prevent morbi-mortality from type 2 diabetes (T2D). Despite the increasing availability of novel, effective, and safe medications for the treatment of T2D, and periodically updated guidelines on its management, the overall rate of glycemic goal attainment remains low (around 50%) and has not improved in the past decade. Therapeutic inertia (TI), defined as the failure to advance or de-intensify medical therapy when appropriate to do so, has been identified as a central contributor to the lack of progress in the rates of HbA1c goal attainment. The time to treatment intensification in patients not meeting glycemic goals has been estimated to be between 1 and 7 years from the time HbA1c exceeded 7%, and often, even when an intervention is carried out, it proves insufficient to achieve glycemic goals, which led to the concept of intensification inertia. Therefore, finding strategies to overcome all forms of TI in the management of T2D is a fundamental initiative, likely to have an enormous impact in health outcomes for people with T2D. There are several factors that have been described in the literature leading to TI, including clinician-related, patient-related, and healthcare system-related factors, which are discussed in this review. Likewise, several interventions addressing TI had been tested, most of them proving limited efficacy. Within the most effective interventions, there appear to be two common factors. First, they involve a team-based effort, including nurses, pharmacists, and diabetes educators. Second, they were built upon a framework based on results of qualitative studies conducted in the same context where they were later implemented, as will be discussed in this article. Given the complex nature of TI, it is crucial to use a research method that allows for an in-depth understanding of the phenomenon. Most of the literature on TI is focused on quantitatively describing its consequences; unfortunately, however, not many study groups have undertaken qualitative studies to deeply investigate the drivers of TI in their diverse contexts. This is particularly true in the United States, where there is an abundance of publications exploring the effects of different strategies to overcome TI in type 2 diabetes, but a severe shortage of qualitative studies aiming to truly understand the phenomenon. [ABSTRACT FROM AUTHOR]

The current systematic review examined the similarities and differences between mothers' and fathers' reported barriers and facilitators to engaging in family-based interventions for child and adolescent behavioural problems (aged 2–17 years). Systematic searches of six electronic databases and grey literature alongside a two-way screening process identified twenty eligible qualitative studies from 2004 to 2019. A thematic meta-synthesis identified similarities in major themes of psychological, situational, knowledge/awareness, programme/intervention, co-parenting, practitioner, and beliefs/attitudes factors, alongside group experiences and stages of engagement. However, differences emerged in subthemes related to parental, treatment, and service delivery factors that included individual ideologies of parenting, parental roles, and treatment participation; the role of mothers in facilitating engagement; and individual preferences for treatment content and delivery. Overall, findings suggest that while mothers and fathers experience similar challenges to engagement, they can also experience distinct challenges which need to be addressed at the treatment outset to maximise engagement. [ABSTRACT FROM AUTHOR]

Aims: In pandemics, infection exposure and quarantine represent critical occupational risks for healthcare workers (HCWs). However, while the psychological consequences of HCWs' quarantine have been reviewed, other potential implications of quarantine on HCWs, such as those that are work-, professional-, social- and private-related, have not been summarised to date. Summarising quarantined HCWs' experiences in the current and past pandemics, as investigated with qualitative studies, might improve awareness of their needs, concerns, and the consequences of quarantine on their personal lives. Therefore, the lived experience of quarantined HCWs was reviewed and subjected to meta-synthesis and -summary. Methods: A systematic review of qualitative studies followed by a meta-synthesis and -summary allowing an interpretative integration of the findings of qualitative studies, was performed. PubMed, CINHAL and Scopus databases were explored up to 31 January, 2021, without any limitation in time. The methodological quality of the studies was assessed using the Critical Appraisal Skills Programme. Methods and findings are reported according to the Enhancing transparency in reporting the synthesis of qualitative research statement. Results: A total of 635 records were retrieved and five studies were included. Overall, five themes summarised the lived experience of quarantined HCWs: 1) Being emotionally challenged; 2) Living the quarantine limitations; 3) Losing freedom; 4) Accepting the quarantine; and 5) Staying away from me. The most frequent categories across studies were 'Feeling stressed' and 'Being constrained' (both 100%). The least frequent were 'Feeling sad' (20%), 'Enjoying my family' (20%) and 'Being refused as a family member' (20%). Conclusions: The lived experience of HCWs is multidimensional, the implications of which also affect private spheres of life: the immediate family and wider relatives. Understanding and learning from HCWs' lived experiences might support policymakers, public health authorities and managers with the goal of maintaining the highest physical and mental health of staff during outbreaks. Timely services supporting HCWs, both during and after episode(s) of quarantine, are suggested to prevent additional burdens on frontline professionals. [ABSTRACT FROM AUTHOR]

After the eruption of Mt. Ontakesan Volcano in 2014, Ontakesan Volcano Laboratory, Nagoya University was established in 2017 to keep and develop the face-to-face relationship between the local community and volcano experts. In 2018, the Ontakesan Volcano Meister System also started to undertake activities for volcanic disaster management and promotion of the regional economy. Additionally, two visitor centers opened in Kiso Town (at the foot of Mt. Ontakesan) and Otaki Village (at the entrance of the trail to the summit) in 2022. We compared these activities in the Ontakesan area with other volcanic areas (Usuzan, Bandaisan, Hakoneyama, Fujisan, Asosan, Unzendake, and Sakurajima) from the perspective of literacy enhancement on volcanic disaster management. We made an interview survey of the organizations/facilities responsible for volcanic disaster prevention education in these volcano areas to evaluate the activity of the Ontakesan Voclano Meisters. We considered common and specific issues among them to clarify the characteristics of literacy enhancement for volcanic disaster reduction in the Ontakesan area. In all the organizations that we surveyed, there is a common emphasis on the education for children to transfer disaster memories to the next generation and to raise their awareness of disaster prevention. Though the Ontakesan Volcano Meisters have less interaction with the local residents than other areas, they exceed in the enlightenment for climbers and have made efforts to raise the safety awareness of climbers on site since their establishment. [ABSTRACT FROM AUTHOR]

Some have viewed the internationally acclaimed blockbuster hit, the Black Panther film, as feminist; meanwhile, others have highlighted its aspects of African culture focusing on its traditional elements and Afrofuturistic aspects. One of the main characters, Actress Lupita Nyong'o, who played Nakia said that Black Panther signifies a balanced representation of women and men, and she later alluded to feminism as she explained the balanced idyllic gender representation between the sexes. This study found that the roles of the leading women characters in this Afrofuturistic film—the top characters were derived from the IMDB's list—represented Africana womanism. The women at the heart of this study are warriors including Nakia, a War Dog of Wakanda; Okoye, the first lieutenant of the Dora Milaje and Ayo, a member; Princess Shuri, the head of Wakanda's technological division; the Queen Mother of Wakanda, Ramonda, who was King T'Challa and Princess Shuri's mother; and the Merchant Tribe Elder and the Mining Tribe Elder of the Wakandan Tribal Council. The egalitarian relationship between the women and the men in the film, and the representation of the women, showed a revisioning of African history in the recreation of an Afrofuturistic present. Thereby, the women's portrayal emerged from the wider egalitanian Wakandan society, which depicted a mythological African utopian nation, and yet, simultaneoulsy reignited an African historical reality. [ABSTRACT FROM AUTHOR]

AbstractDuring the early waves of the COVID-19 pandemic in Italy, social distancing hindered mourners in their help-seeking. A netnographic approach was employed to investigate grief and empathy expressions on a Facebook support group, created for the purpose and moderated by a psychologist. Participants (23 Females, 2 Males) knew about the research and co-participated in the improvement of the group experience. The virtual space was used by group members with two different purposes: some mainly vented their anger but others created a new and coherent narration of their loss. Differently from other peer-to-peer support groups, users supported each other continuously and in some cases took up the role of moderators. The results shed light on continuous peer support and user-driven moderation dynamics, advancing our understanding of online groups moderated by professionals. The study also prompts reflection on distinct aspects of grieving on social media during the initial 2 years of the pandemic. [ABSTRACT FROM AUTHOR]

Healthcare practitioners face significant risks of workplace violence due to various reasons such as hospital congestion, miscommunication, and aggressive behaviours of patients and relatives. Exposure to workplace violence may disrupt the workflow process and compromise patient care in healthcare facilities, ultimately affecting job performance, reducing job satisfaction, and negatively affecting the physical and mental health of healthcare practitioners. This study aimed to review all the published studies conducted on the experiences of workplace violence among healthcare practitioners. This study is a systematic review of qualitative studies. Data were collected through online databases including ScienceDirect, PubMed, MEDLINE and JSTOR were searched from the year 2015--2021. The inclusion criteria were: qualitative methods and mixed methods of data collection and analysis; studies that were carried out among healthcare practitioners who have been experience on workplace violence; scope of the primary studies included experience of workplace violence; and published in English/Malay in academic journal between 2015 and 2021. A total of 15 papers were included in the final analysis. The overall quality of the included papers was high. Of the 15 papers, 12 studies fully met the CASP criteria. The results of the 15 included studies were organised into the thematic groups of: i) verbal violence as the common workplace violence; ii) perceived causes of workplace violence and iii) seeking help. Across different countries, verbal violence was the most common type of workplace violence reported by healthcare practitioners. This review also identified that a lack of information, failure to meet patient expectations, and delayed treatment were the main contributing factors to workplace violence. [ABSTRACT FROM AUTHOR]

The new paradigm in Forensic Sciences initiated by the entry of genetics (the current standard of legal evidence) and accentuated by recognized wrongful convictions derived from experts today in the eye of criticism, has highlighted the potential for bias and error in forensic disciplines when they depend on human interpretation and subjectivity, which has not been avoided by Forensic Odontology (FO). However, a subjective judgment is not necessarily wrong, so the refinement of processes, the development of standards, and robust research can contribute to the validity of interpretation to increase objectivity. Latin America (LATAM) has its own realities and needs, which have conditioned the priorities and objectives of FO research. A scoping review is presented to systematically map the investigation of LATAM researchers and identify the objective or subjective nature of their assessments. LATAM shows interesting productivity and intentions to adhere to international standards, with Brazil leading this research significantly, followed by Chile and Colombia, among others. However, there is a disproportionate approach in certain lines of research (dental age estimation), and needs to address other quantitative studies, and to improve the visibility of the LATAM FO research. [ABSTRACT FROM AUTHOR]

While cross-cultural research has identified universally accepted ethical leadership characteristics, Eastern cultural traditions, philosophical views, and religious beliefs suggest culturally specific characteristics. Academics in Asia offer valuable insights into underexplored Eastern ethical leadership, contributing through both scholarship and pivotal leadership roles. As educators, they shape environments that foster student learning, growth, and potential leadership in multinational organisations. We conducted interviews with 21 academics from 15 countries across South, Southeast, and East Asia to explore Eastern ethical leadership. We found that the characteristics identified as important by our interviewees reflect the nature and context of societies in Asia. For instance, caring for individuals is an important characteristic in societies that emphasise collectivism, as is showing concern for the welfare of the wider community, particularly when poverty is prevalent. Our interviewees are influential leaders with experience, who have a significant impact on shaping and disseminating knowledge across industries. Their perspectives, therefore, enhance Western-dominated views on ethical leadership prevalent in Aotearoa/New Zealand. [ABSTRACT FROM AUTHOR]

This paper reports on the growing issues experienced when conducting web-based--based research. Nongenuine participants, repeat responders, and misrepresentation are common issues in health research posing significant challenges to data integrity. A summary of existing data on the topic and the different impacts on studies is presented. Seven case studies experienced by different teams within our institutions are then reported, primarily focused on mental health research. Finally, strategies to combat these challenges are presented, including protocol development, transparent recruitment practices, and continuous data monitoring. These strategies and challenges impact the entire research cycle and need to be considered prior to, during, and post data collection. With a lack of current clear guidelines on this topic, this report attempts to highlight considerations to be taken to minimize the impact of such challenges on researchers, studies, and wider research. Researchers conducting web-based research must put mitigating strategies in place, and reporting on mitigation efforts should be mandatory in grant applications and publications to uphold the credibility of web-based research. [ABSTRACT FROM AUTHOR]

BackgroundThere has been an increasing interest in the concept of hope within the field of brain injury rehabilitation. Existing reviews have nevertheless focused on stroke, leaving out the broad population of people with acquired brain injury (ABI). Furthermore a majority of the included studies in those reviews excluded the subgroup of people with communication difficulties, thus primarily giving voice to a select group of people with ABI.MethodsA qualitative systematic review was conducted with the purpose of systematically reviewing and thematically synthesise findings about hope as experienced by adults with ABI in a rehabilitation or recovery process. The search strategy included peer-reviewed qualitative studies published after 2000 in English or Scandinavian languages. Searches of EBSCO databases incorporating CINAHL, MEDLINE, and PsycINFO were conducted together with SocINDEX, Social Work Abstracts, Eric and Web of Science. Ten qualitative studies were included, and the Critical Appraisal Skills Program (CASP) was used for assessing the quality and relevance of the ten studies. Qualitative findings were synthesized using Thomas and Harden's methodology.ResultsThrough a thematic synthesis eleven subthemes were identified relating to experiences of hope. These were grouped into four analytical themes: (1) hope a two folded phenomenon; (2) time and temporality; (3) progress, goals and visibility and (4) the alliance; a balancing act requiring good communication skills.ConclusionThis review has shown that even though hope has both a positive and negative side to it, it is necessary as a driving force for people with ABI in terms of supporting them to keep going and not give up. Rehabilitation professionals are advised to embrace the ambiguity of hope, customizing the support of hope to each person with ABI. Attention is needed on how to make progress visible for persons with ABI during their rehabilitation process just as rehabilitation professionals should acknowledge the alliance with the person with ABI as a core component of rehabilitation. This requires a focus on professionals' communication skills if hope promoting relationships between professionals and persons with ABI are to be achieved.

Salpe Malkon,1 Björn Wettermark,1 Thomas Kahan,2 Pia Bastholm-Rahmner,3 Jan Hasselström,4 Miriam Qvarnström1 1Department of Pharmacy, Uppsala University, Uppsala, Sweden; 2Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden; 3Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; 4Department of Neurobiology and Care Sciences and Society, Karolinska Institutet, Stockholm, SwedenCorrespondence: Miriam Qvarnström, Department of Pharmacy, Faculty of Pharmacy, Uppsala University, Box 580, Uppsala, 751 23, Sweden, Email miriam.qvarnstrom@farmaci.uu.sePurpose: Few studies explored what patients initiated on blood pressure medication in primary care think about their disease and their medications. The aim of this study was to gain an understanding of hypertensive patients’ views on and experiences of hypertension and the use of antihypertensive medications.Methods: A qualitative study based on open-ended questions from a survey on medication adherence, which captured treated hypertensive patients’ perspective on their condition and treatment. Data were collected for 219 patients on antihypertensive medication, ≥ 30 years old, who consulted 25 primary health care centers in Stockholm, Sweden, during 2016. Thematic analysis with both inductive and deductive approach was applied.Results: We identified 21 codes from the data and grouped them under the World Health Organization’s five dimensions of adherence: condition-, therapy-, health care team and system-, patient-, and socioeconomic-related factors. The analyses revealed that many patients with hypertension have limited knowledge of their disease, are afraid of drug side effects and experience various issues in primary health care that may negatively impact adherence, including short doctor appointments, prescribing without communication and room for improvement in individualization of therapy and a person-centered approach.Conclusion: Many patients with hypertension have limited understanding of their hypertension and fear of adverse events from their antihypertensive medications. There is also room for improvement in how the patients are managed in primary health care. Interventions should focus on these issues to promote a better blood pressure target achievement.Plain Language Summary: Few studies have explored what patients initiated on blood pressure medication in primary care think about their disease and their medications.In this study, we analyzed free comments collected from 219 patients responding to a survey on medication adherence. Those who responded used antihypertensive medication, were ≥ 30 years old, and consulted primary health care centers in Stockholm, Sweden.The analyses revealed that many patients with hypertension have limited knowledge of their disease, are afraid of drug side effects and experience various issues in primary health care that may negatively impact adherence, including short doctor appointments, prescribing without communication and room for improvement in individualization of therapy and a person-centered approach.Interventions to promote a better blood pressure treatment would likely benefit from targeting these problems raised by patients.Keywords: hypertension, antihypertensive treatment, medication adherence, patient perspectives, primary health care, qualitative studies

Purpose: Managers' actions can facilitate the return to work (RTW) process for breast cancer survivors (BCS). However, data on BCS' experiences of managers' actions regarding RTW are dispersed across multiple qualitative studies and do not offer useful insights for managers to support employees returning to work. This study aimed to summarize and map managers' actions experienced by BCS over three RTW phases (before, during, after) and categorize them as facilitating or hindering RTW. Methods: A scoping review of qualitative studies was conducted. Four databases (MEDLINE, PsycINFO, Cochrane Library, EMBASE) were systematically searched for articles published between 2000 and 2022. Studies and participant characteristics were extracted using an excel spreadsheet. A thematic analysis with a predominantly deductive and semantic approach was conducted. Results: Twenty-nine studies were included after screening 1042 records. Five themes were generated from the data. Two themes addressed the phase 'before RTW': 'managers' interpersonal skills' and 'preparing for RTW'; three in the 'during RTW' phase: 'managers' interpersonal skills', 'offering work flexibility', and 'offering work accommodations', and only one, 'paying attention to follow-up', was addressed in the 'after RTW' phase. Conclusion: This review mapped managers' actions experienced by BCS in three phases of the RTW process. Results suggested that, according to BCS, managers need to mobilize specific skills to provide appropriate support during the RTW process. Further research is needed to better understand the skills underlying managers' actions facilitating the RTW process. [ABSTRACT FROM AUTHOR]