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This study sheds light on how to develop inclusive pedagogy in higher education, from the point of view of 42 inclusive faculty members from 6 Spanish universities. A qualitative methodology was used through semi-structured in-depth interviews. Data analysis was inductive, using a system of categories and topics. The results reveal that the faculty members which develop inclusive pedagogy in general have beliefs linked to the social model of disability and inclusive education approaches. They do not usually have specific training or knowledge about disability. They design their curricula in a flexible and open way to accommodate all students. They show a positive attitude toward students with disabilities and use diverse and participatory teaching methodologies, giving prominence to students. These data are consistent with those found in previous studies and offer keys to those faculty members who are interested in developing an inclusive pedagogy at the university. This paper examines in detail how faculty members of six faculties of educational sciences develop a theoretical framework comprising beliefs, knowledge, designs and actions. The research has found that faculty members hold beliefs about disability based on the social model of disability and inclusive approach. In general, inclusive faculty members' knowledge of disability and attention to diversity issues is scarce. The design of courses and teaching programmes led by inclusive university faculty is characterised by being open, flexible and providing clear and detailed information to students. Faculty who develop inclusive pedagogy use varied, participative and active methodologies, which are combined with a positive and approachable attitude towards students with disabilities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disrupted societies globally. Public health institutions were tasked with responding to the pandemic in a dynamic and uncertain context. This paper sheds light on the experiences of COVID-19 response actors as they navigated multi-dimensional crises associated with the pandemic in general and vaccine hesitancy in particular. This research was conducted during the initial phase of the COVID-19 vaccine rollout in Flanders, Belgium. Participants included informants across all levels of the COVID-19 vaccination strategy including but not limited to those producing scientific knowledge, providing policy input, or implementing public health directives locally. 'Crisis' was identified as a recurring theme in interviews with informants. The paper highlights multi-dimensional crises experienced by informants such as the: (i) crisis of prioritization, (ii) crisis of communication, (iii) crisis of the changing image of science, (iv) crisis of epistemic agency and autonomy, and (v) crisis of trust. [ABSTRACT FROM AUTHOR]

Resilience is an important attribute of incident management teams (IMTs) for managing disasters. Previous research on resilience of IMTs has focused on comparing work-as-imagined (WAI) and work-as-done (WAD) but predominantly used narrative analyses which limited comparisons between IMTs. This paper presents a novel Interaction Episode Analysis (IEA) method to identify the IMT's WAI and WAD episodes by analyzing dynamic interactions that occur between different roles that carry out information management tasks. Observations and audio--visual recordings of two high-fidelity IMT exercises were conducted to capture WAD episodes, and semi-structured interviews with experts elicited corresponding WAI episodes. Quantitative analyses using five interaction-based measures were conducted to detect differences of the WAD episodes between two IMTs. Next, qualitative analyses were focused on identifying reasons why such differences have occurred by comparing the gaps between WAI and WAD episodes. Some of the reasons for WAI-WAD gaps included the non-occurrence of critical interactions that were expected and occurrence of unexpected interactions between IMT members. This paper also identifies cases of preparatory, proactive, and reactive performance adjustment that characterizes IMT resilience. The IEA method shows promise for investigating how and why the gaps between WAI and WAD in IMTs occur. With the identification of these gaps, future research can be conducted to reconcile the gaps between WAI and WAD episodes, and thus enhance resilience of IMTs in future disasters. [ABSTRACT FROM AUTHOR]

A growing body of conceptual evidence over the last decade has increased our understanding of parents' experiences of having an infant with complex congenital heart disease. These concepts include parents' feelings of uncertainty, fear, excitement, and mastery. However, little is known about parents' experiences, confidence, and knowledge acquisition during transition from hospital to home with their infant after the first stage of complex cardiac surgery. A theoretical framework to assess, plan and implement child and family centered care would assist children's cardiac nurses responsible for parental education, discharge planning and coordination. To explore parents' experiences of the transition from hospital to home with their infant, following the first stage of cardiac surgery. A prospective mixed methods longitudinal design. Semi-structured interviews were undertaken, including administration of the Maternal Confidence Questionnaire at four timepoints: before discharge following stage one cardiac surgery (T0), 2 weeks' post discharge (T1), 8 weeks' post discharge (T2) and after stage two surgery (T3). Qualitative data were thematically analyzed. Descriptive statistics were used to characterize the sample and non-parametric repeated measures analysis of variance was used to analyze changes over time in maternal confidence scores. Sixteen parents of 12 infants participated. Four "patterns of transition experience" emerged, the fourth "Mastery", is discussed in this paper. Mastery can be contextualized in terms of the parents' journeys of knowledge construction, gaining confidence and reflection. Learning was dynamic and transformational, but successful learning and acquisition of knowledge was also dependent upon the parents' ability to absorb, integrate and adjust at any given time. Confidence at T0 was significantly lower than at T1 (p =.011), T2 (p =.018) and T3 (p =.012). There were no significant differences between scores at T1, T2 and T3. Liminality, as a concept, described the between and betwixt time that parents experienced as they were preparing for discharge from hospital; excitement to be going home balanced with the fear of being alone and confidence in looking after their fragile infant. Parents of infants with complex congenital heart disease obtain knowledge, confidence, and mastery dependent upon their transition experience and their personal journey through pre-liminal, liminal, and post-liminal phases of discharge from hospital to home. A conceptual framework "Parenting through Transitions – hospital to home" emerged that could assist in structuring assessment of parents' knowledge and support needs within a coordinated discharge process. Identifying individualized support would promote adaptation and adjustment during transition from the pre to post liminal phase, following their infant's first stage of complex cardiac surgery. Parents learning was dynamic and transformational, learning opportunities overlapped transitional phases of their infant's journey, but successful learning and acquisition of knowledge was also dependent upon the parents' ability to absorb, integrate and adjust at any given time. The transition from hospital to home and traversing the physical boundary of leaving the hospital for the first time with their infant (liminal phase), was loaded with emotionally traumatic experiences that could not be separated from the transition that was being explored within this study. Adjusting to the new situation, developing confidence over time, and becoming comfortable as they mastered new skills, demonstrated that some of these parents could pass through that liminal space to mastery of a new normal (post-liminal phase), which encompassed competence, integration, and comfort. [ABSTRACT FROM AUTHOR]

The purpose of this paper was first to gain an in-depth understanding of the barriers and facilitators to implementing the BPS model and pain neuroscience education in the current Lebanese physical therapy health care approach and explore its acceptability. A qualitative semi-structured interview using purposive sampling was conducted with eight Lebanese physical therapists practising in different governorates. The transcribed text from the interviews was analyzed using inductive thematic analysis. Two topics were generated and constructed by the researchers: (1) "barriers to the implementation of pain neuroscience education, with subthemes including (a) "current health care approach," (b) "basic curriculum and continuing education," (c) "patients' barriers"; (2) "facilitators to the implementation of pain neuroscience education," with subthemes containing (a) "interest in the BPS model, (b) "therapeutic alliance," and (c) "motivation for future training on BPS approach." The analysis of the results showed that Lebanese physical therapists currently hold a strong biomedical view of chronic pain, assessment, and treatment. However, despite the presence of barriers and challenges, they are aware and open to consider the implementation and future training about the BPS model and pain neuroscience education in their approach. The exploration of potential barriers and facilitators to the bio-psychosocial model and pain neuroscience education implementation may provide an opportunity for better development and design of a culturally sensitive pain neuroscience education material for Arab-speaking and Lebanese physical therapists. The exploration of barriers and facilitators to the implementation of pain neuroscience education will help to improve pain education and ensure better clinical pain management. The most important barriers were the dominant characteristic of the Lebanese physical therapist's health approach, which is focused on a biomechanically oriented model, and their lack of knowledge to approach chronic pain from a biopsychosocial perspective. [ABSTRACT FROM AUTHOR]

This paper explores how neoliberal ideologies inform both social and political agendas that influence how social workers can provide support to trans and gender diverse people attempting to access gender-affirming healthcare, using an analysis of social workers' experiences working in mental health in Nova Scotia, Canada. Qualitative semi-structured interviews provide a perspective of the experiences of social workers in Nova Scotia and how their ability to provide mental health services to trans and gender diverse people is impacted by neoliberalism. Most social workers attributed the structural context of working within a bio-medical system as contributing to social workers being disempowered, undermined, and not able to practice according to the values of their profession thus limiting their ability to provide affirming mental health supports to trans and gender diverse people in ways that align with their social work professional ethics and values. Through examining how neoliberal ideologies create notions of ideal social citizens by controlling the body, the paper explores how lived experience of neoliberal practices in mental health social work reinforce transnormativity. This paper highlights the necessity for social workers to resist dominant neoliberal and medicalized discourses which serve as mechanisms of power and control. The paper concludes with recommendations for social work practice with trans and gender diverse populations. [ABSTRACT FROM AUTHOR]

Purpose: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. Method: Study data were collected through semistructured qualitative interviews with key stakeholders involved in implementing the IPM. Results: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. Conclusion: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward. [ABSTRACT FROM AUTHOR]

This paper synthesises critique from Māori patients with Bipolar Disorder (BD) and their whānau to identify barriers and propose changes to improve the structure and function of the New Zealand mental health system. A qualitative Kaupapa Māori Research methodology was used. Twenty-four semi-structured interviews were completed with Māori patients with BD and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data. Three key themes identified the impact of structural features of the New Zealand mental health system on health equity for Māori with BD. Themes involved the accessibility, delivery and scope of the current health system, and described how structural features influenced the quality, utility and availability of BD services for Māori patients and whānau. Structural barriers in the existing design, and potential changes to improve the accessibility, delivery and scope of BD services for Māori, were proposed including a redesign of operational, environmental, staffing, and navigation points (information, transition, fatigue) to better meet the needs of Māori with BD. A commitment to equity when implementing structural change is needed, including ongoing evaluation and refinement. This paper provides specific recommendations that should be considered in health service redesign to ensure the New Zealand mental health system meets the needs of Māori patients with BD and their whānau. [ABSTRACT FROM AUTHOR]

This paper reports findings from a qualitative study conducted on the Need for Social work interventions in the Emergency Department (ED) at a large tertiary care center in India. The emergency department is an important social work intervention point for individuals with various psychiatric, medical, and social needs who have little or no additional interaction with social services. Social workers are specially trained to understand the impact of social factors on health outcomes and provide interventions that address social barriers to improving health and accessing community resources; social workers are well prepared to provide services in the emergency department. However, limited research is available to understand the impact of psychosocial services in the emergency department. We aimed to identify areas which require integrated social work services and coordination to address the psychosocial issues within the ED. Interviews with 10 healthcare workers are analyzed thematically. Recurring themes throughout the interviews confirm the need for providing social work interventions to ensure the medical, psychological, and social care needs in the emergency department. [ABSTRACT FROM AUTHOR]

Managing cultural diversity remains a challenge in secondary schools in Spain. In this paper, we approach cultural diversity from the standpoint of school counsellors, who are key professionals attending to immigrant pupils. Through the use of qualitative research techniques (semi-structured interviews and discussion groups), the strengths, weaknesses, opportunities, and threats are identified by counsellors. The findings show the need to implement pupil-focused responses sensitive to their cultural identity and based on the collaboration of all agents involved. Likewise, the school is defined as a privileged setting in which to celebrate cultural diversity and the pivotal role that counsellors play in this process is highlighted. [ABSTRACT FROM AUTHOR]

Assistive technologies have allowed people with disabilities to perform daily tasks with greater independence and autonomy, especially for visually impaired people. Using smart home solutions allows these users to control their homes with less cognitive and physical demand. However, making such applications accessible to meet the needs of visually impaired users, especially in developing countries, remains a challenge. This paper investigates the perceptions of these users about home automation technologies through semi-structured interviews. A total of 20 visually impaired people participated in the interviews. A thematic analysis revealed results concerning the following themes: (1) how people go about their lives at home and around, how people interact with current appliances, objects and environments, (3) how people perceive their attitude to technologies, (4) the Brazilian context of smart homes, (5) what people think smart homes should do and (6) envisaging ways of interacting with smart home systems. The results obtained provide significant insight into the needs of visually-impaired people in Brazil, with analysis of issues that are common with previous studies in more developed countries and specific issues that have important particularities and implications in Brazil and other developing countries. [ABSTRACT FROM AUTHOR]

This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the Somali diaspora in a number of countries across the globe. The rumour stipulates that the MMR vaccine – the silent shot – causes autism spectrum disorder (ASD). Although the association between MMR and ASD is non-causal, and various public health initiatives have promoted health information campaigns, the rumour continues to circulate in the Somali diaspora in many countries, including Sweden. This paper shows that there are valid reasons for this. The findings from this paper draw on a systematic scoping review and qualitative interview data from Sweden. The results show that the Somali community experiences higher than average rates of ASD compared to the general population. Moreover, ASD does not exist in the Somali language or their home country, is considered a Western disease that only affects Somali children in the diaspora, and is a highly stigmatised disease. Also, the Somali diaspora has had negative experiences with ASD diagnosis and care. The rumour has been sustained by the absence of an answer to their ASD fear and through active diaspora networks on social media. The network that surrounds the rumour has arguably further helped to create an epistemic community for a community whose concerns have been silenced. [ABSTRACT FROM AUTHOR]

This paper utilises empirical data to explore the value of 'body work' performed by last responders charged with the duty of dead body management, with a focus on the Global South. While frontline staff work to save lives, little is known about the experiences and roles of those who care for the dead in global health in times of crises and even during normal times. This paper discusses ethical and socio-cultural challenges pathologists face in 'working on the bodies of others' while conducting any form of post-mortem procedures – necessary for ascertaining and recording the causes of death. Identifying and reporting the cause of death have significant public health benefits and provide closure for bereaved families. Despite the foregoing, the pathology field does not attract funding from governments or donors, and it is overlooked compared to other disciplines. Autopsy procedure bears social stigma – as it is associated with body mutilation and therefore disrespecting the dead; certain cultural beliefs or taboos about impurity and death persist, further raising some social and ethical tensions. As a result, the dearth of autopsy procedures contributes to the cause of death uncertainty in global health. [ABSTRACT FROM AUTHOR]

In some countries, far-reaching 'lockdown' measures to contain the spread of coronavirus were implemented early in 2020. In Austria, these early measures were met with a high degree of compliance among the country's population. In this paper, we draw upon qualitative interviews, and ask how people made sense of the restrictions imposed during the first lockdown in April 2020 and what shaped their compliance. Empirical research has so far tried to explain compliance by means of people's disposition and motivations as well as demographic and social characteristics. Instead of focussing on who is compliant, we aim to understand how people practice compliance. We do this by approaching compliance through the concepts of values and practice. First, our findings indicate that people assess whether measures are suitable and legitimate in relation to the values of science, the law, and morality. Second, people assign additional personal value to compliance by stressing its positive implications on their own lives. By adopting a nuanced perspective on compliance as inextricably linked to peoples' values and practices, our paper critically contributes to the political and scholarly discussion of pandemic public health measures. Understanding compliance through the lens of values shows how people make sense of the measures in the context of their everyday lives, helping us to move away from a binary understanding of (non-)compliance that has become morally charged. [ABSTRACT FROM AUTHOR]

This paper explores the perception of "relatives" during the rehabilitation of young adults with severe acquired brain injury (SABI). This longitudinal qualitative study followed eight young adults with a SABI from hospital discharge to a year and a half after discharge. The design encompassed professional records, interviews, and surveys, including a name generator list completed by the young adults and focus group interviews with both their families and professionals. We apply a sociological theoretical framework concerning friendship, and we employ social network analysis (SNA) methodology to capture, visualise, and analyse the young adults' significant social relations. Social relations engaged as relatives during rehabilitation are to a large extent determined by the perceptions of professionals and the parents of the young adult. These perceptions contain a limited number of social relations, with priority given to biological and juridical ties. This might reflect the reduced social support available for the young adult, who initially had a much larger social network. The authors suggest a professional rethinking of who "relatives" are as well as considering these social ties as dynamic. Rehabilitation professionals must be aware of and pay attention to differing perceptions that exist as to who qualifies as significant social relations in order to reconsider the practical implementation of relative involvement. The perception of who relatives are during the rehabilitation process should be reconsidered and extended to include who the young adult perceive as significant social relations. Relatives are not a fixed entity and should be considered dynamically throughout the rehabilitation process. Social relations of the young adult must to a larger extent be considered during rehabilitation to prevent social isolation in the long run. [ABSTRACT FROM AUTHOR]

Background: Drug overdose deaths in Texas have been accelerating in recent years with an increase of 33% in the 12 months leading up to December 2020. Accurate counts of nonfatal overdoses – including associated aspects of overdose, such as substances involved, demographic information, and reversal agents administered is critical to increase timely and adequate response to individuals and communities in need. Methods: Twenty semi-structured interviews were conducted with harm reduction workers across four Texas counties to understand existing methods of reporting overdoses, naloxone dissemination/administration, and recommendations for improving overdose surveillance. Interviews were transcribed and emergent themes were identified based on the a priori research goals. Results: Findings highlighted a variety of overdose data collection methods and tools among harm reduction organizations including Excel spreadsheet, web-based TONI application, notes on personal cell phones, and paper notes. Types of overdose data collected varied widely. Participants noted existing methods are suboptimal and that there is a need for a unified, statewide reporting system to improve overdose data capture. Participants also highlighted that overdose surveillance should include "hidden populations" of people who use drugs that are not currently counted in surveillance methods as a result of not interacting with the healthcare system. Conclusions: Texas lacks a unified overdose reporting system to capture critical data to inform overdose response and prevention efforts. Nontraditional reporters may be critical toward improving overdose syndromic efforts and capturing data among hard-to-reach populations. Harm reduction organizations are uniquely positioned to facilitate reporting among community gatekeepers and people who use drugs. [ABSTRACT FROM AUTHOR]

Global health practitioners and policymakers have become increasingly vocal about the complex challenges of identifying and quantifying the causes of death of the world's poorest people. To address this cause-of-death uncertainty and to minimise longstanding sensitivities about full autopsies, the Bill and Melinda Gates Foundation have been one of the foremost advocates of minimally invasive autopsy technology (MIA). MIA involves using biopsy needles to collect samples from key organs and body fluids; as such, it is touted as potentially more acceptable and less invasive than a complete autopsy, which requires opening the cadaver. In addition, MIA is considered a good means of collecting accurate bodily samples and can provide the crucial information needed to address cause-of-death uncertainty. In this paper, we employ qualitative data to demonstrate that while MIA technology has been introduced as a solution to the enduring cause-of-death uncertainty, the development and deployment of technologies such as these always constitute interventions in complex social and moral worlds; in this respect, they are both the solutions to and the causes of new kinds of uncertainties. We deconstruct the ways in which those new dimensions of uncertainty operate at different levels in the global health context. [ABSTRACT FROM AUTHOR]

Research recruitment, eligibility, and who chooses to participate shape the resulting data and knowledge, which together inform interventions, treatment, and programming. Patterns of research participation are particularly salient at this moment given emerging biomedical prevention paradigms. This paper explores the perspectives of Black and Latino young men who have sex with men (BL-YMSM) regarding research recruitment and eligibility criteria, how their experiences influence willingness to enroll in a given study, and implications for the veracity and representativeness of resulting data. We examine inclusion and recruitment as a complex assemblage, which should not be reduced to its parts. From April to July 2018, we conducted in-depth interviews with 30 BL-YMSM, ages 18–29, in New York City. Interviews were recorded, transcribed, and analyzed using the constant comparative method. Black and Latino YMSM's responses unveiled tensions between researchers', recruiters', and participants' expectations, particularly regarding eligibility criteria (e.g. age, sex frequency), assumptions about 'risky behaviors,' and the 'target' community. Men preferred peer-to-peer recruitment, noting that most approaches miss key population segments. Findings highlight the need to critically examine the selected 'target' community, who sees themselves as participants, and implications for data comprehensiveness and veracity. Study eligibility criteria and recruitment approaches are methodological issues that shape knowledge production and the policies and programs deployed into communities. These findings can inform how future research studies frame recruitment and eligibility in order to better meet the needs of participants and ensure future research engagement. [ABSTRACT FROM AUTHOR]

Purpose: The "Joint Resources – Sedentary Behavior Study" (JR-SB) revealed significant behavioral and cardio-metabolic effects of reducing daily sedentary behavior replaced by light-intensity physical activity in patients with rheumatoid arthritis. This study explores the participant perception and experiences of the intervention and impact on the participants' health, family and physical activity behavior. Materials and Methods: A mixed-methods study design, including quantitative and qualitative data, was applied. Quantitative data were collected post-intervention using a questionnaire (n = 69) evaluating experiences of participation in the intervention. By maximum variation sampling, 18 participants were recruited to three focus group interviews with discussions of intervention elements. Data from the two sub-studies were collected and analyzed separately, although integrated at the interpretation and reporting level. Results: Based on four overarching themes, results indicated participant satisfaction with the individually tailored, behavioral approach and the focus on light-intensity physical activity rather than higher intensities. Study participation had an additional positive impact on the behaviors of family and social relations. Conversely, the family motivated the participants to achieve their physical activity goals. Conclusions: The study results support the use of individually tailored and behavioral approaches to reduce sedentary behavior, increase light-intensity physical activity and improve physical abilities in patients with rheumatoid arthritis. This paper presents positive participant perception and motivation for an individually tailored, behavioural intervention that aimed to reduce sedentary behaviour replaced by light-intensity physical activity in patients with rheumatoid arthritis. The results indicate that especially the focus on light-intensity physical activity, a consistent focus on the individual's everyday life and continuous support from health professionals motivated the participants to reduce their daily sedentary behaviour – also in the long term. Involvement of participants' family members seems to have influence on their own physical activity behavior as well as on the participants' motivation for changing physical activity behavior. Together with earlier evidence, the results underpin the use of behavioural strategies to support patients with rheumatoid arthritis in achieving their physical activity goals and in improving the abilities needed to manage their everyday lives. [ABSTRACT FROM AUTHOR]

Community mobilisation is recognised as an important strategy to shift inequitable gender norms and ensure an enabling environment to prevent gender-based violence (GBV). Yet there is a need to better understand the factors that facilitate effective community activism in particular contexts. Although fundamental to the success of mobilisation programmes, there is also limited appreciation of the experiences and agency of engaged community activists. This paper draws on qualitative evaluations from two community mobilisation GBV prevention programmes: the Gender Violence in the Amazon of Peru (GAP) Project and the Indashyikirwa programme in Rwanda. In Peru, participatory data was collected, in addition to baseline and endline interviews with 8 activists. In Rwanda, baseline and endline interviews and observations were conducted with 12 activists, and interviews were conducted with 8 staff members. The data was thematically analysed, and a comparative case study approach was applied to both data sets. The comparative study identified similar programmatic aspects that could hinder or enable activist's engagement and development, and how these are embedded within contextual social and structural factors. We discuss these insights in reference to the current emphasis in public health on individualistic programming, with insufficient attention to how wider environments influence violence prevention programming. [ABSTRACT FROM AUTHOR]

The landscape of cancer is changing, with earlier detection and the emergence of new treatment options signalling the potential reconfiguration of cancer (for some) as a chronic condition. Cancer is increasingly experienced in terms of chronicity, incorporating both ongoing episodes of acute treatment alongside the long-term management of disease, symptoms, and side effects. This emphasis refocuses attention toward living-with, as well as beyond, cancer. Yet, how cancer chronicity is understood and experienced by both patients and healthcare professionals remains underexplored. While sociological scholarship has critically analysed how chronic illness has been positioned as a problem of/for the person and/or the healthcare system, less attention has been paid to instances like cancer, where chronicity might be viewed as reflective of forms of success (e.g. through the deferral of mortality even in the absence of 'cure'). In this paper we draw on qualitative interview data from a large study of cancer survivorship including patients, their family carers and health professionals, across two Australian hospitals. We critically analyse the dimensions of chronicity in the cancer sphere, understanding cancer-as-chronicity as producing a particular form of subjectivity, shaped by the everyday management and experience of treatment, impairment, symptoms, and side-effects. We posit that constructions of cancer as chronic, and associated imperatives linked to longevity, commitment, and resilience, are placing new demands on patients, family carers, and professionals alike. [ABSTRACT FROM AUTHOR]

This paper explores adolescent girls' and young women's (AGYW) aspirations, factors that influence aspirations, and how their aspirations inform their sexual decision-making and behaviour. This study employed a qualitative design involving six participatory focus group discussions and 17 in-depth interviews with AGYW in – and out-of-school. Fieldwork was undertaken in rural and urban Tanzania. Thematic analysis was conducted using NVIVO software. Aspirations of AGYW's were categorised as short and long-term. Short-term aspirations were associated with the social status derived from obtaining trendy items such as nice clothing, or smart phones. Long-term aspirations included completing secondary education, having a professional job, being respected, getting married and having children. Aspirations were influenced by aspects of the social context, such as peers and structural factors that dictated what was acceptable for respectable AGYW. AGYW lacked the independent capabilities to meet long-term aspirations such as completing education. In pursuit of their short – and long-term aspirations, AGYW engaged in higher risk sexual behaviours such as transactional sex, age-disparate sex and condomless sex. AGYW's aspirations were important in determining their sexual decision making. Interventions should capitalise on AGYW's aspirations when addressing their SRH risks by finding innovative ways of engaging them based on their circumstances and aspirations. [ABSTRACT FROM AUTHOR]

Developing a deep and contextualised understanding of risk is important for public health responses to young people's alcohol consumption, which is frequently positioned as an outcome of risky behaviour. This paper expands conceptualisations of risk to encompass its wider social and cultural context through a social practice exploration of young people's controlled and managed intoxicated alcohol consumption practice. We report data from a fourteen-month qualitative study of the alcohol consumption practices of 23 young people in England, drawing on group interviews and social media interactions. Our findings provide a nuanced understanding of risk-taking, demonstrating that risk is an important aspect of the ongoing participation and performance in alcohol consumption practice and that health information and advice can be and was frequently incorporated into drinking practice without contributing to fundamental change. This raises new questions about the effectiveness of health interventions that focus on the individual, discussed in the final section of the paper. [ABSTRACT FROM AUTHOR]

Like in many countries, the Australian Government has conducted an inquiry into child sexual abuse that occurred in institutional settings (The Royal Commission into Institutional Responses to Child Sexual Abuse). Drawing on the findings from a qualitative study commissioned by the Royal Commission, this paper explores the perceptions of victim/survivors1 of the ways in which institutions (or individuals within them) responded supportively when sexual abuse was reported. While researchers and inquiries have reported on inadequacy of institutional responses, this paper addresses a research gap by investigating responses that victims/survivors perceived as helpful, while mindful of the overwhelmingly negative nature of their experiences. The paper contributes to the literature on institutional responses to child sexual abuse methodologically – by reporting on the challenges of a study of this type – and theoretically, by proposing a framework indicating how different helpful elements of an institutional response to child sexual abuse relate to each other in the victim/survivors' experiences. The findings are relevant for research on best practice in institutional responses to child sexual abuse. [ABSTRACT FROM AUTHOR]

Individualized funding of disability support services has implications for people's choices about when to share their home. This paper examines how people with disabilities made choices about who to live with and the factors influencing these choices. This paper discusses data from interviews with 30 people with mostly intellectual disabilities using individualized support services, 21 interviews with family members, four interviews with service managers, and a focus group with five support workers. The data come from a large evaluation of individualized housing support programs in New South Wales, Australia. Only some people had the opportunity to choose whether to share and with whom. Their choices were constrained by the range of housing options and their limited experience of them, even when they had support to make choices about shared housing or living alone. In some cases, the choices reflected a conceptualization of people with disabilities as different to other citizens in their rights and expectations about their social arrangements. The results have implications for information sharing, housing stock, and the need to challenge the positioning of people with disabilities relative to other people regarding choices about where and with whom to live. Many people preferred not to live alone, so as to improve their economic and social circumstances, and their choice and control. The choices about shared housing that many people and their supporters made were constrained by their limited experience of housing options or their familiarity with the range of choices made by other people with disabilities. Being able to draw on the material, social, and information resources of family made a big difference to their housing choices. It raises questions for policy implementation about whether individualized support may lock some people into shared housing arrangements by failing to include housing costs in the individual package. [ABSTRACT FROM AUTHOR]

This paper explores public health policy implementation through partnership working at the local level by examining how local actors from public health, and the wider workforce make sense of and work on social inequalities in health. An ethnographic case study was used to examine policy implementation in one local strategic partnership in north-west England during a period of significant resource constraint. Semi-structured interviews were the primary method of data generation. Sensitising concepts from figurational sociology were used to develop a theoretical account of how local policy implementation directed at narrowing social inequalities in health tended to give rise to relatively fragmented and short-term services, projects and practices, which focused on lifestyle factors and behaviour change. Theorising partnership work as figurations goes some way to explaining the apparent paradox among participants who expressed a relatively detached appreciation of wider social influences, alongside emotional involvement in their work. This process of individualisation explains how local professionals tended to conceptualise health inequality and the social determinants of health as personal troubles. Individualisation meant that the social reality of working in partnerships on difficult issues was simplified. Thus, any scope for working on the social determinants of health tended to be overlooked. The extent to which this was intentional or a matter of struggling to see opportunities, or a mixture of the two, was difficult to discern. Although the policy landscape has changed, the findings give some insight into understanding how local collaborative processes reproduce local public health work underpinned by lifestyle choices. [ABSTRACT FROM AUTHOR]

This paper investigates the social representations (SR) of tutors and preservice teachers regarding pedagogical strategies that promote generative reflection in practicum tutorials during initial teacher training. Using a qualitative approach, individual and group interviews were conducted with tutors and preservice teachers on video recordings of classes given by the preservice teachers and tutorial sessions. The analysis was inspired by Grounded Theory. The findings reveal that the tutors favour constructivist strategies, but guided strategies are predominant in their training practices, based on their role as experts, which is consistent with the demands of preservice teachers regarding this role. These results conflict with the literature in the area, which points to constructivist strategies as promoting reflective generative practice. [ABSTRACT FROM AUTHOR]

Arts programming can amplify youth voice, creative self-expression, and promote civic engagement and social change. This paper describes a case study of a youth participatory action research at an arts organization in the northeast of the U.S. that promoted youth participation, critical reflection, and action. Field observations and individual interviews with adult and youth staff were conducted and analyzed using thematic analysis. Findings suggest YPAR represented an opportunity for youth to develop critical consciousness, leadership skills, and create change. Adults integrated opportunities for youth to lead in arts dissemination and action initiatives. Implications and challenges including sustainability were identified. [ABSTRACT FROM AUTHOR]

Children with medical complexity (CMC) receive life-sustaining treatments such as tracheostomy. The objective of this paper is to explore the roles of religion and spirituality (R&S) of caregivers of children with medical complexity (CMC) in their decision to pursue tracheostomy for their children. We conducted 41 in-depth interviews of caregivers of CMC who had received tracheostomies in the prior 5 years. Four themes emerged: (1) Caregivers believed R&S to be powerful for their children's healing, and helped them cope with their children's illnesses; (2) Spirituality was an important factor for caregivers in the decision to pursue tracheostomy for their children; (3) Many caregivers did not discuss their spirituality with clinicians for a variety of reasons; (4) Clergy and hospital chaplains played a major supportive role overall; however, they did not play a significant role in the decision-making process. Our study shows the importance of R&S, and the roles of clergy and chaplains in pediatric tracheostomy decision-making. [ABSTRACT FROM AUTHOR]

Internally displaced women are underserved by health schemes and policies, even as they may face greater risk of violence and unplanned pregnancies, among other burdens. There are an estimated 450,000 internally displaced persons in India, but they are not formally recognised as a group. Displacement has been a common feature in India's northeast region. This paper examines reproductive and maternal health (RMH) care-seeking among Bru displaced women in India. The study employed qualitative methodology: four focus group discussions (FGDs) were held with 49 displaced Bru women aged 18–45 between June and July 2018; three follow-up interviews with FGD participants and five in-depth interviews with community health workers (Accredited Social Health Activists – ASHAs) in camps for Bru displaced people in the Indian state of Tripura. All interviewees gave written or verbal informed consent; discussions were conducted in the local dialect, recorded, and transcribed. Data were indexed deductively from a dataset coded using grounded approaches. Most women were unaware of many of the RMH services provided by health facilities; very few accessed such care. ASHAs had helped increase institutional deliveries over the years. Women were aware of temporary contraceptive methods as well as medical abortion, but lacked awareness of the full range of contraceptive options. Challenges in accessing RMH services included distance of facilities from camps, and multiple costs (for transport, medicines, and informal payments to facility staff). The study highlighted a need for comprehensive intervention to improve RMH knowledge, attitudes, and practices among displaced women and to reduce access barriers. [ABSTRACT FROM AUTHOR]

This qualitative study is part of a project aiming to evaluate a community-based approach to the delivery of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) through community health workers (CHWs) in four sub-Saharan African countries: the Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria. The study aimed to understand the factors that influence the anticipated acceptability of this intervention. A total of 216 in-depth interviews and 62 focus group discussions were carried out in the four country sites with pregnant women, women of reproductive age, community leaders, pregnant women's relatives, CHWs, formal and informal health providers. Grounded theory guided the study design and data collection, and content and thematic analysis was performed through a comparative lens. This paper focuses on one crosscutting theme: trust-building. Two mechanisms that underpin communities' trust in delivery of IPTp via CHWs were identified: 'perceived competence' and 'community and healthcare system integration'. Communities' perception of CHWs' competence shapes their trust in them, which suggests that CHWs' credentials should be made public and that specialised training in maternal health is required for them. Integration depends on the promotion of socially embedded practices and the involvement of formal healthcare systems in CHWs' work. [ABSTRACT FROM AUTHOR]

Evidence suggests that physical activity (PA) programmes promoted via healthcare settings worldwide may not currently meet the needs of many patients and healthcare professionals (HCPs). This paper describes the outcomes of a qualitative enquiry into the perspectives of patients and professionals from multiple healthcare services regarding the role of PA. 19 patients and 22 HCPs were purposively recruited from physiotherapy, podiatry, chronic pain, diabetes and continence services at a community-based healthcare clinic in the United Kingdom. Participants' views were explored using semi-structured interviews and analysed using thematic analysis. Results identified five themes: differences between the social and medical rationales underpinning PA promotion; the impact of the patient-professional relationship on patient activation, self-management and PA; a risk culture surrounding PA; challenges to meet variation in patients' needs and preferences; and lack of formal role for PA as a core part of routine healthcare. The study highlights tensions between needs and aspirations, and the reality of delivering advice and support for PA. Challenges resonated with patients and HCPs across different care groups and were not condition-specific. This highlights a need for sharing good practice across healthcare services and system-level interventions to address organisational barriers to the promotion of PA. [ABSTRACT FROM AUTHOR]

Purpose: The main objectives of this study were to learn from youths with intellectual and developmental disabilities about the ways their families were involved in their engagement in community life and to capture how they felt about such involvement. Method: The current study is a secondary analysis of a larger study, the Voices of Youths Research Project, framed by inclusive research methods. Thirty-eight semi-structured interviews that discussed perspectives on friendship, social inclusion, and quality of life from 20 participants (ages 13 to 24 years) were included in this paper. All interviews were video-recorded and coded using NVivo 10. Thematic analysis of the coded segments was guided by a constructivist grounded theory approach. Results: Three major themes emerged from the experiences of youths with intellectual and developmental disabilities on family involvement in their social and community engagement: (1) complex of supports and influences, (2) community engagement with and through family, and (3) points of tension. Conclusions: These thematic findings offer insights into the lived experiences of youths with intellectual and developmental disabilities about engagement in community life. These findings provide an understanding, outside of conventional schemas, of transition into young adulthood for these youths. Rehabilitation professionals often work with youths with intellectual and developmental disabilities who face barriers to reaching transition goals identified either by themselves or others. Family members' views that may focus on goals of maximizing functional independence and/or decreasing caregiver demands can often overshadow the goals or views of youths with intellectual and developmental disabilities themselves. Rehabilitation professionals should find ways to explore with youth their family's roles in engagement and belonging in community life so that they can link youths to appropriate community resources and plan optimal interventions/programs. Rehabilitation professionals need to be aware of and respond to points of tension that can emerge between youths with intellectual and developmental disabilities and their family during transition. [ABSTRACT FROM AUTHOR]

Many Australians living with a disability find themselves recipients of Newstart Allowance when applying for the Disability Support Pension (DSP). Newstart Allowance is designed as a short-term payment for people looking for work, with a lower fortnightly payment and limited medical and transport subsidies compared to the DSP. This paper describes the financial challenges of living with a disability while on Newstart Allowance. With a focus on the experiences of Aboriginal and Torres Strait Islander (Indigenous) Australians from two regional towns, qualitative semistructured interviews and focus groups documented experiences of 39 community members and 21 medical and nonmedical service providers supporting clients living with a disability on Newstart Allowance. Four themes were identified: (i) living with severe financial hardship, (ii) challenges complying with the DSP application, (iii) being financially penalised for not complying with Newstart Allowance conditions, and (iv) supporting community members to manage severe financial stress. Although people living with a disability on Newstart were experiencing severe hardship and poverty, there was limited participation of Centrelink-employed social workers within their described experiences with Centrelink. We argue that social workers can work to humanise human service settings and potentially help to mitigate these financial challenges. IMPLICATIONS Indigenous Australians living with a disability experience severe disadvantage and poverty while living on Newstart Allowance. Social workers must be easily accessible at Centrelink customer service centres and to Newstart Allowance recipients to help coordinate service engagement. Newstart Allowance should be increased to ensure recipients can respond to cost of living pressures. [ABSTRACT FROM AUTHOR]

Purpose: The process of individual ageing in the context of a care environment is marked by continuity and change. It is shaped by individual, health-related factors as well as by diverse social and environmental factors, including characteristics of the places where older people live. The aim of this paper was to explore how longitudinal qualitative research, as a research method, could be used to explore older people's changing care needs. Methods: The study used a longitudinal design to examine how the care and support needs of residents and their expectations of services developed over time and how these were influenced by changes in the organisation of their housing as well as in the make-up of the resident population. Residents were interviewed on four occasions over 20 months. Results: The study highlighted the complex ways in which some participants proactively managed the care and support they received, which we argue would have been difficult to discern through other methods. Conclusion: The study adds to the growing evidence base that supports the use of qualitative longitudinal research; the approach enables the researcher to capture the diverse and mutable nature of older people's experiences at a time of profound change in their lives. [ABSTRACT FROM AUTHOR]

The past two decades have seen a growing call for researchers, policy-makers and health care providers to collaborate in efforts to bridge the gaps between research, policy and practice. However, there has been a little attention focused on documenting the challenges of dealing with decision-makers in the course of implementing a research project. This paper highlights a collaborative research project aiming to implement the accountability for reasonableness (AFR) approach to priority setting in accordance with the Response to Accountable Priority Setting for Trust in Health Systems (REACT) project in Tanzania. Specifically, the paper examines the challenges of dealing with decision-makers during the project-implementation process and shows how the researchers dealt with the decision-makers to facilitate the implementation of the REACT project. Key informant interviews were conducted with the Council Health Management Team (CHMT), local government officials and other stakeholders, using a semi-structured interview guide. Minutes of the Action Research Team and CHMT were analysed. Additionally, project-implementation reports were analysed and group priority-setting processes in the district were observed. The findings show that the characteristics of the REACT research project, the novelty of some aspects of the AFR approach, such as publicity and appeals, the Action Research methodology used to implement the project and the traditional cultural contexts within which the project was implemented, created challenges for both researchers and decision-makers, which consequently slowed down the implementation of the REACT project. While collaboration between researchers and decision-makers is important in bridging gaps between research and practice, it is imperative to understand the challenges of dealing with decision-makers in the course of implementing a collaborative research project. Such analyses are crucial in designing proper strategies for improved communication and for the utilisation of research projects over time. [ABSTRACT FROM AUTHOR]

In this paper, we present findings from a qualitative study that gathered Nicaraguans’ perceptions of short-term foreign medical missions, towards deepening the understanding of what Nicaraguans value or find limited in the work of such foreign missions operating in their country. Fifty-two interviews were conducted with patients, relatives of patients, Nicaraguan physicians and nurses who partnered with or observed missions at work, ‘beneficiary’ community leaders, and individuals who were unable or unwilling to access mission-provided healthcare. Factors underlying participants’ positive and more critical accounts of foreign primary and surgical missions are described and analysed. Empirical investigation on how, whether or not, or on what bases short-term medical missions (STMs) have been perceived as beneficial, harmful, or otherwise by those on the receiving end of these efforts is limited. This study aims to contribute to the evidence base for reflecting on the ethical performance of trans-national STMs. [ABSTRACT FROM PUBLISHER]

Purpose: Little is known about the barriers and facilitators to pregnancy, birth and motherhood for disabled women within the New Zealand context. Our study explored this deficit with the aim of improving health care interventions and support for disabled mothers. Methods: This paper reports on the third phase of a mixed-methods study. The first two phases used semi-structured individual and focus group interviews with disabled women, and health professionals, involved in maternity and postnatal care and has been reported elsewhere. Phase 3 utilised a modified Delphi technique with both groups of participants to seek consensus on the prioritisation of recommendations from the study. This article focuses on the disabled women's recommendations. Results: In all, 20 disabled women took part in the Delphi phase of the study (28% of the cohort from Phase 1). In total, 11 key recommendations were identified by the disabled women, with the top seven discussed in detail here. Conclusions: Health professionals and health systems could, and arguably should, utilise a matrix of these recommendations to facilitate a review of service responsiveness to disabled women. [ABSTRACT FROM AUTHOR]

Objective:In recent decades, psychiatric services have been challenged to be more responsive to patients’ coexisting problems, in particular those concerning substance use. In Australia this has been referred to as a “No Wrong Door” approach. This paper explores the meanings of this move for the acute mental health sector, including attitudes toward a No Wrong Door approach to people with a dual diagnosis of mental illness and substance use disorder.  Methods:This qualitative study involved a review of the research literatures, analysis of policy documents, and interviews with 19 key informants in a case study of the State of Victoria, Australia.  Results:The analysis resulted in two broad themes surrounding the implications of dual diagnosis discourse for the mental health sector. The first involves progress regarding the concept of No Wrong Door with subthemes including interprofessional cultural conflicts, intersectoral professional status issues, terminology, problem definition, perspectives on serious mental illness, the role of the client, and pharmacological treatment. The second overarching theme focuses upon informants’ thoughts on future directions for the sector and highlights divided opinion on the implications of dual diagnosis discourse for the mental health service and social care systems.  Conclusions:While the perspectives on system change and multiple issues such as resource concerns and cultural clashes are presented here, the informants in this study also gave clear guidance for the future of dual diagnosis work in the mental health sector (e.g., focusing on orienting services toward consumer strengths and recovery), along with recommendations for future research. This paper contributes to the small body of qualitative research on the history and course of efforts to develop appropriate practice in mental health services with regard to patients who have substance use problems and other mental health disorders. [ABSTRACT FROM PUBLISHER]

In the context of increasing access to antiretroviral therapy (ART), the issue of childbearing among people living with HIV is important. The little that is known originates from either studies conducted before widespread availability of highly active ART or has focused on women's or men's reproductive behaviours and experiences. This paper therefore explores factors that influence childbearing decisions of married couples living with HIV in patrilineal and matrilineal kinship communities in rural Malawi. Qualitative exploratory research was conducted in two rural districts in the southern part of Malawi. Data were collected using in-depth interviews from 20 couples purposively sampled in matrilineal (Chiradzulu) and patrilineal (Chikhwawa) communities from July to December 2010 and was analysed using the content analysis method. The research findings show that couples living with HIV continue having children despite knowledge of the risk associated with childbearing and resistance from others in the community. Furthermore, the findings suggest that men are driven to have children by the need to cement relationships (patrilineal and matrilineal communities) and to secure position (matrilineal communities) while women do not want to have children because they are afraid of the risks and a heavier childcare burden. Finally, the findings suggest that outcomes of the decisions are dominated by husbands’ desires in both communities. This paper therefore extends the discourse on the value of childbearing beyond the question of adulthood expressed in varying ways according to gender and kinship organisation. We therefore recommend that intervention strategies for both reproductive health and HIV and AIDS must focus on husbands and be sensitive to local culture. The antiretroviral clinics must integrate family planning services in their routine activities and condom use must be complemented with other effective family planning methods to prevent future pregnancies. [ABSTRACT FROM PUBLISHER]

Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients’ journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more effectively, if they and their family have money, useful social relations, and knowledge, together with the capacity to communicate with health staff. Patients coming from households with high socio-economic status (SES) are more likely to have all of these resources, while for patients with low or medium SES, lack of economic resources increases the importance of connections within the health system. [ABSTRACT FROM PUBLISHER]

The paper presents an introduction of a newly developed, avatar-based virtual reality therapy, as an addition to the therapeutic programme, within a therapeutic community prison in the UK. The participants had six group sessions facilitated by a counsellor. The aim of the project was to investigate whether this approach would improve mental health outcomes for the prisoners, interpersonal relationships within the prison and facilitate the achievement of personal goals for the prisoners. The sample size (n = 4) was insufficient to make firm conclusions about the mental health outcomes. However, the qualitative analysis showed a strong engagement with the programme in addressing personal issues, the development of insight and empathy, and improvements in relationships within the participants and with the counsellor. Further research with a larger sample is needed to establish efficacy of this type of therapy with the prison population. [ABSTRACT FROM PUBLISHER]

Objective: In this paper, we apply psychological agency theory to women's interviews of their breastfeeding experiences to understand the role of agency in relation to breastfeeding initiation, maintenance and duration. Design: Qualitative, video interviews were collected from 49 women in the UK from a wide range of ethnic, religious, educational and employment backgrounds about their breastfeeding experiences. We undertook secondary analysis of the data focusing on their accounts of vulnerability and agency. Findings: Women's agency was impacted by a variety of factors including their own vulnerability, knowledge, expectations and experience, the feeding environment and the support of health professionals in sharing decision-making and dealing with uncertainty. Conclusion: Health professionals as co-agents with women are well positioned to maintain, enhance or restore women's sense of agency. Breastfeeding goals should be included in women's birth plans. Training related to agency, continuity of care, and staffing and workload management supported by national breastfeeding policies could improve breastfeeding rates and experiences. [ABSTRACT FROM AUTHOR]

This study explored the experiences of the first generation of adolescents who acquired HIV through vertical transmission when disclosing their diagnosis to friends and romantic partners. The study sample was selected by convenience, with 20 patients (13–20 years old) participating in a qualitative investigation using individual interviews (language: Portuguese; duration: 45 minutes). The participants were followed in specialized clinics for the treatment of pediatric AIDS in São Paulo, Brazil. The results suggest that families who live with HIV tend to keep it a secret, and such behavior is learned and accepted unquestioningly as natural. Respect for privacy and the fear of rejection, coupled with the belief that information about their disease will be spread, are the main beliefs with which participants justify their secrecy. In terms of romantic relationships, adolescents were aware that their HIV status should at some point be shared with current or future sexual partners. However, the decision to reveal an HIV diagnosis in romantic relationships is permeated by anxieties, uncertainties about the right time, and fear of abandonment. In any case, telling the truth requires trust, guarantees of the other’s love, and, in some cases, probing romantic partners beforehand to learn their perceptions about the disease. Participants who had experiences disclosing their HIV status shared positive and negative results, including emotional support, acceptance, and understanding, along with ostracism, discrimination, and abandonment by family members. The findings of this paper reinforce the challenges of revealing an HIV diagnosis to third parties. It requires understanding the meaning and importance of the secret for each patient, along with the conflict between the right to confidentiality and the responsibility of treating others exposed to the disease. All these aspects should be discussed extensively with this population and incorporated into clinical practice. [ABSTRACT FROM PUBLISHER]

This paper examines the preferred sexuality education sources of older Australian adults in later life. Drawing on findings from qualitative interviews with 30 men and 23 women aged 60 years and older, we consider the sources that participants currently use, or would like to use, in seeking information about sex. Where relevant, we examine participants’ experiences of learning about sex in later life using different sources, and the impact these had on their sexual expression, pleasure and well-being. Preferred sources of information include the Internet, the media, health care providers, books and workshops or discussion groups. A substantial number of participants did not actively seek information on sex. For those who had, these educational endeavours could profoundly shape their sexual practices. As such, learning about sex should be viewed as a lifelong endeavour. Our findings carry important implications for the development and delivery of sexuality education for older adults. [ABSTRACT FROM PUBLISHER]

In relation to clinical trials, it is far more usual to speak of the community (singular, static) than of publics (multiple, emergent). Rarely defined, the community is commonly taken to be the existing people in a given area, which the trial will engage, mobilise or sensitise to facilitate successful recruitment and retention. Communities are assumed to pre-exist the research, to be timeless, and to be a whole (sometimes consisting of different parts, referred to as stakeholder groups). In this paper, we suggest a conceptual shift from ‘trial community’ to ‘experimental publics’. Using an empirical case study of an HIV prevention trial in Zambia, we draw out the following key points: firstly, publics do not pre-exist research activities but are enacted in concert with them. Secondly, publics are dynamic and transient. And thirdly, experimental publics are situated at the intersection of various forms of inclusion and exclusion, both locally and globally. Our findings emphasise the need to create long-term forms of participation in science, which transcend both the instrumental goals and the individual timelines of specific trials. [ABSTRACT FROM PUBLISHER]

Young bisexual women experience worse mental and sexual health outcomes in comparison to their heterosexual and lesbian peers. These disparities are associated with stigma and devaluation of bisexual identities. The current paper addresses a community-based focus group project in which participants discussed bisexual stigma in regard to bisexual erasure and other stereotypes. Specifically, participants detailed experiences of feeling pressured to provide evidence of their bisexual identity, modifying their relationship or sexual behavior to conform to these expectations, as well as feeling excluded from queer community. Further, participants discussed how these experiences were related to decreased mental and sexual health. Future research should further investigate the relationship between bisexual stigma, pressure to provide evidence of bisexual identity, and negative mental and sexual health outcomes. [ABSTRACT FROM PUBLISHER]

Over the past two decades there has been a growing awareness that sport may not be a positive experience for all children. For example, we know that some children experience sexual abuse in the context of organised sport, and that these offences are often committed by trusted adults, including coaches and club officials. However, less attention has been given to the physical abuse of child athletes. This paper presents a study that explored children's experiences of organised sport, as recounted by young people between the ages of 18 and 25 years in Australia. The study explored the experience of child physical abuse in organised sport including violence, overtraining, and training while injured. A mixed methods research design produced 107 survey responses and 10 in-depth interviews with young adults. Most respondents reported the positive impact that participating in sport had had on their development, but more than a third of the respondents also described experiences of overtraining, being forced to train when injured or of direct physical violence. Drawing upon a thematic analysis of the qualitative data, a conceptual model has been developed and is presented to assist in the understanding of the dynamic of secrecy, which may facilitate ongoing physical harm to children in this context. [ABSTRACT FROM AUTHOR]

In Britain, there has been an increased emphasis on the use of risk assessments in mental health services over the past 20 years. Mentally disordered offenders subject to Section 41 of the Mental Health Act 1983 (England and Wales) are defined as posing a serious risk of harm to others. They are thus dealt with by forensic mental health services, which are often seen as specialists in risk assessments. This paper is based on original research in three mental health trusts in the South of England which was carried out between March 2009 and September 2011. The paper examines mentally disordered offenders’ awareness and attitude to formal risk assessments in relation to theories of governmentality. Service users subject to Section 41 of the Mental Health Act 1983 were aware that their level of risk was being assessed by professionals caring for them but were commonly unaware of the content of these assessments. These risk assessments were viewed by participants as a means through which professionals measured and monitored behaviour. Although participants often referred to levels of risk, they did not view risk screening schedules as objective, but rather emphasised the need to persuade staff that their risk had reduced. Despite showing a limited awareness of the content of these risk assessments, participants generally identified more risks, in relation to their vulnerability, than did the professional assessments. However, participants generally identified fewer risks in relation to the dangers they posed to others than did professional staff. [ABSTRACT FROM PUBLISHER]

Children and young people living in households affected by HIV are experiencing poorer educational outcomes compared to their peers. This article explores how different forms of marginalisation interface and manifest themselves in classroom concentration problems, undermining their education. This mixed qualitative methods study was conducted with teachers and pupils from three primary and three secondary schools in the Siaya County of Western Kenya. Specifically, it involved 18 teachers through individual interviews and 51 HIV-affected children and youth through individual interviews (n = 47) and Photovoice (n = 51). Verbatim transcripts were imported into NVivo10 for thematic indexing and analysis. The analysis revealed three core pathways to classroom concentration problems amongst HIV-affected pupils. One, a general ‘lack of care’ and neglect in the context of household poverty and illness, meant that many of the participating pupils went to school hungry, unable to follow classes. Others were teased by peers for looking visibly poor, and felt anxious when in school. Two, some HIV-affected pupils play a key role in keeping their household afloat, generating food and income as well as providing practical support. ‘Caregiving’ pupils often reported coming to school exhausted, with limited physical and mental energy left for learning. Three, many participating pupils had their minds at home (‘caring about’). They were concerned about sick or frail household members, thinking about their next meal and care needs. Although the pupils demonstrated an admirable attentiveness to the needs of others, this came at a heavy price, namely their ability to concentrate in class. The paper argues that care ethics, household poverty and familial HIV are central to understanding the classroom concentration problems of HIV-affected pupils. To ensure school-going children and youth affected by HIV have the same opportunities as their peers, education initiatives must simultaneously alleviate both household poverty and other challenges pertaining to familial HIV. [ABSTRACT FROM PUBLISHER]