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Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. 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 Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. 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.)

This paper investigates how healthcare professionals experience digital platforms in their work practices and how these relationships enable forms of emotional labour and contribute to shaping their emotional health. Methodologically, the contribution draws on audio-diaries kept by 15 healthcare professionals and a final semi-structured interview conducted with the same informants. The research material was analysed using open and axial coding techniques, in a grounded theory fashion. Findings provides meaningful insights to the literature on the emotional labour of healthcare professionals, as well as to studies on digital health and labour. Specifically, we show that participants associate different and even contrasting reflections and emotional states with their relationships with digital platforms. Thus, there is not exclusively one trajectory that can explain the implications of media uses, as different and potentially conflicting emotions coexist within the same experience. Given this scenario, we argue that it can be fruitful to use the lens of 'ambiguity' to scrutinise the ambivalences and tensions characterising platform experiences, and how emotional labour in healthcare intertwines with technological developments. Moreover, we advocate for the development of critical digital literacy skills among healthcare professionals. • We contribute to literature on digital health and emotional labour. • We show the emotional ambivalences in healthcare professionals' platform experiences. • We argue for the merits of using the concept of 'ambiguity'. • We advocate for critical digital literacy among healthcare professionals. [ABSTRACT FROM AUTHOR]

This paper examines the experiences of adolescents from mixed migratory status families affected by deportation. We analyze the impacts on their mental and emotional health when they are separated from one parent in the United States, forcibly displaced with another to Oaxaca, and experience the consequences of their deportation in Mexico. We use a qualitative and ethnographic methodology. This paper focuses on data from semi-structured interviews and focus groups with 15 parents who had been deported from the United States and 53 adolescents who moved with them to Mexico. The data was collected between 2018 and 2020. The main findings show the existence of emotions that are sustained in the transnational flow and acquire new nuances upon return. They also show the emergence of new conditions related to family separation, all of which have an impact on the adolescents' well-being and on important areas of their lives, such as education. The research contributes to knowledge in two main ways: 1) it addresses the impacts of parental deportation on the well-being of adolescents in mixed-status families, which have typically focused on children; 2) it studies how parental deportation affects the mental and emotional health of adolescents de facto deported to Mexico, a field still little studied. • De facto deportation has mental health consequences among adolescents. • The forced nature of de facto deportation produces helplessness, aggression and anger. • The code of silence associated with deportation generates fear, stress, anxiety. • Ambiguous loss is accentuated at important moments in academic and developmental life. • Family separation and de facto deportation affect school performance. [ABSTRACT FROM AUTHOR]

There is limited provision of inpatient detoxification relative to other treatments for alcohol and other drug (AOD) use. This means people often need to wait prior to detoxifying. However, waiting for healthcare is generally perceived as negative and stressful. This paper aims to understand patients' experiences of waiting for inpatient AOD detoxification to ascertain whether and how service-level policies and practices might be improved. Semi-structured telephone interviews were conducted with 32 people (20 males, 12 females; aged 25–67 years) who were waiting for inpatient detoxification. Data collection was part of a wider evaluation of a policy initiative started in 2021 to increase detoxification service capacity in England, UK. Interviews were professionally transcribed and data on waiting experiences were coded using qualitative software. Analyses were informed by new materialist thinking and undertaken via Iterative Categorisation. We found that waiting was constituted through five dimensions: i. duration; ii. support; iii. information; iv. preparations; and v. emotions. These five dimensions were multi-faceted and operated in and through wider interacting social, material, and affective forces (e.g., professional judgements, formal and informal relationships, the availability of beds and funding, bureaucratic procedures, the utility and relevance of information, and participants' diverse feelings, including desperation for treatment). Not all accounts of waiting were negative. The experience was complex, non-uniform and variable over time. Moreover, it affected how people felt and how they behaved. Changes to service-level policies and practices can potentially minimise the stress of waiting for inpatient AOD detoxification. The negative impact of waiting may be reduced if professionals more consistently engage patients in a wider range of constructive pre-treatment activities, offer regular 'check-ins' to mitigate any anxiety, explain changes in wait duration to help with planning and demonstrate fairness, and facilitate contact between those waiting to lessen feelings of isolation. [ABSTRACT FROM AUTHOR]

Medical students with chronic health conditions are an underrepresented and often overlooked population in medical education. Previous research describes the dual roles they hold as both healthcare recipients and providers and details challenges they face related to accommodations and accessibility. However, less is known about how having a chronic health condition shapes the day-to-day aspects of medical education. To address this gap in knowledge, I conducted semi-structured interviews with eighteen medical students with chronic conditions and examined data using reflexive thematic analysis. Findings revealed the competing demands students face between medical school expectations and the need to manage their health. They work to reconcile these demands using tools like accommodations and strategic communication and by reconstructing narratives to re-assess self-imposed expectations. These participants understand having a chronic health condition as just one piece of their larger sense of self. Participants approach this understanding in individualized and nuanced ways, yet all share a cohesive view that their experiences having chronic health conditions inform their medical practice for the better through the development of genuine empathy for patients. This paper concludes with recommendations drawn from participant interviews of how medical schools can better support students with chronic health conditions. • Chronic condition management and medical training compete for time and energy. • Demands are reconciled at structural, interpersonal, and intrapersonal levels. • Having a chronic condition influences but does not define medical training. • First-hand healthcare experiences build genuine empathy and improve patient care. [ABSTRACT FROM AUTHOR]

Universal health coverage (UHC) has become an influential global health policy. This study asked whether and to what extent UHC became a "hegemonic" health policy. The article consists of three parts: a historical timeline of UHC's rise, a bibliometric analysis of UHC in the literature, and a qualitative thematic analysis of how UHC is defined and the thematic content of those definitions. The roots of UHC can be traced to policies enacted by international financial institutions (IFIs) such as the World Bank and International Monetary Fund (IMF) during the latter half of the twentieth century. These policies caused the debt of low- and middle-income countries (LMICs) to rise precipitously and led the same IFIs and other institutions like the World Health Organization to become involved in the development and restructuring of health systems. UHC was presented as the leading method for financing development of health systems. As the bibliometric analysis shows, UHC has come to predominate in the literature around health system reforms. The thematic analysis based on a random selection of papers obtained in the bibliometric component of the study shows that often the term is not defined or only poorly defined. There is wide variation in the definitions, with many papers mentioning concepts such as quality, access, and equity without further clarification. Usually, papers define UHC to include tiering of benefits, with discussions of financing that focus on preventing "catastrophic [individual] expenditures" rather than discussing universal budgeting of a national health care system or national health insurance. We conclude that UHC has become hegemonic within global health policy, to the exclusion of discussions about other approaches to the transformation of health systems that are not predominately based on insurance coverage such as Health Care for All system, a system which provides equal services for the entire population. • Universal health coverage (UHC) has become hegemonic in global health policy. • UHC emerged largely as an initiative of international financial institutions. • UHC predominates in the literature and is often poorly defined or not defined. • Discussions of finances focus on individual spending instead of global budgeting. • UHC's hegemony diverts attention from other policies such as Health Care for All. [ABSTRACT FROM AUTHOR]

Background: Family carers provide strong support for many older adults, often enabling older adults to remain at home. Little is known about the care recipients' perspectives of the role and contributions of family carers, particularly when hospital admissions occur as part of end of life care. Aim: This paper explores the meanings of family caring for care recipients by drawing on older adults' perspectives about the impact of hospital admission on established family caring relationships. Design: Exploratory semi-structured qualitative interviews. Key findings reported in this paper emerged from within the inductive research design. Setting: Interviews were conducted in older adults' place of residence in northwest England between June 2009 and July 2010. Participants: Participants were 27 older adults living with heart failure (n = 13) or lung cancer (n = 14), aged 69-89 years (mean 79 4.3 years) and considered by their health professionals to be in their last year of life. In 12 of the interviews, a family carer was also present and made contributions. Findings: For community-dwelling older adults, family carers are conceptualised as 'conductors'; making strong contributions to maintaining the rhythm of good care throughout the illness trajectory. Following older adults' hospital admission, family carers find themselves in the role of 'second fiddle', their ability to work with the individual and to make or influence decisions vastly reduced. Despite this, carers continue to invest considerable effort in maintaining continuity in the carer relationship to maximise the individual's wellbeing by identifying needs, filling gaps in provision and advocating on patients' behalf. Family carers act flexibly to provide continuity, support and take responsibility for older adults' wellbeing across settings. Conclusions: Nurses and family carers working together, and greater appreciation of the contribution and role of family carers by health professionals may contribute to improving the quality and continuity of care for older adults. [ABSTRACT FROM AUTHOR]

There is limited literature on the processes of choice-making in families of young people with learning disabilities. This paper examines the factors considered by parents of young people with learning disabilities when deciding their own and their child's role in a range of significant choices (health, social care and education) about their child's life. The paper reports data collected from a sub-sample of 14 parents recruited from 11 families participating in a longitudinal (2007–2010) qualitative study based in England. The parents all had children with learning disabilities and participated throughout the study. Data were collected over three semi-structured interviews. Parents' accounts demonstrated a continuum of parental involvement ranging from young people being unaware a choice was taking place to young people being fully involved in choice-making. Parents did not always adopt the same approach to choice-making; different approaches to their own and their son/daughter's level of involvement emerged when parents discussed different choices. Five choice-making factors are presented. These factors were used by parents to guide their own and their child's level of involvement. Although young people's level of understanding was considered, it was not always the most important factor. Other factors were important and, at times, could be considered more important by parents. The other factors were: parents' views on the nature of the choice, protecting their child, parents' personal attitudes/beliefs and confidence in practitioner knowledge. Insights from these factors highlight some important practice issues when practitioners work with families of young people with learning disabilities making significant life-choices. [Copyright &y& Elsevier]

This paper discusses the findings from the observation phase of a more extensive, appreciative inquiry qualitative study exploring registered nurses' experiences of administering medications. The observations aimed to explore the participants' application of the five-rights of medication administration in practice. Twenty registered nurses working in inpatient medical/surgical units at a regional Australian hospital were observed administering medications from the commencement to the completion of their shift. A data collection tool based on the five-rights of medication administration was used. The findings indicated that medication administration was not as routine as the rights framework suggests. Indeed, what was observed rarely reflected all the criteria of the rights framework. Notably, in practice, some of the rights were unable to be observed because the critical thinking that underpins the rights are implicit. However, the participants were observed to implement strategies beyond those described by the rights framework that ensured safe and timely medication administration. In brief, medication administration in contemporary healthcare settings is more complicated than the linear process suggested by the rights framework. So more attention is warranted, to the safe practice strategies of nurses who, to deal with complex clinical contexts. Their person-centred strategies respond to patient circumstances and maintain safety. [ABSTRACT FROM AUTHOR]

Abstract This paper presents the final phase of a national project exploring grading of practice in programmes leading to registration as a midwife in the United Kingdom. The aim was to develop a generic framework for grading practice, enhancing standardisation while enabling flexibility in application of current and new educational standards. A mixed method on-line survey considered existing practice assessment tools, factors contributing to robust and reliable assessment and perceptions of two assessment tools developed by the research team: a 'Lexicon Framework' and 'Rubric' , which were tested through scenarios. Participants included 170 midwifery and nursing academics, clinicians and students, representing 20 universities in the UK. Seven key themes emerged, from which an 'Evidence Based Model for Professional Practice Assessment' was developed. The proposed tools were overall positively evaluated and demonstrated a good level of reliability. A national tool to standardise midwifery practice assessment is recommended, and scope for transferability of our tools to all midwifery programmes and to nursing was identified. Other recommendations include engagement of key stakeholders in development of practice assessment documentation, and maintaining the professional purpose of grading practice as central to the process. A set of key principles for assessing practice is presented. Highlights • A national tool to standardise midwifery practice assessment is recommended. • Key stakeholders should engage in development of practice assessment documentation. • The professional purpose of grading practice should be central to the process. • Key principles and an evidence based model for assessing practice are presented. • A toolkit of generic resources supporting practice assessment is near completion. [ABSTRACT FROM AUTHOR]

• We provide new evidence for the benefits and challenges of accessing SMART Recovery mutual-help groups virtually via videoconference. • Identified benefits include availability, ease of access and the zoom chat feature. • Potential challenges included in-group engagement, group size, non-verbal cues, social interaction and technology problems. • Virtual SMART Recovery mutual-help groups appealed to different people under different circumstances. • Our findings have implications for research, training and practice. COVID-19 prompted widespread transition of face-to-face mutual-help groups to virtual delivery. Current understanding of the experience of virtual mutual-help groups is limited to 12-step approaches or asynchronous groups (e.g., forums). This paper explores participant and facilitator perspectives regarding the benefits and challenges of accessing SMART Recovery mutual-help groups virtually via videoconference. A self-selected convenience sample of participants (n = 29) and facilitators (n = 15) from SMART Recovery mutual-help groups in Australia were enrolled. Participants and facilitators were sampled to reflect experience of virtual groups delivered via videoconference ('online'), face-to-face groups ('face-to-face') or both types of groups ('both'). Telephone qualitative interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed, and analysed using iterative categorisation. Participant and facilitators discussed their experience across eight interconnected themes benefits were typically discussed with regard to the (1) availability, (2) ease of access and (3) value add of the chat feature in online groups. Challenges largely pertained to (1) in-group engagement, (2) group size, (3) non-verbal cues, (4) social interaction and (5) technology problems. The impact of these challenges on participant and facilitator experience varied, and neither modality was consistently identified as superior. SMART Recovery mutual-help groups provided participants with another option for accessing mutual-help and appealed to different people under different circumstances. Depending on the needs and preferences of the individual, online SMART Recovery mutual-help groups may help to mitigate a range of barriers to help seeking and may also engage people otherwise unable or reluctant to engage in treatment. To inform training, practice and policy, improved understanding of the individual and contextual factors that enhance participant engagement, experience and outcomes is needed. [ABSTRACT FROM AUTHOR]

• During COVID-19, care leavers in Wales looked to their corporate parents for support. • Social care workers sought to provide continued support despite lockdown restrictions. • Some young people felt supported, but others felt neglected and forgotten. • Corporate parenting responses had the potential to mitigate or compound adversities during COVID-19. • Evidence from this study supports on-going efforts in Wales to strengthen corporate parenting. This paper considers the support available to care leavers during the Covid-19 pandemic from their corporate parents. The paper contributes to a developing evidence base concerned with social work efforts to adapt and maintain support provision during the unprecedented circumstances, and provides insight into how such support was perceived and experienced. Funded by Voices from Care Cymru and Cardiff University, a qualitative, mixed method study was conducted which included a survey of Welsh Local Authority professionals (n = 22) and interviews with Welsh care-experienced young people aged 17–24 (n = 17). The findings of this paper show the propensity of corporate parents to provide protection against the adversities of the pandemic, or to compound difficulties. While some young people reported being both practically and emotionally supported, for others corporate parenting support was perceived as unavailable, unhelpful and / or uncaring. The Covid-19 pandemic provides a unique lens to consider the strengths, flaws and future opportunities for corporate parenting. The findings emphasise the need for parity of support for young people leaving care and consideration of national, local and individual responses is included. Yet consistent with findings pre-dating the pandemic, the findings reaffirm the enduring importance of both relationships and resources in ensuring good support for care leavers. [ABSTRACT FROM AUTHOR]

Following the successful development of vaccines for COVID-19, attention turned to the problem of vaccine access. However, in contexts where vaccines are available, hesitancy remains a major problem. Informed theoretically by the scholarship on vaccine anxiety, this paper uses a qualitative research approach that included 144 semi-structured interviews to investigate how social and political dynamics shaped people's perspectives in particular environments in Ghana, Cameroon, and Malawi about COVID-19's viral spread and COVID-19 vaccines. Vaccines and the viral spread of COVID-19 are related to political tensions and class-related fractures in particular contexts, and how the public interprets COVID-19's viral spread and engages with vaccination is based on people's social and political environment and their experience. Subjectivities are also rooted in coloniality. Vaccine confidence goes beyond clinical and regulatory authority approvals, and encompasses forces that are economic, social, and political in nature. Thus, an exclusive focus on technical prescriptions for enhancing vaccine uptake will not achieve significant positive results. • Vaccines are related to political tensions and class-related fractures in particular settings. • Political context shapes how people view mandatory vaccination. • The body is a mirror of socio-political context. • Worries about getting COVID-19 vaccines cut across professional and income-related categories. • Distrust in vaccines has national and international dimensions. [ABSTRACT FROM AUTHOR]

Home visitation programs offer a unique opportunity to implement a novel digital early childhood obesity prevention program. Evaluate usability of a digital infant feeding nutrition education module with key stakeholders (N=21) of a home visiting program in Florida. Home visitors (n=11) and enrolled mothers (n=10) of a home visiting program in Florida participated in a one-time, 45-minute qualitative interview via Zoom with a trained researcher using a semi-structured script based on constructs from the Technology Acceptance Model (TAM) and Social Cognitive Theory (SCT). Participants also completed a modified version of the mHealth App Usability Questionnaire (MAUQ). Interviews were audio-recorded, deidentified, transcribed verbatim and coded by two trained researchers using an inductive thematic analysis approach based on TAM and SCT constructs to develop themes. MAUQ subscales were analyzed using descriptive statistics. Most participants noted that they liked the digital format, and specifically mentioned the visual or interactive components, convenience and accessibility of the information, and general preference for digital information over paper handouts. Home visitors were interested in content related to food allergies and readiness for solid foods, whereas mothers were interested in all of the infant feeding topics. Nonetheless, the majority (90%) reported that they would be very likely to use information in the learning modules as part of home visits. Usability of the module was high across all three MAUQ subscales (mean ratings out of 7±SD: ease of use = 6.88±0.2, interface and satisfaction = 6.90±0.4, usefulness = 6.78±0.1). Limited access to technology by parents, compatibility of the module with various phone types, and necessity of keeping information updated were mentioned by home visitors as limitations that may impact usability. The results revealed that a digital nutrition education module to prevent early childhood obesity was deemed usable by both staff and parents of a home visiting program. Future research is needed to determine impact on parental feeding behaviors and child health outcomes. University of Florida Mowery Innovative Research Fund [ABSTRACT FROM AUTHOR]

• Becoming parents implies redefining the complex relationships with birth families. • This process opens up to care-experienced parents new relational adjustments, but also several challenges. • Care-experienced parents are able to cope in part by using skills learned within the Child Protection System. • The key role of positioning/protecting vis-à-vis the birth family. • The need to assuage concerns about the lack of an extended family for their children. This paper studies how care-experienced parents, i.e. parents with a looked-after background, represent their relationship with the birth family. This relationship appears to be crucial in the intergenerational transmission of maltreatment and may enable an understanding of the dynamics that mediate its reproduction. Constructivist Grounded Theory approach was used in this qualitative study. I conducted online in-depth semi-structured interviews with 17 care-experienced parents in Italy from May to November 2021. The interviews were analysed using open, focused and theoretical coding with the support of NVivo12 and the analysis itself was discussed with a board of care-experienced parents. The relationship with the birth family is an aspect that frequently emerges in the interviewees' narratives. Birth family is represented through the more physical dimension of its presence in everyday life, as well as in the more symbolic one linked to one's inner experience. This means that birth family is crucial even when contacts are sporadic or no longer possible. Interviewees see parenting as an opportunity to create new relational adjustments, particularly in reference to their relationship with birth families. In fact, an internal daily dialogue and renegotiation with their own complex family history appears to take place. New parents compare their own childhoods with their children's, with this placing further pressure on the actual relationship with the birth family. In this process parents show interesting resources, possibly acquired within the child protection system. This study highlights relevant aspects of the relationship between the birth family and care-experienced parents. It represents a promising approach to a better understanding of the links affecting the intergenerational transmission of maltreatment, also vis-à-vis the role of the child protection system. [ABSTRACT FROM AUTHOR]

• Examining adolescent perceptions of their parents influence on their access and use of mental health services. • Use qualitative face to face interviews. • Parents were highlighted by adolescents as prominent influences in adolescent mental health journeys, however this influence could be positive and negative for the adolescent. • Highlights the complexity of the involvement of parents in their child's mental health service use. To explore adolescent experiences of accessing and utilising mental health service in Perth, Western Australia. This paper focusses on the adolescent identified influence of parents in accessing and using mental health services. Qualitative semi-structured face-to-face interviews with 22 adolescents aged 14–18 years old in Perth, Western Australia. Interviews were transcribed verbatim and analysed thematically. The influence of parents on adolescents' experiences within the mental health system were grouped under three themes: parental involvement in accessing and continued use of mental health services for their children; parental understanding and awareness of child's mental health problems; parent–child relationship. It was common for adolescents to report that the influence and involvement of their parents could create facilitators and barriers to mental health care. This research highlighted the complexities in how parents can be both supportive and hindering influences in their child's mental health care. Adolescent experiences highlight the need for parents to be a key area of focus for mental health services and future reforms to support and improve adolescent mental health service use. Additional research is needed to explore how to effectively increase parental mental health literacy in the community and what factors are needed to create trusted parent-adolescent relationships. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. 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.)

This study assessed a) the impact of playing the Dignity board game on participants' understanding of respectful maternal and newborn care and b) participants' perceptions of how the game influenced their subsequent practice in Malawi and Zambia. Nurse-midwives' poor understanding of respectful maternal and newborn care can lead to substandard practice; thus, effective education is pivotal. Used in several disciplines, game-based learning can facilitate skills acquisition and retention of knowledge. a quasi-experimental study, using mixed-methods of data collection. Data were collected between January and November 2020. Nurse-midwives (N = 122) and students (N = 115) were recruited from public hospitals and nursing schools. Completion of paper-based questionnaires, before and after game-playing, assessed knowledge of respectful care principles and perceptions around behaviours and practice. Face-to-face interviews (n = 18) explored perceived impact of engaging with the game in clinical practice. Paired and unpaired t-test were used to compare scores. Qualitative data were analysed and reported thematically. The study was completed by 215 (90.7 %) participants. Post-test scores improved significantly for both groups combined; from 25.91 (SD 3.73) pre-test to 28.07 (SD 3.46) post-test (paired t = 8.67, 95 % confidence interval 1.67–2.65), indicating an increased knowledge of respectful care principles. Nurse-midwives performed better than students, both before and after. In Malawi, the COVID pandemic prevented a third of nurse-midwives' from completing post-game questionnaires. Qualitative findings indicate the game functioned as a refresher course and helped nurse-midwives to translate principles of respectful care into practice. It was also useful for self-reflection. The Dignity board game has the potential to enhance understanding and practice of respectful maternal and newborn care principles in low-resource settings. Integration into nursing and midwifery curricula and in-service training for students and healthcare workers should be considered. [ABSTRACT FROM AUTHOR]

Background Ability to elicit individuals’ perceptions of complex behavioral processes can be challenging, as it hinges not only upon the skill of the researcher, but also upon assumptions of a shared language and individuals’ ability to recall, analyze, and effectively communicate events. In a case-based qualitative-descriptive study about teens’ experiences of asthma self-management, we found that variations in terminology and descriptions of events, symptoms, and responses made it difficult to understand teens’ experiences of asthma. In particular, teens’ conceptualization of their asthma symptoms and self-management responses differed from situation to situation, from other teens in the study, from the interviewer, and from prior reports in the literature. These differences across many levels made it difficult to identify patterns in individual processes of self-management, and among teens in general.. Objectives To address these challenges, we developed a card sorting activity to facilitate in-depth exploration of teens’ experiences of asthma. Design Case-based qualitative description. Setting: Teen-parent dyads (N=28) were recruited from the community, Emergency Department, Pediatric Pulmonary Department, and prior study subjects of a major medical center. Methods Teens first identified and then sequenced their own unique sets of asthma symptoms and self-management responses. Teens then developed contextually grounded narratives using the card sort they had created as a visual aid. Results This technique not only allowed us to bridge teen-interviewer communication barriers and develop shared terminology, but also resulted in a visible sequence of asthma symptoms and self-management responses. Conclusions The card sort technique facilitated researcher-teen discussion and enabled comparison of self-management patterns across teens in our study. This technique is potentially useful for other areas of research exploring behavioral processes with complex and individual-specific experiences, in particular those involving sequences of events and self-management responses. This paper delineates the development, utility, and potential applications of the symptom-response card sorting technique for research and clinical practice. [ABSTRACT FROM AUTHOR]

Nursing students' first clinical placement experience can be a critical turning point -reinforcing professional aspirations for some, and for others, a time of emotional turbulence. There is a paucity of research focusing on students' perceptions and concerns prior to their first placement experience. Thus, the aim of this study was to explore the concerns of first year bachelor of nursing students from one Australian university as they prepared for their first clinical placement. Participants completed an online 'readiness for practice' survey consisting of 22 items. This paper focuses on participants' responses to the one open ended question: 'Please comment on any concerns that you have in relation to being prepared for your first clinical placement'. Summative qualitative content analysis was used for analysis. 144 students (55%) responded to the open ended question. Responses were categorised into six themes including: Not prepared for placement; feeling nervous, anxious and worried; bullying and belonging; practicalities; patient safety and making mistakes; and working outside of my scope of practice. It appears that activities designed to equip students with the capacity to manage the inherent challenges of undertaking a clinical placement may sometimes have a paradoxical effect by increasing students' level of stress and anxiety. An enhanced understanding of students' concerns may help educators implement appropriate support strategies. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance This paper provides significant ethnopharmacological information on plants used to treat cardiovascular diseases in Navarra, Spain. Material and methods Information was collected using semi-structured ethnobotanical interviews with 667 informants (mean age 72; 55.47% women, 44.53% men) in 265 locations. Official sources such as the European Scientific Cooperative on Phytotherapy (ESCOP), German Commission E, World Health Organization (WHO), European Medicines Agency (EMA), European Pharmacopoeia (Ph. Eur.) and Real Farmacopea Española (RFE) monographs were consulted in order to establish the therapeutic efficacy of the reported uses and to obtain further details about quality and safety aspects. A literature review was carried out on the plants that were most frequently cited and were not the subject of a monograph, using a new tool developed by the University of Navarra, UNIKA. Results A total of 460 pharmaceutical uses were reported by the informants, belonging to 90 plant species and 39 families, mainly represented by Urticaceae , Rosaceae , Asteraceae , and Equisetaceae . The most frequently used parts of the plants were the aerial parts followed by leaves and flowers. Seventeen out of 90 plants (19%) and 208 out of 460 popular uses (45%) had already been pharmacologically validated in relation to their therapeutic efficacy and safety aspects. Conclusions The authors propose to validate five species for their use in cardiovascular diseases: Rhamnus alaternus L., Potentilla reptans L., Equisetum telmateia Ehrh., Centaurium erythraea Rafn and Parietaria judaica L. [ABSTRACT FROM AUTHOR]

Background: An implementation gap exists between policy aspirations for provision and the delivery of self-management support in primary care. An evidence based training and support package using a whole systems approach implemented as part of a randomised controlled trial was delivered to general practice staff. The trial found no effect of the intervention on patient outcomes. This paper explores why self-management support failed to become part of normal practice. We focussed on implementation of tools which capture two key aspects of self-management support - education (guidebooks for patients) and forming collaborative partnerships (a shared decision-making tool). Objectives: To evaluate the implementation and embedding of self-management support in a United Kingdom primary care setting. Design: Qualitative semi-structured interviews with primary care professionals. Settings: 12 General Practices in the Northwest of England located within a deprived inner city area. Participants: Practices were approached 3-6 months after undergoing training in a selfmanagement support approach. A pragmatic sample of 37 members of staff - General Practitioners, nurses, and practice support staff from 12 practices agreed to take part. The analysis is based on interviews with 11 practice nurses and one assistant practitioner; all were female with between 2 and 21 years' experience of working in general practice. Methods: A qualitative design involving face-to-face, semi-structured interviews audio- recorded and transcribed. Normalisation Process Theory framework allowed a systematic evaluation of the factors influencing the work required to implement the tools. Findings: The guidebooks were embedded in daily practice but the shared decision- making tools were not. Guidebooks were considered to enhance patient-centredness and were minimally disruptive. Practice nurses were reluctant to engage with behaviour change discussions. Self-management support was not formulated as a practice priority and there was minimal support for this activity within the practice: it was not auditable; [ABSTRACT FROM AUTHOR]

Background: The nature of end-stage renal disease and the need for continuous ambulatory peritoneal dialysis require patients to manage various aspects of the disease, its symptoms and treatment. After attending a training programme, patients are expected to adhere to the renal therapeutic regimen and manage their disease with the knowledge and skills learned. While patients are the stakeholders of their health and related behaviour, their perceptions of adherence and how they adhere to their renal therapeutic regimen remains unexplored. Aims: To understand adherence from patients' perspectives and to describe changes in adherence to a therapeutic regimen among patients undergoing continuous ambulatory peritoneal dialysis. Design: This study used a mixed methods design with two phases - a survey in phase I and semi-structured interviews in phase II. This paper presents phase II of the study. Settings: The study was conducted at a renal unit of an acute hospital in Hong Kong. Participants: Based on the phase I survey results, maximum variation sampling was employed to purposively recruit 36 participants of different genders (18 males, 18 females), ages (35-76 years), and lengths of dialysis experience (11-103 months) for the phase II interviews. Methods: Data were collected by tape-recorded semi-structured interviews. Content analysis was employed to analyse the transcribed data. Data collection and analysis were conducted simultaneously. Findings: Adherence was a dynamic process with three stages. At the stage of initial adherence, participants attempted to follow instructions but found that strict persistent adherence was impossible. After the first 2-6 months of dialysis, participants entered the stage of subsequent adherence, when they adopted selective adherence through experimenting, monitoring and making continuous adjustments. The stage of long-term adherence commenced after 3-5 years of dialysis, when participants were able to assimilate the modified therapeutic regimen into everyday life. Conclusions: The process of adherence was dynamic as there were fluctuations at each stage of the participants' adherence. With reference to each stage identified, nursing interventions can be developed to help patients achieve smooth transition throughout all the stages. [ABSTRACT FROM AUTHOR]

Background: International studies have generally defined nursing as a female-dominated occupation. The almost absence of male nurses seems universal, except as a privileged minority occupying positions within nursing specialties ('islands of masculinity'). Nursing is associated with relatively low status owing to gender and income, and is also influenced by cultural perceptions of social status, the nature of the work and sexuality. Objective: This study aims to describe and analyse how gender and cultural perceptions influenced the development of nursing in Mauritius. This paper examines why nursing in Mauritius became gendered in different ways due to the impact of gender equivalence in the work force, the gendered segregation in clinical practice and the absence of caring feminisation in nursing. Design and setting: This qualitative study is based on in-depth, semi-structured interviews and convenience sampling. The sample includes nurses working at five hospitals. They all come from the central and southern part of Mauritius. The data were collected over a fivemonth period during 2006. Participants: Individual qualitative interviews were conducted with 47 nurses, both men (27) and women (20), of different grades, ages, religions and ethnic backgrounds. Results: Nursing practice is gender segregated, influenced and supported by cultural traditions and perceptions of gender relations, sexuality and touch in nursing. However, the professional identity and role is considered non-gendered, implied by the title of 'nursing officer' and the presence of male nurses who constitute almost 50 percent of the work force. Male nurses do not face similar barriers deterring them from entering nursing profession. Nursing did not develop the image of women's work and a low status job in Mauritius. Conclusions: The nursing profession in Mauritius has been shaped by a different 'history of origin', social, cultural and societal conditions on the basis of the absence of gender imbalance in the work force and caring feminisation in nursing. Moreover, the increase of men's presence in nursing influenced its name, status and perception, shifting nursing into a masculine sphere with advantageous impacts on nursing. [ABSTRACT FROM AUTHOR]

Objectives: Cancer treatment can impair fertility. The aim of this review was to investigate (1) fertility information needs, receipt and provision, (2) fertility information preferences, and (3) factors associated with receiving/providing fertility information. Cancer patients' and professional caregivers' perspectives were considered. Design: Mixed-methods systematic review. Data sources: Six electronic databases (PubMed, Web of Science, CINAHL, CRD, Embase) were systematically screened to retrieve articles published between January 2001 and March 2012. Reference lists and conference abstracts were checked for additional publications. Review methods: The principles outlined in the Cochrane Handbook for Systematic Reviews of Intervention were applied. Publications were included if they explored fertility-related information/communication in cancer patients/survivors of reproductive age or professional caregivers. The Critical Appraisal Skills Programme for Qualitative Studies and the Quality Assessment Tool for Quantitative Studies were used to assess the methodological quality. A standardised form based on the Cochrane guidelines for systematic reviews was used to extract the data. Two independent reviewers performed all methodological steps. Results: Of the 1872 papers found, 27 were included in this review. The majority (66- 100%) of the cancer patients wanted information about the impact of cancer therapy on fertility. The need and importance were higher in younger and childless patients, and in patients having childbearing plans. The number of patients receiving this information ranged from 0% to 85%. Several factors were associated with the lack of information receipt, including female gender and age 35 years or older. Patients preferred information via an individual consultation. In the diagnostic phase patients needed information about the impact of the treatment on fertility and preservation options. At the end or after the treatment, information needs shifted towards long term effects. Professional caregivers experienced several barriers in providing fertility information, including caregiver-, patient- and institutional-related factors. Nurses in particular, perceived difficulty in providing fertility-related information due to additional barriers associated with limited responsibility and opportunity in fertility information provision. Conclusion: Professional caregivers experienced multiple barriers that hinder information provision. Further exploration of the role of Advanced Nurse Practitioners/Midwifes and the development of an evidence based intervention to overcome caregiver-related barriers are recommended to improve information provision. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the construction of the motivational climate surrounding elite sports performers by investigating the behaviours of coaches, peers and parents that were perceived to be motivationally relevant by elite athletes. Design: Qualitative – inductive. Method: Twenty-eight national, international and world-class athletes (15–29 years old) took part in semi-structured focus groups and interviews investigating how they believe coaches, parents, and peers influence their motivation. Results: An inductive content analysis indicated that elite athletes perceived a multitude of motivationally-relevant social cues. Coaches and peers were reported to be focal influences, whilst the role of parents appeared to be limited to emotional and moral support. Themes of feedback/evaluation, and pre-performance motivating behaviours were common to all social agents, whereas only the coach–athlete and peer–athlete relationships appeared to be important in moderating and directly influencing motivation towards sport. The influences of social agents related to the specific roles they performed in the athlete's life: instruction and leadership for coaches; emotional support, collaborative and/or competitive behaviours for peers, and for parents, a diminished role relative to when the athletes were younger. Conclusions: A central finding of the paper is that there was no discernible one-to-one correspondence between specific behaviours and their impact on motivation. Instead, the findings suggest complex contextual interactions between the immediate behaviours of social agents and the impact on the athlete's motivation. If supported, this finding would necessitate new and novel approaches in future research in order to facilitate a more advanced understanding of athlete motivation in elite sport. [Copyright &y& Elsevier]

This paper identifies antecedents to frustration arising in micro-task crowd work (MTCW) and measures their impact on a frustrating work experience. Surprisingly, research to date has said little on frustration in MTCW, despite it being a central challenge to working persistently in these increasingly important socio-technical work environments. Guided by an experiential computing perspective, we applied a mixed-method approach to reveal how the interplay between platforms and other workers' behavior shapes frustration experienced in MTCW. We present qualitative and quantitative findings on frustration in virtual MTCW. Based on 96 narratives, we qualitatively identify three dominant antecedents to frustration: technical problems in conducting tasks, platform competition and, the inability to disconnect from work. We subsequently conducted a quantitative two-wave survey (N = 181), to test the factors' impacts on MTCW frustration. The results confirm the three factors and additionally reveal that autonomy largely reduces frustration. However, autonomy also reinforces frustration arising from the inability to disconnect from work. Thus, workers' inability to disconnect from work can lure them into excessive availability for taking on additional tasks. Thereby, workers experience additional frustration and underutilize the benefits of autonomy in crowd work. Our manuscript offers three central contributions: First, we identify frustration as pivotal in the experience of MTCW and its antecedents. Second, we shed light on the heterogenous role of autonomy in relation to MTCW frustration. Finally, we link the findings on frustrating MTCW experience to experiential computing. • Identifying antecedents of experienced frustration in micro-task crowd work (MTCW) • Platform competition, technical problems, inability to disconnect spur frustration • Autonomy decreases frustration and eases coping with technical problems • Autonomy reinforces frustration from workers with inability to disconnect from MTCW [ABSTRACT FROM AUTHOR]

Abstract: The MANAS trial evaluated the effectiveness of a lay counselor led collaborative stepped care intervention for Common Mental Disorders (CMD) in public and private sector primary care settings in Goa, India. This paper describes the qualitative findings of the experience of the intervention and its impact on health and psychosocial outcomes. Twenty four primary care facilities (12 public and private each) were randomized to provide either collaborative stepped care (CSC) or enhanced usual care (EUC) to adults who screen positive for CMDs. Participants were sampled purposively based on two criteria: gender and, in the CSC arm, adherence with the intervention. The qualitative study component involved two semi-structured interviews with participants of both arms (N = 115); the first interview within 2 months of recruitment and the second 6–8 months after recruitment. Data were collected between September 2007 and November 2009. More participants in the CSC than EUC arm reported relief from symptoms and an improvement in social functioning and positive impact on work and activities of daily life. The CSC participants attributed their improvement both to medication received from the doctors and the strategies suggested by the lay Health Counselors (HC). However, two key differences were observed in the results for the two types of facilities. First, the CSC participants in the public sector clinics were more likely to consider the HCs to be an important component of providing care who served as a link between patient and the doctor, provided them skills on stress management and helped in adherence to medication. Second, in the private sector, doctors performed roles similar to those of the HCs and participants in both arms placed much faith in the doctor who acted as a confidante and was perceived to understand the participant's health and context intimately. Lay counselors working in a CSC model have a positive effect on symptomatic relief, social functioning and satisfaction with care in patients with CMD attending primary care clinics although the impact, compared with usual care, is greater in the public sector. [Copyright &y& Elsevier]

Abstract: Very little in-depth information is available on the educational and transition experiences, perceptions, and actions of youth in foster care who are receiving special education services. This paper describes a qualitative study that followed seven youth in foster care receiving special education services, ages 15 to 18, for six to nine months. The youth were interviewed an average of seven times and they were invited to take photographs and make journal entries depicting their lives. The findings documented the complex challenges that youth experience, including educational struggles, difficulty in clarifying their relationships with biological family, and having to make major decisions in the context of uncertainty and inadequate and sometimes restrictive supports and services. Having consistent and committed adult support, knowledge of options and services, and opportunities, skills, and confidence to take positive action toward goals emerged as important themes in the youth''s success. [Copyright &y& Elsevier]

This paper aims to describe caring perceptions and behaviors among student nurses in Italy as they progress through their nursing education. As nursing students are potential nurses of the future, there is an expectation that in addition to appropriate academic qualifications, they will develop appropriate caring behaviors/attitudes. However, there has been some evidence that the educational process does not always modify their caring perceptions/behaviors or that the direction of the change is not always positive. A qualitative longitudinal design with three data collection points, was performed from October 2013 to October 2016 at the University of Verona, Trento Campus. Semi-structured interviews were conducted at the time of entry into a 3-year bachelor's degree program in nursing and at the end of the second and third years. Observation of the students during their clinical practice was carried out at the end of each of the three years of education. Thirty students commenced the study and 24 finished. Data were analyzed using a phenomenological approach. The iterative process of analyzing interviews and observations resulted in nine themes collectively from all three stages: establishing a trusting relationship with the patient, satisfying the patient's needs, paying attention, being respectful, being competent, giving time, being concerned with the emotional dimension, acting within context to facilitate caring actions and giving information. At the end of the third year the students' concept of caring was enhanced; their initial generic or lay view of caring turned into an intentional, competent, conscious, accountable and realistic caring approach. [ABSTRACT FROM AUTHOR]

Current research suggests that nursing students do not apply all sets of physical assessment skills (PAS) learned in their nursing education. The aim of this study was to evaluate third-year nursing students' process of clinical judgment using PAS in clinical rotation. Specific focus was on how the process of clinical judgment affected when the nursing students performed physical assessment, and which types of knowledge were implied in their practice. Ten nursing students performed PAS independently while in clinical rotation; these performances were audiotaped and observed. Shortly after, individual semi-structured stimulated recall interviews (SRI) took place. Regardless of the nursing students' stated level of PAS utilization, self-efficacy or scientific knowledge, clinical judgment was primarily based on contextual factors and personal prerequisites. This study contributes to in-depth knowledge about how nursing students perform physical assessment, how they describe their clinical judgment process and their strategies towards systematically and confidently using PAS. We conclude the paper with pedagogical strategies and learning activities that can facilitate reflection-in-action and reflection-on-action. • Nursing students do not apply all sets of physical assessment skills. • Self-confidence and competence influence skills application. • Confidence and competence leads to appropriate skills appliance. • Articulation of clinical judgment can contribute to adequate skills utilization. [ABSTRACT FROM AUTHOR]

This paper investigates the impact of the Stepping Stones Creating Futures (SSCF) intervention on young women in informal settlements in eThekwini, South Africa. Specifically, whether following participation in the intervention the young women experienced a reduction in intimate partner violence, strengthened agency and shifted gender relations. Where changes occurred, it examines how they occurred, and barriers and enablers to change. SSCF is a gender transformative and livelihoods strengthening intervention using participatory, reflective small groups. Qualitative research was undertaken with fifteen women participating in the SSCF randomised control trial between 2015 and 2018. The women were followed over 18 months, participating in in-depth interviews at baseline, 12- and 18-months post intervention. To supplement these, eight women were involved in Photovoice work at baseline and 18 months and seven were included in ongoing participant observation. Data were analysed inductively. Data revealed many women changed their behaviours following SSCF, including: having more power within relationships, improved communication and relationship skills, increased resistance to controlling partners, shifting relationship expectations, emergence of new femininities and improved livelihoods. Despite these important shifts many women did not report a reduction in IPV. Nonetheless we argue most of the women, following the intervention, became more agentic. Drawing on the notion of 'distributed agency' as developed by Campbell and Mannell (2016), we show that SSCF bolstered the women's distributed agency. Distributed agency recognizes small agentic acts that women take, acts which to them are significant, it further notes that agency is temporal, fluid, dynamic and context specific. Women do not 'either have agency or not', rather being agentic depends on time, context and the particular incident. These findings provide an important contribution to the limited application of distributed agency and femininities work in informal settlements and are critical for policy and intervention science to reduce IPV and support women's agency. • South African informal settlements have high rates of intimate partner violence. • The Stepping Stones Creating Futures intervention strengthened young women's agency. • Women developed new skills, reduced violent confrontations and improved livelihoods. • However, many women remained in violent relationships. • Participatory, group-based, gender transformative interventions can reduce violence. [ABSTRACT FROM AUTHOR]

This paper explores the experiences of 19 Spanish faculty members teaching nursing students with disabilities and their recommendations to other colleagues about how to facilitate their retention and success. Students themselves nominated those faculty members they felt had contributed to their learning at university. We carried out a qualitative study with individual interviews and observations. We conducted an analysis of all the information using a system of categories and codes with different themes: experience teaching students with disabilities, personal and professional impact on the faculty and recommendations to other colleagues. The findings indicate that the participants had positive experiences teaching nursing students with disabilities, although they also commented on negative aspects. The impact of students with disabilities was greater at the professional level, as they had helped them become better professionals. Moreover, these participants gave recommendations to help other colleagues contribute to the inclusion of all their students. The study concludes that it is necessary to engage in inclusive pedagogy that contemplates students' needs and develops practices that allow for their learning and participation. Just like their peers, students with disabilities can successfully complete their degrees providing the necessary support is offered, and this includes sensitized, well-informed and properly-trained faculty. • Nursing students with disabilities encounter barriers for learning at university. • Faculty members are an essential key for including students with disabilities. • This qualitative study shows experiences and recommendations by inclusive faculty. • This study concludes that when students have the necessary support, their experience at university is successful. [ABSTRACT FROM AUTHOR]

Prominent nursing organizations globally have called for a concerted effort to increase diversity in nursing education. While the number of men in the nursing workforce in the United States has increased slowly over the past five decades, the proportion of men in the profession remains low in comparison to the U.S. population. In response to research indicating a less-than-optimal experience for male nursing students, faculty and students embarked on a collaborative effort to improve the experience of this student population. This paper explores the reasons that men choose to enter nursing as well as the lived experience of men in a baccalaureate prelicensure nursing program in the United States. The purpose of the study was to determine if progress had been made toward a shared goal of an improved experience for male students. Of the 19 male students who met the inclusion criteria, 13 students agreed to participate in the descriptive phenomenological study. Findings of this study indicate that previous interventions aimed at creating a more welcoming environment for male nursing students at the research site have been moderately successful. Clinically, it is evident that there is still more work left to be done, specifically regarding the maternal-newborn clinical experience. • Male nursing students experience gender bias in didactic and clinical education. • Men choose nursing for the caring aspect of the profession, similar to women. • Men also choose nursing for the perceived job security and financial rewards. • Mentorship and male role models would benefit male nursing students. • Faculty must ensure gender equity in didactic and clinical learning opportunities. [ABSTRACT FROM AUTHOR]

Qualitative content analysis and other 'standardised' methods are sometimes considered to be technical tools used for basic, superficial, and simple sorting of text, and their results lack depth, scientific rigour, and evidence. To strengthen the trustworthiness of qualitative content analyses, we focus on abstraction and interpretation during the analytic process. To our knowledge, descriptions of these concepts are sparse; this paper therefore aims to elaborate on and exemplify the distinction and relation between abstraction and interpretation during the different phases of the process of qualitative content analysis. We address the relations between abstraction and interpretation when selecting, condensing, and coding meaning units and creating categories and themes on various levels. The examples used are based on our experiences of teaching and supervising students at various levels. We also highlight the phases of de-contextualisation and re-contextualisation in describing the analytic process. We argue that qualitative content analysis can be both descriptive and interpretative. When the data allow interpretations of the latent content, qualitative content analysis reveals both depth and meaning in participants' utterances. [ABSTRACT FROM AUTHOR]

Simulation-based learning (SBL) is becoming an accepted part of health education. Providing high-quality simulation-based education depends more on skilled facilitators than on elaborate simulator equipment. In the last six years, a cross-professional facilitator course has been developed to train interprofessional staff and faculty from health educational institutions in Bergen. The course starts with two days of traditional simulation theory and practice followed by a third day five weeks later. During the third day, participants present their own experiences from practising as facilitators in their own workplaces. In this paper, we present the course content and the participants' evaluation of the course based on the qualitative content analysis of their answers to open-ended questions. The main findings were that the course format and primary focus on practice were appreciated and that the follow-up day was especially useful to broaden the learning experience. • Facilitator training programmes are in demand, both in hospitals and university colleges. • Training health professionals together with health educators is fruitful. • Assignment where participant must plan, deliver, and evaluate in situ simulation promotes self-confidence as facilitator. [ABSTRACT FROM AUTHOR]

Venous leg ulcers represent the most common chronic wound problem managed in Australian primary care. Despite the prevalence of the condition, there is an evidence-practice gap in both diagnosis and management of venous leg ulcers. We used the Theoretical Domains Framework to identify barriers and enablers perceived by primary care practitioners in implementing venous leg ulcer guidelines in clinical practice. We collected data to explore the experiences of practice nurses and general practitioners related to their use of clinical practice guidelines in management of venous leg ulcers. We recruited participants from primary care settings located in metropolitan and rural areas across Victoria, Australia. We recruited general practitioners (15) and practice nurses (20). We conducted 35 semi-structured face-to-face and telephone interviews. Content analysis of health practitioners' statements was performed and barriers to implementing clinical practice guidelines were mapped across the Theoretical Domains Framework theoretical domains. Six main domains from the Theoretical Domains Framework (Environmental context and resources, Knowledge, Skills, Social influences, Social/Professional Role and Identity and Belief about Capabilities) best explained these barriers and enablers. Many participants were not aware of venous leg ulcer clinical practice guidelines. Those that were aware, stated that finding and accessing guidelines was challenging and most participants relied on other sources of information. Venous leg ulcer management was greatly influenced by professional experience and suggestions from colleagues. Other barriers included busy clinical practice, absence of handheld Doppler ultrasonography, insufficient skills and a lack of confidence related to the use of technology to rule out arterial involvement prior to compression application, a particular skill related to venous leg ulcer management that will impact on healing outcomes. We identified a number of barriers and the lack of enablers that influence the uptake of venous leg ulcer clinical practice guidelines in primary care. This paper adds a theoretically sound, systematic approach for understanding and addressing the behaviour change required to improve translation of venous leg ulcer clinical practice guidelines in clinical practice. Tweetable abstract: The need to optimise venous leg ulcer clinical practice guidelines (CPG) has never been greater as the current estimate of health cost is AUD3billion and increasing due to rising epidemics of diabetes and obesity. We found most primary care health practitioners are unaware of CPG and this will impact on health and healing outcomes in Australian primary care. [ABSTRACT FROM AUTHOR]