Search

Background: Dysphagia impacts negatively on quality of life, however there is little in‐depth qualitative research on these impacts from the perspective of people with dysphagia. Aims: To examine the lived experiences and views of people with lifelong or ongoing dysphagia on the impacts of dysphagia and its interventions on quality of life, and barriers and facilitators to improved quality of life related to mealtimes. Methods & Procedures: Nine adults with lifelong or acquired chronic dysphagia engaged in in‐depth interviews and a mealtime observation. The observations were recorded and scored using the Dysphagia Disorders Survey (DDS). Interviews were recorded, transcribed and de‐identified before content thematic and narrative analysis, and verification of researcher interpretations. Outcomes & Results: Participants presented with mild to severe dysphagia as assessed by the DDS. They viewed that dysphagia and its interventions reduced their quality of life and that they had 'paid a high price' in terms of having reduced physical safety, reduced choice and control, poor mealtime experiences, and poor social engagement. As part of their management of dysphagia, participants identified several barriers to and facilitators for improved quality of life including: being involved in the design of their meals, being adaptable, having ownership of swallowing difficulties, managing the perceptions of others and resisting changes to oral intake. Conclusions & Implications: This research improves understanding of the primary concerns of people with dysphagia about their mealtime experiences and factors impacting on their quality of life. Clinicians working with people with dysphagia need to consider how self‐determination, autonomy and freedom of choice could be improved through involvement in food design of texture‐modified foods. It is important that future research considers the views of health professionals on how these findings could impact on policy and practice particularly in ways to address the barriers and enhance facilitators to improved quality of life for people with dysphagia. What this paper adds: What is already known on the subject: Dysphagia impacts on quality of life, particularly as the severity of the dysphagia increases. Research to date has focused on people with dysphagia associated with an acquired health condition and has used quantitative assessment methods to measure quality of life. What this paper adds to existing knowledge: This study provides a qualitative examination of the impacts of dysphagia on quality of life from the perspective of people with lifelong or ongoing acquired dysphagia and their supporters. This study also provides qualitative insights into the barriers and facilitators of mealtime‐related quality of life. What are the potential or actual clinical implications of this work?: Health professionals should engage in open communication with their clients with dysphagia regarding the impacts of dysphagia on their lifestyle and quality of life. By considering these impacts, health professionals may be able to recommend interventions that are more acceptable to the person with the dysphagia which may have a positive impact on their mealtime experience. [ABSTRACT FROM AUTHOR]

Background: Improving the quality of life for individuals with severe dysphagia is a priority when considering new areas of dysphagia management, especially if this increases opportunities to participate in social activities associated with eating and drinking. Edible foam is widely researched and available in the food industry; however, the use of edible foam within the field of dysphagia remains unexplored. Despite no research published on effectiveness and safety, a commercial product currently on the market is widely distributed across both Europe and the UK, including 28 NHS Trusts, suggesting that it is increasingly being used in clinical practice. Aims: To explore the perceptions and experiences of healthcare professionals on the use of stabilized edible foam (SEF) with adults with severe dysphagia in order to inform areas for future research in this novel dysphagia intervention. Methods & Procedures: Healthcare professionals were recruited using purposeful sampling and snowballing technique. A total of 56 healthcare professionals were initially approached, of which 10 completed the semi‐structured interviews. Interview questions were developed from a topic guide and a pilot questionnaire. Outcomes & Results: Thematic analysis was used to identify three themes: potential impact, consideration of risk and perceived experiences. Overarching each of these themes was the element of the unknown. Conclusions & Implications: Use of SEF with adults with dysphagia is in its infancy. Whilst results indicate that some clinicians are embracing this novel approach, others express concerns. Therefore, further research is needed, particularly in relation of direct experience of individuals and contra‐indications. What this paper adds: What is already known on the subject: The use of SEF with individuals with swallowing problems is a relatively novel area of dysphagia intervention in the UK. There are currently no published studies on its effectiveness and safety profile. What this paper adds to existing knowledge: This study provides valuable preliminary work into the area of SEF and adults with severe dysphagia, capturing the experience and perceptions of healthcare professions who have an awareness of SEF. What are the potential or actual clinical implications of this work?: Increasing clinicians and researcher's awareness of this novel area of dysphagia management. [ABSTRACT FROM AUTHOR]

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

Background: The impact of digital gamified language learning on language achievement has been corroborated in the literature; however, its impact on language achievement, especially in the English as a foreign language (EFL) context needs further investigation. In addition, the related literature has not sufficiently confirmed the impact of digital gamified language learning on some psychological domains of EFL learning. Objectives: This study, therefore, employed a sequential explanatory mixed‐methods approach to explore the effects of digital gamified language learning using a mobile application (app) affordances on EFL learners' language achievement, foreign language enjoyment (FLE), and ideal second language (L2) self. Methods: To this end, 36 EFL learners were randomly divided into two groups; one group was randomly assigned to the digital class, including 19 EFL learners, and the other group was assigned to the non‐digital class, consisting of 17 EFL learners. The digital learners did the digital gamified language learning activities individually and interactively and received peer and instructor feedback, whilst the non‐digital learners did the same language learning activities in printed format and received peer and instructor feedback. A language achievement test, the FLE scale, and the ideal L2 self‐scale were used to collect the quantitative data and an individual semi‐structured interview was carried out to gather the qualitative data. Results and Conclusions: One‐way ANCOVA, used to analyse the quantitative data, revealed that the digital and non‐digital classes improved the EFL learners' language achievement, FLE, and ideal L2 self; however, the digital learners outperformed their non‐digital counterparts in all the measures. Thematic analysis, utilised to analyse the qualitative data, uncovered some themes about the digital learners' positive and negative attitudes and perceptions towards the digital gamified language learning activities, clarifying the quantitative findings. Implications: Pedagogical implications are discussed. Lay Description: What is already known about this topic: Digital gamification involves employing game‐supported activities to interact with other learners, improving their language learning.Several studies have been carried out focusing on the salient role of digital gamified language learning activities in improving learners' language learning.As elements of positive psychology, foreign language enjoyment and ideal L2 self can improve learners' enthusiasm and involvement in digital gamified language learning activities. What this paper adds: Digital gamification using a mobile app's gamified affordances develops English language learners' language achievement, foreign language enjoyment, and ideal L2 self.Digital gamification is more effective than non‐digital gamification in improving English language learners' language achievement, foreign language enjoyment and ideal L2 self.English language learners in digital classes hold positive attitudes and perceptions towards the effects of digital gamification on their language learning. Pedagogical implications: Digital gamified language learning activities can be an effective and engaging supplement to non‐digital classroom teaching, especially in English language contexts where learners may have limited opportunities for authentic language learning collaboration.English language learners can utilise digital gamified language learning affordances for language development, particularly for their collaborative language learning activities with other classmates. [ABSTRACT FROM AUTHOR]

Background: Introducing new technologies in education sparks debates, disrupting traditional practices, and requiring teacher adaptation. ChatGPT is an example. Research explores its benefits and concerns in education, with recommendations for classroom use. Nevertheless, limited evidence supports ChatGPT as a tool for supporting English as a Foreign Language (EFL) students' research competency. Moreover, while the literature primarily focuses on the perspectives of scholars and teachers, it is essential to incorporate students' viewpoints in order to maximize the potential of this technology. Objectives: The present study investigated EFL undergraduates' perceptions and practices of ChatGPT as a tool for promoting their research competency. Additionally, the study examined the potential influence of metacognitive awareness (MA) levels in this context. Methods: The study utilized a mixed‐method research design, collecting quantitative and qualitative data from 27 EFL undergraduates (12 with low MA and 15 with high MA) over one semester. Data sources included a self‐report questionnaire, self‐study log, and semi‐structured interviews. Results and conclusions: Quantitative analysis showed significant differences between low and high MA groups in their perceptions of ChatGPT (U = 37.500, Z = 2.570). Regression analysis revealed a positive correlation between MA scores and students' perceptions and practices of ChatGPT. Qualitative analysis revealed diverse perceptions and practices of ChatGPT between the high MA and low MA groups, showcasing behaviours ranging from replication to using ChatGPT as a thought‐stimulating and supportive tool, accessing supplementary information, and seeking guidance. Key factors for effective ChatGPT use included prompt formulation, systematic thinking, self‐regulation strategies, and trust in AI. Lay Description: What is currently known about this topic: Research competency and metacognitive awareness are important for EFL undergraduates.Technology has been explored for promoting research competency.ChatGPT is used as a learning tool in EFL instruction contexts. What does this paper add: It provides a deeper understanding of the practical application of AI tools like ChatGPT for developing research competency among EFL students.It enhances understanding of metacognition's role in successful learning in digital environments by exploring MA's impact on using ChatGPT for research purposes. Implications for practice/policy: Provide explicit instructions and guidelines for EFL students to effectively use ChatGPT for research competency, emphasizing clear prompt design and fostering responsible use through critical thinking and awareness of biases and limitations.Enhance EFL students' metacognitive awareness through scaffolding, explicit instruction, and activities.Implement assessments and monitoring mechanisms to track metacognitive development and guide instructional interventions.Offer professional development opportunities for EFL teachers to enhance their understanding and skills in integrating AI tools into research instruction and other EFL aspects. [ABSTRACT FROM AUTHOR]

People who hear voices that others do not often rely on mainstream mental health services. Several alternatives to treatment have grown in popularity including "Hearing Voices Groups" and other self-help groups for voice hearers. The aim of this systematic review is to evaluate the current evidence relating to the use of Hearing Voices Groups (HVGs) and other self-help groups for voice hearers, and identify the benefits felt by those attending such groups. The following databases were searched for relevant academic articles: CINAHL; APA PsycArticles; APA PsycInfo; Social Sciences; SocINDEX; UK & Ireland Reference Centre and Medline, with 13 papers identified for inclusion. Participants reported several benefits of attending a HVG/self-help group, which reduced isolation, improved social and coping skills, and gave them a better understanding of the meaning and context of their voices. The groups also provide hope for the future and act as a catalyst for recovery. These study findings suggest that voice hearers find some benefits from attending HVGs/self-help groups. Evidence indicates that voice hearers can live meaningful lives and continue to hear voices once context and meaning to their voices become clear. HVGs/self-help groups provide a vital service to voice hearers, which they felt was not available within mainstream mental health services. If mental health providers gained a better understanding of the HVN, they may be able to integrate the values and ethos of the HVN into groups for voice hearers within mainstream mental health services or signpost voice hearers to these groups. [ABSTRACT FROM AUTHOR]

Creating a learning health system could help reduce variations in quality of care. Success is dependent on timely access to health data. To explore the barriers and facilitators to timely access to patients’ data, we conducted in-depth semi-structured interviews with 37 purposively sampled participants from government, the NHS and academia across Scotland. Interviews were analysed using the framework approach. Participants were of the view that Scotland could play a leading role in the exploitation of routine data to drive forward service improvements, but highlighted major impediments: (i) persistence of paper-based records and a variety of information systems; (ii) the need for a proportionate approach to managing information governance; and (iii) the need for support structures to facilitate accrual, processing, linking, analysis and timely use and reuse of data for patient benefit. There is a pressing need to digitise and integrate existing health information infrastructures, guided by a nationwide proportionate information governance approach and the need to enhance technological and human capabilities to support these efforts. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic has resulted in major disruption to economic, health, education, and social systems. Families with preschool children experienced extraordinary strain during this time. This paper describes a qualitative study examining the experience of parents of preschool children in Hawaii during the COVID-19 pandemic. Sample: Thirteen (N = 13) parents of preschool children living on the island of Oahu, Hawaii, participated in small group discussions occurring in February and March 2021, approximately 1 year after the start of the pandemic in the state. Discussion transcripts were coded and sorted into themes. Results: Four themes emerged: stressors due to the COVID-19 pandemic, family coping and resources, meaning of the COVID-19 crisis to the family, and family adaptation patterns. Themes mapped to the Family Adjustment and Adaptation Response model. Conclusion: Families relied on various resources to cope with stressors experienced due to the COVID-19 pandemic, and adopted new patterns related to seeking healthcare and household emergency preparedness. Findings may inform policies and interventions to support families during the ongoing COVID-19 pandemic and future public health emergencies. [ABSTRACT FROM AUTHOR]

Background: Autistic people require varying levels of support at different stages of their lives. Yet, the healthcare needs of autistic adults are largely unmet. Speech and language therapy (SLT) is one healthcare service that has an important role in supporting autistic people: both with initial diagnosis, and with the ongoing support needed to navigate different communicative challenges across the lifespan. Despite recommendations for such support, currently there is no clear SLT pathway for autistic adults, and a lack of established approaches to support autistic adults' speech, language and communication needs. Aims: To seek autistic adults' views on (1) their communication skills and support needs; (2) the type of support SLT could offer; and (3) how such support could be provided. Methods & Procedures: A total of 18 autistic adults were interviewed in their preferred mode of communication (e.g., face to face, phone call, text messaging, e‐mail), expressing their views on their communication skills and needs. Interview data were analysed using thematic analysis. Outcomes & Results: Autistic adults presented complex views on communication, identifying the benefits of communication, while also emphasizing the significant negative impact that communication difficulties can have on their everyday lives. Identifying a range of internal (e.g., personal feelings) and external (e.g., the communication partner) factors, they highlighted the need for support at both individual levels (for specific life situations) and broader societal levels (to increase awareness and acceptance of communication difficulties). Conclusions & Implications: Considering the negative impact that communication difficulties can have for autistic adults, a need for support was emphasized. Despite recognition of this need within current legislation (in the UK) and positive steps toward providing support, more needs to be done. As experts in supporting individuals with communication difficulties, speech and language therapists could play a pivotal role in providing support at an individual level, as well as increasing awareness of communication differences more widely. What this paper addsWhat is already known on this subjectThere is a growing population of autistic adults with unmet support needs. A core characteristic of autism is difficulty with neurotypical social communication and interaction, which persists into adulthood and impacts across various life domains.What this paper adds to existing knowledgeAutistic adults outlined the types of communication difficulties they experience, and how these can negatively impact on physical and mental health. Results highlight how these difficulties are not just rooted within the person themselves but can be influenced by external factors (e.g., the environment and the communication partner).What are the potential or actual clinical implications of this work?Some autistic adults may benefit from direct support from SLT services. However, increased awareness and respect for communication differences at a broader societal level is also needed. Speech and language therapists can play an important role in increasing this level of awareness, positively highlighting differences in communication and ways to support people with communication difficulties/differences. [ABSTRACT FROM AUTHOR]

Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale-up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale-up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. [ABSTRACT FROM AUTHOR]

Continual course correction during implementation of nutrition programmes is critical to address factors that might limit coverage and potential for impact. Programme improvement requires rigorous scientific inquiry to identify and address implementation pathways and the factors that affect them. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powder (MNP) interventions for young children. This paper focuses on how MNP interventions undertook key elements of programme improvement, specifically, the use of programme theory, monitoring, process evaluation, and supportive supervision. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that although much has been written and published about the use of monitoring and process evaluation to inform MNP interventions at small scale, there has been little formal documentation of lessons for the transition from pilot to scaled implementation. Supervision processes and experiences are not documented, and to our knowledge, there is no evidence of whether they have been effective to improve implementation. Improving the efficiency and effectiveness of interventions requires identification of critical indicators for detecting implementation challenges and drivers of impact, integration with existing programmes and systems, strengthened technical capacity, and financing for implementation of effective monitoring systems. Our understanding of programme improvement for MNP interventions is still incomplete, especially outside of the pilot stage, and we propose a set of implementation research questions that require further investigation. [ABSTRACT FROM AUTHOR]

An effective delivery strategy coupled with relevant social and behaviour change communication (SBCC) have been identified as central to the implementation of micronutrient powders (MNP) interventions, but there has been limited documentation of what works. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' three working groups were formed to summarize experiences and lessons across countries regarding MNP interventions for young children. This paper focuses on programmatic experiences related to MNP delivery (models, platforms, and channels), SBCC, and training. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that most countries distributed MNP free of charge via the health sector, although distribution through other platforms and using subsidized fee for product or mixed payment models have also been used. Community-based distribution channels have generally shown higher coverage and when part of an infant and young child feeding approach, may provide additional benefit given their complementarity. SBCC for MNP has worked best when focused on meeting the MNP behavioural objectives (appropriate use, intake adherence, and related infant and young child feeding behaviours). Programmers have learned that reincorporating SBCC and training throughout the intervention life cycle has allowed for much needed adaptations. Diverse experiences delivering MNP exist, and although no one-size-fits-all approach emerged, well-established delivery platforms, community involvement, and SBCC-centred designs tended to have more success. Much still needs to be learned on MNP delivery, and we propose a set of implementation research questions that require further investigation. [ABSTRACT FROM AUTHOR]

Aim: To assess the perception of the nursing profession in Armenia from the perspective of multiple stakeholders, including nurses and the general public. Background: Nurses' role perception is a complex phenomenon defined by multiple stakeholders. Methods: The assessment used a convergent parallel mixed‐methods design, with a dominant qualitative status. We conducted the qualitative phase through focus group discussions and in‐depth interviews with 235 people and collected quantitative data in a cross‐sectional telephone survey with 389 participants. Results: The nursing profession has been influenced by medical hierarchy and subordination, and none of the participants recognized nursing as an autonomous health care profession. The quantitative survey findings were largely consistent with the qualitative results. Our findings highlighted empathy and compassion as inherent qualities of nurses in Armenia. Conclusion: To change opinions about the nursing profession and highlight nurses' meaningful contribution to the provision of health care services, it is important to develop a national definition of nursing and introduce higher educational opportunities for nurses in Armenia. Implications for nursing management: The paper highlights the importance of quality education for preparing highly competent nurse managers who can become role models in promoting nurses' roles in health care systems and improving the professional and public image of nursing. [ABSTRACT FROM AUTHOR]

Purpose: A nursing home is a place that is familiar with death, since many older adults will spend the latter part of their lives in such a setting. However, research on this topic is still limited, especially in Indonesia. The purpose of this paper is to explore the barriers to successful palliative and, more generally, end-of-life care (EOLC) for older adults in nursing homes and to explore nurses' views on the subject. Design/methodology/approach: The study is of a qualitative nature and it employs a phenomenological approach. In-depth interviews with 15 nurses who taken care of older adults in a nursing home were conducted. The data were analysed using thematic content analysis. Findings: Barriers to effective EOLC include lack of knowledge, ineffectual communication and insufficient resources. Research limitations/implications: Better policies are needed, especially in training related to palliative/EOLC subjects and equitable distribution of professional health workers to overcome the barriers. The government should also encourage collaboration involving hospitals, Puskesmas (Health Centre Services), community and resident care settings in sharing knowledge and skills, especially for nurses. Originality/value: The barriers identified in palliative and EOLC have been found to be almost identical to those encountered in other health services. [ABSTRACT FROM AUTHOR]

This paper examines the ways in which older people's residential and nursing homes can constitute heteronormative environments – social spaces in which the same-sex attractions and desires of residents are disregarded in the provision of everyday care. The aim of this discussion is to examine the synergies and differences between older lesbian, gay and bisexual (LGB) adults' expectations for future care home provision and the expectations of care staff and managers in providing residential services to older people with diverse sexual backgrounds. We present qualitative evidence from research into the provision of care environments in Wales. In this paper, we present findings from two cohorts: first, from five focus groups with care and nursing staff and managers; and second, from 29 semi-structured interviews with older LGB adults (50–76 years) residing in urban and rural locations across Wales. We argue that residential care environments can constitute heterosexualised spaces in which LGB identities are neglected in comparison to the needs and preferences of other residents. To this extent, we discuss how care staff and managers can be more attentive and responsive to the sexual biographies of all residents and argue against the separation of care and sexual orientation in practice. [ABSTRACT FROM PUBLISHER]

The current study examined the teacher candidates' perceptions of ways a process-based reflective teacher training course-especially those focused on bumpy moments in the classroom, through situational role plays, video reflections, and scenarios- could assist them in their reflective and caring practices. In this regard, a sample of 45 pre-service teacher candidates enrolled at a teacher education university in Iran partook in the study and filled in the reflective and caring practices questionnaire before and after the treatment. Moreover, three teacher candidates were offered to keep reflective journals about the procedure based on their observations. Furthermore, pre- and post-phase interview was conducted with 15 participants. The results of this study revealed that the participants across all three intervention groups experienced improvement as a result of engaging in the teacher training course. The scenario group had the highest mean, followed by the video group; the role play group showed the least amount of improvement in reflective questionnaire mean score of all the treatment groups. The implication is that the process-oriented reflective teacher training course through situational role-play, video-based reflection, and scenario-based reflection can make teacher candidates more cautious about the caring and reflective aspects of their teaching. [ABSTRACT FROM AUTHOR]

Background: Individuals living with HIV are at increased risk of developing cardiovascular diseases. This heightened vulnerability is influenced by various factors, including the direct impact of HIV infection, the side effects of HIV medications, and a higher presence of traditional cardiovascular risk factors. Detecting and managing cardiovascular diseases early in HIV-infected individuals is crucial for their overall health and well-being. Electrocardiography, a simple and non-invasive test, can provide valuable information in this regard. However, there is currently no published data on the prevalence of electrocardiographic abnormalities and the associated factors among HIV-infected adults in Ethiopia. Objectives: This study was aimed at assessing the prevalence of ECG abnormalities and associated factors among HIV-infected adults on antiretroviral therapy. Methodology: A hospital-based comparative cross-sectional study was conducted at Mettu Karl Specialized Hospital (MKSH), southwest Ethiopia, among 96 HIV-infected patients and 96 HIV-negative control groups. A systematic random sampling technique was used to select HIV-infected respondents, and HIV-negative respondents were purposively recruited from caregivers. A face-to-face interview with a semi-structured and pretested questionnaire was conducted to collect the socio-demographic and behavioral characteristics of the study participants. Electrocardiography was done for all study participants using a 12-lead electrocardiograph, interpreted by a cardiologist, and classified according to the Minnesota Code classification system. The data were entered into Epi-Data version 4.6 and exported to SPSS version 25 for analysis. Finally, descriptive statistics, chi-square, independent t-test, bivariable, and multivariable logistic regression analyses were done at a 5% significance level. Results: The study found that 49% of HIV-infected and 19.8% of HIV-negative participants had at least one ECG abnormality. The proportion of coded ST-segment abnormalities, T-wave abnormalities, longer QT interval, and sinus tachycardia was significantly higher in HIV-infected respondents than in HIV-negatives. Being a smoker [AOR = 3.7, 95%CI: 1.03-13.6], being on Protease inhibitors [AOR = 3.6, 95%CI: 1.02-13.1] and having CD4 less than 350 cells/mm3 [AOR = 3.2, 95%CI: 1.22-8.49] were significantly associated with ECG abnormalities among HIV-infected respondents. Conclusion: Compared to HIV-negative participants, HIV-infected patients had a significantly higher prevalence of ECG abnormalities. Screening for ECG abnormalities is needed for the early detection of cardiac abnormalities and the reduction of future complications. [ABSTRACT FROM AUTHOR]

Introduction/Objective: The objective of the study was to develop an understanding of the perceptions of people with Parkinson's disease and clinical academics on the implementation of a regional interdisciplinary model of care. Methods: A qualitative descriptive study was undertaken. A PD interdisciplinary clinic was conducted in an Australian regional location. As a novel variation, in this clinic, 4 clinical academics consulted simultaneously offering a long, 3-h appointment. Following the clinic, we conducted 2 focus groups with all clinical academics and 6 semi-structured interviews with people with PD and carers. Data were analyzed using Elo & Kyngäs' inductive content analysis approach. Results: An overarching main category namely, "interdisciplinary care proved valuable to regional people with PD and clinical academics," and 3 generic-categories including "identifying interdisciplinary care as a viable option in regional locations," "current care provision is disempowering and burdensome," and "regional residing people with PD and their carers seek locally accessible healthcare with PD skilled clinicians" were identified. Conclusion: Our findings suggest the implementation of interdisciplinary care to regional healthcare systems is valued by clinical academics and people with PD and carers. Further research is required to establish how interdisciplinary care can be implemented in regional Australia and its effects on practice changes, patient outcomes, and quality of life. [ABSTRACT FROM AUTHOR]

Background: Relative to country-specific epidemiological trends, Kuwait experiences a far greater burden of type 2 diabetes among its population. Information behaviours form a significant component of self-care management for patients diagnosed with type 2 diabetes, however this remains an understudied aspect of disease management. This study aims to investigate the information behaviours of patients with type 2 diabetes in Kuwait, and characterise the methods employed to manage their disease. Methods: This qualitative study employed a grounded theory method. Semi-structured interviews were conducted with twenty-seven participants over three phases of data collection in primary, secondary and tertiary healthcare settings across Kuwait. These were complemented by in-depth interviews to detail the information behaviours of these participants. The interviews were translated where appropriate, transcripts, and analysed through qualitative coding to synthesise the information behaviour patterns. Results: The findings demonstrated that living with type 2 diabetes involved a range of developmental and transformative stages, including changes to the patients' emotional state, reconstruction of their lifestyle and identity, and changes in the ways they find and use information. Living with the chronic condition was viewed as a dynamic and transitional process, where patients' information behaviours continually changed throughout the process across various identifiable stages. This dynamic pattern was reflected most prominently across the participants' behavioural needs, sources and information-seeking patterns. Conclusion: Patients with type 2 diabetes continuously adapted their information behaviours to optimise the self-management of their condition across a relatively predictable pattern. Greater understanding of these behaviours across a wider population would improve the provision of clinical care for patients with diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Culturally and linguistically diverse population groups disproportionately experience higher weight and other non–weight‐related discrimination in healthcare settings outside of their ancestral country. Little is known about the experiences of individuals with Arab heritage. This study aimed to qualitatively explore the intersectional weight‐related healthcare experiences of individuals of Arab heritage with higher weight in Australia. Methods: A general inductive enquiry approach was used. Purposive, convenience and snowball sampling was used to recruit individuals of Arab heritage residing in Australia. Individuals were invited to participate in an online semistructured interview. Interviews were recorded, transcribed and thematically analysed. Results: Fifteen participants took part in the study. Of these participants, 93% were female (n = 14), 80% were aged between 18 and 44 years (n = 12), 73% were university educated (n = 11), 53% were born outside of Australia (n = 8) and all were Muslim (n = 15). Four main themes were identified: (1) appearance‐based judgement, (2) generalised advice and assumptions, (3) cultural responsiveness and (4) healthcare system constraints. Conclusion: Individuals of Arab heritage with higher weight in Australia, namely, females, often perceive their healthcare experiences as dismissive of their cultural and religious needs and driven by causality assumptions around weight. It is crucial that care delivered encompasses cultural humility, is weight‐inclusive and acknowledges systemic constraints. Cultural safety training benchmarks, healthcare management reform and weight‐inclusive healthcare approaches are recommended to assist healthcare providers in delivering effective, holistic and culturally safe care. Patient or Public Contribution: Insights gained from conversations with Arab heritage community members with lived experiences regarding weight‐related healthcare encounters informed the study design and approach. [ABSTRACT FROM AUTHOR]

Aims and objectives: This qualitative study explored the experiences of neonatal nurses with facilitating closeness between parents and babies with congenital abnormalities in the neonatal intensive care unit (NICU). Background: Babies with congenital abnormalities often require admission to the neonatal intensive care unit. Parents may experience emotional distancing from their baby, due to their response to their baby's congenital abnormality, as well as physical separation due to their baby's hospitalisation in the NICU. NICU nurses can help facilitate the development of closeness between babies and parents in the NICU. Method: This qualitative interpretive description study involved face‐to‐face, semi‐structured interviews with twelve neonatal nurses following which the data collected were thematically analysed. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in preparing this paper. Results: Three major themes emerged from the analysis—"Everyone copes differently," "You have to focus on what is the normal thing" and "It's very much an individualised approach." Participants often felt unprepared to care for babies with congenital abnormalities and implemented coping mechanisms to overcome the emotional labour they experienced. Skin‐to‐skin cuddles were considered the most beneficial strategy for parents to develop closeness with their baby. Participants recognised that they sometimes "pushed" parents into engaging with their baby. Participants highlighted the importance of individualised, supportive care for these parents. Conclusions: Neonatal nurses require increased education about congenital abnormalities and individualised care to support them in caring for babies with congenital abnormalities. Relevance to clinical practice: Further research is needed on parental experience of developing closeness with a baby with a congenital abnormality in the NICU. [ABSTRACT FROM AUTHOR]

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

This paper reports finding from a nested qualitative study designed to elicit the views and perceptions of those who participated in a randomised controlled feasibility trial testing a non-pharmacological intervention, Respiratory Distress Symptom Intervention (RDSI), for the management of the breathlessness-cough-fatigue symptom cluster in lung cancer. Semi-structured interviews were conducted with 11 lung cancer patients, three caregivers and seven researchers involved in recruitment, consent, RDSI training and delivery and participant follow-up. Thematic analysis identified key considerations including: the importance of informed consent emphasising commitment to completion of paperwork and raising awareness of potential sensitivities relating to content of questionnaires; ensuring screening for the presence of symptoms reflects the language used by patients; appreciation of the commitment required from participants to learn intervention techniques and embed them as part of everyday life; conduct of interviews with patients who decline to participate; and conduct of serial interviews with those receiving RDSI to further inform its routine implementation into clinical practice. This study will inform the development of a fully powered follow-on trial testing the hypothesis that RDSI plus usual care is superior to usual care alone in the effective management of this symptom cluster in lung cancer. [ABSTRACT FROM AUTHOR]

Background: Interventions within preschool settings have gained prominence due to the need to increase physical activity (PA) in early childhood. We first developed a 10-week preschool-based behaviour change intervention, guided by the UK Medical Research Council's framework for complex interventions. We then conducted a cluster feasibility randomised controlled trial (RCT) among young children. Aim: This process evaluation was embedded within the cluster feasibility RCT and aimed to assess the acceptability of the 10-week IAAH intervention among both preschool staff and parents. Methods: The study utilised a mixed method, involving post-intervention questionnaires completed by preschool staff (n = 4) and children's parents/caregivers (n = 9) and focus groups with preschool staff (n = 3) and parents/caregivers (n = 7). Quantitative data were analysed using SPSS to calculate acceptability scores, while qualitative data underwent thematic analysis using NVivo 12. Results: The intervention was well-received, with preschool staff reporting a 94.5% acceptability rate (mean score of 10.4 out of 11) and parents/caregivers indicating an 86% acceptance rate (mean score of 5.2 out of 6). Thematic analysis of focus group discussions revealed facilitators to intervention delivery, such as user-friendly materials and alignment with preschool curricula, and identified barriers, including time constraints, spatial limitations, and policy conflicts. Parental engagement was hindered by time restrictions, although the intervention materials were praised for their clarity and visual appeal. Conclusions: The findings suggest that the IAAH programme was acceptable to both preschool staff and parents. However, the identified barriers to intervention delivery and engagement should be addressed in the planning of a future cluster RCT to evaluate the efficacy of the intervention. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused universities worldwide, including those in Sweden, to adopt online distance learning as the primary teaching approach. However, there is limited research on how larger environmental changes affect university students' occupational balance. In this study, 15 university students were interviewed, and their responses were analyzed using qualitative content analysis. The findings suggest that the students had to take more responsibility for maintaining their occupational balance, as the pandemic and shift to online learning limited their social and physical environment and altered their daily activities and routines. [ABSTRACT FROM AUTHOR]

Background: A sustainable point-of-care (POC) diagnostic testing implementation in low-resourced facilities enhances quick diagnostic investigation and halts unnecessary referrals. This study identified the barriers impeding the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana; as well as explored potential solutions that could enhance the accessibility and effectiveness of POC diagnostic testing, ultimately improving the quality of healthcare delivery. Methods: A total of twenty-eight participants were purposively selected from health facilities in low-resourced settings in the Bono Region for a descriptive qualitative study. Of the twenty-eight participants, seventeen including ten healthcare providers from CHPS facilities, six district health depot managers, and one regional depot manager were engaged in in-depth interviews. Additional eleven including nine healthcare providers and two district depot managers were also engaged in focus group discussions. NVivo version 12 software was employed for condensation, labelling, and grouping of themes. Data was analysed narratively. Results: Work overloads, limited POC testing services, stock-outs of POC tests at the facilities, and supply-related challenges of POC test kits were identified as major barriers to POC testing services. To solve these barriers, adequate funding, an effective delivery system, stakeholders' engagement and advocacy, and in-service and refresher training courses were suggested as potential solutions to POC diagnostic testing services implementation by the stakeholders. Conclusions: This study's findings emphasize the need to address the barriers hindering the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana. The suggested solutions provide a roadmap for improving the accessibility and effectiveness of POC testing, which has the potential to enhance the quality of healthcare delivery, reduce unnecessary referrals, and ultimately improve patient health outcomes in underserved settings. [ABSTRACT FROM AUTHOR]

Purpose: To strengthen the translation of evidence to actionable policy, stakeholder engagement is necessary to synthesize, prioritize and contextualize the academic research content into accessible language. In this manuscript we describe a multi-level evidence-based stakeholder consultation process and related outcomes proposed to promote awareness of and foster cross-sectorial collaborations towards human rights-based approaches for children with disabilities. Methods: Mixed-methods participatory action research done in three steps: (1) A literature review of peer-reviewed evidence on rights-based approaches in childhood disabilities; (2) Consultation with researchers in diverse fields, grassroot organizations, caregivers, and youth with disabilities; (3) A constructive dialogue with decision makers at federal and provincial levels in Canada to discuss consultations results. Results: Stakeholders value human rights approaches that can have a direct impact on practical aspects of their daily living. Organizations give high importance to adopting rights-based approaches to measure policy outcomes, while parents value service provision and youth emphasize accessibility. Conclusion: The implementation of rights-based approaches in childhood disabilities can support policy, services, and daily lives of children with disabilities and the ecosystems around them. It can also guide research priorities, and create a common language to foster collaborations across sectors and interested parties. [ABSTRACT FROM AUTHOR]

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]

Prenatal depression affects approximately 10% to 15% of women. Guidelines recommend supporting women to make informed treatment decisions; however, minimal evidence exists regarding this decision-making process. This study aimed to develop a constructivist grounded theory of prenatal antidepressant treatment decision-making. Semi-structured interviews were conducted with purposively sampled women from the community or specialty clinics (N = 31). Iterative data collection and analysis, theoretical sampling, and member checking supported model sufficiency. In the Creating Comfort in Choice theory that we developed, participants were highly conscious of societal stigma toward mental illness and prenatal medication use, so fear, anxiety, and guilt dominated decision-making. Participants navigated dynamically among three clusters of decision-making activities: seeking information, making sense of information, and self-soothing. "Seeking information" included internal and external processes. In "making sense of information," participants appraised available evidence. In "self-soothing," participants engaged in coping strategies to try to alleviate painful emotions. The Creating Comfort in Choice theory can support patient-oriented decision-making regarding prenatal mental healthcare. [ABSTRACT FROM AUTHOR]

Two case studies of parenting programs for parents of children 0 to 36 months of age, developed and implemented by Save the Children/Ministry of Health/Khesar Gyalpo University in Bhutan and UNICEF Zambia, were conducted by an independent research group. The focus was on how program delivery and scale-up were revised on the basis of feedback from implementation research. Feedback on workforce delivery quality was based on observations of deliveries using a monitoring form, as well as survey and interview data collected from the workforce. In-depth interviews with the resource team during the fourth year of implementation revealed how the feedback was used to address horizontal and vertical scaling. Delivery quality was improved in some cases by revising the delivery manual, offering refresher courses, and instituting regular monitoring. Scaling challenges in Zambia included slow progress with regard to reaching families in the two districts, which they addressed by trialing group sessions, and stemming workforce attrition. The challenges in Bhutan were low attendance and reducing the workload of providers. Vertical scaling challenges for both countries concerned maintaining demand through continuous advocacy at community and government levels to sustain financing and to show effectiveness in outcomes. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To develop and validate a behavioural driving model for adherence to home‐based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence. Background: Despite the benefits of home‐based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored. Design: An exploratory sequential mixed‐methods study was conducted in this study. Methods: A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self‐report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1). Results: Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self‐efficacy and exercise fear played a chain‐mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence. Conclusions: This study reveals a potential pathway mechanism for social support to improve adherence to home‐based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence. Relevance to Clinical Practice: To enhance exercise adherence in home‐based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self‐efficacy and alleviate exercise fear. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to explore Senior nurses’ experiences of leading organizational change. There is a substantial literature reporting middle-level nurse managers’ experiences of change; however, there is less evidence concerning senior nurses’ perspectives. In view of this, interview data collected from senior nurses, as part of a study of major organizational change, were analysed to redress this imbalance. Design/methodology/approach – In-depth semi-structured interviews (n = 14) were conducted with senior nurses (between 2009 and 2012). Findings – Senior nurses’ activity centred on leadership and workforce issues, internal influences and external pressures. In periods of change, appropriate leadership was vital, and “weak” leaders were considered to have an adverse effect on teams. Concerns were expressed about financial strictures and their impact on patient care and service provision. The senior nurses were striving to provide the best quality of service delivery with the limited resources available. Concentration on operational matters was necessary to maintain stability in periods of change. However, this prevented senior nurses from influencing strategic decision-making in their organizations. Practical implications – If senior nurses are to realise their potential to operate at a strategic level, they need to be given time and support to lead, rather than just react to change. This research emphasises the importance of a “nursing voice” to inform board-level decisions and maintain a focus on patient care. Originality/value – This research sheds light on the work of a key group of staff in health-care organizations. Understanding senior nurses’ experience of and contribution to change is a useful contribution to health services research. [ABSTRACT FROM AUTHOR]

Background: Recognizing the need to increase access to safe abortion services to reduce maternal mortality and morbidity, the state government of Bihar, India introduced an innovative mechanism of accrediting private health care facilities. The program, Yukti Yojana ('a scheme for solution'), accredits eligible health facilities and supports them in providing abortion-related services free of charge to rural and low-income urban women. This paper describes implementation of Yukti Yojana. Methods: A descriptive analysis of abortion services provided under the Yukti Yojana program was conducted using four data sources: 1) assessment of accredited facilities over 6 months; 2) induced and incomplete abortion service registers; 3) client exit interviews and associated direct observation of client-provider interaction for a sample of accredited facilities; and 4) in-depth interviews with providers and key stakeholders responsible for providing or influencing abortion services. These analyses assessed characteristics of women receiving abortion services, quality of care and client satisfaction, and barriers and facilitating factors of a successful accreditation process. Results: Forty-nine private facilities were accredited during the first two years of the program, and 84 % had begun providing abortion services, in all 27,724 women were served. Overall, 53 % of beneficiaries reported holding a "Below Poverty Line" card, while 71 % had low living standard. The majority of women (n = 569) reported satisfaction (90 %) with their care, while 68 % perceived good quality of services. Having a government-led initiative was considered a key element of success, while stringent requirements for site approval, long waiting time for accreditation, complicated and delayed reimbursement process and low reimbursement fees for abortion services were identified as barriers to implementation. Conclusions: Yukti Yojana provides a model for successfully involving private OB/GYNs and general physicians to deliver safe abortion services to poor women on a large scale and offers additional evidence that public-private partnerships can be used to ensure availability of high-quality maternal health services to women in low-income countries. Private facility accreditation also offers a promising solution to the limited availability of safe abortion services in low resource settings such as Bihar, India. [ABSTRACT FROM AUTHOR]

Background. Clinicians recognize that client motivation is key to optimizing rehabilitation; however, they are limited in its assessment by a paucity of motivation measures. Purpose. This paper presents the preliminary psychometrics of the Pediatric Motivation Scale (PMOT) designed to measure motivation from a child's perspective. Method. Content validity of the PMOT was measured through expert feedback (n = 12), and field testing ocurred with 41 children, 21 in rehabilitation and 20 healthy. Pearson product-moment correlations were used to analyze subscale correlations, test-retest reliability, and convergent validity with the Pediatric Volitional Questionnaire (PVQ). Internal consistency was measured using Cronbach's alpha. Findings. Preliminary psychometric evaluation indicates strong internal consistency for PMOT total (α = .96) and subscales (α = .79-.91). The PMOT and PVQ moderately correlated in the rehabilitation subsample (r = .71, p < .01); no correlation was found in the healthy subsample (p > .05). Test-retest reliability was excellent (r = .97). Implications. This study provides preliminary psychometric evidence of the PMOT for children undergoing rehabilitation. These pilot findings warrant ongoing scale development. [ABSTRACT FROM AUTHOR]

Background: In the United States, Latinos face a wide array of cultural and structural barriers to accessing and utilizing mental health care. Latino men specifically are at high risk of receiving inadequate mental health care, possibly due to additional obstacles they experience that are related to masculinity. Among men more generally, greater adherence to emotional control and self-reliance is associated with higher depression severity and less depression help-seeking. Men experience more stigma toward depression and help-seeking and are less likely to be diagnosed with depression than women. However, Latino men's barriers and facilitators to depression care remain largely unexplored. The objective of this study was to examine barriers and facilitators to depression care that are related to masculinity among English- and Spanish-speaking Latino men in a primary care setting. Methods: We used convenience and purposive sampling to recruit primary care patients who self-identified as Latino men, spoke English or Spanish, and screened positive for depressive symptoms on the Patient Health Questionnaire-2 or had a history of depression. Semi-structured interviews were conducted between December 2020 and August 2021. The interview guide examined views and experiences of depression, masculinity, and barriers and facilitators to engaging in depression care. Utilizing consensual qualitative research and thematic analysis informed by modified grounded theory, barriers and facilitators to depression care were identified. Results: We interviewed thirteen participants who varied in English proficiency, education, income, and country of origin. Barriers and facilitators were placed into three domains—Self-Recognition of Depression, Seeking Help for Depression, and Depression Diagnosis and Treatment. Participants described aspects of masculinity as barriers (emotional control and pressure to provide), facilitators (honesty, courage, collaboration, practicality, and responsibility), or both (self-reliance and autonomy). Conclusions: Masculinity influences barriers and facilitators for depression care among Latino men at the levels of self-recognition, seeking help, and diagnosis and treatment. Clinicians may promote Latino men's engagement in depression care by understanding patients' values and framing depression care as affirming masculinity. Providing education to primary care physicians and other healthcare professionals on gender and depression and addressing structural barriers are essential to providing access to all who need depression care. [ABSTRACT FROM AUTHOR]

The aim of this research is to explore nurses' experiences in caring for migrants, regular and non-regular, within outpatient clinics in Italy. Materials and Methods: Thirteen nurses have been interviewed through online semi-structured interviews, conducted with the support of a questionnaire, made by researchers, consisting of open-ended questions on legislative issues, cultural issues, and regarding best practices. Purposive sampling has been used, along with phone and email recruitment. The audio recordings of the interviews were verbatim transcribed, then examined. This study is a qualitative descriptive fundamental research project. Results: Interviewees highlight migrants' difficulties in accessing care, critical points of legislation, transcultural skills crucial to nurses, and good practices. A total of 105 labels were developed and grouped into 23 categories under 7 themes (Italian legislation and migrants; structural difficulties in assistance; the influence of politics; the work of NGOs and associations; nursing care; winning strategies; and the role of the Family and Community Nurse). Conclusion: The research highlights how access to care for migrants is hindered by legislative, structural, and cultural barriers, with consequences on the NHS (improper accesses to the emergency room, increased workload, and economic expenditure). For the full realization of the right to health, as enshrined by Art. 32 of the Constitution, changes are needed with respect to regulations and professionals' training. [ABSTRACT FROM AUTHOR]

Purpose--The aim of this paper is to design and pilot test a culturally tailored intervention that meets the support needs and preferences of two refugee groups. Design/methodology/approach--The study employed a multi-method participatory research design and was conducted in two urban centres in western and central Canada. Support was delivered to Sudanese and Somali refugees (n = 58), by trained peer and professional helpers, in face-to-face groups matched by gender and ethnicity and in telephone dyads. Participants completed three quantitative measures before (pre-test) and following (post-test) the intervention. Group interviews with refugee participants and individual interviews with peer and professional helpers conducted at post-test, elicited qualitative data on perceived impacts and factors influencing impacts of the intervention. Service providers and policy influencers (n = 22) were interviewed in groups about the implications of this intervention study for services, programs and policies. Findings--There were significant increases in perceived support and social integration and significant decreases in loneliness following the intervention. Participants reported that they learned how to seek services and supports and how to cope with challenges faced by refugees. Service providers and policy influencers were impressed by the success of the intervention. Originality/value--No peer support intervention studies focused on the unique support needs of African refugees have been reported. This pilot intervention study demonstrates the supportive power of like-ethnic peers and could guide subsequent community-based intervention trials and the design of culturally appropriate health-related programs. [ABSTRACT FROM AUTHOR]

Objective: Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan. Methodology: This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists' awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly. Results: The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5–20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists' perceptions, barriers and challenges, knowledge and awareness, and improvement strategies. Conclusion: Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices. [ABSTRACT FROM AUTHOR]

Aims and objective: To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID‐19 pandemic (May–June 2020). Background: As other healthcare professionals, nursing students who worked during the first COVID‐19 wave suffered from dysfunctional mental health symptoms. Design: Sequential, mixed‐method, multicentre study. Methods: The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi‐structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting. Results: The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned. Conclusion: The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members. Relevance to Clinical Practice: In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience. [ABSTRACT FROM AUTHOR]

Aims: To examine registered nurses' attitudes about end‐of‐life care and explore the barriers and facilitators that influence the provision of high‐quality end‐of‐life care. Design: A sequential explanatory mixed methods research design was used. Methods: An online cross‐sectional survey was distributed to 1293 registered nurses working in five different hospitals in the Kingdom of Saudi Arabia. The Frommelt Attitudes Towards Care of the Dying Scale was used to assess nurses' attitudes towards end‐of‐life care. Following the survey, a subset of registered nurses were interviewed using individual semi‐structured interviews. Results: Four hundred and thirty‐one registered nurses completed the online survey, and 16 of them participated in individual interviews. Although nurses reported positive attitudes towards caring for dying patients and their families in most items, they identified negative attitudes towards talking with patients about death, their relationship with patients' families and controlling their emotions. The individual interview data identified the barriers and facilitators that registered nurses experience when providing end‐of‐life care. Barriers included a lack of communication skills and family and cultural and religious resistance to end‐of‐life care. The facilitators included gaining support from colleagues and patients' families. Conclusion: This study has identified that while registered nurses hold generally favourable attitudes towards end‐of‐life care, they have negative attitudes towards talking with patients and families about death and managing their emotional feelings. Relevance to clinical practice: Education providers and leaders in healthcare settings should consider developing programmes for undergraduate nurses and nurses in clinical practice to raise awareness about the concept of death in a cross‐section of cultures. Nurses' attitudes towards dying patients will be enhanced with culture‐specific knowledge which will also enhance communication and coping methods. Reporting method: This study used the Mixed Methods Article Reporting Standards (MMARS). [ABSTRACT FROM AUTHOR]

Aim. To explore academic and clinical nurses' perceptions and experiences on academic-practice partnership in evidence-based practice. Background. Academic-practice partnership could promote evidence-based practice which is crucial for high-quality care. Academic and clinical nurses are the foundation of the partnerships; however, there is little knowledge of their perceptions and experiences on academic-practice partnership in evidence-based practice. Methods. This is an interpretive description study. Twenty-two eligible participants were interviewed through face-to-face or online videoconferencing meetings. Guiding questions for the interviews focused on the perceptions and experiences of academic-practice partnership in the context of evidence-based practice. Interviews were recorded, transcribed, and checked verbatim. We used constant comparative analysis to analyze the qualitative data. Results. Four themes with fifteen subthemes were generated: necessities, modes, challenges, and benefits of the academic-practice partnership in evidence-based practice. Participants believed that academic-practice partnership was a necessary strategy to promote evidence-based practice and could be built through different modes. Nevertheless, most academic-practice partnerships were superficial because of specific types of challenges. However, a good academic-practice partnership could create a win-win situation for both nursing academia and clinical practice. Conclusion. Academic-practice partnership is a win-win strategy for both the academic side and clinical side to promote evidence-based practice. Different modes of academic-practice partnership provide academic and clinical nurses with more opportunities to promote evidence-based practice with a higher likelihood of successful implementation. However, related challenges require multilevel measures to provide better environments to initiate, build, and maintain intensive collaborations between academic and clinical nurses. Implications for Nursing Management. Academic and clinical organizations, leaders, and individuals should take multilevel measures to initiate, build, and maintain a close academic-practice partnership to promote evidence-based practice, which is crucial for high-quality nursing care, patient safety, and nursing discipline development. [ABSTRACT FROM AUTHOR]

Aim: To understand the postpartum care received by birthing people with disabilities and their newborns, from their own perspectives. Design: A qualitative study with semi‐structured interviews. Methods: Between July 2019 and February 2020, in‐person and virtual interviews were conducted with 31 people with physical, sensory, and intellectual/developmental disabilities in Ontario, Canada, about the formal inpatient and outpatient services and supports they used in the first few months after they gave birth. Thematic analysis was used identify common themes. Results: We identified three overall themes concerning participants' postpartum care experiences and the different types of formal services received in and out of hospital: (1) lack of adequate care, (2) lack of provider awareness of disability and disability accommodations, and (3) fear of judgement, discrimination, and intrusive surveillance. The identified themes were applicable across disability groups. However, most comments on disability accommodations came from participants with physical or sensory disabilities, while participants with intellectual/developmental disabilities most commonly reported concerns about lack of adequate care and fear of judgement, discrimination, and intrusive surveillance. Conclusion: Findings indicate that postpartum care often fails people with disabilities. This could contribute to negative health consequences for them and their newborns. Impact: Birthing people with disabilities need multidisciplinary, proactive, and strengths‐based postpartum care to mitigate risk for health complications. Further, disability‐related training and guidelines for health and social service providers is required. Reporting method: Consolidated criteria for reporting qualitative research (COREQ). Patient or Public contribution: Our research team included two peer researchers with physical disabilities who served as co‐interviewers and participated in data analysis, contributing their lived experience of disability and interactions with the health care system. All stages of the study were also informed by feedback from the study's Advisory Committee, which comprised women with disabilities (many of whom are parents), disability organization staff, clinicians, and policy representatives. [ABSTRACT FROM AUTHOR]

Childhood trauma has long been implicated in the development of anorexia nervosa and is known to impact more women than men. Still, less is known about the meaning women attribute to food and bodily practices and how they contribute to feminine subjectivity. In this article, we examine the subjective experiences of women with histories of childhood abuse and anorexia and women who did not develop an eating disorder. Through a visual narrative analysis of eight body maps and narratives, we identified five themes: "time and the body have a way of showing what matters," "femininity and family," "sexual subjectivities and food meanings," "voices, dissociation, and sexual subjectivities," and "religion and healthism." In women with anorexia, specific eating and bodily practices reconstructed the traumatic events to align with the available cultural discourses related to health, religion, and family and had implications for their feminine and sexual subjectivities and self-worth. This research showcased how arts-based methodologies add value and advance knowledge about the role of culturally available representations in the development of anorexia and has implications for therapy and prevention of anorexia. [ABSTRACT FROM AUTHOR]

Background: Very little attention has been given to the social accountability of conferences, either in action or in scholarship, in particular, of scientific conferences. Concerns that have been raised include: (1) Local communities and regions suffer from ecological pressure caused by conferences, (2) There is limited value to the local community, (3) International conferences take place at locations irrelevant to the topics discussed; hence there is no connection with locals, and (4) It has been the observation of the authors that <10% of participants may come from the region where the conference is organized, which makes it challenging to make a "positive societal impact" locally. We conducted a natural experiment investigating the interactions between academia, conference organizers, and community leaders. Methods: We utilized a case study approach to report on the outcomes of two 2022 annual international conferences that seek to improve community health. We used a mixed-methods approach of surveys and interviews. Thematic analysis was conducted to identify the key themes. Results: We obtained 358 responses from all six World Health Organization regions. Results from both conferences were split into two categories: the why and the how. A strong consensus among participants is that bi-directional learning between conference organizers and local communities leads to shared understanding and mutual goals. The data emphasize that including communities in academic conferences helps us progress forward from intentions toward demonstrating accountability and reporting impact. Discussion: A diversity of perspectives is needed to advance socially accountable health system transformation. Five best practices from conference participants are laid out as a framework to assist in the change: (1) Build trust, (2) provide funding for community member participation, (3) appreciation of local community knowledge, (4) involve the local community in the planning stages, and (5) make the local community part of the conference and learning. [ABSTRACT FROM AUTHOR]

Background: Tobacco usage has been identified as a leading preventable cause of mortality and is responsible for six million fatalities per year globally. India had enacted COTPA in 2003. Tobacco vendors are one of the key stakeholders for Cigarettes and Other Tobacco Products Act (COTPA) implementation. Objective: To assess the knowledge gap on COTPA and to explore the perceived factors influencing implementation of COTPA among tobacco vendors in Puducherry. Materials and Methods: A mixed-method study was conducted among tobacco vendors from Point of Sale (PoS) around 230 educational institutions (schools and degree colleges) in Puducherry for three months. Simple random sampling was applied to select educational institutions and the tobacco vendors from PoS located around these institutions were included. Data capture was done using a pretested, face-validated questionnaire incorporated in Epicollect software 5 and data analysis by SPSSv24. Purposive sampling was employed to conduct in-depth interviews among tobacco vendors till the point of saturation and manual content analysis performed. Written informed consents were sought. Institutional Ethical Committee approval was obtained. Results: Majority (95.7%) reported that they were aware of tobacco control legislation, but only one person had heard of COTPA. Awareness about the display of signage boards at PoS was observed in 75.7% vendors. Around 41.7% reported that they should not advertise any kind of tobacco products. Three major themes were identified: facilitators, barriers, and suggested measures for COTPA implementation. Conclusion: Tobacco vendors in Puducherry were aware of tobacco control legislations but not familiar with the COTPA and its provisions. It is necessary to put forth efforts to educate these important stakeholders to be more cognizant of COTPA and to effectively include them in anti-tobacco programs. [ABSTRACT FROM AUTHOR]

General education teachers' self-efficacy is often identified as the main factor for the successful implementation of inclusion for students with visual impairment (SVI), yet limited research has been conducted in this area. Thus, the purpose of this study is to investigate the general education teachers' self-efficacy toward including SVI in the government secondary schools of Wolaita Zone. In this study, a mixed-methods approach with convergent design was employed. The target population included teachers, SVI, and principals. The sample consisting of 440 participants was selected using purposive and multistage sampling techniques. Data were collected using questionnaire, semi-structured interview, and focus group discussion (FGD). One-sample t-test and thematic analysis were used for analyzing the quantitative and qualitative data, respectively. The findings revealed that, in general, teachers showed positive self-efficacy in student engagement, instructional strategies, and classroom management of inclusion for SVI. [ABSTRACT FROM AUTHOR]

Two case studies of parenting programs, aiming to improve parenting practices and child development outcomes, and implemented by Save the Children/Ministry of Health/Khesar Gyalpo University in Bhutan and Boston College/University of Rwanda/FXB in Rwanda, respectively called Prescription to Play and Sugira Muryango, were conducted by an independent research and learning group. Implementation research focused on the workforce, a crucial but little-studied element determining the success of programs going to scale. Mixed methods were used to examine their training, workload, challenges, and quality of delivery. Health assistants in Bhutan and volunteers in Rwanda were trained for 10–11 days using demonstrations, role plays, and manuals outlining activities to deliver to groups of parents (Bhutan) or during home visits (Rwanda). Workers' own assessments of their delivery quality, their confidence, and their motivations revealed that duty, confidence, and community respect were strong motivators. According to independent observations, the quality of their delivery was generally good, with an overall mean rating on 10 items of 2.36 (Bhutan) and 2.44 (Rwanda) out of 3. The facilitators of scaling for Bhutan included institutionalizing training and a knowledgeable workforce; the barrier was an overworked workforce. The facilitators of scaling for Rwanda included strong follow-up supervision; the barriers included high attrition among a volunteer workforce. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the role of ethnic enclaves in perceived discrimination among Arab American adolescents. Little research has investigated what specific risk and protective factors play a role in perceived discrimination within ethnic enclaves; and which of these factors may be the most salient to Arab American adolescents. The study used a phenomenological approach, using semi‐structured interviews, journals, and parent interviews to collect and triangulate the data. Member checking and peer debriefing were also used to check for validity. A 'protective' theme, described as 'living in a bubble' and two 'risk' themes described as 'cracks' (i.e., within‐group discrimination) and 'pores' (i.e., online discrimination) were identified. Although ethnic enclaves appeared to protect adolescents from out‐group discrimination, it also appeared to be porous, with risk factors, such as online discrimination, 'seeping' into the community. [ABSTRACT FROM AUTHOR]

To analyse the effects of leisure-based community activities in improving neighbourhood support and social cohesion, data were collected in two neighbourhoods of Barcelona (Spain) through questionnaires and interviews. The results indicate that promoting neighbourhood support requires a different strategy from promoting participation in leisure-based activities aimed at developing social cohesion within a community. The study also suggests various useful strategies to strengthen the effects of leisure-based community activities. The strategies recommended revolve around networking, use of the public space, recognition of diversity and conflict management. [ABSTRACT FROM AUTHOR]

Aims and objectives: To provide guidance to nurses by examining how critical care nurses perceive and perform the family support person role during resuscitation. Background: Nurses can serve as family support person when families witness a loved one's resuscitation. However, few studies have examined the role of family support person to provide nurses with sufficient knowledge to enact the role. Design: An exploratory‐descriptive qualitative design with individual, semi‐structured interviews. Methods: Sixteen critical care nurses who had served as family support person completed interviews. The data were analysed by thematic analysis. COREQ guidelines were followed. Results: Six themes were identified: Hard but Rewarding Role, Be With, Assess, First Moments, Explain and Support. Findings explicated nurses' perceptions of the role and key role activities. Conclusions: Nurses perceived the role as hard but rewarding. Role challenges included the need for quick, accurate assessments and interventions to keep family members safe, informed and supported, while allowing them to witness resuscitation. Key role activities included: being fully present and compassionately attentive to family, continuously assessing family members, coordinating the first moments when family presence during resuscitation commences, explaining in simple, tailored terms the resuscitation activities, and supporting the family emotionally and psychologically through a variety of strategies. Nurses noted the high variability in how families respond and the complexity of simultaneously performing the multi‐faceted role activities. Relevance to clinical practice: To effectively support the growing global trend of family presence during resuscitation, nurses need the knowledge this study provides about how to fulfil the family support person role. Identifying the role activities may facilitate development of clinical guidelines and educational preparation for the role. Nurses can refine the many skills this role requires, building their competence and confidence, to increase opportunities for family members to experience family presence during resuscitation in a safe, and high‐quality manner. [ABSTRACT FROM AUTHOR]