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The controversy over vaccines, which has recently intensified following the COVID-19 pandemic, provokes heated debates, with both advocates and opponents raising allegations of bias and fraud in research. Researchers whose work raises doubts about the safety of certain vaccines claim to be victims of discriminatory treatment aimed at suppressing dissent, including the unjustified retraction of their published research. Such practices have previously been discussed in other controversial fields in science (e.g., AIDS, the environment, and water fluoridation) but not in the field of vaccines. The purpose of this study was to analyze, for the first time, the subjective views of researchers whose papers were retracted. Study participants are active researchers, most with international reputations in their respective fields. They perceived retraction as a means of censoring and silencing critical voices with the aim of preserving the pro-vaccination agenda of interested parties. Participants also reported additional measures aimed at harming them personally and professionally. These findings point to the need for a fair, open, and honest discourse about the safety of vaccines for the benefit of public health and the restoration of trust in science and medicine. [ABSTRACT FROM AUTHOR]

Background: Incarcerated trans women experience significant victimization, mistreatment, barriers to gender-affirming care, and human rights violations, conferring high risk for trauma, psychological distress, self-harm, and suicide. Across the globe, most carceral settings are segregated by sex assigned at birth and governed by housing policies that restrict gender expression—elevating ‘safety and security’ above the housing preferences of incarcerated people. Aim/methods: Drawing upon the lived experiences of 24 formerly incarcerated trans women in Australia and the United States and employing Elizabeth Freeman’s notion of chrononormativity, Rae Rosenberg’s concept of heteronormative time, and Kadji Amin’s use of queer temporality, this paper explores trans women’s carceral housing preferences and contextual experiences, including how housing preferences challenge governing chrononormative and reformist carceral housing systems. Findings: Participants freely discussed their perspectives regarding housing options which through thematic analysis generated four options for housing: 1) men’s carceral settings; 2) women’s carceral settings; 3) trans- and gay-specific housing blocks; and 4) being housed in protective custody or other settings. There appeared to be a relationship between the number of times the person had been incarcerated, the duration of their incarceration, and where they preferred to be housed. Conclusions: This analysis contributes to richer understandings regarding trans women’s experiences while incarcerated. This paper also informs the complexities and nuances surrounding housing preferences from the perspectives of trans women themselves and considers possible opportunities to enhance human rights, health and wellbeing when engaging in transformative approaches to incarceration. [ABSTRACT FROM AUTHOR]

Community housing services adopt care models such as rehabilitation, recovery-oriented care and person-centered planning to improve the quality of life of service users with an intellectual or psychiatric disability. However, the way these care models are implemented and practiced can negatively impact service users' experience with the service as their complex needs go unmet. In this paper, we conceptualize these experiences through developing the counternarrative of burdens of support. For this we draw on burden of treatment theory. We conducted ethnographic fieldwork in a community service organization in the Netherlands. This included participant observation (84 h), interviews with service users (n = 20), experts-by-experience (n = 8), family members (n = 10) and photovoice workshops. Our analysis identifies four burdens of support: burden of self-determination; re-identification; responsibilisation and re-placement. The results show that burden of support is very much a relational concept: through their support, professionals can aggravate or alleviate burden. People with intellectual or psychiatric disabilities often receive support with living in the community. Good support fits people's needs (e.g. person-centered planning), builds on people's strengths and contributes to recovery and community participation. Even when support is practiced or organized with such aims, service users can have negative experiences. In this research we call this: 'burden of support'. Examples of burden of support identified include: Clients' needs and wishes are sometimes not sufficiently attended too when working with a personal care plan. Too much responsibility is sometimes shifted to clients, which results in feelings of failing or abandonment. The focus on strengths and recovery sometimes leaves too little room for clients to voice support needs. Having to move to a different home or neighborhood as part of becoming more independent can result in many difficulties including loneliness. The research recommended that those who improve services should also alleviate these burdens. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents qualitative research findings from the evaluation of a Parkinson's Dance well-being venture in the UK. Methods: Qualitative data was gathered to see how bespoke dancing sessions helped people with Parkinson's (PwP) to manage their conditions and improve their lives and prospects. Principles of a participatory approach were incorporated and methods included semi-structured interviewing, researchers participant observation and an elicitation-based activity. Nineteen PwP, six carers, four dance artists and seven helpers participated in the study. Results: Participating in Parkinson's Dance sessions meant that PwP could experience the possibilities to dance, develop a "can do" attitude, experience fun, enjoyment, social connection, exercise, movement to music, improvement and/or maintenance of their balance, suppleness, coordination and confidence with movement, symptoms being pushed back and ability to learn new things. Conclusions: Our findings add to the evidence-base about the benefits of dance for people experiencing Parkinson's and through novel application of the Life-world based well-being framework of K. T. Galvin and Todres (2011) we propose a theoretical basis for Parkinson's Dance as a resource for well-being. There is scope to consider application of the well-being framework to other arts activities and as the basis of an arts and well-being evaluation tool. [ABSTRACT FROM AUTHOR]

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

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

This paper examines how the use of multiple platforms is tied to awareness of algorithms. It builds on the premise that users interact with ecologies or environments of technologies rather than single platforms. The study also supplements work on algorithmic awareness by implementing a mixed-method study to account for how Costa Rican users of Netflix and Spotify understood and related to the algorithms of these platforms. This study combined a survey of 258 participants and 21 in-depth semistructured interviews. Findings demonstrate that multi-platform users were more aware of algorithms and carried out more practical actions to obtain algorithmic recommendations than single-platform users. Although user type did not predict participants' attitudes towards algorithmic recommendations, higher levels of awareness were associated with more positive attitudes towards algorithms. The study also shows that differences in levels of awareness explained users' emotional arousal derived from algorithms. [ABSTRACT FROM AUTHOR]

Based on the Theory of Planned Behavior, this paper explores the perceptions of the COVID-19 vaccine among South Asian communities residing in the UK. Thirty-eight semi-structured interviews were conducted using a qualitative approach and analyzed using thematic analysis. Participants represented Indian, Pakistani, Bangladeshi, Sri Lankan, Afghani, and Nepali backgrounds. The participants revealed that family and community influence their perceptions of the COVID-19 vaccine. The results suggest that normalizing vaccine acceptance, addressing unknown side effects, and popularizing vaccine efficacy data will increase vaccine uptake within the South Asian community in the UK. [ABSTRACT FROM AUTHOR]

Young people with intellectual disability seem to be more vulnerable on the Internet than youth in general. Therefore, it is important to investigate not only their strategies for managing negative online experiences but also how they experience Internet-related support. This study applies a qualitative and interpretative approach drawing on individual and pair interviews with pupils in upper secondary special programme schools in Sweden. A thematic analysis resulted in the following themes: 'a lesson to be learned', 'the important role of siblings', 'the dilemma of support' and 'negotiation of control'. With regard to negative online experiences, strategies for managing privacy, safety and risky situations are understood as problem-focused coping and efforts to manage external/internal demands. The central role of social networks is emphasised with regard to Internet-related support. It is concluded that online restrictions may discourage open dialogue. A perspective of positive risk-taking, focusing on opportunities rather than risks, is advocated. This article investigates the participants' perspectives in their own words. The key contribution of the paper is finding out how young people with intellectual disability in Sweden handle negative online experiences and how they experience Internet-related support. The study highlights a range of themes from lessons learned and sibling relationships to problems of support and control that reflect many social and individual characteristics. The participants use different coping strategies to handle negative online experiences. They seem to manage privacy and safety on their own and refuse control in risky situations. With regard to Internet-related support, the participants prefer turning to their social network (family and friends) rather than public authorities (teachers in school). This type of research is important because it focuses on young people with intellectual disability and their vulnerability online as well as the development opportunities for Internet-related support. [ABSTRACT FROM AUTHOR]

Venous leg ulcer is a recognized condition, affecting people globally. Ulcers mainly affect the elderly and recurrences are not uncommon. There is knowledge about life with venous leg ulcers, but the situation after healing is unexplored. This paper explores and describes meanings of experiences of daily life after healing of a hard-to-heal venous leg ulcer. Lived experiences of 15 individuals with healed hard-to-heal venous leg ulcers generated data for this study. Interviews were recorded for analysis using a reflective lifeworld research approach. An essence emerged, further described by its constituents. Memories of a difficult time with leg ulcer were ever present, in a way becoming part of the self. A striving for control in daily life entailed a struggle to do what was best for the own body. After healing, a new normal emerged in daily life, a reality that encompassed the risk for a new ulcer. The body had changed physically, with marks alongside those from ageing, in a life that still went on. For those who had healed from a venous leg ulcer, life had changed. Even if they referred to life as normal, it was not the same normal as before. [ABSTRACT FROM AUTHOR]

Drawing on participant observation and interviews in two yoga studios in the highly socially stratified city of Marseille, France, this paper explores the understandings of yoga as a health practice that emerge at the intersections between yoga styles and their social contexts of consumption. Its insights emerge from the comparison of three modern yoga styles that were developed for Western English-speaking cultural contexts – Iyengar, Bikram and Forrest – and which differ in form but also in the chronology of their emergence on the global yoga market and that of their reception in France. These three yoga styles are also branded through contrasting mythologies of transformational healing, and the aim of this paper is to explore how a brand conceptualization of yoga as a health practice relates to or resonates with the embodied experiences of practitioners, and to the socio-cultural contexts in which practitioners and their practices are embedded. The paper contributes a new case study to the global yoga scholarship and to a poorly studied French yoga scene, but more importantly, it cross-examines the discourses through which a yoga style is branded, the way it is transmitted, and the social context and social positioning of the individuals who practice it. Combining perspectives on the body, narrative and rituals, it identifies how yoga healing is construed in relation to gender, ethnicity and class and the points of consensus and dissent that emerge from the encounters between French social bodies and exogenous yoga styles. [ABSTRACT FROM AUTHOR]

Recent mental health policy endorses a personal recovery framework that focuses on individual purpose and meaning. Therefore, psychology pre-registration training needs to promote knowledge and attitudes that are aligned with this framework.The 5 + 1 training pathway was recently established in Australia and emphasises readiness for practice. This study examined how provisional psychologists undertaking the 5 + 1 pathway perceived recovery. Semi-structured interviews were completed with nine provisional psychologists completing the coursework component of the 5 + 1 pathway. Interviews focused on perspectives of recovery and were analysed with thematic analysis. Three themes related to perspectives of (i) recovery as a process that involved building capacity to undertake key life roles, (ii) ways that psychologists can promote recovery through their stance and their practices and (iii) factors that have influenced participants' views of recovery. The findings indicate that provisional psychologists in the 5 + 1 pathway are able to develop appropriate but limited perspectives that are generally consistent with the personal recovery framework. Participants were more influenced by client contact than coursework. Learning about recovery could be enhanced by explicitly teaching models of recovery and incorporating views of people with lived experience. Key Points What is already known about this topic: Mental health clinicians' attitudes and perspectives of their work have an impact on the nature of the support they provide. Training plays an important role in developing psychologists' attitudes and perspectives towards recovery. The 5 + 1 internship is a recently established training pathway to registration as a psychologist. What this paper adds: This paper reports on one of few studies related to the Australian 5 + 1 training pathway for psychologists. Although unfamiliar with formal models of recovery, students' perspectives were mostly consistent with personal recovery but there were some indications of conceptual confusion. Recommendations are made for extending development of students' perspectives of recovery. [ABSTRACT FROM AUTHOR]

This paper examines how a group of mosque-practicing Muslim women in Denmark cope with personal discriminating actions and confrontations with stigmatising stereotypical discourses related to their religion and gender. Based on qualitative interviews with 33 mosque-practicing Muslim women, we provide examples of various experiences with discrimination related to their religion and gender. The study demonstrates how mosques support women by providing a strong sense of belonging and a religious language of advocacy. Hence, this study empirically highlights an aspect of the relationship between religious belonging and individuals' mental health and contributes to the knowledge of Muslim minorities by providing insights into women's experiences of victimisation. Additionally, we clarify misconceptions about the meaning of Muslim practices, such as the wearing of a veil and gender division in mosques. [ABSTRACT FROM AUTHOR]

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

This paper presents findings of a phenomenological study entitled: Healing from Recurrent Suicide Attempts: The Impact of Being a Peer Facilitator. The study examined the impact of being a peer facilitator (PF) in the Skills for Safer Living: A Psychosocial/Psychoeducational Intervention for People with Recurrent Suicide Attempts (SfSL/PISA) group on the PFs' healing journey. Using eight semi-structured interviews, the study privileged the lived experience of participants. The results identified four themes in survivors' healing: new identity formation, navigating stigma, developing agency in the activation of personhood, and achieving personal mastery: skills and competencies. [ABSTRACT FROM AUTHOR]

Growing numbers of women are showing interest in clitoral reconstructive surgery after 'Female Genital Mutilation'. The safety and success of reconstructive surgery, however, has not clearly been established and due to lack of evidence the World Health Organization does not recommend it. Based on anthropological research among patients who requested surgery at the Brussels specialist clinic between 2017 and 2020, this paper looks at two cases of women who actually enjoy sex and experience pleasure but request the procedure to become 'whole again' after stigmatising experiences with health-care professionals, sexual partners or gossip among African migrant communities. An ethnographic approach was used including indepth interviews and participant observation during reception appointments, gynecological consultations, sexology and psychotherapy sessions. Despite limited evidence on the safety of the surgical intervention, surgery is often perceived as the ultimate remedy for the 'missing' clitoris. Such beliefs are nourished by predominant discourses of cut women as 'sexually mutilated'. Following Butler, this article elicits how discursive practices on the physiological sex of a woman can shape her gender identity as a complete or incomplete person. We also examine what it was that changed the patients' mind about the surgery in the process of re-building their confidence through sexology therapy and psychotherapy. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the feasibility of the family talk intervention (FTI) and its acceptability to dependent children when a parent is cared for in palliative home care. The main goal of FTI is to increase family communication about the illness. The present paper derives from a pilot study and is based on 25 children's reports, involving both questionnaires and interviews, after participation. A majority of the children appreciated the structure and content of FTI. They felt seen, heard, and acknowledged by the interventionists and recommended FTI to other children in similar situations. [ABSTRACT FROM AUTHOR]

HIV and emotional distress often co-occur and interact in syndemic clusters with social, political, and economic factors that amplify the 'syndemic suffering' of individuals. In this paper, I describe how HIV+ women seeking antiretroviral therapy (ART) at a hospital in northern Tanzania engaged with plural methods of healing to ease suffering and address the multiple dimensions of illness. I explain the case of a famous faith healer at the time of research from 2011–12, 'Babu wa Loliondo,' from whom a third of the women interviewed – 25 of 75 – sought care in addition to their ART. These women experienced significantly fewer symptoms of emotional distress compared with those women who did not, suggesting that either those who sought his care were already healthier, or one strategy for coping – engagement with medical pluralism – played a role in buffering against syndemic HIV and emotional distress. [ABSTRACT FROM AUTHOR]

Background: While research on trans People of Color's experiences has been increasing in recent years, this intersectional work has often not included a focus on the specificities of multiracial and multiethnic trans experiences. Aims: This study explores shifts in racial identity by multiracial/multiethnic trans people as they transition gender and the ways Whiteness and nationalist ideology shape their racialized gender experiences. Methods: This paper is based on six in-depth, semi-structured interviewswith self-identifiedmultiracial, multiethnic, andmulti-heritage trans people in the USA. Data collection centered participants' experiences of self-identification and interactionswith others (e.g., family, acquaintances, and strangers). Results: As participants transitioned gender and were acknowledged by others in their gender identity, shifts in their embodiment were used by others to ascribe a new racialized gender. This often resulted in participants reflecting on their sense of self and racialized gender identities in new ways. Discussion: Multiracial and multiethnic transgender people's experiences in transitioning race confirm the importance of intersectional analysis, reveal the intersectional fluidity of social categories, explicate how social understandings of one category (e.g., race) influence another category (e.g., gender), demonstrate that the meanings associated with racialized gender are based in relations of power, and show that, in transgender studies particularly, we must attend to the ways that the concept of transition implicates not only gender, but also other categories such as race and nationality. [ABSTRACT FROM AUTHOR]

To evaluate the usability and acceptability of the Mental Capacity Assessment Support Toolkit (MCAST) in healthcare settings and whether its use was associated with increased legal compliance and assessor confidence. A mixed methods convergence triangulation model was used. Multidisciplinary professionals used the MCAST during mental capacity assessments for UK hospital patients with diagnoses of stroke or acute or chronic cognitive impairment. Changes in legal compliance were investigated by comparing scores on case note audits before and after implementation of the MCAST. Changes in assessor confidence and professionals' perceptions of the MCAST's usability and acceptability were explored using surveys. Patients' and family members' views on acceptability were determined using semi-structured interviews. Data were integrated using triangulation. Twenty-one professionals, 17 patients and two family members participated. Use of the MCAST was associated with significant increases in legal compliance and assessor confidence. Most professionals found the MCAST easy to use and beneficial to their practice and patients. Patients and family members found the MCAST materials acceptable. The MCAST is the first toolkit to support the needs of individuals with communication disabilities during mental capacity assessments. It enables assessors to deliver high quality, legally compliant and confident practice. Mental capacity assessment practice needs to be improved to maximise patient autonomy, safety and well-being. The MCAST is a paper-based toolkit designed to facilitate and improve mental capacity practice in England and Wales. This study suggests the MCAST would be easy and acceptable to use in healthcare settings and could lead to improvements in assessment quality and assessor confidence. [ABSTRACT FROM AUTHOR]

The introduction of progesterone vaginal ring (PVR) in sub-Saharan Africa calls for insights on the product's role in promoting women's autonomy regarding their reproductive decision-making and behaviour. Such insights could inform the positioning of the method within family planning programmes in the region. In this paper, we explore husbands' experiences with PVR as perceived by their wives and as reported by husbands of a subset of women users in Kenya, Nigeria, and Senegal. We discuss how such experiences might influence women's rights and autonomy regarding their reproductive decisions and contraceptive behaviour. We use a mixed-methods approach drawing on data from quantitative interviews with 174 women and qualitative in-depth interviews with 10 husbands of a subset of the women in the three countries. The findings show that husbands appreciated PVR's attributes relating to user-control (women could insert and remove the method themselves), ease of use, and non-interference with sex and flow of breast milk. Wives' perceptions of their husbands' experiences regarding PVR's non-interference with sex were consistent with the husbands' own reports. In addition, health care providers played important roles in supporting sustainable use of the method through giving information, counselling, and assisting women who experienced ring slippage to manage those challenges. The findings suggest that self-managed health technologies such as PVR could expand women's choices and control over their reproductive decisions. The findings further suggest that sustainable use of such products could require linkages with appropriate health systems structures to address challenges with use if and when they arise. [ABSTRACT FROM AUTHOR]

Purpose: Despite increased focus on parenting support internationally, there is a lack of agreement in what constitutes parenting support. This paper explores the experiences of parenting support activities from the perspective of stakeholders in Norwegian basic schools. Methods: Five focus group interviews were conducted with representatives from the schools' parent work committee, class teachers, health nurses, and social workers from nine schools. The data were interpreted using an inductive thematic analysis. Results: Three main themes emerged from the data: (1) A community for the best of the child, (2) uniting through relations, and (3) sharing knowledge and language. Parenting support was experienced as universal, relational, and multidimensional. It was related to everyday life interactions between the home, school, and the parenting community with the best interest of the child as a goal. Conclusion: To avoid reducing parents to passive recipients of expert advice, parenting support activities should be an integral part of everyday school-home-parenting community collaborations. Abbreviation: EU-The European Union; UN-The Unition Nations; CoE-The Council of Europe; NSD-The Norwegian Centre for Research Data; CTP-Class teachers in primary school; CTJS-Class teachers in junior secondary school; P-Parents; H-Health nurses; SW-Social workers [ABSTRACT FROM AUTHOR]

Purpose: Self-reliance and social participation are strongly promoted by social policy. Both concepts are linked to the concept of vulnerability, for people who do not meet these standards are labelled "vulnerable people". In this paper, the insider's perspective takes central stage by seeking to explore what it means to be labelled a "vulnerable person", and through this to further our insight into the meaning of the concept of vulnerability. Method: Thirty-three in-depth interviews were conducted with 16 allegedly vulnerable people. The data were subjected to thematic content analysis. Results: Our analysis revealed three main dimensions and eight sub-dimensions of perceived vulnerability, outlining an insider's concept of vulnerability. This concept includes manifestations of vulnerability, feelings coexisting with vulnerability, and the image of vulnerable people. Conclusion: The perception of vulnerability changes when interacting with others in society, especially with social policy implementers. In this interaction, the perceived vulnerability increases and becomes societal vulnerability. It concerns a dependency situation in which one's strength and self-determination are not recognized, and the help needed is not provided. By acknowledging the insider's perspective, social policy can fulfil a more empowering role towards "vulnerable people" and contribute to people's well-being. [ABSTRACT FROM AUTHOR]

Everyone who serves in the military (and survives the experience) will eventually become a Veteran, and most will face the challenge of finding a civilian job. This paper investigates how contemporary Veterans experience the transition period between military exit and entrance into civilian life and how their own actions before separation shape their post-transition outcomes. We follow 35 servicemembers through the transition process, interviewing them before and several months after they left the military. These interviews reveal the importance of three factors - the conditions triggering their exit, the strength of their military identity, and their own planning (or lack thereof) for the transition to civilian life - in enhancing or detracting from achievement of a stated post-military goals and objective success in moving into work or school. The strength and depth of an individual's institutional identity shapes how and when servicemembers plan for military exit and how they adjust to unanticipated military exits. Early planning reflects anticipatory socialization for new civilian roles and is associated with better post-military outcomes. But early planning is often hindered by a strong military identity or facilitated by a weak military identity. These findings have important implications for the military and advocates who serve them with the recent military policy changes to transition assistance and the retirement pension system that encourage early planning for post-military life. [ABSTRACT FROM AUTHOR]

Syringe service programs (SSP) increasingly serve rural areas of the United States, yet little is known about access and perceived need for their services. Objectives: This paper presents the HIV and viral hepatitis prevention, testing, and treatment, and, substance use disorder treatment and overdose prevention services offered at three SSPs and which services their clients accessed. Across the three SSPs, 45 clients (people who inject drugs [PWID]), 11 staff, and five stakeholders were interviewed. Results: Most clients (n = 34) reported accessing SSP services weekly and primarily for sterile syringes and injection-related supplies. All clients reported testing for HIV at least once, though concern for acquiring or transmitting HIV was divided between some or no concern. Most clients (n = 43) reported testing for hepatitis C virus (HCV). Concern for acquiring or transmitting HCV was also mixed. Vaccination for hepatitis A and/or B teetered around half (HAV: n = 23) to a third (HBV: n = 15). Most clients (n = 43) knew where to access the overdose countering medication, Narcan. Feelings about substance use treatment options varied, yet most felt not enough were available. Of note, not all assessed services were offered by the sampled SSPs. Conclusions/Importance: The findings help us understand PWIDs' rationale regarding services accessed and preference for particular services. The need for some services was not perceived by those at risk for the illness the services addressed. Discussing risk and providing tailored education is important when providing SSP services to rural residing PWIDs. [ABSTRACT FROM AUTHOR]

This two-year (2016–2018) study aimed to identify what a good life is for Aboriginal people with disability in remote Central Australia and how service providers can support them to achieve a good life. This paper presents the findings that relate to barriers to delivering services for Aboriginal people with disability. In-depth interviews and focus groups were held with Aboriginal people with disability and their carers aged at least 18 years from the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Lands and community organisations providing services there. The data were analysed using thematic analysis. There were 109 participants, of whom 47 were workers in service provider organisations and 62 were Aboriginal people. From the data, barriers to delivering services to support Aboriginal people to live a good life and solutions to overcome the barriers, were identified and described under the headings of environmental barriers and systemic issues. We discuss the policy implications of these findings with regard to addressing Indigenous disadvantage and how governments, service providers, communities, and Aboriginal people with disability and their families can work in partnership to address these barriers. Indigenous people with disability living in remote and very remote communities experience significant access and equity barriers to culturally responsive services that enable them to live a socially and culturally engaged life. Localised government and service provider disability policy approaches in Indigenous communities need to focus on both environmental and systemic issues. Greater investment in local remote communities is required to build the capacity of Indigenous families to support Aboriginal people with a disability to live a culturally and socially included life. [ABSTRACT FROM AUTHOR]

Advances in the management of chronic diseases, combined with an aging population, have escalated the prevalence of people with life-limiting conditions and demand for palliative care. In Australia, this has prompted calls for change in policy frameworks, service systems and funding models that underpin care. The complex social, cultural and policy transformation required to enact these changes has been problematic. This paper reports on qualitative research into a unique, Australian Community Palliative Care program reflecting these aspirational changes. The research examined the program design and its implementation through the perspectives of program staff and volunteers. [ABSTRACT FROM AUTHOR]

Medicalisation of hospice care has been discussed simultaneously with the development of palliative care into a medical speciality. However empirical knowledge of the role of medicalisation in hospice practice is underexplored. This paper considers hospice managers' perspectives on hospice care in the complex between values related to hospice philosophy and a specialised medical approach to hospice care. Focus groups and small group interviews were conducted with hospice managers from 16 out of the 19 Danish hospices. Drawing on hope as a theoretical framework, the study contributes to further understanding of the complexity of navigating hospice care in the impasse between an existential hope focused on meaning at the end of life and a medical hope for control of the dying body. Hospice care appeared as pulled between these dimensions of hope. The hospice managers took a pragmatic approach to medicalisation but their emphasis on dying as an existential event also points to a role for hospices as a critical voice against over-medicalisation of dying. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate what characterizes individual teachers' reflections on proposals for change in situated teamwork sessions and discuss the potential for professional development that lies in teachers' reflections. The teamwork sessions take place in the context of school-based professional development. Stimulated recall interviews (SRI) with teachers commenting on video recordings from their participation in teamwork form the empirical basis for the research. The sample consists of 17 teachers representing four teacher teams from different schools. We identified three primary types of reflection on proposals of change – comment and describe, extend and exemplify, and critical exploration. In the last type of reflection, when teachers critically explore, reflect and problematize existing practices whilst watching critical incidents that contain proposals for change, we identified tensions arising. The tensions emerged between teachers' established practices grounded in national regulations (ex. national tests, exams, documentation) and their basic assumptions, values, and beliefs. [ABSTRACT FROM AUTHOR]