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Introduction: Fresno, California, is home to more than 30,000 Hmong. The purpose of this research was to explore the utilization of Hmong shamans 40 years after the first Hmong immigrants arrived in the United States. Hmong shamanism is examined to identify and analyze changes to shamans' practices or patients. Methods: Using grounded theory, semistructured interviews were conducted with a convenience sample of 20 shamans in their homes. Transcribed data were qualitatively analyzed. Results: Shamans continue to train and practice in this community; utilization by older patients persists while young adult patients have become the fastest-growing group of users. Healing rituals have changed in response to the legalities of animal sacrifice in urban areas and the time demands of work schedules. Discussion: Nurses' awareness that the availability of biomedicine does not preclude the continuing or recurring utilization of traditional healers can facilitate understanding of culturally defined health care needs. [ABSTRACT FROM AUTHOR]

Acute care nurses continue to rely on personally created paper-based tools—their “paper brains”—to support work during a shift, although standardized handoff tools are recommended. This interpretive descriptive study examines the functions these paper brains serve beyond handoff in the medical oncology unit at a cancer specialty hospital. Thirteen medical oncology nurses were each shadowed for a single shift and interviewed afterward using a semistructured technique. Field notes, transcribed interviews, images of nurses’ paper brains, and analytic memos were inductively coded, and analysis revealed paper brains are symbols of patient and nurse identity. Caution is necessary when attempting to standardize nurses’ paper brains as nurses may be resistant to such changes due to their pride in constructing personal artifacts to support themselves and their patients. [ABSTRACT FROM AUTHOR]

This paper explores the concept of "community-engaged research" (CEnR) within the context of Veteran health care delivery and reintegration programs. A multi-sector expert panel (msExP) was formed to evaluate and make recommendations on Veteran community reintegration research and programs. The panel consisted of Veterans, care partners, clinical providers, researchers, community stakeholders, and subject matter experts. The paper examines the composition and lifecycle of the panel, highlighting the characteristics and experiences of the participants. Shifts in the panel's purpose and engagement levels occurred in response to unanticipated disruptions, particularly the COVID-19 pandemic. The transformation of the panel emphasizes the importance of aligning individual and group needs and deepening intrapersonal relationships Findings based on observations, surveys, and interviews with panel members contribute to the field of community-engaged research by demonstrating the utility of catalytic validity that balances group and individual development. As part of a broader study on Veteran reintegration, the panel and its development over time allowed for various perspectives on Veteran experiences and reintegration within the community that shaped the overall project. Despite the challenges of developing and maintaining a panel alongside a research study, feedback from the panel members on their participation provides insight into the potential for future working alliances in community-engaged health research. [ABSTRACT FROM AUTHOR]

Researchers and practitioners continue to call for professional learning (PL) for multi-tiered systems of support (MTSS) to promote implementation with fidelity. Different PL interventions and MTSS frameworks raise questions about what types of PL support educators to engage in key practices. Questions also remain regarding educators' perspectives and experiences with PL for MTSS and factors that facilitate or hinder educators' learning. In this paper, we report findings from a qualitative research synthesis on PL for MTSS in the United States. We found 46 studies that explored educators' perspectives and experiences with PL. Findings illuminated educators' positive experiences with ongoing, job-embedded PL, particularly PL communities and coaching. Studies also illustrated the importance of collaboration and trust within learning communities as well as leaders who empower and trust educators. We discuss the implications of these findings in K–12 school settings. [ABSTRACT FROM AUTHOR]

Argumentation is a fundamental communicative ability that children develop over time through formal schooling and daily practice with peers and family members. Literature on children's argumentation appears to have focused on their social interactions out of school, clinical environment, or informal pedagogic contexts. Even though there are research inquiries into children's argumentation in formal academic learning, many have been focused on argumentative writing in math or science classes. Much less is known about teacher-led argumentation and the youngest children's emerging argumentation in language art classes, where argumentation is formally and systematically introduced and learned. This paper reports a year-long ethnographic study on argumentation in a first-grade English language art classroom in the United States. Ethnographic discourse analysis was conducted to analyze two key literacy events from the daily reader's and writer's workshop. It is supplemented with qualitative analysis of the researchers' field notes and the students' artifacts. Our findings highlight the inherent intertextual nature of children's argumentation and a critical role the teacher played in eliciting and steering the children's argumentation construction through strategic instructional conversations (especially accountable talk). Our findings also revealed teacher-led children's intertextual argumentation as a powerful heuristic process and tool to enrich students' learning. The paper concludes some classroom argumentation teaching practices based on the research findings. [ABSTRACT FROM AUTHOR]

Little is known about the lived experience of the dyad following a fetal death and the impact on relationships. The purpose of this paper is to explore the dyadic relationship between partners, with health care providers, and with the baby's memory after birth. This qualitative study utilized hermeneutic phenomenology. The sample included 10 heterosexual dyads from the United States and Canada. All experienced a fetal death between 6 months and 7 years prior to their interviews. The data revealed three themes: (a) The Dyad Relationship: Moving Through the Experience Together; (b) Keeping the Memory Alive: Memorializing the Baby; and (c) Relationships With Health Care Providers: A Spectrum of Caring. The findings from this study provide the beginning knowledge needed to improve the care of dyads who have experienced a fetal death and for future studies to improve care delivery for dyads as their relationships change after fetal death. [ABSTRACT FROM AUTHOR]

While bystander intervention education has demonstrated promise as a strategy to reduce dating and sexual violence (DSV) on campus, little is known about whether survivors on whose behalf the interventions take place find these helpful. This paper uses qualitative, in-depth interviews with 33 DSV survivors to explore their perspectives on bystander intervention. Results indicate that while some interventions were identified as helpful, especially those that provided support to the survivor, many were not helpful enough or even harmful. Further work is needed to understand the consequences of bystander action. [ABSTRACT FROM AUTHOR]

Undocumented monolingual Spanish-speaking immigrants are one of the most vulnerable and marginalized groups to experience intimate partner violence (IPV) in the United States. This paper explores the barriers that prevent IPV disclosure in healthcare settings. Qualitative interviews (n = 14) were conducted with previously undocumented Spanish-speaking legal clients of a community domestic violence agency. The major barriers expressed by the interviewees regarding IPV screening and disclosure include limited opportunities for IPV screening, misinformation about legal rights from abusers, fear of deportation and separation from children, and lack of knowledge about resources. [ABSTRACT FROM AUTHOR]

Background: The use of electronic intake forms within the electronic health record (EHR) is an emerging method for routinely collecting patient-reported outcomes (PRO). However, few studies have evaluated experiences/perspectives toward electronic forms among outpatients receiving care within Integrative Health and Medicine (IHM) clinics. The study purpose was to understand patients' perspectives of electronic intake and PRO forms in the outpatient IHM setting. Methods: Electronic intake (e.g., treatment expectations, medical history, chief complaints, prior experience with integrative modalities) and PRO forms (i.e., Patient Reported Outcome Measurement Information System [PROMIS]-29, Perceived Stress Scale 4, Oswestry Disability Index) were designed in collaboration with clinic leadership and the Information Technology team. Semi-structured interviews were used to gather perspectives of the functionality and acceptability of the forms among outpatients receiving care at the IHM center. Interviews were coded to describe themes regarding perceptions and suggestions for improvement. Results: Qualitative interviews were completed with 10 participants (median age 51 years, 70% female, 30% Black/African American). Participants considered electronic intake and PRO forms as relevant to their health concerns, valuable for conveying important health information to providers, and easy to navigate. Suggested changes to the intake form included adding relevant open-ended questions, save and print functions, and examples and definitions to prompt responses. Conclusion: Participants felt the electronic format was a feasible and acceptable method of collecting patient information and PROs. Future goals are to implement the revised forms in a common EHR to patients receiving care at multiple IHM clinics across the United States. [ABSTRACT FROM AUTHOR]

This paper explores a case example of qualitative research that applied productive hermeneutics and the central concept, fusion of horizons. Interpretation of meaning is a fusing of the researchers' and subjects' perspectives and serves to expand understanding. The purpose is to illustrate an exemplar of qualitative research without establishing a rigid recipe of methodology. The illustration is based on in-depth observational and textual data from an applied anthropological study conducted in western Alaska with Yup'ik hunters and fishers and government agency employees as they worked towards collaborative management. The metaphor of the hermeneutical circle is showcased to help the reader understand the philosophical underpinnings and the analytical processes used to realize a meaningful interpretation. A series of organizing systems for the interpretation is described, culminating in a final organizing system to communicate a fully realized understanding of collaborative management at the time. [ABSTRACT FROM AUTHOR]

The article discusses the dissertation about institutional change in the transfer of climate-friendly technology among businesses in the U.S. The paper is aimed at acting on the interest among institutional theorists to explain institutional change brought about by actors embedded in an organizational field. The author uses qualitative method in studying international climate change policy. An overview and discussion of the dissertation are offered.

Background: Despite a fast-paced environment, the emergency clinician has a duty to meet the palliative patient's needs. Despite suggested models and interventions, this remains challenging in practice. Aim: To raise awareness of these challenges by exploring the experience of palliative care patients and their families and informal carers attending the emergency department, and of the clinicians caring for them. Design: Qualitative systematic literature review and thematic synthesis. Search terms related to the population (palliative care patients, family carers, clinicians), exposure (the emergency department) and outcome (experience). The search was international but restricted to English and used a qualitative filter. Title, abstracts and, where retrieved, full texts were reviewed independently by two reviewers against predefined inclusion criteria arbitrated by a third reviewer. Studies were appraised for quality but not excluded on that basis. Data sources: MEDLINE [1946-], Embase[1947-], CINAHL [1981-] and PsycINFO [1987-] with a bibliography search. Results: 19 papers of 16 studies were included from Australia (n = 5), the United Kingdom (n = 5), and United States (n = 9) representing 482 clinical staff involved in the emergency department (doctors, nurses, paramedics, social workers, technicians), 61 patients and 36 carers. Nine descriptive themes formed three analytic themes: 'Environment and Purpose', 'Systems of Care and Interdisciplinary Working' and 'Education and Training'. Conclusion: In the included studies, provision of emergency palliative care is a necessary purpose of the emergency department. Failure to recognise this, gain the necessary skills or change to systems better suited to its delivery perpetuates poor implementation of palliative care in this environment. [ABSTRACT FROM AUTHOR]

Postfeminist young women are encouraged to "embrace" their sexuality by sexualizing their bodies as a means of empowerment. In stark contrast, dominant understandings of violence identify these same bodily displays as risk factors, condemning women who enact them as "asking for" victimization. While these competing demands on the female body have been widely documented in popular media, empirical work has not investigated if, and the extent to which, women reproduce these tension-filled constructions of the body in their own lives. Using in-depth interviews with 15 participants of varied race, class and gender identity in the US, this paper explores the ways in which these conflicting discursive constructions of the body are enacted by participants in their everyday lives. While participants took up varied sensibilities of the body and empowerment (including several that emphasized sexiness and sexuality), participants uniformly discussed perceptions of risk that inscribed the female body as vulnerable. This produced tensions in reasoning for some participants (but not all), in ways that were intersectionally inflected by race and gender presentation. More broadly, data suggests that postfeminist (and other) visions of the body that appear to otherwise produce lived experiences of empowerment are deemed invalid in contexts of risk. [ABSTRACT FROM AUTHOR]

Civil war in Syria has resulted in the largest refugee group and the newest wave of refugees resettling in countries worldwide. Although they have experienced war, migration, and great trauma, resettlement introduces a new set of obstacles including cultural adjustment, language learning, and the development of a new social network. This paper is a qualitative analysis of the acculturation, mental health, and academic experience of Syrian refugee adolescents in the United States. The study is unique in its use of an ecological framework to organize emerging themes, and integrates responses from parents and adolescents to provide a comprehensive understanding of this experience. Moreover, the researchers focus on an important setting for support and intervention: the school system. Implications and recommendations for assessment, intervention, and programming are provided. [ABSTRACT FROM AUTHOR]

This paper examines how gender beliefs are embedded in the organizational practices of the reproductive market. Third party reproduction blurs boundaries between familial and non-familial members, making gamete banks and donation agencies important sites for studying the construction of family. Cultural beliefs about gender are implicated in the discourses and practices of these organizations, which shape and constrain the experiences and options for both gamete donors and recipient families. To evaluate this process, I conducted qualitative analyses on the recruitment materials of all of sperm banks, egg banks, and egg donation agencies in the United States. My analysis demonstrates that the reproductive market still relies on heteronormative assumptions of family. However, the extent to which these organizations facilitate participation in new, non-normative family forms breaks down along gendered lines, where sperm donors have more freedom, status, and potential to create relationships with recipient families than egg donors. [ABSTRACT FROM AUTHOR]

Purpose: This study explored barriers and facilitators to utilizing health-care services for foster youth, from the perspective of foster parents. Background: There are nearly 437,283 youths in the United States foster care system. Youths living in locations that are different from their familial home situations have a significantly higher occurrence of physical and mental health illnesses than children who remain in their familial homes, increasing risk for homelessness, substance use and abuse, chronic long-term illnesses, and incarceration, thus placing additional burden on the health-care system. Design and Methods: This study utilized a qualitative descriptive design with purposive sampling, with video focus groups to explore 15 foster parents' experiences in accessing health-care services for foster youth. Results: Barriers and facilitators to accessing health care and care coordination were identified, including logistics, transportation, electronic health record access, location of health care, and the impact of the social worker. Practice Implications: Nurses are well-positioned to aid in closing gaps in care for foster youth. Conclusions: These experiences provide important insights and implications for health-care providers and for future research and policy development. [ABSTRACT FROM AUTHOR]

This study explored the manifestations of intersectional structural stigma and stigma-reducing strategies in the context of health among a diverse group of persons experiencing homelessness in the southwest United States. Purposive sampling was used to recruit youth (ages 12–17), young adults (ages 18–24), adults (ages 25 years old or older), women with children, veterans, and males over 60 years old who self-identified as homeless. Grounded theory was applied, and thematic analysis was conducted using data collected from seven focus groups (n = 76 participants). A model of intersectional stigma was adapted from the Health Stigma and Discrimination Framework. This adaptation depicts pathways for addressing intersectional stigmatization experienced by individuals with multiple intersecting identities across the interpersonal, organization, and community levels not explicitly addressed in the Health Stigma and Discrimination Framework. At the interpersonal level, participants indicated they experienced stigmatizing behaviors and practices by service providers due primarily to their identities related to economic or unhoused statuses, gender, age, and mental health. Facilitators of intersectional stigma were identified through organization practices and processes. Multiple stigmatized identities due to social beliefs also facilitated stigmatization at the community level. Health outcomes influenced by stigmatization were also identified. Despite the stigmatization they experienced, participants discussed stigma-reducing strategies related to community assets, medical care, and destigmatizing practices by service providers. [ABSTRACT FROM AUTHOR]

Although U.S.-based mandatory and preferred arrest laws and policies were created to promote domestic violence survivors' safety, at times they have contributed to the wrongful arrest of women defending themselves against their abusive partners. While these laws and policies are the subject of broad critique, less considered are domestic violence survivors' descriptions of the events that unfold after police officers respond to a domestic violence incident and before they make an arrest. This is an important area of inquiry as these events may highlight how the circumstances leading to wrongful arrest decisions are more complex than the laws and policies alone. Data from the present study came from the author's larger in-depth qualitative investigation of 33 cisgender women's descriptions of their legal and child protection systems involvement. The women were recruited from an antiviolence intervention agency receiving referrals from communities with mandatory and preferred laws and policies. The women had agency contact due to their use of force or alleged use of force. The respondents were diverse across race, age, class, ability, U.S. citizenship status, and sexual identity. The author analyzed the 33 women's 51 interview transcripts and extensive fieldnotes using rigorous iterative analysis and constructivist grounded theory. The analysis revealed that seven of the 33 women, all of whom identified domestic and sexual violence survivorship histories, described a patterned series of events that unfolded after the police arrived at the domestic violence incident and before the police made an arrest. In this study, the author details three of the seven women's stories to demonstrate how a series of events, including police prearrest questioning and their coercively controlling male partners' tactics, facilitated the women's entanglement in what the author refers to as an "arrest web." Their incremental disentanglement from the arrest's impact is also explored. Broad system-focused implications are discussed. [ABSTRACT FROM AUTHOR]

Amid ongoing controversies in ethnography concerning representation, reproducibility, and generalizability, social scientific scholarship has increasingly taken a mixed-methods turn. While studies that blend qualitative and quantitative data promise to enhance the validity of representations of social worlds under analysis, they cannot escape contending with foundational dilemmas of scientific translation, integration, and commensurability across methodological paradigms. Recent debates have ignited a new line of inquiry about the integration of multiple methods in ethnography. In this paper, we argue that “cameo appearances”—the summoning of either qualitative or quantitative analyses in separate, purely mono-method studies—amounts to a form of methodological tokenism under the guise of methodological pluralism. We articulate sampling design, enhanced training, and curriculum development as crucial for arbitrating these debates as mixed-methods research emerges as a distinct innovation in twenty-first-century ethnography. [ABSTRACT FROM AUTHOR]

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end. [ABSTRACT FROM AUTHOR]

Background: We created a survey to assess menstrual side effects after COVID-19 vaccination when we noticed news stories that denied or discounted the experiences of tens of thousands of menstruating and formerly menstruating people who reported experiencing bleeding changes. This survey had an unprecedented response hundreds of times higher than we had anticipated (n = 101,824). Objectives: We investigated what motivated our sample to participate without remuneration to understand both general motivations for survey participation as well as why this survey captured the interest of so many. Design: We used open-ended responses from our online, mixed-method survey collected from April to October 2021. Methods: Using computer-assisted qualitative data analysis tools in R, we conducted a thematic analysis on open-ended responses. We used topic modeling to cluster the data, synthesize responses across 22,737 participants, and inform the themes summarizing the responses to "What is your interest in this project?" We compared and contrasted responses across groups (racial identity, ethnicity, gender) to examine whether the themes were representative across the demographic groups in our study. Results: The themes that characterized participants' interest in participating were vaccine effects and women's/people's health, personal experience related to the vaccine, and a love for science and data. We compared responses among demographic subgroups to avoid an overfocus on majority group responses and found the themes were reflected across each group. Lastly, we found our themes reflected multiple types of altruism. Conclusion: These results were important in showing how emergent research that focuses on the concerns of potential participants can encourage high response rates from both marginalized and majority communities. Inclusive practices and familiarity with the research team built credibility that engendered trust with the public. Plain language summary: No one listens to us, we know this, so we participated: Qualitative evidence from menstruation research during the COVID-19 pandemic Despite the success of the COVID-19 vaccine rollout, trust in science was put to the test as tens of thousands of people who currently menstruate or people who used to menstruate (e.g., postmenopausal) reported experiencing changes to their menstrual bleeding or new bleeding. News stories and medical professionals denied or discounted their experiences. In response, we created a survey to assess menstrual side effects after COVID-19 vaccination. The survey had an unprecedented response. Therefore, we investigated our sample's motivations, in particular, because this was unpaid research. We used computer-assisted tools to synthesize open-ended answers to "How did you hear about this project" and "What is your interest in this study?" To understand what led people to participate, we found participants' interests were vaccine effects and women's/people's health, personal experience related to the vaccine, and a love for science and data. We compared responses among demographic subgroups to avoid an overfocus on the majority responses (e.g., cisgender women or White people), and we found our themes reflected multiple types of altruism. These results were important in showing how research that is responsive to public needs encourages high responses from both marginalized and majority communities. We utilized inclusivity and familiarity to build credibility and create online presences to engender trust with the public. Future clinical research can be informed by our findings. We show strategies for doing ethical clinical research by speaking to people from all groups who may be affected. [ABSTRACT FROM AUTHOR]

Black and non-White Latinx children have historically been diagnosed with autism at a later age and with more significant impairments than White peers. This study aimed to gather insights from members of the autism service provider workforce on current barriers and facilitators to achieving equity in early childhood autism evaluation, referrals, and treatment. We employed a qualitative descriptive design using semi-structured virtual focus groups with autism experts in North Carolina (N = 26). Our final sample included pediatric clinicians across disciplines, researchers, family/caregiver advocates, and policymakers/government representatives. We identified four overarching themes representing challenges to equitable autism service provision: (1) workforce composition and recruitment concerns, (2) workforce capacity and accessibility concerns, (3) workforce compensation obstacles, and (4) COVID-19 pandemic adaptations' impact. Our findings demonstrate the need for improved workforce diversity, autism-specific education, adequate compensation, and interventions to address burnout. To remediate existing barriers to equity, diversity in recruitment across training levels, cultural awareness, autism education for all pediatric providers, and partnerships with caregivers as experts must be prioritized. These investments in the autism workforce will allow its interdisciplinary professionals to better meet the needs of children and families from historically marginalized communities and achieve equitable early childhood service provision. Black and non-White Latinx children tend to receive autism diagnoses later in life and with a higher degree of impairment than White children. The purpose of this study was to learn what is currently helping as well as preventing Black and non-White Latinx children from getting access to autism evaluation and services. We held virtual interviews with 26 experts who work with autistic children and their families, including clinical providers, researchers, advocates, and policymakers/government representatives. From these interviews, we identified four themes that have an impact on equity in autism services: (1) who makes up the workforce, (2) w orkforce capacity and accessibility, (3) workforce payment structure, and (4) changes due to the COVID-19 pandemic. These findings show the need for improved workforce diversity, autism-specific education, payment structures, and additional support for workforce members to avoid burnout. To make childhood autism services more equitable, diversity in recruitment across training levels, cultural awareness, increased autism education for all pediatric providers, and partnerships with caregivers as experts must be prioritized. These investments in the autism workforce will allow professionals in the field to better meet the needs of children and families from Black and non-White Latinx communities and achieve equity in early childhood autism services. [ABSTRACT FROM AUTHOR]

Native Hawaiians and Pacific Islanders (NHPIs) are peoples diverse in culture and history who are too often represented as a monolithic entity, a tendency that undermines efforts to ameliorate health inequities. The current study represents a partnership between academic researchers and a community organization serving NHPIs, in which space was held for five multigenerational NHPI families (N = 15 family members) to share their experiences with educational and healthcare systems, including issues of discrimination and barriers to accessing services. Qualitative analysis of the interviews identified four themes: Cultural Values and Strengths; Mental Health—Past, Present, and Future Directions; Systemic Racism and Discrimination; and Need for Culturally Informed and Linguistically Accessible Healthcare. These results, including the importance of family systems within NHPI cultures, positive intergenerational shifts in mental health, and the pervasive impacts of colonization on health, are discussed in terms of implications for the health of NHPI communities. [ABSTRACT FROM AUTHOR]

Equitable access to appropriate care, emergency department services, and in-home support aids are needed to minimize the occurrences of adverse events that have a significant impact on families. However, many families of children with medical complexity (CMC) lack consistent care due to issues of health inequity. We conducted 11 qualitative interviews with primary caregivers who were asked about their experiences of providing care to children who have a tracheostomy and are supported by multiple life-saving machines at home. Guided by ecological systems theory, we identified three themes that contextualize the lived experiences of the participants who expressed needs that arose from poor interactions within the mesosystem. Findings convey participant frustrations that result from insufficient support, ineffective training, and inadequate healthcare coverage. Although each theme is organized systematically to emphasize specific concerns within the mesosystem, together these themes emphasize the inextricable relationship between daily needs with systemic barriers to care. We provide a discussion of these needs with a broader context that also impacts the perceived quality of care among families managing the needs of their children who are supported by life-saving technology. By addressing existing challenges and identifying opportunities for improvement within the healthcare system, we seek to contribute to the collective effort of advocating for ethical systemic change on behalf of CMC and their families. [ABSTRACT FROM AUTHOR]

Background: Clinical judgment is declining in new graduate nurses, which affects patient safety and is therefore tested on the Next Generation NCLEX. There is limited research describing barriers and facilitators impacting nursing faculty's experiences teaching clinical judgment. Aims: The purpose of this study was to explore barriers and facilitators affecting undergraduate nursing faculty's clinical judgment teaching methods. Methods: Sixteen qualitative interviews were conducted with full-time nursing faculty at seven universities in the Northeast and Southeast regions of the United States. Results: The findings revealed program, student, and faculty factors affecting clinical judgment teaching methods. Subthemes included time, class size, students' class preparation, critical thinking, task orientation, professional development, and faculty resistance. Conclusion: Minimizing barriers and strengthening facilitators based on participants' practices and previous research can support more effective clinical judgment pedagogy, which has the potential to achieve Next Generation NCLEX success and potentially increase patient safety. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7–10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy. We conducted a randomized controlled trial at a tertiary care academic medical center in the southeastern US with 100 postpartum individuals (50 per arm) from 2018 to 2019. Among 100 trial participants, blood pressure follow-up within 7–10 days postpartum was higher albeit not statistically significant between postpartum individuals randomized to the remote assessment intervention versus office-based standard care (absolute risk difference 18.0%, 95% CI −0.1 to 36.1%, p = 0.06). Patient-reported facilitators for remote blood pressure monitoring were maternal convenience, clarity of instructions, and reassurance from the health assessments. These positive aspects occurred alongside barriers, which included constraints due to newborn needs and the realities of daily postpartum life. [ABSTRACT FROM AUTHOR]

Several measures have been developed to assess loneliness in the general population. Here, we examined if, and how accurately, widely-used measures capture the experience of loneliness in autistic adults. A total of 203 autistic participants from the UK completed an online survey, which included two widely-used loneliness questionnaires: the University of California, Los Angeles (UCLA) Loneliness Scale Version 3 and the Social and Emotional Loneliness Scale for Adults (SELSA). Participants completed the measures and provided their views on how well they captured their experiences of loneliness. A direct measure, asking participants how often they felt lonely, was also completed. Results demonstrated that scores on the UCLA and SELSA questionnaires positively correlated with the direct measure of loneliness, suggesting that these tools accurately index autistic experiences of loneliness. However, qualitative responses suggested that participants found both scales difficult to complete. Using reflexive thematic analysis, we identified three themes that encapsulated participants' views: (1) failing to distinguish between the characteristics/experiences of loneliness and being autistic, (2) loneliness is not a static trait and (3) inappropriate wording. Given that our sample of autistic participants tended to prefer the UCLA scale to the SELSA, we provide initial recommendations around how the UCLA scale could be adapted for autistic adults. There has been increasing interest in research on loneliness in autistic adults. Much of this research has involved giving autistic adults widely-used questionnaires that are thought to measure how lonely people are. However, these questionnaires have been developed for the general public. We do not know whether these questionnaires accurately measure how lonely autistic adults are. We asked 203 autistic adults to complete an online survey that included two widely-used loneliness questionnaires: (1) the University of California, Los Angeles (UCLA) Loneliness Scale Version 3 and (2) the Social and Emotional Loneliness Scale for Adults (SELSA). We also asked participants to rate how lonely they were from 1 (often/always) to 5 (never). Participants were then asked to give their views on the questionnaires (e.g. what they thought was good, and what they thought was not so good about them). We found that the scores on the UCLA scale and the SELSA aligned with participants' ratings of how lonely they were, which suggests that these two questionnaires accurately measure loneliness in autistic people. However, our participants also identified several ways to improve the questionnaires. This included (1) better distinguishing the characteristics/experiences of loneliness from those of being autistic; (2) better reflecting how loneliness may change at different times and in different contexts and (3) making the phrasing of the questions clearer. Overall, our autistic participants tended to prefer the UCLA scale to the SELSA. Therefore, we present some recommendations about how the UCLA scale could be changed to be more suitable for autistic people. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) screening tools for autism are gaining in prevalence, and have benefits such as video content and direct resources linkage. However, it is unclear whether such tools will ameliorate autism inequities or will help only those already advantaged in autism care. To investigate this issue, we conducted semi-structured qualitative interviews with 18 primary care and Early Intervention/Early Childhood Special Education providers in six US states. Providers were given hypothetical scenarios in which a family presents to care with results from one of 9 mHealth autism screening tools. Providers discussed their clinical approach and assessed the tool's fit with their patient/client population. Each transcript was audio-recorded, transcribed, and coded; a phenomenological approach was used to develop key themes. 4 themes and 18 subthemes emerged. These included Clinical and business factors (e.g. scope of practice concerns and clinical efficiency), Validity and trustworthiness (e.g. familiarity, data privacy/security), Family interaction quality (e.g. supporting family advocacy, provision of information, affecting family anxiety, and emotional support), and Accessibility (e.g. English proficiency/language issues, cultural inclusivity, and literacy/educational level). Providers suggested modifications to enhance equity, such as portraying diverse families, reducing the reading level of text, and making tools shorter to better fit clinical context. Families may find information about autism online, and health care and education providers may use online tools to screen for autism. However, we do not know if online autism screening tools are easily used by families and providers. We interviewed primary care and educational providers, asking them to review results from online tools that screen for autism. Providers had concerns about how usable and accessible these tools are for diverse families and suggested changes to make tools easier to use. [ABSTRACT FROM AUTHOR]

In this paper the author reports on the use of Theater of the Oppressed in a long-term critical ethnography. Building on the work of performative ethnographers, she reviews the literature on the uses of drama in qualitative research and explores the traditional research lines that are blurred in the process. More important, she details the experiences collecting and analyzing data using Theater of the Oppressed. In other published accounts of performative ethnography, data collection is emphasized and data analysis is not usually discussed, in part, because the line between data collection and analysis is blurred in the use of theater as inquiry. The author not only examines that blurring but suggests a method of analysis that others might find useful. The study focused on the integration of English language learners in a Midwestern U.S. high school. The author used Theater of the Oppressed with teachers to explore their role in the bullying activities of students. The analysis reveals changes in awareness witnessed through the drama. [ABSTRACT FROM AUTHOR]

Waiting is an under-explored area of social stratification and domination. Lower-income Americans frequently endure long waits, including waits to secure social welfare benefits, and these waits may serve the purpose of instilling in clients the need for compliance. Using qualitative interview data, this paper explores how low and moderate-income women in a US state understand their waits for public benefits; how those understanding shape their responses to the wait; and what those responses tell us about waiting as a form of social control as it is negotiated between the parties. Despite describing the process of obtaining benefits as one of “waiting it out,” women ascribe different meanings to their waits and take action based upon their assessments of the cause of the delay, the complexity of the situation, and past experiences with public bureaucracies. These approaches allow women to assert some control over a situation in which so much is out of one’s control. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders (SUDs) in the United States cause many preventable deaths each year. Finding effective ways to manage SUDs is vital to improving outcomes for individuals seeking treatment. This has increased interest in using e-health technologies in behavioral healthcare settings. This research is part of a larger study evaluating the efficacy of the NIATx coaching intervention for implementing RISE Iowa, an e-health patient recovery app, in SUD treatment organizations and seeks to examine clinician perspectives of the barriers and facilitators to its implementation. Method: Semi-structured qualitative interviews were conducted with 13 clinicians from 9 different intervention sites involved in the study. Results: Major barriers to implementing e-health technology include inability to access the technology, lack of time for both patients and clinicians, and a perceived lack of patient motivation to make changes. Facilitators to implementation include collaboration with other staff using e-health technology and integrating technology use into typical workflows. Conclusions: Implementation of e-health technology in SUD treatment will require integrating the technology into clinical workflows and improving patient access to the technology. [ABSTRACT FROM AUTHOR]

Background: The increased contamination of illicit drugs with fentanyl in the United States drug market has contributed to escalating mortality from drug overdose. Leisure and hospitality service industry workers are encountering opioid-triggered overdoses in their workplaces, such as restaurants and bars. Consequently, this increases the need for overdose education and naloxone distribution (OEND) training, which has been limited. We aimed to describe the experiences among service industry workers encountering an overdose in their workplace. Methods: We conducted in-depth qualitative interviews with service industry workers in Little Five Points (L5P), Atlanta, between October 2019 and April 2020 and triangulated methods with participant observations and fieldwork. Purposive criterion sampling methods were applied to recruit from different establishments in the L5P commercial district, which comprised restaurants, bars, retail shops, and theaters. After an initial seed sample was identified by engaging key stakeholders during fieldwork (business owners, managers, and the business association), a snowball sample followed for a final sample of N = 15. To contextualize the local population of harm reduction workers, people who use drugs and/or obtain safer drug consumption supplies in L5P (sterile syringes, safer using kits, naloxone), and service industry workers and their customers in L5P, the first author volunteered with an Atlanta syringe services program from October 2019 to April 2020. The first author conducted participant observations during the syringe exchange program and field notes were taken during observation (44 hours). This engagement ensured a rich, thick description. We used a pragmatic approach to thematic data analysis for this study. Data were analyzed iteratively and inductively from interviews and observations. Two independent researchers reviewed transcripts to identify passages in the data related to the question of interest. The passages were contextualized within the full data set independently to understand the relationships in developing a theory of what was commonly occurring across participants' experiences, and these relationships led to emerging salient themes regarding encountering an opioid overdose at work. Results: One salient theme related to overdose response emerged with the service industry workers included fear of negative consequences of overdose response, specifically, fear of disease transmission from artifacts of drug use and overdose response, including the spread of blood-borne disease, violence, and exposure to unintentional overdose. When discussing drug use, participants' beliefs about the potential for personal danger from drug use artifacts (syringes and discarded drugs) and violence were identified as barriers to opioid overdose responses. Conclusions/Implications for Occupational Health Practice: Our findings provide valuable insights for tailoring OEND training for service industry workers to confront fears associated with opioid overdose response in their places of work to decrease mortality from the opioid epidemic. Harm reduction approaches need to be sensitive to the places in which overdose occurs and who the overdose responder is likely to be, which requires appropriately tailoring OEND training for service industry workers. [ABSTRACT FROM AUTHOR]

Background: While menstruation is a physiologic process, it remains highly stigmatized. Despite the sheer number of menstruators, menstruation is a highly individualized experience, with wide variation in duration, symptoms, and management. This wide variability lends itself to large disparities in access to menstruation management products and subsequently the lived experience of menstruators. Objectives: The research team sought to understand lived menstrual experiences, symptoms, management tactics, and commonly used and desired resources among 20 cisgendered women aged 18–45 years in Philadelphia. Design: This project was a qualitative research study. Methods: We used a collaborative, community-based participatory research approach with No More Secrets, a Philadelphia-based grassroots sexuality awareness and menstrual health hub. Semi-structured telephone interviews were used to gain insight into general menstruation-related experiences, communication, worries, and concerns, with subsequent thematic analysis via Key Words in Context approach. Results: Four themes emerged following analysis: cycle characteristics, menstruation management, coping resources, and future resources. Participants largely spoke about their menses as a negative experience, asked for more comprehensive, verified sources of information and needed greater access to menstrual management supplies. Conclusion: Menstruation is a highly individualized experience with a large variety in knowledge, menstrual product use, and individual needs. Despite the individuality of menstruation, our community-based research shows that there is a dire need for interventions that promotes knowledge and access to menstrual care. [ABSTRACT FROM AUTHOR]

The out-of-school time (OST) field in the United States has a complex history. The push to offer programming reflects a legacy rooted in moral panics about racially minoritized youth. However, this field is populated by community spaces that act as multipurpose sites of culturally sustaining educational practices supporting positive youth development. We report findings from interviews with OST leaders, youth workers, policy influencers, and youth about how to create, sustain, and protect more liberatory and humanizing practices, demonstrating that racism and deficit-based thinking continue to inform programmatic practices and youth experiences. Furthermore, this study reveals that programs with expansive ideas of youth voice, healing justice, and whole-child approaches to youth development create better opportunities for connection and belonging. [ABSTRACT FROM AUTHOR]

This systematic review investigates how participatory visual methods (PVMs) (1) are applied in community health interventions (CHIs) with adult migrant populations and (2) identify potentials for participation. The search was performed in PubMed in 2021 and 2023. Eighteen articles fulfilled inclusion criteria as they investigated a CHI targeting migrants and used a visual method. We excluded articles that used quantitative methods, articles written in languages other than English, Danish, Swedish, or Norwegian, and the formats reviews, protocols, and theoretical articles. As a framework to graduate the degree of participation, we applied Arnstein's 'A Ladder of Citizen Participation'. Most of the studies took place in the United States, and the most frequent method used was photovoice. We categorize an equal number of articles as 'degrees of citizen power' or 'degrees of tokenism'. We identify the capacity to accommodate the needs of specific target groups to be a strength in PVMs, which has potential to engage migrants in several parts of the research process. Additionally, PVMs can be used to support a change in the participants' lives by facilitating a reflexive process concerning their life situation. However, utilization of PVMs also include a risk of tensions, they can be resource-demanding and potentially exclude certain groups. [ABSTRACT FROM AUTHOR]

Immigrant mothers engage in numerous transnational activities. In this qualitative study, we explored one distinct type of transnational activity, a return trip to the home country for visit, as experienced by Korean immigrant mothers. Through purposeful sampling, 11 married middle-class Korean immigrant women with children were recruited to be interviewed during their visit to South Korea. By exploring the transcripts through the thematic analysis, we paid attention to how these women negotiated and constructed the meaning of their return trip. These mothers carefully planned and coordinated these return trips so that their children could find their Korean roots by being immersed in the culture and build close intergenerational relationships. The mothers also perceived the trip as an opportunity to see their relatives face-to-face and spend quality time with their aging parents. Similar to other transnational activities, the meanings of return trip to home country might reflect social and cultural climates of Korea and the United States. [ABSTRACT FROM AUTHOR]

Data on school health policy implementation are limited due to the absence of a validated measurement tool. The purpose of this study was to create and pilot a school health policy implementation survey. A modified, four-round Delphi process was used to achieve consensus on content and format of the survey. The final 76-item survey was piloted in 655 schools with a return rate of 57.1% (n = 378). Seven schools participated in environmental audits. Based on the audits, survey responses represented an accurate description of school practices for 84.2% (n = 64) of questions. The remaining 15.8% (n = 12) of survey items were eliminated or revised. This measurement tool begins to fill the research gap between the evaluation of written school health policy and implementation. Further, this tool may be used by school nurses in alignment with the Framework for 21st Century School Nursing Practice. [ABSTRACT FROM AUTHOR]

Background: The literature on menstruation defines period poverty as the inability to access sufficient period products, education, and sanitary facilities needed to manage menstruation healthily and effectively. While research has identified shortcomings of healthcare in the carceral setting, period poverty behind bars has remained largely absent from criminal legal discourse. Objectives: The current study examines the interplay of period poverty and carceral control to introduce the novel concept of menstrual victimization, defined as the physical, emotional, and financial victimization that results from period poverty perpetuated through carceral control. Methods: The study uses qualitative content analysis to systematically gather and code journalistic accounts pertaining to the menstrual experiences of incarcerated and previously incarcerated females, criminal justice practitioners, and journalists. The analysis uses literary pieces (n = 99), which were coded deductively and guided by concepts related to structural violence and radical feminist criminology. Results: The findings shed light on the unique structural harms incarcerated menstruators face and reveal the dearth of needed empirical research on period poverty in carceral spaces. The narratives in the sample revealed how manufactured scarcity of period products within carceral spaces is used as a means of oppression by institutional agents. The emergent themes highlight how the intersection of period poverty and carceral control led to menstrual victimization characterized through shame, humiliation, control, and coercion. Conclusion: Potential outcomes associated with understanding menstrual victimization in the carceral setting are discussed, including reducing menstrual stigma, disseminating health education, minimizing health disparities, and ultimately, shifting modes of holding accountability away from oppressive, retributive, and controlling tactics. Plain Language Summary: Exploring how access to period products is used to harm people who menstruate in correctional facilities using an analysis of journalistic accounts Period poverty is defined as the inability to access sufficient period products, education, and sanitary facilities needed to manage menstruation healthily and effectively. Research reveals the shortcomings of healthcare in prisons and jails but period poverty in prisons is largely unexplored. The current study uses published media and research reports discussing menstruation in correctional facilities to examine how the control of period products, access to washrooms, and medical care impacts is used to harm people who menstruate experiencing incarceration. The findings suggest correctional staff leverage access to menstrual health resources to control, coerce, shame, and humiliate incarcerated menstruators. In conclusion, we offer potential reforms are discussed including reducing menstrual stigma, providing health education and care, and ultimately, holding staff accountable and shifting away from oppressive, punitive, and controlling tactics. [ABSTRACT FROM AUTHOR]

The discipline of epidemiology utilizes the constructs of agent, host, vector, and environment to study the incidence and prevalence (i.e., the nature, extent, distribution, correlates) and the contexts, and consequences of drug abuse in the United States. This paper provides a selected review of the results of 40 years of epidemiological study of drug abuse using surveillance systems, general population surveys, ethnography and qualitative research approaches. It then addresses the challenges in conducting research on drug abuse epidemiology. The paper concludes with some missed opportunities and lessons learned in four decades of a large portfolio of research studies conducted by an impressive array of distinguished scientists. [ABSTRACT FROM AUTHOR]

Describes the use of qualitative research for the strategic and message development phases of the National Youth Anti-Drug Media Campaign in the U.S. Main purpose of the focus groups conducted in the strategic development process; Research phases of the strategy development for the marijuana initiative; Results of tests conducted on the marijuana advertisements using focus groups.

Introduction: The United States is experiencing maternity care shortages. Family physicians can play a role in addressing these shortages. Family medicine obstetrics fellowships train family physicians in obstetrics care. Fellowship websites are important for promoting programs and attracting applicants. However, whether websites provide sufficient program information is unknown. This study aimed to assess completeness and utility of family medicine obstetrics fellowship websites across the United States. Method: The study analyzed 46 family medicine obstetrics fellowship websites. The component analysis evaluated the presence of 17 components related to orientation, curriculum, program, personnel, and additional content. The qualitative analysis included ratings for navigation and application, information quality, and esthetics. Analysis included percentages for websites and components and average qualitative ratings. Results: Common components included overviews, training requirements, and contact information. Description of the patient population was the least common component. Usability ratings varied across programs, with higher ratings observed for navigation and application, and information quality. Esthetics and visual appeal received lower ratings. Regional analysis indicated that websites from fellowships in the West and Southwest tended to include more components compared to those in the Southeast. Discussion: Family medicine obstetrics fellowship websites serve as valuable sources of program information for prospective applicants. However, not all websites include essential program details. Some information is rarely provided. Given the shortage of maternity care providers, it is crucial to develop informative and functional websites to attract applicants. Improving website content and design could prove to be a cost-effective strategy to increase the number of applicants. [ABSTRACT FROM AUTHOR]

Background : A healthy physician performs better clinically and provides superior care to patients than a physician struggling with burnout. Objective : The purpose of this study is to assess the physician perception of "health" and "burnout," to identify successful wellness-promoting behaviors, and to build a model characterizing the successful transition from poor health to wellness. Methods : Utilizing a qualitative approach, the team conducted one-on-one, in-depth, semi-structured interviews with physicians from different specialties. Questions focused on behaviors, beliefs, and system changes that facilitated their transition from poor health/burnout to wellness. Interviews were recorded and responses qualitatively coded from a set of definitions of wellness and burnout. These coded responses were quantified, and code prevalence was analyzed. Results : Fourteen physicians completed interviews. The codebook consisted of 74 total themes, with nine occurring in more than 10 (71%) of the interviews. Most themes yielded to categories of Wellness, Unwell, and Burnout, with several themes related to individual agency in facilitating wellness. Highly prevalent themes included support systems, nutrition, exercise, and cognitive health. Subjects generally described comprehensive approaches to successfully transitioning to wellness. Conclusion : This study describes strategies for the successful transition to wellness: physician-level factors such as a healthy support system, maintaining a healthy lifestyle, and developing consistent daily routines. These findings support the importance of physician autonomy and individual-level wellness-promoting strategies for a physician's transition to wellness. More research should investigate the overall effect of individual-level strategies versus system-level interventions. [ABSTRACT FROM AUTHOR]

Background: People with chronic illnesses may struggle to adapt psychologically to the illness experience and have feelings of identity loss, self-diminishment, and biographical disruption. This may limit people's ability to engage in optimal self-management. Systemic sclerosis is a debilitating, stigmatizing, and life-limiting progressive chronic illness with significant disfiguring effects. Little is known about the identity management process in people with disfiguring and debilitating conditions such as systemic sclerosis. Purpose: The purpose of this study was to generate a grounded theory explicating the process of maintaining a sense of self in people living with systemic sclerosis. Methods: Fifteen women with systemic sclerosis were recruited to ensure representation of a range of illness duration and progression. Semi-structured interviews were conducted, transcribed, and analyzed using open, selective, and theoretical coding. Results: A basic social process of "maintaining self" was generated from the data that explained the women's experience of living with systemic sclerosis and how they tried to hold on to their identity. Three core categories were identified. Adapting to changes are the behaviors that participants struggled through to carry on with their everyday lives. Dismantling of self was a distressing internal process where participants lost their sense of self and purpose. Restoring self was a transformative process that allowed participants to rewrite and rebuild their biographies. Conclusions: Findings suggest that the management of identity was important for understanding how people adapt to life with systemic sclerosis. This study can help nurses better understand how to support patients holistically with the management of systemic sclerosis. [ABSTRACT FROM AUTHOR]

There is a growing body of literature that documents high rates of intimate partner violence within South Asian American communities, indicating a critical need for research that can respond directly to this issue. From a socioecological perspective, Hindu temples can influence members' behaviors at multiple levels of change and thus may be important sites of collaboration for the prevention of intimate partner violence. Through in-depth qualitative interviews with South Asian families, temple leaders, and community stakeholders, this study indicates that Hindu temples have tremendous capacity to significantly impact intimate partner violence within South Asian American communities. [ABSTRACT FROM AUTHOR]

Although intimate partner violence (IPV)-exposed mothers report distress during family court proceedings, no known research examines what helps them cope. We analyzed qualitative responses from 214 IPV-exposed mothers to the question of who/what helped during family court. Participants described (a) receiving social support, (b) accessing tools and resources, (c) modifying actions, thoughts, and emotions to adapt to a system that is not trauma-informed, (d) being believed/validated, and (e) managing post-separation family life as helpful. Participants also reported (f) barriers to navigating family law proceedings; a few expressed nothing helped. Findings support a trauma-informed, network-oriented approach to supporting family court-involved survivor mothers. [ABSTRACT FROM AUTHOR]

This research explored the instructional practices and strategies used by orientation and mobility (O&M) specialists in March and April 2020 during the COVID-19 pandemic. The Access and Engagement survey from the American Foundation for the Blind included open-ended responses from 318 O&M specialists. The authors used thematic analysis to examine the main themes regarding instructional practices consistent throughout the responses. This article focused on the themes of collaboration between families and professionals and the creative instructional strategies used for adaptive O&M lessons. Parents took on a more active role and professionals found creative ways to make instruction useful in most cases. There were fundamental changes to the content and structure of O&M lessons when they were moved from in-person to online instruction. Creative and collaborative practices were used to adapt for the absence of the travel environment. Virtual instruction in O&M will continue to be used in certain circumstances when in-person services are not possible, but we need to better explore how to ensure it is safe and effective. [ABSTRACT FROM AUTHOR]

In the throes of an intractable overdose crisis, U.S. pharmacists have begun to engage in an unexpected practice—policing patients. Contemporary sociological theory does not explain why. Theories of professions and frontline work suggest professions closely guard jurisdictions and make decisions based on the logics of their own fields. Theories of criminal-legal expansion show that non-enforcement fields have become reoriented around crime over the past several decades, but past work largely focuses on macro-level consequences. This article uses the case of pharmacists and opioids to develop a micro-level theory of professional field reorientation around crime, the Trojan Horse Framework. Drawing on 118 longitudinal and cross-sectional interviews with pharmacists in six states, I reveal how the use of prescription drug monitoring programs (PDMPs)—surveillance technology designed for law enforcement but implemented in healthcare—in conjunction with a set of field conditions motivates pharmacists to police patients. PDMPs serve as Trojan horse technologies as their use shifts pharmacists' routines, relationships with other professionals, and constructions of their professional roles. As a result, pharmacists route patients out of the healthcare system and leave them vulnerable to the criminal-legal system. The article concludes with policy recommendations and a discussion of future applications of the Trojan Horse Framework. [ABSTRACT FROM AUTHOR]

This article, based on collaborative ethnography, describes five low income white mothers' equity literacy practices as they advocated for their children's diverse "failing" school during a state takeover. Mothers used both hard and soft advocacy. They promoted equity by reinforcing positive aspects of the school community, and resisting and reframing negative stories perpetuated about the school based on stigma at the intersection of race, class, and standardized educational attainment. They shared the ideal of exposing their children to "real life" by staying loyal to their school. These mothers' stories present possibilities, and challenges, for realizing interracial solidarity that fosters and sustains equitable schooling in the United States long term. [ABSTRACT FROM AUTHOR]

Maternal health in the United States is an area of immediate concern. The compounded disadvantages and unique global positions of refugee women highlight the need for research that explores the experiences of refugee women during pregnancy and childbirth. The present study examines how contextual factors shape pregnancy and childbirth experiences for Syrian, Afghan, Congolese, and Karen women living in Clarkston, Georgia, US. Qualitative data were collected via focus groups facilitated by community interpreters. We used a reproductive justice framework to center women's desires, needs, and experiences, and to highlight the importance of structural factors in the findings and analysis of this study. Using codebook thematic analysis, three themes were developed: (1) isolation and alienated knowledge, (2) gendered disparities and structural inequities, and (3) community support and precarity. The findings reflect both the diversity and constancy of women's experiences and highlight how the context of the US impacts women's ability to exercise agency during pregnancy and childbirth. Systemic change is needed to improve women's access to tools that increase their capacity to exercise agency both during pregnancy and childbirth, and beyond. [ABSTRACT FROM AUTHOR]

Turner's (1960) sponsored and contest mobility framework has been much utilized in analyzing mobility in England and the United States. This paper focuses on Turner's more central concern with how folk norms influence educational practices and the efforts to reform them. To test Turner's proposition that reformers and reform debates are bound by the logic of folk norms, I investigated efforts to reform the General Certificate of Education examinations in English secondary education between 1966 and 1976. Qualitative analysis of focused interviews and documentary data suggests that English educators and reformers alike were by and large actuated and constrained by sponsorship beliefs. But the paper moves beyond Turner. It reveals how sponsorship folk norms and functions are inscribed in the ideology and interests of particular educational constituencies who effectively institutionalized and perpetuated sponsorship principles in England. [ABSTRACT FROM AUTHOR]