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Purpose: There is a shortage of generalist physicians globally impacting health equity and access to care. An important way in which medical schools can demonstrate social accountability is by graduating learners interested in careers in generalism. While generalism is endorsed as a matter of principle in medical education, how this translates into curricula is less clear. The aim of this study was to identify how generalism is understood and supported by family physician educational leaders in undergraduate medical education (UME) in Canada., Methods: We conducted a qualitative study, interviewing 38 family medicine leaders in UME across all 17 Canadian medical schools. We examined the data with template analysis, informed by the iceberg model of systems thinking., Results: Four themes were identified: (1) Teaching and learning strategies in support of generalism-a consistent range existed across UME curricula; (2) Curriculum patterns-changes in leadership and curriculum reform created positive or negative feedback loops that promoted or hindered initiatives to support generalism; (3) Curriculum structures-organ-system-based curricula and availability of generalist faculty presented particular challenges to teaching generalist approaches; (4) Mental models and ways of knowing-the preponderance of biomedical frameworks of thinking in curricula unconsciously undermined generalist approaches to patient care., Conclusions: UME programmes promoted generalism through a range of teaching activities and strategies, but these efforts were countered by curriculum structures and mental models that perpetuate epistemic inequity between biomedical approaches to medical education and generalist models of care. Novel curricular frameworks are needed to align undergraduate programmes' commitment to social accountability with community-based need., (© 2024 The Author(s). Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

The present qualitative study examined how a group of Peruvian adolescents (N = 32) from different cultural contexts conceive their well-being. The goal was to identify the domains that structure their conception of well-being and how they evaluate it based on their elaboration. For this objective, 32 in-depth interviews were carried out with adolescents from different cultural contexts in Perú. Elements such as region, academic performance, and gender were considered to identify specificities during the analysis. Interviews were analyzed using a thematic analysis strategy. As a result, six domains of adolescent well-being emerged where well-being is associated with socioeconomic factors, family and peer relationships, future aspirations, social skills and self-esteem, academic performance, and health care. Participants' evaluations of well-being were mainly grounded in the socioeconomic, family, and educational domains. Findings highlight the need to further develop psychology research on adolescence in non-WEIRD societies., (© 2024 Society for Research on Adolescence.)

Background: When implementing new interventions into clinical practice, it is of great importance to investigate the implementation process to better understand factors promoting and impeding the implementation to stimulate engagement and sustainability of the intervention. It is essential to consider perspectives both from the health professionals delivering the intervention and those receiving the intervention to be open to their suggestions for enhancing the dissemination and implementation of the intervention. The aim of the study was to evaluate adoption, acceptability and appropriateness of a person-centred group intervention (PCGI) from the perspectives of facilitators and participants with mental illness in mental health outpatient services right after delivery., Methods: A qualitative interview study design was used. Interview data from three individual interviews, one group interview with facilitators and 16 individual interviews with participants were analyzed through content analysis., Results: As described in the following three categories, the facilitators and participants found the PCGI overall useful and meaningful to deliver and receive: (1) application of a PCGI in clinical practice, (2) balancing the facilitator role and (3) establishing and maintaining a safe relationship., Conclusion: Facilitators and participants found the form and structure of the PCGI useful and meaningful. Some participants dropped out as they did not feel comfortable in a group setting. The components in the sessions, questions on cards and reflection sheets together with peer-to-peer interactions provided a safe environment. However, facilitation from facilitators requires appropriate skills and qualifications, which must be provided by the hospital together with supervision and the possibility for peer feedback and exchange of experiences., (© 2024 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Purpose: This study aims to explore the daily stressors experienced by adolescents with Type 1 diabetes (T1D) and the perceived impact of those stressors on their self‐management and psychological well‐being. Design and Methods: We conducted semistructured in‐depth telephone interviews using a qualitative descriptive approach with 20 adolescents aged 14–17 years with T1D and analyzed subsequent data using thematic analysis. Results: Participants who were non‐Hispanic white made up 85% of the sample, 75% identified as female and mean age was 15 years. The study identified two key themes: "the everyday stress of living with diabetes" and "managing stress and supporting psychological well‐being." Participants described heightened mental load, the impact of daily activities, stress associated with public diabetes management, and added stress due to COVID‐19. Primary mitigation techniques included family support, peer support networks, activity engagement, and personal acceptance of their condition. Practice Implications: We found that there is a compound effect that occurs with balancing daily disease management with normative activities of daily living. These data will help guide the design of new interventions and tailoring of existing interventions. Future intervention development may include physical exercise, mindfulness training, and stress reducing techniques. [ABSTRACT FROM AUTHOR]

Rationale: Healthcare systems remain disease oriented despite growing sustainability concerns caused by inadequate management of patients with multimorbidity. Comprehensive care programmes (CCPs) can play an important role in streamlining care delivery, but large differences in setup and results hinder firm conclusions on their effectiveness. Many elements for successful implementation of CCPs are identified, but strategies to overcome barriers and embed programmes within health systems remain unknown., Aims and Objectives: To address this knowledge gap through a detailed study of implementing a CCP in a Dutch hospital setting, including patient experiences, facilitators, barriers and ways to overcome those barriers. Additionally, this study aims to explore effects on patient satisfaction and healthcare use., Methods: A qualitative study design with 39 semistructured interviews and focus groups between July 2020 and February 2023 with 16 patients and 17 involved professionals. Additionally, effects on quantitative outcomes for patient satisfaction (PACIC-20) and healthcare use were explored., Results: Professionals expressed a wide range of topics related to implementation and ways to overcome barriers at hospital and system level. Alterations in the design to accommodate varying care demands, focus on inclusions through referrals, and lack of long-term support and appropriate financing were key topics. Patients expressed varying experiences, stated a strong desire for comprehensive information, and emphasised the importance of trust in caregivers. Patient satisfaction showed no effects, while healthcare use showed slight decreases in trends, but patient numbers were limited., Conclusion: The introduction of a CCP is feasible, and exploratory analysis on effectiveness shows lower hospital care use without decreasing patient satisfaction. However, this is accompanied by several challenges that show current fragmented systems still do not support implementation of integrated care initiatives. Overcoming those comes with substantial costs and may require a strong bottom-up implementation within a motivated team and actions on all levels of healthcare systems., (© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

During the coronavirus pandemic, changes in the way science is done and shared occurred, which motivates meta‐research to help understand science communication in crises and improve its effectiveness. The objective is to study how many Spanish scientific papers on COVID‐19 published during 2020 share their research data. Qualitative and descriptive study applying nine attributes: (a) availability, (b) accessibility, (c) format, (d) licensing, (e) linkage, (f) funding, (g) editorial policy, (h) content, and (i) statistics. We analyzed 1,340 papers, 1,173 (87.5%) did not have research data. A total of 12.5% share their research data of which 2.1% share their data in repositories, 5% share their data through a simple request, 0.2% do not have permission to share their data, and 5.2% share their data as supplementary material. There is a small percentage that shares their research data; however, it demonstrates the researchers' poor knowledge on how to properly share their research data and their lack of knowledge on what is research data. [ABSTRACT FROM AUTHOR]

Aim: To gain insight into child-health nurses' experiences of using pictorial support in health visits within child-health services., Methods: A qualitative study involving interviews conducted with 17 child-health nurses in Sweden. The interview data were analysed using content analysis., Results: The nurses experienced that pictorial support could facilitate communication with families and increase opportunities for children to participate in child-health services, although it may come with challenges. This theme can be broken down into three main categories: (1) Pictorial support makes interaction with families clearer and easier and is used in different ways; (2) The design and extensiveness of the pictorial support can create obstacles; and (3) Pictorial support influences children's attitudes towards, and participation in, health visits., Conclusion: Pictorial support is an important and useful tool in child-health nurses' own work and improves their communication with children and caregivers during health visits. It can also increase children's participation and help them express themselves. Communicative tools such as pictorial support are very helpful to healthcare professionals striving to offer child- and family-centred care., (© 2024 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: Medical advancements will lead to more children with long-term illnesses and/or disabilities undergoing the transition to adult care. Previous studies show that many young adults are unprepared for this transition, and might suffer from loss of follow-up. This study aimed to investigate the post-transfer experiences of the transition among young adults with long-term illnesses and/or disabilities., Methods: A qualitative descriptive design was used. Three semi-structured focus group interviews were conducted with 15 participants (18-25 years of age) recruited via patient organisations focusing on children and young adults with disabilities and/or long-term illnesses. The interviews were analysed with conventional content analysis., Results: One theme emerged: limbo, defined as an indefinite experience without knowing when or even if something would happen, or whether they would be overlooked. The theme rested on four categories: transition experiences, organisational aspects, influence on daily life, and self-management., Conclusion: Areas for improvement were identified across the entire transition that is, in the preparation, transfer, and post-transfer stages. Our findings indicate a limited understanding among healthcare providers (HCPs) that the transition continues until the young adult has been fully integrated into adult care., (© 2024 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19-23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was 'Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health', comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently., (© 2024 The Authors. European Journal of Oral Sciences published by John Wiley & Sons Ltd on behalf of Scandinavian Division of the International Association for Dental Research.)

The current study addresses the lack of out-of-school time (OST) research in low- and middle-income countries by exploring OST use in the context of Pakistan and incorporating youth's voices. Using a qualitative descriptive design with focus-group discussions, we conducted a study in three middle schools set in low- to middle-income neighborhoods in urban and rural areas of Karachi, Pakistan. We engaged 86 youth (50% girls; aged 10-15 years) that were purposefully selected from grade six (31.4%), seven (44.2%) and eight (24.4%) classrooms, balancing gender and locality. In each focus group, we asked participants to describe their afterschool activity routine on a typical weekday afternoon until bedtime. Digital recordings of discussions were transcribed verbatim and analyzed using content analysis. Based on sixteen focus groups with five to six participants in each group, we identified eight distinct categories: religious activities, schoolwork, screentime, helping adult family members, family time, outdoor play, indoor leisure activities, and hanging out with friends. We found that structured activities (e.g., religious activities and schoolwork supervised by an adult) were reported more frequently than unstructured activities (e.g., outdoor play and family time). Participation in activities varied by gender and location (i.e., urban vs. rural), highlighting disparities associated with the sociocultural context that marginalized youth face. Our findings provide a glimpse into the everyday lives of Pakistani youth outside of school. Additionally, they elucidate how economic resources, sociocultural norms regarding gender, and community safety shape youth's time use and socialization patterns. Findings from this study can inform the development of OST activities and initiatives aimed at promoting the positive development of Pakistani youth., (© 2024 The Authors. Journal of Research on Adolescence published by Wiley Periodicals LLC on behalf of Society for Research on Adolescence.)

Aim: To explore the health beliefs of clinical and academic nurses from Japan, Australia and China regarding wearing paper masks to protect themselves and others, and to identify differences in participants' health beliefs regarding masks. Background: The correct use of face masks and consensus among health professionals across the globe is essential for containing pandemics, and nurses need to act according to policy to protect themselves, educate the public and preserve resources for frontline health workers. Paper masks are worn by health professionals and the general public to avoid the transmission of respiratory infections, such as COVID‐19, but there appear to be differences in health beliefs of nurses within and between countries regarding these. Methods: This qualitative descriptive study used content analysis with a framework approach. Findings: There were major differences in nurse participants' beliefs between and within countries, including how nurses use paper masks and their understanding of their efficacy. In addition, there were cultural differences in the way that nurses use masks in their daily lives and nursing practice contexts. Conclusion: Nurses from different working environments, countries and areas of practice hold a variety of health beliefs about mask wearing at the personal and professional level. Implications for nursing policy and health policy: The COVID‐19 pandemic has sparked much discussion about the critical importance of masks for the safety of health professionals, and there has been considerable discussion and disagreement about health policies regarding mask use by the general public. Improper use of masks may have a role in creating mask shortages or transmitting infections. An evidence‐based global policy on mask use for respiratory illnesses for health professionals, including nurses, and the general public needs to be adopted and supported by a wide‐reaching education campaign. [ABSTRACT FROM AUTHOR]

Purpose: To review and synthesize the qualitative literature on service users' experiences of endings from a psychological service or therapy., Methods: A systematic search of the peer-reviewed literature identified qualitative studies meeting specific inclusion criteria. A modified CASP tool was used to critically appraise their quality, and a meta-ethnographic approach was used to synthesize their findings., Results: Twelve papers met the inclusion criteria. The interpretation of findings suggested three key themes: anticipation of ending, service user control, and sense of responsibility. Although studies varied in geographical location and type of service, they were consistently of high quality., Conclusions: The review highlights the importance of service users' perspectives in understanding the experiences of endings. The findings complement existing literature and provide new interpretations. Considerations for practice were limited; however, the review provides useful directions for future research., Practitioner Points: When ending therapy, clinicians should consider the dyadic nature of the therapeutic relationship and the emotional impact this may have upon both service users and staff. Further consideration should be given to how staff manage their responses to the ending. The time-limited structure of therapy may aid the ending process by relieving staff and service users of responsibility., (© 2018 The British Psychological Society.)

As one of the typical high‐polluting and high‐energy‐consuming industries in China, the paper industry's environmental behavior has become the focus of a range of stakeholders, policy makers, and the whole society because the industry's business activities are a main source of environmental pollution and contribute to massive energy consumption. This study used a qualitative approach to examine the relative importance of external and internal pressures (EP and IP) in driving the environmental behavior of paper enterprises in China. Based on grounded theory, this study aimed to examine the EP and IP on the environmental behavior of paper enterprises to create a comprehensive theoretical model based on grounded theory code analysis. It was found that government pressure, economic pressure, social pressure, and IP have direct and significant positive effects on the corporate environmental behavior (CEB) of paper enterprises in China. Furthermore, government, economic, and social pressures have indirect and significant positive effects on CEB through other pressures. Finally, the paper concludes with a discussion of these four pressures and provides policy implications. [ABSTRACT FROM AUTHOR]

The article discusses life cycle analysis (LCA), environmental management systems (EMS), and a methodology for integrating them. It discusses LCA methodological options and it uses a pulp-and-paper plant case study to explain application of the methodology. Use of the methodology in assessing the environmental suitability of capital projects is addressed. As an introduction, it discusses aspects of EMS including ISO 14001, the basis of its design. It compares aspects of ISO 14001 and ISO 14040, the latter of which applies to LCA.

Rationale, aims and objectives Despite extensive evidence on the value of patient decision support interventions ( DESIs), there is no consensus on optimal DESI formats. Assessing clinicians' perceptions about DESI formats can help facilitate their adoption. The aim of this study was to assess clinicians' perceptions of DESIs formats and potential use in practice. Methods Semi-structured qualitative interviews were conducted with doctors from diverse practice areas (internal medicine, OB/ GYN, surgery, medical oncology, emergency medicine) and elicited perceptions toward patient DESIs formats (digital vs. paper) and timing of administration. Questions also elicited beliefs underlying attitudes, perceived social norms and self-efficacy for using DESIs and the feasibility of doing so. Data analysis was conducted using a thematic analysis approach. Results Participants identified strengths of both more comprehensive digital and shorter paper-based tools and thought they could complement each other. Participants consistently expressed the advantages of using DESIs outside the consultation to supplement clinical discussions about cancer decisions given the amount of information to discuss during these emotion-laden conversations. Participants felt that patients with older age and lower socio-economic status were more likely to use a paper-based compared with a digital DESI. Participants also noted challenges related to reliable resources such as computers and Internet in the practice setting, which would be necessary for implementing the digital DESIs on site. Conclusions Clinicians' perceptions and opinions about value of DESIs can vary widely across doctor, patient and clinic characteristics. A one-size-fits-all approach to implementation might not be feasible, suggesting that flexible approaches to providing decision support for patients are needed to drive broader adoption. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The Healthy, Hunger-Free Kids Act of 2010 ( HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing the changes. METHODS Food service directors from rural school districts were invited to complete a semistructured telephone interview and online survey. A total of 51 respondents completed both, 6 completed only the online survey, and 16 completed only the telephone interview. Qualitative interview data were analyzed through open thematic coding; descriptive statistics were calculated for the quantitative data. RESULTS Food service directors mostly perceived the changes as negative, challenging, and burdensome. They believed that the changes resulted from concern about childhood obesity, which they did not view as a problem for their students. Diverse challenges were reported related to cost, preparation, and student preference. CONCLUSIONS Food service directors in isolated, rural areas need support to enhance understanding of HHKA requirements, build professional networks to learn from one another, and communicate with students, families, and other stakeholders. Future efforts should focus on changing perceptions and supporting directors in order to make implementation a success. [ABSTRACT FROM AUTHOR]

Traditionally males have been regarded as the more aggressive sex. However, recent research in several countries has challenged this notion by considering different forms of aggression. This paper provides an overview of a qualitative investigation of teenage girls' indirect forms of aggression (e.g., exclusion from the group, spreading false stories). Focus groups and pair and individual interviews were used to collect data from adolescent girls and their teachers in two schools. The study provides some clear insights into the nature of teenage girls' indirect aggression. The predominant indirectly aggressive behaviors include talking about others and excluding peers from the group. Key explanations for these behaviors concern a desire to create excitement and a range of friendship and group processes centered on girls' needs for close personal relationships and to be a part of the peer group. The girls described the devastating effects of indirect aggression, particularly on girls with certain characteristics that predispose them to victimization. The girls were pessimistic about the potential of interventions, although peer mediation processes may be a way forward. Aggr. Behav. 26:67–83, 2000. © 2000 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

BACKGROUND Problem solving practice involving paper-and-pencil solutions is a common activity in undergraduate engineering training. This paper addresses three questions: What indicators of problem-solving skill are available in paper-and-pencil solutions, beyond a simple accuracy measure? Can these indicators distinguish between problem solvers in terms of their skill level? How can these indicators be used to improve the effectiveness of instructor feedback to problem-solving exercises? PURPOSE (HYPOTHESIS) Based on the published literature on cognition and problem solving, several indicators were hypothesized to signal knowledge and skill: an accurate free-body diagram, specification of assumptions, accurate expansion of key principles, strategic (forward) inferences, and checking equations and solutions. DESIGN/METHOD A mixed experimental methodology was applied that combined qualitative and quantitative analyses. The qualitative data was comprised of paper-and-pencil solutions and video recordings of participants while they solved problems. Frequency counts of skill indicators and grader-assigned scores comprised the quantitative data. RESULTS Statistical tests confirmed that the hypothesized indicators were associated with individuals' level of skill. However, reliable evidence for these indicators was only partially found in the paper-and-pencil solutions and could only be firmly established by including data from the video recordings. CONCLUSIONS The results show that paper-and-pencil solutions can be diagnostic of the strengths and weaknesses of problem-solvers. However, to provide useful and reliable feedback to students, these solutions must be supplemented with additional input, possibly through regular structured sampling throughout a course, or through more extensive use of computer resources. [ABSTRACT FROM AUTHOR]

Aim. The aim of the paper is (1) to offer an overview of different theoretical approaches to discourse analysis and (2) to review papers published in the Journal of Advanced Nursing from 1996–2004 in which discourse analysis is identified as a method of data analysis. Background. Discourse analysis offers rigorous approaches to analysing naturally occurring talk and texts. Forms of discourse analysis have developed across broad theoretical bases. Such development has created challenges for researchers wishing to adopt this methodology and readers wishing to evaluate the quality of discourse analytic work. Methods. First, key documents which describe the theoretical range of discourse analysis are used to provide (i) a comprehensive overview of the approach, (ii) the identification of categories of discourse analysis and (iii) minimum criteria for determining if an individual paper can realistically claim to be adopting discourse analysis. Secondly, an electronic search followed by hand search of the Journal of Advanced Nursing full- contents between 1996 and 2004 was undertaken. The papers were grouped into the types of approach identified in i, and evaluated to see whether they met the ‘minimum criteria’ also identified in i. Findings. The search of Journal of Advanced Nursing revealed 24 papers where the authors stated that discourse analysis was among the methods or was the sole method of data analysis. The majority of the papers cluster around critical approaches to discourse analysis. Only a few approach discourse analysis primarily as analysis of conversation. Some papers are excellent, while others offer analysis that bears little resemblance to any form of discourse analysis. Conclusions. A strategy for improvement could include more rigorous attention on the part of those practising discourse analysis to methodology and the key features that differentiate the different approaches to discourse analysis from other qualitative methods. Authors should include sufficient detail of their approach. [ABSTRACT FROM AUTHOR]

Rationale A multidisciplinary primary care clinic in Sydney, Australia, was planning to use electronic questionnaires to measure patient-reported outcomes. Methods Semi-structured interviews with 20 patients were undertaken to explore, among other things, practical issues regarding different questionnaire formats. The response rates and costs of email versus postal invitations were also evaluated. Results Compared with postal invitations, email invitations offered a cost-effective and practical alternative, with a greater proportion of patients volunteering for an interview. Assuming the interface is well-designed and user-friendly, many patients were happy to use the Internet to answer questionnaires. Most patients thought alternate formats should also be offered. Patients discussed advantages and disadvantages of the Internet format. Although more younger patients and females had given the clinic an email address; both sexes, and young and old patients, expressed strong preferences for either wanting or not wanting to use the Internet. Conclusion Researchers should consider using email invitations as a cost-effective first-line strategy to recruit patients to participate in health services research. Internet questionnaires are potentially cheaper than paper questionnaires, and the format is acceptable to many patients. However, for the time being, concurrent alternate formats need to be offered to ensure wider acceptability and to maximize response rates. [ABSTRACT FROM AUTHOR]

Background: This paper examines the appropriateness of using interpretative phenomenological analysis (IPA) in research with people who have intellectual disabilities, focussing on quality. Methods: We conducted a systematic search to identify published studies. We assessed the quality of the studies using a bespoke framework, adapted from previous reviews, and articles on indicators of "good" IPA work. Results: Twenty‐eight papers were reviewed. The studies were of varying quality: 6 (22%) papers were rated as "good" quality; 16 (57%) were "acceptable", and 6 (21%) were "poor." This ratio was comparable to that found in assessments of IPA papers in other domains, suggesting that issues of quality reflect researcher competence, rather than challenges with the population. Conclusions: IPA can be an appropriate methodology to use with people with intellectual disabilities. We encourage researchers to develop more detailed analyses, to provide more transparency about their sampling strategies, and more detail of the characteristics of their samples. [ABSTRACT FROM AUTHOR]

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The article offers information on the journal's invitation for the submission of papers on the topics of open science, qualitative methods, and social psychology.

Although child maltreatment has often been described as leading to language deficits, the few well-controlled investigations of language acquisition in maltreated children have focused on language content rather than form, or have used qualitative rather than quantitative measures. This study examines syntactic complexity in 19 maltreated and 14 nonmaltreated preschool-aged children. Mother–child dyads participated in play sessions that were transcribed and scored for the presence of morphosyntactic forms in child speech and for specific sentence constructions in maternal speech. Findings indicated that child maltreatment was associated with language delay in both vocabulary and production of syntactic structures. There were also qualitative differences in characteristics of maternal utterances between maltreating and comparison groups. Because maltreatment initially occurred before age 2, this study highlights the long-lasting negative influence of maltreatment on language development and also provides the first demonstration of child language delays and differences in maternal speech within a single maltreatment sample. [ABSTRACT FROM AUTHOR]

This special issue dedicated to qualitative accounting research shows the commitment of Accounting & Finance to support and publish qualitative research. This introductory piece explains the rationale behind this commitment and recounts the process followed with this special issue, before introducing the papers published in it. The first paper in the special issue, co‐authored by De Villiers, Dumay and Maroun, will be of interest to a large cross‐section of accounting researchers, even those with a quantitative bent, because it dispels some myths around qualitative research, and it sets a research agenda that others may pursue. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to identify and analyse the US Health Sector concept of the 'Meaningful Use' of electronic health records (EHR's) based on the wide diversity of discourses in the published literature. Meaningful Use is defined as 'use of digital medical and health records to improve quality, safety and efficiency of patient health information'. Methods: Herman Dooyeweerd's philosophical suite of aspects was the chosen research tool used to analyse seminal papers concerning the Meaningful Use of EHRs. The methodology included the identification of the criteria for choosing the papers: application of the criteria to the literature and then selection of the papers and finally the application of Dooyeweerd's aspects to the papers in order to analyse and classify the motivations of the authors. Results: As a result of the aspectual analysis of the relevant texts in the seminal papers, two aspects were identified, one as primary and another one as secondary. In addition, the analytic aspect was repeated twice as the primary aspect. Although there were a number of papers distinctively centred on different aspects, overlaps and similarities were also clearly identified. Discussion: Dooyeweerd's philosophy is useful in helping to affirm the factors that are important to the authors of the seminal papers and the philosophy helps us to accommodate this diversity in a unique way, therefore enhancing our understanding of approaches in the area. Conclusion: By employing the lens of Dooyeweerd's aspects, the study enhances the understanding of diversity in one discipline and could potentially provide a new system for the classification of diversity within other related disciplines. [ABSTRACT FROM AUTHOR]

Background: The under‐detection of depression in adolescents suggests that a better understanding of its presentation may be needed. Conceptualizations of adolescent depression are largely the same as adult depression, with minimal consideration of developmental stage. Exploration of first‐hand accounts could help to identify any unique features of adolescent depression. Therefore, this systematic review aimed to understand the lived experience of adolescents with depression to inform clinical practice. Methods: The review was registered with PROSPERO (CRD42020198141). Databases (PsychINFO, CINAL, MEDLINE and EMBASE) were searched in March 2022 to identify peer‐reviewed qualitative studies on first‐hand experiences of adolescent depression. The Joanna Briggs Institute's qualitative data extraction tool and checklist for qualitative research were used to obtain study data and assess methodological quality of included papers. Meta‐aggregation was the method of synthesis, whereby extracted themes from the papers were grouped according to shared meanings. Results: Fifteen papers of mixed methodological quality were identified for inclusion from screening a total of 1,983 references. Studies were published between 2002 and 2021, spanned seven countries and included participants aged 11 to 22 years old. Aggregation of 56 themes resulted in 16 categories and 3 synthesized findings encompassing key aspects of adolescent depression: causes, symptoms and coping. Variability in adolescents' perspectives across these domains was evident. Some symptoms described, such as social disconnection and anger, are not listed in existing diagnostic criteria. Conclusions: Subjective experiences of depression among adolescents vary and may not entirely match diagnostic criteria. Awareness of this when assessing for depression may improve detection and help to ensure adolescents feel understood. [ABSTRACT FROM AUTHOR]

Introduction: Engaging youth in mental health research and intervention design has the potential to improve their relevance and effectiveness. Frameworks like Roger Hart's ladder of participation, Shier's pathways to participation and Lundy's voice and influence model aim to balance power between youth and adults. Hart's Ladder, specifically, is underutilized in global mental health research, presenting new opportunities to examine power dynamics across various contexts. Drawing on Hart's ladder, our study examined youth engagement in mental health research across high‐ and middle‐income countries using Internet‐based technologies, evaluating youth involvement in decision‐making and presenting research stages that illustrate these engagements. Methods: We conducted a directed content analysis of youth engagement in the study using primary data from project documents, weekly AirTable updates and discussions and interviews with youth and the research consortium. Using Hart's Ladder as a framework, we describe youth engagement along rungs throughout different research stages: cross‐cutting research process, onboarding, formative research and quantitative and qualitative study designs. Results: Youth engagement in the MindKind study fluctuated between Rung 4 ('Assign, but informed') and Rung 7 ('Youth initiated and directed') on Hart's Ladder. Engagement was minimal in the early project stages as project structures and goals were defined, with some youth feeling that their experiences were underutilized and many decisions being adult‐led. Communication challenges and structural constraints, like tight timelines and limited budget, hindered youth engagement in highest ladder rungs. Despite these obstacles, youth engagement increased, particularly in developing recruitment strategies and in shaping data governance models and the qualitative study design. Youth helped refine research tools and protocols, resulting in moderate to substantial engagement in the later research stages. Conclusion: Our findings emphasize the value of youth–adult partnerships, which offer promise in amplifying voices and nurturing skills, leadership and inclusiveness of young people. Youth engagement in project decision‐making progressed from lower to higher rungs on Hart's Ladder over time; however, this was not linear. Effective youth engagement requires dynamic strategies, transparent communication and mutual respect, shaping outcomes that authentically reflect diverse perspectives and mental health experiences. Patient or Public Contribution: There was substantial patient and public involvement in this study. This paper reports findings on youth engagement conducted with 35 young people from India, South Africa and the United Kingdom, all of whom had lived experience of mental health challenges. Youth engagement in the MindKind study was coordinated and led by three professional youth advisors (PYAs) in these contexts, who were also young people with lived experience of mental health challenges. Each of the three study sites embedded a full‐time, community‐based PYA within their study team to inform all aspects of the research project, including the development of informational materials and the facilitation of Young People's Advisory Group (YPAG) sessions referenced in this paper. Each PYA also consulted with a site‐specific YPAG that met bi‐monthly throughout the project, shaping the formation of study materials and serving as a test group in both the quantitative and qualitative studies. Youth participants in this study also contributed extensively, engaging in data collection and manuscript writing. The following youth advisory panels members (J.B., L.B., D.O.J., M.V.) and all PYAs (E.B., S.R., R.S.) in the MindKind study contributed to the writing of this manuscript and are acknowledged as co‐authors. [ABSTRACT FROM AUTHOR]

Aims Assessment of the impact of health research is a growing but problematic field. We examined how a combination of approaches might together inform assessment of the impact of a body of diabetes research published in 1981 and help identify factors behind success. Methods Three broad approaches were applied to the work of one team leader of acknowledged influence. Standard bibliographic analysis was complemented by a second approach which categorized the importance of the primary publications to the papers citing them, in four domains. In parallel, a third approach involved qualitative assessment using surveys, critical pathway analysis by, and interviews of, co-authors and external experts. Extending the approach incorporated key additional publications from other years. Results In 1981, the team leader published 29 papers. Citations to these 29 first generation papers varied from 1 to 76 and resulted in 799 second generation papers. Citations to these produced 12 891 third generation papers. Analysis of second generation papers suggested the cited first generation paper was thought to be of considerable or essential significance in only 9% of cases. While much research made little impact, qualitative analysis included a wealth of information, sometimes missed by standard bibliographic techniques, on where the identified research influenced important streams of clinical development. Analysis covered major research studies (such as the Diabetes Control and Complications Trial), insulin pump therapy, and career development of co-authors. Conclusions Understanding the impact of research requires multiple approaches. With refinement, these techniques could be employed more widely and potentially could inform research policy. [ABSTRACT FROM AUTHOR]

Background: Qualitative research explains observations, focusing on how and why phenomena and experiences occur. Qualitative methods go beyond quantitative data and provide critical information inaccessible through quantitative methods. However, at all levels of medical education, there is insufficient exposure to qualitative research. As a result, residents and fellows complete training ill‐equipped to appraise and conduct qualitative studies. As a first step to increasing education in qualitative methods, we sought to create a curated collection of papers for faculty to use in teaching qualitative research at the graduate medical education (GME) level. Methods: We conducted literature searches on the topic of teaching qualitative research to residents and fellows and queried virtual medical education and qualitative research communities for relevant articles. We searched the reference lists of all articles found through the literature searches and online queries for additional articles. We then conducted a three‐round modified Delphi process to select papers most relevant to faculty teaching qualitative research. Results: We found no articles describing qualitative research curricula at the GME level. We identified 74 articles on the topic of qualitative research methods. The modified Delphi process identified the top nine articles or article series most relevant for faculty teaching qualitative research. Several articles explain qualitative methods in the context of medical education, clinical care, or emergency care research. Two articles describe standards of high‐quality qualitative studies, and one article discusses how to conduct the individual qualitative interview to collect data for a qualitative study. Conclusions: While we identified no articles reporting already existing qualitative research curricula for residents and fellows, we were able to create a collection of papers on qualitative research relevant to faculty seeking to teach qualitative methods. These papers describe key qualitative research concepts important in instructing trainees as they appraise and begin to develop their own qualitative studies. [ABSTRACT FROM AUTHOR]

In recent years, there has been a focus in social psychology on efforts to improve the robustness, rigour, transparency and openness of psychological research. This has led to a plethora of new tools, practices and initiatives that each aim to combat questionable research practices and improve the credibility of social psychological scholarship. However, the majority of these efforts derive from quantitative, deductive, hypothesis‐testing methodologies, and there has been a notable lack of in‐depth exploration about what the tools, practices and values may mean for research that uses qualitative methodologies. Here, we introduce a Special Section of BJSP: Open Science, Qualitative Methods and Social Psychology: Possibilities and Tensions. The authors critically discuss a range of issues, including authorship, data sharing and broader research practices. Taken together, these papers urge the discipline to carefully consider the ontological, epistemological and methodological underpinnings of efforts to improve psychological science, and advocate for a critical appreciation of how mainstream open science discourse may (or may not) be compatible with the goals of qualitative research. [ABSTRACT FROM AUTHOR]

Introduction: Research with young people (YP) is ethically challenging and bound in a complex maze of issues relating to power, voice and representation. Such sensitivities mean that the challenges raised in researching marginalised YP are often hard to navigate. This paper reports on research carried out with YP to explore links between mental health, school exclusion and involvement in criminal gangs. It aims to provide a practical guide to negotiating some of the methodological and ethical challenges experienced. Method: In‐depth interviews conducted with 28 YP (aged 14–24 years) who were gang involved or seen to be at risk of gang involvement. Research was conducted in youth clubs, alternative provision and youth justice settings. Results: Observations/Reflections We reflect on how navigating ethics can create barriers to involving YP as primary informants in research. We consider why it is important to overcome these hurdles and how public engagement work with recognised gatekeepers and the use of creative interview methods can facilitate meaningful encounters, where YP feel able to share valuable insights into their lives. Conclusion: Alongside a number of specific learning points, the paper reflects on theories behind research with YP, including the need for recognition of power imbalances and reflexivity. It concludes with thoughts on the practical realities of achieving meaningful participation or an 'authentic voice' with marginalised groups and the importance of this in informing policy and practice. Patient or Public Contribution: The focus of this work was to collect experiences of YP who are recognised as gang‐involved or at risk of being so, with a view to informing health and education policies. The scoping study for the project involved extensive public engagement work with YP exploring and trialling suitable methods of accessing, recruiting and ultimately interviewing this target group. This is central to the discussion within the body of the paper. [ABSTRACT FROM AUTHOR]

Background: Exact quantification of research conducted by dietitians and tracking the effectiveness of interventions or training programs to increase either evidence‐based practice (EBP) or research behaviours have been hampered by the variety of tools used to measure these constructs. Methods: In this narrative review, we identified and classified the various tools previously used to measure constructs related to research and/or EBP in the dietetics profession, and to summarise estimates of the constructs measured. Results: We identified and classified 15 scored tools that had been used at least once in the dietetics profession and extracted tool parameter estimates from 22 resulting papers. We also identified six unscored tools and three qualitative studies. The most frequent constructs measured were attitudes and behaviours. Very few tools measured objective knowledge (skills). No objective measures of research outputs were identified. Several tools were closely related to one another. Conclusions: Even when tools were used across multiple papers, reporting method varied making comparisons difficult. This review should encourage future researchers to utilise existing tools when possible, and encourage the development or adaptation and testing of tools that fill identified gaps. The constructs measured by the tools identified may also provide a starting point for the development of educational interventions aiming to increase research or EBP skills among dietitians. Only by using consistent tools will the dietetics profession be able to track the progress in increasing research conduct and EBP implementation over time. Key points: In this narrative review, we identified 15 scored tools and nine unscored or qualitative tools for assessing research and/or evidence‐based practice knowledge and or conduct by dietitians. No tool was identified as a gold standard. Many tools measured overlapping constructs and/or had evolved over time. Few tools had objective measures of knowledge or behaviour. Researchers should strive to use consistent tools, and develop additional objective measures of these constructs. [ABSTRACT FROM AUTHOR]

Disagreement is a fundamental dimension of social life. In many situations, however, people are reticent to explicitly criticise the actions of others. It follows that if social researchers wish to study differences in people's common sense judgements of other's actions in an interview setting they need to carefully design how discussion of these differences are structured. This paper examines a research project that used context‐specific video clips to structure interviews with users of a communal infrastructural resource. In digging into the practical detail of an interview encounter, the paper contributes to human geography's ongoing conversation about the practicalities of doing interview‐based research. This paper examines a research project that used context specific video clips to structure interviews with users of a communal infrastructural resource. In digging into the practical detail of an interview encounter the paper contributes to human geography's on‐going conversation about the practicalities of doing interview based research. [ABSTRACT FROM AUTHOR]

Emerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper, we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma-related changes in their social identities. Analysis of these accounts highlighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families., (© 2024 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Purpose: This paper explores how frontline nurses experienced the onset of the coronavirus disease (COVID-19) pandemic to provide appropriate care during a global health crisis., Design and Methods: A qualitative descriptive phenomenological study. The sample consisted of 13 frontline nurses from Turkey, working in intensive care units, inpatient clinics and emergency unit. Data were collected online through face-to-face interviews based on a semi-structured interview guide. Data were analysed using thematic analysis., Findings: Nurses experienced certain difficulties in the continuous use of protective personal equipment, communication both with patients and colleagues, administrative processes. Besides, they experienced exhaustion, reduced job satisfaction and certain physical complaints., Conclusions: Hospital administrators and health policy makers should effectively manage human and hospital resources effectively and solve nurses' problems in times of crisis, such as pandemics., Clinical Relevance: Understanding the challenges faced by frontline nurses during the onset of the COVID-19 pandemic may help healthcare practitioners and policy makers to implement targeted interventions, support mechanisms and resource allocation strategies that enhance the well-being of frontline nurses and optimise patient care delivery during health crises., (© 2024 John Wiley & Sons Ltd.)

Introduction: Qualitative approaches have flourished in medical education research. Many research articles use the term 'lived experience' to describe the purpose of their study, yet we have noticed contradictory uses and misrepresentations of this term. In this conceptual paper, we consider three sources of these contradictions and misrepresentations: (1) the conflation of perspectives with experiences; (2) the conflation of experience with lived experience; and (3) the conflation of researching lived experience with phenomenology. We offer suggestions to facilitate more precise use of terminology., Argument: Our starting point is to free researchers from unnecessary shackles: Not every problem in medical education should be studied through experience, nor should every study of experience be phenomenological. Data based on participants' perceptions, beliefs, opinions and thoughts, while based on reflections of experiences, are not in and of themselves accounts of experience. Lived experiences are situated, primal and pre-reflective; perspectives are more abstract. Lived experience-as opposed to experiences as such-deeply attune to bodies, relationality, space and time. There is also a difference between experiences as lived, how a person makes sense of these and what the researcher interprets and represents. Phenomenology is a meaningful approach to the study of lived experience, but other approaches, such as narrative inquiry and self-study, can also offer useful avenues for undertaking this type of research., Discussion: We aim to broaden researchers' scope with this paper and equip researchers with the information they need to be clear about the meaning and use of the terms experience and lived experience. We also hope to open new methodological possibilities for researching experiences as lived and, through highlighting tensions, to prompt researchers of lived experience to strive for ontological closeness and resonance., (© 2024 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Objectives To analyse the contributions of authors from three major regions of China - the Mainland ( ML), Hong Kong ( HK) and Taiwan ( TW) - in the field of health care sciences and services. Methods Articles published by Chinese authors between 1998 and 2012 in the category of health care sciences and services were retrieved from the Science Citation Index Expanded ( scie) database. The numbers of total articles, impact factors, citations, articles included in the top 10 highest impact journals and the 10 journals that published the most papers were recorded. Results ML, HK and TW published 615, 415 and 1162, respectively, with accumulated impact factors of 1281.65, 904.29 and 2361.44; average impact factor of 2.08, 2.18 and 2.03; and total citation times of 2313, 2652, and 4818. Regarding the top 10 high-impact journals, ML, HK and TW accounted for 28.25%, 27.68% and 44.07%, respectively. Total impact factors of the most popular 10 journals for ML, HK and TW were 20.86, 22.08 and 18.92, respectively. Discussion and Conclusions Both the quality and quantity of papers published in health care sciences and services journals from ML, HK and TW have greatly improved. ML and HK have different strong points, while the gap with TW diminished. [ABSTRACT FROM AUTHOR]

Background: Online learning has grown significantly during the past two decades, and COVID‐19 pandemic has expedited this process. However, previous research has shown how academic dishonesty is more prevalent under these modalities. Therefore, there is the challenge of performing trustworthy remote assessments, in order to obtain valid and reliable measures of students' knowledge. Objectives: The research question that drove this research was: what actions have been proposed in contemporary research to improve remote assessment trustworthiness from a technological and pedagogical perspective? Methods: We analysed the papers accepted for the special issue titled 'Trustworthy Assessment and Academic Integrity in Remote Learning' following a deductive qualitative category coding methodology to find the main approaches. Results and conclusions: We identified eight approaches to improve trustworthiness in remote assessment: four for exams and high‐stake tests, one exclusively for performance‐based assessments, and three for any type of assessment. Our findings shift attention from academic dishonesty to trustworthy assessment, integrating recent findings of papers accepted to this special issue. Implications: Our findings deepen current understanding of trustworthy remote assessments, inviting practitioners and researchers to explore different types of assessment methods and different moments related to assessing learning. Lay Description: What is already known about this topic?: Online learning has grown significantly during the last decade.This growth increases the need for online assessment methods that can provide a valid, reliable, and fair measure of student knowledge.Research demonstrated the prevalence of academic dishonesty in online learning.There is a timely need to research and develop methods for trustworthy online assessment, as well as to raise the awareness of researchers, practitioners, and administrators, to the topic and to the solutions at hand. What this paper adds?: A review of the state‐of‐the‐art with respect to trustworthy assessment in online learning.A typology of strategies to improve trustworthy assessment, characterizing the pedagogical approach, technological method, context, and type of assessment.An analysis of different solutions, approaches, and case studies, with respect to the proposed typology.A novel approach to inform the design and implementation of valid and reliable online assessment. The implications for practitioners: The paper presents strategies and approaches for implementing trustworthy assessment in online learning.The paper provides a conceptual framework that can inform the design of valid and reliable assessments methods, and analyse both existing and newly proposed onesHighlighting the importance of including the assessment as an integral part of the instructional design phase of online learning offerings. [ABSTRACT FROM AUTHOR]

Objective: In the context of the Covid‐19 pandemic and subsequent lockdown restrictions, service providers faced significant challenges in delivering programmes to support their vulnerable service users. Foster carers‐an already often isolated group of caregivers ‐ were offered an adapted remote‐delivery model of the Reflective Fostering Programme (Redfern et al., Adopt. Foster., 42, 2018, 234) from March 2020. Method: This paper outlines the adaptation process of the original programme to online‐remote delivery and describes the feedback from participants in the programme. Results: The adaptation of the Reflective Fostering programme to online, remote delivery had both strengths and weaknesses ‐ including wider access to foster carers who might struggle to attend in person and challenge a to maintaining a Mentalizing space online and ensuring confidentiality within a therapeutic space. The programme was overwhelmingly well received by foster carers in this format. Conclusions: There are opportunities and challenges in the delivery of online therapeutic services, particularly those with a group format. This paper contributes initial reflections to what we hope will be a rapidly developing literature on best practice of supporting group services in an online format. [ABSTRACT FROM AUTHOR]

The arrival of migrant children at the US–Mexico border has prompted vigorous debates about how to handle their admission and manage their access to resources. Portrayals of child migrants often draw on dominant conventional notions of childhood, creating binary representations that simultaneously infantilize and adultify them. This binary representation either strips children of their agency or criminalizes their actions and denies them protection. This paper exposes the inadequacies of the infantilization and adultification binary to represent and understand the experiences of child migrants, particularly youth who immigrate as teenagers, through a transdisciplinary approach. Integrating original historical analysis via archival research with contemporary social scientific analysis from qualitative research, this paper examines the longstanding binary representations of migrant children and their harmful impacts. The historical analysis shows that infantilization and adultification have defined the US response to child migrants since the mid‐1960s. Making connections to the present, through the stories of two unaccompanied teenage arrivals, we show how the binary is experienced and how Deferred Action for Childhood Arrivals (DACA) reflects and reinforces the binary. The paper also highlights how young people, who do not fit neatly into the binary, come to subjectively feel adult, elucidating the need for an alternative narrative that embraces child migrants' agency and advocates for support and protection for all youth. [ABSTRACT FROM AUTHOR]

Equal opportunities in the context of education can be interpreted as ensuring equitable access to certain kinds of education (e.g. an academic track) or as equal opportunities to lead a fulfilling life regardless of the educational route followed (e.g. vocational or academic). These interpretations are in tension: the former implies a hierarchy where some forms of education are considered better than others, whereas the latter requires that they are all considered valuable. This paper presents a case study of a secondary school in the Netherlands that pursued both interpretations of equal opportunities and made systemic reforms to achieve this. Building on interviews, focus groups and participant observation with students, staff and management, the paper analyses the tension these actors experienced between the two interpretations of equal opportunities. It is argued that this stems from a societal context that endorses the first interpretation of equal opportunities but aligns less with the second interpretation. The analysis shows that individual institutions like schools have limited power to shift narratives surrounding educational tracks, especially when these do not align with prevailing trends in society. Additionally, the paper underlines the value of applying analysis of different interpretations of equal opportunities, which is usually undertaken by theoretical work, to empirical data. [ABSTRACT FROM AUTHOR]

Introduction: The Activating Lived Experience Leadership (ALEL) project was a South Australian participatory action research project that aimed to improve the ways lived experience is recognised, valued and integrated across mental health and social sector systems. ALEL was completed during 2019–2021, where it engaged 182 participants in generating community action and research knowledge. Objective: Our paper discusses the project's processes of building a collective partnership among lived experience leaders and other leaders from within the sector, so that the actions and strategies identified through research could be implemented by systems‐level impact. We describe the collaborative process and key learnings that resulted in eight key action areas for transformative systems change in South Australia. Methods: The project invited a diverse range of self‐identified lived experience and other leaders to be involved in a PAR process featuring formal qualitative research (focus groups, surveys and interviews) as well as community development activities (leaders' summit meetings, consultations, training and community of practice meetings). These processes were used to help us describe the purpose, achievements and potential of lived experience leadership. Project priorities and systems‐level analysis was also undertaken with lived experience sector leaders and project advisors across two leaders' summit meetings, integrating research outcomes with sector planning to define high‐level actions and a vision for transformational change. Results: Participatory action research as informed by systems change and collective impact strategies assisted the project to generate detailed findings about the experiences and complexities of lived experience leadership, and collective responses of how systems could better support, be accountable to and leverage lived experience perspectives, experience and peer‐work approaches. Conclusion: Systems change to define, value and embed lived experience leadership benefits from collective efforts in both formal research and sector development activities. These can be used to generate foundational understandings and guidance for working together in genuine ways for transforming mental health and social sector systems, experience and outcomes. Public Contribution: Members of lived experience communities codesigned the project, and contributed to project governance and the development of all findings and project reports. [ABSTRACT FROM AUTHOR]

Background: Approximately 4.4 million people in England (8% of the total population) are living with a long‐term neurological condition. Within this group of vulnerable individuals, there will be individuals living with severe spasticity that requires regular outpatient treatment with botulinum toxin injection. The closure of outpatient spasticity services during the pandemic impacted individuals who required spasticity treatment and their carers, as well as the specialist clinicians responsible for service delivery. Objectives: We aimed to gain insight into the experiences of individuals living with spasticity, their carers and a clinical spasticity service lead during the pandemic, and to reflect on potential learning for the future. Methods: A qualitative study was designed using semi‐structured interviews conducted by telephone. Participants comprised patients living with a long‐term neurological condition who attended outpatient spasticity clinics before the start of the pandemic in England, primary carers who accompanied patients attending these clinics and a clinical spasticity service lead. Data were audio recorded, transcribed, anonymised and coded. Data analysis utilised the One Sheet of Paper thematic approach to identify themes, which were discussed and analysed by the interdisciplinary research team and two patient and carer participants. Results: Out of the 11 participants recruited, aged 36–77 years, seven comprised people living with spasticity related to a long‐term neurological condition, three were carers and one was a clinical spasticity service lead. Six participants were male and five were female. Among the participants, four were stroke survivors, two were living with spinal cord injury and one was living with multiple sclerosis. Analysis revealed six major themes: experience of living with spasticity during the pandemic; impact of the pandemic on patient, carer and clinician health; access to and experience of outpatient clinic appointments; coping strategies during the pandemic; system improvements; and learning from the pandemic period. Conclusion: These findings contribute research knowledge to a very limited research knowledge base and suggest that there is scope for improving system and service delivery through the allocation of research funding to senior clinicians working in this specialist area. [ABSTRACT FROM AUTHOR]

Objectives: The overarching aim of this study is to explore, examine and identify the experience that young women with congenital heart disease face as they transition through adolescence into womanhood. Design: This is an empirical qualitative study conducted in the form of three focus groups. The study design and analysis adopted a feminist ontological positioning to elucidate the voice of women and offer an alternative perspective of cardiology health care. Data were analysed using the inductive thematic approach informed by the study aims. Participants: A group of seven female participants (mean age 26) based in the United Kingdom, each with varying degrees of congenital heart defects that required open heart surgery growing up, was included in the study. Results: Three key themes with antecedent concepts emerged: (a) the impact of womanhood and the potential influence of motherhood on the young women themselves transitioning through adolescence with CHD within medical and sociocultural contexts, (b) the challenges of being a woman and undergoing heart surgery during adolescence on the young women's health before, during and after surgery and (c) the effect of existing online/offline healthcare and social structures on women's health during transitioning through adolescence These themes were encompassed under an overarching theme of psychological complexities developed throughout the cardiac journey from diagnosis through to post‐surgery. Conclusion: This study built on the limited exploration of being a young woman and having CHD and confirmed that there are vulnerabilities and challenges in having CHD as a young woman transitioning through adolescence. This was a result of sex (biological characteristics) and gender factors (socially constructed roles). This leads to short‐ and long‐term implications on psychological well‐being. This research indicates that enhancements are needed in the provision of care and psychological support for young women with CHD. This will help to enable women to achieve a good quality of life in addition to increased life expectancy offered by medical advancements. Patient or Public Contribution: Active participant involvement was crucial to ensure the authentic female voice in the study. This study received support from young women with congenital heart disease. Young women contributed to the study design, recruitment of participants and analysis of results. Two of the women were also co‐authors of this paper. [ABSTRACT FROM AUTHOR]