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The purpose of this study was to explore the ways in which in-service physical education teachers construct their self-efficacy beliefs toward teaching students with disabilities in general physical education classes. Using a qualitative descriptive approach situated within self-efficacy theory, data were collected via semistructured audio-recorded interviews with 16 in-service physical educators. Three interrelated themes were constructed: (a) The more I do it, the better I feel: the importance of professional experiences; (b) I've learned from others: the influence of colleagues; and (c) Being in the general educational setting is a challenge: the impact of contextual factors. Findings supported the influence of the four sources of self-efficacy (i.e., mastery experience, vicarious experience, social persuasion, and affective and physiological state), in addition to potential contextual factors (i.e., class sizes and availability of hands-on support), impacting participants' self-efficacy to teach students with disabilities in general physical education classes. [ABSTRACT FROM AUTHOR]

This paper investigates the potential of the Gamified Metaverse as a platform for promoting library services. The study compares the effectiveness of a traditional library program with a Metaverse- based library program in terms of knowledge acquisition and library anxiety. The research also examines students' perceptions of implementing gamification within the context of the Gamified Metaverse platform. A mixed-methods approach was adopted, including pre- and post-test analysis, statistical analysis, and qualitative data collection. The results indicate that both the traditional and Metaverse-based library programs effectively increased the participants' knowledge, with no significant difference between the two approaches. However, the Metaverse-based program was found to be less effective in facilitating interaction with librarians and reducing library anxiety. Additionally, students expressed positive perceptions of implementing gamification in the Gamified Metaverse platform, finding it engaging and motivating. These findings contribute to the understanding of the effect of the Metaverse as a tool for promoting library services and enhancing knowledge acquisition. However, it is not as effective in reducing library anxiety, particularly in terms of interaction with librarians and staff. It should be noted that the platform may have limitations such as high costs and potential side effects of virtual reality, making it more suitable as an additional tool for promoting library services, taking into account its feasibility and potential benefits for specific student populations and larger libraries. [ABSTRACT FROM AUTHOR]

Organizational culture in sports affects well-being, performance, and overall success. Although team culture has been explored within able-bodied teams, little is known about culture development within parasport. Using a descriptive case study approach, our study examined the culture development and experiences of an elite parasport team. Two semistructured individual telephone interviews were conducted with nine participants (athletes and staff), and one athlete-participant completed one interview. An inductive thematic analysis revealed two themes: approach to culture development and team culture components. Culture development was linked with facilitative leadership and important resources. This supported the team to create their shared values and mechanisms, including a behavioral framework, other artifacts (e.g., shared language and team motto), and a relaxed environment. These helped to maintain their agreed culture and benefited their well-being, progress, and team cohesion. Our results offer a starting point regarding research into the culture of elite parasport and have practical implications for managers, coaches, and psychologists. [ABSTRACT FROM AUTHOR]

Projecting authenticity is crucial for athletes engaged in personal branding. Prior scholarship has emphasized the "frontstage" of authenticity: what tactics athletes use to present themselves and how audiences perceive such tactics. But it has not yet examined the "backstage": why athletes pursue authenticity and the strategic considerations involved in such ongoing self-presentations. Using a constructivist grounded theory that draws on interviews with 30 elite athletes engaged in personal branding, we unpack these backstage processes, which are not straightforward but entail an ongoing cycle of authenticity negotiation. Our model of authenticity negotiation identifies conflicting authenticity demands and constraints imposed by various actors, which athletes attempt to resolve over time using a range of authenticity management tactics. By modeling the backstage processes in authenticity negotiation, our research integrates, contextualizes, and suggests extensions to the existing frontstage work on authenticity. It offers guidance to athletes and practitioners on managing athlete brands and stakeholder collaborations. [ABSTRACT FROM AUTHOR]

Despite a growing body of scholarship exploring university–organization collaborations in the sport for development (SfD) field, there has been limited consideration of the experiences of practitioners and partnering organizations in these partnerships. The purpose of this study was to examine their experiences when partnering with academic institutions, programs, scholars, and/or students, with a specific focus on research and evaluation partnerships. Interviews were conducted with 22 participants working at 20 SfD organizations in the United States. Findings were organized into six main categories (e.g., motivations, factors that facilitate or impede collaboration, collaboration outcomes). A conceptual process framework for university–organization collaboration emerged from the data. This study is one of the first in the SfD field to examine practitioners' perspectives of university–organization collaborations centered on research and evaluation activities. The findings help advance the SfD field, identifying the various factors at play as these partnerships are formed, activated, and sustained. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to understand how people with multiple sclerosis experience dual-tasking situations in their everyday lives. Methods: Focus groups involving a total of 11 individuals with multiple sclerosis (eight females and three males) participated in this qualitative inquiry. Participants were asked open-ended questions focused on the nature of and consequences around dual tasking when standing or walking. Reflexive thematic analysis was employed to examine the data. Results: Three themes were generated from the data: (a) Life Is a Dual Task, (b) The Social Divide, and (c) Sacrifices for Stability. Conclusions: This study highlights the significance and impact of dual tasking on the lived experience of adults with multiple sclerosis, furthering the need to more fully examine this phenomenon and potentially improve fall-prevention interventions and facilitate community participation. [ABSTRACT FROM AUTHOR]

This study provides insight into an inclusive program between Special Olympics (SO) and academy football (soccer) players in the United Kingdom from the perspectives of players and facilitators. Qualitative focus groups were conducted across 30 participants (six facilitators, 14 Premier League academy players, and 10 SO players). Focus groups compared stakeholders' experiences of participating in a season-long inclusive football program. Three overarching higher order themes were generated, which highlighted positive outcomes from taking part. SO players provided endorsement for developing friendships and improving football skills, whereas academy players cited the positive impact that SO players had on their mood and motivation. Facilitators reflected on positive player outcomes and subsequent accomplishments. Overall, the findings indicated that this shared experience had psychosocial and football-specific benefits for everyone who participated. Facilitators indicated that these benefits could transition into everyday life but noted that there needs to be further considerations for future programs. [ABSTRACT FROM AUTHOR]

Identifying factors that influence physical activity (PA) among individuals with Down syndrome is essential for PA promotion. Insight can be gained from guardians and health professionals. The purpose of this study was to explore the perspectives of guardians and health professionals on facilitators and barriers of PA in individuals with Down syndrome. Interviews were conducted with 11 guardians (five mothers, four fathers, and two legal guardians) and 11 professionals (four PA specialists, three physical therapists, and four occupational therapists). Grounded theory was applied. Barriers and facilitators fit the levels of the ecological model of health behavior: (a) intrapersonal (perceived rewards), (b) interpersonal (interaction), (c) community (availability of programs), (d) organizational (school systems), and (e) policy (education). Guardians and professionals agreed on the importance of enjoyment, interaction, and programs to promote PA. Differences between groups were identified at the organizational and policy levels. PA in persons with Down syndrome is influenced by interactions between individual and environmental factors. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Nearly 60 million youth ages 6–18 participate in athletics within the United States. Over the last 30 years, the outlook on youth sport participation has drastically changed, resulting in an increased emphasis on performance and college sport participation. These evolving expectations have created a sense of perfectionism, demanding more time and energy to be placed into a single sport, resulting in an increased prevalence of sport specialization, and consequently, an increased rate of injury. Clinical Question: What is the impact of sport specialization on lower-extremity neuromuscular control in female adolescent athletes? Summary of Key Findings: Four studies were included, all comparing movement efficiency and movement patterns among multisport and sport-specialized female adolescent athletes. Three studies showed that sport specialization is associated with lower-extremity biomechanical alterations that are indicative of altered levels of neuromuscular control, which can predispose an individual to an increased risk of injury. One study concluded that no differences in neuromuscular control exist when comparing sport-specialized to multisport adolescent female athletes. Clinical Bottom Line: Sport specialization has the potential to create negative alterations in a female adolescent athletes' lower-extremity biomechanics, leading to the creation of altered levels of neuromuscular control and a possible increased risk for injury. Strength of Recommendation: Level B evidence exists to support the conclusion that sport specialization negatively affects a female adolescent athlete's lower-extremity neuromuscular control. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence indicates that the provision or experience of "variety" may be an important determinant of physical activity behavior. Variety refers to diverse endeavors, opportunities, or tasks and, in the context of physical activity, has been examined as a feature of an activity or environment (i.e., variety support) and an experience (i.e., one's felt experience or perceived variety). Objective: The primary aim of our review was to synthesize studies investigating the provision or experience of variety in physical activity settings on health and well-being, behaviors, and motivation. Our secondary aim was to examine quantitative data reporting on different facets of variety in physical activity settings. Methods: We conducted a systematic search of five electronic databases (Scopus, SPORTDiscus, Science Direct, MEDLINE, and the Human Kinetics Library) to identify studies providing a quantitative or qualitative assessment of variety in physical activity settings. Results: We identified 5,576 potentially relevant articles to examine. After title and abstract screening (and removal of duplicates), 74 articles remained for full-text screening, from which 28 studies were deemed eligible. Our findings from qualitative and quantitative (experimental and cross-sectional) studies demonstrate that the provision and experience of variety relates to participation and engagement in physical activity, motivation for exercise and physical activity, and well-being outcomes. Our results also indicate that the provision of variety can increase enjoyment, interest (i.e., motivation), and adherence to a physical activity program. Conclusion: Our findings support the assertion that variety should be considered during planning, implementation, and evaluation of physical activity programs. Additional experimental studies are needed to gain a better understanding of how elements of physical activity and exercise programs, delivery, and environment can be manipulated to increase variety and foster participation in physical activity. [ABSTRACT FROM AUTHOR]

This article is based on the 2022 Earle F. Zeigler Lecture Award that I presented in Atlanta, Georgia. For this paper, I reflect upon my career as a qualitative sport management researcher, with a specific focus on the mistakes I have made. I have two objectives with this paper. One objective is to advocate for continued learning about and rethinking how we conduct qualitative research. The second objective is to highlight ways in which we, as a field, can improve our qualitative research literacy. In the paper, I discuss eight learnings on the topics of ontologies and epistemologies, research designs, themes, pseudonyms, rigor, generalizability, positionality, and the publisher SAGE. In learning from my mistakes, we can be better consumers, producers, and evaluators of qualitative research. [ABSTRACT FROM AUTHOR]

Sport team licensed merchandise plays an important role in sport fan experiences. Existing work has explored how consumers perceive these items, motivation and consumption habits, and intent to purchase. Extending upon the performative sport fandom framework, this study explores the marketing messages of sport fan merchandise, and the resulting implied gendered and fan performances. Employing a multimodal critical discourse analysis, we analyzed the top 20 T-shirts for men and women for five National College Athletic Association institutions on their official ecommerce sites. By examining the text descriptions, visual images, and messages perceived when combining text and visuals, we found that the marketing messages of clothing items rely heavily on traditional discourses of femininity and masculinity, placing gender performances as more relevant to fan performances for women. Atypical designs suggest alternative gender and fan performances but continue to indicate that gender identity is central to clothing appearance and messaging to consumers. [ABSTRACT FROM AUTHOR]

Schools can support physical education (PE) among students with mobility disabilities (SMDs). However, previous research has indicated that people and resources in the school environment have served as facilitators and barriers to engaging SMDs in PE. Thus, the purpose of this pragmatic, qualitative study was to explore physical educators' perceptions and experiences of teaching SMDs to learn how to develop a PE environment supportive of SMDs. Eleven K-8 PE teachers who taught SMDs engaged in semistructured interviews. A thematic analysis revealed three themes describing facilitators and barriers of a supportive PE environment for SMDs: (a) teacher planning, (b) students in the PE environment, and (c) resources and support. These findings provide context to PE environments for SMDs and highlight a need for increased communication and collaboration with students with or without mobility disabilities, training or professional development for PE teachers to develop skills for adapted PE, and financial and personnel support. [ABSTRACT FROM AUTHOR]

Low morale studies verify the low-morale experience as one caused by repeated, long-term exposure to workplace abuse and neglect, and that the experience has negative and long-term mental health and physical health outcomes for impacted individuals. This qualitative study centers the low-morale experiences of leaders working in libraries of all types. Data confirm the development and outcomes of low morale, validate impact factors that perpetuate workplace abuse and neglect, and reveal impact factors that manifest in low-morale experiences faced by library employees with formal (organizationally conferred) administrative, managerial, or supervisory duties. [ABSTRACT FROM AUTHOR]

Sleep is essential for maintenance and restoration of health, yet studies exploring this in hospitalized children are scarce. In a qualitative study, we assessed the perceived quality of sleep, factors affecting sleep, and the role of health care professionals in the sleep environment for hospitalized children aged 1 to 12 years. Data were obtained from 11 semi-structured, audio-recorded, and verbatim-transcribed interviews with parents, and analyzed using a systematic thematic analysis. The interviews were coded based on iterative assessment of transcripts. Subsequently, categories and interpretative main themes were identified. Four themes emerged: (1) being informed, keeping informed; (2) coordination of care; (3) parents as main advocates for their child's sleep; and (4) environmental disturbers. Parents reported differences in their child's sleep quality during hospital compared with home. Sleep is substantially affected during hospitalization, prompting the need for interventions to improve the quality of sleep of children. Parents provided valuable suggestions for improvements. [ABSTRACT FROM AUTHOR]

The Selkov oscillator was formulated in 1968 and now it is a classical model for studying the glycolysis. It is a differential system of two equations depending on two parameters in dimensionless variables. When the two equations are polynomials we prove that the Selkov system is not Liouvillian integrable. Additionally, we prove that the polynomial Selkov system for any integer n ≥ 1 has nine distinct phase portraits in the Poincaré disk. [ABSTRACT FROM AUTHOR]

Emerging research points to high rates of major psychiatric disorders and chronic medical conditions among autistic adults. However, the unique healthcare needs of autistic adults are often overlooked, perhaps due to limitations in population-level surveillance and widespread public misconceptions about autism in adulthood. Understanding the mechanisms underlying this prevalence of poor health outcomes in autistic adults requires an exploration into the lived experiences of autistic adults across their lifespans. This study uses a qualitative approach to investigate the healthcare experiences of autistic adults. We conducted semi-structured interviews with 23 autistic adults in the United States, ranging in age from 18 to 56 years, seven of whom identified as nonbinary or gender non-conforming. We asked autistic adults about how they manage their health and interact with healthcare systems. Through thematic analysis of the data, barriers to receipt of quality care for autistic adults were identified. Results were then conceptualized through the Systems Engineering Initiative for Patient Safety model of work system and patient safety. Through this model, this study describes the interactions between autistic adults and their healthcare systems, pointing to specific areas for improvement and intervention. Overall, findings advocate for a system-level approach to improving health outcomes of autistic adults. Research has suggested that autistic adults may have a bigger chance of having mental health and physical health conditions such as depression, anxiety, sleep disorders, diabetes, obesity, and heart problems than adults without autism. Unfortunately, the unique healthcare needs of autistic adults are often overlooked, so it is not clear why autistic adults have worse health or what can be done to improve it. This study wants to find out the challenges autistic adults experience in taking care of their health and in going to different doctors. Researchers interviewed autistic adults across the country about their healthcare experiences. The interviewed autistic adults told the researchers about the barriers (things that did not help) and facilitators (things that did help) that impacted whether they received the care they needed. The researchers then organized what they learned from the autistic adults into a model called the Systems Engineering Initiative for Patient Safety model of work system and patient safety. This model explains how different parts of a healthcare system (person, tasks, technology and tools, environment, and organization) interact with one another and impact the healthcare experiences and outcomes of the patients in their care, like autistic adults. Overall, this study advocates for a systems-level approach to improving the healthcare experiences of autistic adults and their health outcomes. [ABSTRACT FROM AUTHOR]

As mental health concerns coupled with inadequate supports have been described as reaching crisis proportions in autistic people, there is a pressing need for accessible and effective support systems. While self-compassion has shown various benefits in the general population, its application in supporting autistic individuals remains limited. This study investigated the experiences of 39 autistic adults who participated in an autism-specific online self-compassion program. The program included a series of five modules which incorporated psychoeducation, meditation, and self-reflective exercises that were completed over a 5-week period. Qualitative data was collected through weekly check-ins and a post-program survey, which underwent thematic analysis through the lens of an autistic researcher resulting in four key themes: the positive impact of self-compassion, challenges faced during the program, recognizing self-compassion as a journey, and the value of program adaptations. These findings shed light on the experiences of autistic adults engaging with self-compassion interventions, highlighting both the benefits and barriers they encountered. The study underscores the importance of developing tailored interventions that consider the unique needs and perspectives of autistic individuals to promote improved mental health outcomes and foster inclusivity. Autistic people often struggle to find the right support for their mental health. We wanted to change that by trying a new approach to help autistic adults with their emotions and well-being. We focused on something called "self-compassion," which is a way of being kind and understanding toward ourselves. This approach has worked well for many people, but we didn't know if it would work for autistic individuals. We invited 39 autistic adults to join an online program that taught them about self-compassion. The program lasted 5 weeks and included educational materials, meditation exercises, and self-reflection activities. We asked the participants for feedback each week and at the end of the program. From their responses, we discovered four important things. First, self-compassion had a big positive impact on the well-being of autistic adults. Second, they faced some challenges during the program. Third, they saw self-compassion as a journey that takes time and practice. Finally, they described how they valued changes to help autistic people engage with the program. Our findings show that self-compassion can really help autistic adults. We learned about the benefits they experienced and the difficulties they faced. Most importantly, we found that personalized support is crucial for autistic individuals. By creating programs that consider their specific needs, we can improve their mental health and make their lives better. [ABSTRACT FROM AUTHOR]

The experiences of autistic parents when interacting with statutory services for their autistic children is not well understood. This study investigates the experiences of autistic parents' interactions with statutory services, including education and healthcare, in relation to their autistic children. Interpretative Phenomenological Analysis was used to investigate their experiences. Ten autistic mothers of autistic children in mainstream education completed semi-structured interviews, which were co-developed with autistic parents. Two superordinate themes were developed: (1) The wider system is the problem and (2) Feeling judged and stigmatised. While Theme 1 demonstrates some similarities in the experiences of autistic parents to that of non-autistic parents in previous studies, theme 2 is unique to autistic parents who may feel that they are being treated differently. These themes indicate the importance of training encouraging a strength-based rather than deficit-based understanding of autism. Participants highlighted the wider system is the problem rather than individual professionals, and that it places some families at a disadvantage. Becoming a parent is an important part of adult life for many people, including autistic people. Many parents of autistic children can find getting the right support for their children difficult. Knowledge is currently poor about how this is experienced by parents who are also autistic themselves. The main researcher is also an autistic parent to an autistic child and other experts by experience were consulted in the development of the study. Ten autistic mothers with autistic children in mainstream education were interviewed about their experiences of seeking support for their autistic children from services such as healthcare and education. Participants talked about finding the overall system being the main problem, rather than the individuals working in it, and about needing to fight to get the right support for their children. These are points that non-autistic parents have also raised before. Participants also talked about feeling judged and stigmatised for being autistic, and about struggling to manage sensory and communication difficulties, which is something that has not been talked about by non-autistic parents. Improving services to offer better support to autistic families is important and can be achieved through better training. This training should be developed and run by autistic adults and focus on positive aspects of autism, rather than negative. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the views of autistic adults on randomised controlled trials, specifically on processes such as randomisation and blinding, to understand the barriers and facilitators for recruiting autistic people to randomised controlled trials involving medications. We conducted one-to-one interviews with 49 autistic adults. Interviews were audio-recorded and analysed thematically. The participants found randomised controlled trial processes acceptable and linked positive attitudes towards randomised controlled trial participation to autistic peoples' heightened sense of fairness and preference for evidence-driven knowledge. However, randomised controlled trial designs may be incompatible with a (1) preference for a controlled predictable world, (2) perceived vulnerability at physical and mental health levels and (3) history of misunderstanding and exclusion, crucially from healthcare professionals. Suggestions that emerged from our findings include efforts to co-produce research to nurture trust and adapting communication practices to improve access to trials. Autistic people are a highly motivated group to work with research teams to mitigate barriers to randomised controlled trial participation. We explored what psychosocial determinants play a role in the acceptability of randomised controlled trials to test interventions to improve quality of life and mental health in autistic adults. The study provides useful information that may help the design and conduct of more accessible trials with and for the autistic community. Large randomised controlled trials are used to test healthcare treatments. Yet there are no large randomised controlled trials on effective treatments for common mental health issues affecting autistic adults. The purpose of this study was to learn what autistic adults think about randomised controlled trials in preparation for a randomised controlled trial testing a medication for anxiety. This means we wanted to know their opinions about the way randomised controlled trials are done, such as how people are chosen to be in the study and how the study is carried out. We did this by talking to 49 autistic adults individually and asking them questions. We found that most of the people we talked to were okay with the way randomised controlled trials are done. They thought it was fair and they liked that it was based on evidence. However, some autistic people might find it hard to take part in randomised controlled trials. Some people did not like the uncertainty of not knowing what treatment they would receive in a randomised controlled trial. Others felt too vulnerable and may have had bad experiences with healthcare in the past. We found that it is important to involve autistic people early on and at every stage when designing a clinical trial. Care about how clear and precise the study communication is will build trust and improve access to research. Our study indicates that it is possible to conduct large randomised controlled trials with and for autistic people. This can ultimately contribute to the improvement of healthcare outcomes for this population. [ABSTRACT FROM AUTHOR]

The article examines how visions of the future were constructed by eight adolescent girls graduating from secondary school under a COVID-19 lockdown in Germany. Employing grounded theory method to analyse interview data, it theorises how the girls under lockdown constructed visions of their future along space and time in terms of traffic mobility, nature and embodied reproduction. The findings indicate that the girls creatively used topic-dependent constructions of space and time to generate hope and control and thereby maintained their agency and an adolescent self-identity for their anticipated futures during the lockdown-present. These findings are then integrated into a theoretical model that introduces the strategy of 'morphing temporality' to describe how the girls constructed hope and control and maintained agency and an adolescent self-identity despite the sudden spatial lockdown constraints. [ABSTRACT FROM AUTHOR]

Background: Advanced practice nurse (APN) roles bring great added value to health systems. However, their integration into the health workforce and the sustainability of the role depend on contextual factors surrounding their implementation. Aim: To explore the contextual factors that influence the organization, implementation, and performance of clinical practice among oncology APNs in Catalonia (Spain). Methods: This is a descriptive qualitative study. A framework of contextual factors was applied to explore the perspectives of 14 oncology APNs in public hospitals in Catalonia by means of semistructured interviews. Data were analyzed according to the thematic analysis approach. The COREQ checklist was used to report the study. Results: APNs in cancer care strongly depend on the hospital environment where they are introduced. Recognition by the multidisciplinary team, the existence of mentoring experiences, and networking between APNs are critical factors that can help or hinder the development and autonomy of the APNs. Likewise, support from nursing managers and directors is decisive in defining the professional profile, establishing accountability mechanisms, and securing financial resources, including economic recognition. Factors related to the external environment can also contribute, including a standardized national APN model and scientific societies. Conclusions: Contextual factors around clinical practice, institutional structures, and professional networks are crucial determinants for adequately integrating APNs at the health system level. Implications for nursing policy: Professional bodies and national nursing organizations should lay the groundwork for defining standards of practice and advocate for specific regulations. In addition, financial recognition and accountability mechanisms to assess the impact of their contribution should be a priority to ensure sustainability and APN satisfaction. [ABSTRACT FROM AUTHOR]

Opioid-related overdose death continues to be a public health crisis in the United States, reaching a new peak in 2021 with more than 100,000 people dying of drug overdose; 75% of these deaths involved an opioid. Naloxone, often known by the brand name Narcan®, can be easily administered to prevent opioid overdose death. While naloxone is a central harm reduction tool, it has generated controversy as discussions of its use have been framed by longstanding stigmas associated with drug use. Critics have framed it as a "moral hazard" that encourages drug use, stigmatizing its distribution and uptake. Harm reductionists have responded by countering misinformation about drug use and harm reduction and humanizing people who use drugs. Social media platforms have become key sites for these debates. These are digital social spaces in which individuals may fuel stigma and/or build community with others by enacting identities, exchanging knowledge, and bonding over shared experiences. TikTok, a video-based platform, has become an active space for community-building around harm reduction. This article examines the experiences of people who post about naloxone on TikTok. We draw on thematic analyses of semistructured, open-ended interviews with 13 TikTok users who tagged posts with #naloxonesaveslives or #narcansaveslives hashtags from June 2020 to April 2023. Specifically, we explore how these individuals understand and leverage TikTok's association, creative, and interactive affordances as "doors" to build harm reduction community and to educate others about drug use and harm reduction. We also explore how they navigate the "traps" of visibility on TikTok that pose challenges to using the platform for harm reduction activism: stigma, burnout, mental distress, and digital silencing. Finally, we consider the implications of our findings for future research and practice related to digital harm reduction activism. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is a common functional gastrointestinal condition. A respectful patient-doctor relationship with good communication is crucial for optimal treatment. Q-methodology is a combination of qualitative and quantitative methods used to study subjectivity. The aim of this study was to compare viewpoints on IBS between patients with IBS and general practitioners (GPs). We conducted a Q-methodology study by including 30 patients and 30 GPs. All participants were asked to complete Q- sorting of 66 statements on IBS using an online software program. Data were processed using factor analysis. In addition, 3 patients and 3 GPs were interviewed. Three factors were extracted from both groups: Patient Factor 1 'Question the diagnosis of IBS', Patient Factor 2 'Lifestyle changes for a physical disorder', Patient Factor 3 'Importance of a diagnosis', GP Factor 1 'Unknown causes of great suffering', GP Factor 2 'Lifestyle changes are important, stress makes IBS worse', GP Factor 3 'Recognized the way IBS affects patients'. There was a strong and statistically significant correlation between patient Factor 1 and GP Factor 1, with a Pearson's r of 0.81 (p < 0.001). Correlations between other factors varied. There was consensus between patients and GPs that IBS is a physical and not a psychiatric disorder of unknown etiology. They also seemed to agree that IBS has a great negative impact on patients' lives and that lifestyle changes are beneficial. There were conflicting opinions regarding gender, cultural factors and the use of antidepressants. [ABSTRACT FROM AUTHOR]

Following a longitudinal study to understand how evidence-based practice evolves during the initial years of occupational therapy (OT) and physiotherapy (PT) practice, we held an end-of-grant symposium with representatives from education, practice, research, and policy. The objectives were to: (1) elicit feedback on the implications of the study results; and (2) co-develop a list of actionable recommendations for each sector. Qualitative participatory approach. The symposium was held over two half days and consisted of a presentation of study findings, a discussion on the implications of the research for each sector and future recommendations. Discussions were audio recorded, transcribed verbatim and analyzed using qualitative thematic analysis. The themes related to implications of the longitudinal study included: (1) A need to rethink what evidence-based practice (EBP) really is; (2) How to practice EBP; and (3) The continuing challenge of measuring EBP. The co-development of actionable recommendations resulted in nine strategies. This study highlighted how we may collectively promote EBP competencies in future OTs and PTs. We generated sector-specific avenues that may be pursued to promote EBP and argued for the importance of pooling efforts from the four sectors so that we may achieve the intended ethos of EBP. There is a need to revisit the definition of evidence-based practice (EBP) and the traditional 3-circle model in rehabilitation to include a broader conceptualization of what constitutes evidence. We recommend using EBP measures as tools for self-reflection and professional development that can support practitioners to be reflective and accountable evidence-based practitioners. Optimal promotion of EBP competencies in occupational therapists and physiotherapists should rest upon collaborative efforts from the education, practice, research, and policy sectors. [ABSTRACT FROM AUTHOR]

Persistent symptoms experienced by adults following mild traumatic brain injury (mTBI) can significantly impact their daily activities. It is often difficult for them to access specialized rehabilitation services. The aim of this study is to explore this population's experience surrounding access to specialized rehabilitation services, including waiting time. This study used a qualitative phenomenological approach and was conducted using semi-structured interviews. Twelve adults with mTBI who had received specialized interdisciplinary rehabilitation services were recruited. The interviews focused on participants' recollection of their patient journey after injury, their perception of waiting, barriers and facilitators to access, and the impacts of these experiences on their condition. Participants reported experiencing symptoms such as anxiety, depression, worry, sadness, and discouragement before accessing specialized services. They all agreed that they did not receive clear information about their recovery process or the health services available to them, which exacerbated their mental health symptoms. The findings show that participants experienced uncertainty because they lacked information regarding recovery and access to health services after their injury. Education about symptoms and recovery, as well as emotional support for people with mTBI should be made available during the waiting period. Adults with persistent post-mild traumatic brain injury (mTBI) symptoms experienced many challenges in accessing health services such as long wait times, which they perceived as impacting their recovery. According to those concerned, more support from qualified health professionals is needed in the first weeks or months following the injury. Participants unanimously support free and timely access to specialized mTBI rehabilitation services. [ABSTRACT FROM AUTHOR]

The evolving virtual health care experience highlights the potential of technology to serve as a way to enhance care. Having virtual options for assessment, consultation and intervention were essential during the coronavirus (COVID-19) pandemic, especially for children with disabilities and their families. The purpose of our study was to describe the benefits and challenges of outpatient virtual care during the pandemic within pediatric rehabilitation. This qualitative study, part of a larger mixed methods project, involved in-depth interviews with 17 participants (10 parents, 2 youth, 5 clinicians) from a Canadian pediatric rehabilitation hospital. We analyzed the data using a thematic approach. Our findings demonstrated three main themes: (1) benefits of virtual care (e.g., continuity of care, convenience, stress reduction and flexibility, and comfort within the home environment and enhanced rapport); (2) challenges related to virtual care (e.g., technical difficulties and lack of technology, environmental distractions and constraints, communication difficulty, and health impacts); and (3) advice for the future of virtual care (i.e., offering choice to families, enhanced communication and addressing health equity issues). Clinicians and hospital leaders should consider addressing the modifiable barriers in accessing and delivering virtual care to optimize its effectiveness. Families are invested in access to virtual care appointments and can benefit from clear communication about choices regarding appointment options and supports in how to access and use technology for equitable access to care. Hospitals should aim to provide clinicians with an appropriate workspace (i.e., private, quiet with adequate room to demonstrate what they need to do), equipment and technology to have virtual care appointments. Current understanding of virtual care delivery suggests a tailored approach, with some types of appointments, such as follow-ups or check-ins, more suited to this modality than other more hands-on therapy. [ABSTRACT FROM AUTHOR]

To examine the applicability and process of change of Cognitive Functional Therapy (CFT) in the management of pain and disability in people with knee osteoarthritis who were offered knee replacement surgery and had risk factors for poor response to surgery. Single-case experimental design with a mixed-methods, repeated measures approach was used to investigate the process of change through CFT in four participants. Qualitative interviews investigated beliefs, behaviours and coping responses, and self-reported measures assessed pain, disability, psychological factors, and function at 25 timepoints. Study registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12619001491156). Qualitative data indicate that CFT promoted helpful changes in all participants, with two responses observed. One reflected a clear shift to a biopsychosocial conceptualisation of osteoarthritis, behavioural re-engagement and the view that a knee replacement was no longer necessary. The other response reflected a mixed conceptualisation with dissonant beliefs about osteoarthritis and its management. Psychological and social factors were identified as potential treatment barriers. Overall, quantitative measures supported the qualitative findings. The process of change varies between and within individuals over time. Psychological and social barriers to treatment have implications for future intervention studies for the management of knee osteoarthritis. Cognitive Functional Therapy is applicable in the management of knee osteoarthritis. Reconceptualisation of osteoarthritis reflected a helpful change. Psychological and social factors emerged as barriers to recovery. [ABSTRACT FROM AUTHOR]

This study explored severe malaria-related disability in children from the perspectives of their caregivers. The interpretive description qualitative approach was employed. The participants were selected using the purposive sampling technique considering the child's history of severe malaria, age (0–10 years), and location (urban/rural). Data were collected through face-to-face interviews with sixteen caregivers. Reflexive thematic data analysis was utilized. Through prolonged engagement, reflective journaling, an audit trail, and co-authors' review, trustworthiness was enhanced. The study generated five themes from the interviews: mitigators of disability, contributors of disability, impact on body function, impact on activities and participation, and uncertainties about future well-being. The findings revealed previously unstudied social components of disability and environmental factors. Furthermore, the research uncovered health-related quality of life aspects that are out of the scope of the current comprehensive disability framework. The study contributes to a deeper understanding of severe malaria-related disability in children from the biopsychosocial perspective. The findings could help policymakers, researchers, and clinicians who want to design rehabilitation interventions for the affected children or examine the components of disability on a large scale using quantitative methods. Various contextual factors interacted with severe malaria and influenced functioning either as facilitators or barriers, implying disability related to malaria can be prevented or created. The long-term impacts of severe malaria are not limited to functioning and disability but also affect the health-related quality of life of children who survive severe malaria. Rehabilitation professionals should consider applying comprehensive functioning and disability frameworks such as the ICF when designing (or applying) screening tools, planning interventions, and evaluating the outcomes of intervention for children with severe malaria-related disability. Rehabilitation interventions for children with severe malaria-related disability should consider patient– or caregiver–reported outcomes (components of disability). [ABSTRACT FROM AUTHOR]

To explore quantitative and qualitative features of anomia in participants with left-hemisphere stroke, Parkinson's disease, or multiple sclerosis. This descriptive cross-sectional study compares signs of anomia within and across participants (n = 87), divided into four groups; moderate to severe anomia after stroke (MSAS, n = 19), mild anomia after stroke (MAS, n = 22), PD (n = 19) and MS (n = 27). Aspects analysed include naming accuracy and speed, the nature of incorrect responses, semantic and phonemic verbal fluency, information content in re-telling, and the relationship between test results and self-reports on word-finding difficulties and communicative participation. All groups had impaired verbal fluency, prolonged response times and reduced information content in re-telling. The MSAS group had significantly more signs of anomia than the other groups. Results from the other groups overlapped on a MAS—PD—MS continuum. Both semantically and phonologically incorrect responses were common in the stroke groups, while semantically incorrect ones predominated in the PD and MS groups. All four groups reported a similar negative impact on self-perceived communicative participation. Correlations between self-reports and test results were inconsistent. Anomia features have quantitative and qualitative similarities and differences across neurological conditions. People with moderate or severe anomia after stroke not only exhibit more severe symptoms of word-finding difficulties but also manifest a wide variety of such symptoms, compared to people with Parkinson's disease or multiple sclerosis. The present findings underscore the need to ask patients about their self-perceived word-finding difficulties. Regardless of the degree of difficulties or the underlying condition, self-perceived word-finding difficulties can have a negative impact on communicative participation and should therefore be appropriately addressed. An assessment comprising aspects such as verbal fluency, connected-speech tasks and the measurement of response times in naming tasks may serve to affirm the self-reported word-finding difficulties. [ABSTRACT FROM AUTHOR]

To describe experiences of improvement among women with chronic widespread pain (CWP). Recruitment was made from a cohort of women with CWP who participated in a 10- to 12-year follow-up study in 2016. The inclusion criterion was an improvement of at least 30% on a visual analog scale of pain intensity between baseline and follow-up. Seventeen women participated in semi-structured interviews. Data were analysed using qualitative content analysis. The analysis resulted in three categories with eight subcategories: Experience of improvement included feeling better despite persisting symptoms and to be capable of more activity. Developing strategies for better health included choosing to act to improve health, developing a constructive mental approach to the illness, and changing one's view of oneself and one's life. Contextual factors supporting improvement included support from healthcare, social support from one's environment, and reduced load in daily life. Experiences of health improvement involved active changes as well as contextual factors. Clinical implications of this study are that increased knowledge regarding pain management, increased physical activity, and reduced stress could contribute to symptom improvement in persons with CWP. The women's own actively chosen changes and contextual factors appear to be important for the improvement of chronic widespread pain. Treatments that contribute to increased knowledge regarding pain management, increased level of physical activity, and reduced stress were found to be of importance for the improvement of chronic widespread pain. Women with chronic widespread pain could be gained by person-centered rehabilitation based on their individual needs and resources. [ABSTRACT FROM AUTHOR]

Introduction: Disposable duodenoscopes and duodenoscopes with disposable endcaps are being used in clinical practice to reduce or eliminate the risk of transmitting infections. The study aim was to assess perceptions and experiences regarding the use of these duodenoscopes among advanced endoscopy fellows in a nationally representative sample. Methods: A 17-item electronic survey was sent to 74 advanced endoscopy training programs. The survey was completed by 50 participants and their responses were included for analysis. Results: Most participants were from academic training programs (82.7%) and identified as being in their 7th year of post graduate training (92%; PGY-7). Participants performed an average of 414 ERCPs. 29% reported difficulty with cannulation using disposable duodenoscopes versus 15.7% with duodenoscopes with disposable endcaps (vs. standard duodenoscope). 96% of trainees perceived disposable duodenoscopes as not cost effective and 92% stated they would not use this device during independent practice. 100% of trainees stated that they would use duodenoscopes with disposable endcaps during independent practice. For their most challenging cases, 90% of trainees preferred using standard reprocessable duodenoscopes while no trainee indicated they would prefer using a disposable duodenoscope in this scenario. 82% of participants stated that disposable duodenoscopes and disposable endcaps should be used exclusively or preferentially for high-risk patients citing cost, functionality, and concerns regarding environmental impact. Discussion: Advanced endoscopy fellows perceive disposable duodenoscopes as impacting technical maneuverability. Concerns about functionality, cost effectiveness and environmental impact are barriers to adoption. [ABSTRACT FROM AUTHOR]

Background: Malignant Gastric Outlet Obstruction (mGOO) has been standardly treated by surgical Gastrojejunostomy (S-GJ) or Endoscopic Stenting (ES). Recently, EUS-Gastrojejunostomy (EUS-GJ) has emerged as an alternative, despite its worldwide diffusion is heterogeneous. The aim of this survey was to assess clinical decision-making around mGOO and to explore current opinions regarding EUS-GJ. Methods: An online survey, spread through social networks and EPC newsletter, was created exploring opinions regarding indications, contraindications, benefits/risks, availability of mGOO treatments; 2 case vignettes explored clinical decision-making in different scenarios. Results: Overall, 290 pancreatologists from 44 countries responded, of whom 35% surgeons and 65% gastroenterologists. The most common treatment for mGOO was ES (86%), followed by laparoscopic GJ (76%). EUS-GJ was accessible to 59% of respondents, with 10% proficient in this technique. Gold-standard treatment for mGOO varied by specialty; 45% of gastroenterologists preferred ES, 20% EUS-GJ, and 10% surgical GJ, while among surgeons, these were 24%, 8%, and 25%, respectively. A higher annual volume of mGOO treated correlated with increased EUS-GJ adoption and reduced surgical advice. For 51%, EUS-GJ will become the primary treatment for mGOO, notably higher among gastroenterologists and high-volume centers. For 14%, EUS-GJ spread will be limited in the future, or used only when ES fails (19%). Life expectancy, disease stage and patient's frailty are the main decision driver in therapeutic choice, whereas future surgical resectability does not contraindicate any treatment for 75%. EUS-GJ's main advantages were its minimally invasive nature and clinical efficacy, offset by its steep learning curve. Conclusions: This survey revealed significant differences in the management of mGOO, depending on specialties, local expertise and treatment volume, suggesting the lack of standardized algorithms. Life expectancy and patients' frailty are the main decision drivers. Regarding EUS-GJ, its availability remains suboptimal, with learning curve as the main perceived barrier. [ABSTRACT FROM AUTHOR]

One of the important elements of teachers' technology integration is Technological Pedagogical Content Knowledge (TPACK). Though there are studies on TPACK, limited information exists about its context element. This gap causes context-isolated studies for TPACK-related research. The aim of this research is to elaborate on science teachers' technology-based lesson practices in terms of contextual factors influencing TPACK. The study participants consisted of 12 science teachers and 7 educational technologists by using snowball sampling. The case study design method was used in this study within the qualitative research paradigm. The data was collected with semi-structured interviews by following the protocol for strategic performance problems. The interviews were examined employing content analysis to reveal the themes. The findings of the study indicated that TPACK is not only a stand-alone knowledge and skills, but also it is context-oriented. The multifaceted factors represent components of a multi-layered structure of the context. These factors can be perceived by the teachers at different levels according to school types. Furthermore, sub-themes of the contextual factors showed complex interrelationships. This study contributes to the literature by revealing the sub-themes of the context and in-depth examination of contextual factors suggested for future studies. [ABSTRACT FROM AUTHOR]

In the early years of the State of Israel (since 1948), education in the Arab sector suffered from discrimination and neglect, and it is only recently (since 2015) that programs have begun reducing these gaps. The aim of the present study was to examine the existence or non-existence of gaps in ability to learn and an in sensations after performing Feldenkrais method exercises. The Feldenkrais method seeks to improve individual ability, through movement. Qualitative and quantitative analyses of the responses of 21 students from the Technion-Israel Institute of Technology, and 18 students from Kaye Academic College of Education, who practiced the method in 14 Feldenkrais lessons, showed no gaps in learning ability, and small gaps in sensations. [ABSTRACT FROM AUTHOR]

Aims and method: There are numerous challenges in the recruitment and retention of the medical workforce in psychiatry. This mixed-methods study examined the role of psychiatry clinical attachments for international medical graduates (IMGs) to enhance recruitment and retention. An online survey was launched to capture views and perceptions of IMGs about clinical attachments. The quantitative and qualitative responses were analysed to elicit findings. Results: In total, 92 responses were received, with respondents commonly from India, Pakistan and Egypt. Respondents were mostly aged 25–34, with ≥3 years of psychiatry experience. Over 80% expressed strong interest in completing a psychiatry clinical attachment and believed it would support career progression. Qualitative data indicated that IMGs hoped to gain clinical experience and understanding of the National Health Service (NHS). They wished for a clearer, simpler process for clinical attachments. Clinical implications: Clinical attachment can be mutually beneficial, providing IMGs with opportunity to confidently start their psychiatry career in the UK and enhance medical recruitment in mental health services across the NHS. [ABSTRACT FROM AUTHOR]

Aims and method: The prevalence of delaying psychiatric care until the patient has received 'medical clearance', and the definitions and understanding of 'medical clearance' terminology by relevant clinicians, are largely unknown. In a service evaluation of adult liaison psychiatry services across England, we explore the prevalence, definitions and understanding of 'medical clearance' terminology in three parallel studies: (a) an analysis of trust policies, (b) a survey of liaison psychiatry services and (c) a survey of referring junior doctors. Content and thematic analyses were performed. Results: ' Medical clearance' terminology was used in the majority of trust policies, reported as a referral criterion by many liaison psychiatry services and had been encountered by most referring doctors. 'Medical clearance' was identified as a common barrier to liaison psychiatry referral. Terms were inconsistently used and poorly defined. Clinical implications: Many liaison psychiatry services seem not to comply with guidance promoting parallel assessment. This may affect parity of physical and mental healthcare provision. [ABSTRACT FROM AUTHOR]

This paper presents the results of qualitative research on academic inbreeding in Czech higher education, the first of its kind. Its focus is on exploring the significance of academic inbreeding, its types, practices, and possible solutions. The research for this paper was done among academic staff at eight institutions of higher education in the Czech Republic. It was conceptually informed by ideas about different types of inbred employees (immobile, mobile, silver-corded, and adherent) and available policy tools. The results show that academic inbreeding has long flown under the radar as an issue. Its impact is perceived ambivalently, as both positive and negative, by academics and experts alike. Generally, its avoidance has not been taken into account in staff recruitment, which has allowed it to become widespread among Czech higher education institutions. The policy tools for combatting academic inbreeding include nodality (open recruitment), reorganization of recruitment procedures, capacity-building (including stays abroad), and hortatory proclamations (paying attention to the issue). Overall, the evidence gathered in the course of research suggests that some progress has been made in limiting academic inbreeding at some workplaces, and that what we would call purely immobile inbred employees are giving way to mobile and "silver-corded" inbred academic staff. Finally, Czech higher education institutions register few cases of pseudo-inbreeding, combining work at the same institution where a PhD was taken with an academically relevant position in a state research institute or the Academy of Sciences. [ABSTRACT FROM AUTHOR]

Rationale: The shift toward virtual academic detailing (AD) was accelerated by the COVID‐19 pandemic. Aims and Objectives: We aimed to examine the role of external, contextual, and intrinsic programme‐specific factors in virtual engagement of healthcare providers (HCPs) and delivery of AD. Methods: AD groups throughout North America were contacted to participate in semistructured interviews. An interview guide was constructed by adapting the Consolidated Framework for Implementation Research (CFIR). A point of emphasis included strategies AD groups employed for provider engagement while implementing virtual AD programmes. Independent coders conducted qualitative analysis using the framework method. Results: Fifteen AD groups from Canada (n = 3) and the United States (n = 12) participated. Technological issues and training detailers and HCPs were challenges during the transition to virtual AD visits. Restrictions on in‐person activities during the pandemic created difficulties engaging HCPs and fewer AD visits. Continuing education was one strategy to incentivize participation, but credits were often not claimed by HCPs. Groups with established networks and prior experience with virtual AD leveraged connections to mitigate disruptions and continue AD visits. Other facilitators included emphasizing contemporary topics, including opioid education beyond fundamental guidelines. Virtual AD had the additional benefit of expanding geographic reach and flexible scheduling with providers. Conclusions: AD groups across North America have shifted to virtual outreach and delivery strategies. This trend toward virtual AD may aid outreach to vulnerable rural communities, improving health equity. More research is needed on the effectiveness of virtual AD and its future implications. [ABSTRACT FROM AUTHOR]

Rationale: Body image undergoes significant changes during pregnancy, marking a pivotal phase in a woman's life. Aim and Objective: This study aimed to explore the body image perceptions of primiparous pregnant women during their third trimester. Methods: Employing a qualitative research approach grounded in phenomenology, the study involved interviews to explore the experiences of primiparous pregnant women in their third trimester. The interviews were conducted via an online platform, with a sample group of 13 participants chosen through purposive sampling. Data analysis followed a content analysis approach, with the information being transferred to MAXQDA Analytics Pro Qualitative Data Analysis Programme for coding. The study adhered to the reporting guidelines outlined in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: Systematic analysis of the interview transcripts led to the identification of three main themes under the overarching framework of body image experiences among primiparous pregnant women during the third trimester: Physical Changes, Mental Changes, and Behavioural and Social Changes. Among the identified themes, pregnant women demonstrated a relatively lower level of discourse regarding Physical Changes, in contrast to a significant emphasis on Mental Changes. Within the latter theme, pregnant women exhibited significant dissatisfaction with their pregnancy experiences significantly. Conclusion: It was determined that pregnant women experience physical and psychological changes related to body image during pregnancy. [ABSTRACT FROM AUTHOR]