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BACKGROUND: Ambulatory access to academic medical centers (AMCs) for patients insured with Medi-Cal (i.e., Medicaid in California) is understudied, particularly among the 85% of beneficiaries enrolled in managed care plans. As more AMCs develop partnerships with these plans, data on patient experiences of access to care and quality are needed to guide patient-centered improvements in care delivery. METHODS: The authors conducted semi-structured, qualitative interviews with Medi-Cal-insured patients with initial visits at a large, urban AMC during 2022. Participant recruitment was informed by a database of ambulatory Medi-Cal encounters. The interview guide covered Medi-Cal enrollment, scheduling, and visit experience. Interviews were transcribed and inductively coded, then organized into themes across four domains: access, affordability, patient-provider interactions, and continuity. RESULTS: Twenty participant interviews were completed (55% female, 85% English speaking, 80% self-identified minority or other race, and 30% Hispanic or Latino) with primary and/or specialty care visits. Within the access domain, participants reported delays with Medi-Cal enrollment and access to specialist care or testing, though appointment scheduling was reported to be easy. Affordability concerns included out-of-pocket medical and parking costs, and missed income when patients or families skipped work to facilitate care coordination. Participants considered clear, bilateral communication with providers fundamental to positive patient-provider interactions. Some participants perceived discrimination by providers based on their insurance status. Participants valued continuity, but experienced frustration arising from frequent and unexpected health plan changes that disrupted care with their established AMC providers. CONCLUSIONS: The missions of AMCs typically focus on clinical care, education, research, and equity. However, reports from Medi-Cal insured patients receiving care at AMCs highlight their stress and confusion related to inconsistent provider access, uncompensated costs, variability in perceptions of quality, and fragmented care. Recommendations based upon patient-reported concerns suggest opportunities for AMC health system-level improvements that are compatible with AMC missions.

BackgroundA longer duration of untreated psychosis (DUP) is associated with poorer treatment outcomes. Screening for psychosis spectrum disorders in the primary care setting could help support the earlier detection and treatment of individuals in need. However, the acceptability of screening for psychosis in this setting as part of routine care is currently unknown.MethodsWe conducted a qualitative interview study with providers and service users who participated in an early psychosis screening program conducted in an integrated behavioral health primary care (IBH-PC) setting. Interviews were recruited from one of eight WellSpace Federally Qualified Health Center IBH-PC clinics in the Sacramento, CA area. Transcripts of the recorded interviews were analyzed using thematic analysis.ResultsIn total, 12 providers and eight service users participated in the interviews. Most service user and provider participants were supportive of psychosis screening in an IBH-PC setting, but not as part of the general practitioner consultation due to the brief, non-behavioral health nature of many of the appointments, and the expected low prevalence of psychosis in this population. The support of leadership, adequate training and support, staff turnover, and organizational changes were all seen to impact the successful implementation of the program. Different barriers and facilitators were considered important at each stage of the process from introducing the screening procedures to service users; to determining when, where, and how to screen; and how to effectively manage the referral and post-referral stages.ConclusionsDespite the additional challenges of screening in an IBH-PC setting relative to secondary mental health services, the process was considered acceptable and feasible to providers and service users. Services that plan to conduct psychosis screening in their clinics need to consider the challenges and their potential solutions to implementation at each stage of the screening process.

Intimate partner violence (IPV) is a major criminal, social and public health problem. As one effort to prevent IPV and intimate partner homicide, several countries have adopted legislation requiring professionals to disclose IPV to the authorities (commonly referred to as mandatory reporting). The child welfare service (CWS) is centrally positioned for detecting, reporting and preventing IPV, but there is limited empirical knowledge concerning how the service handles IPV cases or of social workers' awareness of mandatory reporting of IPV. Using qualitative interviews, we explore how CWS workers in Norway describe their discretionary space and mandatory obligations towards adults subjected to IPV. Our findings indicate an inexpedient interplay between understandings of professional mandate and individual responsibility and local routines and organisation and insufficient knowledge about IPV and mandatory reporting. We suggest that a reframing of CWS workers' understanding of their discretionary space is needed to ensure that their individual responsibility towards adults subjected to IPV is understood as part of their mandate. This reframing presupposes structural efforts, such as formal training. We propose further investigations concerning how local organisation and routines either facilitate or interfere with systematic and thorough handling of IPV in families with which the municipal CWS meets. [ABSTRACT FROM AUTHOR]

In situations where parents do not accept support while their family situation is assessed as unsafe (for instance in cases of child abuse and neglect), it is sometimes necessary to offer mandatory support to families. The aim of the current study is to investigate how parents perceive the results of mandatory support from Child Protection Services (CPS) and which elements of the mandatory support parents mark as crucial for the results of the support. In‐depth semi‐structured interviews were conducted with 18 parents. Parents report mixed feelings about the results of the mandatory support. According to parents, reaching alignment with professionals about the problem definition, as well as the aims of CPS at the start of mandatory CPS, is a crucial element contributing to results of CPS. Additionally, the perceived quality of the support (both on the organizational and professional level) is simultaneous important conditions for a positive view on the support of parents. Implications for practice include the importance of multi‐directed partiality of professionals to reach an agreement about the problems definition and the aims of the mandatory CPS involvement. [ABSTRACT FROM AUTHOR]

Objective: As an increasing number of children are identified as insufficiently physically active, the school environment has been targeted for efforts to promote physical activity (PA) among inactive children. While research has highlighted teachers' role in promoting generic school-based daily PA, less is known about the early childhood education teachers' experiences of physically inactive children and the strategies they use to promote PA. This study's aim was to explore early childhood education teachers in Sweden's experiences of physically inactive children and their strategies to promote PA among members of this group in their everyday school settings. Design: Qualitative interview study. Setting: Four small municipalities in Midwest Sweden. Method: Ten teachers working in early childhood education settings participated in individual semi-structured interviews. Data were analysed with a focus on teacher agency and the social, material and cultural resources teachers used to promote PA. Result: Findings indicated that teachers shoulder the worry and unarticulated responsibility for inactive children. This resulted in their use of strategies that varied and which were largely subjective in character. At the same time, teachers expressed how their agency was limited by insufficient resources. Conclusion: Teachers used social, material and cultural resources to promote PA, but their strategies were not informed by evidence or formal guidelines. None of the resources they used were specifically designed for inactive children. Instead, teachers used general resources which they adapted to inactive children's interests and needs. [ABSTRACT FROM AUTHOR]

Aim Method Findings The experience of being a patient has been regarded as one of the principal means through which psychotherapists' skills and personal qualities have been nurtured. While it has been hard to demonstrate the effects of therapist personal therapy on patient outcomes, qualitative studies suggest that many practitioners regard personal therapy as highly valuable. The aim of this study was to explore the meaning of personal therapy in relation to a broader contextual understanding of therapist life experience and practice.In‐depth qualitative interviews were conducted with 15 mid‐career therapists and analysed using a hermeneutic, phenomenologically informed thematic approach.Participants typically reported that they had received therapy prior to entering training in order to address symptoms and/or life problems. In addition, many had been in therapy at later points in their life, as part of training programmes. The experience of an accepting and authentic therapy relationship has helped them to become more generous towards others and more able to set boundaries. Expressing vulnerability in a patient role made them feel safer in prioritising presence with their own patients. They also reflected that their therapist became a useful internalised point of reference and that disappointments in their therapies had sensitised them to what can be hurtful for patients. These themes are examined in relation to findings from analyses of how these therapists interacted with their own patients. Implications are discussed for understanding the contribution of personal therapy to therapist development, and in relation to the conduct of therapy outcome research as a whole. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONEarly supported discharge (ESD) aims to enable the transition of care from specialised stroke units to patients’ homes. Even though ESD is well-researched, little is known about the experiences faced by persons with stroke in very early supported discharge (VESD). The aim of this study was to understand these experiences when participating in a VESD rehabilitation program.Qualitative individual and semi-structured interviews were held (at 3 months post-discharge) with stroke survivors discharged home at a very early stage and participating in a VESD programme. A thematic analysis process was applied.Nine participants living in Sweden and following a mild or moderate stroke expressed their narratives through the following themes: “The importance of the VESD team intervention during the initial home rehabilitation”; “Everyday life was perceived as a struggle depending on close relatives”; “Experiencing problems with fatigue and low energy” and “Feeling angrier or more worried in everyday life”Home-based VESD rehabilitation was important for increasing patients’ sense of independence and control in daily life, while at the same time making them feel secure in the support from the rehabilitation team. Future research may investigate how VESD functions in other countries and healthcare systems.People following a stroke seem positive to rehabilitate in their familiar home environment when working towards personalised goals with the support of a rehabilitation team.Through Very Early Supported Discharge people with stroke may experience engagement and motivation in their own rehabilitation process from the onset.Very Early Supported Discharge tends to encourage family members to be supportive and involved in the rehabilitation early after a stroke.Early rehabilitation in a home environment may enhance the individuals’ feelings of self-reliance and independence. [ABSTRACT FROM AUTHOR]

The last decades have witnessed a widespread rise in populist, right-wing, anti-gender movements targeting gender-equality politics and gender studies throughout Europe. While the situation for Swedish gender studies remains relatively stable, with institutionalized gender departments, this paper focuses on how Swedish gender studies scholars conceive of their situation and the status of gender studies in the current era. Through an interview study drawing on the concept of “affective atmosphere”, the article explores how the anti-gender discourse induces a precarious situation that produces a sense of apocalypse and a crisis of hope for gender studies. As such, the anti-gender discourse calls upon scholars to react and engage. In the interviews, the future of gender studies was discussed as being at risk, while at the same time the interviewees described gender studies as an academic success story. However, to avoid falling into the trap of being either too optimistic or too pessimistic about the current state of the art, the authors argue that the knowledge production of gender studies as such can be reconfigured as a site for resistance, for detecting openings and creating possible pathways into the future that extend beyond the hegemonic neoliberal, authoritarian one. [ABSTRACT FROM AUTHOR]

Background: Outcome measures are crucial to support a treat-to-target approach to rheumatoid arthritis (RA) care, yet their integration into clinical practice remains inconsistent. We developed an Electronic Heath Record-integrated, patient-facing side-car application to display RA outcomes (disease activity, functional status, pain scores), medications, and lab results during clinical visits ("RA PRO Dashboard"). The study aimed to evaluate patient perceptions and attitudes towards the implementation of a novel patient-facing dashboard during clinical visits using a mixed-methods approach. Methods: RA patients whose clinicians used the dashboard at least once during their clinical visit were invited to complete a survey regarding its usefulness in care. We also conducted semi-structured interviews with a subset of patients to assess their perceptions of the dashboard. The interviews were transcribed verbatim and analyzed thematically using deductive and inductive techniques. Emerging themes and subthemes were organized into four domains of the Ecological Model of Health. Results: Out of 173 survey respondents, 79% were interested in seeing the dashboard again at a future visit, 71% felt it improved their understanding of their disease, and 65% believed it helped with decision-making about their RA care. Many patients reported that the dashboard helped them discuss their RA symptoms (76%) and medications (72%) with their clinician. Interviews with 29 RA patients revealed 10 key themes: the dashboard was perceived as a valuable visual tool that improved patients' understanding of RA outcome measures, enhanced their involvement in care, and increased their trust in clinicians and the clinic. Common reported limitations included concerns about reliability of RA outcome questionnaires for some RA patients and inconsistent collection and explanation of these measures by clinicians. Conclusions: In both the quantitative and qualitative components of the study, patients reported that the dashboard improved their understanding of their RA, enhanced patient-clinician communication, supported shared decision-making, and increased patient engagement in care. These findings support the use of dashboards or similar data visualization tools in RA care and can be used in future interventions to address challenges in data collection and patient education. [ABSTRACT FROM AUTHOR]

Background: At present, there are no specific guidelines for the treatment of diabetes in palliative care in Norway. The aim of this study was therefore to explore healthcare professionals' experiences of providing palliative care to individuals with diabetes in specialist as well as primary care settings. Methods: We interviewed 12 healthcare professionals from two palliative care units in specialist healthcare, one hospice unit in a nursing home, and one dietary care unit providing counselling in the municipality in the eastern part of Norway. Thematic analysis was used to analyze the data. Results: Our analysis generated three main themes: 1) "Quality of life is the main focus", which showed that the healthcare professionals' main focus was on comforting patients through engagement and communication; 2) "An individualized approach", emphasizing that the treatment was tailored to the unique circumstances of each individual and considered factors such as life expectancy, difficult blood glucose control, and multidisciplinary collaboration, and 3) "Diabetes in the background", which highlighted that they had a modest focus on diabetes. Diabetes was seen as another aspect of health that they had to be aware of, but their limited knowledge of diabetes guidelines, technical tools, and treatment choices underscored that attentiveness to the diabetes treatment was not prominent. Conclusion: The findings show that a lack of guidelines allowed for diverse approaches to the treatment of patients with diabetes in palliative care. Attentiveness to diabetes was based on the individual healthcare professionals' experience and expertise, professional views, and the circumstances of each individual. [ABSTRACT FROM AUTHOR]

Background: Advance research directives (ARDs) provide a promising way to involve individuals with mild cognitive impairment (MCI) in research decisions before they lose the capacity to consent. At the same time, the views of people with MCI on ARDs are underexplored. This study assesses the perceptions of people with MCI and family members on the benefits and challenges associated with ARDs. Aims: The aim of this study was to investigate the perspectives of individuals with MCI and family members of individuals with MCI on ARDs. We focus specifically on willingness to participate in nontherapeutic research, understanding of ARDs and the ethical considerations involved. Methods: Thirteen open-ended, face-to-face interviews were conducted using a semi-structured format. Seven interviews were conducted with individuals with MCI, and six with family members of individuals with MCI. The narratives were transcribed verbatim and qualitative content analysis was carried out. Results: Research participation and ARDs were viewed positively, largely based on altruistic motives and the desire to contribute to society. The participants recognized the potential advantages of ARDs in reducing the decision-making burden on family members and maintaining personal autonomy. They also highlighted challenges in comprehending ARDs and navigating the complexities surrounding potential conflicts between current preferences versus preferences described in an ARD.Conclusions: ARDs were predominantly seen as valuable instruments that enable individuals with MCI to participate in research. This study provides insights into the reasons why affected individuals are interested in drafting ARDs. These insights can guide the development of supportive interventions that are tailored to assist individuals with MCI and their families in navigating ARD processes. [ABSTRACT FROM AUTHOR]

The control function of reception centers hinders asylum seekers' settlement to their host communities. Even though open accommodation centers compose the majority of the European reception system, few studies have comprehensively analyzed their controlling aspects from the asylum seeker perspective. In this article, we examine asylum seekers' experiences of confinement in Finnish reception centers by using semi-structured and individual interviews (n = 28). We identified three "layers" of confinement in asylum seekers' accounts: spatial, service-based, and communicative. Together, these permeable but overlapping and accumulative layers define asylum seekers' experiences by hampering their efforts to participate in local communities and reducing their autonomy. [ABSTRACT FROM AUTHOR]

Rapport is generally considered an essential component of successful interviewing, where participants are willing to share and divulge information. The present paper contributes to the research on rapport in qualitative interviewing by exploring ethical tensions that researchers may experience when conducting qualitative interviews with vulnerable participants. The analysis is based on semi-structured interviews with nine researchers from various fields within social sciences who had extensive experience in doing research with diverse vulnerable groups. We identified six ethical tensions related to building rapport with people in vulnerable life situations that cover issues concerning both too little and too much rapport. Findings illustrate that rapport as the 'ideal' for the researcher-participant relationship may need nuancing. The study concludes that researchers undertaking qualitative interviews on sensitive topics need to have a conscious awareness of ethical tensions that may arise when building rapport with their participants [ABSTRACT FROM AUTHOR]

Background: Compulsive exercise is common in eating disorders (EDs), but a systematic treatment model is lacking. The CompuLsive Exercise Activity TheraPy (LEAP) is a cognitive behavioral therapy treatment for compulsive exercise in EDs, delivered by trained therapists in groups over four consecutive weeks (8 groupsessions and 1 individual session), aiming to promote healthy physical activity. LEAP is currently evaluated in a randomized efficacy trial. In parallel, it is crucial to learn more about how it is perceived by qualitatively investigating participants' subjective experiences. Methods: Nine patients with various EDs participating in the LEAP trial were interviewed about their experiences of taking part in LEAP and about compulsive exercise as an ED symptom using a semi-structured interview guide. The interview transcripts were analyzed according to thematic analysis. Results: The informants expressed that compulsive exercise had not been addressed in their standard ED treatment and that LEAP as such provided an important complement, spurring reflection, awareness, and changed feelings and behaviors in relation to compulsive exercise. Initially, increased PA was triggered for some, but this side effect was transitory. A wish for more treatment time, in terms of longer or additional sessions, was expressed. Conclusions: Overall, LEAP seemed to fill an important treatment need and seemed both acceptable and feasible to patients. However, treatment time and the initial increase in PA may need further investigation and attention in order to optimize this treatment. Trial registration: The trial is registered with the ISRCTN registry (registration date 20200325), trial ID ISRCTN80711391. Plain English summary: Compulsive exercise (CE) is very common in individuals with eating disorders (EDs) often tightly connected with the eating pathology. Even so, most standard treatments do not specifically target CE, leaving patients without strategies to normalize their exercise. The CompuLsive Exercise Activity TheraPy (LEAP) is delivered as an adjunctive treatment to standard ED treatment (targeting CE in patients with EDs. In this study, nine former LEAP patients were interviewed about their experiences of taking part in LEAP and about CE as an ED symptom. The informants were in general satisfied with LEAP and indicated that participation had positive effects on their exercise-related thoughts and attitudes, as well as actual exercise behaviors. They all experienced that CE was not addressed in their standard treatment, although they were motivated to work towards changing it. LEAP was therefore viewed as an important complement. Participating in LEAP initially triggered some informants to exercise more, which fortunately ceased over time and is similar to the temporal negative effect (increased food occupation) often observed initially in cognitive behavioral therapy for eating disorders. The content of LEAP was experienced as valid, informative, and eye-opening, and being able to discuss CE-related topics in a group setting was for many a positive experience. The experiences expressed in this study are very useful for continued development of LEAP. Although preliminary, the results also suggest that LEAP may be a valuable add-on treatment within ED care. [ABSTRACT FROM AUTHOR]

Previous studies have investigated the impacts of high-rise living on neighbourhood social interactions, yet this body of literature does not focus explicitly on intergenerational interactions, which are associated with distinctive benefits for older and younger generations. This qualitative study investigated how younger and older people interact in high-rise neighbourhoods, and identified the factors that hinder intergenerational interactions, through in-depth interviews with 23 young adults and 26 older people in Hong Kong. The findings revealed that the two generations rarely interact, partly due to generational differences in the use of public spaces, and partly due to socio-cultural factors, especially the pervasive culture of digital communication among younger people, and aversion to small talk in public spaces. The findings also highlighted the potential of new forms of interdependency-oriented interventions in enhancing intergenerational support, while respecting residents' desire for privacy. These findings highlight the need for culturally-sensitive interventions, in order to foster meaningful intergenerational interactions in high-rise neighbourhoods across different cultural contexts. [ABSTRACT FROM AUTHOR]

AbstractThis study aims to explore how travel serves as a tool for trauma recovery, aiding individuals in coping with psychological trauma and promoting mental health. We adopted a pragmatic mixed-methods approach, conducting two complementary studies: qualitative interviews with individuals who have experienced trauma and a quantitative survey. The qualitative interviews reveal the mechanisms and key factors of travel in the trauma recovery process. Based on the interview data, we constructed a conceptual model that includes latent variables such as travel experience, emotional regulation, self-reflection, social support, and trauma recovery. This model was subsequently validated through a quantitative survey study using Partial Least Squares Structural Equation Modeling. The results indicate that travel significantly promotes trauma recovery by providing a restorative environment, facilitating emotional regulation, and enhancing social interaction. This study provides new insights into the role of travel in trauma recovery and offers practical guidance for mental health interventions. [ABSTRACT FROM AUTHOR]

Burnout among psychotherapists is a pervasive challenge affecting both professional well-being and client care. This study aims to explore the experience of burnout among integrative psychotherapists and examine the strategies they employ to cope with this phenomenon. Interviews were conducted with 17 integrative psychotherapists, and the data were analyzed using Braun and Clarke's six-step thematic analysis. Through this analysis, two themes were identified: (1) work-related pressures and burnout manifestations and (2) strategies for maintaining optimal functioning. Fatigue, headaches, challenges in decision-making or session planning, numbness in the form of paralysis, and disconnection from clients emerged as primary symptoms, impacting therapeutic efficacy. Participants' intense sense of responsibility toward clients and their self-worth validation through client progress intensified burnout risks, particularly among novices. Personal therapy and clinical supervision emerged as pivotal in mitigating burnout, offering support, and enhancing therapist resilience. Additionally, peer support and organizational interventions were deemed crucial during crises, emphasizing the need for structured support systems within professional bodies. These findings contribute to a deeper understanding of burnout in psychotherapy and highlight the need for targeted interventions to enhance professionals' resilience and sustain effective client outcomes. [ABSTRACT FROM AUTHOR]

Introduction: There is a growing need for alternative forms of care to address citizen demands and ensure a competent healthcare workforce across municipalities and regions. One of these forms of care is the use of mobile care units. The aim of the current study was to describe physicians and nurses experiences of providing care to patients within a mobile care unit in Sweden. Method: Data were collected between March 2022 and January 2023 through qualitative interviews with 14 physicians and nurses employed in various mobile care units in different regions in Sweden. These interviews were transcribed verbatim and subjected to content analysis, with the study adhering to the Standards for Reporting Qualitative Research (SRQR). Results: The analysis resulted in two main categories: "Unlocking the potential of mobile care", and "The challenges of moving hospitals to patients' homes"; and seven subcategories. The respondents viewed mobile care at home as highly advantageous, positively impacting both patients and caregivers. They believed their contributions enhanced patients' well-being, fostering a welcoming atmosphere. They also noted receiving more quality time for each patient, enabling thorough assessments, and promoting a person-centered approach, which resulted in more gratifying mutual relationships. However, they experienced that mobile care also had challenges such as geographical limitations, limited opening hours and logistical complexity, which can lead to less equitable and efficient care. Conclusions: Physicians and nurses in mobile care units emphasized positive outcomes, contributing to patient well-being through a person-centered approach. They highlighted increased quality time, comprehensive assessments, and overall satisfaction, praising the mobile care unit's unique continuity for enhancing safety and fostering meaningful relationships in the patient's home environment. In order for mobile care to develop and become a natural part of healthcare, challenges such as geographical limitations and logistics need to be addressed. [ABSTRACT FROM AUTHOR]

Background: Chronic cough, a cough lasting >8 weeks, includes refractory chronic cough (RCC) and unexplained chronic cough (UCC). Patient-reported outcome (PRO) measures are needed to better understand chronic cough impacts that matter most to patients. The 19-item Leicester Cough Questionnaire (LCQ), an existing PRO measure of chronic cough, assesses impacts of cough across physical, psychological, and social domains. However, the content validity of the LCQ evaluating these concepts in patients with RCC/UCC had not been established. Objectives: To evaluate the content validity of the LCQ in patients with RCC/UCC. Design: A cross-sectional, qualitative interview study. Methods: First, previously completed qualitative interview results in adults with RCC/UCC (N = 30) were evaluated and mapped to LCQ concepts. Next, a clinical cough expert reviewed each LCQ item and assessed the salience of its concepts for patients with RCC/UCC. Finally, semistructured interviews—including both concept elicitation and cognitive debriefing—were conducted in adults with RCC/UCC (N = 20) to elicit a comprehensive set of participant experiences and to assess the appropriateness of using the LCQ in this population. Results: Concepts reported in the past and present qualitative interviews were included across all LCQ items, and most impacts reported to be the "most bothersome" were assessed in the LCQ. In the current study, all participants indicated that reduced cough frequency would be an important treatment target. During cognitive debriefing, each LCQ item was endorsed by ⩾70% of participants. Additionally, participants were generally able to understand, recall, and select a response for each LCQ item. All participants and the clinical expert indicated that the LCQ was appropriate and assessed the impacts most relevant to patients with RCC/UCC. Conclusion: Our findings support the content validity of the LCQ and demonstrate that this measure is fit-for-purpose and includes important cough impacts in adults with RCC/UCC. [ABSTRACT FROM AUTHOR]

Adolescents' supportive relationships with nonparental adults are beneficial when they are close and have trust, but few studies explore how adolescents believe closeness and trust unfold over time. I propose a method for prompting adolescents to retrospectively describe the development of abstract components of such relationships by sharing a study that used interviewee‐created graphing to prompt adolescents to move from concrete parts of the relationship to abstract concepts using a tool adolescents would be familiar with from math classes. Analyses using Venn diagrams and matrices suggested adolescents conceptualized closeness and trust differently, however, this was shaped by whether the adult was a part of their family. Reflections on how the proposed graphing method can effectively be used will be discussed. [ABSTRACT FROM AUTHOR]

The issue of grade inflation has been studied in many countries across the globe, yet it remains under-researched in Pakistan. This study aims to understand grade inflation in Pakistani universities by examining the contributing factors and its consequences. The data for this study was collected through in-depth interviews of 20 professors from four (two public and two private sector) universities in the federal capital of Islamabad, Pakistan. The data reveals that the major cause for grade inflation in the selected universities was the competition between public and private universities to recruit students without giving due consideration to merit. Additionally, the culture of hiring untrained candidates as visiting faculty who aspire to be hired in permanent positions was a key contributing factor that led to grade inflation. Other factors include the limitations of the semester system and individualised directed studies. This study recommends the need to monitor and revisit the examination and grading system in Pakistani universities to enhance imparting quality education and to compete at the international level. [ABSTRACT FROM AUTHOR]

Homonormativity refers to the ratification and endorsement of heteronormative institutions and structures into lesbian, gay, bisexual and transgender (LGBT) lives, culture and discourse. While homonormativity is commonly manifested in (relatively) privileged, White, able‐bodied gay men, this paper focuses on lesbian, bisexual and transgender (LBT) women's experiences in Israeli peripheral and rural spaces. As a concept, homonormativity has the potential of reducing lived experiences into a widely criticized category. Instead, we voice the geographical, temporal and gendered potential of homonormative processes to articulate varied ways for leading a queer life under capitalism. Based on 61 qualitative interviews with LBT women living in the Israeli peripheries, we argue that LBT women employ two major homonormative processes of becoming political subjects to negotiate their sexualities in a space fraught with LGBTphobia. These homonormative processes are comprised of assimilation and contestation, revealing a nuanced mode of political subjectivity, shaped by ongoing experiences of LGBTphobia. [ABSTRACT FROM AUTHOR]

Working at night is associated with adverse cardiometabolic health outcomes. However, there are a lack of nutritional intervention studies conducted amongst night workers, subsequently contributing to a lack of evidence‐based guidelines for night workers. The aim of The Eating on the Night Shift study was to understand how night shift workers view working at night in relation to nutritional health and wellbeing, the barriers and enablers to participate in research and what kind of guidance would be useful to them. Semi‐structured qualitative interviews were conducted with a convenience sample (n = 18) of night workers based in England. The interview covered experiences of working night shifts, perceptions about night work and their health, and perceptions of and likely engagement with nutritional research. Interviews were audio recorded and transcribed verbatim. Transcripts were coded using an inductive thematic analysis approach. Of the final sample 13 were female (72%), 39% worked a rotating shift pattern and 78% had worked night shifts for 1 year or more. Four overarching themes were identified: (1) the consequences of night work on health and wellbeing, (2) eating at night means a less healthy diet, (3) working at night has wider knock‐on effects on aspects of lifestyle and wellbeing and (4) nutritional research is perceived as important, but there are barriers to participation. Night workers are aware that working at night can negatively impact their diet as well as their health. Nutritional researchers need to engage with night workers when considering intervention design and implementation as well as in the development of any resultant evidence‐based guidance to ensure its relevance. [ABSTRACT FROM AUTHOR]

Attention to children's emotional health and wellbeing (EHWB) has increased over the last decade due to a decline in children and young people's mental health. COVID-19 escalated this need globally as children were subjected to immediate and drastic changes to their education and daily lives. This paper reports on a UK qualitative study exploring the perceptions of teachers working in primary schools and the level of support they require for children's EHWB. Semi-structured online interviews were conducted with teachers during COVID-19. The findings highlighted four themes of professional support that were required: 1) funding support 2) support with pedagogical responsibilities, 3) external support and 4) home and parental support. Overall, teachers considered there was a lack of provision for their role, with additional pressures placed on them to support children's EHWB. The paper concludes that more resources are required long term to support teachers in a post-COVID-19 education system. [ABSTRACT FROM AUTHOR]

This qualitative phenomenological study explores the experiences of parents of children with special needs in Turkey, specifically their encounters with Guidance and Research Centers (GRCs) during the process of obtaining educational assessment reports. Through semi-structured interviews with 25 parents, the study reveals complex emotions and concerns over the assessment process, including the adequacy of assessment tools, the duration of evaluations, and the involvement of parents in the decision-making process. While many parents expressed satisfaction with the outcomes, significant issues were highlighted, such as the lack of communication between professionals and families and discrepancies in the accuracy of assessments and placement decisions. The research underscores the need for a more collaborative approach between parents and professionals, emphasizing the importance of improved communication, enhanced diversity of assessment tools, and longer evaluation periods to ensure a fairer and more comprehensive understanding of each child’s unique needs. The findings also suggest that greater parental involvement in the assessment and placement processes could lead to better educational outcomes and increased satisfaction for families. These insights have important implications for future policy and practice in special education assessment and support in Turkey. [ABSTRACT FROM AUTHOR]

Introduction: Individuals living with Crohn's disease (CD) experience burdensome symptoms. As such, it is important to measure CD symptom severity in clinical research. The goal of this study was to evaluate the content validity, psychometric performance, and score interpretability of a new patient-reported instrument, the Crohn's Symptom Severity (CSS) questionnaire, among adolescents and adults with moderately to severely active CD. Methods: Cognitive debriefing interviews (N = 30; n = 20 adults, n = 10 adolescents) were conducted to evaluate the content validity of the CSS. Additionally, the CSS scores were evaluated for reliability and validity using data from a phase 3 randomized clinical trial of risankizumab (NCT03105128; N = 850). Meaningful within-patient change (MWPC) thresholds were estimated using anchor-based methods. Results: All interview participants (n = 30/30, 100.00%) reported the CSS was easy to complete and most participants (n = 28/29, 96.55%) reported that the CSS was relevant to their experience of CD. Among the clinical trial subjects (N = 850) the following was found for the CSS: mostly acceptable item–total correlations (0.26–0.79); weak to moderate inter-item correlations (r = 0.07–0.57), good internal consistency (Cronbach's α = 0.76–0.87); intraclass correlation coefficients ranged from 0.48 to 0.70, not consistently exceeding the acceptable range for test–retest reliability (0.70); acceptable convergent validity and known-groups results; and demonstrated sensitivity to change. Analyses supported an MWPC estimate of 6–11 points. Conclusions: This study supports use of the CSS for measuring CD symptoms and sleep impact among adolescents and adults aged 16 and older with moderately to severely active CD in clinical research. Trial Registration: NCT03105128 (registration date 4 April 2017). [ABSTRACT FROM AUTHOR]

Self-leadership has traditionally been positioned as an individual-level phenomenon, putting strong emphasis on individuals' responsibility to influence themselves in order to achieve positive outcomes. However, this perspective may oversee that individuals are embedded in a social system, and that self-leadership may be best achieved as a collective endeavour that involves the individual and their interaction with the social environment. The present research thus aims to understand how individuals and their social environment at work (i.e. managers, co-workers) play together in order to enable self-leadership. The question was addressed using an inductive coding approach to qualitative data that stem from 73 semi-structured interviews with job newcomers from one organization in Germany. The findings showed that newcomers' self-led behaviour could be enabled by two key aspects of their social environment (i.e. individualized support for learning; team members acting as partners), which shaped and were shaped by newcomers' internal process of becoming aware of their task and relations-oriented contributions at work. Overall, our findings point to the role that the social environment plays for self-leadership. We discuss the implications for self-leadership theory. MAD statement Self-leadership is of increasing importance in today's complex and rapidly changing work environment. As individuals do not operate in a social vacuum, but are constantly impacted by and are impacting their social environment themselves, it is important to explore how an individual's social environment at work (i.e. their leaders and co-workers) can encourage individual self-leadership. Based on qualitative interviews, we describe the interplay between job newcomer's perceptions of leader and co-worker behaviour, their internal awareness processes, and self-led behaviour. Thereby, we provide specific aspects of how leaders and co-workers can encourage individual self-leadership at work. [ABSTRACT FROM AUTHOR]

Abstract Background Outcome measures are crucial to support a treat-to-target approach to rheumatoid arthritis (RA) care, yet their integration into clinical practice remains inconsistent. We developed an Electronic Heath Record-integrated, patient-facing side-car application to display RA outcomes (disease activity, functional status, pain scores), medications, and lab results during clinical visits (“RA PRO Dashboard”). The study aimed to evaluate patient perceptions and attitudes towards the implementation of a novel patient-facing dashboard during clinical visits using a mixed-methods approach. Methods RA patients whose clinicians used the dashboard at least once during their clinical visit were invited to complete a survey regarding its usefulness in care. We also conducted semi-structured interviews with a subset of patients to assess their perceptions of the dashboard. The interviews were transcribed verbatim and analyzed thematically using deductive and inductive techniques. Emerging themes and subthemes were organized into four domains of the Ecological Model of Health. Results Out of 173 survey respondents, 79% were interested in seeing the dashboard again at a future visit, 71% felt it improved their understanding of their disease, and 65% believed it helped with decision-making about their RA care. Many patients reported that the dashboard helped them discuss their RA symptoms (76%) and medications (72%) with their clinician. Interviews with 29 RA patients revealed 10 key themes: the dashboard was perceived as a valuable visual tool that improved patients’ understanding of RA outcome measures, enhanced their involvement in care, and increased their trust in clinicians and the clinic. Common reported limitations included concerns about reliability of RA outcome questionnaires for some RA patients and inconsistent collection and explanation of these measures by clinicians. Conclusions In both the quantitative and qualitative components of the study, patients reported that the dashboard improved their understanding of their RA, enhanced patient-clinician communication, supported shared decision-making, and increased patient engagement in care. These findings support the use of dashboards or similar data visualization tools in RA care and can be used in future interventions to address challenges in data collection and patient education.

Abstract Background At present, there are no specific guidelines for the treatment of diabetes in palliative care in Norway. The aim of this study was therefore to explore healthcare professionals’ experiences of providing palliative care to individuals with diabetes in specialist as well as primary care settings. Methods We interviewed 12 healthcare professionals from two palliative care units in specialist healthcare, one hospice unit in a nursing home, and one dietary care unit providing counselling in the municipality in the eastern part of Norway. Thematic analysis was used to analyze the data. Results Our analysis generated three main themes: 1) “Quality of life is the main focus”, which showed that the healthcare professionals’ main focus was on comforting patients through engagement and communication; 2) “An individualized approach”, emphasizing that the treatment was tailored to the unique circumstances of each individual and considered factors such as life expectancy, difficult blood glucose control, and multidisciplinary collaboration, and 3) “Diabetes in the background”, which highlighted that they had a modest focus on diabetes. Diabetes was seen as another aspect of health that they had to be aware of, but their limited knowledge of diabetes guidelines, technical tools, and treatment choices underscored that attentiveness to the diabetes treatment was not prominent. Conclusion The findings show that a lack of guidelines allowed for diverse approaches to the treatment of patients with diabetes in palliative care. Attentiveness to diabetes was based on the individual healthcare professionals’ experience and expertise, professional views, and the circumstances of each individual.

Abstract Background Compulsive exercise is common in eating disorders (EDs), but a systematic treatment model is lacking. The CompuLsive Exercise Activity TheraPy (LEAP) is a cognitive behavioral therapy treatment for compulsive exercise in EDs, delivered by trained therapists in groups over four consecutive weeks (8 groupsessions and 1 individual session), aiming to promote healthy physical activity. LEAP is currently evaluated in a randomized efficacy trial. In parallel, it is crucial to learn more about how it is perceived by qualitatively investigating participants’ subjective experiences. Methods Nine patients with various EDs participating in the LEAP trial were interviewed about their experiences of taking part in LEAP and about compulsive exercise as an ED symptom using a semi-structured interview guide. The interview transcripts were analyzed according to thematic analysis. Results The informants expressed that compulsive exercise had not been addressed in their standard ED treatment and that LEAP as such provided an important complement, spurring reflection, awareness, and changed feelings and behaviors in relation to compulsive exercise. Initially, increased PA was triggered for some, but this side effect was transitory. A wish for more treatment time, in terms of longer or additional sessions, was expressed. Conclusions Overall, LEAP seemed to fill an important treatment need and seemed both acceptable and feasible to patients. However, treatment time and the initial increase in PA may need further investigation and attention in order to optimize this treatment. Trial registration The trial is registered with the ISRCTN registry (registration date 20200325), trial ID ISRCTN80711391.

Abstract Background Ambulatory access to academic medical centers (AMCs) for patients insured with Medi-Cal (i.e., Medicaid in California) is understudied, particularly among the 85% of beneficiaries enrolled in managed care plans. As more AMCs develop partnerships with these plans, data on patient experiences of access to care and quality are needed to guide patient-centered improvements in care delivery. Methods The authors conducted semi-structured, qualitative interviews with Medi-Cal-insured patients with initial visits at a large, urban AMC during 2022. Participant recruitment was informed by a database of ambulatory Medi-Cal encounters. The interview guide covered Medi-Cal enrollment, scheduling, and visit experience. Interviews were transcribed and inductively coded, then organized into themes across four domains: access, affordability, patient-provider interactions, and continuity. Results Twenty participant interviews were completed (55% female, 85% English speaking, 80% self-identified minority or “other” race, and 30% Hispanic or Latino) with primary and/or specialty care visits. Within the access domain, participants reported delays with Medi-Cal enrollment and access to specialist care or testing, though appointment scheduling was reported to be easy. Affordability concerns included out-of-pocket medical and parking costs, and missed income when patients or families skipped work to facilitate care coordination. Participants considered clear, bilateral communication with providers fundamental to positive patient-provider interactions. Some participants perceived discrimination by providers based on their insurance status. Participants valued continuity, but experienced frustration arising from frequent and unexpected health plan changes that disrupted care with their established AMC providers. Conclusions The missions of AMCs typically focus on clinical care, education, research, and equity. However, reports from Medi-Cal insured patients receiving care at AMCs highlight their stress and confusion related to inconsistent provider access, uncompensated costs, variability in perceptions of quality, and fragmented care. Recommendations based upon patient-reported concerns suggest opportunities for AMC health system-level improvements that are compatible with AMC missions.

Abstract Introduction There is a growing need for alternative forms of care to address citizen demands and ensure a competent healthcare workforce across municipalities and regions. One of these forms of care is the use of mobile care units. The aim of the current study was to describe physicians and nurses experiences of providing care to patients within a mobile care unit in Sweden. Method Data were collected between March 2022 and January 2023 through qualitative interviews with 14 physicians and nurses employed in various mobile care units in different regions in Sweden. These interviews were transcribed verbatim and subjected to content analysis, with the study adhering to the Standards for Reporting Qualitative Research (SRQR). Results The analysis resulted in two main categories: “Unlocking the potential of mobile care”, and “The challenges of moving hospitals to patients’ homes”; and seven subcategories. The respondents viewed mobile care at home as highly advantageous, positively impacting both patients and caregivers. They believed their contributions enhanced patients’ well-being, fostering a welcoming atmosphere. They also noted receiving more quality time for each patient, enabling thorough assessments, and promoting a person-centered approach, which resulted in more gratifying mutual relationships. However, they experienced that mobile care also had challenges such as geographical limitations, limited opening hours and logistical complexity, which can lead to less equitable and efficient care. Conclusions Physicians and nurses in mobile care units emphasized positive outcomes, contributing to patient well-being through a person-centered approach. They highlighted increased quality time, comprehensive assessments, and overall satisfaction, praising the mobile care unit’s unique continuity for enhancing safety and fostering meaningful relationships in the patient’s home environment. In order for mobile care to develop and become a natural part of healthcare, challenges such as geographical limitations and logistics need to be addressed.

Este trabajo aborda la incertidumbre, foco central del actual debate epistemológico, en una triple concreción sociológica. En primer lugar, concreción temática: la incertidumbre en el ámbito del cambio climático (CC, en adelante). En segundo lugar, se fija en actores concretos: expertos en ese ámbito. Y tercero: concreta una observación empírica, con entrevistas a expertos españoles en CC. Se asume una perspectiva emic, atenta al habla de los expertos sobre sentido, localización y gestión de la incertidumbre climática. Como recoge la sucesión de los distintos informes del IPCC, la incertidumbre ha sido y es asunto central de reflexión en el estudio del CC. Dado que son los expertos los que la definen, clasifican, miden y comunican al resto de la ciudadanía, su estudio debe pasar necesariamente por la indagación de su peculiar relación con la heterogénea comunidad de los expertos. Tras dar cuenta de la relevancia dada a la incertidumbre en los informes del IPCC, se propone una reconstrucción selectiva del debate sobre la experticia y la incertidumbre, presentando algunos resultados de las indagaciones sobre el tema en España, para centrar después la atención en el análisis de las evidencias aportadas por una investigación cualitativa, concluyendo con los principales resultados alcanzados. Uncertainty is one of the central issues in the current epistemological debate. This paper proposes to approach it within the framework of a triple sociological concretion. First, a thematic concretion: uncertainty in the field of climate change. Second, it focuses on specific actors: experts in the field of climate change. And third, it is based on an empirical sociological observation of qualitative interviews with a significant sample of Spanish climate change experts. Thus, an emic perspective is adopted, paying attention to what the experts say about the meaning, location, and management of uncertainty. Uncertainty has been and continues to be a central topic of reflection in the study of climate change, as shown by the succession of different IPCC reports. Since it is the experts who define, classify, measure, and communicate the uncertainty of climate change to the rest of the citizens, its study must necessarily include the observation of the peculiar relationship with the heterogeneous community of experts. This work aims to make a contribution in this respect. After an account of the importance given to uncertainty in the IPCC reports, it proposes a selective reconstruction of the debate on expertise and uncertainty, presenting some of the results of research on the subject in Spain, to then focus attention on the analysis of the evidence provided by recent qualitative research, and to end with some conclusions that identify the main results obtained.

Over the past decade, the protest against so-called 'gender ideology' in Italian schools has witnessed widespread and pervasive mobilisations. Prompted by the directives of anti-gender organisations, grassroots networks activated at the local level have opposed educational programmes related to gender equality, sexuality and the prevention of discrimination against LGBT+ individuals. Through qualitative interviews with Catholic mothers and teachers who participated in the anti-gender conferences in 2015, we adopted a micro-level perspective to interpret their narratives as strategies aimed at defending their ethical and heteronormative educational competence against emerging norms of sexual democracy. The analysis shows how these women position themselves and construct their opposition to gender ideology as a means of asserting social and cultural legitimacy against the perceived risk of symbolic marginalisation in the field of education.

Abstract Objectives To explore how to reach immigrant women through community agencies to raise awareness of the role of physical activity (PA) in reducing cancer risk. Study design Qualitative description. Methods We conducted semi-structured telephone interviews with immigrant women and community agency managers to discuss the ideal design of an education session on PA and cancer risk, and identified themes using content analysis. Results Participants included 22 women (6 African or Caribbean Black, 4 Chinese, 3 Filipino, 5 Indian, 4 Pakistani) and 16 agency managers from across Canada. Women were not familiar with Canada’s PA guidelines, and few were aware that PA reduces the risk of cancer. All expressed interest in education about PA and cancer. Diverse women and managers expressed similar preferences for education session design including content (e.g. PA amount/type), format (e.g. in person preferred but virtual more practical), personnel (external expert plus agency staff), cultural tailoring (e.g. translated supplemental take home information) and reinforcing (e.g. follow-up with participants) strategies. Women and managers identified few barriers to participating in education sessions, chiefly, that women lacked time due to work and family responsibilities; and noted several enablers of participation (e.g. emphasize social aspect, provide gift cards or recreation centre passes). Conclusions We generated insight on the ideal characteristics of a community-based education session that could raise awareness among immigrant women of the importance of PA in reducing cancer risk. Further research is needed to assess the feasibility and impact of PA education sessions designed based on these findings.

Purpose: When mobility deficits persist after stroke or spinal cord injury (SCI), outpatient neurorehabilitation services are required. This study aimed to explore the current practice of German outpatient neurorehabilitation services and identify factors associated to this practice. Methods: This was a qualitative observational study in which semi-structured interviews were conducted with professionals from outpatient neurorehabilitation services and mobility-impaired patients. A qualitative content analysis with a data-driven coding process was used. Results: Three general practitioners, five physical, five occupational, and one speech therapist, one neuropsychologist, two outpatient nurses, one rehabilitation technician, one social worker, two patient advocates (long-term survivors, each stroke and SCI), and 20 patients (10 after stroke, 10 after SCI, all first-ever affected since approximately one year) participated. The reported experiences ranged from high satisfaction to perceived deficits in participation-oriented, evidence-based, and coordinated care. Identified associated factors were: (a) availability of specialised therapists and professional education, (b) outpatient service catalogue, (c) cost coverage, (d) setting rehabilitation goals, and (e) physician as care coordinator. Conclusion: Areas of improvement identified focused on: setting rehabilitation goals towards participation, training therapists on evidence-based treatments and shared decision-making, updating the outpatient service catalogue, and implementing coordination actions. Implementation of these recommendations should be evaluated. IMPLICATIONS FOR REHABILITATION: Professionals need to be trained in setting rehabilitation goals and treatments. The continuing education should be based on current evidence and address interprofessionalism. Academization and continuing education in scientific work for therapists should be advanced. Professionals should educate patients about rehabilitation goals and set rehabilitation goals together, both interprofessional coordinated and with the patient (shared decision-making). Activity and participation should be the central aspects. Rehabilitation clinicians should give instructions to therapists on what to do if rehabilitation goals are not worked on. Rehabilitation clinicians should encourage interprofessional collaboration and information exchange where this is not the case. The exchange of information between outpatient professionals should be promoted through appropriate measures, that is, interprofessional meetings could be introduced. The outpatient service catalogue should be revised regarding evidence-based and participation-oriented treatments and enable appropriate cost coverage. [ABSTRACT FROM AUTHOR]

Background: Hereditary Angioedema (HAE) due to C1-inhibitor deficiency (C1INH) is a rare condition, clinically characterised by recurrent swelling. The unpredictability of attacks affects the patients' quality of life (QoL). HAE patients and their families have vast unmet physical, psychological, and social needs. A human-centred design (HCD) approach to describing the needs of different user types is to utilise personas, a data-driven narrative tool for communicating user archetypes that capture the individuals' attitudes, goals, and behaviours. The aim of this study was to create and analyse personas based on HAE patients' and their caregivers' interviews. Semi-structured interviews were conducted through anthropological conversations with patients, patient-caregivers (double role of patient and caregiver), and non-affected caregivers. Qualitative and quantitative insights from analyses formed the basis to create personas. Results: We enrolled 17 subjects: 15 patients (6 of them were patient-caregivers) and 2 non-affected caregivers. The mean age of participants was 50.3 ± 14.4 years. Eight patients were on treatment with prophylactic therapy. The mean percentage score of Angioedema Quality of Life (AE-QoL) for HAE patients was 19.8 ± 12.0. Six personas were identified describing the participants' personal history, disease management, and needs: four personas referred to patients, one to patient-caregivers, and one non-affected caregiver personas were identified. Across patient personas, the most expressed needs were psychological support and better awareness amongst healthcare professionals. Caregivers, on their side, desired better information about the disease, including the latest therapies, and higher awareness within the community. Conclusion: A Human Centred Innovative Approach Based on Persona extends beyond the physical symptoms to encompass the psychological and social aspects of the individual's well-being also including the family in the evaluation. [ABSTRACT FROM AUTHOR]

The aim was to explore patients' early experiences of symptoms after hemithyroidectomy and how these symptoms influenced their daily lives. An inductive explorative qualitative research design was performed. Sixteen patients from two hospitals were interviewed between two-three weeks after the surgery. All the patients experienced compression symptoms before the surgery. The study was analyzed with conventional manifest content analysis. The inductive analysis yielded two main categories and one subcategory. The two main categories were: Early postoperative symptoms that caused disadvantage in daily life and Early postoperative symptoms and coping strategies. The subcategory was: Early postoperative experiences of concerns about the future. Key points: 1. Patients experienced early postoperative symptoms that affected their lives in multiple levels, making them develop coping strategies and awaking concerns about remaining symptoms in the future. 2. The effect of hemithyroidectomy influenced patients' daily life in the early postoperative phase considerably. 3. The study shows that tailored preoperative patient information is important. The findings may guide professionals to tailored preoperative information to optimize the care for this patient group. [ABSTRACT FROM AUTHOR]

The process of anonymization during the analysis and the restitution of qualitative interviews is complex and cannot be achieved by following a set of steps dictated by a manual. It implies finding a balance between preserving the confidentiality of those who, during ethnographic exercises, share their stories and facts with us, while recovering and showing the analytical richness of the information collected. In this article, based on my fieldwork experience in a sensitive field, I propose a path of anonymization of qualitative interviews consisting of four levels, which can be applied to specific conditions and dilemmas that researchers commonly face. [ABSTRACT FROM AUTHOR]

Objectives: To explore how to reach immigrant women through community agencies to raise awareness of the role of physical activity (PA) in reducing cancer risk. Study design: Qualitative description. Methods: We conducted semi-structured telephone interviews with immigrant women and community agency managers to discuss the ideal design of an education session on PA and cancer risk, and identified themes using content analysis. Results: Participants included 22 women (6 African or Caribbean Black, 4 Chinese, 3 Filipino, 5 Indian, 4 Pakistani) and 16 agency managers from across Canada. Women were not familiar with Canada's PA guidelines, and few were aware that PA reduces the risk of cancer. All expressed interest in education about PA and cancer. Diverse women and managers expressed similar preferences for education session design including content (e.g. PA amount/type), format (e.g. in person preferred but virtual more practical), personnel (external expert plus agency staff), cultural tailoring (e.g. translated supplemental take home information) and reinforcing (e.g. follow-up with participants) strategies. Women and managers identified few barriers to participating in education sessions, chiefly, that women lacked time due to work and family responsibilities; and noted several enablers of participation (e.g. emphasize social aspect, provide gift cards or recreation centre passes). Conclusions: We generated insight on the ideal characteristics of a community-based education session that could raise awareness among immigrant women of the importance of PA in reducing cancer risk. Further research is needed to assess the feasibility and impact of PA education sessions designed based on these findings. [ABSTRACT FROM AUTHOR]

Background: Disparities in cervical cancer screening rates among marginalized groups is a driver of inequalities in cervical cancer. Self‐sampling for human papillomavirus (HPV) testing is a newly emerging alternative to clinician‐performed testing to screen for cervical cancer, and has high potential to reduce screening barriers in under‐screened and marginalized groups. We study the acceptability in of HPV self‐sampling and informational materials among Black/African American, Hispanic/Spanish speaking, American Indian/Alaska Native and transgender/nonbinary populations. Methods: We conducted qualitative interviews with patients, ages 30–65, who were Black/African American, Hispanic, American Indian, and/or transgender/nonbinary individuals assigned female at birth. Telephone interviews were conducted in English or Spanish. Patients did not complete the test, rather were asked about the attractiveness, comprehensibility, and acceptability of the HPV self‐test, instructions, and messaging. Results: Among 23 completed interviews (5 American Indian/Alaska Native, 7 Hispanic [2 bilingual, 5 Spanish‐speaking], 5 Black/African American, and 6 transgender/nonbinary), patients from all groups thought the test was straightforward and convenient, and they would complete the test at home or in clinic. The transgender/nonbinary patients preferred at‐home testing. American Indian and transgender/nonbinary patients liked that the test might avoid pain, discomfort, and invasiveness. All patients liked the letter and instructions. All groups had specific suggestions for making the materials more culturally acceptable. Conclusions: The HPV self‐test and the instructions and materials for use were acceptable for a diverse group of patients. Tailored outreach and messaging should be considered to reduce screening disparities among groups that have been historically underserved by the medical system. [ABSTRACT FROM AUTHOR]

During their early political socialization young people start to recognize their agency as political actors and to develop their political identity. This article presents the findings of a comparative study across different types of youth activism in two cities, Athens and Cologne, which differ in their youth cultures of participation and the opportunities they provide to mobilize. Our data derive from in-depth qualitative interviewing, which is considered to be most fruitful for the exploration of the reasons behind activists' trajectories. We identified three groups of influences: micro-, meso- and macro-level influences, with micro-level influences being most visible in the path of social movement-related activism, meso-level influences being dominant in the path of partisan activism, and macro-level influences prevailing in grassroots activism. Finally, the implications of the differential impact of the studied socio-spatial contexts are critically discussed. [ABSTRACT FROM AUTHOR]

The study is devoted to investigating the turnover intentions of international academics at Japanese universities. Semi-structured interviews were conducted with 40 full-time international academics in Japan. The interview data were coded and analyzed through an inductive process based on a four-stage procedure. The study suggests that although many international academics perceived themselves as tokenized symbols, stimulated by the determinants ranging in the dimensions of ease of movement, internal environmental factors, and external environmental factors, the majority of international academics were more inclined to remain in Japan. The study fills in the research gap regarding international academics' turnover intentions, it also challenges and enriches Matier's (1990) claim, highlighting that only when faculty members perceived ease of mobility and high internal and external environmental benefits, would they terminate their employment. Implications for policymakers, scholars and university administrators are offered for future studies and institutional practices. [ABSTRACT FROM AUTHOR]

Cognitive behaviour therapy for psychosis (CBTp) should be offered to patients receiving psychiatric inpatient care, yet very little is known about patients' perspectives on this. The aim of this study was to examine patients' experiences of a CBTp‐informed intervention delivered in inpatient settings. We recruited 10 participants from the intervention arm of a randomised controlled trial examining the feasibility and acceptability of a CBTp‐informed intervention for psychiatric inpatient settings. We undertook semistructured interviews examining their experiences of the intervention and analysed them using thematic analysis. The study was conducted in partnership with a coproduction group of key stakeholders (people with lived experience, family and carers, and clinicians). The intervention was found helpful by almost all participants, and all participants would recommend it to others in similar situations to themselves. The results demonstrated that participants valued the therapist's professionalism and emphasised the importance of the therapeutic relationship. Participants highlighted the importance of the therapy focusing on navigating admission and developing skills to manage the crisis experience so they could return to their normal lives. Participants described challenges to having psychological therapy in the acute crisis context including therapy interruptions and ongoing distressing experiences of psychosis. The study demonstrated the importance of prioritising the therapeutic relationship, that therapy was a valued process to navigate admission and discharge, but that some environmental and patient‐level challenges were present. Further research is needed to explore inpatients' experiences of psychological interventions in this setting. Trial Registration: ISRCTN trial registry: ISRCTN59055607 [ABSTRACT FROM AUTHOR]

Over the past decade, there has been a strong focus on studying individuals' responses to stigmatisation, discrimination and racism, while the question of how individuals recognise and make sense of an exclusionary event, has been largely side-lined. To fill in this gap, this study leverages an affect-theoretically informed reformulation of Essed's (1991, Understanding Everyday Racism: An Interdisciplinary Theory. London: Sage) classic concept of 'comprehension of racism' to investigate how individuals understand and make sense of experiences of ethnoracial exclusion. Empirically, the article analyses 419 experiences/incidents of ethnoracial exclusion reported in 66 semi-structured interviews with highly educated, second and 1.75 generation immigrants representing three 'groups' of Germans who (may) experience exclusion due to their migrant background: Germans of Polish migrant background, Black Germans and Germans of Turkish migrant background. The study identifies three modes by which interviewees talked about exclusionary experiences/incidents: (1) by normalisation (interpreting an experience/incident as 'normal'), (2) by categorisation (identifying an experience/incident as, e.g. 'racist', 'discriminatory', or 'disadvantaging') or (3) by indicating feelings of unease. For each of the three modes, the article outlines the role of affects and emotions in interviewees' narratives, provides insight into the types of experiences/incidents for which the modes were used and highlights differences between the three groups of respondents. [ABSTRACT FROM AUTHOR]

This qualitative study consisted of in-depth, retrospective interviews with participants over the age of 18 who experienced child sexual abuse. Through narrative analysis, study findings shed light on three overall findings: the perception of memories, the perception of grooming, and the perception of the lived lives of child sexual abuse survivors. Findings suggest that the narratives elicited from the participants included current views but also past experiences and anticipation about the future, including individual and societal levels of meaning. These narratives are furthermore entangled and inexorably linked – temporally, culturally, generationally, materially, and emotionally – and the results are thus presented from a holistic perspective. Study findings help explain the complex dimensions concerning the lived experiences of child sexual abuse. As such, this research speaks to the field of social and health care practitioners working with children and families facing the complex phenomenon of child sexual abuse. [ABSTRACT FROM AUTHOR]

Introduction/Aims: To better understand the disease burden faced by individuals with Duchenne muscular dystrophy (DMD) of all ages and elucidate potential targets for therapeutics, this study determined the prevalence and relative importance of symptoms experienced by individuals with DMD and identified factors associated with a higher disease burden. Methods: We conducted qualitative interviews with individuals with DMD and caregivers of individuals with DMD to identify potential symptoms of importance to those living with DMD. We subsequently performed a cross‐sectional study to assess which symptoms have the highest prevalence and importance in DMD and to determine which factors are associated with a higher disease burden. Results: Thirty‐nine individuals, aged 11 years and above, provided 3262 quotes regarding the symptomatic burden of DMD. Two hundred participants (87 individuals with DMD and 113 caregivers) participated in a subsequent cross‐sectional study. Individuals with DMD identified limitations with mobility or walking (100%), inability to do activities (98.9%), trouble getting around (97.6%), and leg weakness (97.6%) as the most prevalent and life altering symptomatic themes in DMD. The symptomatic themes with the highest prevalence, as reported by caregivers on behalf of those with DMD for whom they care, were limitations with mobility or walking (90.3%), leg weakness (89.2%), and emotional issues (79.6%). Steroid/glucocorticoid use (e.g., prednisone or deflazacort) was associated with a lower level of disease burden in DMD. Discussion: There are many symptomatic themes that contribute to disease burden in individuals with DMD. These symptoms are identified by both individuals with DMD and their caregivers and have a variable level of importance and prevalence in the DMD population. [ABSTRACT FROM AUTHOR]