An ID card allowing access to municipal services for migrants with precarious status in Montreal and its influence on social inclusion: a mixed method study

Identity Cards: Social Sorting by Database

In 2006, the Turkish Grand National Assembly (TGNA) made a notable departure from historical precedent when it replaced the Population Register Law of 1972. The 1972 law, in Article 43, required that the national registry records on all households in Turkey contain the religion of all family members unless, under Article 46, an individual or family went to court to make a revision in these records. This was the legal basis of the inclusion of religious information on Turkish identity cards, issued in accordance with the information in family registers. Article 35 of The Population Services Law of 2006 now provides: “Requests about the religious information in household registers shall be approved, modified, left blank or deleted, in accordance with the written application of the concerned person.”We shall argue, in this paper that Article 35 of the Population Services Law of 2006 is unconstitutional just like Article 43 of the Population Register Law of 1972 was, and that information about individuals' religions should be deleted from both the national register and individuals' identity (ID) cards. The inclusion of religious information in the identity cards of citizens or resident aliens, who apply for Turkish citizenship, violates the religious liberty in Turkey, particularly under a “neutrality” conception of that right. We shall review the jurisprudence of the Turkish Constitutional Court concerning ID cards in the light of the negative and positive aspects of religious liberty, focus on the different meanings of neutrality such as “formal neutrality,” “substantive neutrality,” “aim neutrality,” “justification neutrality” and “consequences neutrality.” Before we evaluate this practice under neutrality theory, however, it would be appropriate to begin with a historical narrative about the origin of religious notations on Turkish identity cards, and explain the content and the meaning of the new law.

Sequential explanatory mixed method design is the most frequently applied in both health and social sciences literature. It is denoted by ‘QUAN → qual’ which represents the quantitative study occurs first and has greater weight in addressing the study’s aims, and the qualitative study follows to explain quantitative results. Despite the extensive use of sequential explanatory design, there are limited references to this design. Therefore, this methodological paper attempts to fill the gap by providing an illustration in developing a sequential explanatory interview schedule based on complementary-alternative medicine (CAM) study among clinical psychologists in Indonesia. The most important step to develop sequential explanatory interview schedule was the construction of aspects and questions that were immensely grounded on the most notable quantitative results. In this study, eight aspects of interview schedule were constructed after analyses of the nationwide survey. The interview schedule then piloted among participants with fairly similar characteristics to the participants in the main interviews. This process enhanced the quality of questions through feedback from participants and improved the interviewer’s skills through familiarization with questions. It is expected that this reflection report could be adopted as a practical guideline in developing interview schedule for sequential explanatory mixed method design, particularly in the field of psychology.

Confidential youth consultations aiming at enhancing adolescent autonomy are a cornerstone of transitional care. At the same time, parental support is essential. These conflicting considerations result in a clinical dilemma. The aim of this study was to examine the attitudes of parents to chronically ill adolescents regarding confidential youth consultations and to explore the underlying reasons. A sequential explanatory mixed methods design consisting of a cross-sectional questionnaire survey (n = 117) and three focus group interviews among parents (n = 12) to chronically ill adolescents (12-19 years) was used. Quantitative data were analyzed descriptively. Qualitative data were analyzed using King's template method. The parents preferred independent youth consultations starting around the age of 14-15 years. Around 60% of the parents had one or more concerns regarding independent youth consultations. Although 64% of the parents supported conditional or full confidentiality during adolescence, 95% wanted information even though their child did not consent. In the qualitative analysis, the parents described caring for a child with chronic disease as a term of life perceiving themselves as an "octopus" with numerous roles related to daily care and treatment and at the same time with thoughts and worries regarding the future. We found four themes: 'a life with chronic disease', 'responsibility', 'protection' and 'apprenticeship'. The parents' attitudes were influenced by their roles and their perception of the adolescent's competences as well as their experience with the healthcare system. Our findings suggest that parents need transitional care too.

Aim: The aims of this sequential explanatory mixed method study were twofold 1. Firstly, to evaluate the implementation of a spiritual care subject in a nursing program. 2. Secondly, to examine undergraduate nursing students' perceptions of providing spiritual care within their holistic care practice. Background: Studies conducted internationally indicate many nurses feel inadequately prepared to provide holistic care inclusive of spiritual care due to insufficient spiritual care education. Design: Two phase, sequential explanatory mixed method design which comprised of a quantitative study followed by a qualitative study. Methods: The setting was an Australian faith-based university. Participants comprised of undergraduate nursing students who were enrolled in a spiritual care subject. Findings: Two study findings emerged: 1. Participants' knowledge and practice of spiritual care were transformed by the spiritual care subject, and 2. The spiritual care subject broadened perceptions of spiritual care so participants viewed themselves more equipped to provide spiritual care in their holistic care provision. Conclusion: The spiritual care subject had an affirmative influence on participants' perceptions of providing spiritual care within holistic care practice. The findings have implications for nurse educators to consider how spiritual care content can be included within undergraduate nursing curricula.

Transformative sequential mixed methods design in a cross-cultural context is seldom straightforward. Using a community-based participatory research approach as the transformative lens in an African refugee context in the southern United Status, we explored: (a) the intersection of culture, financial stress, and financial self-efficacy and (b) tested the efficacy of financial literacy as the focus of a culturally responsive solution grounded in community-identified priorities. Through a three-phased explanatory sequential mixed methods design, we demonstrate how the addition of a third phase of analysis that focuses on convergence and expansion of quantitative and qualitative data integration and cyclical processes of dissemination and action can strengthen the utility of transformative mixed methods research in a cross-cultural context. Our study offers a unique contribution to the long-standing methodological dialogue between the design elements of mixed methods research, community-based participatory research, and migration studies by expanding the transformative explanatory sequential design archetype in a cross-cultural context.

Mariana’s narrative presents just one example of the complexities of going about daily life as a transgender or intersex person in Chile contemporary. In a society where identity (ID) cards are central to accessing most services, from public health to the labor market, the incongruence between self-presentation and official identification serve to perpetuate the discriminatory practices directed toward transgender 2 and intersex individuals. This frequently results in the denial of access to basic rights. These are seen as part of a vicious circle. Not having a legal identity congruent with the person’s adopted gender essentially implies exclusion from education, employment, and health. Such a scenario has encouraged some to seek legal change to gender and name status as a means of ameliorating their inclusion in society. However, in order to do so, individuals need sufficient financial resources to undergo surgery and hormonization in a costly, privatized health service. Though gender identity is not currently regulated by law, a gap in the law has thus far been exploited in order to allow individuals to “re-sex” their transgender bodies. However, this has occurred predominantly in the cases of “the post-surgical body” (Sharpe, 2002, 3).

BackgroundApathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient’s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy–related apathy scale (E-RAS) in adults with epilepsy.MethodsThis study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct [exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200)], convergent and divergent Validity and reliability (internal consistency and stability) were investigated.ResultsThe results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach’s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001).ConclusionE-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients.

BackgroundAntimicrobial resistance is a serious threat to public health. To reduce antimicrobial resistance, interventions to reduce gram-negative infections, specifically urinary tract infections, are vital. Early evidence suggests increased fluid intake is linked with a reduction in UTIs and subsequently has potential to reduce antibiotic usage. Care homes have a high prevalence of UTIs and provide an opportunity in a closed setting to deliver an intervention focused on increasing fluid intake, where it is supported and monitored by health care workers. The study aimed to evaluate the impact and feasibility of an online staff focused intervention over a 30 day period to increase the hydration of care home residents with a view to reducing the burden of AMR in this setting.MethodsThe study was a pre and post intervention with a sequential explanatory mixed methods design. The intervention was delivered online in 3 care homes, containing 3 main components underpinned by the COM-B model including hydration training, 7 structured drinks rounds and a hydration champion to change behaviour of care home staff. A pre and post questionnaire assessed the impact of the intervention on staff and data was collected on fluid intake, drinks rounds delivered to residents, UTIs, antibiotic used to treat UTIs, falls and hospitalisation. Descriptive statistics summarised and assessed the impact of the study. Focus groups with care home staff provided qualitative data which was thematically analysed.ResultsStaff increased in self-perceived knowledge across the six components of hydration care. 59% of residents had an increase in median fluid intake post intervention. During the time of the intervention, a 13% decrease in UTIs and antibiotic usage to treat UTIs across the 3 care homes was recorded, however falls and hospitalisations increased. Themes arising from focus groups included the role of information for action, accessibility of online training, online training content.ConclusionsThis study demonstrates that a brief, low cost, online multi-component intervention focused on care home staff can increase the fluid intake of residents. A reduction in UTIs and antibiotic consumption was observed overall. Empowering care home staff could be a way of reducing the burden of infection in this setting.

Self-directed learning about normal birth with web-based support for nurse-midwife students in Thailand: A mixed methods study

In an IPE environment, students are expected to have better understanding of the roles, responsibilities, and contribution of other health care professions to enhance interprofessional working and collaboration with an end result of improving patient-centred and team-based care. Although many studies have investigated students’ attitudes, very few employ a mixed methods design and hardly are from Middle Eastern countries. A two-staged sequential explanatory mixed method design was used to comprehensively capture the perspectives of pharmacy students toward IPE and collaborative practice. A quantitative survey was conducted as the first stage of the study, followed by an in-depth discussion of these perspectives through a qualitative phase by conducting two focus groups. For the quantitative surveys, the overall response rate was 102/132 (77%) for pharmacy students in Qatar. This was followed by two focus groups with a total of 27 participants from senior and junior students. In exploring the qualitative data, three main themes were identified in relation to the pharmacy students’ perspectives. These were on the pharmacy students’ perception on the enablers (professional related benefits, patient-related benefits and current positive influences), barriers (previous IPE experiences, educational related issues and current working practices and processes), and recommendations to implementing IPE and collaborative practice (future IPE and pharmacy profession). Overall, the results demonstrate a strong readiness and positive perception by pharmacy students toward IPE and collaborative practice. This study has highlighted different dimensions in pharmacy students’ perceptions. It also provided a useful insight into the readiness of pharmacy students in a Middle Eastern university. Students are seeking more IPE experiences formally incorporated into their curriculum and hence educators should capitalise on these positive and enthusiastic attitudes to identify the most effective means for delivering IPE and inform curricula planning. Collaborative practice-ready graduates will produce better-educated professionals delivering higher quality care.

Background Research on the factors that promote the health of older veterans is limited. Purpose To explore the relationships between military service, occupational participation, resilience and successful aging for older U.S. military veterans. Method A sequential explanatory mixed methods design was used, a survey (n = 41) and follow-up interviews (n = 9). Findings Occupational participation was associated with resilience (r = 0.60, p < .01). Three integrated themes emerged: (1) staying engaged & connected, (2) relationship between occupation and resilience, and (3) positive impact of military service. Conclusion Findings help fill the gap in research identifying intervention targets for older veterans. KEY MESSAGES The meaningful occupational participation of older veterans has received little attention in previous literature and is an important area of focus with strong relevance for occupational therapy Occupational therapy practitioners can play an important role in promoting the healthy aging and resilience of this population through occupation-based interventions

BackgroundAlcohol Management Plans (AMPs) were first implemented by the Queensland Government a decade ago (2002–03). In 2008, further stringent controls were implemented and alcohol was effectively prohibited in some of the affected remote Indigenous communities. With the Queensland Government currently reviewing AMPs, prohibitions may be lifted making alcohol readily available once more in these communities. As yet no work explores the impact of alcohol related injuries in relation to individual, family and community resilience in Indigenous Australians. A resilience model recognises individuals and families for their strengths rather than their deficits. By revealing how some individuals and families survive and thrive, new ways of working with families who need support may be identified and adopted. The research will explore in detail the long-term impact of this kind of injury on individuals, families and communities.Methods/designThis project will use a sequential explanatory mixed method design. Four discrete Indigenous communities in Cape York, far north Queensland are included in this program of research, chosen because there is previous data available regarding injury and alcohol related injuries. Four sequential studies will be conducted in order to address the research questions and provide a rich description of the impact of alcohol related injuries and resilience in these populations. The time period January 2006 to December 2011 was chosen because it captures the three years before and three years after 2008 when tight alcohol restrictions were implemented in the four communities.DiscussionLong term effects of the AMPs are as yet unknown and only fragmented attempts to look at the impact of injury related to alcohol have been conducted. A well-structured research program that explores the long-term impact of alcohol related injuries in these communities will help inform policy development to capture the current situation and so that appropriate benchmarking can occur.The project has been approved by the James Cook University Human Research Ethics Committee H5618 & H5241.

Firefighter willingness to participate in a stem cell clinical trial for burns: A mixed methods study

The Rural Primary Health Services Delivery Project aims to improve the quality and coverage of health services to rural populations in Papua New Guinea. There are limitations in measuring performance of such projects through analysis of health information system data alone due to data quality issues and a multitude of unmeasured factors that affect performance. A mixed methods study was undertaken to understand the contextual factors that affect health service performance. A performance assessment framework was developed including service delivery indicators derived from the National Health Information System. Prior to implementation, a baseline analysis of the indicators was undertaken. Subsequently, semi-structured interviews were conducted with health administrators, in which they were asked about factors they perceived to influence health facility performance. During the interviews, key informants were provided with health indicators for their province and asked to interpret the performance of facilities. Interviews were transcribed and inductive thematic analysis performed. Performance indicators varied greatly within and between districts. Key informants cited a number of reasons for this variation. Health facilities accessible by road in urban areas, with competent and/or higher level staff and health services operated by churches or private companies, were cited as contributors to high performance. For high performing districts, key informants also discussed use of health information, planning and targeted strategies to improve performance. Inadequate numbers of staff, poorly skilled staff, funding delays and challenging geography were major contributors noted for poor performance. Analysis of quantitative indicators needs to be performed at health facility level in order to understand district level performance. Interpretation of performance through key informant interviews provided useful insight into previously undocumented contextual factors affecting health delivery performance. The sequential explanatory mixed methods design could be applied to evaluations of other health service delivery programs in similar contexts.