Broad Themes Research Articles

Barriers and facilitators to pre-exposure prophylaxis uptake among Black/African American men who have sex with other men in Iowa: COM-B model analysis.

In Iowa, men who have sex with men (MSM) accounted for 54% of persons with HIV in 2022 and Non-Hispanic Black/African Americans were over 10 times more likely to be diagnosed with HIV than Non-Hispanic white Iowans. To address this disparity in HIV incidence and prevalence, the United States (US) government ending the HIV epidemic (EHE) initiative seeks to expand pre-exposure prophylaxis (PrEP) coverage across the United States. Recent data showed that PrEP coverage is suboptimal in Iowa (a rural state), and Black Iowans were less likely to engage with PrEP services. Using capability, opportunity, motivation and behavior (COM-B) model for behavior change, this study sought to identify the key barriers and facilitators to PrEP uptake among Black/African American MSM in small urban areas in Iowa. This was a phenomenological study aimed to explore subjective views of Black MSM on PrEP use. In-depth semistructured interviews were conducted with 12 Black MSM aged 20-42 years in two small urban counties. Broad themes identified from the interview transcripts were analyzed inductively and mapped onto the COM-B constructs deductively. Results showed that barriers to PrEP uptake were closely associated with five (of six) COM-B subcomponents: physical capability, psychological capability, social opportunity, reflective motivation, and automatic motivation. The thematized barriers were (1) lack of medical insurance; (2) limited PrEP awareness; (3) PrEP stigma; (4) fear of distrust among partners; (5) anticipated side effects; and (6) doubt about PrEP effectiveness. Similarly, facilitators to PrEP uptake were aligned with four subcomponents of COM-B model: physical capability, psychological capability, social opportunity, and physical opportunity. The thematized facilitators were (1) increased PrEP awareness; (2) PrEP access without discrimination; (3) state provision of PrEP to uninsured; and (4) physicians buy-in and recommendation. No motivation-related facilitators were reported. To reduce the current disparity in HIV incidence and to achieve the EHE goals of expanding PrEP coverage in Iowa, efforts should be directed toward the provision of low-cost or free PrEP services, healthcare providers' training on cultural competence, and the development of culturally appropriate strategies to deliver PrEP to the Black MSM community.

예비교사와 현직교사가 인식하는 ‘현장’에 대한 메타포 연구

Purpose: This study aimed to explore the perceptions of pre-service and in-service teachers regarding
 the term ‘field’ using metaphorical methodology and to identify whether differences in metaphorical
 representations exist between pre-service and in-service teachers.
 Methods: A survey was administered to twenty-one pre-service teachers and twenty-three in-service
 teachers, prompting them to express metaphorical representations of the term ‘field’. Alongside this,
 the reasons behind their chosen expressions were also collected and qualitatively analyzed.
 Results: Metaphors for the term ‘field’ were categorized into four broad themes and eight sub-themes.
 A notable difference was observed in how pre-service teachers perceived ‘field,’ primarily focusing
 on themselves, whereas in-service teachers tended to center their perceptions on students, parents,
 and others.
 Conclusion: The findings suggest that the term ‘fiel’ used in teacher training programs emphasizing
 school-site connections may yield different definitions and meanings depending on the user. Such
 variation may contribute to ineffective communication and potential confusion regarding the concept
 of ‘field.’ Therefore, it is recommended that clear definitions and meanings for the term ‘field’
 throughout teacher training programs. Additionally, providing opportunities for pre-service teachers
 to directly experience a specific ‘field’ was suggested to enhance their understanding.

How talent management execution impacts career experiences: exploring the organization-individual intersect.

The aim of the research was to investigate the ways in which talent management execution impacts the individual career experiences of talent, specifically exploring how talent management execution and career enablement can be closer aligned to unlock value for both the organization and the individual. A qualitative research design was employed to explore the research question. During the first phase of the research data was collected from 13 talent management professionals using purposeful sampling and semi-structured interviews. During the second phase of the research the Delphi method was used to validate the findings (n = 8). Four broad themes were identified as the most prominent ways in which talent management execution impacts the career experiences of individuals. The first is the philosophical underpinning that the organization holds in how talent is defined as well as the exclusivity or inclusivity of their approach. The second is the identification criteria used to identify talent within the organization. Thirdly, the extent to which talent management practices are aligned with career enablement practices and the congruence between these. Lastly, the role of the psychological contract and employee experience in managing mutual expectations. The resultant tension must be proactively managed by (1) clearly articulating the talent philosophy and making this visible through talent management execution, (2) ensuring alignment between talent management practices and the career enablement available to talent, and (3) delivering on expectations through the lived experiences of talent. The study contributes to the existing body of knowledge on talent management and careers, with a specific focus on the intersection between these and defining ways to align these practices to create congruent and authentic career experiences for individuals.

Development And Validation of A Scale For Measuring Petro Retail Service Quality: A Bilateral Approach

Purpose: Global retail fuel markets are being disrupted by a number of broad themes that are being highlighted by the emergence of alternative energy, new mobility models, and elevated customer expectations that are centered around convenience and personalization. Consumers express a need for individualized products and services that take into account each individual. Digital is becoming the norm in the new situation. The changing purchasing habits of customers are a result of technological advancements. As a result, factors affecting the consumer experience have also changed. The purpose of the study is to ascertain Petro Retail's service quality scale from an Indian standpoint. 
 Design /Methodology/ Approach: The study was conducted from October to December 2022 at fuel stations in Mumbai and Ranchi with face-to-face interviews with OMC officials at HQ and field levels. The primary data was collected through a Quantitative field studyanalysedlyzed using suitable statistical tools. Exploratory Sequential Mixed Method design ( Qual-Quan ) was followed for the study.
 Findings and Originality: Technology advancements significantly impact consumers and industries and transform people's lifestyles and behaviour. Predictive analytics, artificial intelligence, and the Internet of Things are important components in developing customer-facing projects that result in the creation of service protocols for improved purchasing experiences.
 Technology adoption in petroleum retail is dispersed, with IoT, automation, and AI/ML-based technological solutions being tested in isolated ways without a centralized understanding of the whole value chain. Utilizing assets more efficiently is the main goal of this type of technology adoption. Nevertheless, few applications have been explored to improve consumer purchasing behavior, such as identification and satisfaction. In the digital age, IoT is altering customer expectations and controlling the experience in India's petroleum retail industry from the viewpoints of both service providers and customers (a dyadic approach). Accordingly, the service quality has also evolved over a period of time. There is very limited work carried out on the Petro Retail service quality. The scale developed with the bilateral approach shall help academians and industry managers to understand the service quality in petro retail, and the “BISQUE” constract can be used for measuring the same. The study is one of its kind on the aspect of petro retail.

Helping High-Achieving, Low-Income, Black Students Gain Admission Into America’s Elite Colleges: Considerations for School Counselors

The recent decision by the United States Supreme Court to limit affirmative action in college admissions could make it even more challenging for academically talented students of color to gain access to competitive schools. The importance of school counselors in guiding and supporting these students is now more crucial than ever. This qualitative study aimed to determine what school counselors need to know, do, and believe to help academically talented, Black students from low-income households gain admission into highly selective colleges and universities. Three broad themes and 10 subthemes emerged from the data analysis. The themes were (a) knowledge and awareness, (b) mindsets and beliefs, and (c) habits and practices. Implications for school counselor practice, training, and research are discussed.

Social Connections and Future Horizons: Socioemotional Selectivity Among Midlife and Older Adults in Aotearoa/New Zealand During COVID-19

AbstractThe current study uses socioemotional selectivity theory (SST; Carstensen in Psychology and Aging. 7(3):331–338,1992,10.1037/0882-7974.7.3.331) as a framework to examine the experiences of older adults during COVID-19 in Aotearoa/New Zealand. SST posits that when time horizons are perceived as limited—such as with increasing age, or during times of medical uncertainty—people selectively focus on spending time with emotionally close others and in personally fulfilling activities. This may be the case particularly when uncertainty is experienced by older people. Aotearoa/New Zealand instigated an elimination strategy early in the pandemic (prior to widespread vaccine availability), employing a series of lockdowns that further challenged older adults’ perceptions of future horizons, their ability to maintain social connections with loved ones, and engagement in pleasurable activities. This study used thematic analysis to analyze existing qualitative COVID-19-related data drawn from the experiences of 510 older adults who participated in the 2021 Health, Work, and Retirement study (HWR). Participants ranged in age from 56 to 87 (Mage = 69.73); 15.9% identified as Māori, and 76.2% identified as female. Two broad themes were revealed: Social Connection and Anticipating the Future. Although most participants expressed comparatively more positive than negative experiences, some also expressed frustration and anxiety about health directive-related divisions in relationships, and the inability to share in important life events (such as weddings, births, and funerals). Findings highlight the complex impact of COVID-19 on older adults’ perceptions of time horizons, and the opportunities presented by the pandemic for reassessment of social relationships and activities.

Exploring perceptions of gender roles amongst sexually active adolescents in rural KwaZulu-Natal, South Africa.

Traditional gender and social norms reinforce asymmetrical power relations, increase the risk of experiencing gender-based violence and mediate poor engagement with sexual and reproductive health services. This study explored gender norms and expectations amongst cisgender adolescents in rural KwaZulu-Natal, South Africa. A purposive sample of 29 adolescents aged 16-19 years old were enrolled as part of a longitudinal qualitative study. The current analysis reports on the first round of in-depth interviews, which focused on the role of men and women in their community. A theoretically informed thematic analysis identified three broad themes: 1) Adolescent interpretation and understanding of gender identity, 2) Gendered essentialism and Gender roles (two sub-themes: Young men: Power through providing, and Young women: The domestication process which highlighted that gender roles were defined by being the provider for men, and the successful fulfilment of traditional domestic behaviours amongst women), 3) Gender and fertility highlighted how participants highly valued fertility as affirming of manhood/womanhood. These norms reinforce gender roles that maintain asymmetrical power relations, carrying them over into adulthood. The subtle social pressure to prove fertility could have unintended consequences for driving teenage pregnancy. Structural, gender-based interventions emphasising positive gender-role development in early childhood are needed.

The quest for continuous quality improvement in Australian long day care services: getting the most out of the Assessment and Rating process

The National Quality Framework (NQF) was intended to drive continuous improvement in education and care services in Australia. Ten years into implementation, the effectiveness of the NQF is demonstrated by steady improvements in quality as measured against the National Quality Standard (NQS). The process of assessing and rating services is a key element in the NQF, drawing together regulatory compliance and quality assurance. This paper draws on findings from a national Quality Improvement Research Project investigating the characteristics, processes, challenges and enablers of quality improvement in long day care services, concentrating on Quality Area 1 Educational program and practice and Quality Area 7 Governance and leadership. This was a mixed-method study focusing on long day care services that had improved their rating from Working toward NQS to Meeting NQS or to Exceeding NQS. The study comprised three phases, and in this paper, we draw on Phase 3 to understand the contribution of the NQS Assessment and Rating (A&R) process to continuous quality improvement from the standpoint of providers and professionals delivering these services. Phase 3 involved qualitative case studies of 15 long day care services to investigate factors that enabled and challenged quality improvement. Data was collected during two-day site visits, using professional conversations and field notes to elicit the views and experiences of service providers, leaders and educators. In this paper, we look at how the A&R process is experienced by those involved in service provision, with a focus on the factors that enabled and challenged quality improvement. Recognizing the interchangeability of enablers and challenges, three broad themes emerged: (i) curriculum knowledge, pedagogical skills and agency; (ii) collaborative leadership and teamwork; and (iii) meaningful engagement in the A&R process. The study found that meaningful engagement in the A&R process informed priorities for ongoing learning and acted as a catalyst for continuous quality improvement. Apprised by stakeholder views and experiences of A&R, we offer a model to foster stakeholder participation in quality assurance matters through affordances of meaningful engagement.

A gap analysis on modelling of sea lice infection pressure from salmonid farms. II. Identifying and ranking knowledge gaps: output of an international workshop

Sea lice are a major health hazard for farmed Atlantic salmon in Europe, and their impact is felt globally. Given the breadth of ongoing research in sea lice dispersal and population modelling, and focus on research-led adaptive management, we brought experts together to discuss research knowledge gaps. Gaps for salmon lice infection pressure from fish farms were identified and scored by experts in sea lice-aquaculture-environment interactions, at an international workshop in 2021. The contributors included experts based in Scotland, Norway, Ireland, Iceland, Canada, the Faroe Islands, England and Australia, employed by governments, industry, universities and non-government organisations. The workshop focused on knowledge gaps underpinning 5 key stages in salmon lice infection pressure from fish farms: larval production; larval transport and survival; exposure and infestation of new hosts; development and survival of the attached stages; and impact on host populations. A total of 47 research gaps were identified; 5 broad themes emerged with 13 priority research gaps highlighted as important across multiple sectors. The highest-ranking gap called for higher quality and frequency of on-farm lice count data, along with better sharing of information across sectors. We highlight the need for synergistic international collaboration to maximise transferable knowledge. Round table discussions through collaborative workshops provide an important forum for experts to discuss and agree research priorities.

'There is no justice in nursing school': A qualitative analysis of nursing students' experiences of discrimination shared on Reddit.

To explore nursing students' experiences of stigma and discrimination within nursing programmes as shared on Reddit, and how other Reddit users offer support and guidance. Qualitative interpretive description. Through a critical social theory lens, this study draws on students' posts from three nursing subreddits: r/studentnurse, r/nursingstudent and r/nursing. Data were collected from March 2013 to March 2023. Reflexive thematic analysis was conducted to generate broad themes of nursing students' experiences of stigma and discrimination, and how other Reddit users offered support and guidance. A total of 43 posts with 1412 associated comments were included in this analysis, which generated three predominant themes of nursing students' experiences. Nursing students faced stigma and discrimination across contexts, including from peers, nurses and other healthcare providers working in clinical practicum sites, and patients. Nursing students' posts described navigating the impacts and consequences of such experiences, including on well-being, and programme and career success. In contexts where students were often alone in their experiences of stigma and discrimination within their programmes and with few identified supports, Reddit users sought support and community through Reddit. While many comments offered validation and support, challenges of this social media platform included conflicting advice and unhelpful, judgmental messages. Despite widely articulated social justice commitments in the profession, nursing students continue to experience stigma and discrimination across contexts within their nursing programmes. Nurses and nurse educators have a responsibility to acknowledge and make visible such experiences, and take direct action to prevent and remediate stigma and discrimination within nursing education. This research contributes to the growing empirical evidence that nursing students' experience stigma and discrimination within nursing programmes and the healthcare system. Adherence to COREQ guidelines was maintained. No patient or public contribution.

When autistic writing is superior to neurotypical writing: the case of blogs

ABSTRACT Research on autistic individuals’ writing has long focused on weaknesses in structural complexity, organisation, and perspective-taking skills. More recently, awareness has grown that writing can be a strength, as suggested by research on autistic memoirs. To learn more about how well autistic individuals write when they use language for their own purposes, we turned to autistic-authored blogs. Online word usage patterns were analysed for 30 self-identified autistic bloggers and 30 age and gender-matched non-autistic bloggers, assumed to be neurotypical (NT). In addition, blog content was analysed for the range of topics discussed. Topics were categorised according to broad topics including common hobbies (e.g. sports, arts, crafts), preoccupations (e.g. people, vehicles, food, machines), and academic domains (e.g. belief systems, science, numbers, history). Compared to NT bloggers, autistic bloggers wrote in a more complex manner, as measured by word and sentence length and rare vocabulary. Autistic bloggers often wrote about science or other abstract topics rather than discussing daily life events. These findings suggest that one subset of autistic individuals, those who write blogs, are able to write in a more complex style than their NT peers. This may reflect having an intellectual orientation, or, autistic people with sophisticated writing skills are the ones who choose to author blogs. Raising awareness that some autistic individuals can be strong writers will be of broad help to diverse stakeholders, including educators, clinicians, families and autistic individuals themselves.

Beyond abjection: Exploring narratives after premenstrual dysphoric disorder

Qualitative research on the experiences of those living with premenstrual dysphoric disorder (PMDD) is limited. Utilising the material–discursive–intrapsychic (MDI) framework, the purpose of the study was to privilege the voices present within individuals who have moved into a space of recovery, management, or transformation of PMDD, and explore these narratives. The study involved seven, in-depth narrative interviews. The data were then analysed using the Listening Guide, a feminist, poststructural method used to capture the polyphony of perspectives surrounding PMDD experiences. The analysis generated two broad narrative themes, with four subsequent voices under each: (a) “within abjection”—the voice toward the Other, the voice silenced, the voice of anger, the voice of agency; and (b) “beyond abjection”—the voice of action, the voice of surrender, the voice of resistance, the voice of reembodiment. Significant findings from the research involved identifying the movement toward a space of recovery, management, or transformation of PMDD as attainable, with PMDD being a negotiable and therefore plastic experience for participants. Further, the participant accounts of dismissive, uninformed, and harmful treatment from medical providers were heard; experiences which led participants toward self-help options for PMDD management.

Factors Affecting the Physical and Functional Performance of Buildings in Kenya

Building performance is a broad subject whose meaning covers the ability of structures to serve the intended function based on a well-defined criterion such as the assessment of functional, physical, environmental, or even social attributes considered jointly or separately. Building failures and general collapses are some of the most severe consequences of failed performance of buildings which have a great impact on livelihoods yet have remained persistent in Kenya over decades despite various interventions. This paper analyses building performance based on observable attributes and sentiments of respondents collected from construction project sites across Kenya. The study aimed to characterize buildings that are likely to fail physically and functionally at different stages based on five factors drawn from the literature as institutional, ethical, financial, legal, and technical factors, with the intention of proposing the necessary stop-gap measures. The study employed a cross-sectional (survey) design in which quantitative research methods were applied to collect and analyze data from a random sample of 400 building construction projects selected through proportionate cluster sampling across the 47 counties of Kenya. A semi-structured questionnaire was used to gather data on the perception of industry professionals, building users, and generally the stakeholders on the identified area of the research. Data was analyzed using descriptive statistics, factor analysis, and regression analysis. The physical performance of buildings appeared to cause an alarming concern with elements such as wall and slab stability recording poor scores. Based on functional performance the aspects of disability mainstreaming and compliance to green building standards were noted to be under-performing. Multiple Regression analysis results revealed that institutional, ethical, financial, legal, and technical factors explained 17.1% of the variability in building performance. Notably, only ethical, legal, and technical factors were the statistically significant predictors of building performance. The study thus recommends a detailed review, restructuring, and optimization of the ethical, legal, and technical environment of building construction management to enhance buildings performance.

전문상담교사의 직무스트레스에 대한 현상학적 연구

Objectives The aim of this study is to investigate the job-related stress experienced by school counselors and identify the factors contributing to this stress within educational settings.
 Methods To achieve this goal, in-depth interviews were conducted either in person or over the phone with school counselors having a minimum of five years of experience. The experiential data obtained from 20 participants were analyzed using the Giorgi's phenomenological method by employing procedures such as ‘recognizing the entire content,’ ‘splitting semantic units,’ ‘converting into academic terms,’ and ‘integrating into structures.’
 Results After analyzing and reviewing the interviews with expert council, eighty eight meaningful statements were identified and categorized. These statements were further classified into nine categories with twenty one sub-categories. The nine categories included ‘excessive workload’, ‘role ambiguity’, ‘unfair treatment’, ‘challenges in the working environment’, ‘the burden of crisis counseling’, ‘dealing with difficult clients’, ‘bias against school counseling’, ‘lack of counseling competency’, and ‘psychological exhaustion’. These nine categories could be con-solidated into three broader themes: work-related job stress, counseling-related job stress, and personal job stress specific to school counselors.
 Conclusions Based on the findings of this study, we gained better understanding of the job stress faced by school counselors, which can be used as essential information for the development of training programs and inter-ventions aimed at preventing stress and equipping school counselors with effective coping strategies.

Comparing the Effect of Internet-Delivered Interpersonal Psychotherapy and Compassion-Focused Therapy on the Quality of Life and Grief Experience of First-Degree Relatives of the Deceased Due to COVID-19

Background: The COVID-19 pandemic presents an extreme threat to global health and stands as one of the leading causes of death worldwide. Loss, as a broader theme, intertwines with various aspects of people’s lives during these challenging times. Failing to address the urgent needs of individuals experiencing loss and grief can result in poor mental and physical health. Objectives: Our study aimed to evaluate the impact of interpersonal psychotherapy (IPT) and compassion-focused therapy (CFT) on the grief and quality of life (QoL) of first-degree relatives who lost loved ones due to the COVID-19 pandemic. Methods: This study was a randomized clinical trial. Participants who had lost a family member to COVID-19 between March 2019 and September 2020 and who visited the hospitals affiliated with Isfahan University of Medical Sciences were selected based on specific inclusion and exclusion criteria. Forty participants were randomly assigned to either IPT or CFT, and each group underwent 6 weekly sessions. The Grief Experience Questionnaires and the World Health Organization’s Quality of Life Questionnaires were administered to all individuals via phone interviews before commencing treatment and 1 month after completing the sessions. Results: The results indicated a significant improvement in both treatment groups individually (P < 0.001). However, when comparing the 2 groups while adjusting for the pre-test effects, there were no significant differences between them in any of the following areas: Physical response (P2 = 0.45), notoriety (P2 = 0.53), justification and coping (P2 = 0.59), guilt (P2 = 0.31), feelings of abandonment (P2 = 0.52), judgment by others (P2 = 0.78), and embarrassment and shame (P2 = 0.79). Conclusions: The findings from our study demonstrate that both IPT and CFT resulted in improved QoL and reduced grief experiences. Therefore, these therapeutic approaches can be employed to alleviate grief symptoms and enhance overall QoL.

Examining the Role of Social Determinants of Health and COVID-19 Risk in 28 African Countries

While the impact of the pandemic has varied between and within countries, there are few published data on the relationship between social determinants of health (SDoH) and COVID-19 in Africa. This ecological cross-sectional study examines the relationship between COVID-19 risk and SDoH among 28 African countries. Included were countries with a recent demographic and health survey (years 2010 to 2018). The response variables were COVID-19 case rates and death rates (reported as of 15 August 2020); and the covariates comprised eight broad topics common to multiple SDoH frameworks aggregated to the country level: geography (urban residence), wealth index, education, employment, crowding, and access to information. A negative binomial regression was used to assess the association between aspects of SDoH and COVID-19 outcomes. Our analysis indicated that 1 in 4 (25.1%) households in study countries are without safe and clean water and a space for handwashing. The odds of COVID-19 morbidity and deaths were higher in countries with a high proportion of households without access to safe and clean water. Having a high proportional of educated women (1.003: 95% CI, 1.001–1.005) and living in a less crowded home (0.959: 95% CI, 0.920–1.000) were negatively associated with COVID-19 deaths, while being insured and owning a mobile phone predicted illness. Overall, aspects of SDoH contribute either negatively or positively to COVID-19 outcomes. Thus, addressing economic and environmental SDoH is critical for mitigating the spread of COVID-19 and re-emerging diseases on the African continent.

Engaging healthcare professionals and patient representatives in the development of a quality model for hospitals: a mixed-method study.

Top-down and externally imposed quality requirements can lead to improvement but do not seem as sustainable as intended. There is a need for a quality model that intrinsically motivates healthcare professionals to contribute to quality and safe care in hospitals. This study shows how a quality model that matches the identity and the quality vision of the organization was developed. A multimethod design with three phases was used in the development of the model at a large teaching hospital in Belgium. In the first phase, 14 focus groups and 19 interviews with staff members were conducted to obtain an overview of the quality and safety challenges, complemented by a plenary discussion with the members of the patient advisory council. In the second phase, the challenges that had been captured were further assessed using a hospital-wide survey for all hospital staff. Finally, a newly established quality review board (with internal and external stakeholders) critically evaluated the input of Phases 1 and 2 and defined the basic quality standards to be implemented in the hospital. A first evaluation 2 years after the implementation was conducted based on (i) patients' perceptions of quality of care and patient safety by publicly available indicators collected in 2016, 2019, and 2022 and (ii) staff experiences and perceptions regarding the acceptability of the new model gathered through (grouped) interviews and an open questionnaire. The quality model consists of eight broad themes, including norms for the hospital staff (n = 27), sustained with quality systems (n = 8), and organizational support (n = 6), with aid from adequate management and leadership (n = 6). The themes were converted into 46 standards. These should be supported within a safe, efficient, and caring work environment. The new model was launched in the hospital in June 2021. The evaluation shows a significant difference in quality and safety on different dimensions as perceived by hospitalized patients. The perceived added value of the participatory model is a better fit with the needs of employees and the fact that the model can be adjusted to the specific context of the different hospital departments. The lack of hard indicators is seen as a challenge in monitoring quality and safety. The participation of various stakeholders inside and outside the organization in defining the quality challenges resulted in the creation of a participatory quality model for the hospital, which leads towards a better-supported quality policy in the hospital.

Clinical practice guidelines for the diagnosis and management of Duchenne muscular dystrophy: a scoping review.

Our objective was to identify recent CPGs for the diagnosis and management of DMD and summarize their characteristics and reliability. We conducted a scoping review of CPGs using MEDLINE, the Turning Research Into Practice (TRIP) database, Google Scholar, guidelines created by organizations, and other repositories to identify CPGs published in the last 5 years. Our protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses for scoping reviews. To assess the reliability of the CPGs, we used all the domains included in the Appraisal of Guidelines Research and Evaluation II. We selected three CPGs published or updated between 2015 and 2020. All the guidelines showed good or adequate methodological rigor but presented pitfalls in stakeholder involvement and applicability domains. Recommendations were coherent across CPGs on steroid treatment, except for minor differences in dosing regimens. However, the recommendations were different for new drugs. There is a need for current and reliable CPGs that develop broad topics on the management of DMD and consider the challenges of developing recommendations for RDs.

“Shared experience makes this all possible”: documenting the guiding principles of peer-led services for people released from prison

BackgroundThere is a growing body of evidence demonstrating the effectiveness of peer-led services in supporting community reintegration for people released from prison. This study aims to document the guiding principle of a peer-led service for people released from prison, from the perspective of peer mentors.MethodsData were collected using focus groups (N = 10; 2 groups with 5 participants each) and one-on-one interviews (N = 5) including a total of 13 people, representing all UTGSS staff at the time of the study. An inductive thematic analysis was used to identify patterns in the data. Initial coding was done by using “in-vivo” codes (i.e. applying codes to terms used by participants). This informed the direction of the next stage of analysis, which focused on identifying categories that synthesized the codes and data across transcripts. In this stage, broad themes and sub-themes were developed.FindingsSix themes were constructed to reflect the guiding principles of UTGSS staff. This includes four central themes: 1) Offering hope; 2) Building respectful relationships; 3) Providing consistent support; 4) Meeting people where they are at. Two connected themes are also reported: 1) Relying on shared experience, which participants reported serves as the foundation for practicing these guiding principles and 2) Bridging connections to services, which reflects the outcome of practicing these guiding principles.ConclusionThe principles identified in this study can be used by UTGSS staff as a guide for checking-in on progress with clients and may be considered as a model for reflection on practice by staff providing similar peer-led services. These principles should not be applied in a prescriptive way, as relationship building is at the centre of peer support, and different applications will be required depending on clients’ goals and the range of supports available within their community.

Communication in Primary Healthcare: A State-of-the-Art Literature Review of Conversation-Analytic Research

ABSTRACT We report the first state-of-the-art review of conversation-analytic (CA) research on communication in primary healthcare. We conducted a systematic search across multiple bibliographic databases and specialist sources and employed backward and forward citation tracking. We included 177 empirical studies spanning four decades of research and 16 different countries/health systems, with data in 17 languages. The majority of studies originated in United States and United Kingdom and focused on medical visits between physicians and adult patients. We generated three broad research themes in order to synthesize the study findings: managing agendas, managing participation, and managing authority. We characterize the state-of-the-art for each theme, illustrating the progression of the work and making comparisons across different languages and health systems, where possible. We consider practical applications of the findings, reflect on the state of current knowledge, and suggest some directions for future research. Data reported are in multiple languages.