Constant Comparative Technique Research Articles

Taiwanese nurse educators' behaviour or intention to teach LGBT health content: A qualitative study.

To explore factors associated with Taiwanese nurse educators' behaviour or intention to teach lesbian, gay, bisexual and transgender (LGBT) health content. Nurse educators were found to have limited experiences and readiness to teach LGBT health content. However, limited evidence exists to comprehensively understand factors associated with nurse educators' behaviour and intentions to teach LGBT health content. A qualitative descriptive study design was adopted. A total of 24 nurse educators were interviewed. One-on-one interviews were conducted employing a semi-structured topic guide and were audio-recorded. Interview data were analysed using the socio-ecological model and constant comparative technique. This article was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. Most nurse educators had no experience of teaching LGBT health content and expressed their low or no intention to teach it. Factors associated with nurse educators' behaviour and intention to teach LGBT content were categorised by the socio-ecological model level: intrapersonal factors, interpersonal factors, community factors and societal and policy factors. This study identified multilevel factors associated with Taiwanese nurse educators' behaviour and intention to teach LGBT health content. Recommendations were provided to address multilevel barriers to diminish nurse educators' challenges in teaching LGBT health content. Supervisors of nurse educators should assess and discuss nurse educators' concerns and competencies regarding teaching LGBT health content. To address schools' or organisations' adverse climates and conventional societal atmosphere, related policies and regulations should be developed and implemented.

Cervical Cancer Screening Uptake and Experiences of Black African Immigrant Women in Canada

Cervical cancer is one of the leading causes of cancer-related death among African women. Unfortunately, in most sub-Saharan African nations, women are vulnerable if they are unaware that cervical cancer is preventable with frequent screening and early treatment. The aim of this study was to examine Black African immigrant women’s perceptions and experiences of cervical screening in British Columbia, Canada. Twenty Black African immigrant women were interviewed using the qualitative research method Interpretive Description. Data collection approaches included indepth interviews and analytic memos. Data were analyzed using a constant comparative technique guided by a socioecologic framework to capture subjective experiences and perceptions. Four key themes were identified, including confusing conceptualizations about cancer and cancer screening, competing priorities, concerns for modesty, and commitment to culture. The study findings point to the need for more active approaches to promoting cervical screening for this population.

English as a ‘local’ language in Russia: the practice of meaning-making in in-group communication

The unprecedented global spread of the English language has become the catalyst for its transformation into the local meaning-making resource encoding the communication needs of various speech communities in different parts of the world. This dual process of globalization and localization is particularly evident in the Expanding Circle countries, where originally English had the status of a foreign language and was used primarily to communicate with foreigners. In Russia, which is one of the Expanding Circle countries, various aspects of “glocalization” of English, especially in the sphere of vocabulary, have attracted considerable attention. However, they have not been systemically studied, and our analysis aims to fill this gap. This paper describes the function of English as a language of in-group interaction in Russia. Taking a multiple case study approach and using a constant comparative technique, we reviewed our previous research on the use of English in different communities of practice, namely, the Russian offices of international companies, the young biking community, and the community of popular music professionals. We re-examined all previously collected material, including observational linguistic data and ethnographic interviews, and identified the following three features of English as a “local” language: truncated repertoire, bilingual creativity, or translanguaging, and ingroup-only function. We have also searched the Russian National Corpus for the frequency of several commonly used Anglicisms and English-derived tokens recorded from each community of practice. Based on the multiple case analysis and the Russian National Corpus study, we argue that English and Anglicisms are perceived by community members as an integral part of group repertoire, and group membership hinges on the knowledge of these terms and the ability to use them creatively.

Stress and Coping in Emergency Nurses Following Trauma Patient Care: A Qualitative Grounded Theory Approach.

Experiencing symptoms of traumatic stress may be the cost of caring for trauma patients. Emergency nurses caring for trauma patients are at risk for traumatic stress reactions. This study explored the stress and coping behaviors experienced by emergency nurses who provide trauma care. Focus groups were held at three urban trauma centers in the Midwestern United States: a Level I pediatric trauma center, a Level I adult trauma center, and a Level III adult trauma center. Data were collected between December 2009 and March 2010. Data analysis was guided by the principles of grounded theory. Line-by-line coding and constant comparative analysis techniques were used to identify recurring constructs. A total of 48 emergency nurses participated. Recurring constructs emerged in the data analysis and coding, revealing four major themes: care of the trauma patient, professional practice, personal life, and support. Nurse job engagement, burnout, and professional and personal relationships are influenced by trauma patient care. The study's resulting themes of care of the trauma patient, professional practice, personal life, and support resulted in the development of the "trauma nursing is a continual experience theory" that can be used as a framework to address these effects. Intentional support and timely interventions based on this new theory can help mitigate the effects of traumatic stress experienced by trauma nurses.

Managing the co-creation of accessible and inclusive family recreation retail encounters: A critical incident analysis

Entertainment and recreation are pull factors for retail shopping malls and supercentres. For families in particular, recreation is a relevant part of their retail visits. However, families with children with disabilities (FCwD) continue to face access challenges in retail service environments. In this paper, we empirically explore how a value co-creation process undertaken with FCwD can enhance their perception of an accessible and inclusive family recreation retail visit. Our findings are based on a collaborative research project conducted in 2019 with a major shopping mall in the city of Barcelona, Spain. The methodology consisted of focus groups with stakeholders, ethnographic techniques and interviews with 20 FCwD using a constant comparative technique. The research design included two studies: Study 1, on the design of accessible and inclusive recreation retail encounters for FCwD, and Study 2, on the design of accessible and inclusive recreation retail encounters with FCwD. Using critical incident techniques (CIT), we found that the families perceived the recreation retail encounters in Study 2 to be more inclusive and accessible. From this research, we provide retail managers with recommendations for the successful design of inclusive family recreation retail opportunities in shopping malls.

Unraveling attrition and retention: A qualitative study with rehabilitation professionals.

Health human resources are scarce worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. To investigate the phenomena of attrition and retention with OTs, PTs and S-LPs who stayed in, or left their profession. Cultural-historical activity theory provided the theoretical scaffolding for this interpretive description study. We used purposeful sampling (maximum variation approach) to recruit OTs, PTs, and S-LPs from Quebec, Canada. Individual interviews were conducted with 51 OTs, PTs, and S-LPs from Quebec, Canada, in English or French (2019-2020). Inductive and deductive approaches, and constant comparative techniques were used for data analysis. Six themes were developed: 1) characteristics of work that made it meaningful; 2) aspects of work that practitioners appreciate; 3) factors of daily work that weigh on a practitioner; 4) factors that contribute to managing work; 5) relationships with different stakeholders that shape daily work; and 6) perceptions of the profession. Meaningfulness was tied to participants' sense that their values were reflected in their work. Factors outside work shaped participants' work experiences. Recurrent negative experiences led some to leave their profession. Findings underscore a critical need to address contributing factors to attrition and retention which are essential to ensuring the availability of OTs, PTs and SLPs for present and future rehabilitation needs.

Women’s Self-Management of Dyspareunia Associated With Endometriosis: A Qualitative Study

Given the limitations of medical treatment for endometriosis, self-management is a critical component of symptom management, and providing patients with information and education is a necessary complement to medical interventions. Though 50 to 70% of people with endometriosis experience dyspareunia (painful sex), there is limited knowledge of self-management specific to painful sex. A comprehensive understanding of the self-management strategies used is foundational to developing supportive care interventions that help ease pain and related psychosocial sequelae. The objective was to describe people's experiences of navigating endometriosis-associated painful sex and developing self-management strategies. We analyzed interview data from 20 women using constant comparative and thematic analysis techniques, guided by qualitative interpretive description methodology. Participants (age range 18–44 years) all identified as women and were predominately Caucasian (90%) and heterosexual (80%). Throughout their lives, the women appeared to gradually develop self-management strategies while navigating painful sexual experiences. This complex journey encompassed four phases: 1) viewing painful sex as normal, 2) experiencing evolving thoughts and emotions, 3) coming to understand painful sex and seeking help, and 4) learning strategies to navigate painful sex, these include preparing mentally and physically for sex and communicating with intimate partner(s). Women in this study developed self-management strategies over time through engagement with others who understood their challenges. Future research is warranted regarding initiatives to counter the normalization of painful sex, develop and disseminate patient-facing information, provide education specific to dyspareunia, improve access to multidisciplinary care, facilitate social connections and support, and enhance communication with intimate partners. PerspectiveIn this paper, we report on the experiences of women with endometriosis-associated painful sex and their self-management strategies. Clinicians may be interested in a qualitative exploration of endometriosis-associated painful sex as they seek to further understand their patient’s experiences and what strategies can be implemented to alleviate dyspareunia. Data AvailabilityThe data sets generated during and/or analyzed during the current study are not publicly available as participants did not consent to making their data publicly available but are available from the corresponding author on reasonable request.

Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana

BackgroundLow birth weight (LBW) is associated with short and long-term consequences including neonatal mortality and disability. Effective linkages in the continuum of care (CoC) for newborns at the health facility, community (primary care) and home care levels have a high tendency of minimizing adverse events associated with LBW. But it is unclear how these linkages work and what factors influence the CoC process in Ghana as literature is scarce on the views of health professionals and families of LBW infants regarding the CoC. Therefore, this study elicited the drivers influencing the CoC for LBW infants in Ghana and how linkages in the CoC could be strengthened to optimize quality of care.MethodsA constructivist grounded theory study design was used. Data was collected between September 2020 to February 2021. A total of 25 interviews were conducted with 11 family members of LBW infants born in a secondary referral hospital in Ghana, 9 healthcare professionals and 7 healthcare managers. Audio recordings were transcribed verbatim, analyzed using initial and focused coding. Constant comparative techniques, theoretical memos, and diagramming were employed until theoretical saturation was determined.ResultsEmerging from the analysis was a theoretical model describing ten major themes along the care continuum for LBW infants, broadly categorized into health systems and family-systems drivers. In this paper, we focused on the former. Discharge, review, and referral systems were neither well-structured nor properly coordinated. Efficient dissemination and implementation of guidelines and supportive supervision contributed to higher staff motivation while insufficient investments and coordination of care activities limited training opportunities and human resource. A smooth transition between care levels is hampered by procedural, administrative, logistics, infrastructural and socio-economic barriers.ConclusionA coordinated care process established on effective communication across different care levels, referral planning, staff supervision, decreased staff shuffling, routine in-service training, staff motivation and institutional commitment are necessary to achieve an effective care continuum for LBW infants and their families.

RELEVANTIZING METHOD OF TARJĪH AL-ḤADĪTH IN TIMES OF COVID-19: A STUDY ON AL-SHĀFI‘Ī’S IKHTILĀF AL-HADĪTH

With the emergence of the deadly COVID-19 pandemic in 2019, Muslim scholars have been going back and forth searching for Qur’anic and Prophetic injunctions on how to face this fatal virus. Prophet PBUH said, “If you hear about it (an outbreak of plague) in a land, do not go to it; but if the plague breaks out in a country where you are staying, do not run away from it.” With this injunction, Malaysia’s government implemented a nationwide lockdown known as Movement Control Order (MCO) from 18 March 2020 (first phase) until 3 May 2020 (fourth phase), with the latter marking the end of the total lockdown. It is during these phases that fake news started to develop in the middle of mass information regarding the outbreak of COVID-19, that fake news seems to be the truth, while the fact appears to contradict. This turmoil is not rare, as hadith scholars had been facing them early on with a handful of ahadith that seemed to contradict each other. Indeed, this contradiction will have a negative impact on the authority of hadīth as it is one of the primary sources of understanding Islam, especially to the public. Scholars of Islam had come up with the solution on how to solve the contradictions in hadīth through their writings from the early second century of Hijrah, in which the earliest writing that appropriately touches on the issues of contradictory hadīth is Ikhtilāf al-Hadīth by al-Shāfi‘ī. This study aims to analyze the approach used by al-Shāfi‘ī on identifying contradictory ahadīth by the method of al-tarjīh and use the same process in identifying credible information by using constant comparative technique, inductive and deductive methodologies. This paper concludes that the method of al-tarjīh used by al-Shafi‘ī when solving the contradiction in hadīth can also be used in identifying truth and credible information or news, especially during COVID-19.

Communication and collaboration: The paradox of the new competency-based curriculum in Kenya

Successful implementation of any curriculum is built on the foundation of teamwork among all stakeholders. The new competency-based curriculum in Kenya encourages teachers and parents to cooperate and communicate in order to implement the curriculum effectively. Being a new innovation, the channels of communication and collaboration used to involve parents in their children’s education have not been empirically documented. The purpose of this study is to explore communication and collaboration between teachers and parents for effective implementation of the competency-based curriculum in Kenya. Schramm’s interactive model of communication was adopted as a theoretical framework for this study. This study adopted a qualitative approach that used a grounded theory research design based on a relativist–interpretivist paradigm. The study focused on teachers and parents in 395 primary schools in Vihiga County. Purposive and snowball sampling strategies were used in selecting 12 teachers and 20 parents. Data was collected using interviews and analysed inductively using the grounded theory method of analysis through the constant comparative technique. The study established that teachers and parents were reported to be using several communication channels. These channels proved ineffective because each one used them separately. These frequently led to breakdowns in communication and insufficient teacher-parent cooperation in the implementation of the curriculum. Therefore, this study suggests using a number of complementary communication and cooperation methods. It is hoped that the implementation of the findings of these studies will enhance parent-teacher communication and collaboration.

American Indian Perspectives on Culturally Aligning a Digital Smoking Cessation Resource.

Innovative smoking cessation approaches that overcome barriers such as traveling to program site or that require the staff and infrastructure for sustaining are likely needed to improve smoking quit rates among American Indian (AI) peoples in the United States. In this study, qualitative methods identified recommendations from AI peoples to guide alignment of an evidence-based smoking cessation smartphone app (i.e., QuitGuide) to the culture and needs of AI persons. Semi-structured interviews were conducted with AI adults who smoke (n = 40) and with public health professionals (n = 6). Questions included: "The app asks if something triggered you to slip and lists several options. What options were you expecting to see on this list?" as well as how to make the app more engaging such as "What would make the app more helpful for AI peoples, like you, who want to quit smoking?." Constant comparative techniques were used to develop codes and themes. Loss, grief, and not accessing traditional tobacco were put forward as smoking triggers to be addressed in the app. Features that help users connect with and learn about AI cultures and promote healing, such as encouraging traditional tobacco use, being in community, embracing Native spirituality, and participating in cultural crafting were recommended. Some noted the need to motivate AI peoples to think about legacy and ability to care for younger generations and Indigenizing the app with Native imagery. Themes pointed towards promotion of strengths-based factors, such as healing, cultural connectedness and traditional tobacco use, in the app. Results will be used to culturally align a smartphone app for smoking cessation among AI peoples and may be insightful for other tribal, federal, and state public health efforts aimed at advancing health equity for AI peoples.

Role Identity Transition: A Conceptual Framework for Being the Spouse of a Person With Early Onset Dementia.

Informal caregivers of persons with early onset dementia (PWEOD) are usually the spouses of affected individuals. These caregivers face unique challenges related to the unexpected nature of disease onset at this early life stage along with the accompanying symptoms, which can be different from those in late onset dementia. The current study explores the meanings these caregivers make of their situations and actions in response to their experiences. Findings provide a basis for development of a conceptual framework illustrating the basic, psychosocial processes underlying their shared situation. Grounded theory methodology was used. Qualitative data were collected through semi-structured interviews with 15 participants. Data were analyzed using constant comparative techniques and situational analysis. A distinction was made across participants between identifying as spouse versus caregiver for their PWEOD. Each participant had made or was making an identity transition from viewing their role as becoming more caregiver-like toward an eventual, complete shift to that of caregiver in a stepwise fashion. Incremental shifts in identity reflected challenges to the notion held of what it means to be a spouse. Results support prior research highlighting the unique experiences of caregivers of PWEOD while providing a framework for understanding the unique situations of these care-givers. Findings also inform nursing interventions tailored for spouses of PWEOD. [Journal of Gerontological Nursing, 49(8), 27-34.].

Women’s Metaphors About BRCA Gene Testing and How They Can Inform Health Communication Theory and Practice

ABSTRACT Genetic testing can detect whether an individual carries a harmful variant in the BRCA1 or BRCA2 (Breast Cancer 1 or 2) gene which, if present, drastically increases a woman’s risk for breast and ovarian cancer. The experience of BRCA gene testing can be an emotionally laden process yielding significant uncertainty. In this study, we examined women’s experiences of BRCA gene testing by exploring how participants communicatively framed and made sense of this process through the use of metaphors. Comparing uncertain and unfamiliar experiences to familiar references through metaphor can help people in challenging health-related situations with sense-making and communicating complex emotions. Furthermore, metaphors can be employed as a therapeutic tool by health care professionals, but their use has not often been studied regarding experiences of genetic testing, including BRCA gene testing. We conducted in-depth interviews with 42 women who have undergone BRCA gene testing (regardless of results), and analyzed data using constant comparative techniques. Eight categories of metaphors that women used surrounding BRCA gene testing were evident in the data, including those related to (a) knowledge is power; (b) gambling; (c) a journey; (d) a rollercoaster; (e) battle, disaster, or wreckage; (f) Pandora’s box or a can of worms; (g) doom and gloom; and (h) the release or placing of a weight. Results enhance our understanding of women’s experiences related to the uncertainty-inducing process of BRCA gene testing and lead to valuable theoretical implications and practical recommendations, including regarding the potential use of metaphors in patient-provider communication about BRCA genetic risk.

Reducing Overuse by Healthcare Systems: A Positive Deviance Analysis.

Healthcare in the USA is increasingly delivered by large healthcare systems that include one or more hospitals and associated outpatient practices. It is unclear what role healthcare systems play in driving or preventing overutilization of healthcare services in the USA. To learn how high-value healthcare systems avoid overuse of services DESIGN: We identified "positive deviant" health systems using a previously constructed Overuse Index. These systems have much lower-than-average overuse of healthcare services. We confirmed that these health systems also delivered high-quality care. We conducted semi-structured interviews with executive leaders of these systems to validate a published framework for understanding drivers of overuse. Leaders at select healthcare systems in the USA. None APPROACH: We developed an interview guide and conducted semi-structured interviews. We iteratively developed a code book. Paired reviewers coded and reconciled each interview. We analyzed the interviews by applying constant comparative techniques. We mapped the emergent themes to provide the first empirical data to support a previously developed theoretical framework. We interviewed 15 leaders from 10 diverse healthcare systems. Consistent with important domains from the overuse framework, themes from our study support the role of clinicians and patients in avoiding overuse. The leaders described how they create a culture of professional practice and how they modify clinicians' attitudes to facilitate high-value practices. They also described how their patients view healthcare consumption and the characteristics of their patient populations allowed them to practice high-value medicine. They described the role of quality metrics, insurance plan ownership, and alternative payment model participation as encouraging avoidance of overuse. Our qualitative analysis of positive deviant health systems supports the framework that is in the published literature, although health system leaders also described their financial structures as another important factor for reducing overuse and encouraging high-value care delivery.

Adolescent Self-Consent for COVID-19 Vaccination: Views of Healthcare Workers and Their Adolescent Children on Vaccination Autonomy

PurposeThis study explored the perceptions of healthcare worker parents (physicians, nurses, and staff) and their adolescents (aged 12–17 years) on adolescent self-consent to COVID-19 vaccination by applying the concept of positive deviance of those already vaccinated against COVID-19. MethodsWe used a qualitative descriptive design to conduct individual, semi-structured interviews with COVID-19–vaccinated healthcare workers in Southern California and their vaccinated adolescent children. Separate interviews were conducted with parents and adolescents from November to December 2021 using digital phone conferencing software. All interviews were recorded and transcribed. Thematic and constant comparative analysis techniques were used to identify relevant themes and subthemes. ResultsTwenty one healthcare workers (9 nurses, one nurse practitioner, one technologist, and 10 physicians) and their adolescents (N = 17) participated. Three overarching themes were identified to describe participants' perspectives about adolescent self-consent for COVID-19 vaccination: (1) Family values and practices around adolescent vaccination; (2) Differences in parent and adolescent support for vaccine self-consent laws; and (3) Parent and adolescent uncertainty on readiness for vaccine self-consent laws. Adolescents largely supported self-consent while parents supported the policy if they would be able to have a discussion with their adolescent prior to the decision. DiscussionParents and adolescents supported adolescent self-consent for COVID-19 vaccination, with the reservation that adolescents should discuss the decision alongside their parents to exercise their medical autonomy with supportive guidance. Greater adolescent involvement in making decisions and providing self-consent for healthcare, including vaccines, could prepare adolescents to have a greater sense of autonomy over their health and contribute to population health measures.

THE IMPACT OF CODE-SWITCHING IN AFFECTIVE SUPPORT AND LEARNERS’ SUCCESS IN PAKISTANI ESL CLASSROOMS AT UNIVERSITY LEVEL

Background and Purpose: English is an official language of Pakistan and it is not only taught as a subject, but it is also used as a medium of instruction in Pakistan. However, students find English language learning a difficult experience. Their difficulties are compounded by monolingual English language teaching policies and their individual differences which are linked with their motivation, level of anxiety and confidence. This study aimed at finding out the relationship between code-switching and learners’ affective response and its impacts on attaining success in ESL classrooms.
 
 Methodology: Data for this mixed method study were collected through purposive sampling via questionnaires, interviews, and field notes from the students majoring in English at a private university in Pakistan. Quantitative data is analyzed throughSPSS whereas qualitatively the data is analyzed by using constant comparative technique.
 
 Findings: The findings unveil that code-switching is an effective teaching strategy in ESL classrooms to deal with the learning of vocabulary, comprehension of abstract concepts, the performance of a difficult task, participation in classroom discussions, and the clarity of concepts. Moreover, switching to L1 also gives them satisfaction, fosters attention span, creates enjoyment, and boosts confidence, resultantly their performance improves.
 
 Contribution: The study provides implications for stakeholders including teachers, teacher trainers and policy makers to introduce pedagogical code-switching in ESL classrooms to foster the motivation and self-confidence of the students. The study concludes that though code-switching carries benefits, however, it should be used strategically to improve learners’ performance.
 
 Keywords: Code-switching, affective-response, success, ESL classrooms.
 
 Cite as: Nawaz, N., Atta, A., & Naseem, N. (2023). The impact of code-switching in affective support and learners’ success in Pakistani ESL classrooms at university level. Journal of Nusantara Studies, 8(1), 95-116. http://dx.doi.org/10.24200/jonus.vol8iss1pp95-116

Patients’ Experiences, Expectations, Motivations, and Perspectives around Urinary Tract Infection Care in General Practice: A Qualitative Interview Study

While there are many alternatives to antibiotics for the symptomatic treatment of urinary tract infections (UTIs), their application in practice is limited. Among other things, general practitioners (GPs) often feel pressure from patients to prescribe antibiotics. To gain a better understanding of why this happens and where this pressure originates from, we investigated experiences, expectations, motivations, and perspectives of patients with UTIs in general practice. During this qualitative study we performed 14 semi-structured online interviews among female UTI patients in general practice. Interviews were based on a topic list derived from sensitising concepts. All the interviews were recorded, transcribed, and analysed using a constant comparative technique. Three main categories emerged from the data; (1) experienced versus unexperienced patients with UTI, (2) patient's lack of knowledge, and (3) patients feeling understood. Inexperienced patients consult a general practitioner for both diagnosis and symptom relief, while experienced patients seem to consult specifically to obtain antibiotics. In addition, patients have a lack of knowledge with regard to the diagnosis, treatment, self-care, and cause of UTIs. Finally, patients' satisfaction is increased by involving them more in the process of decision making, so they feel understood and taken seriously. Patients' expectations in UTI management in general practice often arise during their first experience(s) and play a major role in subsequent episodes. In conclusion, preventing misconceptions is especially important in the inexperienced patient group, as this may prevent future overtreatment of UTIs. In addition, involving patients in the decision making process will lead to greater understanding of the GP's treatment choices.

Parental involvement in grade four learners’ take-home assignments in Vihiga county, Kenya

Successful implementation of the new competency-based curriculum in Kenya partly depends on efforts of the teacher who is tasked with effecting curriculum changes, and to a greater extent the parent. Parental involvement in learners' educational achievement has been cited to be one of the guiding principles of the new education system. One way of involving parents is through take-home assignments. This study explored parental involvement in grade four learners' take-home assignments in Vihiga County. By applying a grounded theory research design, this study interrogated 20 parents. The collected data was then analyzed inductively using grounded theory techniques specifically constant comparative technique. From the analysis it was established that: parents were involved in an array of activities while assisting their children undertake, take-home assignments. However, their involvement was limited by a range of factors including inadequate resources, inadequate time, limited knowledge on CBC, poor and late communication as well as negative attitude by parents. The challenges were further aggravated by failure of the curriculum to cater for diversity in parenting styles and family setups. The study thus recommends for a further reconceptualization of parental involvement in learner's take-home assignments by curriculum developers. This can be done by putting into consideration the diverse parenting styles and family setups that exist currently in Kenya.

When chronic critical illness is a family affair: A multi-perspective qualitative study of family involvement in long-term care.

Those with chronic critical illness (CCI) remain dependent on life-sustaining treatments and increasingly reside in long-term care facilities equipped to meet their needs. The nature of family involvement in care remains undetermined thwarting approaches to mitigate poor family outcomes. The research objective was to explicate family involvement in the care of an individual with CCI who resides in long-term care. In this qualitative research, we used thematic analysis and constant comparative techniques to analyze data from interviews with 38 participants: 11 family members, 6 residents with CCI, and 21 healthcare providers. Involvement in care entailed family: (1) reorienting their life despite the stress and emotional toll; (2) assuming responsibility for meaningful activities and management of practical matters, yet struggling alone; (3) advocating for care by being present, reminding and pushing, and picking their battles; and (4) figuring out how to contribute to nursing care, but with unclear expectations. The burden of family caregiving was substantial, contrasting the assumption that family are relieved of their caregiver responsibilities when the patient with CCI is in a care facility. Research to address unmet family needs specific to their roles and responsibilities could potentially improve family outcomes and is warranted.

Cross disciplinary teaching: A pedagogical model to support teachers in the development and implementation of outdoor learning opportunities

There is a growing body of empirical evidence documenting the positive effects associated with participation in environmental education and outdoor learning for students, teachers and the wider community. Despite this, there has been a substantial reduction in outdoor learning opportunities for school students, possibly due to the focus on evidenced-based outcomes, high-stakes standardised testing programs, and a lack of teacher knowledge, confidence and expertise in teaching and learning outdoors. Accordingly, this study presents an evidenced based model to support teaching practice. The model will assist teachers in the development and implementation of outdoor learning opportunities and offers applied examples that address curriculum outcomes. A comprehensive literature review methodology was implemented to identify peer-reviewed literature on teaching and learning outdoors and outdoor pedagogies. A thematic synthesis and constant comparative technique enabled development of themes, from which three themes emerged: the environment; the learner; and the educator, which inform the proposed model offered by the authors. The three interrelated components (the environment, the learner and the educator) require consideration for students to gain maximum benefit from outdoor learning experiences. The model, coupled with the applied examples, supports teachers to plan and facilitate immersive outdoor experiences that promote learning.