Inductive-deductive Approach Research Articles

Physician perspectives of clinical performance feedback and impact on well-being: a qualitative exploration

ObjectivesProviding clinical performance feedback to physicians is an established method to improve care, but the impact on physician well-being is unclear. This evaluation aimed to better understand physician perspectives on...

Goals of Surgical Interventions in Youths Receiving Palliative Care

Most youths receiving palliative care undergo many surgical interventions over their lifetimes. The intended purposes of interventions in the context of goals of care are not commonly articulated. To describe the goals and purposes of surgical intervention in youths receiving palliative care and propose a framework discussing intervention using goal-oriented language. This retrospective cohort analysis was conducted among a subset of patients enrolled between April 2017 and March 2021 in a prospective multicenter cohort study of youths receiving palliative care (the Pediatric Palliative Care Research Network's Shared Data and Research [SHARE] Study). Patients younger than 30 years receiving palliative care services were eligible for inclusion in SHARE, and all enrolled at Boston Children's Hospital/Dana Farber Cancer Institute, a SHARE site, were included in this study. Goals and purposes of all surgical interventions from the time of diagnosis through the present were abstracted from patient records. A goal and purpose framework was generated using a hybrid deductive-inductive approach based on established goals-of-care frameworks and the clinical context of surgical interventions. Data were analyzed in September 2023. Primary outcomes included goals and purposes of surgical interventions performed in the study population. Among 197 youths receiving palliative care (mean [SD] age at palliative care start, 8.01 [7.53] years; 108 male [54.8%]; 6 Asian [3.0%], 12 Black [6.1%], 129 White [65.5%], and 16 with >1 race [8.1%]; 27 Hispanic [13.7%] and 142 not Hispanic [72.1%]), almost all individuals (189 youths [95.9%]) underwent at least 1 surgical intervention (mean [SD] 17.5 [16.3] interventions; median [IQR] 13 [5-22] interventions). Of 3331 surgical interventions, there were 878 interventions (26.5%) conducted with the goal of life extension, 1229 interventions (37.1%) conducted for life enhancement, and 79 interventions (2.4%) conducted for both goals; the remaining 1130 interventions (34.1%) held neither goal. Most interventions were performed with the purpose of diagnosis (1092 interventions [32.9%]) or cure and repair (1055 interventions [31.8%]), with fewer performed for the purpose of placing or maintaining assistive technology (696 interventions [21.0%]) or for supportive (434 interventions [13.1%]) or temporizing (39 interventions [1.2%]) purposes. Patients with cardiovascular disease and cancers constituted approximately half (592 patients [56.1%]) of those undergoing curative or repair interventions, whereas youths with neurologic or genetic conditions constituted approximately half (244 patients [56.2%]) of those undergoing supportive interventions. In this cohort study, nearly all youths underwent surgical intervention, and the purposes of intervention differed by serious illness type. These findings suggest that conversations centered on a proposed framework concerning goals and purposes of surgical intervention may facilitate goal-concordant, high-quality care for youths with serious illness.

Conceptual foundations for implementing European and international non-financial reporting standards

Throughout the current years, non-financial reporting has undergone rapid development, manifesting both in international frameworks by non-governmental organizations and via national or regional (European) standards. However, internationallystandardised reporting standards play a crucial role in ensuring the efficiency of international capital markets and satisfying users’ needs for data comparability. This article aims to examine the theoretical foundations and principles underlying the implementation of non-financial reporting standards in the EU and at the international level. The study explores the nuances of incorporating sustainable development components into non-financial reporting standards.The significance of materiality is defined for prioritizing information from the financial aspect and ESG concerns. It has been contemplated that the scope of reporting encompasses activities, products, services, and risks extending beyond a company, encouraging the consideration of value creation chains. Emphasis is placed on the potential to present non-financial information at various levels of consolidation, aiming for relevance and compatibility. Types of information subject to disclosure are disclosed.Crucial principles of sustainable reporting are highlighted, considering a focus on essential information and stakeholder orientation. Global policy priorities are noted to expect business contributions towards achieving sustainable development goals and corporate social responsibility. Standards and frameworks are shown to be pivotal in presenting non-financial information related to sustainable development, facilitating its digitization. It has been accentuated that the assessment of materiality defines the content of non-financial reports, yet challenges arise due to the absence of recommendations and stakeholder perspectives. Sustainability information should encompass the company’s value creation chain with guidance for priorities and impact assessment to enhance the effectiveness of actions and reporting. General scientific and special methods are used: analysis and synthesis, theoretical-applied analysis of sources, inductive-deductive approach, generalization and abstraction, ascent from the abstract to the concrete. The contribution of business to the global policy of sustainable development and the role of corporate social responsibility are also considered. It is substantiated that the assessment of materiality determines the content of non-financial reports, but challenges arise due to the lack of recommendations and taking into account the perspective of interested parties. The current research stimulates further scientific developments in the field of NFZ.

Promoting intergenerational learning in higher education: participants’ perspectives on co-management and project-based learning

ABSTRACT Intergenerational (IG) practices foster understanding among diverse age groups, enhancing active ageing and social cohesion. Universities, as key stakeholders in lifelong learning, are pivotal in IG initiatives. Hence, this study investigates IG practices, rooted in project-based learning and co-management, in an international collaboration of universities. It explores participants’ views on IG learning experiences, emphasising generational perspectives and institutional situatedness. The research was conducted in 2022/2023 across Central and Eastern European universities, involving 45 participants (25 older learners, 20 students). Focus group interviews were employed, using a hybrid deductive-inductive approach. Results reveal age-related differences in IG learning perceptions: younger participants emphasised self-expression and connections, while older adults reported view changes about younger generations. Project-based collaboration and effective communication were key facilitators. Institutional situatedness was also identified as a relevant perspective. Participants at Mendel University emphasised the social engagement of older adults; at Eötvös Loránd University, the focus was on the choice of topics and roles; while at University of Split, there was an emphasis on fostering creativity and cooperation. The study thus underscores IG learning’s complexity and advocates for inclusive IG practices in universities, leveraging project-based and co-management principles.

Experiences of family caregivers of children living with thalassaemia-major in Karachi: a phenomenological study

IntroductionThalassaemiamajor, a global health burden, presents a growing challenge in Pakistan’s strained healthcare system. This study explores how caregivers of children with beta-thalassaemia major navigate healthcare services, aiming to identify facilitators and barriers to accessing optimal care.MethodsA qualitative interpretative phenomenological approach was employed. In-depth interviews with 18 purposively sampled caregivers from Karachi thalassaemia centres were conducted. Thematic analysis using a combined inductive-deductive approach identified themes within the interview data.ResultThe study revealed significant challenges for caregivers at individual, interpersonal and organisational levels. Lack of awareness about carrier states, limited disease knowledge, financial constraints and concerns about the child’s future emerged as primary hurdles. Parents felt helpless due to the absence of emotional and social support for their children’s treatment. Obstacles such as complicated registration processes at thalassaemia-care centres, high costs of chelating agents and blood unavailability were major barriers to seeking care and caregiving. Additionally, the study highlighted the absence of guidelines for thalassaemia-carrier detection among mothers during antenatal care.ConclusionThe study emphasised the importance of implementing premarital screening programmes due to the lack of knowledge about the disease and carrier state. To prevent the disease, it is crucial to include thalassaemia-carrier detection for mothers in antenatal guidelines and provide counselling at the primary level. Additionally, caregivers encountered treatment accessibility issues, prompting the establishment of a satellite thalassaemia centre linked to a top-tier tertiary care hospital in the public sector. This initiative addressed treatment challenges and improved overall care for patients with thalassaemia and their caregivers.

Exploring parents’ experiences of working with educational psychologists to support their autistic daughters

ABSTRACT Understanding of autism has changed considerably in recent years, with growing awareness of the under-recognition of autism in girls. Research has sought to explain the under-diagnosis and experiences of autistic girls, and to provide recommendations for support. Research has also highlighted that parents are often dismissed by professionals; thus, it is crucial that the experiences of parents are represented in the literature. This study explored parents’ experiences of working with educational psychologists to support their autistic daughters. A single embedded case study design and semi-structured interviews were utilised to explore the experiences of five parents of autistic girls. Interviews were analysed using a deductive-inductive approach to thematic analysis. Nine themes and 22 subthemes were identified which highlighted what parents found to be helpful/unhelpful, and areas for development, when working with educational psychologists to support their daughters. The findings are discussed in relation to the existing literature and implications for professional practice are highlighted.

العلاقة بين المساواة بين الجنسين في الكتاب والسنة وأهداف التنمية المستدامة 2030 –"عرض وتقويم"

This research deals with the relationship between the concept of gender equality in the Qur’an and Sunnah, and what is stated in the 2030 Sustainable Development Goals document issued by the United Nations, and addressing the problems of racial discrimination between the sexes that peoples suffer from in all previous and contemporary civilizations, and clarifying this concept by stating the legal basis for its objectives and the wisdom of it in the Qur’an and Sunnah. The research included two topics: defining the concept of gender equality in the Qur’an and Sunnah and in the Sustainable Development Goals document and the difference between them. The second: areas of the relationship between gender equality in the Qur’an and Sunnah and the Sustainable Development Goals document. In this research, I adopted the inductive-deductive approach in analyzing legal texts and what is stated in international agreements. The research concluded with important results, which are: - Explaining the greatness of the Islamic religion, including its provisions that are appropriate for all times and places, with regard to gender equality. - Supporting the United Nations initiatives to enable gender equality within the sustainable development goals, in a manner that does not contradict what is stated in the Qur’an and Sunnah.

Older people’s challenges accessing health services in central Nepal: a qualitative study using the domain of access framework

BackgroundLow- and middle-income countries face rapid population aging. However, the health system has remained largely unprepared to deliver health services to an aging population. As the population is rapidly aging in Nepal, their challenges and experience should be the focus for health care providers to address these issues. There is a paucity of evidence on barriers and facilitators to accessing health care services among older people in Nepal. The aim of this study was to investigate the challenges that older people experience while accessing health services in central Nepal.MethodsThis qualitative study was conducted between April and June 2023. In-depth interviews were conducted among older people of a municipality in central Nepal, which were analysed thematically using a deductive-inductive approach based on the theory of access.ResultsHypertension and diabetes were the most common health problems among the participants. The affordability of health services was a major issue, although there is a health insurance scheme and a major focus on universal health coverage from the Government of Nepal. Other issues included poor acceptability, poor communication between older people and health staff, and poor accommodation due to a lack of elderly-friendly services, including long wait times in the clinic. Living with family was a major facilitator of access to health care services and was interrelated with multiple domains of access.ConclusionsThis study identified barriers to accessing health care services for older adults in Nepal. We found that the affordability of health services, poor acceptability, poor communication between older people and doctors, and a lack of elderly-friendly services are the key challenges experienced by older people. Older people felt that these barriers were easier to overcome when they had family support. Therefore, for those living with their children, family support was reported as the major facilitator.

The Online Health Information-Seeking Behaviors of People Who Have Experienced Stroke: Qualitative Interview Study.

Stroke is a leading cause of death and disability worldwide. As health resources become digitized, it is important to understand how people who have experienced stroke engage with online health information. This understanding will aid in guiding the development and dissemination of online resources to support people after stroke. This study aims to explore the online health information-seeking behaviors of people who have experienced stroke and any related barriers or navigational needs. Purposeful sampling was used to recruit participants via email between March and November 2022. The sampling was done from an existing cohort of Australian stroke survivors who had previously participated in a randomized controlled trial of an online secondary prevention program. The cohort consisted of people with low levels of disability. Semistructured one-on-one interviews were conducted via phone or video calls. These calls were audio recorded and transcribed verbatim. The data were analyzed by 2 independent coders using a combined inductive-deductive approach. In the deductive analysis, responses were mapped to an online health information-seeking behavior framework. Inductive thematic analysis was used to analyze the remaining raw data that did not fit within the deductive theoretical framework. A sample of 15 relatively independent, high-functioning people who had experienced stroke from 4 Australian states, aged between 29 and 80 years, completed the interview. A broad range of online health information-seeking behaviors were identified, with most relating to participants wanting to be more informed about medical conditions and symptoms of their own or of a family member or a friend. Barriers included limited eHealth literacy and too much generalization of online information. Online resources were described to be more appealing and more accessible if they were high-quality, trustworthy, easy to use, and suggested by health care providers or trusted family members and friends. Across the interviews, there was an underlying theme of disconnection that appeared to impact not only the participants' online health information seeking, but their overall experience after stroke. These responses were grouped into 3 interrelated subthemes: disconnection from conventional stroke narratives and resources, disconnection from the continuing significance of stroke, and disconnection from long-term supports. People who have experienced stroke actively engage with the internet to search for health information with varying levels of confidence. The underlying theme of disconnection identified in the interviews highlights the need for a more comprehensive and sustained framework for support after stroke beyond the initial recovery phase. Future research should explore the development of tailored and relatable internet-based resources, improved communication and education about the diversity of stroke experiences and ongoing risks, and increased opportunities for long-term support.

Pandemic perspectives from detained youth during COVID-19: Bridging the knowledge gap for future safeguards.

Despite the worsening health disparities among youth in detention during the COVID-19 pandemic, there has been minimal exploration into the pandemic experiences of detained youth and opportunities for pandemic mitigation. This paper analyzes the perspectives of youth in detention on the pandemic, including the effect of the pandemic on their detention experience and their perceptions about COVID-19 vaccination. The study used purposive sampling to recruit 16 participants (aged 14-17 years) from two juvenile detention centers in the urban Midwest. We conducted semi-structured interviews and analyzed verbatim transcripts using a hybrid deductive-inductive approach and thematic analysis. Four themes emerged: 1) personal experience influenced youth perceptions of pandemic severity and risk; 2) distrust and misconceptions contributed to youth vaccine hesitancy or refusal; 3) desired opportunities and parental opinion motivated youth to get the COVID-19 vaccine; and 4) pandemic mitigation strategies negatively impacted youths' detention center experience. Study findings identify opportunities for detention centers to minimize the negative impacts of pandemic mitigation strategies on youth in detention, expand vaccination knowledge and uptake, and build trust to positively impact the health and wellbeing of detained youth currently and during future pandemics.

Stakeholder Perspectives on the Acceptability, Design, and Integration of Produce Prescriptions for People with Type 2 Diabetes in Australia: A Formative Study.

Produce prescription programs can benefit both individuals and health systems; however, best practices for integrating such programs into the Australian health system are yet unknown. This study explored stakeholders' perspectives on the acceptability, potential design and integration of produce prescription programs for adults with type 2 diabetes in Australia. Purposive sampling was used to recruit 22 participants for an online workshop, representing six stakeholder groups (government, healthcare service, clinician, food retailer, consumer, non-government organisation). Participant responses were gathered through workshop discussions and a virtual collaboration tool (Mural). The workshop was video-recorded and transcribed verbatim, and thematic analysis was conducted using a deductive-inductive approach. Stakeholders recognised produce prescription as an acceptable intervention; however, they identified challenges to implementation related to contextuality, accessibility, and sustainability. Stakeholders were vocal about the approach (e.g., community-led) and infrastructure (e.g., screening tools) needed to support program design and implementation but expressed diverse views about potential funding models, indicating a need for further investigation. Aligning evaluation outcomes with existing measures in local, State and Federal initiatives was recommended, and entry points for integration were identified within and outside of the Australian health sector. Our findings provide clear considerations for future produce prescription interventions for people with type 2 diabetes.

How does community health feature in Global Financing Facility planning documents to support reproductive, maternal, newborn, child and adolescent health and nutrition (RMNAH-N)? insights from six francophone West African countries

ABSTRACT Background Community health is key for improving Reproductive, Maternal, Newborn, Child, and Adolescent Health and Nutrition (RMNCAH-N). However, how community health supports integrated RMNCAH-N service delivery in francophone West Africa is under-researched. Objective We examined how six francophone West African countries (Burkina Faso, Côte d’Ivoire, Guinea, Mali, Niger, and Senegal) support community health through the Global Financing Facility for Women, Children and Adolescents (GFF). Methods We conducted a content analysis on Investment Cases and Project Appraisal Documents from selected countries, and set out the scope of the analysis and the key search terms. We applied an iterative hybrid inductive-deductive approach to identify themes for data coding and extraction. The extracted data were compared within and across countries and further grouped into meaningful categories. Results In country documents, there is a commitment to community health, with significant attention paid to various cadres of community health workers (CHWs) who undertake a range of preventive, promotive and curative roles across RMNCAH-N spectrum. While CHWs renumeration is mentioned, it varies considerably. Most community health indicators focus on CHWs’ deliverables, with few related to governance and civil registration. Challenges in implementing community health include poor leadership and governance and resource shortages resulting in low CHWs performance and service utilization. While some countries invest significantly in training CHWs, structural reforms and broader community engagement are lacking. Conclusions There is an opportunity to better prioritize and streamline community health interventions, including integrating them into health system planning and budgeting, to fully harness their potential to improve RMNCAH-N.

Ethical concerns in caring for persons with anorexia nervosa: content analysis of a series of documentations from ethics consultations

BackgroundCaring for patients with anorexia nervosa (AN) is associated with high levels of moral distress among healthcare professionals. The main moral conflict has been posited to be between applying coercion to prevent serious complications such as premature death and accepting treatment refusals. However, empirical evidence on this topic is scarce.MethodsWe identified all 19 documentations of ethics consultations (ECs) in the context of AN from one clinical ethics support service in Switzerland. These documentations were coded with a sequential deductive-inductive approach and the code system was interpreted in a case-based manner. Here, we present findings on patient characteristics and ethical concerns.FindingsThe ECs typically concerned an intensely pretreated, extremely underweight AN patient endangering herself by refusing the proposed treatment. In addition to the justifiability of coercion, frequent ethical concerns were whether further coerced treatment aimed at weight gain would be ineffective or even harmful, evidencing uncertainty about beneficence and non-maleficence and a conflict between these principles. Discussed options included harm reduction (e.g. psychotherapy without weight gain requirements) and palliation (e.g. initiating end-of-life care), the appropriateness of which were ethical concerns in themselves. Overall, nine different types of conflicts between or uncertainties regarding ethical principles were identified with a median of eight per case.ConclusionsEthical concerns in caring for persons with AN are diverse and complex. To deal with uncertainty about and conflict between respect for autonomy, beneficence and non-maleficence, healthcare professionals consider non-curative approaches. However, currently, uncertainty around general justifiability, eligibility criteria, and concrete protocols hinders their adoption.

Patient and professional perspectives on physical activity promotion in routine cancer care: a qualitative study

BackgroundsPhysical activity is associated with many benefits in reducing cancer symptoms and treatments side effects. Yet, studies consistently show that knowledge about physical activity is under-promoted among people diagnosed with cancer. Therefore, we aimed to contribute to filling this gap by ascertaining patient and professional perspectives regarding physical activity promotion.MethodsThis study took place in Montreal, Canada. We conducted individual, semi-structured interviews with cancer patients who participated in a physical activity program and professionals working in the healthcare system. Participants had to be aged over 18 years, be able to communicate verbally in either English or French, and consent to an audio-recorded interview. A hybrid deductive-inductive approach to content analysis was applied to analyze interview transcripts using Dedoose and Microsoft Excel software.ResultsOur sample comprised 21 patients (76.2% women) and 20 professionals (80% women). We identified 24 factors (barriers, facilitators, and improvement suggestions) influencing physical activity promotion across organizational, community, and social levels. Results suggest that to improve physical activity promotion in cancer care, it is necessary to showcase exercise specialists as a healthcare resource, to champion for this change within health organizations, to develop partnerships between public and private sectors of the health and fitness industries, and to reassess social norms concerning cancer survivorship and treatment.ConclusionThese findings shed light on the gaps and the bright lights in physical activity promotion for people diagnosed with cancer across numerous levels.

Nurses' health promotion practices in rural primary health care in Nigeria. A qualitative study.

Nurses play a vital role in providing high-quality primary healthcare and health promotion services. The state of research highlights their often complex operational realities and shows the need for an evidence-based understanding of nurses' perspectives on health promotion practices, especially in low-resource settings. This study focuses on how community health nurses in rural primary healthcare centers in Nigeria perceive their health promotion role and the opportunities and challenges of, and potential entry points for strengthening, their practice. A sample of 10 nurses from eight rural primary healthcare centers in eight local government areas of Anambra state, Nigeria, was purposively selected. Data were collected via semistructured telephone and written interviews and analyzed by qualitative content analysis using a deductive-inductive approach. Nurses emphasized their commitment to supporting patients and communities to develop skills and take control of their own lives. Nurses described their role as facilitators of behavioral and environmental change, individual and community empowerment facilitators as well as social activists. Factors that enhance the health promotion practice of nurses include adequate skills, sufficient human and material resources and community support and participation. Inhibiting factors included insufficient funding, poor working conditions, staff shortages, high workload, lack of training opportunities and low participation of community members. Overcoming challenges and facilitating health promotion activities in rural communities require bolstering nurses by providing further training opportunities for enhancing their health promotion competencies and creating supportive environments. Future research should focus on how to strengthen nurses' health promotion efforts through interprofessional and intersectoral collaboration.

Evaluation of Digital Technology Management in Mathematics Learning

The rapid advancement of digital technology necessitates that teachers enhance their competencies in the teaching and learning process of mathematics. This study aims to evaluate the demographic factors affecting teachers' use of digital technology and their digital skills, explore the frequency of online learning platform usage in relation to teachers' digital skills, and identify challenges while providing recommendations for integrating technology into mathematics instruction through a Sequential Explanatory Design mixed-methods approach. The quantitative sample consisted of 104 mathematics teachers, with 14 teachers selected as respondents for the qualitative phase. Data collection instruments included questionnaires, structured interviews, and non-participant observations, with quantitative data analyzed using Jamovi 2.4.8.0 software, and qualitative data manually coded and thematically analyzed using an inductive-deductive approach. The findings indicate that employment status, teaching experience, and school level significantly influence the use of digital technology in teaching mathematics. Teachers who are government employees under contract, have over 10 years of teaching experience, and teach at the middle or high school level tend to integrate technology more effectively. Consequently, government policies and educational programs for technology development should prioritize teachers irrespective of their employment status, offering continuous training (both online and offline) focused on mathematics.

Using a combination of cognitive behavioral therapy, case management and eHealth components for patients with depression or panic disorders in primary care practices in Hesse, Germany: an exploration of healthcare professionals’ lived experiences

BackgroundDepression and panic disorders have high prevalence rates in primary care. Given the crucial role of general practitioners in diagnosing and treating mental disorders, the two-arm cluster-randomized, controlled PREMA trial was designed. PREMA was aimed at investigating a new intervention combining cognitive behavioral therapy, case management and eHealth components for patients with depression and/or panic disorder with or without agoraphobia in primary care practices in Germany. This qualitative study, embedded in the PREMA trial, explores primary healthcare professionals’ lived experiences in using the new treatment program. Using a qualitative design, we conducted eleven interviews with general practitioners and medical assistants from Hesse, Germany, between July 2021 and March 2022. For both groups we relied on a semi-structured interview guide covering the following subjects: study procedures, implementation, practicality, and individual components of the treatment program. Interviews were audio-recorded, transcribed verbatim and analyzed by two researchers using content analysis. A deductive-inductive approach was used for the analysis according to Kuckartz.ResultsWe narratively summarized the facilitators and barriers from two different stakeholders across five key themes regarding experiences of feasibility and practicability of the new treatment program: study instruction materials, individual components of the treatment program, practicality, target population, and benefits of the treatment program. Facilitators to become familiar with the study include study instruction materials that are easy to understand and not too complex, considering the limited time resources available; barriers included text-heavy instruction materials, lack of collegial exchange, and issues especially with digital materials also involved access and log-in difficulties on the online platform. Facilitators for using the treatment program include the combination of face-to-face consultations and the use of an online platform, enabling a structured approach and regularity; barriers included patients feeling unsupported in performing anxiety exercises independently at home. For practicality, the professional skills of medical assistants and their central role as points of contact for patients facilitated the implementation; barriers included time-intensive organization and planning of monitoring phone calls and consultations. Regarding the target population, general practitioners and medical assistants state that the treatment program would be most appropriate for patients with mild to moderate depression and for those waiting for psychotherapeutic treatment; it would be less suitable for older patients, and those with negative attitudes towards technological tools. For benefits of the program, facilitating factors included free and low-threshold access to the online platform and strengthening the relationship between medical assistants and patients; barriers included a preference for in-person conversations and the inability of some people to use online applications.ConclusionsThe complexity of the new treatment program and the associated high workload underline the need for further adjustments to the treatment approach. Team-based care and the expanded responsibilities of medical assistants demonstrated promising results.Trial registrationThe study was registered in the German Clinical Trials Register (DRKS00016622) on February 22, 2019.

Understanding the Perspectives and Experiences of Patients with Acute Severe Ulcerative Colitis in the Hospital: A Qualitative Analysis.

Acute severe ulcerative colitis (ASUC) is a life-treating presentation of ulcerative colitis (UC) that requires prompt initiation of treatment to avoid complication. Unfortunately, outcomes for ASUC are suboptimal, with as many as 20-30% of patients requiring colectomy. This can be challenging for patients and highlights the need to understand patient experiences and perspectives navigating ASUC. A qualitative descriptive study utilizing semi-structured interviews was conducted to understand perspectives and experiences of patients navigating ASUC. Adult patients hospitalized for ASUC between January 2017 and March 2024 were eligible. Interviews were conducted both retrospectively among patients with a recent hospitalization and prospectively among patients within 24h of hospitalization for ASUC. Interviews were analyzed using a well-established hybrid inductive-deductive approach. Thirty-four patients (44.2% response rate) hospitalized for ASUC were interviewed. Hybrid thematic analysis uncovered five major themes: (1) the pervasive impact of UC on QoL and mental health, (2) challenges associated with navigating uncertainty, (3) prioritizing colon preservation, (4) bridging the divide between outpatient expectations and inpatient realities, and (5) balancing rapid symptom improvement with steroid safety. Our findings advocate for transparent approach to care, emphasizing the need for effective communication, education, and better alignment with patient values and expectations. Five key themes were identified, each with significant implications for developing a more patient-centered approach to ASUC care. These themes captured meaningful insight into patient perceptions and experiences, identifying multiple areas for actionable interventions to improve care.

Experiences Accessing Health and Social Services during and after Natural Disasters among People Who Use Drugs in Houston, Texas.

People who use drugs (PWUD) disproportionately experience health-related and social vulnerabilities, which may affect service needs and access during and after natural disasters. We conducted qualitative interviews with N = 18 PWUD recruited via a syringe services program in Houston, Texas. We assessed their health and social service needs, as well as related service access experiences, during and after natural disasters using a combined inductive-deductive approach. Participants described a range of service-related needs related to illicit drug use, poverty, neighborhood disadvantage, acute and chronic health problems, and housing insecurity. They endorsed decreased access to medical and substance-related services and difficulty accessing disaster relief aid. Interviews highlighted the importance of mutual aid for sharing harm reduction supplies and meeting practical needs. Results suggest that some PWUD experience disproportionate vulnerability after natural disasters related to multiple marginalized identities that intersect with illicit drug use.

Resilience throughout COVID-19: Unmasking the realities of COVID-19 and vaccination facilitators, barriers, and attitudes among Black Canadians.

Black communities have suffered disproportionately higher numbers of COVID-19 cases and deaths in Canada. Recognizing the significance of supporting targeted strategies with vulnerable populations extends beyond the COVID-19 pandemic, as it addresses longstanding health disparities and promotes equitable access to healthcare. The present study investigated 1) experiences with COVID-19, 2) COVID-19's impact, and 3) factors that have influenced COVID-19 vaccine acceptance and uptake among stakeholders and partners from the Federation of Black Canadians' (FBC). We conducted semi-structured interviews with 130 individuals and four focus groups with FBC, including stakeholders and partners, between November 2021 and June 2022. The semi-structured interviews and focus group discussions were conducted virtually over Zoom and lasted about 45 minutes each. Conversations from interviews and focus groups were transcribed and coded professionally using team-based methods. Themes were developed using an inductive-deductive approach and defined through consensus. The deductive approach was based on Consolidated Framework for Implementation Research (CFIR) domains and constructs. First, regarding experiences with COVID-19, 36 codes were identified and mapped onto 13 themes. Prominent themes included 39 participants who experienced highly severe COVID-19 infections, 25 who experienced stigma, and 18 who reported long recovery times. Second, COVID-19 elicited lifestyle changes, with 23 themes emerging from 62 codes. As many as 97 participants expressed feelings of isolation, while 63 reported restricted mobility. Finally, participants discussed determinants that influenced their vaccination decisions, in which 46 barriers and four facilitators were identified and mapped onto nine overarching themes. Themes around the CFIR domains Individuals, Inner Setting, and Outer Setting were most prominent concerning vaccine adoption. As for barriers associated with the constructs limited available resources and low motivation, 55 (41%) and 46 (34%) of participants, respectively, mentioned them most frequently. Other frequently mentioned barriers to COVID-19 vaccines fell under the construct policies & laws, e.g., vaccine mandates as a condition of employment. Overall, these findings provide a comprehensive and contextually rich understanding of pandemic experiences and impact, along with determinants that have influenced participants' vaccination decisions. Furthermore, the data revealed diverse experiences within Black communities, including severe infections, stigma, and vaccine-related challenges, highlighting the importance of targeted interventions, support, and consideration of social determinants of health in addressing these effects.