Inductive-deductive Approach Research Articles

Young Adult Cancer Survivors' Perspectives on Cancer's Impact on Different Life Areas Post-Treatment: A Qualitative Study.

Purpose: Young adult cancer survivors experience disruptions in various life domains (e.g., relationships, academic/career) during and after treatment. This study examined life disruptions and related supports to update interventions to improve psychological outcomes. Methods: In April-July 2023, young adult survivors (n = 23) were recruited (via clinics, support groups, nonprofit organizations, etc.) to complete semi-structured interviews assessing cancer's impact across life domains, how they coped with related disruptions, and facilitators to improved psychosocial well-being. We used a dual deductive-inductive approach to develop a codebook and then coded transcripts in Dedoose. Results: This sample was on average 33.7 years old (standard deviation [SD] = 4.4), 78.3% female, 73.9% non-Hispanic White, 47.8% married/cohabitating, 2.4 (SD = 1.0) years post-diagnosis, 1.4 years (SD = 0.9) post-treatment, and largely diagnosed with breast cancer (52.1%) or leukemia/lymphoma (34.7%). The most salient themes related to disruptions included mental health, feelings of isolation during survivorship, and disruptions to career and relationships with family or partners. Participants reported challenges navigating these feelings and disruptions, and difficulty understanding and conveying their needs. Many experienced limited support for navigating cancer-related trauma and life disruptions as a survivor. Participants also reported some positive impacts, like reevaluating their values and goals or feeling resilient, and emphasized the need to identify supports, accept that life had changed because of cancer, and have their needs and continued struggles validated by others during survivorship. Conclusions: Young adults experience ongoing disruptions across multiple life domains, underscoring the need for integrated, longer-term psychosocial supports to help them navigate these disruptions and reevaluate their goals.

Barriers and facilitators of implementing a multicomponent intervention to improve faecal immunochemical test (FIT) colorectal cancer screening in primary care clinics, Alberta

Background and objectiveColorectal cancer (CRC) screening is effective at reducing the incidence and mortality of CRC. To address suboptimal CRC screening rates, a faecal immunochemical test (FIT) multicomponent intervention was...

Patient Lung Cancer Screening Decisions and Environmental and Psychosocial Factors

Screening for lung cancer using low-dose computed tomography is associated with reduced lung cancer-specific mortality, but uptake is low in the US; understanding how patients make decisions to engage with lung cancer screening is critical for increasing uptake. Prior research has focused on individual-level psychosocial factors, but environmental factors (eg, historical contexts that include experiencing racism) and modifying factors-those that can be changed to make it easier or harder to undergo screening-also likely affect screening decisions. To investigate environmental, psychosocial, and modifying factors influencing lung cancer screening decision-making and develop a conceptual framework depicting relationships between these factors. This multimethod qualitative study was conducted from December 2021 to June 2022 using virtual semistructured interviews and 4 focus groups (3-4 participants per group). All participants met US Preventive Services Task Force eligibility criteria for lung cancer screening (ie, age 50-80 years, at least a 20 pack-year smoking history, and either currently smoke or quit within the past 15 years). Screening-eligible US participants were recruited using an online panel. Key factors influencing screening decisions (eg, knowledge, beliefs, barriers, and facilitators) were the main outcome. A theory-informed, iterative inductive-deductive approach was applied to analyze data and develop a conceptual framework summarizing results. Among 34 total participants (interviews, 20 [59%]; focus groups, 14 [41%]), mean (SD) age was 59.1 (4.8) years and 20 (59%) identified as female. Half had a household income below $20 000 (17 [50%]). Participants emphasized historical and present-day racism as critical factors contributing to mistrust of health care practitioners and avoidance of medical procedures like screening. Participants reported that other factors, such as public transportation availability, also influenced decisions. Additionally, participants described psychosocial processes involved in decisions, such as perceived screening benefits, lung cancer risk appraisal, and fear of a cancer diagnosis or harmful encounters with practitioners. In addition, participants identified modifying factors (eg, insurance coverage) that could make receiving screening easier or harder. In this qualitative study of patient lung cancer screening decisions, environmental, psychosocial, and modifying factors influenced screening decisions. The findings suggest that systems-level interventions, such as those that help practitioners understand and discuss patients' prior negative health care experiences, are needed to promote effective screening decision-making.

‘Let him die in peace’: understanding caregiver’s refusal of medical oxygen treatment for children in Nigeria

IntroductionEfforts to improve oxygen access have focused mainly on the supply side, but it is important to understand demand barriers, such as oxygen refusal among caregivers. We therefore aimed to...

Values-Based Education for Sustainable Development (VbESD): Introducing a Pedagogical Framework for Education for Sustainable Development (ESD) Using a Values-Based Education (VbE) Approach

It is widely recognized that quality and sustainable education is a key enabler for all the SDGs, and that affective education significantly enhances such education. However, while certain pedagogical approaches have been found to support the competencies and skills within Education for Sustainable Development (ESD), there is no tangible framework to facilitate ESD in classrooms. This paper introduces and demonstrates Values-based Education for Sustainable Development (VbESD): a comprehensive, replicable, and actionable pedagogical framework that explicitly and holistically fosters sustainability as an intrinsic value by using the principles of Values-based Education (VbE) in an ESD context. The VbESD framework presents eight pillars—modelling, Inner Curriculum, reflection, atmosphere and ethos, curriculum, leadership, ethical vocabulary, and sustainable school operations (MIRACLES)⁠—that holistically facilitate the development of intrinsic positive values into quality education for sustainable development. Using a deductive-inductive approach with two mixed-method surveys and 157 responses, VbESD was developed and validated with significant interest in, support for, and willingness to implement the framework. All surveyees responded neutrally or positively to valuing sustainability, believing it is important as an intrinsic value, incorporating sustainability into the educational system, and implementing the VbESD framework. This study proposes VbESD as a potential method for primary educational institutions and educators to nurture resilient, ethically intelligent change-leaders who can champion the social change needed for a peaceful, prosperous, and sustainable world.

The design of an Obstetric Telephone Triage Guideline (OTTG): a mixed method study

BackgroundClarifying the dimensions and characteristics of obstetric telephone triage is important in improving the quality of services in the health system because researchers can evaluate the effectiveness of treatment, care and diagnostic measures in the form of obstetric telephone triage by developing a guideline. Therefore, this study aimed to design an Obstetric Telephone Triage Guideline (OTTG) using a mixed-method study.MethodsThe present study was carried out using an exploratory sequential mixed method study in two qualitative and quantitative phases. An inductive-deductive approach was also used to determine the concept of obstetric telephone triage. In this respect, a qualitative study and a literature review were used in the inductive and deductive stages, respectively. Moreover, the validity of the developed guideline was confirmed based on experts’ opinions and results of the AGREE II tool.ResultsThe guideline included the items for evaluating the severity of obstetric symptoms at five levels including “critical”, “urgent”, “less urgent”, “no urgent”, and “recommendations”. The validity of the guideline was approved at 96%, 95%, 97%, 95%, 93%, and 100% for six dimensions of AGREE II including scope and purpose, stakeholder involvement, the rigor of development, clarity of presentation, applicability, and editorial independence, respectively.ConclusionThe OTTG is a clinically comprehensive, easy-to-use, practical, and valid tool. This guideline is a standardized tool for evaluating the severity of symptoms and determining the urgency for obstetrics triage services. By using this integrated and uniform guideline, personal biases can be avoided, leading to improved performance and ensuring that patients are not overlooked. Additionally, the use of OTTG promotes independent decision-making and reduces errors in triage decision-making.

A Digital Communication Intervention to Support Older Adults and Their Care Partners Transitioning Home After Major Surgery: Protocol for a Qualitative Research Study.

Older adults (aged ≥65 years) account for approximately 30% of inpatient procedures in the United States. After major surgery, they are at high risk of a slow return to their previous functional status, loss of independence, and complications like delirium. With the development and refinement of Enhanced Recovery After Surgery protocols, older patients often return home much earlier than historically anticipated. This put a larger burden on care partners, close family or friends who partner with the patient and guide them through recovery. Without adequate preparation, both patients and their care partners may experience poor long-term outcomes. This study aimed to improve and streamline recovery for patients aged ≥65 years by exploring the communication needs of patients and their care partners. Information from this study will be used to inform an intervention developed to address these needs and define processes for its implementation across surgical clinics. This qualitative research protocol has two aims. First, we will define patient and care partner needs and perspectives related to digital health innovation. To achieve this aim, we will recruit dyads of patients (aged ≥65 years) who underwent elective major surgery 30-90 days prior and their respective care partners (aged ≥18 years). Participants will complete individual interviews and surveys to obtain demographic data, characterize their perceptions of the surgical experience, identify intervention targets, and assess for the type of intervention modality that would be most useful. Next, we will explore clinician perspectives, tools, and strategies to develop a blueprint for a digital intervention. To achieve this aim, clinicians (eg, geriatricians, surgeons, and nurses) will be recruited for focus groups to identify current obstacles affecting surgical outcomes for older patients, and we will review current assessments and tools used in their clinical practice. A hybrid deductive-inductive approach will be undertaken to identify relevant themes. Insights from both clinicians and patient-care partners will guide the development of a digital intervention strategy to support older patients and their care partners after surgery. This study has been approved by the Massachusetts General Hospital and Harvard Institutional Review Boards. Recruitment began in December 2023 for the patient and care partner interviews. As of August 2024, over half of the interviews have been performed, deidentified, and transcribed. Clinician recruitment is ongoing, with no focus groups conducted yet. The study is expected to be completed by fall 2024. This study will help create a scalable digital health option for older patients undergoing major surgery and their care partners. We aim to enhance our understanding of patient recovery needs; improve communication with surgical teams; and ultimately, reduce the overall burden on patients, their care partners, and health care providers through real-time assessment. DERR1-10.2196/59067.

Inference on The Abrogation of The Hadith Unanimously Not to Act Upon It, The Hadith of Umm Salamah, May God Be Pleased with Her, regarding the Pilgrim Returns in Ihram after He is Dissolved, If He Does Not Perform Tawaf Al-Ifadah on The Day of Sacrifice (Qurban Day) Before Evening, As an Example

The research seeks to explain and clarify the scholars' approach to deducing the hadith abrogation by unanimously renouncing working with it and verifying their argument and claims with evidence. It also explains how the nation's prevailing consensus affected the hadith's opposition and its inability to be invoked despite its veracity. It used an inductive-deductive approach. Its primary outcomes includes: Unanimity is required to end the abovementioned religious law's mandate and to repeal its verdict. The method used by the nation's experts from the era of the Prophet's companions, may God be pleased with them, and after them, is the inference on the abrogation of the hadith with the indication of the unanimity of rejecting working with it. This is the opinion of most experts on hadith, jurisprudence, and origins. The hadith of Umm Salamah, may God be pleased with her, in the pilgrim returns to Ihram after he is dissolved, if he does not perform Tawaf al-Ifadah on the day of sacrifice (Qurban Day) before evening, is an agreed-upon hadith. Its witness rises to the level of authenticity for others. It was authenticated by several imams, and only Ibn Hazm and some contemporary scholars and students of knowledge weakened it. There was an agreement to forego reciting what was mentioned in Umm Salama's hadith, may God be pleased with her, and to stick with the odd saying that went against the general opinion. It is unavoidable that the hadith on the authority of the Prophet, may God bless him and grant him peace, will be revoked if it is generally agreed that it should not be followed. Peace be upon him, as it was spoken about him.

Unpacking Digital Transformation: Identifying key enablers, transition stages and digital archetypes

This study aims to identify recurring Digital Transformation (DT) archetypes within firms and explore the capabilities and values associated with each archetype. Underpinned by the Resource-Based View (RBV) and Socio-Technical Systems (STS) theory, the study provides a framework explicating the enabling factors, their characteristics, interdependencies, operational capabilities, and resultant value creation within the context of digitalizing firm operations. Employing a deductive-inductive approach, an exhaustive literature review combined with an in-depth, multiple case study analysis of sixteen firms provides rich insights into the digital transformation journey. Findings reveal technology, data, human capital, processes, and organization structure as key enablers alongside their critical, complementary roles for transformation. Cross-case analysis identified instances of the DT framework, uncovering three archetypes: process efficiency, responsiveness, and strategic agility. Each archetype exhibits distinct socio-technical enabler configurations and improvements to business processes, resulting in unique operational capabilities and value generation. This research provides actionable guidance for managers in leveraging socio-technical enablers to achieve successful digital transformation. It underscores the need for tailored strategies, recognizing that a one-size-fits-all approach is inadequate. Managers must strategically select desired values and develop the necessary socio-technical system components, processes, and operational capabilities to attain them. OriginalityThis study develops digital archetypes of firm operations linking sociotechnical components, operational capabilities, and goals of firm operations. To the best of our knowledge, no prior research has developed such digital archetypes.

`It's not just linguistically, there's much more going on': The experiences and practices of bilingual paediatric speech and language therapists in the UK.

Despite the high prevalence of bilingualism in the United Kingdom, few speech and language therapists (SLTs) are bilingual themselves. Most SLT research on bilingualism has generated knowledge to inform service delivery for bilingual clients, but few studies have investigated how being a bilingual SLT influences one's professional experiences and practices. Better understanding the unique positionality of bilingual SLTs can yield critical insights to meaningfully address issues of diversity, inclusion and equity in the profession. To investigate the experiences and practices of bilingual paediatric SLTs in the United Kingdom through the lens of Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF), a new theoretical framework developed to conceptualise the activities of professionals working in the field of disability. In this qualitative study, 19 bilingual paediatric SLTs practising in the United Kingdom were interviewed individually. Participants were recruited through a snowball sampling strategy, and semi-structured interviews conducted online. The data were analysed using reflexive thematic analysis and following a hybrid inductive-deductive approach to map the results onto the CHAT-ICF framework. Six overarching components of the CHAT-ICF framework hosted the 12 sub-themes identified to capture the experiences and practices of bilingual SLTs: (1) Subject (intersectionality); (2) Tools (language skills, education, clinical resources); (3) Rules (systemic barriers, sense of responsibility); (4) Community (sense of inclusion); (5) Division of labour (parents, colleagues); and (6) Practice (empathy with children, holistic mindset, flexible approaches). The use of the CHAT-ICF theoretical lens revealed two fundamental structural phenomena: (1) the distribution of sub-themes across many components of CHAT-ICF demonstrated that being a bilingual SLT is a multifactorial experience; and (2) the chain reactions between sub-themes illustrated the dynamic nature of bilingual SLTs' experiences which can be harnessed to challenge marginalisation and promote equity in the profession. This is the first qualitative study to date to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. These insights can be mobilised to inform the meaningful inclusion of bilingual SLTs in workforce planning efforts and service development. Recommendations include using intersectional lenses, providing cultural and anti-racism awareness training to SLTs, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in recruitment processes and increasing accountability at the leadership level. Research giving voice to bilingual SLTs, and other underrepresented demographics in the SLT workforce, can catalyse action to promote a more diverse and inclusive profession in line with the Royal College of Speech and Language Therapists' strategic vision 2022-2027. What is already known on the subject Most research on bilingualism in speech and language therapy is focused on issues related to service provision and delivery for bilingual clients with little consideration for bilingual speech and language therapists' (SLTs) unique positionality. A few survey studies have shown that bilingual SLTs report significantly higher competency and greater confidence when working with clients who speak multiple languages, but there are significant gaps in understanding how bilingualism impacts other aspects of their professional experiences. What this paper adds to existing knowledge This is the first study to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. We show that being bilingual profoundly impacts many aspects of their professional experiences, including their clinical identity, skillset, sense of inclusion in the workplace, work relationships and clinical approaches. Bilingual SLTs expressed developing trust relationships with bilingual families and adopting flexible approaches to account for their clients' environmental factors, all of which can contribute to more equitable SLT services. This study also makes a novel contribution by proposing and using the Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF) framework to conceptualise and investigate SLTs' experiences and practices. What are the potential or actual clinical implications of this work? This study provides evidence-based recommendations to inform progress towards the Royal College of Speech and Language Therapists' strategic vision 2022-2027 and the diversification of the profession. Actions to support bilingual SLTs and diversify the profession include shifting a rigid mindset of linguistic and cultural `competence' to self-growth and awareness, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in SLT recruitment processes and career progression and increasing accountability and leadership around issues of diversity in the workplace. The novel CHAT-ICF framework has the potential to be used to support therapists' reflexivity in their practice or structure audits of rehabilitation services. Intersectionality theories and transformative processes can catalyse positive change in clinical services and research around bilingualism.

Rural Friendship Bench: A qualitative study in Zaka district, Zimbabwe

BackgroundWe piloted the Friendship Bench—an evidence-based, urban-area task sharing intervention for common mental disorders—in rural Zimbabwe. The intervention combines problem solving therapy with income generating activities. This study sought to understand the intervention's implementation in terms of acceptability, feasibility, and sustainability as well as local attitudes towards mental wellbeing in rural Zimbabwe. MethodsUsing four separate semi-structured interview guides, we conducted in-depth interviews (N = 32) with patients (n = 9), village health workers (n = 12), nurses (n = 6), and community leaders (n = 5). We analyzed our data using thematic analysis with a diverse coding team using an integrative deductive-inductive approach. ResultsFive themes emerged: 1) explanatory models for mental illness, 2) clinical workflow and emphasis on documentation, 3) positive feedback about the Friendship Bench, 4) accessibility, and 5) feasibility. ConclusionIn its current format, our intervention was acceptable but neither feasible nor sustainable. Sociocultural context is critical in the development of rural task sharing interventions for mental health. We thus recommend a robust pilot and adaptation phase when scaling task sharing interventions in rural sub-Saharan Africa to elevate community voices, leverage existing social structures, and embed interventions as deeply into communities as possible.

“Wanna cry this out real quick?”: an examination of secondary traumatic stress risk and resilience among post-overdose outreach staff in Massachusetts

BackgroundPost-overdose outreach programs engage overdose survivors and their families soon after an overdose event. Staff implementing these programs are routinely exposed to others’ trauma, which makes them vulnerable to secondary traumatic stress (STS) and compassion fatigue. The purpose of this study was to explore experiences of STS and associated upstream and downstream risk and protective factors among program staff.MethodsWe conducted a post-hoc analysis of semi-structured interviews with post-overdose outreach program staff in Massachusetts. Transcripts were analyzed using a multi-step hybrid inductive-deductive approach to explore approaches and responses to outreach work, factors that might give rise to STS, and compassion fatigue resilience. Findings were organized according to the three main constructs within Ludick and Figley’s compassion fatigue resilience model (empathy, secondary traumatic stress, and compassion fatigue resilience).ResultsThirty-eight interviews were conducted with staff from 11 post-overdose outreach programs in Massachusetts. Within the empathy construct, concern for others’ well-being emerged as a motivator to engage in post-overdose outreach work – with staff trying to understand others’ perspectives and using this connection to deliver respectful and compassionate services. Within the secondary traumatic stress construct, interviewees described regular and repeated exposure to others’ trauma – made more difficult when exposures overlapped with staff members’ personal social spheres. Within the compassion fatigue resilience construct, interviewees described the presence and absence of self-care practices and routines, social supports, and workplace supports. Job satisfaction and emotional detachment from work experiences also arose as potential protective factors. Interviewees reported inconsistent presence and utilization of formal support for STS and compassion fatigue within their post-overdose outreach teams.ConclusionPost-overdose outreach program staff may experience secondary traumatic stress and may develop compassion fatigue, particularly in the absence of resilience and coping strategies and support. Compassion fatigue resilience approaches for post-overdose outreach staff warrant further development and study.

Signs of nature in Bediuzzaman Said Nursi: A significant contribution to Islamic semiotics

In the life circle, humans always produce, receive, and search for the meaning of signs. The meanings have ultimate value concerning Islamic worldview which then determines human salvation. Therefore, these issues are very important to research. The researchers worked in a deductive-inductive approach: a quasi-qualitative method characterized by the use of theories to be reconstructed after critical dialogues aimed at revealing the meanings of the natural signs based on an Islamic worldview and proposing a model of the Islamic theory of sign. The subject of this research is the books of Risale-i Nur as the representation of the Islamic worldview. Further, the techniques of the data collection are (1) preparing the domain (2) constituting the taxonomy of the data; (3) note-taking in the text of the Risale-i Nur. Furthermore, the latent content analysis was employed. The researchers categorized qualitative textual data into clusters of similar entities, or conceptual categories, to identify consistent patterns and relationships between themes. Finally, the researchers concluded that the meanings of the natural signs in the Risale-i Nur are the manifestation of the perfection of God’s Names. Moreover, the significant contribution of the Risale-i Nur to Islamic semiotics is revealed and proposed.

Unravelling Low-Value Care Decision-Making: Residents' Perspectives on the Influence of Contextual Factors.

Several initiatives have been developed to target low-value care (ie, waste) in decision-making with varying success. As such, decision-making is a complex process and context's influence on decisions concerning low-value care is limitedly explored. Hence, a more detailed understanding of residents' decision-making is needed to reduce future low-value care. This study explores which contextual factors residents experience to influence their decision-making concerning low-value care. We employed nominal group technique (NGT) to select four low-value care vignettes. Prompted by these vignettes, we conducted individual interviews with residents. We analyzed the qualitative data thematically using an inductive-deductive approach, guided by Bronfenbrenner's social-ecological framework. This framework provided guidance to "context" in terms of sociopolitical, environmental, organizational, interpersonal, and individual levels. In 2022, we interviewed 19 residents from a Dutch university medical center. We identified 33 contextual factors influencing residents' decision-making, either encouraging or discouraging low-value care. The contextual factors resided in the following levels with corresponding categories: (1) environmental and sociopolitical: society, professional medical association, and governance; (2) organizational: facility characteristics, social infrastructure, and work infrastructure; (3) interpersonal: resident-patient, resident-supervising physician, and resident-others; and (4) individual: personal attributes and work structure. This paper describes 33 contextual factors influencing residents' decision-making concerning low-value care. Residents are particularly influenced by factors related to interactions with patients and supervisors. Furthermore, organizational factors and the broader environment set margins within which residents make decisions. While acknowledging that a multi(faceted)-intervention approach targeting all contextual factors to discourage low-value care delivery may be warranted, improving communication skills in the resident-patient dynamics to recognize and explain low-value care seems a particular point of interest over which residents can exercise an influence themselves.

Imagine your perfect park: a qualitative study on adolescents’ usage of green spaces, perceived benefits and preferences

ABSTRACT Green spaces are essential urban infrastructures. They represent cost-effective interventions to reduce health inequities and contribute to climate-resilient cities and adolescents’ health and well-being. Nevertheless, evidence suggests they are underused by adolescents, especially in Southern Europe. We explored the perspectives of adolescents on their use of green spaces (including frequency of use, activities performed, and types of space), perceived benefits, and preferences regarding green spaces’ characteristics. We performed seven online focus groups with 34 adolescents (15–16 years old) recruited from the Generation XXI cohort (a population-based birth cohort from the Porto Metropolitan Area, Portugal), stratified by socioeconomic status. Data were analyzed thematically by a deductive-inductive approach. Participants reported regular use of green spaces to perform physical activity, rest, and socialize. They perceived associated benefits for their general well-being and respiratory and mental health. The views shared by the participants suggest that the perfect park was idealized as large and multifunctional, providing a diversity of equipment and sufficient vegetation. It should be close to school and residential neighborhoods, upkeep, and made dynamic by the organization of cultural or sports events. Youth-led perspectives in urban planning might improve adolescents’ use of green spaces and encourage sustainable and equitable health-promoting urban environments.

Barriers and Facilitators of Vestibular Rehabilitation: Patients and Physiotherapists' Perspectives.

Poor adherence to vestibular rehabilitation protocols is a known barrier to optimal care. Vestibular clinicians' comprehensive understanding of the barriers and facilitators to vestibular home exercise programs (VHEP) is a key element to achieving optimal care in the context of vestibular rehabilitation. The aims of this study are as follows: (1) to identify primary barriers and facilitators to VHEP from the perspective of patients with vestibular dysfunction and vestibular physical therapists (PTs); and (2) to provide strategies for clinicians to improve adherence and outcomes of VHEP. A qualitative research with single-session focus groups conducted separately for: (1) patients with vestibular disorders and (2) vestibular PTs. Six focus groups were conducted, 3 for each population, with a total of 39 participants. An online survey was conducted to evaluate the estimates of adherence rates, followed by a structured discussion over barriers and facilitators to VHEP as perceived by patients and PTs. Thematic data analyses were performed using a mixed deductive-inductive approach. Eighteen patients with vestibular disorders and 21 experienced vestibular PTs participated in this study. Six barrier categories and 5 facilitator categories were identified. Barriers included motivation aspects, provocation of symptoms, time management, associated impairments, missing guidance and feedback, and psychosocial factors. Facilitators included motivation aspects, time management, patient education and exercise instructions, exercise setting, and associated symptom management. Clinicians who prescribe home exercise to patients with vestibular disorders can use this information about common barriers and facilitators for patient education and to provide optimal care and improve rehabilitation outcomes. for more insights from the authors (see the video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A467 ).

Views of German mental health professionals on the use of digital mental health interventions for eating disorders: a qualitative interview study

IntroductionDigital mental health interventions (DMHIs) are getting increasingly important for mental health care. In the case of eating disorders (EDs), DMHIs are still in early stages. Few studies so far investigated the views of mental health professionals for EDs on the integration of DMHIs in routine care.ObjectiveTo gain insights into the experiences, perspectives, and expectations of mental health professionals for EDs regarding DMHIs and to identify requirements for the future integration of DMHIs into routine care.MethodsSemi-structured qualitative telephone interviews with 24 German mental health professionals treating patients with EDs were conducted. A content analysis following a deductive-inductive approach asked for experiences, advantages and chances, disadvantages and boundaries, desired functions and properties, target groups, and general conditions and requirements for DMHIs for patients with EDs.ResultsOnly few professionals reported experiences with DMHIs besides video-based psychotherapy during the pandemic. From the therapists’ point of view, DMHIs have the potential to deliver low-threshold access for patients with EDs. Useful functionalities were seen in digital meal records, skills training, and psychoeducation. However, a stable therapeutic alliance was reported as an important prerequisite for the successful integration into care. Therapists expressed concerns in case of severe anorexia nervosa or suicidality. The participants felt to be informed inadequately on recent developments and on the evidence base of DMHIs.ConclusionsMental health professionals for EDs show positive attitudes towards DMHIs, however many barriers to the integration in routine care were observed. The highest potential was seen for the use of DMHIs in addition to outpatient care and in aftercare. Specific requirements for DMHIs are related to different areas of the healthcare spectrum and for the different symptom profiles in anorexia nervosa, bulimia nervosa and binge eating disorder. Targeted DMHIs are needed and appropriate especially for concepts of blended care.

Assessment of women’s needs, wishes and preferences regarding interprofessional guidance on nutrition in pregnancy – a qualitative study

BackgroundA healthy nutrition in pregnancy supports maternal health and fetal development, decreasing the risk for adverse pregnancy outcomes. Guidance by prenatal care professionals can increase women’s awareness regarding the importance of nutrition in pregnancy and thereby contribute to a reduced risk for adverse pregnancy outcomes. The aim of this study was to assess the needs, wishes and preferences of pregnant women regarding the interprofessional guidance on nutrition in pregnancy.MethodsUsing a qualitative approach and a purposive maximum variation sampling strategy, 25 pregnant women were recruited to participate in six semi-structured, guideline-oriented online focus groups. In addition, two semi-structured, guideline-oriented interviews, with a midwife and an obstetrician, were conducted. The focus groups and interviews were audio-recorded and transcribed. Transcripts were analysed using a systematic deductive-inductive approach to qualitative content analysis according to Kuckartz.ResultsFocus group participants covered diverse perspectives in terms of their age, different models of prenatal care as well as dietary forms from omnivorous to vegan. The majority of women perceived the guidance on nutrition during pregnancy as insufficient. Involved healthcare professionals, namely midwives and obstetricians, should provide more consistent information, especially to avoid uncertainties exacerbated by the internet and social media. There is a need for individual nutrition information regarding dietary supplements and the specifics of different dietary forms during pregnancy, such as a vegan diet. The majority of participants supported the integration of a free-of-charge professional nutrition counselling in prenatal care. Interviews with experts identified time pressure and the complexity of nutrition as a topic as the main obstacles in consultation settings. Both midwife and obstetrician emphasised the need for improved professional education on nutrition in pregnancy in their respective studies.ConclusionProfessional guidance for pregnant women on nutrition and uncertainties going along with certain forms of diet during pregnancy could alleviate the burden and overwhelming amount of web-based information. Additionally, information adapted to the needs, wishes and preferences of pregnant women would improve prenatal care through a more personalised approach. The quality of nutrition guidance in pregnancy should be improved by the implementation of this topic in the education of involved healthcare professionals.

Obstacles to Electric Vehicle Adoption in India and Proposed Remedies

The inductive approach focuses on analyzing the factors influencing Electric Vehicle (EV) adoption in India, while the deductive approach centers on understanding how these factors play out in developed nations and their applicability to developing countries. By iteratively applying the inductive-deductive approach, a taxonomy is developed categorizing these factors into micro-, macro-, and meso-level antecedents. This taxonomy serves as a framework for systematically organizing cohesive initiatives to promote EV adoption in developing nations, stressing the importance of tailoring these factors to the unique infrastructural, economic, and market conditions of such countries. One significant challenge hindering the adoption of EVs is the concern over their limited driving range. Recent proposals suggest the implementation of dynamic wireless charging, enabling power exchange between vehicles and the grid while in motion. This paper highlights the importance of optimizing EV routes requiring charging to maximize the utilization of Mobile Energy Disseminators (MEDs) functioning as mobile charging stations. The growing popularity of EVs has brought about a corresponding increase in challenges. Lengthy waiting times at charging stations present a major hurdle to widespread EV adoption. To address this, battery swapping stations (BSSs) offer an efficient solution, reducing wait times and promoting healthy recharging cycles for batteries. Additionally, these swapping stations create opportunities not only for EVs but also for power systems, providing regulation services to the grid, particularly beneficial for smaller networks like microgrid (MG) systems. This study delves into determining the optimal location and size of swap stations to maximize revenue within an MG system.

“I Wish I Had That!”: A Qualitative Analysis of Psychosocial Treatment Preferences Among Young Adults With Recent Concussion and Anxiety

ObjectiveTo assess psychosocial treatment preferences and factors that may affect treatment participation among young adults with a recent concussion and co-occurring anxiety. DesignIn-depth, semi-structured individual qualitative interviews, followed by thematic analysis using a hybrid deductive-inductive approach. SettingAcademic medical center in the US Northeast. ParticipantsSeventeen young adults (18-24y) who sustained a concussion within the past 3-10 weeks and reported at least mild anxiety (≥5 on the Generalized Anxiety Disorder-7 questionnaire). InterventionsNot applicable. Main Outcome MeasuresPrimary outcomes include preferences for program content (eg, topics and skills), delivery modality, format, and barriers and facilitators to participation. ResultsWe identified 4 domains characterizing participants’ perceptions of and preferences for treatment. (1) Program content: Participants preferred a program early after injury that included psychoeducation and coping skills (eg, activity pacing, deep breathing, mindfulness). (2) Therapeutic processes: Participants preferred a person-centered approach in which clinicians normalized anxiety postconcussion and reassured them of recovery. (3) Program logistics: Participants endorsed that a brief, virtual program would be acceptable. They preferred access to program components through multiple modalities (eg, audio, video) and accommodations to manage concussion symptoms. (4) Barriers and facilitators to participation: Barriers included acute concussion symptoms (eg, screen sensitivity), time constraints, and forgetting sessions. Facilitators included a program that is flexible (format, scheduling), personalized (self-chosen mode for reminders, measure of accountability), and accessible (ie, advertising through health care professionals or social media). ConclusionsParticipants need psychosocial support that normalizes their experiences and provides education and coping tools. Treatments should be accessible, flexible, and person centered. Psychosocial treatments meeting these preferences may help optimize the recovery of young adults with recent concussion and anxiety.