Community Experience Research Articles

Utilizing Large Language Models in Ophthalmology: The Current Landscape and Challenges.

A large language model (LLM) is an artificial intelligence (AI) model that uses natural language processing (NLP) to understand, interpret, and generate human-like language responses from unstructured text input. Its real-time response capabilities and eloquent dialogue enhance the interactive user experience in human-AI communication like never before. By gathering several sources on the internet, LLM chatbots can interact and respond to a wide range of queries, including problem solving, text summarization, and creating informative notes. Since ophthalmology is one of the medical fields integrating image analysis, telemedicine, AI, and other technologies, LLMs are likely to play an important role in eye care in the near future. This review summarizes the performance and potential applicability of LLMs in ophthalmology according to currently available publications.

A Qualitative Exploration into How Teachers Understand and Practice Forgiveness

Forgiveness, though hard for many to simply define in concrete terms, is not necessarily a foreign concept or practice for the average individual. In an attempt to further understanding of forgiveness, the present study gathered the thoughts, opinions, and experiences of a specific community of individuals, public school teachers. Using a series of six focus group interviews, analysis of data produced insights and conclusions related to how teachers understand forgiveness in theory and practice, how they practice forgiveness within their jobs, and their thoughts on forgiveness or virtue education within schools. Thematic analysis is presented with quotational support and a discussion of application to both forgiveness theory and future forgiveness education pursuits is offered in summation. Due to the many mental, emotional, and physical health benefits associated with forgiveness, the value of exploring forgiveness and forgiveness education is readily evident. This study provides a glimpse into the experiences of a community of individuals who practice forgiveness regularly within the context of their jobs as public school educators.

Healthcare providers’ communication experience in the pediatric intensive care unit: a phenomenological study

BackgroundHealthcare providers must effectively communicate with other professionals, multidisciplinary teams, and parents of patients in pediatric intensive care units (PICUs) to improve outcomes in children and satisfaction levels of parents. Few studies have focused on healthcare providers’ communication experiences, which are crucial for identifying current problems and suggesting future directions. This phenomenological study was conducted to address this gap.MethodsA qualitative study using online and face-to-face interviews was conducted from January to June 2021 by a trained researcher in PICUs of two tertiary hospitals. Participants were five physicians and four registered nurses who worked in the PICUs and had over five years of clinical experience. The interviews were audio recorded with the participant’s consent and analyzed by the researchers using Colaizzi’s seven-step method.ResultsHealthcare providers’ communication experiences revealed four categories: facing communication difficulties in PICUs, communication relying on individual competencies without established communication methods, positive and negative experiences gained through the communication process, and finding the most effective communication approach.ConclusionsWithout adequate support or a systematic training program, healthcare providers often have to overcome communication challenges on their own. Therefore, support and training programs should be developed to facilitate better communication in the future.

Interdisciplinary provider visits attenuate relationship between patient concerns and distress in older adults with cancer.

This study examined the relationship between multidimensional patient concerns and anxiety and depression in a national sample of older adults with cancer (OACs ≥ 65years) and the buffering effect of visiting providers across disciplines (e.g., oncology, allied health, primary care, mental health) on these relationships. Participants completed a cross-sectional survey through the Cancer Support Community's Cancer Experience Registry (CER), an online community-based research initiative. Eligible participants were 65years and older and diagnosed with cancer in the past five years. Participants completed self-report measures of (1) the severity of their concerns across multiple domains, (2) anxiety and depression, and (3) whether they received care for "symptoms and side effects" from various providers. The sample consisted of 277 OACs; 45% endorsed elevated anxiety and 31% endorsed elevated depression. The most severe concerns were in the domains of body image and healthy lifestyle and symptom burden and impact. More severe concerns were associated with higher levels of anxiety and depression. The relationship between concern severity and distress was weaker in OACs who saw a palliative care, mental health, physical or occupational therapy provider, pharmacist, or primary care provider relative to OACs who did not. A visit with an oncology provider did not moderate most relationships between concerns and distress. The relationship between OACs' concerns and distress was attenuated by treatment with a specialty provider. Interdisciplinary team care may be a vital component of comprehensive patient-centered care for OACs.

Indigenous land-based practices for climate crisis adaptions

Indigenous communities across Canada persist at the forefront of environmental and climate-related challenges, necessitating a concerted effort to integrate traditional Indigenous land-based knowledge and practices that inherently promote environmental protection and resilience. Using a decolonial feminist theoretical framework, this research centers on Indigenous community perspectives on the climate crisis and their land-based adaptions. Such an approach empowers Indigenous communities to reclaim agency over their narratives and shape research agendas congruent with their lived realities and aspirations. The study concludes by promoting the imperative of revitalizing traditional Indigenous land-based knowledge, practices and relationships with their ancestral lands. Despite emerging recognition within the scientific literature and international agreements, such as the Paris Agreement, of the significance of traditional Indigenous land-based knowledge, many climate mitigation and adaptation initiatives continue to overlook Indigenous participation at various decision-making junctures. Hence, this paper advocates the necessity for international frameworks to acknowledge and integrate traditional knowledge systems and Indigenous participation across national borders, fostering inclusive climate crisis solutions that resonate with Indigenous communities' perspectives and experiences.

Assessing childhood community experiences

AimsCommunity-level childhood experiences make up important aspects of early life that are associated with long-term health outcomes. However, to date, there have been no validated measures that assess community-level experiences during childhood. Thus, we aimed to develop and validate a measure that would assess community-level experiences associated with both risk and resilience. MethodsData were collected from 577 undergraduate participants (68.7% female). Exploratory and confirmatory factor analytic strategies were used to examine the factor structure of the Childhood Community Experiences Scale (CCES) comprised of the Community Risk Scale and the Community Protective Scale. Convergent validity and predictive utility of the CCES with existing measures of individual risk and resilience and adult psychosocial functioning were also examined. ResultsResults indicated a 5-factor solution for the Community Risk Scale and a 6-factor solution for the Community Protective Scale to fit the data best. Further, results suggest the convergent validity and predictive utility of the CCES with measures of adult psychosocial functioning.This measure allows for a brief, self-report assessment that can be used to assess childhood community-level risk and protective factors.

Aphasia and acute care: a qualitative study of healthcare provider perspectives

ABSTRACT Background Poor communication between patients with aphasia and healthcare providers has many adverse consequences. Training healthcare providers to support communication not only improves skill in communicating with people with aphasia, but also potentially avoids adverse incidents. However, families have reported negative communication experiences for their relatives with aphasia during early acute hospitalization and healthcare providers in acute hospitals have reported multiple barriers to managing people with aphasia. Aims To gather information from healthcare providers about their experiences and needs relative to managing people with aphasia in the acute hospital setting as part of a larger implementation project designed to 1) improve acute care staff communication with patients with aphasia, and 2) help staff provide support to families of people with aphasia. Methods Qualitative methods were employed to gather perspectives of stroke team staff regarding the management of aphasia in early acute care. Methods for collecting data from staff in a large metropolitan hospital in Ontario, Canada included open-ended surveys, observations on acute stroke units, interviews, and focus groups. Data were transcribed and analyzed to identify themes that defined staff experiences and needs relative to caring for people with aphasia in the acute setting. Results The overall finding was that staff found communication and caring for people with aphasia and their families in the acute context to be challenging and frustrating. Themes included identification of the following barriers: fast-paced context with competing priorities; limited staff familiarity with communication access or support; priority given to swallowing by speech-language pathologists; and difficulty in addressing the pressing need to provide support and information to family members of patients with aphasia. In addition, a pervasive need for communication with patients with aphasia as part of staff responsibilities was also identified as a theme. Conclusions Findings demonstrate the need for healthcare systems to support acute care staff in their efforts to provide care for people with aphasia. Finding effective ways to influence system change is a priority and is in line with the rationale for the larger implementation project designed to improve staff and patient/family experiences in acute care.

Functional Programming in Financial Markets (Experience Report)

We present a case-study of using functional programming in the real world at a very large scale. At Standard Chartered Bank, Haskell is used in a core software library supporting the entire Markets division -- a business line with 3 billion USD operating income in 2023. Typed functional programming is used across the entire tech stack, including foundational APIs and CLIs for deal valuation and risk analysis, server-side components for long-running batches or sub-second RESTful services, and end-user GUIs. Thousands of users across Markets interact with software built using functional programming, and over one hundred write functional code. In this experience report we focus on how we leverage functional programming to orchestrate type-driven large-scale pricing workflows. The same API can be used to price one trade locally, or millions of trades across thousands of cloud nodes. Different parts of the computation can be run and inspected individually, and recomputing one part triggers recalculation of the dependent parts only. We build upon decades of research and experience in the functional programming community, relying on concepts such as monads, lenses, datatype generics, and closure serialisation. We conclude that the use of functional programming is one of the main drivers of the success of our project, and we see no significant downsides from it.

Rural Natural Disaster Stress: A Survey of Community Resource Use and Effect

ABSTRACT Objective This study identified rural community experiences and preferences related to available resources and their effects on stress following tornadoes and floods. Methods The Rural Natural Disaster Stress and Recovery survey was distributed from December 2021 to February 2022 in rural disaster-affected communities. Within the analysis sample (N = 159) of self-selected participants representing both agricultural and non-agricultural occupations, 125 responded to the Resource Use and Effect survey component that evaluated the effects of 22 resources on post-disaster stress. Additional qualitative questions provided further data. Results The most frequently used resources post-disaster were found to be talking about the event (98.3%), friends and neighbors (97.6%) and family (97.6%). Using a derived Impact per Use score, groups from the neighboring community and personal faith activities most often reduced stress. Resources that increased stress were identified as FEMA or other government organizations; repairing, replacing, or rebuilding property; and following news or social media. Participants reported help from their community (35.8%) or things they did for themselves (31.2%) most effectively decreased disaster stress. Family, friends, faith, neighbors, and community were top choices to decrease stress in a future disaster. Conclusion Rural residents identified available resources for reducing disaster stress, but some common post-disaster activities were found to increase stress. Rural emergency management should adapt response and recovery plans and activities to leverage readily accessible people, groups, and activities to mitigate negative mental and emotional health effects.

Maternal birthplace and experiences of perinatal healthcare in Belgium: Evidence from a cross-sectional survey

BackgroundPatient experience is an important part of perinatal care quality. Migrant women in high-income countries often report more negative experiences than non-migrants, but evidence in Europe is patchy. In this study, we compared the experiences of two migrant populations with non-migrants, taking into account socioeconomic characteristics. MethodsWe surveyed mothers born in Belgium, North-Africa, and Sub-Saharan Africa (n = 877) using an adapted version of the Migrant-Friendly Maternity Care Questionnaire. Two patient experience scores were created using multiple correspondence analyses: a) information and communication with healthcare professionals and overall satisfaction with pregnancy care, and b) patient-centred aspects and satisfaction with delivery care. Through descriptive analyses and multivariable logistic regressions we estimated the associations of maternal characteristics with each score. ResultsOverall, positive experiences were reported in terms of communication (83 %) and patient-centred care (86 %). North African immigrants with low language proficiency had higher odds of negative communication experience (especially problems understanding information) (ORa: 2.30, 95 %CI 1.17–4.50), regardless of socioeconomic position. Among women with language barriers, 88 % were never offered a professional interpreter, relying on family members for translation. Patient-centred care was not associated with maternal birth region but was rated more negatively by older mothers, those with longer residence in Belgium, and higher majority-language proficiency. ConclusionIn Belgium, perinatal care experiences were generally positive, although communication with immigrants was suboptimal. Language barriers, single motherhood, and unstable housing increased communication issues. Our findings underline the necessity to improve information-exchange with immigrants and socioeconomically vulnerable women.

Intersectionality in Marketing: A Paradigm for Understanding Understudied Consumers

Intersectionality remains largely underutilized within marketing. To address this gap, this article synthesizes literature to provide tools for incorporating intersectionality into marketing research, including a framework for an intersectional marketing paradigm, a research design roadmap, a research agenda, and key takeaways for stakeholders. The definition of intersectionality focuses on three main components: (1) awareness and acknowledgment of overlapping (rather than isolated) social categories (e.g., gender, race, and class), (2) understanding of how differences in lived experiences at these intersections influence the marketplace, and (3) recognition of how power shapes these lived experiences. This article's novel research design roadmap features concrete theoretical and methodological approaches for marketing researchers from various backgrounds to utilize intersectionality in solving marketing problems: conducting exploratory subsample analyses, developing intersectional theory and hypotheses, conducting inclusive literature reviews, collecting and reporting detailed demographics, sampling understudied populations, and carefully situating conclusions. The research agenda provides research questions for emerging topics at societal, organizational, and consumer levels. Engaging with intersectionality will help ensure that marketing remains socially relevant, develops diverse and inclusive theories, and more accurately reflects the lived experiences of understudied populations and communities.

The beliefs and practices used to promote physical and mental health in youth who identify as lesbian, gay, bisexual, transgender, intersex, or queer plus (LGBTIQ+) experiencing housing insecurity: An integrative review.

The purpose of this integrative review was to explore the beliefs and practices used to promote physical and mental health among youth ages 18-25 years, identifying as LGBTIQ+ experiencing housing insecurity. The approach used strategies described by Whittemore and Knafl. Peer-reviewed, published research articles in English were identified using eight electronic databases. Eighteen research reports using qualitative, quantitative, and mixed methods were identified. Articles were evaluated for quality using the American Association of Critical Care Nurses Evidenced-Level Hierarchy evaluation tool. Data were analyzed and synthesized using Braun and Clarke's method. Four themes related to the purpose were extracted: pervasive experiences of stigma and discrimination, constantly attuned to navigating risks, inconsistent engagement in health information and care, and inner strength developed through personal and community experiences. There are strong implications for future research, public health nursing practice, and health policy. Public health nurses should incorporate social determinants of health (addressing harmful social processes such as homophobia and racism) as well as a strength-based upstream approach in research, education, and health care practices. More research must also be done to assess engagement in physical and mental health information and care.

Narrowing ‘Bathtub Volunteerism’ in Singapore and Beyond Through High-quality Adolescent and Young Adult Volunteer Experiences

High-quality volunteerism experiences in adolescence are associated with higher volunteerism later in life, yet less is understood about contextualized features of these experiences, especially when school-based programmes are mandatory. Relatedly, narrowing ‘bathtub volunteerism’ (i.e., increasing postgraduation youth volunteerism and shortening the period between volunteer disengagement and resumption) remains a research gap. Therefore, using in-depth retrospective qualitative interviews with 50 young Singaporeans, we aimed to understand features of high-quality volunteer experiences in schools (among adolescents) and communities (among young adults). Findings indicated that within a national context of compulsory school-based volunteerism, ‘bathtub volunteerism’ was narrowed efficaciously when adolescents and young adults were exposed to high-quality school- and community-based volunteer experiences, respectively. High-quality school-based experiences granted student autonomy and facilitated empathy development. Community-based ones combined cause selectivity, personal meaning and close interpersonal relationships. Our findings offer insights to raise volunteerism rates by developing and propagating high-quality volunteer experiences.

Latinx Youth as Linguistic Experts: Documenting Translanguaging Moments in Youth Participatory Action Research

ABSTRACT Drawing on Youth Participatory Action Research (YPAR) and translanguaging frameworks, the purpose of this study is to demonstrate how Latinx youth leverage their community knowledge and language practices in community-based research. Through a multimodal and ethnographic examination of the students engagement in youth-driven research this article highlights how language is central to the expertise they cultivate of their everyday socio-political worlds. Findings showcase how the youth in this study drew on their linguistic expertise alongside their community knowledge and sociopolitical awareness to make sense of the various components of the research process. Further, they document translingual practices that are reflective of the lived realities and of the multilingualism located within their community. Engaging in translingual practices throughout the YPAR project reflected authentic, joyful, and critical practices of meaning making throughout their inquiry. Implications for this study include co-designing linguistically transformative spaces for youth and the importance of recognizing the community knowledge and experience that shapes their linguistic practices.

Rural Suicide: Demographics, Causes, and Treatment Implications.

Suicide rates in rural areas are higher than urban areas and growing, with current treatment developments only exacerbating this discrepancy. Within individual factors, both age and gender relate to and intersect with personal values related to self-reliance and attitudes toward mental health difficulties and treatment to increase suicide risk. The lethality ubiquitous in rural environments and occupations is a leading factor in rural suicide rates, with other factors such as race alternately noted to be a key factor but with more mixed findings. The cultural values of rural communities as typically negative toward mental health disclosure and treatment contribute to the disengagement of rural communities from treatment that may otherwise prevent suicides, exacerbating the physical lack of treatment access many rural communities experience. Working within the primary care system alongside increased telehealth utilization are suggested to reduce rural suicide rates.

Community experience and awareness regarding foreign body aspiration in Asir region, Kingdom of Saudi Arabia.

Foreign body aspiration (FBA) is a serious preventable pediatric health problem and one of the main causes of accidental death in children. Although unusual in adults, it is often overlooked as a cause of airway obstruction with serious consequences. This study assessed awareness and previous FBA experiences in the Asir community, Kingdom of Saudi Arabia. Using validated questionnaire, an annonymous online survey was conducted among 870 people aged 18 years and above. The questionnaire was used to collect data about the personal and sociodemographic characteristics of the respondents, as well as their experiences with FBA, and participants' knowledge and perceived seriousness of FBA. The level of knowledge was deemed good if the score ranged between 60% and 100%, and bad if the score fell below 60%The level of knowledge was deemed good if the score ranged between 60% and 100%, and bad if the score fell below 60%. The majority of the participants (79.7%) were females, 48.1% were aged 18 to 30 years, 72.9% had university degree, 30.6% were students, 26.9% worked in the educational sector, 43.6% reported monthly income of <5000 Saudi Riyals and 19.8% of them identified themselves as healthcarepractitioners. Although the community experience with FBA was considerably high (70.6%) among the study participants, their awareness levels about FBA were deficient. Only 24.7% of the respondents had good knowledge of FBA. Older age, being a health practitioner, and perceiving FBA as a serious incident were significantly associated with good knowledge (P < .001). The findings of this study indicate an urgent need to raise community awareness of FBA. To reduce FBA morbidity and mortality, health education efforts in community and healthcare settings are required to educate people about the seriousness and importance of early diagnosis and management of the condition.

Exploring communicative interactions in debriefing sessions with nursing students: A qualitative study

IntroductionDebriefing as a learning activity aims to elevate participants' competence through communicative interaction. This activity is an integral component of any formative simulation. Thus, the primary objective of this study was to explore debriefing as a communicative experience in nursing students within the context of interactive virtual simulation. The secondary objectives were: 1) To investigate the typology of interactions based on participants' discourse and 2) To identify the actions that students use to develop knowledge during debriefing. MethodA qualitative exploratory study design involving six debriefing groups was conducted with 105 s-year nursing students. The debriefing sessions were analyzed following interactive virtual simulations in an in-person setting in the classroom. All sessions were recorded and transcribed verbatim. A mixed (deductive and inductive) content analysis approach was used. ResultsA total of 2187 units of meaning were identified and categorized into 3 themes (interaction by participant, interaction by communicative action, and interaction by participant's communicative goal); nine subthemes (facilitator-student, student-student and student-facilitator; declarative - unidirectional, reactive – bidirectional and multidirectional-interactive; individualistic, competitive, and collaborative), and 5 categories (providing information; generating creative solutions; processing critical and deliberative information; positive interdependence and psychosocial relationships). ConclusionThe students developed knowledge and practical communication skills, particularly reinforcing soft skills through collaborative interactions, predominantly multidirectional-interactive in nature. The facilitator and the interpersonal relationships among the participants fostered a safe and positive environment.

Understanding the impact of distance and disadvantage on lung cancer care and outcomes: a study protocol

BackgroundLung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging. This place-based, behavioural science-informed qualitative study aims to explore how person-related characteristics interact with a person’s location relative to specialist services to impact their engagement with the optimal lung pathway, and to compare and contrast experiences in rural, coastal, and urban communities. This study also aims to generate translatable evidence to inform the evidence-based design of a patient engagement intervention to improve lung cancer patients’ and informal carers’ participation in and experience of the lung cancer care pathway.MethodsA qualitative cross-sectional interview study with people diagnosed with lung cancer < 6 months before recruitment (in receipt of surgery, radical radiotherapy, or living with advanced disease) and their informal carers. Participants will be recruited purposively from Barts Health NHS Trust and United Lincolnshire Hospitals NHS Trusts to ensure a diverse sample across urban and rural settings. Semi-structured interviews will explore factors affecting individuals’ capability, opportunity, and motivation to engage with their recommended diagnostic and treatment pathway. A framework approach, informed by the COM-B model, will be used to thematically analyse facilitators and barriers to patient engagement.DiscussionThe study aligns with the current policy priority to ensure that people with cancer, no matter where they live, can access the best quality treatments and care. The evidence generated will be used to ensure that lung cancer services are developed to meet the needs of rural, coastal, and urban communities. The findings will inform the development of an intervention to support patient engagement with their recommended lung cancer pathway.Protocol registrationThe study received NHS Research Ethics Committee (Ref: 23/SC/0255) and NHS Health Research Authority (IRAS ID 328531) approval on 04/08/2023. The study was prospectively registered on Open Science Framework (16/10/2023; https://osf.io/njq48).

Persevering through communication challenges: a qualitative descriptive exploration of communication experiences in aphasia

ABSTRACT Background People with aphasia often experience activity limitations and participation restrictions despite wanting to engage in communication activities that are satisfying and meaningful. Communication partner support, the complexity of the communication environment, and the thoughts and feelings of people with aphasia have important implications for both language processing and communicative participation. The perspectives of PWA about the role that environmental and personal factors (e.g. thoughts and feelings) play in their communication experiences could inform clinical practice. Aims To qualitatively explore the communication experiences of people with aphasia and how environmental demands and personal factors (especially emotional responses) affect these experiences. Methods & Procedures Fourteen participants with aphasia completed semi-structured interviews immediately following testing sessions for a larger mixed-methods project investigating the relationship between mood, attention, and language function. Interview questions related to their everyday communication experiences and how their communication environment affected their communication and concentration as well as how their emotions affected their communication. Interviews were recorded, transcribed orthographically, then analyzed using a generic qualitative descriptive approach. Coding was completed in two rounds, which included inductive and deductive coding. Codes were synthesized by reflexively analyzing code co-occurrence. Outcomes & Results Key antecedent variables included language deficits associated with aphasia and environmental demands, often leading to communication challenges. Participation was highlighted as the principal outcome, ranging from proactive engagement to withdrawal. Mental rehearsal, feelings, and attitudes mediated participation, but feelings and attitudes were also described as outcomes. Communication partners played a pivotal mediating role, often determining positive or negative outcomes. Supportive partners facilitated engagement, optimism, and contentment, while unsupportive partners led to frustration. Conclusions The results of this study highlight the role of various factors in influencing the communication experience of people with aphasia and indicate that, within the context of communication challenges, communication partners, attitudes, feelings, and participation play critical and interacting roles. Preparatory strategies such as mental rehearsal can also facilitate participation. These findings imply that targeting communication partner support, mental rehearsal focused on social scripts, or psychosocial adjustment could have important effects on participation.

The Cotillion Community

The Amy Morris Homans Cotillion, held annually from 1982 to 2014, was a safe space for lesbian professionals in kinesiology, as well as a challenge and a disruption to the misogyny, homophobia, and heterosexism that pervaded the field in the mid- and late 20th century. In this article, we highlight the lived experiences of the broader Cotillion community. We conducted oral-history interviews with American Alliance for Health, Physical Education, Recreation and Dance (AAPHERD) convention attendees about their memories of the Cotillion and Pre-Cotillion. Through these stories, we convey the significance of these events for the women and lesbians in kinesiology/physical education departments who attended them. The article begins with descriptions of interviewees’ lives within the field, progresses to how attendees discovered and experienced the Cotillion and/or Pre-Cotillion, and then explores the impact of the Cotillion, both at AAPHERD and beyond the convention.