Experience Research Articles

Assessment of Breastfeeding Content in Accredited Nurse Practitioner Programs

This descriptive cross-sectional study surveyed the breastfeeding and human lactation curricular content of accredited nurse practitioner programs in the specialties of family, pediatrics, neonatal, and women’s health. Coverage of educational topics was inconsistent across the 4 types of programs, with significant topic variation. Most programs include general topics such as infant benefits, contraindications, and safe medication use during breastfeeding. Some programs acknowledge that the personal experiences of their faculty may guide what is taught. Reliance on personal breastfeeding experiences may lead to inconsistent coverage of important topics and the possibility of bias in topic selection. A standard curriculum would assist in the provision of consistent, evidence-based content to improve the knowledge and subsequent care of breastfeeding dyads by nurse practitioners across specialties.

Application of the mind map learning technique of english-speaking students on the example of the topic “Anatomy of the brachial plexus”

Abstract. The issue of teaching brachial plexus anatomy to English-speaking foreign students remains confusing and uncoordinated to these days due to significant differences in the presentation of material in translated educational literature by Russian-language authors and atlases, textbooks, and manuals used in other countries. The purpose is to study the mind maps learning technique and identify the advantages of its use when teaching as a process using the example of the topic “Brachial plexus anatomy.” for medical foreign students Materials and methods. The materials were researches in the subject area of compiling mind maps, textbooks, atlases and manuals, workshops, workbooks of human anatomy for students of medical universities in Russian and English from sections that describing brachial plexus anatomy , and personal experience of using mind maps . Results. the example of using a mind map in human anatomy classes is given in accordance with modern anatomical terminology, the analysis of discrepancies in the description of the brachial plexus anatomy in Russian and English-language anatomical schools was carried out, and the advantages of their use in teaching medical foreign students were identified.

Recontextualization and Imagination: The Public Health Professional and the U.S. Health Care System.

Based on a qualitative study, this paper explores how United States public health professionals view and think about the existing U.S. healthcare system, while also allowing these study participants to imagine new ways of structuring and practicing public health. Using semi-structured qualitative interviews, I show how public health professionals engage with the concept of "the social" and their personal experiences with public health to question the status quo. By giving public health professionals space in which to imagine changes and different ways of practicing public health, I demonstrate the effectiveness of imagination as a capacity that public health professionals possess to take the lead in creating the changes they hope for.

A study exploring the impact of unemployment on the psychological well‐being of youth

AbstractUnemployment is widely recognized to cause a variety of psychosocial problems that might have a harmful impact on mental health. The study looks into the psychological well‐being of youth and their personal experiences with the unemployment. This article draws on primary sources to provide an in‐depth understanding of the effects unemployment among youth in Anantnag, Kashmir. The primary data include narratives, which are a qualitative approach that specifically emphasizes the stories of those who were unemployed. To collect the data, a demographic form and an interview guide were used. An unstructured interview schedule was employed with 25 youths with ages ranging from 21 to 32 years. Data were collected from July to August 2023. Participants were selected using the snowball sampling method. All of the participants were from Anantnag, the district in Jammu and Kashmir. As per the findings of the study, unemployment causes youth to feel worthless, lose self‐identity, feel shame, and experience stress. Given the possible detrimental effects of youth unemployment, efforts should be made to increase psychological support for unemployed youth to address mental health issues.

Barriers to accessing hepatitis B medication: a qualitative study from the USA and Canada

ObjectivesTo collect and document the numerous barriers that people living with hepatitis B (PLHB) encounter when trying to access their hepatitis B virus (HBV) medications.DesignResearchers collected qualitative data through 24...

Material ambiguities of losing a parent: Time, clothing and grief during terminal illness

In the spring of 2023, my father, Arturo, died of brain cancer at the age of 55, after a decade of illness. As he was dying, I began to process my anticipatory grief by writing about my emotional attachments to his clothing. Drawing on material culture, affect and design theory, this article looks at my family’s personal experience of my father’s illness and death to investigate the emotional possibilities and limits of garments belonging to palliative care patients and their loved ones. By looking closely at the material resonances of my father’s clothing while he died, this article explores how clothes reflect the confusing nature of time, grief and love when losing a parent to long-term illness. In theorizing the experience of losing a parent through a material culture lens, this article explores the liminality of anticipating a significant familial loss and the affective qualities of the garments that endure through it.

Gender and Other Inequalities in Secondary Education in Post-Conflict Sierra Leone: Exploring the Experiences and Outcomes of Girls in Schools

This study extends limited research on understanding gender and education in post-conflict contexts. The study goes beyond the descriptive analysis of equality in terms of numbers but rather focuses on the gendered processes and conditions of learning (i.e., The content of what girls learn and how they learn). It gives an account of how schooling experiences produce and reproduce inequalities in secondary education. This critical analysis utilizes the intersectionality framework to illustrate how the intersection of multiple identities such as gender, social class, sexuality, culture, and location influences girls' learning experiences and outcomes in secondary school in post-conflict Sierra Leone. I particularly draw on girls’ explanations of these issues as they negotiate and are affected by them. Therefore, a detailed qualitative ethnographic study was conducted in a secondary school from the south region of Sierra Leone to explore gendered experiences and their intersecting inequalities in everyday schooling. This is to understand the gendered institutional life of the school and as far as possible do this through the voices and perspectives of those within the school, especially the girls. What this research does is to broaden the in-school research knowledge by focusing on investigating the gendered process of learning, everyday formal and informal in-school interactions, cultures and practices and the intersection of gender with other social identities like sexuality, Socioeconomic status (SES), Location and Traditions. I also tracked how these new directions of knowledge influence girls' performance, retention, and attainment. This study adopted a qualitative research method using an ethnographic approach to examine the pupils’ and teachers' detailed secondary schooling experiences. This was achieved by using in-depth interviews to explore students’ individual personal experiences of secondary schooling. The studied participants were purposively selected based on the established parameters for this study. The findings of this study revealed a highly gendered school environment, and that the intersection of multiple identities, such as gender, social class, sexuality, culture, and location, exacerbates inequalities in secondary education and influences girls' learning experiences. Additionally, the study highlighted the impact of societal factors, such as early marriage and teenage pregnancy, on girls' educational outcomes, especially in a post-conflict context like Sierra Leone.

Identity transitions, experiences, and agency: a collaborative autoethnography of Asian international TESOL doctoral students

ABSTRACT This research explored the identities and agency of Asian international TESOL doctoral students at a large Australian university, employing a sociocultural perspective and collaborative autoethnography with qualitative content analysis. The study revealed that these doctoral students navigated complex, co-evolving identities – including learner, early-career researcher, and academic – shaped by their prior professional and research experiences. It highlighted significant identity tensions influenced by the temporal dimensions of their experiences, where past and current identities, as well as imagined future selves, informed their academic decisions and coping strategies. This temporal interplay was conceptualised through Vygotsky’s concept of perezhivanie, reflecting how personal and situational factors coalesced to impact their academic trajectories. A conceptual model, informed by these findings, illustrated how identity and agency were mediated by personal experiences and situationally catalysed tensions. This study highlighted identities as significant and formative episodes in the doctoral learning experience, offering insights into the challenges and developmental trajectories of international doctoral students. It further substantiates the value of a sociocultural perspective for understanding and supporting the academic and professional growth of this cohort.

Surgeon preferences in the treatment of thumb carpometacarpal osteoarthritis

BACKGROUND Primary thumb carpometacarpal (CMC) osteoarthritis is one of the most common conditions encountered by hand surgeons. Of the vast number of operations that have been proposed, none have demonstrated results significantly superior to trapeziectomy alone. AIM The purpose of our study was to determine why surgeons opt for their technique in treating CMC arthritis. METHODS A cross-sectional survey of active members of the American Society for Surgery of the Hand was conducted to evaluate the reasons behind their preferred technique in the treatment of isolated thumb CMC arthritis. Surgeons were contacted by e-mail once and provided with a link to a de-identified survey consisting of 5 treatment questions and 5 demographic questions. RESULTS Of 950 responses were received. 40.5% of surgeons preferred trapeziectomy + ligament reconstruction tendon interposition (LRTI), followed by trapeziectomy + suspensionplasty (28.2%), suture button suspension (5.9 %), trapeziectomy alone (4.6%), prosthetic arthroplasty (3.2%), arthrodesis (1.1%), and other (6.6%). Proponents of trapeziectomy + LRTI cited familiarity (73.2%), exposure during fellowship (48.8%) and less proximal migration (60%) to be the main reasons affecting their decision. Surgeons who preferred trapeziectomy + suspensionplasty most reported simplicity (74.9%), fewer complications (45.3%), less proximal migration (43.8%), and avoidance of autogenous tissue harvest (42.7%). Advocates of suture button suspension cited avoidance of autogenous tissue harvest (80.4%), shorter immobilization (76.8%), and quicker recovery (73.2%) with their technique. Advocates of trapeziectomy alone cited simplicity (97.7%), fewer complications (86.4%), and avoidance of autogenous tissue harvest (59.1%). In their comments, 45% of surgeons choosing trapeziectomy alone cited evidence as an additional rationale. Advocates of prosthetic arthroplasty cited improved pinch strength (83.3%) and improved range of motion (63.3%), while those preferring arthrodesis cited better pinch strength (90%) and frequently in their comments, durability. Of the surgeons who preferred a technique other than LRTI, 41.8% reported they had tried LRTI in the past, citing complexity of the procedure, flexor carpi radialis harvest, and longer operative time as reasons for moving on. CONCLUSION Our study provides an update on current treatment trends and offers new insight into the reasons behind surgeons' decision making in the management of thumb carpometacarpal osteoarthritis. Despite strong Level 1 evidence supporting the use of trapeziectomy alone, our findings demonstrate that most surgeons continue to supplement trapeziectomy with other techniques such as LRTI or suspensionplasty. Several factors including familiarity, personal experience (Level 4 evidence), and comfort may be more influential than Level 1 evidence in determining the techniques in a surgeon's armamentarium. Further prospective studies are needed to determine the optimal technique for surgical management of Eaton stages II-IV CMC arthritis and how these studies will affect surgeons’ choice.

Konversi Agama: Proses dan Faktor yang Mempengaruhi

This research aims to investigate the process of religious conversion and the factors that influence it. Religious conversion is a complex phenomenon involving fundamental changes in an individual's beliefs and identity. Through a qualitative approach, a literature review explores the causes, processes and factors that influence religious conversion. Data analysis was carried out using thematic methods. Research findings show that the religious conversion process involves stages such as search, consideration, religious experience, and decision making. Factors influencing religious conversion include social environmental influences, personal experiences, spiritual crises, search for meaning in life, and external factors such as mixed marriages or exposure to new cultures. The implications of this research can help our understanding of the dynamics of religious conversion and provide insight into intervention and guidance efforts in the context of religious diversity in society.

Analyzing the Characters in the Dream of the Red Mansion and Jane Eyre from the Perspective of Feminism

Feminism not only has many manifestations in theory but also in practical life. This paper explores feminism from the perspective of literary works from both East and West. In the East, although feminism was influenced very late, it began to sprout as early as the feudal society. The feminism of this period was closed, not bold, and oppressive. Cao Xueqin's "Dream of the Red Chamber" can become an encyclopedia of Chinese feudal society. Feminism is manifested in all aspects here. When China was in a backward feudal period, Western societies such as Britain and France had already begun a vigorous bourgeois revolution. Women are already openly and boldly fighting for democracy, freedom, and liberation. British writer Charlotte Bronte, influenced by the idea of compromise and combining her own personal experience, wrote the masterpiece Jane Eyre. This paper analyzed the characters in Dream of the Red Mansion and Jane Eyre from the perspective of feminism.

Why do women choose home births.

In recent years, the US has seen a significant rise in the rate of planned home births, with a 60 % increase from 2016 to 2023, reaching a total of 46,918. This trend positions the US as the leading developed country in terms of home birth prevalence. The American College of Obstetricians and Gynecologists (ACOG) suggests stringent criteria for selecting candidates for home births, but these guidelines have not been adopted by home birth midwives leading to poor outcomes including increased rates of neonatal morbidity and mortality. This paper explores the motivations behind choosing home births in the US despite the known risks. Studies highlight factors such as the desire for a more natural birth experience, previous negative hospital experiences, and the influence of the COVID-19 pandemic on perceptions of hospital safety. We provide new insights into why women choose home births by incorporating insights from Nobel laureate Daniel Kahneman's theories on decision-making, suggesting that cognitive biases may significantly influence these decisions. Kahneman's work provides a framework for understanding how biases and heuristics can lead to the underestimation of risks and overemphasis on personal birth experiences. We also provide recommendations ("nudges according to Richard Thaler") to help ensure women have access to clear, balanced information about home births. The development of this publication was assisted by OpenAI's ChatGPT-4, which facilitated the synthesis of literature, interpretation of data, and manuscript drafting. This collaboration underscores the potential of integrating advanced computational tools in academic research, enhancing the efficiency and depth of our analyses.

Making Information About Cladribine Tablets Accessible to People with Multiple Sclerosis: A Patient-Survey-Led Narrative Review for Healthcare Professionals.

Cladribine tablets have been granted marketing authorization in Europe and approved by the Food and Drug Administration (FDA) in the USA to treat relapsing forms of multiple sclerosis (MS). However, people with MS (PwMS) may be more familiar, and therefore more confident, with treatments requiring long-term and frequent dosing. Differences in such treatment strategies can lead to questions relating to how short-course non-continuous treatments, such as cladribine tablets, can work and how well they are tolerated. In response to this, we aimed to create an evidence-based report on patient-focused aspects of treatment with cladribine. To inform development, MS experts, including healthcare professionals (HCPs) and PwMS, proposed topics that PwMS and their families and caregivers would most like to discuss with HCPs during consultations to help them better understand cladribine treatment. The statements regarding each topic were then ranked by PwMS and used to inform the topics covered in this report. We explain here the use of cladribine tablets, which includes explanations of how cladribine tablets work, how to take cladribine tablets, and considerations required prior to and while taking cladribine tablets. We also describe how cladribine tablets affect relapse rate and quality of life and detail side effects, when they are likely to happen, and for how long. We also discuss how cladribine tablets affect family planning, fertility, and the use of vaccines. Alongside each section is a brief, plain language description of what is covered and an accompanying visual to aid conversations between HCPs and PwMS. Improved understanding by PwMS of treatments, such as cladribine, can empower them to play a bigger role in shared decision-making regarding their treatment. Additionally, the open dialogue we aim to promote with this type of report could lead to treatment choices being better tailored for individuals with chronic diseases on the basis of personal experiences, preferences, and circumstances.

Sex Differences in Wellness Scores in Collegiate Athletes

Subjective wellness scores reflect athlete responses to training, fatigue, personal experiences, and recovery, and evidence suggests these scores may differ between athletes based on sex. This study aimed to evaluate the differences in daily wellness scores between sexes in collegiate soccer, swimming, and basketball athletes. Athletes (n = 294, 63% female) completed daily wellness surveys for energy, health status, mood, muscle readiness, sleep quality, sleep duration, stress, diet, and overall wellness. Variables were evaluated on a 5-point Likert scale, except sleep duration, quantified in hours. Repeated measures, mixed linear models, repeated measures, and ordinal logistic models were used to assess sex differences in wellness outcomes. In basketball, females have 0.30 times the odds (95% CI 0.19, 0.48) of males of a worse health status score. For soccer, females have 2.45 times the odds (95% CI 1.32, 4.44) of males with a worse stress wellness score. In swimming, females, on average, slept 0.40 more hours of sleep per night (95% CI 0.02, 0.79) as compared to males. These data suggest that differences in wellness subcomponents are nuanced by sport. This information can be used to provide targeted programming for athletes to improve wellness and reduce stress, which may subsequently enhance mental health, academic performance, and sports performance.

The spatial development of tourism over eight decades: a Horizon 2050 paper

Purpose The purpose of this paper is to show the spatial extent and growth of tourism and its likely patterns as past forces of change are replaced by new pressures to reduce climate change and meet new definitions of success. Design/methodology/approach The approach involves a review of changes that have occurred over the Horizon period with a focus on the spatial spread and development of tourism, using and based on a literature review, past research and personal experience. Likely new developments are identified based on the expected result of influences including climate change mitigation and altered understandings of what is meant by success in tourism. Findings Much of the spatial change in tourism has been evolutionary rather than revolutionary, but in the future, restrictive forces external to tourism may change travel patterns with severe effects on long haul travel and a change in travel mode. Research limitations/implications The research focus needs to produce effective measures of success as understood by all stakeholders in tourist destinations. Alternative destinations will need to replace those long haul destinations no longer available and research needs to refocus on managing rather than solely attracting visitors. Practical implications Long haul destinations will lose market share, destinations will change goals to satisfaction for stakeholders and travel modes will change to lower emission generators. Social implications Destination choice will be reduced, transport modes may be limited and tourism closer to home will become the norm. Originality/value A general overview of this type has not been presented before.

Investigating the impact of the COVID-19 pandemic on recovery colleges: multi-site qualitative study.

During the COVID-19 pandemic, mental health problems increased as access to mental health services reduced. Recovery colleges are recovery-focused adult education initiatives delivered by people with professional and lived mental health expertise. Designed to be collaborative and inclusive, they were uniquely positioned to support people experiencing mental health problems during the pandemic. There is limited research exploring the lasting impacts of the pandemic on recovery college operation and delivery to students. To ascertain how the COVID-19 pandemic changed recovery college operation in England. We coproduced a qualitative interview study of recovery college managers across the UK. Academics and co-researchers with lived mental health experience collaborated on conducting interviews and analysing data, using a collaborative thematic framework analysis. Thirty-one managers participated. Five themes were identified: complex organisational relationships, changed ways of working, navigating the rapid transition to digital delivery, responding to isolation and changes to accessibility. Two key pandemic-related changes to recovery college operation were highlighted: their use as accessible services that relieve pressure on mental health services through hybrid face-to-face and digital course delivery, and the development of digitally delivered courses for individuals with mental health needs. The pandemic either led to or accelerated developments in recovery college operation, leading to a positioning of recovery colleges as a preventative service with wider accessibility to people with mental health problems, people under the care of forensic mental health services and mental healthcare staff. These benefits are strengthened by relationships with partner organisations and autonomy from statutory healthcare infrastructures.

“Maybe They Don’t Necessarily Realize the Damage They Can Do…”: A Qualitative Study on Bystanders to Non-consensual Forwarding of Nudes Among Adolescents in Switzerland

AbstractPeers can positively or negatively influence situations where nudes are forwarded without the original sender’s consent. This study aims to explore opinions and representations of adolescents regarding bystanders’ reactions to nudes being forwarded without consent. Discussions through focus groups (FG) were facilitated with vignettes using quotes related to bystanders. While discussions revolved around the quotes, acting as scenarios, most participants referred to personal experiences as most knew such situations in their social circles. Between May and June 2021, 42 adolescents (23 females) aged between 14 and 17 years participated in eight online FG. A thematic content analysis was performed. Participants reported different levels of bystanders’ responsibility depending on whether one does nothing, reacts by laughing or insulting, or continues to share, this last action being, for most, the most serious one. Several active behaviors were mentioned: shunning the victim, gossiping, laughing, mocking, insulting, and prolonging the sharing. Peer pressure, fear of retaliation, emotional management, friendships, age, and gender were explanations for the different bystanders’ behaviors. There is a lack of awareness of peers’ responsibility regarding nudes being forwarded without consent. It is essential to include bystanders in prevention strategies to make them aware of their influential role within the social dynamic. Demonstrating the weight that the group, collectively, can have in such situations could encourage bystanders to play a proactive role, fostering a sense of responsibility and empowerment. Deconstructing gender stereotypes from an early age is crucial to reduce violence related to power imbalances, discrimination, or expectations associated with gender roles.

Social Media and the Spiritual Journey: The Place of Digital Technology in Enriching the Experience

This qualitative study explores the utilization of social media among Pakistani pilgrims during spiritual journeys and investigates its impact on their pilgrimage experiences. Thirty Pakistani pilgrims who had embarked on spiritual journeys to various religious sites were interviewed using semi-structured interviews. Thematic analysis was employed to analyze the interview transcripts, revealing five main stages of social media usage: pre-trip preparation, real-time updates and guidance, community building and support, sharing experiences and insights, and post-trip reflection and engagement. At each stage, social media played diverse roles, including providing information and support, fostering connections with fellow pilgrims, sharing personal experiences, and facilitating spiritual dialogue. This explorative study underscores the significance of social media in enhancing the pilgrimage experience for Pakistani pilgrims, serving as a valuable tool for information dissemination, community building, spiritual support, and personal reflection throughout the pilgrimage journey. The findings contribute to a deeper understanding of how social media shapes pilgrims’ experiences and fosters their spiritual growth, emphasizing the need for further research to explore the nuanced dynamics of social media usage in the context of pilgrimage. Overall, this study sheds light on the unique role of social media in the spiritual journeys of Pakistani pilgrims and highlights its implications for pilgrimage practices and the broader discourse on religious tourism.

Navigating the complex dynamics of anesthesiologists’ professional identity formation in the context of their specialty training program: a phenomenographic perspective

BackgroundA specialty training program is crucial for shaping future specialist doctors, imparting clinical knowledge and skills, and fostering a robust professional identity. This study investigates how anesthesiologists develop their professional identity while navigating unique challenges specific to their specialty. The formation of professional identity in anesthesiology significantly influences doctors’ well-being, teamwork, and ultimately patient care, making it a crucial aspect of anesthesiology education. Utilizing a phenomenographic approach, the research explores the learners’ personal experiences and perspectives of professional identity formation in their specialty training programs, providing valuable insights for enhancing future anesthetic educational programs.MethodThe data for this phenomenographic study were collected through semi-structured interviews with anesthesiology trainees and specialists, guided by open-ended questions. The interviews were conducted at a Swedish university hospital, and participant selection used purposive sampling, providing rich and diverse data for analysis after 15 interviews. Iterative analysis followed the seven-step phenomenographic approach. The research team, comprising qualitative research and anesthesiology education experts, ensured result validity through regular review, discussion, and reflective practices.ResultsThe study reveals three fundamental dimensions: ‘Knowledge of Subject Matter,’ ‘Knowledge of Human Relations,’ and ‘Knowledge of Affect.’ These dimensions offer insights into how anesthesiologists comprehend anesthesiology as a profession, navigate interactions with colleagues and patients, and interpret emotional experiences in anesthesiology practice – all crucial elements in the formation of professional identity. The findings could be synthesized and further described by three conceptions: The Outcome-Driven Learner, the Emerging Collaborator, and the Self-Directed Caregiver.ConclusionThe study uncovers differing learner understandings in the development of anesthesiologists’ professional identity. Varying priorities, values, and role interpretations highlight the shortcomings of a generic, one-size-fits-all educational strategy. By acknowledging and integrating these nuanced learner perspectives, as elucidated in detail in this study, the future of anesthesia education can be improved. This will necessitate a holistic approach, intertwining both natural sciences and humanities studies, focus on tacit knowledge, and flexible teaching strategies, to guarantee thorough professional development, lifelong learning, and resilience.

Mental health literacy, mental health experiences and help-seeking behaviours of Chinese elite athletes: a qualitative study

IntroductionElite athletes' help-seeking on mental health might be influenced by their mental health literacy (MHL) and mental health experiences. The current study aimed to explore the MHL, experiences and help-seeking behaviours among elite athletes using a qualitative approach.MethodsFace-to-face semi-structured interviews were conducted among 20 Chinese elite athletes, 12 coaches, and 5 team officials. Interview data was analyzed using content analysis.ResultsSeven main themes emerged from the analysis. The current study revealed that Chinese elite athletes suffered from various mental health issues and athletes' MHL levels, help-seeking attitudes and intentions, Chinese sports environments, and Chinese cultural background could impact their help-seeking behaviours.ConclusionSupport for Chinese elite athletes' mental health and help-seeking requires improvement.