Experience Research Articles

Strategic technological processes in hospitals: Conflicts and personal experiences of healthcare teams.

Global health systems operate amid dynamic factors, including demographic shifts, economic variations, political changes, technological progress, and societal trends that lead to VUCA reality (Volatility, Uncertainty, Complexity, and Ambiguity). To address these challenges, healthcare organizations are increasingly turning to Strategic Technological Processes and digital transformation. Against this background, the current study examined the personal experiences, conflicts, difficulties, and moral dilemmas attendant upon accommodating this digital transformation of healthcare professionals. The study involved 27 healthcare professionals working in Israeli hospitals, whose experiences and perspectives were central to understanding the impact of digital transformation in healthcare settings. The study methodology rested on in-depth interviews, which were analyzed through the prism of the Listening Guide analytical technique. The research obtained pre-approval from the Ethics Committee at the researcher's institution. The study revealed that the healthcare professionals are indeed facing ethical conflicts and personal challenges related to digitalization (such as providing the best quality of care, being the best caregiver, and acting for the betterment of the hospital). It also identified dilemmas resulting from conflicts between the needs and demands of the health system and the healthcare professionals' values and resources. The study findings highlight the impact of ethical and moral challenges accompanying strategic organizational and digital transformation changes implemented by healthcare organizations worldwide. These challenges arise as healthcare institutions adapt to the demands of the 21st century, potentially leading to burnout and moral distress among healthcare professionals, further exacerbating the already stressful reality they face. In conclusion, the study emphasizes the critical necessity for comprehensive support strategies to alleviate stress and burnout among healthcare professionals. As healthcare organizations and personnel navigate significant organizational changes to address contemporary challenges, prioritizing the well-being of healthcare workers through effective support mechanisms becomes imperative.

Boardroom blind spots: why HR exclusion puts corporate reputations at risk

Purpose This study aims to explore the ramifications of a lack of human resources (HR) representation in corporate boardrooms. Design/methodology/approach The author draws upon her personal and professional experience as a director of human resources and as a board member for a corporation. Findings There is a fundamental misunderstanding of the strategic value that HR brings to the table. To thrive in the modern business environment, organisations must acknowledge this strategic value and actively involve HR professionals in high-level decision-making processes. Originality/value This study makes a strong and compelling case for HR’s involvement in high-level decision-making in the boardroom.

Intraoperative Frozen Section Evaluation of Pancreatic Specimens and Related Liver Lesions.

Frozen sections are essential in the surgical management of patients, especially those with pancreatic masses, because frozen sections can provide answers intraoperatively and aid in treatment decisions. Pancreas frozen sections are challenging because of the small tissue size, processing artifacts, neoadjuvant treatment effects, and concurrent pancreatitis-like obstructive changes. The authors present a review of intraoperative evaluation of pancreatic specimens. To provide an approach to the diagnosis of pancreatic adenocarcinoma on frozen sections and to discuss commonly encountered pitfalls. Indications for pancreas frozen sections and specific margin evaluation will be discussed. We will also review frozen section diagnosis of subcapsular liver lesions and tumors other than metastases of pancreatic ductal adenocarcinoma. Data sources included a literature review and the personal experiences of the authors. The features for diagnosis of pancreatic adenocarcinoma include disordered architecture, glands at abnormal locations, and atypical cytology. It is important to be aware of the pitfalls and clues on frozen section. The evaluation of resection margins can be challenging, and in the setting of the resection of cystic tumors, the key is the diagnosis of high-grade dysplasia or cancer. Finally, it is vital to remember the differential diagnosis for subcapsular liver lesions because not all lesions will be metastases of adenocarcinomas or bile duct adenomas. Frozen sections remain a useful tool for the intraoperative management of patients with pancreatic tumors.

Romani Bildungsroman – On the Cultural Trauma of Coming-of-Age as Presented in the Novels - City of Pain and City of Sin by Meti Kamberi

The aim of this paper is to analyze the articulation of cultural trauma of coming-of-age as depicted in the novels City of Pain and City of Sin by the young Romani author Meti Kamberi. The common feature of these two novels is that they both explore the traumatic childhood and coming –of-age experiences through the main protagonist’s point of view, suggesting that they either belong to the genres of autobiography and bildungsroman. Both novels are examined from the ethnic/minority bildungsroman perspective, with a particular focus on the personal experience narrative of coming-of-age of a Romani minority member in post-socialist Serbia as described in either of the two. Through illustrative examples, this paper demonstrates that the literary and artistic creations of minority populations can be a valuable ethnographic source for investigating their self-representations. The pages of these novels represent a space for articulating ethnic as well as racialized traumas, caused by both personal and transgenerational experiences of discrimination, stigmatization, and marginalization of the Romani population in this region. The thematization of life between two worlds, the dichotomy between the community of origin and the mainstream society, is a key characteristic of the Romani bildungsroman.

Cradling disparities: A descriptive qualitative study of maternal experiences of mothers from low-socioeconomic status in the first month postpartum.

To explore the experiences, expectations and needs of mothers from low-socioeconomic status at 1 month postpartum. Descriptive qualitative. Mothers from low-socioeconomic status and irrespective of their parity were invited to participate in one-to-one interviews at 1 month postpartum. Semi-structured interviews were conducted until data saturation. Interviews were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained. Twenty mothers participated and six themes were identified: (1) No choice but to find meaning; (2) Father as a major pillar of support; (3) 'Kampung' Spirit; (4) Trials and Tribulations of Transition to Motherhood; (5) Shame, guilt and internalized stigma and (6) Reclaiming the power. This study reflected the unique struggles of mothers from low-socioeconomic status with pregnancy, childbirth and early postpartum and the wider health inequities within Singapore's maternal health system. To provide much-needed support and improved care, the stakeholders within government, healthcare providers and social organizations should consider the niche needs of this community. Nurses need to reflect on their own biases and ensure consistent care delivery regardless of socioeconomic status. When delivering patient education, patient-centred and sincere advice rooted in personal experience can help to establish rapport. This study is the first to explore the experiences of mothers from low-socioeconomic status in the Singapore context. Low-socioeconomic status mothers experienced less autonomy over their health, the care they received and their childcare options. As mothers adjusted to their new roles, they struggled to cope. However, as they were wary of the stigma surrounding poverty and their guilt of not being a 'good mother', they preferred to seek informal support from their family, friends and self-help through learning from social media, as compared to formal, external help. COREQ checklist. No patient or public contribution.

Hype or hope? Ketamine for the treatment of depression: results from the application of deep learning to Twitter posts from 2010 to 2023

ObjectiveTo investigate societal perceptions of ketamine’s use in depression therapy by analysing Twitter posts from January 1, 2010 to April 1, 2023.MethodsUsing Twitter as the social media platform of choice, and employing search terms based on (depression OR depressed OR depressive) AND (ketamine OR esketamine OR Spravato), we collected English-language tweets from January 1, 2010, to April 1, 2023. Using unsupervised machine learning and natural language processing (NLP) techniques, including Bidirectional Encoder Representations from Transformers (BERT) and BERTopic, the study identified prevalent topics surrounding public chatter around the use of ketamine in depression treatment. Manual thematic analyses further refined these topics into themes.ResultsOut of an initial dataset of 99,405 tweets, after removing duplicate tweets, re-tweets and tweets posted by organizations over Twitter, 18,899 unique tweets from presumably individual users were analysed. Analysis of temporal trends revealed a shift in public attitudes, particularly after the United States Food and Drug Administration (FDA)’s 2019 approval of ketamine for depression. Three major themes emerged: a changing regulatory landscape, cautious optimism, and personal experiences with the drug. There was an initial spike in discussions post-FDA approval in 2019. Thereafter, cautious optimism (Theme 2) decreased among the general public, with more personal accounts (Theme 3) highlighting the potential benefits for some treatment-resistant patients. Limitations of the study include Twitter’s inherent biases towards younger, English-speaking demographics.ConclusionIn summary, the public’s multifaceted perception leans towards a hopeful stance on ketamine’s therapeutic potential for depression.

Navigating uncertainty: exploring parents' knowledge of concussion management and neuropsychological baseline testing

IntroductionParents play an important role in preventing and managing sport-related concussions among youth sport participants. Research indicates that parents understand the severity and consequences associated with the injury but gaps exist in their knowledge of its management. Neuropsychological baseline testing (NBT) is a modality that has gained interest in youth sport to purportedly better manage concussion injuries. Little is known about parents' perspectives on the use of NBT in the management process.MethodsThe present qualitative study used Protection Motivation Theory as a guiding framework and employed focus groups (N = 2) with parents (N = 11) to gain insight into parents' perceptions and experiences with concussion management, specifically focusing on NBT.ResultsInductive Content Analysis developed a core theme of navigating uncertainty. Participants expressed uncertainty about the nature of concussion and its management process, where concussion was not always easy to identify, youth were not always reliable reporters, and there was no prescribed or proscribed path for recovery. Personal experience and concussion management policy provided participants with a degree of certainty in managing concussions. Participants gave NBT mixed reviews in potentially promoting greater certainty but also held reservations about its usefulness in concussion management.DiscussionWe discuss findings relative to existing knowledge and theory in youth sport concussion and identify implications for practice.

Curating Community behind Barbed Wire: Canadian Prisoner of War Art from the Second World War

Though often under-represented in the official and national narratives and in Canadian military historiography more broadly, the intimate and personal lived experiences of Canadian prisoners of war (POW) during the Second World War can be found in archives, photography collections, and collections of war art. In an attempt to see past the mythologised versions of POWs that appear in Hollywood films, best-selling monographs, and other forms of popular culture, it is through bits of ephemera—including wartime log books and the drawings carefully kept and sent home to loved ones along with handwritten letters—that the stories of non-combatant men and women who spent their war as POWs, can be told. Together, Canadian POWs created and curated community and fostered unconventional family ties, sometimes called “emotional communities”, through the collection and accumulation of drawings, illustrations, paintings, and other examples of war art on the pages of their wartime log books while living behind barbed wire. This article uncovers some of these stories, buried in the thousands of boxes in the George Metcalf Archival Collection—the textual archives—at the Canadian War Museum (CWM) in Ottawa, Ontario, Canada.

Experiential learning in the master of public administration classroom: An application of the family-friendly campus toolkit

Public administrators can play a vital role in the articulation of demands emerging from the community and can serve to advance these demands by their position of authority, skills and knowledge to help facilitate the development of programs and projects to address public needs. This article describes the role that a small Master of Public Administration program and several of its faculty and students played to support a project which sought to aid the development of family-friendly policies and programs on the campus of the University of Massachusetts Lowell, a mid-sized, public university in the Northeastern United States. The article lays out the personal experience of the authors as they relate to their decision to participate in the program, a description of the project and the assistance that MPA students were able to render the initiative, the manner in which integrating the commitment to campus improvement for pregnant and parenting students influenced the content of several MPA courses, and the synergies which developed as students worked to develop skills in communication, focus-group moderation, qualitative data analysis, presentation delivery and report-writing.

Retrogasserian trigeminal radiofrequency-thermorhizotmoy for trigeminal neuralgia

Based on a personal experience of 4200 surgeries, radiofrequency thermocoagulation is useful lesional treatment for those trigeminal neuralgias (TNs) not amenable to microvascular decompression (idiopathic or secondary TNs). Introduced through the foramen ovale, behind the trigemnial ganglion in the triangular plexus, the needle is navigated by radiology and neurophysiological testing to target the retrogasserian fibers corresponding to the trigger zone. Heating to 55–75 °C can achieve hypoesthesia without anaesthesia dolorosa if properly controlled. Depth of anaesthesia varies dynamically sedation for cannulation and lesioning, and awareness during neurophysiologic navigation. Proper technique ensures long-lasting results in more than 75% of patients.

A needs assessment of Extension staff to implement inclusive programming for adults with intellectual/developmental disabilities

This study is a needs assessment of Extension staff in the state of Iowa to implement inclusive programming for individuals with intellectual and developmental disabilities (IDD). Electronic surveys were completed by Extension staff on their attitudes and beliefs toward people with IDD, inclusive programming, and training needs. Results showed that Extension staff had positive views, but that staff reporting personal experience with people with IDD had more positive attitudes and beliefs (p <.05). The greatest training need was instructional techniques. The study highlights the importance of direct experience in addition to knowledge-based workshops for training Extension staff to implement inclusive programming.

'Autism is the Arena and OCD is the Lion': Autistic adults' experiences of co-occurring obsessive-compulsive disorder and repetitive restricted behaviours and interests.

Repetitive behaviours and interests are a hallmark feature of autism. It is very common for autistic people to experience mental health difficulties, such as obsessive-compulsive disorder. Previous research has investigated similarities and differences between obsessive-compulsive disorder symptoms and repetitive behaviours in autism through questionnaires and observation studies. This is the first study to interview autistic adults about their personal experiences of differentiating between obsessive-compulsive disorder symptoms and repetitive behaviours related to autism. We interviewed 15 autistic adults who experience obsessive-compulsive disorder symptoms. We recorded these interviews and carefully analysed these to find themes. We found some differences between repetitive behaviours and obsessive-compulsive disorder. Participants said repetitive behaviours are part of who they are and what they want to be doing, whereas obsessive-compulsive disorder symptoms conflicted with how they view themselves. Obsessive-compulsive disorder was said to cause negative emotions, while participants said they experience lots of different emotions when doing repetitive behaviours. A similarity participants reported was trying to stop themselves from doing obsessive-compulsive disorder symptoms and repetitive behaviours that other people can see. There was also overlap between obsessive-compulsive disorder and repetitive behaviours. Participants talked about experiences when obsessive-compulsive disorder would take over routines and make them feel more intense and negative. Also, participants' special interests were sometimes connected to the obsessions they experienced. We conclude that clinicians can use these findings to support conversations with autistic clients in differentiating between repetitive behaviours and obsessive-compulsive disorder symptoms. We also think that further research investigating how obsessive-compulsive disorder symptoms might be hidden by autistic and typically developing people is needed.

EXPRESS: Gender and Serious Drug Recalls: a Textual Sentiment Analysis of Drug Reviews on WebMD

Consumers taking prescription drugs have limited ability to ascertain drug quality before taking the drug. After drug use, however, consumers frequently report their personal experiences with prescription drugs on one of the world’s largest medical websites: WebMD. Drug reviews on WebMD are a potentially rich source of free-form text that can be utilized to inform firms, consumers, researchers, and the Food and Drug Administration (FDA) about the quality and safety of prescription drugs. Additionally, because men and women communicate in starkly different ways, the gender of the reviewer may play a key role in drug reviews signaling drug quality problems. We examine if drug review textual sentiment is associated with the hazard of a serious drug recall and whether this relationship varies depending on the gender of the reviewer. We analyze textual sentiment on drug reviews from WebMD along with 13 years of drug recall data using several hazard models. We find that the more negative the drug review sentiment, the greater the hazard of a serious recall on that drug. This relationship is completely explained by drug reviews written by females; reviews written by males have no explanatory power. Our findings are confirmed by numerous robustness checks. In post-hoc analysis, we explore possible mechanisms by comparing female and male adverse events on the recalled drugs in our study. Our contributions to gender diversity and drug quality literature leads to implications for the FDA, WebMD, and firms that manufacture prescription drugs.

Understanding the Impacts of Online Mental Health Peer Support Forums: Realist Synthesis

Background Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation. Objective This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users. Methods We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff. Results Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users’ perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety. Conclusions This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability. Trial Registration PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528

Experience of undergraduate nursing students participating in artificial intelligence + project task driven learning at different stages: a qualitative study

BackgroundArtificial intelligence is a growing phenomenon that will soon facilitate wide-scale changes in many professions, and is expected to play an important role in the field of medical education. This study explored the realistic feelings and experiences of nursing undergraduates participating in different stages of artificial intelligence + project task driven learning, and provide a basis for artificial intelligence participation in nursing teaching.MethodsWe conducted face-to-face semi-structured interviews with nursing undergraduates participating in Nursing Research Course which adopts artificial intelligence + project task driven learning from a medical university in Ningxia from September to November 2023, to understand their experience of using artificial intelligence for learning and the emotional changes at different stages. The interview guide included items about their personal experience and feelings of completing project tasks through dialogue with artificial intelligence, and suggestions for course content. Thematic analysis was used to analyze interview data. This study followed the COREQ checklist.ResultsAccording to the interview data, three themes were summarized. Undergraduate nursing students have different experiences in participating in artificial intelligence + project task driven learning at different stages, mainly manifested as diverse emotional experiences under initial knowledge deficiency, the individual growth supported by external forces during the adaptation period, and the expectations and suggestions after the birth of the results in the end period.ConclusionsNursing undergraduates can actively adapt to the integration of artificial intelligence into nursing teaching, dynamically observe students’ learning experience, strengthen positive guidance, and provide support for personalized teaching models, better leveraging the advantages of artificial intelligence participation in teaching.

Empowering African‐American museums: The vital role of black museum anthropologists in grantmaking

AbstractMany African American museums face financial constraints and need resources to preserve their collections, create exhibits, and offer educational programs. Grant funding is crucial for the sustainability of these museums. Black anthropologists are essential in grant writing because they provide their extensive knowledge of African American history and culture to help museums develop compelling narratives that resonate with grant funders. Additionally, Black anthropologists are needed as reviewers of grant proposals. By leveraging their unique insights from professional training and personal experiences, Black anthropologists can champion the cause of these museums in the grant‐making process. Their expertise allows them to assess proposals from a culturally sensitive perspective, considering the unique needs, goals, and challenges African American museums face. This essay highlights the significant contributions of Black anthropologists who have advocated for and strengthened grant applications from African American museums, ensuring that they align with the mission and vision of the grant‐making institutions. By helping African American museums secure grant support, Black anthropologists also convey the significance and value of other African American museums.

Chronic neck and low back pain from personal experiences: a written narrative approach.

Background: Chronic neck and low back pain are very common and have detrimental effects for people and society. In this study, we explore the experiences of individuals with neck and/or back pain using a written narrative methodology. Materials & methods: A total of 92 individuals explained their pain experience using written narratives. Narratives were analyzed through thematic analysis and text data mining. Results: Participants wrote about their experience in terms of pain characteristics, diagnosis process, pain consequences, coping strategies, pain triggers, well-beingand future expectations. Text data mining allowed us to identify concurrent networks that were basically related with pain characteristics, management and triggers. Conclusion: Written narratives are useful to understand individuals' experiences from their point of view.

Assessment of inter- and intraobserver agreement for META score in distinguishing osteoporotic from multiple myeloma vertebral fractures.

To conduct an independent assessment of inter- and intraobserver agreement for the META score as a tool for differentiating osteoporotic vertebral fractures and multiple myeloma vertebral fractures. This is a retrospective observational study. The magnetic resonance imaging analysis was made by two independent spinal surgeons. We designated a Subjective assessment, in which the surgeon should establish a diagnostic classification for each vertebral fracture based on personal experience: secondary to osteoporosis, categorized as a benign vertebral fracture (BVF), or attributed to multiple myeloma, categorized a malign vertebral fracture (MVF). After a 90-day interval, both surgeons repeated the evaluations. For the next step, the observers should establish a diagnosis between BVF and MVF according to the META score system, and both observers repeated the evaluations after a 90-day interval. The intra and interobserver reliability of the Subjective evaluation was studied using the kappa (κ) test. Then, the META evaluations were paralleled using the intraclass correlation coefficient (ICC). A total of 220 patients who had the potential to participate in the study were initially enrolled, but after applying the exclusion criteria, 44 patients were included. Thirty-three patients had BVF, and 12 patients presented MVF. Interobserver agreement for both Subjective evaluations moments (initial and 90-days interval) found a slight agreement for both moments (0.35 and 0.40 respectively). Kappa test for both META evaluations moments (initial and 90-days interval) found a moderate interobserver agreement for both moments (0.54 and 0.48 respectively). It was observed that the ICC calculated for the Initial evaluation using META score was 0.680 and that in the 90-days interval was 0.726, indicating regular to good agreement. Kappa test for intraobserver agreements for the Subjective evaluation presented moderate agreement for both Surgeons. On the other side, Kappa test for intraobserver agreements for the META evaluation presented substantial agreement for both Surgeons. The Intraclass Correlation Coefficient of the META score found presented an almost perfect agreement for both Surgeons. Intra and interobserver agreement for both surgeons were unsatisfactory. The lack of consistent reproducibility by the same observer discourages and disfavors the routine use of the META score in clinical decision making, when potentially cases of multiple myeloma may be present.

Formative personal experiences: How benefit recipiency and income changes shape perceptions of system abuse

AbstractPerceptions that others will contribute their fair share are fundamental to the legitimacy of the political system. To better understand how these perceptions take shape beyond the influence of political narratives and socializations, this paper investigates the role of the formative personal experiences of benefit recipiency and income changes in explaining views on welfare abuse as well as tax evasion. Theoretically, both increasing identification or ‘othering’ could occur when these experiences lead to new group adherence. To test this empirically, three‐wave Norwegian panel data (2014–2017) are analysed. Within‐ as well as between‐group analyses show that becoming dependent on benefits leads to lower perceptions of welfare abuse, while positive income changes prompt higher perceptions of tax evasion, albeit mostly among those with lower income levels. Overall, this article shows that formative personal experiences affect views that are fundamental to the perceived fairness, legitimacy and sustainability of the social and political system.

From party to pandemic – Frames and metaphors in the news coverage of the COVID-19 outbreak in Austria

Media framing facilitates people’s understanding of a threat and affects one’s emotional reaction. It therefore plays a vital role in both individual and societal responses to a public health crisis such as the COVID-19 pandemic. Using a combination of conceptual metaphor analysis and qualitative frame analysis, this article examines how three Austrian newspapers framed the initial national outbreak of COVID-19 in March 2020. The results show that at that early stage, media coverage was primarily concerned with the national government’s political actions to contain the disease. Only a few articles framed the situation in terms of personal experiences and possible economic or social consequences. As has been the case in research reporting on other health crises, metaphors of war, journeys, and natural disasters were used to conceptualize the coronavirus pandemic. Yet, overall, the tone remained neutral, as the media framing was clearly aimed at passing on information and conveying a sense of urgency while at the same time trying to avoid scare tactics.