<bold>ABSTRACT</bold> This study examines how 40 Palestinian-Arab women pursuing master’s degrees in education negotiate intersecting structures shaping their lives as minoritized, gendered subjects. Using Photovoice and focus groups, the research analyzes how participants articulate experiences across overlapping roles – Palestinian-Arab, mothers, teachers, students – within sociopolitical conditions marked by patriarchy, inequality, and linguistic domination. Photovoice enabled visual and narrative expressions of tension, agency, and subtle resistance beyond traditional qualitative tools. Guided by an intersectional feminist framework, the study shows how gendered expectations, ethnic marginalization, and linguistic hierarchies generate emotional, academic, and economic pressures. The findings reveal obstacles including time constraints, linguistic exclusion in Hebrew-dominant spaces, and conditional family support rooted in patriarchal bargains. Yet participants mobilized strategies, relational support, time management, and strategic conformity to sustain their studies. The study advances feminist debates on minority women’s educational trajectories and underscores the need for institutions to address structural and sociocultural barriers.

Intergenerational child maltreatment and the case for intensified support for child protection involved families.

Maternal cardiovascular health during and after pregnancy is shaped by biological, behavioral, and social factors. Inadequate personal and family support remains underexplored as a driver of postpartum cardiovascular risk. Understanding this relationship is vital for developing targeted interventions. Using the TriNetX U.S. Collaborative Network, we examined postpartum cardiovascular outcomes among women aged 15-60 years with documented problems in personal or family support (poor support cohort, Cohort 1) compared with matched controls (Cohort 2) with no support-related Z63 codes. Personal/family support concerns were defined using ICD-10 Z63.x codes recorded 9 months before to 1 year after delivery or postpartum encounters. Propensity score matching was applied. Outcomes were assessed within 1 year. After matching (n = 10,669 per cohort), inadequate support was associated with higher odds of major adverse cardiac and cerebrovascular events (odd ratio [OR] 5.012, 95% CI: 3.461-7.257) and acute kidney injury (OR: 1.438, 95% CI: 1.015-2.039). No significant differences were observed for myocardial infarction, stroke, heart failure, or peripartum cardiomyopathy. Poor personal and family support is associated with adverse maternal cardiovascular outcomes. Caution is warranted in interpreting mortality due to potential misclassification. Integrating psychosocial support into postpartum care may reduce risk and improve maternal outcomes.

Perceived social support from family and friends, self-esteem, and their associations with school adjustment and life satisfaction in Peruvian adolescents: A structural equation modeling approach.

"To move or not to move"exercise adherence in home-based cardiac rehabilitation after coronary artery bypass graft surgery: A qualitative study.

Employment trajectories of individuals with intellectual and developmental disabilities: A 7-year longitudinal study.

Home exercise programs (HEPs) are beneficial for the rehabilitation process, yet adherence remains low (30%-50%). People with aphasia (PWA) face unique challenges due to deficits in language comprehension and/or expression, but research on facilitators and barriers to achieving HEP adherence in this population is limited. This study examines speech-language pathologists' (SLPs') perspectives on factors that facilitate or hinder adherence to HEPs in PWA. A 37-item cross-sectional online survey was administered to SLPs treating PWA. A nonprobability purposive sampling method was used. Likert scale responses were analyzed using descriptive statistics and Spearman rho correlations. Open-ended questions were analyzed for patterns and themes. Of 100 responses, 83 completed surveys were analyzed. Participants were primarily female (~93%) practicing in outpatient settings, with over 21 years of experience. Key facilitators to HEP adherence included motivation (98%), caregiver integration (96%), and incorporating the HEP into daily routines (90%). Moderate positive correlations were found between integrating HEPs into daily routines and perceived relevance (rs = .500, p < .001), as well as between caregiver involvement and HEP integration into daily life (rs = .502, p < .001). Facilitators were categorized as internal (motivation, relevance) and external (family and SLP support). Barriers included internal factors (depression, lack of motivation, severity of deficits) and external factors (limited family support, program difficulty, lack of Spanish language resources). SLPs identified multiple factors influencing HEP adherence. Clinicians should consider these factors when developing HEPs for PWA. https://doi.org/10.23641/asha.32484204.

Repeat expansion disorders are caused by unstable DNA sequences that exceed pathogenic thresholds, disrupting normal gene function. These conditions often affect the nervous system, but may involve multiple organs, with presentations ranging from subtle cognitive or motor changes to overt neuromuscular or neurodevelopmental syndromes. Early symptoms can mimic common conditions, making clinical suspicion, family history, and awareness of intergenerational patterns essential. Molecular features, including repeat size, sequence, location and stability, determine disease severity and variability. Nurse practitioners are well positioned to recognize early signs, make early referrals to genetics, and support families with education, anticipatory guidance, and coordination of follow-up care. Case examples include Huntington disease, fragile X syndrome, and myotonic dystrophy and illustrate clinical heterogeneity, premutation effects, and genetic anticipation. Early recognition and referral remain crucial, particularly as emerging gene-targeted therapies may offer potential disease-modifying options.

The Supplemental Security Income (SSI) program remains an important source of financial support for low-income families of children, adolescents, and young adults with disabilities. In most states, SSI eligibility also qualifies children for the state Medicaid program, providing access to health care services. The Social Security Administration (SSA), which administers the SSI program, considers a child disabled under SSI if there is a medically determinable physical or mental impairment or combination of impairments that results in marked and severe functional limitations. The impairment(s) must be expected to result in death or have lasted, or be expected to last, for a continuous period of at least 12months. The income and assets of families of children with disabilities are also considered when determining financial eligibility. When an individual with a disability becomes an adult at age 18, the SSA considers only the individual's income and assets. The SSA considers an adult disabled if there is a medically determinable impairment (or combination of impairments) that prevents substantial gainful activity for at least 12 continuous months. SSI benefits are important for youth with disabilities who are transitioning to adulthood. The purpose of this statement is to provide updated information about SSI medical and financial eligibility criteria and the disability determination process. Although pediatricians do not make the determination for SSI eligibility, this statement discusses the pediatrician's role in alerting families to the possibility of SSI support, connecting families to resources to assist in the application process, and providing timely documentation required for the application.

Patient perspectives on access to bariatric surgical care in the Deep South: A qualitative study.

Heterogeneity in perinatal depression and its related factors: a longitudinal study in Beijing, China.

Psychological burden is a central aspect of living with chronic cardiovascular disorders and profoundly affects how individuals experience and cope with fear, dependency and loss of control. Understanding these experiences is essential for delivering high-quality, holistic and person-centred care. This study explored the experiences of psychological burden among individuals living with chronic cardiovascular disorders in a low- and middle-income context. We conducted a qualitative descriptive study. Nineteen individuals were purposively recruited using maximum variation sampling and interviewed using a semi-structured interview guide between May and September 2024. Data were analysed using reflexive thematic analysis software (MAXQDA). The analysis of 19 interviews generated three overarching themes: (a) multifaceted disruption of life from acute onset to enduring dependency; (b) burden of existential fear and struggle for control; and (c) faith-based burden management: prayer, practice and spiritual resilience. Individuals with chronic cardiovascular disorders experience a significant psychological burden, including sudden illness onset, dependency and existential fear, despite available treatment. Faith, family and community support serve as key sources of coping. The integration of psychological care, spiritual support and culturally sensitive interventions alongside biomedical management is essential for improving outcomes in low and middle-income countries. Health care professionals should integrate psychological screening and counselling to address existential fears, social withdrawal and suppressed emotional expression among individuals with chronic cardiovascular disorders. Patients with chronic cardiovascular disorders informed the design of the interview guide, participated in interviews and helped validate the interpretation of findings, ensuring that the study reflected their lived experiences. This study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ).

Shared decision-making and professional governance have long been defining features of American Nurses Credentialing Center (ANCC) Magnet-designated organizations, supporting high-quality outcomes, professional autonomy, and nurse engagement. Within our multi-Magnet-designated academic medical center, part of a larger academic health system, a shared governance structure had been in place for many years. However, to respond to the evolving demands of the academic medical center, the increasing complexity of health care delivery, and the need for stronger alignment between frontline practice and organizational strategy, the leadership and governance model was redesigned to fully integrate professional shared governance into the model with direct care nurses. The purpose of this article is to describe how an ANCC Magnet-designated academic medical center systematically developed, implemented, and evaluated a transition from traditional shared governance to a robust professional shared governance framework by intentionally engaging nurses at all levels of the organization. This work aimed to strengthen nurses' voice in decision-making; enhance professional accountability; and hardwire structures that align nursing practice, quality, and innovation with organizational priorities. A pre-post survey design was used to examine nurse engagement over a two-year period spanning the implementation of the professional shared governance model. Validated engagement measures were administered to nurses across the academic medical center before the redesign (2024 presurvey) and after its full implementation (2025 postsurvey). Comparative analyses were conducted to assess changes in overall engagement and in specific domains associated with professional practice, informatics, recruitment and retention, recognition, and evidence-based practice/research. A total of 248 and 286 nurses responded to the preimplementation and postimplementation surveys, respectively, and their responses were compared. Overall nurse engagement scores increased between the 2024 presurvey and the 2025 postsurvey, indicating stronger perceptions of involvement, influence, and professional support following implementation of the professional shared governance model. The largest gains were observed in domains related to maximizing the capabilities of clinical and information technology to support patients and families; recruitment, retention, and recognition activities; and engagement in evidence-based practice and research opportunities. Clinical nurses demonstrated increased engagement across all measured categories, mirroring the overall pattern of improvement and showing the most substantial gains in the same high-impact domains. Transitioning from shared governance to professional shared governance within an academic medical center is a complex, iterative, and developmental process that advances over time. Effective professional shared governance structures require intentional design, sustained leadership commitment, and active nurse participation at every level of the organization. To ensure these structures remain meaningful and high performing, they must be continuously evaluated, refined, and adapted to reflect contemporary practice, emerging priorities, and the evolving needs of nurses, patients, and the health system. By leveraging data-driven insights, incorporating innovative strategies, and maintaining a culture of shared accountability and collaboration, professional shared governance can remain agile, forward-thinking, and a powerful driver of nursing excellence and organizational outcomes.

Medical home (MH) is a financially viable, all-inclusive primary care model that can enhance communication, improve care coordination and support patients, families and healthcare providers. No standard screening tool exists for use by hospital-based healthcare providers to identify children with medical complexity (CMC), which can result in inconsistent MH referrals. The purpose of this research was to develop and validate a screening tool for use in identifying CMC who would benefit most from early MH referrals prior to hospital discharge home. This mixed-methods research utilized e-Delphi methodology and retrospective chart review to develop and validate a screening tool for MH referrals. Twenty-three nurses, nurse practitioners, physicians, social workers and case managers participated in four e-Delphi rounds to develop the Pediatric Medical Home Screening Tool (PMHST). The PMHST consists of four sections and 20 criteria. Reliability testing of the PMHST revealed 82% agreement with medical complexity categorization of infants and young children. The PMHST may enhance future care transitions, improve quality of care and reduce the risks of safety events. The PMHST was validated in a sample of infants and young children and will be tested with a broader sample of children in the future.

Children and adolescents with developmental disabilities often encounter substantial barriers to physical activity. However, prior research has rarely provided a comprehensive understanding that integrates multiple perspectives. We conducted semi-structured interviews with nine parents and seven sports professionals in South Korea. Data were analysed thematically using Braun and Clarke's six-phase framework. Identified barriers included inaccessible or poorly maintained facilities, societal stigma, insufficient instructor qualifications, fragmented administrative systems, and uniform, short-term programmes. Parents also reported discomfort in inclusive settings and a preference for designated disability-friendly spaces. Facilitators included government-supported infrastructure, disability awareness training, family psychoeducation, structured instructor certification, and long-term, individualised programmes tailored to individual support needs. Participation in physical activity is shaped by interconnected physical, attitudinal, institutional, social, and programmatic factors. Addressing these challenges requires inclusive infrastructure, standardised qualification systems, emotional and informational support for families, and sustained, tailored programme development.

Iron-deficiency anemia is the most common micronutrient deficiency and a leading cause of disability-adjusted life years among adolescent girls and young women (AGYW) globally. Although multiple micronutrient supplementation (MMS) provides a broader range of micronutrients than iron-folic acid supplementation (IFAS) prior to conception, the acceptability of MMS and home-based supplementation strategies remains underexplored. We assessed the acceptability of MMS, IFAS, and a contextualized nutrition curriculum delivered via school clubs in a two-arm cluster-randomized trial across three rural secondary schools in Monapo District, Mozambique. Fourteen teachers (clusters) were randomized to deliver either weekly school-based IFAS or daily home-based MMS. A total of 492 AGYW aged 13-20 years were enrolled (240 IFAS; 252 MMS); both arms received the same nutrition curriculum. Participants in both arms reported increased energy, improved appetite, and relief from menstrual symptoms. IFAS was significantly more acceptable than MMS for smell, and some participants perceived the once-weekly IFAS regimen as less burdensome than daily MMS. Some AGYW also reported that male peers perceived MMS as birth control, or assumed the girls were pregnant, due to the image of a pregnant woman on the pill bottle. Ratings of the nutrition curriculum and teachers' facilitation were positive in both arms. Participants generally preferred the regimen they were assigned, and family support facilitated adherence. These findings suggest home-based supplementation may be a feasible and acceptable strategy for reaching in-school and out-of-school AGYW in Mozambique. Including boys in future interventions and redesigning the MMS label could help reduce misconceptions and enhance acceptability.

Violence exposure and depression in Chinese adolescents: Mediation by health-risk behaviors and alleviation by family health.

Family-centered interventions for people with substance use disorders in low-and middle-income country settings: a scoping review.

Objectives. To examine (1) the strategies regional public behavioral health boards employ to align county-based public social service agencies with private substance use treatment organizations, (2) regional variations in strategies, and (3) factors that affect community-board relationships. Methods. We conducted a multiple case study of 17 Ohio county-based systems implementing a cross-sector model to support parental substance use disorder (Ohio START). We applied template analyses to 48 small group interviews conducted in 2020-2021 with 104 staff from child welfare and behavioral health organizations and community boards. Results. Participants described direct and indirect ways that boards supported system alignment, funding, brokering of information and relationships, and planning. Reasons for boards not being involved included perceived needlessness and a lack of connection between the board and the community. Rural and Appalachian communities reported various forms of close integration of boards and communities. Conclusions. Behavioral health boards can support cross-system integration by reducing barriers to collaboration and enhancing community capacity to address complex public health issues, especially in resource-limited regions. Public Health Implications. Incorporating a centralized organization could mitigate implementation barriers and promote effectiveness in community collaborations, especially under resource constraints. (Am J Public Health. 2026;116(S3): S202-S209. https://doi.org/10.2105/AJPH.2026.308579).

Baby brain? Evidence for no objective cognitive differences between mothers, fathers and non-parents in the post-partum period.