Institutional Resources Research Articles

Priority-setting for hospital funding of high-cost innovative drugs and therapeutics: A qualitative institutional case study.

Rising costs of innovative drugs and therapeutics (D&Ts) have led to resource allocation challenges for healthcare institutions. There is limited evidence to guide priority-setting for institutional funding of high-cost D&Ts. This study sought to identify and elaborate on the substantive principles and procedures that should inform institutional funding decisions for high-cost off-formulary D&Ts through a case study of a quaternary care paediatric hospital. Semi-structured, qualitative interviews, both virtual and in-person, were conducted with institutional stakeholders (i.e. staff clinicians, senior leadership, and pharmacists) (n = 23) and two focus groups at The Hospital for Sick Children in Toronto, Canada. Participants involved in, and impacted by, high-cost off-formulary drug funding decisions were recruited through stratified, purposive sampling. Participants were approached for study involvement between July 27, 2020 and June 7, 2022. Data was analysed through reflexive thematic analysis. Institutional resource allocation for high-cost D&Ts was identified as ethically challenging but critical to sustainable access to novel therapies. Important substantive principles included: 1) clinical evidence of safety and efficacy, 2) economic considerations (direct costs, opportunity costs, value for money), 3) ethical principles (social justice, professional/organizational responsibility), and 4) disease-specific considerations. Multidisciplinary deliberation was identified as an essential procedural component of decision-making. Participants identified tension between innovation and the need for evidence-based decision-making; clinician and institutional responsibilities; and value for money and social justice. Participants emphasized the role of health system-level funding allocation in alleviating the financial and moral burden of decision-making by institutions. This study identifies values and processes to aid in the development and implementation of institutional resource allocation frameworks for high-cost innovative D&Ts.

Faktor-Faktor Yang Mempengaruhi Tingkat Kepercayaan Masyarakat Terhadap Lembaga Keuangan Syariah: Studi Kasus Masyarakat Kabupaten Labuhan Batu Selatan

The development of Information Technology should make companies grow more rapidly, including Sharia Financial Institutions, both in terms of receiving and distributing funds, but in reality we can see that Islamic financial institutions still tend to be less developed than conventional financial institutions, this is caused by many factors, and Therefore, the aim of this research is to find out whether human resources in Islamic financial institutions, namely employees and the products offered, can influence the level of public trust in Islamic financial institutions, either partially or simultaneously. This type of research is quantitative using a questionnaire as a data collection method which is then tested using multiple linear regression analysis. The research results show that human resources or employees from Islamic Financial Institutions have a positive influence with a significant value of 0.000, while the products offered influence Islamic financial institutions with a significant value of 0.000, while simultaneously the two independent variables have a positive influence with a significance value of 0.000.

The use of the principal component analysis in ranking hemp (<i>Cannabis sativa</i> L.) accessions according to the seed oil fatty acid composition for crop improvement

The use of modern methods for assessing the genotypic diversity of breeding material is effective in crop improvement. Interpretation of the results of a study of the fatty acid biochemical composition in seeds of hemp (Cannabis sativa L.) accessions is one of important stages in breeding oilseed varieties, since hemp possesses a unique fatty acid composition (FAC) among other oilseed crops in Russia. Studies of regularities in formation of seed oil FAC and the principal component analysis (PCA) of fatty acid contents have scientific significance and practical value for ensuring the acceleration of oilseed variety breeding aimed at improving quality and biological activity of oil. The use of PCA can be an effective in achieving this goal. The fatty acid profile of oil has been evaluated at the N.I. Vavilov Institute of Plant Genetic Resources in 25 hemp accessions from the VIR hemp collection. Local and industrial hemp varieties and breeding material of the Middle Russian ecotype were grown in Penza Province with a temperate continental climate on meadow-black soils of the Middle Volga Region of Russia. The seed oil FAC was studied using gas-liquid chromatography with mass spectrometry on an Agilent 6850 chromatograph. The results were processed using the UniChrom and AMDIS software. High content of omega-3 stearidonic fatty acid was found in accessions k-205 from Ukraine (1.23%) and k-168 from Russia (0.87%); that of α-linolenic acid in k-168 from Russia (0.82%) and k-224 from GDR (0.39%); of linoleic acid in k-154 (67.29%), k-360 (66.24%), and k-150 (64.58%) (all three from Russia); of γ-linolenic acid in k-88 from Russia (2.43%) and k-211 from GDR (1.92%). It has been established that the formation of hemp seed oil FAC is a multifactorial process. The main factor determined 27.8% of the variability. The presence of both positive and negative factor loadings was revealed. The highest factor loading for the variance of a complex of characters of the oil FAC is on the main factor, i.e. linoleic acid (+0.73). In relation to this acid, negative loadings were detected for myristic acid (−0.81), lauric acid (−0.78), palmitoleic acid (−0.72), and oleic acid (−0.72). The content of bioactive omega-6 diunsaturated linoleic acid was negatively associated with the content of omega-9 monounsaturated oleic acid, as well as with the content of polyunsaturated omega-6 γ-linolenic, omega-3 stearidonic, and omega-3 α-linoleic acids. The obtained information can be used for identifying accessions with the optimal FAC for their involvement in breeding oilseed hemp varieties.

Financial Management Challenges in Georgia’s Higher Education Institutions

The effective management of financial resources in higher education institutions significantly impacts the overall system’s functionality. The role of education and scientific development in a country’s economic progress cannot be overstated. Georgia possesses the potential to achieve economic growth through its intellectual and educated human capital. However, despite recent reforms, the education system grapples with persistent shortcomings and challenges, hindering the creation of well-prepared and competitive graduates. Strengthening the education system is essential for Georgia to thrive in the global arena. While funding for education has increased over the years, mere financial inflow does not necessarily correlate with improved educational quality. To address this, a strategic and tactical approach to reform, along with efficient distribution of financial resources, is crucial. This paper investigates the impact of existing funding policies on Georgia’s higher education system. It delves into the structure and dynamics of funding for higher education institutions, examining the nature and significance of previously funded projects. Additionally, the study discusses and analyzes the role of education reforms in promoting overall development. Drawing on both qualitative and quantitative analyses, the recommendations put forth within this framework aim to empower stakeholders in overcoming the challenges faced by Georgia’s higher education landscape.

Non-financial assets: Composition and qualification description

Subject. This article examines the composition and classification of non-financial assets in State-funded (municipal) and autonomous institutions. Objectives. The article aims to develop an original approach to the construction of classification characteristics of non-financial assets as an object of accounting in State-funded (municipal) and autonomous institutions. Methods. For the study, we used the methods of comparison, systematization, and data generalization. Results. The article systematizes the composition of non-financial assets of organizations, presents an author-developed classification of non-financial assets based on the methodological approaches of the System of National Accounts, and summarizes information on the composition of non-financial assets in accordance with the requirements for the formation of the balance sheet and the Unified Chart of Accounts for public sector organizations. Conclusions and Relevance. The study of the composition and qualification characteristics of non-financial assets in State-funded (municipal) and autonomous institutions contributes to the development of the public sector of the economy through effective management of the property and resources of institutions. The results of the study can be applied both in theory and practice in the field of development of non-financial assets in State-funded (municipal) and autonomous institutions.

Large language models and bariatric surgery patient education: a comparative readability analysis of GPT-3.5, GPT-4, Bard, and online institutional resources

BackgroundThe readability of online bariatric surgery patient education materials (PEMs) often surpasses the recommended 6th grade level. Large language models (LLMs), like ChatGPT and Bard, have the potential to revolutionize PEM delivery. We aimed to evaluate the readability of PEMs produced by U.S. medical institutions compared to LLMs, as well as the ability of LLMs to simplify their responses.MethodsResponses to frequently asked questions (FAQs) related to bariatric surgery were gathered from top-ranked health institutions. FAQ responses were also generated from GPT-3.5, GPT-4, and Bard. LLMs were then prompted to improve the readability of their initial responses. The readability of institutional responses, initial LLM responses, and simplified LLM responses were graded using validated readability formulas. Accuracy and comprehensiveness of initial and simplified LLM responses were also compared.ResultsResponses to 66 FAQs were included. All institutional and initial LLM responses had poor readability, with average reading levels ranging from 9th grade to college graduate. Simplified responses from LLMs had significantly improved readability, with reading levels ranging from 6th grade to college freshman. When comparing simplified LLM responses, GPT-4 responses demonstrated the highest readability, with reading levels ranging from 6th to 9th grade. Accuracy was similar between initial and simplified responses from all LLMs. Comprehensiveness was similar between initial and simplified responses from GPT-3.5 and GPT-4. However, 34.8% of Bard's simplified responses were graded as less comprehensive compared to initial.ConclusionOur study highlights the efficacy of LLMs in enhancing the readability of bariatric surgery PEMs. GPT-4 outperformed other models, generating simplified PEMs from 6th to 9th grade reading levels. Unlike GPT-3.5 and GPT-4, Bard’s simplified responses were graded as less comprehensive. We advocate for future studies examining the potential role of LLMs as dynamic and personalized sources of PEMs for diverse patient populations of all literacy levels.

Optimizing Resource Usage in Cagayan de Oro City Institutions, Philippines

Aside from the Human Resources, the most valuable resources of the company are the assets comprising the current assets and fixed assets. Currently, many companies require better management of their assets but the misuse of company resources is a serious issue that many firm employees see as “no big deal.” However, the principle remains the same that firm resource is a lasting resource and it is for the use of firm and nothing else. This study examined the misuse of firm resources in government and non-government sectors in Cagayan de Oro City. The objectives were: determining the commonly misuse firm resources, awareness and involvement of employees in misusing the resources, and management report on misusing the resources. This study used descriptive research design with the aid of survey questionnaire in gathering the primary data supported by interview. Findings revealed that the commonly misused resources of the firms were office supplies with 40%, followed by internet usage with 30%, and telephone usage with 15%. In awareness and involvement of employees on the commonly misused resources, first in the rank was aware but involved with 30% followed by aware and not involved with 25% of the employee respondents. In the category of reporting of employees of the misused resources to the management, the employee witnesses but does not report with 40% followed by witnesses and does the report to the management with 30%. Interview revealed that misused of resources happened due to lack of proper orientation on mission and goals of the firm, over supply of resources, and absence of guidelines. The researchers concluded that intentional insider misuse of institution resources represents a significant threat to the organizations and whether government or non-government institutions, the presence of misuse of resources committed by the employees based on the results of this study still exists. Recommendations are: there should be a proper inventory system, policies and guidelines in using the resources, and close monitoring of firm resources.

It’s a Three-Ring Circus: How Morally Educative Practices Are Undermined by Institutions

Since the publication of Alasdair MacIntyre’s After Virtue in 1981, tensions inherent to the relationship between morally educative practices and the institutions that house them have been widely noted. We propose a taxonomy of the ways in which the pursuit of external goods by institutions undermines the pursuit of the internal goods of practices. These comprise substitution, where the institution replaces the pursuit of one type of good by another; frustration, where opportunities for practitioners to discover goods or develop new standards of excellence are frustrated by institutional priorities and resource allocation; and injustice, which undermines the integrity of relationships within the organization and/or with partners. These threats, though analytically distinct, are often mutually reinforcing. This conceptual contribution is illustrated both by the extant literature and by a novel context, the three-ring circus.

The changing social structure of housing tenures through China’s successive urban housing reforms

Housing system transitions often involve successive but overlapping periods of reform with crucial implications for housing inequality dynamics. Building on welfare regime and market transition discussions, this paper considers how the shifting roles of the state, market, and family in housing provision in China have led to changing housing tenures and differentiated access to them between populations with varying socio-economic resources. Drawing on two national datasets, our analyses reveal that the four decades of reforms dramatically upended urban China’s tenure structure with market homeownership becoming the dominant tenure. Nevertheless, we find a substantial and increasing role of the family in housing provision, especially for people with fewer socio-economic resources. The advantages associated with better institutional resources under the previous socialist housing system not only persist in accessing state-provided tenures but have also extended their influence into market housing. Meanwhile, homeownership outcomes have become increasingly polarized among groups with different income and education levels. Our findings expose the reproduction and apparent amplification of tenure-related housing inequalities over the period of housing regime transformation.

Development and Validation of the Adolescent and Children Risk of Abuse and Maltreatment Unaccompanied Scale (ACRAM-US)

Independent migration of children and adolescents is becoming a political and social issue in recent years. Literature documents that the migration process of young people without an adult referent entail serious psychological problems. Moreover, the lack of coherence in the assessment and care processes aggravates the damage suffered by minors, which requires a greater investment of institutional resources. The aim of this research is to describe the development and provide psychometric properties of Adolescent and Children Risk of Abuse and Maltreatment Unaccompanied Scale (ACRAM-US), a 9-items scale for the assessment of risks factors of child abuse and neglect in the specific population of unaccompanied asylum-seeking children and adolescents. Structural validity, reliability and convergent-related validity were studied for this measure in a sample of 128 unaccompanied children and adolescents. The sample included cases of 14 different nationalities. Children’s mean age was 16.94 (SD = 1.84), and 96.9% were male and 3.1% were female. Cases were informed by child welfare workers from different protective services in the XXXX Community (XXXX). The results of Exploratory Factor Analyses (EFA) indicate performance better solution with 2-dimensions which was also in line with theoretical formulation (χ2 = 31.55, df = 19, p = .035, CFI = 0.991, SRMR = 0.081, RMSEA = 0.072, [90% CI: 0.019 − 0.115]). Results of convergent validity showed significant correlation with the Children Trauma Questionnaire-Short Form (CTQ-SF). Therefore, this study provides data of the first scale that assess risks factors of maltreatment for the unaccompanied asylum-seeking children and adolescents.

Molecular Characterization of Vigna unguiculata (L.) Walp Collection based on ISSR Markers

Background: In Azerbaijan, cow pea is one of the fundamental legumes. This study was carried out at the Institute of Genetic Resources, Azerbaijan National Academy of Sciences to evaluate genetic diversity in 28 cowpea accessions from Azerbaijan national gene bank. The aim of this study was to evaluate the genotypic diversity, relatedness and population structure among local cow pea resources available in Azerbaijan and the cultivated VIR accessions based on ISSR markers. Methods: The studies were conducted in 2017-2019 at the Institute of Genetic Resources (IGR) of the National Academy of Sciences (NAS) of Azerbaijan. 28 samples were used as research material: 10 of them were local forms and 18 were samples obtained from VIR. Sowing of collection samples was carried out in duplicate with an area of food of one plant 10 ´ 45 cm at the optimum time, in the at the end of April. Result: In the study, 28 alleles were synthesized for the collection with five ISSR markers, with an average polymorphism index of 75%. The rich genetic diversity (GMO = 0.80; PIC = 0.34) was found in the collection. Statistical analyzes have shown that the efficiency of the UBC 835 and the UBC 818 premieres was high. The average genetic distance index in the cow pea collection was 0.33. 71% of the samples were genetically identifiable and 29% revealed that the genotype was identical across the studied loci. PCoA and cluster analysis identified 3 genetically distinct groups within the collection, with the first two coordinates explaining 57% of this genetic variation.

Do natural resource rents aid renewable energy transition in resource‐rich African countries? The roles of institutional quality and its threshold

AbstractTransitioning to a carbon‐neutral renewable energy (REN) option to decarbonize ecosystems and mitigate carbon dioxide (CO2) emissions and the negative impacts of climate change is consistent with United Nations Sustainable Development Goals 7 and 13. Scholars have identified natural resource wealth and institutions as critical factors in the REN transition in resource‐rich countries. Financial barriers are arguably the most significant impediments to transitioning to REN, as it is more capital‐intensive and costly to produce, invest in, and use than traditional fossil fuel‐based energy. Meanwhile, weak institutions and corruption in most resource‐rich countries culminate in the resource curse phenomenon and the mismanagement of natural resource wealth. It implies that institutions (weak or strong) modify the natural resource rent contribution to the REN transition. Previous research has paid little attention to the impact of the interplay between natural resources and institutional quality on the REN transition in resource‐rich African countries. This study examines how institutions moderate the contribution of natural resource wealth to accelerating or inhibiting the REN switch in resource‐rich African countries for the period 2000–2021, using fully modified ordinary least squares, a Driscoll–Kraay nonparametric covariance matrix, and moments‐based quantile regression estimators. This study departs from earlier studies by determining the institutional quality threshold above which institutions significantly stimulate natural resource rents to accelerate Africa's REN transition. The findings indicate that institutions in resource‐rich African countries breed inefficient bureaucracies and corruption in natural resource rent administration. These undermine the ability of natural resource incomes to facilitate a shift to renewable energy sources. The threshold analyses indicate that most resource‐rich African countries operate below the institutional quality threshold. This finding corroborates that inefficient institutions abet natural resource rent mismanagement and hinder the channeling of resource income toward the REN transition. The findings' policy implications are robustly articulated and outlined.

Trends in abortion-related behaviour of Russians in the context of demographic policy

The article discusses results of an expert survey conducted in February-May 2021 in ten constituent entities of the Russian Federation in order to analyze trends in abortion-related behaviour of Russians, as well as to develop recommendations for a comprehensive special program to prevent and reduce abortion rates in the Russian Federation. The conducted expert interviews (n=15) with representatives of socially oriented non-profit organizations (SO NPO) and specialists of health care facilities (gynecologists, psychologists) made it possible to structure the areas of activity in the field of pre-abortion counseling in the constituent entities under study and identify effective institutional resources. The regions under study significantly differed in both socio-cultural characteristics and technologies for organizing pre-abortion counseling. The article doesn’t distinguish between the concepts of “pre-abortion” and “prior to abortion” counseling using them synonymously. The study showed that some experts (with a personal position that abortions are unacceptable without medical indications) are reluctant to use the concepts of “pre-abortion” and “prior to abortion” counseling and prefer to use the concept of “anti-abortion” counselling instead, which, according to hermeneutics, fills this concept with a different meaning, highlighting the purpose of the technologies used. The following problems have been identified: difficulties in collecting statistical data in private health care facilities, insufficient number of qualified specialists, and lack of a unified methodology for conducting pre-abortion counselling. According to the data obtained, the abortion-related behaviour of Russians is being transformed under the influence of new medical technologies. Measures of state support for families with children hardly change the abortion-related behaviour of Russians.

Competency in evidence-based medicine and associated factors among medical radiology technologists in Addis Ababa, Ethiopia.

Evidence-based medicine integrates clinical expertise, patient values and best research evidence in clinical decision-making. This study aimed to assess evidence-based medicine knowledge, attitudes, practices and associated factors among medical radiology technologists in Addis Ababa, Ethiopia. A cross-sectional study was conducted among 392 medical radiology technologists from May to August 2022 using a self-administered questionnaire. Bivariate and multivariate logistic regression identified factors associated with evidence-based medicine practice. Most medical radiology technologists (57.7%) had moderate evidence-based medicine knowledge and 94.9% had favourable attitudes. However, 64.8% demonstrated poor evidence-based medicine practice. Factors significantly associated with better evidence-based medicine practice were moderate knowledge (AOR 1.949, 95% CI 1.155-3.291), good statistical understanding (AOR 1.824, 95% CI 1.135-2.930), sufficient time for evidence-based medicine (AOR 1.892, 95% CI 1.140-3.141), institutional support (AOR 2.093, 95% CI 1.271-3.440) and evidence-based medicine resource access (AOR 1.653, 95% CI 1.028-2.656). Despite moderate knowledge and positive attitudes towards evidence-based medicine, most medical radiology technologists had suboptimal utilisation. Strategies to improve knowledge, ensure dedicated time, provide institutional support and resources could enhance evidence-based radiology practice.

A Study on the Cross-cultural Academic Adaptation of Southeast Asian Students Pursuing a Master’s Degree in Teaching Chinese as a Second Language in China

Amid accelerating globalization, the issue of cross-cultural academic adaptation among Southeast Asian students pursuing a master’s degree in Teaching Chinese as a Second Language in China has intensified. However, current research has insufficiently considered diverse factors affecting academic adaptation. This study employed questionnaires and interviews to analyze the academic adaptation of 83 Southeast Asian students in China, using SPSS24.0 and the Random Forest algorithm to examine six dimensions: study motivation, study attitudes, academic competence, academic self-efficacy, study mode, and academic environment. Results reveal their strong study motivation, particular value on degree and academic achievements, and generally positive study attitudes. Despite their confidence and capabilities in comprehending course content and conducting academic research, there remains room for improvement in independent assignment completion and participation in academic exchanges. Most students rate their academic self-efficacy positively. Though generally satisfied with the teaching approaches and materials, some struggle with the course and examination adaption. Feedback on the academic environment and institutional resources is generally positive. The feature importance analysis highlights study motivation, academic environment, and study attitude as pivotal in Chinese language acquisition. This study offers insights for schools and teachers to enhance international students’ cross-cultural academic adaptability and improve teaching and educational management.

Spatio-temporal characteristics and influencing factors of land disputes in China: Do socio-economic factors matter?

Land disputes pose significant challenges to social stability and development. In this paper, land dispute intensity (LDI) is measured at the provincial level in China from 2009 to 2018 and its spatiotemporal evolution characteristics and influencing factors are explored. The ordinary least squares(OLS), spatial durbin model (SDM), geodetector model, and panel threshold model are used to explore the spatial spillover effects of LDI and its potential non-linear relationship with socio-economic factors. The results reveal that LDI is spatially distributed in a decentralized form, with local areas showing the structural characteristics of “single core, multiple clusters”. The LDI exhibits a significant positive spatial autocorrelation and follows a “logarithmic” upward trend over time. The urbanization rate (UR), social security expenditures (SSE), and the number of land and resources institutions (NLRI) are important driving forces affecting LDI. The SSE and NLRI have a single threshold effect on the LDI, with a “V” shaped weakening trend, and the UR is an important factor causing nonlinear effects. Interestingly, the effect shifts from inhibition to stimulation when the SSE and NLRI cross the corresponding threshold value. This paper can provide new insights into the governance of land disputes.

Impact of mission and vision on academic services mediated by governance and human resources in higher education institutions of Indonesia

Mission and vision play an essential role in strategic management. They are the philosophical foundation and strategic direction of higher education, serving as a guide, inspiration, and control tool to achieve organizational goals. Therefore, this study aims to investigate the relevance and impact of mission and vision on academic services provided by Indonesian higher education institutions through governance and human resources. The research instrument is based on relevant literature and uses a Likert scale to measure implementation, socialization, and effectiveness of mission and vision, academic services, governance, and human resources. Data were collected using the online random sampling method, and the number of respondents was 10,937 lecturers. The study uses a serial mediation analysis to test the hypotheses. The research results show that governance and human resources positively affect academic services. As a mediator variable, they can improve academic services. The results highlight the significant contribution of mission and vision to governance. Governance also contributes significantly to human resource management. Human resources can boost academic services. This study emphasizes the importance of the university’s mission and vision, namely the philosophical foundation and strategic direction of academic services supported by appropriate human resources and good governance.

Research data management in selected East African libraries: A survey

This article investigates the knowledge of research data management and services among library professionals in selected East African libraries. A survey research design was employed, and data was collected using a structured questionnaire from 180 respondents representing four East African countries: Malawi, Mozambique, Zambia and Zimbabwe. The findings reveal that only 31.1% of the selected East African librarians agreed that their institutional libraries provided research data management services. The standard research data management services offered by their libraries included data publishing, sharing and reuse, while collaboration with academic programmes was identified as an essential approach for research data management skill development. The study highlights the need for librarians to acquire legal, policy and advisory skills and knowledge of institutional and extra-institutional resources and the research life cycle for effective research data management service delivery.

When the stars align: The effect of institutional pressures on sustainable human resource management through organizational engagement

We examined whether institutional pressures explained sustainable company behavior based on sustainable Human Resource Management. Additionally, given that company voluntariness is a key factor of sustainable behavior, we analyzed the role of organizational engagement in employees. A sample of 206 firms in the chemical and chemical manufacturing industries as well as in the base metal manufacturing sector was used to test the hypotheses, using Partial Least-Squares Structural Equation Modelling. Our findings suggest that institutional pressures explain sustainable Human Resource Management and that organizational engagement mediates the relationship between institutional pressures and sustainable Human Resource Management. Moreover, a circular relationship develops that may play an even more pivotal role at the early stage of the diffusion of these practices.

Perceptions and barriers about mental health services among Pacific Islanders: An interpretative phenomenological analysis.

Every year, millions of Americans do not receive needed mental health (MH) services. Although Pacific Islanders (PI) have a high need for MH services, this group has the lowest rate of MH care help seeking. This is especially concerning as the rate of suicide has been increasing within the PI community. This study explored how Pacific Islanders think about MH supports, including their attitudes toward and perceptions of barriers to receiving MH services. An interpretative phenomenological analysis focus group study was conducted with cross-generational Pacific Islanders residing in one western state. The findings include (a) PI perceptions that MH help seeking results in family burdensomeness, stigma, and shame; (b) negotiating PI social customs and beliefs related to MH help seeking, care, and support; and (c) PI mistrust of institutional resources. These themes seemed to interact with each other and create perpetuate barriers which prevent help-seeking behaviors. Clinical and research implications will be provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).