Participant Interviews Research Articles

Improved treatment satisfaction with once-weekly insulin icodec compared with once-daily basal insulin in individuals with type 2 diabetes: An analysis of patient-reported outcomes and participant interviews from ONWARDS 2 and 5 and a physician survey from ONWARDS 1

AimsThe ONWARDS phase 3a clinical trials evaluated once-weekly insulin icodec (icodec) versus once-daily basal insulin in type 2 diabetes. This analysis investigated the treatment-related experiences of participants from ONWARDS 5 and 2, and physicians from ONWARDS 1. MethodsPatient-reported outcomes were only collected during ONWARDS 5 (icodec with a dosing guide app vs. once-daily basal analogues) and 2 (icodec vs. once-daily insulin degludec). ONWARDS 1 (icodec vs. once-daily insulin glargine U100) physicians’ treatment preferences and satisfaction were obtained via an online survey. ResultsIn ONWARDS 5 and 2, there was a statistically significantly greater increase in total treatment satisfaction from baseline to end of treatment for icodec/icodec with app versus once-daily comparators, mostly driven by participants’ willingness to continue and recommend treatment. In ONWARDS 2, 93.7 % of icodec users preferred once-weekly over once-daily basal insulin, mainly owing to less frequent injections and ease of use. ONWARDS 1 physicians reported greater satisfaction with once-weekly than with once-daily basal insulin and were more likely to recommend once-weekly injections. ConclusionsThese results demonstrate improved treatment satisfaction with, and strong preferences for, once-weekly versus once-daily basal insulin. Treatment convenience and willingness to continue and recommend once-weekly basal insulin treatment were highlighted.Clinical trial registrations: ONWARDS 1: NCT04460885; ONWARDS 2: NCT04770532; ONWARDS 5: NCT04760626

Parent Education and Counseling (PairEd-C) Intervention to Improve Family-Centered Care: Protocol for a Prospective Acceptability Study Using the Theoretical Framework of Acceptability.

Family-centered care (FCC) is an intervention approach based on a respectful relationship between family and health care providers (HCPs) to ensure the health and well-being of children and their families. Although HCPs have a better perception of FCC, the level of its implementation is low. Reasons for low implementation include limited understanding, lack of training, and lack of implementation guidelines and tools to support implementation. Thus, we developed the Parent Education and Counseling (PairEd-C) intervention to improve FCC in pediatric oncology settings and assess its acceptability. The objective of this study is to assess the prospective acceptability of the PairEd-C intervention using the theoretical framework of acceptability (TFA) in the pediatric oncology department in a tertiary hospital in Ethiopia. The study was conducted using an exploratory qualitative study design. We aimed to recruit 10 to 15 participants for the in-depth interview. The study participants were health service leaders working in child cancer, HCPs, social workers, and parents of children with cancer. The intervention was developed using the integration of the first phase of the Medical Research Council (MRC) framework for developing and testing complex interventions and the behavior change wheel (BCW) framework. The main PairEd-C intervention components align with the intervention functions of education, persuasion, training, environmental restructuring, modeling, and enablement, which were intended to improve FCC in the pediatric oncology unit by providing structured and comprehensive education and counseling of parents of children with cancer. The intervention was implemented by providing training for the health care team, facilitating discussion among HCPs and setting a shared plan, improving the commitment of the health care team, providing education for parents, improving parents' capacity to attend the intervention sessions, arranging discussion among parents of children with cancer, and provision of education and counseling on distress. The HCPs working in the unit received training on the designed intervention. The trained educators and the health care provider delivered the intervention. Data will be analyzed using deductive thematic coding with a framework analysis technique based on the 7 TFA constructs. Atlas ti. version 9 will be used for data analysis. Funding was acquired in 2017, and ethical clearance for conducting the study was obtained. We conducted the interviews with the study participants from December 2023 to January 2024. As of the acceptance of this protocol (June 2024), 12 study participants were interviewed. The data analysis process was started subsequently, and the manuscript will be completed and submitted for publication in early 2025. This acceptability study is expected to show that the designed intervention is acceptable to study participants, and the findings will be used to improve the intervention before progressing to the next step of our project. DERR1-10.2196/54914.

‘Pain free if I ever will be’: lived experience of workers seeking care for pain attributed to musculoskeletal disorders

BackgroundPain attributed to musculoskeletal disorders are a significant hinderance to work ability and economic growth, especially in developing countries. Quality of life and lived experience of workers with musculoskeletal disorders have not been explored enough to determine whether person-centred care is provided. There is a wealth of evidence for using the biomedical approach in the management of workers with musculoskeletal disorders, which has proved ineffective in reducing absenteeism and symptoms experienced by workers. The purpose of this study was to explore the lived experience of workers seeking care for musculoskeletal disorders and how their pain attitudes and beliefs influenced their experience.MethodsA qualitative approach with thematic analysis was used. Purposive sampling was used to recruit six participants for semi-structured interviews. All participants were either experiencing pain attributed to a musculoskeletal disorder or had received care for a musculoskeletal disorder.ResultsPain attitudes and beliefs of workers with a musculoskeletal disorder and healthcare professionals greatly influenced the care and recovery process of musculoskeletal disorders. There is a primary biomedical lens informing care of workers with musculoskeletal disorders received. Workers expect healthcare professionals to explore their concerns further, but the focus of care for most participants was their presenting complaint. There is also a need for the autonomy of workers to be preserved, and communication between healthcare professionals and workers with musculoskeletal disorders needs to improve.ConclusionsMany stakeholders are involved in the recovery process from musculoskeletal disorders. There is a need for a biopsychosocial informed practice to improve return-to-work (RTW) in workers with musculoskeletal disorders. Change is needed at all healthcare system levels to reduce the negative experiences of workers and maladaptive pain beliefs that is associated with persisting symptoms and extended absenteeism.

The role of Teff crop in Ethiopian life: consumption and contribution to rural livelihoods

Teff (Eragrostis tef) is believed to be the smallest grain in the world. It is the most important crop in Ethiopia in terms of production and consumption. Smallholder farmers produce Teff, and it is the main source of income for farmers in comparison to other cereal crops. Teff is the daily staple food for over 50 million Ethiopians. There is a need for information on agricultural consumption, disaggregated at district level, to support evidence-based decision-making at local level. The objective of this paper is to understand the consumption of Teff among rural smallholder producers at district level and assess the position of Teff among cereals in the lives of Ethiopian rural farmers. The study employed a multistage sampling technique to select the top Teff producing regions, districts, and kebeles (small administrative units) and collected primary data through focus group discussions (FGDs), key informants, and questionnaire respondents. The survey collected qualitative and quantitative data from 357 households. FGD, key informant interview (KII) participants and survey respondents were drawn from the same areas where the survey was conducted. The quantitative and qualitative data were subjected to statistical and content analysis respectively. The study findings revealed that on average households consume 26.92% of their Teff production per year. Moreover, there is a shift in the consumption of Teff which might be due to improved standards of living among the farmers, a health-conscious community, and improved income from Teff sales. Although Teff is a staple grain in Ethiopia, there is a statistically significant variation in Teff consumption among districts.

The role of strategic communication and sensemaking in implementing management innovation

PurposeThis study explores the dynamics of implementing management innovation, focusing on a case of innovation in human resource management within a large Japanese firm. It aims to understand how innovators perceive and react to employees’ evolving responses to management innovation and how these perceptions and reactions influence innovation implementation.Design/methodology/approachThe study employed a single-case study design because it was suitable for exploring complex phenomena within their real-life context. It involved an in-depth analysis of a firm undergoing management innovation through participant observation, interviews and analysis of company documents.FindingsThe study identified a multi-phase process of management innovation at the research site, characterized by initial resistance followed by gradual acceptance of the innovation. Innovators’ strategies to manage and respond to employee feedback and adaptation of the innovation process were crucial in the eventual acceptance of management innovations. Despite achieving a degree of acceptance, cultural and structural challenges persisted, highlighting the complex interplay between innovation, organizational culture and employee responses.Originality/valueThis research contributes to the management innovation literature by illuminating the intricate dynamics of implementing management innovation. It extends existing theories of innovation implementation by demonstrating the significance of managing recipient perceptions through strategic communication and the importance of cultural and contextual sensitivities in management innovation.

Welcome To #Spoonietok: Understanding and Supporting Disability Expertise, Storytelling Abilities, and Collective Information Practices on Tiktok and Beyond

ABSTRACTThis poster reports developing dissertation research, exploring the individual and collective storytelling practices of people experiencing difficult to diagnose chronic pain and fatigue (CSSs) on TikTok to understand and ultimately support these embodied, creative, and collective storytelling abilities on and off‐app. Ongoing data collection and analysis using constant comparison, guided by critical disability studies sensitizing concepts, of 150 videos and their top‐20 comments, and interviews with 6 community members indicate that people with CSSs are using TikTok affordances to tell and scaffold complex micro‐stories sharing disabled expertise; creatively visualize invisible illness; use intimate, documentary cinematography; tell composite stories using skits and collapsed time; and make audio, visual, and community/collective mimetic alterations. This poster shares a pragmatic sampling approach using algorithm training, and results from visualization activities during interviews which indicate a messy overlapping landscape of what I call algorithmically mediated online health communit(ies) (AMOHCs), which have slippery boundaries, where health information is found serendipitously, and people connect across specific chronic illness categories. This dissertation‐in‐progress is developing a set of disability‐specific storytelling abilities, which interview participants indicate are transferable to off‐app settings; and upcoming codesign workshops creating storytelling support materials with community members will further distill disability storytelling support needs.

Experiences and barriers with home bladder manometry in the pediatric neurogenic bladder population: A qualitative study

Patients with neurogenic bladder are at risk of developing renal deterioration secondary to increased intravesical pressures. To date, urodynamics is the gold standard test to properly assess bladder dynamics. Home bladder manometry is a low-cost and simple method to evaluate bladder pressures and volumes during clean intermittent catheterization (CIC). Previous literature has shown that home manometry measurements correlate with urodynamic pressures and hydronephrosis on ultrasound. However, no studies have evaluated the challenges and barriers faced by caregivers with the process. Our objective was to investigate the experiences and perceptions of caregivers, healthcare providers, and nurses with home manometry. We conducted semi-structured interviews and focus group discussions with 23 stakeholders. Stakeholders included caregivers of pediatric spina bifida neurogenic bladder patients, providers, and nursing staff. Grounded Theory Methods were used to analyze transcripts and identify preliminary concepts that described attitudes towards the current home bladder manometry process. Interview participants were composed of 10 (43%) caregivers, 9 (40%) healthcare providers, and 4 (17%) nursing staff. The mean age was 39 years (range 26-66). The four themes identified during discussions were perspectives on home manometry, patient-specific characteristics, challenges with home manometry, and learning experience. All caregivers expressed understanding and agreement with the purpose and importance of home manometry. Emergent concepts identified as targets for improvement were the need for standardization of teaching processes with focus on hands-on practice, understanding of patient characteristics and the home environment that make the process more challenging, and the need for appropriate materials including extension tubing and catheters. Home bladder manometry is a feasible and beneficial way for neurogenic bladder patients to monitor their bladder pressures and volumes at home. This qualitative study offers valuable insights into the experiences and viewpoints of caregivers, healthcare providers, and nurses regarding both home manometry and the general experience with CIC.

Outcomes from an Early Adopters Home Hospital Accelerator for Acute Care at Home.

Following the Centers for Medicare and Medicaid Services' approval of the Acute Hospital Care at Home waiver, an increasing number of health care organizations launched Home Hospital (HH) programs in the USA. Ongoing barriers include access to HH expertise and a standard, comprehensive set of implementation tools. We created the HH Early Adopters Accelerator to bring together a network of health care organizations to develop tools ("knowledge products") necessary for HH implementation. To demonstrate the feasibility of the Accelerator approach for generating and implementing relevant, high-quality knowledge products. Mixed methods evaluation of the Accelerator. Surveys and qualitative interviews of Accelerator participants were conducted. Surveys elicited feedback on the knowledge products, including time spent on development, perceived utility and quality, and implementation success. The qualitative interviews gathered more in-depth information on topics covered in the surveys. Eighteen healthcare organizations and 105 individuals participated in the Accelerator. The Accelerator reached its goal and developed 20 knowledge products in 32 working weeks (more efficient than expected). Participants agreed that the knowledge products were useful (developers: 98.1%; stakeholders: 93.8%), of high quality (developers: 96.8%), and would improve patient care if implemented in their HH program (developers: 91.7%; stakeholders: 91.2%). Two thirds (66.7%) of the participating organizations who had implemented knowledge products at 3 months continued utilizing knowledge products in their HH program at 1 year. Agreement that knowledge products improve patient care persisted (92% strongly agreed or agreed) at 1 year. Several programs created new tools, policies, and workflows as a result of implementing the knowledge products. The Accelerator created high-quality, comprehensive knowledge products that healthcare organizations found useful for safe HH implementation 1 year later. The Accelerator approach can feasibly help healthcare organizations safely bridge the gap between innovation and standard practice.

“So, That Would Have Been Useful”: Curriculum in LIS in Support of Liaison Librarian Preparation

LIS education has historically come under fire for what some perceive as a disconnect between what is taught in the classroom and what the job really entails. This study is part of a larger research study that used a sequential explanatory mixed-methods design to investigate liaison librarians’ perceptions of their academic preparation to take on the liaison role, specifically whether and how their LIS program curriculum prepared them for this role. This qualitative strand of the study relied on in-depth semi-structured interviews of survey participants to explore two research questions: What are the perceptions of academic liaison librarians regarding the degree to which their programs prepared them for their current role? And which factors influenced these perceptions? This research identified the main reasons hindering the effectiveness of LIS education for preparing librarians for the liaison role to be a range of complex issues that LIS programs and educators should consider, such as changing career plans among students who did not initially plan to become liaison librarians, students not taking certain courses due to scheduling or course timing issues, and the abstract nature of some course content which obscures connections to real-world practice. Participants also identified courses in collection development, reference, instruction, and research methods as those that should take center stage when preparing liaison librarians. These results have the potential to inform various aspects of LIS program curriculum planning and design and provide course-selection guidance for LIS students considering a career in academic libraries.

Water in the West: Analyzing the disconnect between farmers' and policymakers’ perceptions of Colorado River Basin shortages in Arizona

The Colorado River Basin is facing a record-breaking megadrought that is depleting water resources and threatening farmers' livelihoods. This article investigates Arizona's water crisis to convey how farmers' worries, perceptions, and experiences about water align and depart from policymakers'. We conducted an ethnography among farmers and policymakers, involving participant observation and interviews, and used iterative qualitative coding to interpret themes. Farmers expressed deeply emotional experiences with water, remarking on the idea that water is central to life in Arizona. In response to constituent concerns, policymakers were willing to go to great lengths to improve the water crisis, but their viewpoints often echoed an “us versus them” and “all is well” mentality that could hinder progress. While farmers tended to prioritize preserving agriculture, policymakers tended to emphasize the importance of investing in development. Ultimately, this study reveals that there remain disconnects between farmers' and policymakers' viewpoints, experiences, and proposed policies.

Barriers to and facilitators of physical activity in pediatric pulmonary hypertension.

Therapeutic exercise has not been widely adopted in pediatric pulmonary hypertension (PH), despite adult data supporting its safety and efficacy. While physical limitations may prevent children with PH from participating in physical activity, other barriers to and facilitators of physical activity are unknown. Youth ages 8-18 years with World Symposium of PH diagnostic Groups 1-4, functional class I or II, and ambulatory status were prospectively enrolled in a cross-sectional study including separate 30-min participant and caregiver interviews regarding attitudes toward physical activity and a proposed exercise intervention in pediatric PH. Interview questions were guided by Social Cognitive Theory and explored autonomy, self-confidence, and self-efficacy. Interviews were transcribed, coded, and analyzed using an iterative process to determine themes and patterns. Demographics and relevant PH condition-specific data were abstracted from the medical record. Thirty PH participant/caregiver dyads were interviewed. Facilitators of physical activity included enjoyment/interest in the activity, socialization, incentivization, and feelings of safety and normalcy. Barriers to physical activity included lack of interest, fear/anxiety, and self-consciousness. Findings were similar in children and adults. Participants rarely reported restriction of activity by caregivers or medical providers. Attitudes toward engagement in a proposed exercise program were generally positive and reflected personal experiences with physical activity. Monitored exercise interventions that focus on patients' interests, cultivate confidence, respect limitations, and acknowledge the need for extrinsic incentivization may have benefits in pediatric PH. Future trials should test the impact of these characteristics on patient wellbeing and clinical outcomes.

Patient and care team experiences with an EHR-integrated symptom management program (eSyM) in routine oncology practice.

324 Background: Clinical trials have shown that collecting electronic patient-reported outcomes (ePROs) improves quality of life and survival in cancer patients. To bolster integration of ePROs into routine care, the SIMPRO Research Consortium developed an electronic symptom management (eSyM) program, deployed it at six cancer centers, and conducted a hybrid effectiveness-implementation study. eSyM, an ePRO toolkit integrated into the Epic EHR, enables patients to report and care teams to triage symptoms in real-time. To assess eSyM, we conducted structured qualitative interviews with patients and clinic staff, including doctors, nurses, advanced practice providers, and administrative staff. We sought to understand eSyM from the patient and staff perspectives. Methods: Using an iterative process, we developed semi-structured interview guides to query the experiences and perceptions of patients and staff exposed to eSyM. Questions were informed by the Consolidated Framework for Implementation Research. One year after eSyM was launched, sites identified and referred participants for interviews or focus groups. Participants must have either used eSyM to submit symptoms (patients) or had access to eSyM at their institution (staff). Patients provided written consent; a consent waiver was obtained for staff. Interviews were recorded and transcribed, and a common analytic codebook was developed. Transcripts were dual or triple-coded and underwent thematic analysis to identify key contexts and concepts within and across patient and staff groups. Results: From 9/28/20 to 4/14/23, 50 staff participated in individual interviews and 29 participated in focus groups (79 total). From 9/14/23 to 3/14/24, 14 patient interviews were conducted. Transcripts revealed that staff and patients held similar beliefs regarding eSyM compatibility, communication, and prioritization. 93% (13/14) of patients and 72% (57/79) of staff believed eSyM was easy to use and improved communication. Both cohorts (66% staff, 36% patients) noted that competing demands often needed to be prioritized over responding to symptom concerns. Discordance emerged in the domains of receptivity and technology; patients were more receptive and capable of using eSyM than staff perceived. Both groups believed eSyM was helpful but perceived that deeper engagement from patients and staff was necessary for sustainability. Conclusions: Most interviewees reported that eSyM added value and was easy to navigate. Competing clinical demands, however, frequently deprioritized use of eSyM. Staff tended to underestimate patients’ receptivity to use eSyM and were more likely to cite competing demands as a barrier to their own use of eSyM. Sites looking to adopt eSyM, or similar ePRO programs, will benefit from understanding the facilitators that need to be incorporated and the barriers that need to be surmounted to optimize success. Clinical trial information: NCT03850912 .

Assessment of impacts of air pollution on people living in Ezza North close to quarry operation sites in Ebonyi State, Nigeria

Quarrying activities have become lucrative work for low income people in low income countries most found in Africa. This study aimed assess the impacts of air pollution on people living in Ezza North close to quarry operation sites in Ebonyi State, Nigeria. A descriptive cross sectional study was used and pollution level was determined with the use of calibrated Handheld GPS, Amex multiple gas meter, Sound meter and interview of participants with a questionnaire on the health status. The collected data were entered into the Statistical Package for Social Sciences (SPSS) software (version 21). The one sample T-test was used to test the hypotheses at 95% confidence interval and 0.05 level of significance. The results showed that 31–40 years had 19(5.37%) males and 20(5.65%) females as highest quarrying workers. The concentration of carbon monoxide was highest at 193ppm, Sulphur dioxide at 568ppm, nitrogen dioxide at 1.9ppm, Suspended particulate Matter (SPM) at 1982ppm and sound level at 82.9dB. The concentrations of these pollutants were found to be significantly higher (P<0.05) than normal levels apart from sound level without significant impact at P = 0.285. The 93.3% of the participants reported blasting of rocks produced highest air pollution, 87.5% that reported crushing, conveying, sieving produce a lot of dust. Also, 80% of participants reported high level of noise came from machinery blasting rocks, processing and haulage trucks. In all, 35% reported they had fair health condition when asked about the health status since they started quarrying work. In conclusion, the concentrations of carbon monoxide, carbon dioxide, sulphur dioxide, particulate matter and nitrogen oxides were all higher than normal. It was observed air pollutants had association with respiratory system. Therefore, the air pollution at quarrying site can be mitigated through dust suppression techniques and treating quarry pit with water before discharging.

Improvements in Transitional Care Among Medicaid-Insured Patients With Serious Mental Illness.

The Thrive program is an evidenced-based care model for Medicaid-insured adults in the hospital-to-home transition. A substantial portion of Thrive participants live with serious mental illness (SMI), yet Thrive's efficacy has not been tested among these patients. To compare 30-day postdischarge outcomes between Thrive participants with and without SMI and explore Thrive's appropriateness and acceptability among participants with SMI. We conducted a sequential explanatory mixed-methods study of 252 (62 with SMI) Thrive participants discharged from an academic medical center from February 2021 to August 2023. Interviews of participants with SMI were analyzed using rapid qualitative analysis. Participants with and without SMI experienced similar rates of 30-day readmissions, emergency room visits, and postdischarge follow-up visits, with these differences being nonsignificant. Participants with SMI were highly satisfied with Thrive's care coordination and attention to social needs, yet participants suggested stronger connections to behavioral health care. Participants with and without SMI benefit equitably from Thrive.

Continuous adaptation of conversation aids for uterine fibroids treatment options in a four-year multi-center implementation project

BackgroundFibroids are non-cancerous uterine growths that can cause symptoms impacting quality of life. The breadth of treatment options allows for patient-centered preference. While conversation aids are known to facilitate shared decision making, the implementation of these aids for uterine fibroids treatments is limited. We aimed to develop two end-user-acceptable uterine fibroids conversation aids for an implementation project. Our second aim was to outline the adaptations that were made to the conversation aids as implementation occurred.MethodsWe used a multi-phase user-centered participatory approach to develop a text-based and picture-enhanced conversation aid for uterine fibroids. We conducted a focus group with project stakeholders and user-testing interviews with eligible individuals with symptomatic uterine fibroids. We analyzed the results of the user-testing interviews using Morville’s Honeycomb framework. Spanish translations of the conversation aids occurred in parallel with the English iterations. We documented the continuous adaptations of the conversation aids that occurred during the project using an expanded framework for reporting adaptations and modifications to evidence-based interventions (FRAME).ResultsThe first iteration of the conversation aids was developed in December 2018. Focus group participants (n = 6) appreciated the brevity of the tools and suggested changes to the bar graphs and illustrations used in the picture-enhanced version. User-testing with interview participants (n = 9) found that both conversation aids were satisfactory, with minor changes suggested. However, during implementation, significant changes were suggested by patients, other stakeholders, and participating clinicians when they reviewed the content. The most significant changes required the addition or deletion of information about treatment options as newer research was published or as novel interventions were introduced into clinical practice.ConclusionsThis multi-year project revealed the necessity of continuously adapting the uterine fibroids conversation aids so they remain acceptable in an implementation and sustainability context. Therefore, it is important to seek regular user feedback and plan for the need to undertake updates and revisions to conversation aids if they are going to be acceptable for clinical use.

The perspectives of Māori on community treatment orders: A thematic analysis.

To understand the themes for Māori subjected to compulsory community treatment orders. The Mental Health (Compulsory Assessment and Treatment) Act 1992 has been utilised in Aotearoa New Zealand for more than three decades. Despite Māori having higher rates of being subject to community treatment orders, there is little research examining their perspectives of its benefits and harms. Thematic analysis of a purposive sample of Māori in Hawke's Bay, New Zealand. Five themes were developed. Māori described community treatment orders as restrictive and stigmatising. Some Māori described being poorly informed of the structures surrounding the use of community treatment orders and saw it as a mechanism to circumvent information-giving regarding treatment. Counterbalancing these, Māori described community treatment orders as mandating support and saw them as a mechanism to access care. Finally, some described their compulsory treatment status as unimportant and irrelevant. Thematic analysis identified five clear themes from interview participants. Conceptualisation of community treatment orders was largely negative, although Māori acknowledged that being subject to community treatment orders demanded more support from services. Themes of stigma and restriction are common in the literature, however, conception of the use of community treatment orders to bypass consent is novel. The literature describes community treatment orders as providing support, however, in this study, the interpretation suggests a need to lose personal autonomy to receive care, a potentially 'slippery slope' towards a two-tier type service. These findings remind services of the importance of attending to cultural elements of care, being clear around the process of consent. In terms of policy, weaving in cultural understanding appears to be important from an Indigenous perspective.

Perception of Women Toward Childbirth Positions Among Women on Postnatal Unit at Jimma Medical Center, South West Ethiopia: A Phenomenological Qualitative Study

Objective: To explore the perceptions of women toward child birthing positions among women on the postnatal unit at Jimma Medical Center, Jimma town, Ethiopia, in 2020. Design: A descriptive phenomenological approach was employed among women from the postnatal unit and maternity care providers from the labor and delivery unit. Setting: Jimma Medical Center, south-west Ethiopia Participants: 40 study participants were selected purposively. 30 postnatal women were recruited for both an in-depth interview and a focus group discussion. From maternity health care providers, 10 health professionals were interviewed. Results: This study involved 30 study participants for in-depth interviews and one focus group discussion with 10 participants. Regarding the variables influencing the use of alternative birth positions in the medical facility, responses were obtained from both women and medical professionals. The women were placed in common supine positions because they were ignorant of other birth positions, because they were passive in allowing themselves to be in the position that they preferred, and because medical professionals lacked the necessary knowledge and expertise to provide alternative birth positions. Conclusion and Recommendations: The women were coerced to take birth positions against their will by healthcare providers. Thus, evidence-based alternative birth positions should be made available and implemented in order to enhance the practice of healthcare providers.

Konaway Nika Tillicum Native Youth Academy: Enacting a medicine wheel educational framework.

Native American youth need educational experiences that promote positive, healthy development, which requires decolonizing current educational experiences. Konaway Nika Tillicum Native Youth Academy (KNT) offers a holistic approach to education, incorporating Tribal cultures and values along with valuing higher education. Across two complementary studies, we seek to understand how the Medicine Wheel framework supports the design of educational experiences and the effectiveness of this design on positive development factors, including cultural identity development, self-esteem, and academic optimism. To address our research questions, we first share an ethnographic study including participant observations and interviews with five KNT staff to investigate how the educators of KNT enact the Medicine Wheel in designing educational experiences for Native youth. We then examined the effectiveness of this Medicine Wheel framework on positive development factors across two summers of the academy with youth ages 11-18 (23 boys, 38 girls) representing diverse tribal affiliations. Findings from our first research question reveal a Medicine Wheel Educational Framework that offers holistic and culturally sustaining/revitalizing education experiences for Native youth. Findings from our second research question indicate that Native youth experienced significant increases in their cultural identity and academic optimism directly and indirectly via increasing self-esteem through engaging in the KNT. Implications of findings show that when educated in a learning space that promotes Native students' culture, youth show healthy development in factors valued across Indigenous and Western perspectives, including cultural identity, self-esteem, and academic optimism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pediatric Dentistry Program Directors as stakeholders in the process of Board certification.

Board certification is an important credential for pediatric dentists to achieve for purposes of career advancement, hospital privileges, and reputation. The purpose of this pilot study was to assess the engagement of residency Program Directors (PDs) with the Board certification process in terms of criteria for clinical readiness, curriculum development, and value. An additional objective was to identify challenges and ways in which PDs may need support as they prepare residents for Board certification. Eighty-seven PDs were invited to participate in this study, out of which 32 agreed to participate (36% response rate). The study included a digital non-validated survey and verbal interviews. Digital and verbal survey results were analyzed using descriptive statistics. PDs had recurrent themes in their descriptions of clinical readiness, including information gathering, application of knowledge, and professional awareness. Half of the participants used the American Board of Pediatric Dentistry (ABPD) exam domains as a guideline in their curriculum development. Of the verbal interview participants (N=32), 30(94%) felt that Board certification was very important to their residents and program. Many barriers to successful completion of the Board exam were discussed, and a diverse array of suggestions were made for mechanisms to better support PDs as they prepare residents for Board certification. Board certification is valued by PDs and influences their criteria for clinical readiness. Increased engagement with the ABPD will facilitate better support for PDs and will enhance the consistency of training standards in residency programs.

EXAMINING UNIVERSITY TEACHERS’ AND STUDENTS’ AWARENESS & ACCEPTANCE ABOUT CULTURALLY RESPONSIVE TEACHING

This research examines awareness and acceptance of culturally responsive teaching (CRT) amid university teachers and students, aiming to elucidate its implications for educational practice and policy. This qualitative study seeks to explore the awareness and acceptance of CRT among university teachers and students, shedding light on the nuances of their perceptions and experiences. Through thematic analysis of participant interviews, this study explores how CRT is understood & integrated into teaching practices across diverse disciplines. Findings show that varying levels of awareness among educators, highlighting importance of professional development & institutional support in promoting effective CRT implementation. Student viewpoint underline effect of culturally related pedagogy on engagement and academic performance of teachers. Ultimately, research underscores CRT's potential to foster inclusive learning environments & prepare students for diverse global contexts, leading to debates on equity and social justice in education. Thus, by exploring knowledge, acceptance and execution of CRT in educators & students of university, this research pinpoint strengths and weaknesses of implementing CRT principles into university teaching and learning endeavors.