Overarching Categories Research Articles

Attitudes toward Voluntary Assisted Dying for people in prison in Australia

End-of-life care options in Australia, recently including Voluntary Assisted Dying (VAD), are available to people in prison. Little is known about how the public perceives this right. We aimed to identify the attitudes of the public by conducting a qualitative content analysis of comments across four Australian online news media outlets discussing the first case of a person in prison being granted VAD (a sexual offender). From 434 comments, we identified four overarching categories: not punished enough; unsupportive of VAD; approving of VAD; and negative characteristics of VAD recipient and other stakeholders involved. Most comments were punitive, highlighting the opinion that VAD was escaping punishment and reflected a tension between the rights of the individual versus the perceived rights of the community. We highlight the risks these attitudes can pose in terms of providing end-of-life care to people in prisons.

Exploring the impact of the COVID-19 pandemic and shift to online formats on hearing voices group facilitators in the UK

ABSTRACT Background This study explores the impact on Hearing Voices Group (HVG) facilitators on the rapid shift to using video-teleconferencing communication (VTC) to host HVGs triggered by the COVID-19 global pandemic. Method A qualitative, interview-based design was implemented, adopting a Grounded Theory approach. Semi-structured interviews were conducted with seven HVG facilitators from across the UK using VTC. Results Nine major themes were identified with four overarching thematic categories; (1) Societal reality & change; (2) Increased reliance on technology; (3) Impact on groups; (4) Impact on facilitator role. Discussion A preliminary theory is presented which discusses the inter-relating impact on facilitators and HVGs, in the context of increased reliance on technology, social reality and social change. The recurring themes of limited understanding of and access to IT, and the lack of support structures for HVG facilitators need addressing to support the future efficacy of VTC-mediated HVGs. Limitations are discussed alongside suggestions for future practice.

The Development of the Service-Learning Outcomes Measurement Scale—Short Version (S-LOMS-SV) and Its Preliminary Validation

This article describes the development and validation of a short version of the Service-Learning Outcomes Measurement Scale, the S-LOMS-SV. The original Service-Learning Outcomes Measurement Scale (S-LOMS) is a previously validated 56-item instrument measuring developmental outcomes in 11 domains under four overarching categories, especially appropriate for use in Hong Kong and related contexts. In developing SLOMS-SV, 14 experienced service-learning researchers and practitioners reviewed the full-length S-LOMS for content validity and identified items with potential for inclusion in a shortened version. Through an iterative process, 21 items maintaining the original scale’s factor structure were selected for the S-LOMS-SV. Validity and internal consistency analyses using preexisting student data sets demonstrated that the S-LOMS-SV has robust psychometric properties that match those of the full-length S-LOMS. Theoretical and practical implications and next steps are discussed. The 21-item S-LOMS-SV is included in the Appendix.

Cultivating Leadership and Teamwork in Medical Students Through Rowing: A Phenomenological Study.

This study was conducted to allow us to understand the subjective experiences of medical students participating in rowing exercise classes at a medical school in South Korea and to derive implications for medical education. Accordingly, we analyzed their reflective journals, focusing on leadership and teamwork development. The study involved 40 second-year premedical students, and Colaizzi's analysis was employed to understand and structure their experiences. The comprehensive analysis revealed 149 meaningful statements expressing students' thoughts and experiences regarding the rowing exercise. From these statements, 13 meanings were synthesized, resulting in nine themes and four overarching categories, which provided a multilayered understanding of students' experiences. The factors that enhanced teamwork included communication, trust, respect among team members, and a sense of responsibility. By contrast, the hindering factors were competitiveness, impatience, and avoidance of responsibility. Before the class, a mix of anticipation, excitement, and dissatisfaction regarding the rowing exercise course was observed. However, after the class, students realized that the role of the entire team, rather than individual ability, is crucial, and collaboration with peers is key-the concept of shared leadership. This study is significant in that it demonstrates rowing's potential as a team sport to serve as an effective program for fostering collaboration and leadership within the medical school curriculum.

Taxing experiences: theorizing negative incidents at the frontlines

ABSTRACT Negative interactions with citizens can leave frontline workers stressed, anxious, and traumatized. Here, we construct a theoretically interdisciplinary framework for understanding frontline negative incidents that was thus far lacking. Drawing from 1302 descriptions of Dutch and Belgian frontline tax officials’ most negative experience with citizens, we identify four overarching categories: citizen aggression, facing tragedy, violations of professional norms, and absence of support. We show the importance of non-aggression incidents and reveal how the nature, direction, and impact of these incidents differ and depend on workers’ sense-making processes. We outline consequences for the study of frontline encounters and for public agencies.

Unequal Framing in Times of Hardship? How Newspapers from Germany, Spain, the United Kingdom and Switzerland Portray Syrian and Ukrainian Refugees – Evidence from a Deductive and Inductive Automated Content Analysis

ABSTRACT The mostly welcoming attitudes toward refugees from Ukraine stand in stark contrast to restrictive policies and often negative attitudes toward refugees from Syria in Europe. By emphasizing certain aspects of reality whilst leaving out others, media framing plays an important role in the public image of both refugee groups. To better understand how the different refugee groups were framed in European media, we applied Latent Dirichlet Allocation (LDA) topic modeling and a thorough manual analysis and validation process to identify frames from the topic modeling results. We identified eleven generic and issue-specific emphasis frames in a sample of 84,623 newspaper articles from Germany, Spain, the UK, and Switzerland from 2014–2022. The frames were grouped into four overarching frame categories: Fate, Threat, Value and Context Frames. Syrian refugees were mostly portrayed negatively through Threat Frames and Context Frames, whereas more positive humanitarian and victimization perspectives were pronounced in Fate Framing of Ukrainian refugees. The findings indicate more negative and delegitimizing framing patterns in news coverage about Syrian compared to Ukrainian refugees.

Why do people avoid health risk information? A qualitative analysis

Despite the potential benefit of receiving personalized health risk information, when given the opportunity to learn their risk, some people avoid that information. An extensive body of research has revealed various reasons for such information avoidance. Most of this existing work has used quantitative methods, with less focus on self-reported reasons for avoiding health risk information. We used a content analysis approach across four datasets (Dataset 1: n = 174, Dataset 2: n = 326, Dataset 3: n = 83, Dataset 4: n = 168), with the goal of identifying a broad range of self-reported reasons for avoidance. In each study, U.S. adults had the opportunity to learn their personalized risk estimate for a health condition through an online risk calculator (Health condition contexts: Dataset 1: heart disease, stroke, diabetes, prediabetes, lung cancer, colon cancer, melanoma skin cancer, breast cancer, or prostate cancer; Datasets 2 and 3: prediabetes; Dataset 4: melanoma skin cancer, stroke, lung cancer, osteoporosis, prediabetes, or diabetes). Participants who avoided their risk were asked to explain their reason(s) for avoidance via an open-ended question. Coding of these responses resulted in four overarching categories of self-reported reasons for information avoidance: information appraisal, self-perceptions of health, low utility, and affective consequences. The reasons identified both support and extend the current understanding of why people avoid health risk information.

Management of childbearing with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders: A scoping review and expert co-creation of evidence-based clinical guidelines.

To co-create expert guidelines for the management of pregnancy, birth, and postpartum recovery in the context of hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD). Scoping Review and Expert Co-creation. United Kingdom, United States of America, Canada, France, Sweden, Luxembourg, Germany, Italy, and the Netherlands. Co-creators (n = 15) included expertise from patients and clinicians from the International Consortium on the Ehlers-Danlos syndromes and Hypermobility Spectrum Disorders, facilitated by the Ehlers-Danlos Society. A scoping review using Embase, Medline, the Cochrane Central Register of Controlled Trials and CINHAL was conducted from May 2022 to September 2023. Articles were included if they reported primary research findings in relation to childbearing with hEDS/HSD, including case reports. No language limitations were placed on our search, and our team had the ability to translate and screen articles retrieved in English, French, Spanish, Italian, Russian, Swedish, Norwegian, Dutch, Danish, German, and Portuguese. The Mixed Methods Appraisal Tool was used to assess bias and quality appraise articles selected. The co-creation of guidelines was based on descriptive evidence synthesis along with practical and clinical experience supported by patient and public involvement activities. Primary research studies (n = 14) and case studies (n = 21) including a total of 1,260,317 participants informed the co-creation of guidelines in four overarching categories: 1) Preconceptual: conception and screening, 2) Antenatal: risk assessment, management of miscarriage and termination of pregnancy, gastrointestinal issues and mobility, 3) Intrapartum: risk assessment, birth choices (mode of birth and intended place of birth), mobility in labor and anesthesia, and 4) Postpartum: wound healing, pelvic health, care of the newborn and infant feeding. Guidelines were also included in relation to pain management, mental health, nutrition and the common co-morbidities of postural orthostatic tachycardia syndrome, other forms of dysautonomia, and mast cell diseases. There is limited high quality evidence available. Individualized strategies are proposed for the management of childbearing people with hEDS/HSD throughout pregnancy, birth, and the postpartum period. A multidisciplinary approach is advised to address frequently seen issues in this population such as tissue fragility, joint hypermobility, and pain, as well as common comorbidities, including dysautonomia and mast cell diseases.

Doctors of Tomorrow: Evaluating the effectiveness and impact of a virtual medical pipeline program during the COVID-19 pandemic

Background Doctors of Tomorrow (DoT) is a medical student-run pipeline program between the University of Michigan Medical School and high schools in Detroit, MI. During the COVID-19 pandemic, this program was offered virtually for the first time during the 2020–2021 academic year. There are limited studies on the outcomes of virtual pipeline programs. This study aims to identify the successes and limitations of the virtual DoT program by examining the participants’ self-reported perspectives and knowledge acquisition from their session participation. Methods Multiple methods were executed in this study. Matched pre- and post- surveys completed by the 2020–2021 participant cohort were analyzed using paired t-tests. In addition, participants’ responses to free-response questions were analyzed by coding with NVivo and subsequent content analysis. Results Program participants experienced a significant increase in their self-rated knowledge of delivered content after each session. Additionally, a significant increase in familiarity was detected with the path to becoming a physician and with a variety of medical fields. In the qualitative analysis, five overarching categories emerged: 1) path to medical school, 2) mentorship and role models, 3) scientific inquiry, 4) sense of belonging, and 5) fields of medicine. Conclusions The DoT virtual pipeline program provides convincing evidence that distance learning can still be an effective way to help URiM students explore careers in medicine, gain awareness about the path to medical school, and connect with mentors. This may serve as a low-cost option for universities to engage with and extend their service to communities, especially in an increasingly digital world.

The lived experiences of individuals with postpartum psychosis: A qualitative analysis

Postpartum psychosis (PP) is a severe psychiatric illness that occurs in about 1 to 2 per 1000 people in the perinatal period. To date, qualitative research investigating PP has focused on specific topics, such as treatment experiences or the impact of the illness on patients' lives and families. These studies have included small samples of women with histories of PP, often limited to certain geographical areas or treatment centers. Given the heterogeneity in presentations of PP and access to care, larger and geographically diverse samples are needed to broadly understand this complex illness. Initiated in 2018, the Massachusetts General Hospital Postpartum Psychosis Project (MGHP3) consists of a large, international sample of those who have experienced PP. In addition to the specific aims of MGHP3, which include to better understand the phenomenology and potential genetic underpinnings of PP, this investigation invites participants to qualitatively describe their narratives of postpartum psychosis. This analysis included 130 participants who reported on 133 episodes of PP. Participants' responses to the PP narrative prompt fell under several overarching categories: 1) broad psychosocial experiences surrounding postpartum psychosis, 2) impact on the mother-baby dyad, 3) treatment experiences, and 4) recovery experiences. Our findings shed light on a range of ways in which individuals' lives are impacted by this illness, and point to areas for future research and clinical directions to improve the support and care for individuals with PP and their families.

Exploring Care and Recovery for Individuals With Post-traumatic Stress Disorder: A Scoping Review.

Most people experience trauma at some point in their lives. The sources of trauma can include accidents, natural disasters, physical or sexual assault, combat, torture, or the death of a loved one. Experiencing or witnessing any of these, or other terrifying events, may make one susceptible to developing post-traumatic stress disorder (PTSD), a trauma- and stressor-related mental health condition. The common symptoms and consequences of PTSD include intrusive and distressing thoughts, memories, or flashbacks related to the traumatic event; avoidance of situations, people, or activities that remind one of the traumatic event; irritability, sleep difficulties, or hypervigilance; feelings of guilt, shame, or fear; substance use; strains on relationships; and suicidal thoughts and behaviors. These consequences can have devastating effects on the individual and their family members, friends, co-workers, peers, and communities. Effectively treating PTSD, therefore, is critical not only for the individual but also for the well-being of families, communities, and society at large. However, while treatments for PTSD exist, effectively treating patients with PTSD remains elusive. Further, despite the recognition that people's experiences are essential in understanding PTSD and provide valuable insights into what interventions are effective and how they impact recovery, patient perspectives and experiences of care and recovery have not been well-explored. We conducted a scoping review to address the following question: what is known about the experiences and perspectives of care and recovery for individuals with PTSD? We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, American Psychological Association's (APA) PsycInfo, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PTSDPubs, and Google Scholarfor peer-reviewed and grey literature that used qualitative methods to report on the recovery or care experiences of adults with lived experiences of PTSD. We extracted information about study objectives, study characteristics, and key findings; reported summary statistics; and performed content and thematic analyses. We identified 14 relevant studies that provide insight into the participants' lived experiences and perspectives of PTSD care and recovery. Though limited, the body of literature sheds light on critical themes and processes in the journey of care of PTSD, which we organized into four overarching categories: pre-treatment understanding and experiences of PTSD, the experience of care or treatment, the importance of relationships and social support, and expanding the understandings of recovery. Living with and healing from PTSD are a unique and individualized human experience of developing and redeveloping relationships with oneself, with others, and with society. The recommendations for practice include educating and establishing well-informed support networks for individuals with PTSD, training healthcare practitioners in all aspects of formal and informal PTSD treatment and care needs, ensuring a continuum of care, and understanding the human experience of PTSD.

Wellbeing Conceptual Model: Why Identity Deserves Discriminate Consideration

This paper proposes a high-order conceptual model of human wellbeing that isolates identity among other discriminate variables that are constituents and determinants of wellbeing. Drawing on germane literature, the paper understands wellbeing as a dynamic and subjective state that is satisfied when individuals can pursue and achieve their aspired quality of life. Achievement of this state is facilitated by conversion factors that can be summarized into three overarching categories namely environmental, social, and personal conditions. These conversion factors enable individuals to transform resources or opportunities into functionings or their desired outcomes. The paper notes the vital role and magnitude of the influence of identity on human action in the pursuit of wellbeing at individual level and proposes a high-order conceptual model of wellbeing expressed as a function of identity, environmental, social, and personal conditions. Although identity is an element of personal conditions, it is argued here that identity deserves to be considered discriminately in the wellbeing model because of its unique and profound influence on human action, which lends weight to the explanatory power of the conceptual model of wellbeing. The paper appeals for inclusion of identity transformation interventions in the agenda of development practice and recommends areas that need further research.

Which outcome measurement instruments are used to measure core infant feeding outcomes in children up to 1 year of age? A scoping review protocol

Background How, what, and when infants are fed plays a role in the aetiology of childhood obesity. Heterogeneity in how infant feeding outcomes are measured in trials of interventions to prevent childhood obesity limits evidence syntheses and understanding of intervention effectiveness. An infant feeding core outcome set (COS) was previously developed to standardised outcome measurement and reporting. The COS represents what to measure; determining how best to measure these outcomes is the next essential step to improve intervention evaluations. The aim of this scoping review is therefore to identify what outcome measurement instruments have been used in trials, and how they have been used, to measure the core infant feeding outcomes. Methods A scoping review will be conducted. MEDLINE, EMBASE, CINAHL, PsychINFO, the Cochrane Central Register of Controlled Trials, OpenGrey and GreyNet will be searched from inception. Papers are eligible for inclusion if they report trials involving primary data collection that measure and report at least one core infant feeding outcome in infants ≤one year of age. Following searching and screening, eligible studies will be categorised into the following four overarching categories for data extraction, synthesis and write-up: caregiver-related outcomes; diet-related outcomes; feeding environment outcomes; child weight outcomes. Data will be narratively described and presented in tabular format, with findings presented in four separate review papers delineated by the four overarching categories. Discussion This scoping review forms part of the Standardised measurement for Childhood Obesity Prevention (SCOPE) study (www.eiascope.com). Evidence from this scoping review on what measurement instruments are used, and how they are used, represents an essential first step in developing recommendations and guidance about how best to measure core infant feeding outcomes for childhood obesity prevention. This can improve evidence syntheses and understanding of what infant feeding interventions are most effective for childhood obesity prevention.

“Two Years Later I’m Still Just as Angry”: A Focus Group Study of Emergency and Internal Medicine Physicians on Disrespectful Communication

Phenomenon: Disrespectful behavior between physicians across departments can contribute to burnout, poor learning environments, and adverse patient outcomes. Approach: In this focus group study, we aimed to describe the nature and context of perceived disrespectful communication between emergency and internal medicine physicians (residents and faculty) at patient handoff. We used a constructivist approach and framework method of content analysis to conduct and analyze focus group data from 24 residents and 11 faculty members from May to December 2019 at a large academic medical center. Findings: We organized focus group results into four overarching categories related to disrespectful communication: characteristics and context (including specific phrasing that members from each department interpreted as disrespectful, effects of listener engagement/disengagement, and the tendency for communication that is not in-person to result in misunderstanding and conflict); differences across training levels (with disrespectful communication more likely when participants were at different training levels); the individual correspondent’s tendency toward perceived rudeness; and negative/long-term impacts of disrespectful communication on the individual and environment (including avoidance and effects on patient care). Insights: In the context of predominantly positive descriptions of interdepartmental communication, participants described episodes of perceived disrespectful behavior that often had long-lasting, negative impacts on the quality of the learning environment and clinical work. We created a conceptual model illustrating the process and outcomes of these interactions. We make several recommendations to reduce disrespectful communication that can be applied throughout the hospital to potentially improve patient care, interdepartmental collaboration, and trainee and faculty quality of life.

Using HIPAA (Health Insurance Portability and Accountability Act)-Compliant Transcription Services for Virtual Psychiatric Interviews: Pilot Comparison Study.

Automatic speech recognition (ASR) technology is increasingly being used for transcription in clinical contexts. Although there are numerous transcription services using ASR, few studies have compared the word error rate (WER) between different transcription services among different diagnostic groups in a mental health setting. There has also been little research into the types of words ASR transcriptions mistakenly generate or omit. This study compared the WER of 3 ASR transcription services (Amazon Transcribe [Amazon.com, Inc], Zoom-Otter AI [Zoom Video Communications, Inc], and Whisper [OpenAI Inc]) in interviews across 2 different clinical categories (controls and participants experiencing a variety of mental health conditions). These ASR transcription services were also compared with a commercial human transcription service, Rev (Rev.Com, Inc). Words that were either included or excluded by the error in the transcripts were systematically analyzed by their Linguistic Inquiry and Word Count categories. Participants completed a 1-time research psychiatric interview, which was recorded on a secure server. Transcriptions created by the research team were used as the gold standard from which WER was calculated. The interviewees were categorized into either the control group (n=18) or the mental health condition group (n=47) using the Mini-International Neuropsychiatric Interview. The total sample included 65 participants. Brunner-Munzel tests were used for comparing independent sets, such as the diagnostic groupings, and Wilcoxon signed rank tests were used for correlated samples when comparing the total sample between different transcription services. There were significant differences between each ASR transcription service's WER (P<.001). Amazon Transcribe's output exhibited significantly lower WERs compared with the Zoom-Otter AI's and Whisper's ASR. ASR performances did not significantly differ across the 2 different clinical categories within each service (P>.05). A comparison between the human transcription service output from Rev and the best-performing ASR (Amazon Transcribe) demonstrated a significant difference (P<.001), with Rev having a slightly lower median WER (7.6%, IQR 5.4%-11.35 vs 8.9%, IQR 6.9%-11.6%). Heat maps and spider plots were used to visualize the most common errors in Linguistic Inquiry and Word Count categories, which were found to be within 3 overarching categories: Conversation, Cognition, and Function. Overall, consistent with previous literature, our results suggest that the WER between manual and automated transcription services may be narrowing as ASR services advance. These advances, coupled with decreased cost and time in receiving transcriptions, may make ASR transcriptions a more viable option within health care settings. However, more research is required to determine if errors in specific types of words impact the analysis and usability of these transcriptions, particularly for specific applications and in a variety of populations in terms of clinical diagnosis, literacy level, accent, and cultural origin.

Predictors, mediators, and moderators of response to digital interventions for eating disorders: A systematic review.

Digital interventions show promise as an effective prevention or self-management option for eating disorders (EDs). However, it remains unclear how, for whom, and through what mechanisms they work in this population, as a synthesis of outcome predictors, moderators, and mediators is lacking. This systematic review synthesized empirical research investigating predictors, mediators, and moderators of response to digital interventions for EDs. Six databases were searched (PROSPERO CRD42022295565) for studies that assessed predictors, moderators, or mediators of response (i.e., uptake, drop-out, engagement, and symptom level change) to a digital prevention or treatment program for EDs. Variables were grouped into several overarching categories (demographic, symptom severity, psychological, etc.) and were synthesized qualitatively across samples without a formally diagnosed ED (typically prevention-focused) and samples with a formally diagnosed ED (typically treatment-focused). Eighty-six studies were included. For studies recruiting samples without a formal diagnosis (n = 70 studies), most predictors explored were statistically unrelated to outcome, although participant age, baseline symptom severity, confidence to change, motivation, and program engagement showed preliminary evidence of prognostic potential. No robust moderators or mediators were identified. Few studies recruiting samples with a formal diagnosis emerged (n = 16), of which no reliable predictors, moderators, or mediators were identified. It remains unclear how, for whom, and under what circumstances digital programs targeting EDs work. We offer several recommendations for future research with the aim of advancing understanding of client characteristics and intervention elements that signal success from this intervention modality. Digital interventions have shown potential as an effective, scalable, and accessible intervention option for EDs. However, responsiveness varies, so advancing understanding of predictors, mediators, and moderators of outcome to digital interventions for EDs is needed. Such knowledge is important for enabling safe and efficient treatment matching, and for informing future development of effective digital interventions.

Perceptions of the dental education-wide climate: Analysis of the 2022 ADEA climate study focus groups.

Climate assessments in higher and postsecondary education institutions are essential in landscaping inclusiveness and belonging for students, faculty, and staff. Although some climate assessments in dental education have been conducted either as part of their own campus or parent university climate assessment, a dental education-wide climate study has not been conducted across dental schools and allied dental education programs in the United States and Canada. As integral part of the 2022 ADEA Climate Survey in Dental Education, focus groups were conducted from March to April 2022 to ascertain the perceptions of students, faculty, and staff in dental education. A phenomenological study on 85 focus group participants comprised of students, faculty, and staff at U.S. and Canadian dental schools and allied dental education programs was conducted. Thematic analyses were structured on four overarching categories: (1) belonging, (2). bias, (3) challenges and barriers, and (4) future recommendations. Several themes emerged across all groups. The lack of inclusion and belonging on campuses, deficit of faculty of color, microaggressions and differential treatment of students of color, and the need to enhance recruitment of diverse students and faculty of color were among themes identified. Exclusive to U.S. allied dental education programs, exposure to unique community and clinical opportunities for students was identified as an important theme to enhance diversity, equity, inclusion, and belonging (DEIB). The first-ever dental education-wide climate study exposes the need to undertake this initiative in academic dentistry. The ongoing challenges unveiled in this study offer an opportunity to identify solutions that are meaningful, inclusive, impactful, and that foster humanistic learning environments for students, faculty, and staff in dental education.

Policy instruments to reduce food loss prior to retail – Perspectives of fruit and vegetable supply chain actors in Europe

Food loss and waste burdens the food system with an unnecessary use of natural resources such as soil, land and water as well as with the avoidable generation of further climate-relevant emissions. These negative externalities may provide a rationale for public sector intervention where feasible and efficient.Semi-structured interviews with 22 experts (farmers, producer organisations and retailers) in Germany and a questionnaire survey with 215 suppliers of a retailing company from Germany, Spain and Italy were conducted. The material reveals the perspectives and claims of relevant actors in upstream fruit and vegetable supply chains on political intervention.Stakeholders identified policy instruments from four overarching thematic categories: (I) communicative and cooperative policies, (II) subsidisation and food prices, (III) regulation and political framework conditions and (IV) questioning of necessity and effectiveness of food loss interventions. Four further categories of private sector measures were identified: (I) mechanisation, innovation and process optimisation, (II) communication and cooperation, (III) reconditioning and repackaging and (IV) processing, alternative marketing and redistribution.Issues that should be addressed by policy include consumer education and awareness, supply chain cooperation and power relations, food prices, marketing standards, alternative marketing and processing and promotion of technologies, infrastructure and agronomic practices to reduce food loss. The study shows that additional leverage points for policy action are still unrecognised and that stakeholders should be more involved in tackling the root causes of food loss. These policies should be holistically embedded in the sustainability transformation of the food system.

Parenting Experience of Shift Nurses With Elementary School-Aged Children During the COVID-19 Pandemic: A Phenomenological Study

Purpose: This phenomenological study aimed to comprehend the altered parenting experience of nurses during the coronavirus disease 2019 (COVID-19) pandemic.Method: Using a qualitative approach, the research design employed a phenomenological methodology. The participants were 6 nurses with elementary school-aged children. The nurses were employed in tertiary general hospitals, working on rotating shifts during the COVID-19 pandemic. In-depth interviews were conducted to collect individual data, which were then analyzed using Colaizzi phenomenological method.Results: Analyzing the collected data led to 178 significant results, from which 13 themes were derived. These 13 themes were further integrated into 5 distinct theme clusters: (1) struggling as a nurse-mom, (2) providing a supportive presence, (3) facing challenges in facilitating children's learning activities, (4) navigating parental roles in a chaotic situation, and (5) pursuing physical safety. These clusters were subsequently categorized into four overarching categories: “suffering,” which encompassed the themes of pressure of infection and providing a supportive presence, as well as “controlling,” “parenting,” and “seeking,” representing the remaining clusters, respectively.Conclusion: The parenting experiences of shift nurses during the COVID-19 pandemic encompassed various aspects, including the challenges posed by the pressure of infection, the importance of providing a supportive presence, difficulties in managing children’s learning activities, navigating parental roles amid chaotic circumstances, and the pursuit of physical safety. These experiences significantly impact the stability of shift nurses’ caregiving abilities for both their patients and their children. Therefore, it is crucial to establish a comprehensive nationallevel care support system in times of disaster situations like the COVID-19 pandemic.

Perspectives of Early Intervention Program Directors on Provider Retention Efforts

There is a national shortage of early intervention (EI) providers for young children with disabilities or developmental delays. This needs assessment study employed in-depth semi-structured interviews to explore the perspectives of EI program directors ( n = 27) across a large state on provider retention efforts. Through a qualitative analysis, we identified 12 themes across four overarching categories—(a) compensation and financial incentives, (b) program management and organization, (c) positive climate and culture, and (d) training and mentoring. We discuss implications and suggestions for future research.