Overarching Themes Research Articles

The Content of Personalised Network-Based Case Formulations

Case formulation is at the heart of personalised care in psychotherapy. Scientific research into case formulations can provide new insights in the heterogeneity of psychopathology which are relevant for advances in personalised psychopathology research and practice. This mixed-methods study examined the content of 483 fully personalised network-based case formulations in psychotherapy in terms of uniqueness (i.e., frequencies of concepts) and commonality (i.e., the presence of common themes over the different case formulations). In a real-world clinical care setting, patients co-created network-based case formulations with their therapist as part of their routine diagnostic process. These case formulations feature concepts that are relevant to individual patients and their current situation. We assessed how often concepts were used by different patients to quantify uniqueness. We applied a bottom-up thematic analysis to identify patient-relevant themes from the concepts. The case formulations of 483 patients diagnosed with mood and/or anxiety disorders contained a total of 4908 interpretable concepts of which 4272 (87%) were completely unique. Through thematic analysis, we identified seven overarching themes in the concepts: autonomy, connectedness, emotions, self-care, identity, self-efficacy, and bodily sensations. Case formulations were highly unique, thereby illustrating the importance of personalised diagnostics. The unique concepts could be grouped under seven overarching themes which seem to encompass basic human needs. Current advancements in personalised diagnostics and assessment should have a broader scope than symptoms alone, and could use the themes identified here as part of a topic list in the generation of (network-based) case formulations.

Exploring workplace-based learning in distributed healthcare settings: a qualitative study

BackgroundDistributed healthcare settings such as district hospitals, primary care, and public health facilities are becoming the real-life settings for workplace-based learning required to educate the future healthcare workforce. Therefore, a major focus should be on designing and developing workplace-based learning in these learning environments. Healthcare professionals and educational policymakers play a significant role in these settings as role models in workplace-based learning, and as leaders in integrating learning into their work environments. It is relevant to explore their beliefs, attitudes, and behaviors towards workplace-based learning in their own settings, in order to provide context-relevant recommendations that can assist in shaping workplace-based learning environments.MethodsWe used individual interviews to understand professionals’ experiences with workplace-based learning in distributed healthcare settings. We - three clinicians, an educationalist, and a philosopher - thematically analyzed transcripts of 13 interviews with healthcare professionals and educational policymakers from different healthcare settings who were involved in the clinical phase of undergraduate medical education.ResultsClustering and categorizing of the data led to the construction of five overarching themes: Identification with and attitude towards medical education, Sense of ownership, Perceived time and space, Mutual preconceptions and relations, and Curriculum for a changing profession.ConclusionsThese themes accentuate aspects relevant to the development of workplace-based learning in distributed healthcare settings on the individual, team, or organizational level. We highlight the significance of individual professionals in the development of workplace-based learning and emphasize the need for recognition and support for those occupying the ‘broker’ role at the intersection of education and practice. For future research and educational practice, we recommend prioritizing initiatives that build on good-practices in workplace-based learning and involve dedicated individuals in distributed healthcare settings.

Evaluating the environmental impact of agri-food waste reduction: A bibliographic analysis and conceptual framework

Increasing concerns about the environmental impact of agri-food waste (AFW) have strengthened the need to assess the environmental performance of AFW reduction. Yet comprehensive literature reviews in this area remain scant. This paper presents a review of the research using a bibliographic analysis. Based on a sample of 171 research articles, we proposed a conceptual framework for evaluating the environmental impact of AFW reduction. The contribution of this review is threefold. First, a bibliographic analysis and semi-structured interviews are utilized to systematically review relevant literature and to propose a conceptual framework, which draws on existing research to determine ways of assessing the environmental impacts of AFW reduction. Second, our identification of four overarching research themes with respect to studies on the environmental impacts of AFW reduction offers fresh insights into AFW studies. Third, our conceptual model is refined following the semi-structured interviews we conduct, which serves to reveal the practical implications of our findings and research opportunities for the future.

Identity leadership and adherence to COVID-19 safety guidance in hospital settings.

COVID-19 presents unique and complex challenges to the Scottish National Health Service (NHS). As COVID-19 preventative measures are effective at reducing disease spread, promoting staff adherence in high-risk workplaces is vital. The present research explored the role of identity leadership on (a) staff's appraisals of leadership and (b) staff's adherence to and attitudes towards COVID-19 guidance. Semi-structured interviews (N = 25) were conducted with NHS staff across two Scottish hospitals. Using Reflexive Thematic Analysis, two over-arching themes were generated: leadership presence and approachable leadership who act on group concerns, where both created positive appraisals of leadership and were seen to facilitate adherence. Guidance from present leaders was perceived as both practical and applicable. Approachable leaders were viewed to facilitate information sharing, clarify guidance, and allow staff to raise concerns. Leaders who were seen to act on group concerns provided resources or updated guidance to promote adherence. The present study provides theoretical and practical advancements to (a) expand the known role of identity leadership in promoting safety in workplaces and (b) facilitate routes for adherence to safety guidance beyond COVID-19.

Perceived effects of drama therapy in people diagnosed with personality disorders: A qualitative study

Arts and psychomotor therapies are often part of the multidisciplinary treatment for people diagnosed with Personality Disorders (PDs). Drama therapy is aimed at promoting emotion regulation and strengthening of interpersonal skills. The added value of drama therapy has not been sufficiently examined and available studies only provide indirect client reports. Hence, we focus on what people with PDs perceive as effects of drama therapy. This qualitative study followed the Grounded Theory Approach utilising indepth, semi-structured interviews in a natural drama therapy context. Interviews were held with 19 people diagnosed with PDs, who were purposefully sampled. They were recruited from five treatment centres, with five drama therapists involved. Interviews were transcribed verbatim and analysed using a three-step approach: open, axial, and selective coding. Open coding resulted in 93 codes. In the coding process, four overarching themes came to the fore: allowing playfulness and its inherent benefits, connecting the inner and outer emotional world, understanding of maladaptive coping styles, and intrapersonal and interpersonal behavior change. The perceived effects as reported by people diagnosed with PDs provide information about what drama therapy means to them, in their daily lives and which aspects of the treatment were most valuable to them. This study contributes to the necessary underpinning of drama therapy.

Barriers and facilitators of lifestyle management among adult South Asian migrants living with chronic diseases: A mixed-methods systematic review

Background and aimSouth Asian migrants have a higher prevalence of chronic diseases than Caucasians. Despite much literature that has explored challenges in chronic disease management amongst the South Asian population in the past decades, their chronic disease management is still suboptimal. Understanding their determinants of disease management behaviour using the Theoretical Domains Framework will inform the development of a culturally sensitive intervention relevant to consumer-end-users. This study aimed to synthesise qualitative and quantitative studies on chronic disease management among adult South Asian immigrants. MethodsA mixed-methods systematic review was conducted using electronic databases. The Mixed Methods Appraisal Tool assessed the quality of the included studies. Quantitative data were transformed into qualitative data and analysed thematically. Subthemes were mapped in the Theoretical Domains Framework presenting barriers and facilitators under each theme. Results18293 studies were identified, of which 37 studies were included. The barriers and facilitators identified were categorised into four overarching themes: patient-provider interaction and relationship (e.g., complex language use by health professionals), the impact of migration (e.g., weather conditions had an impact on engagement with physical activity), heritage-based practices (e.g., an obligation to consume energy-dense food in social gatherings), and chronic disease management strategies (e.g., lack understanding of appropriate disease management strategies). ConclusionThis review provides a comprehensive understanding of the complexity of chronic disease management among South Asian migrants and insights into developing multifaceted interventions to address barriers to chronic disease management, guiding the healthcare professionals in helping overcome South Asians perceived barriers to managing chronic disease in the host countries.

A Model of How Students Engineer Test Cases With Feedback

Background and Context. Students’ programming projects are often assessed on the basis of their tests as well as their implementations, most commonly using test adequacy criteria like branch coverage, or, in some cases, mutation analysis. As a result, students are implicitly encouraged to use these tools during their development process (i.e., so they have awareness of the strength of their own test suites). Objectives. Little is known about how students choose test cases for their software while being guided by these feedback mechanisms. We aim to explore the interaction between students and commonly used testing feedback mechanisms (in this case, branch coverage and mutation-based feedback). Method. We use grounded theory to explore this interaction. We conducted 12 think-aloud interviews with students as they were asked to complete a series of software testing tasks, each of which involved a different feedback mechanism. Interviews were recorded and transcripts were analyzed, and we present the overarching themes that emerged from our analysis. Findings. Our findings are organized into a process model describing how students completed software testing tasks while being guided by a test adequacy criterion. Program comprehension strategies were commonly employed to reason about feedback and devise test cases. Mutation-based feedback tended to be cognitively overwhelming for students, and they resorted to weaker heuristics in order to address this feedback. Implications. In the presence of testing feedback, students did not appear to consider problem coverage as a testing goal so much as program coverage . While test adequacy criteria can be useful for assessment of software tests, we must consider whether they represent good goals for testing, and if our current methods of practice and assessment are encouraging poor testing habits.

Exploring older migrants’ meaning-making of ‘happiness’: “The main thing is health. Young people might say otherwise.”

ABSTRACT Purpose As our ageing population is growing and diversifying, it is important to gain insight into the well-being of older migrants. However, the meanings of happiness can vary cross-culturally. Therefore, prior to exploring older migrants’ happiness, their meaning-making of “happiness” should be explored. This way, cultural or individual variations can be considered when analysing older migrants’ happiness. Not only migration background but also age could influence the meaning of well-being. For example, the meaning of well-being can change as people grow older. Therefore, both migration background and age are considered in exploring older migrants’ meaning-making of happiness. Methods To do so, in-depth interviews with older migrants (n = 22) from various ethnicities were conducted in which their meaning-making of happiness was questioned via a semi-structured interview guide. Results After analysing the results via thematic analysis, three overarching themes are discussed: (1) happiness associations, (2) happiness-pursuing strategies, and (3) happiness obstructions. The analysis then further focuses on the role of migration background and ageing on the meaning-making of happiness. Conclusions Participants’ meaning-making of happiness seems strongly imbued with age-related references. On the contrary, the impact of migration background is rather limited. To explain this difference, the value of incorporating participants’ life course experiences emerged.

The experiences and impact of the COVID-19 pandemic on young carers: practice implications and planning for future health emergencies

BackgroundYoung carers are children or young people aged up to 25 years old who undertake unpaid caring responsibilities for a friend or family member. Young carers faced significant challenges brought on by the COVID-19 pandemic. We explored the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the United Kingdom (UK) to understand how to improve services, as well as support this population in future health emergencies.MethodWe conducted 22 qualitative semi-structured interviews from May to November 2021 with 14 young carers and eight staff working in organisations that supported them. Interviews took place remotely over video or telephone call and explored participant experiences of the pandemic and its impact on their health, wellbeing and caring responsibilities. We used reflexive thematic analysis to analyse interview transcripts.ResultsWe identified four overarching themes pertaining to the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the UK: (1) challenges in protecting loved ones from the virus, (2) changes to and loss of routine, (3) reduced access to pre-pandemic informal and formal support structures and (4) better understanding of inner resilience and goals. Many participants struggled with their mental health and wellbeing as a result of pandemic related restrictions which impacted on support structures for themselves and the individual they cared for. However, positive impacts pertained to additional support provided by local authority and third sector organisations.ConclusionsOur findings highlight some of the changes that affected young carers during the COVID-19 pandemic. The impact of changes to routine and a reduction in pre-pandemic support were the greatest concerns reported by participants in this study. The additional support provided by local authority and third sector organisations during social restrictions suggests such organisations could play a greater role in supporting this population going forward and that schools and Governments may wish to put in additional strategies and provisions to protect young carers in the future.

Barriers to Oral Health Care for Autistic Individuals-A Scoping Review.

Challenges in providing adequate dental care for individuals with Autism Spectrum Disorder (ASD) are recognised by parents, caregivers, and dental practitioners, leading to a higher prevalence of unaddressed dental needs. This scoping review aims to explore existing research on the obstacles to oral health care as perceived by individuals with ASD, as reported by their parents, caregivers, and dental professionals. Systematic searches were conducted in DOSS, Medline, and PubMed databases using relevant keywords to identify relevant studies. Barriers identified within these studies were then categorised based on themes identified. The initial search yielded a total of 254 studies. Following the removal of duplicates and screening of titles and abstracts, 47 studies were further assessed against predetermined criteria, ultimately resulting in the inclusion of 16 articles in this scoping review. The identified barriers were grouped into five overarching themes: challenges in accessing appropriate care (n = 8), negative past experiences (n = 5), parental perceptions of the impact of ASD (n = 8), clinician bias (n = 2), and clinician education (n = 7). The findings of this review highlight the obstacles faced by individuals with ASD in obtaining routine oral health care. These results underscore the imperative for the development, testing, and implementation of tailored interventions focused on autism, as well as their integration into educational curricula for dental practitioners at various educational levels. This approach aims to enhance the delivery of equitable oral health care to individuals with ASD, starting from undergraduate through to postgraduate dental education.

Lived experiences: Growing up with a seriously mentally ill parent.

Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. This study used an interpretive phenomenological design. Participants were invited to voluntarily participate in the study through a call posted on social media. Semi-structured interviews were conducted with 30 adults (age range, 20-55 years) who grew up with a parent with serious mental illness. The interviews were recorded and transcribed, and inductive thematic analysis was used to identify main and overarching themes. The overarching theme of transition from childhood survival to adulthood survival emerged and included four main themes: (1) a traumatic childhood, (2) perceived control, (3) resilience and general self-efficacy, and (4) adult quality of life. A traumatic childhood consisted of experiences of neglect and abuse, while participants used perceived control to achieve personal growth, self-care, and care of others. Resilience and general self-efficacy emerged during the transition to adulthood and helped participants further their social status and strengthen family bonds. Lastly, adult quality of life was described as being disturbed by feelings of loneliness and being burdensome, stemming from an inherent tendency to rely solely on themselves, leading to trust issues and mental health complications. Therefore, these adults found it difficult to reach out and get help or treatment for their concerns, as they initially did not want to appear dysfunctional or in need. This study has illuminated the lived experiences of a specific, vulnerable population that has not been intentionally explored until now. To delve into these experiences, we employed a distinctive qualitative approach, merging the interpretive phenomenological perspective with an inductive thematic analysis. This allowed for rich insight with a relatively large group of participants and enabled an in-depth exploration within this methodological framework. Consequently, this study constitutes a notable contribution to the extant body of knowledge, exploring the intricacies of personal growth and its impact on participants' quality of life. It uncovers the essence of resilience and general self-efficacy, revealing how these elements intertwine with the negative results observed. However, the study findings emphasize the need for healthcare professionals, including nurses and other caregivers, to be mindful of the long-lasting effects of the adverse experiences of children of patients with serious mental illness. Prioritizing active clinical assessment and implementing tailored interventions to address such children's specific needs and difficulties across different developmental stages is imperative. Such comprehensive and targeted approaches are crucial in providing appropriate support and promoting the well-being of these individuals. Enhanced clinical attention in holistic psychiatric care is crucial for individuals and their relatives, especially children. Comprehensive assessments of children and adults raised by seriously mentally ill parents can enable tailored and preventive interventions, positively impacting overall quality of life.

Information Technology in Healthcare: A Systematic Literature Review

Aim/Purpose. The aim of this study is to recognize the factors that contributed to the development of IT in the healthcare industry. Background. The healthcare Information Technology (IT) solutions market has experienced remarkable growth, with the healthcare sector emerging as a $303 billion industry. However, despite its substantial size, the healthcare industry has faced criticism for its slow adoption of innovative technologies. This study aims to explore factors driving the evolution of IT in the healthcare sector. Methodology. The researchers conducted a systematic literature review, searching the PubMed and Emerald databases for relevant peer-reviewed articles. After filtering based on defined criteria, 433 articles were included for analysis. Thematic analysis was applied to the abstract of articles which spanned the period of 1997 to 2023. Contribution. This study provides a conceptual framework elucidating the key factors driving the evolution of IT in the healthcare industry. By systematically analyzing the existing literature, the research identifies four overarching themes – government policies, technological potentials, healthcare delivery needs, and organizational motivations – that have propelled the development and adoption of healthcare IT solutions. Provide a conceptual model for understanding, and design of the healthcare it solutions. Findings. Based on the analysis in this paper, four themes emerged: government policies promoting IT adoption through initiatives like incentives for electronic health records; technological breakthroughs enabling new healthcare IT capabilities; healthcare delivery needs to drive IT integration for improved quality and safety; and patient experience and organizational motivations to leverage IT for streamlining processes and knowledge management. Recommendations for Practitioners. The conceptual model can guide practitioners in developing IT solutions aligned with policy drivers, technological capabilities, care delivery needs, and organizational imperatives. Recommendations for Researchers. The conceptual framework developed in this study offers a lens for researchers across disciplines to continue investigating the role of information technology in the healthcare industry. Impact on Society. Examining the evolution of IT in the healthcare industry revealed the importance of information technology in enhancing the delivery and affordability of healthcare services and addressing issues of accessibility and inequality. Future Research. Future research will explore global perspectives showcasing the successful impact of IT on healthcare, as emerging technologies impact healthcare delivery and patient outcomes.

Emergency medical service interventions and experiences during pandemics: A scoping review.

The global impact of COVID-19 has been profound, with efforts to manage and contain the virus placing increased pressure on healthcare systems and Emergency Medical Services (EMS) in particular. There has been no previous review of studies investigating EMS interventions or experiences during pandemics. The aim of this scoping review was to identify and present published quantitative and qualitative evidence of EMS pandemic interventions, and how this translates into practice. Six electronic databases were searched from inception to July 2022, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. A narrative synthesis of all eligible quantitative studies was performed and structured around the aims, key findings, as well as intervention type and content, where appropriate. Data from the qualitative studies were also synthesised narratively and presented thematically, according to their main aims and key findings. The search strategy identified a total of 22,599 citations and after removing duplicates and excluding citations based on title and abstract, and full text screening, 90 studies were included. The quantitative narrative synthesis included seven overarching themes, describing EMS pandemic preparedness plans and interventions implemented in response to pandemics. The qualitative data synthesis included five themes, detailing the EMS workers' experiences of providing care during pandemics, their needs and their suggestions for best practices moving forward. Despite concerns for their own and their families' safety and the many challenges they are faced with, especially their knowledge, training, lack of appropriate Personal Protective Equipment (PPE) and constant protocol changes, EMS personnel were willing and prepared to report for duty during pandemics. Participants also made recommendations for future outbreak response, which should be taken into consideration in order for EMS to cope with the current pandemic and to better prepare to respond to any future ones. The review protocol was registered with the Open Science Framework (osf.io/2pcy7).

"Not doing it justice": Perspectives of Recent Family Medicine Graduates on Mental Health and Addictions Training in Residency.

Family physicians report feeling inadequately prepared to meet the evolving mental health care needs of the population. Little scholarship exists evaluating the effectiveness of curricula designed to teach mental health and addiction (MH&A) care to family medicine (FM) residents. As such, the purpose of this study was to explore the experiences of recent FM residency graduates in providing mental health care, and their perceptions of mental health training gaps during their residencies. A qualitative descriptive study design was conducted by 8 recent graduates of the University of Toronto's FM residency program, who participated in semi-structured video interviews. A thematic analysis approach was used to collect and analyze the data. Through thematic analysis, 3 overarching themes were developed: (1) barriers in providing mental health and addiction care, (2) curriculum renewal, and (3) the role of FPs and professional identity. Consistent with the literature, the majority of recent FM graduates expressed discomfort when managing patients with mental health and addiction concerns. Additionally, participants perceived residency program time constraints, rotational site differences, and limited exposure to marginalized populations all impacted learning and mastery of skills. The findings of this study underscore current gaps within the FM residency curriculum and highlight the need to address current curricular deficits.

Menstrual Cycle and Hormonal Contraceptive Symptom Severity and Frequency in Athletic Females

The purpose of this study was to determine symptom severity and frequency in female exercisers and athletes from a diverse range of sports who have a menstrual cycle (MC) or use hormonal contraceptives (HCs). An additional aim was to explore the perceived impact of MC/HC use upon exercise and sport performance. In total, 604 self-identifying female athletes and exercisers (M = 29.4 years, SD = 9.0) from 85 sports/activities completed a survey which included: sport/exercise participation, bleeding characteristics, HC use, symptom severity/frequency, symptom management strategies, menstrual product use, and perceived impact of MC/HC use on exercise performance. The data were subject to mixed-methods analysis. Over one third (n = 225; 37.25%) of participants reported current HC use. Ninety-five percent (95.36%) of participants experienced symptoms related to MC or HC use. Physiological, psychological, and affective symptoms were all among the most prevalent. The most frequently noted severe and very severe symptoms for all participants, MC and HC users, were abdominal cramps (36.92%, 39.32%, and 32.89%, respectively), mood changes (26.16%, 25.07%, and 28.00%, respectively), and tiredness (25.33%, 25.59%, and 24.89%, respectively). Symptom impact was self-managed through medical and/or other (cognitive/behavioral) strategies. Qualitative content analysis of the data produced four overarching themes: (a) the impact of symptoms, (b) menstrual stigma and taboos, (c) protective factors, and (d) coping strategies. In conclusion, menstruation is a multifaceted, unique experience that impacts upon sport/exercise performance. Practitioners should consider athletes’ distinct needs, including the frequency of occurrence and severity of their symptomatic experiences, when facilitating menstruation-supportive training, avoiding a “one-size fits-all” approach.

A Qualitative Exploration of Coaches’ Perceived Challenges and Recommendations Relating to Social Justice in Canadian High School Sport

Sport can at once promote social justice and reinforce systemic inequities. Considering the influence coaches have on athlete development, research related to coaches’ perspectives on social justice issues is warranted. The purpose of the study was to explore Canadian high school sport coaches’ attitudes towards social justice. An online survey saw 392 coaches respond to six open-ended questions on perceived challenges (three questions; n = 989 responses) and recommendations (three questions; n = 724 responses) related to social justice within their teams, schools, and school boards. A content analysis led to coaches’ responses being classified into three groups: (a) high school sport faces social justice issues (57.38%), (b) no social justice challenges and/or recommendations to share (39.34%), and (c) urgency regarding social justice issues is overblown (3.28%). A reflexive thematic analysis, guided by the critical positive youth development framework, was used to develop several overarching themes, highlighting persistent inequities, a lack of involvement from school boards, missed/ignored social justice issues, and a small group of antisocial justice coaches within the Canadian high school sport system. Considerations for coach education programmes and future research are discussed.

Chaplain development in Clinical Pastoral Education (CPE) in healthcare settings in England: A mixed methods study.

Clinical Pastoral Education (CPE) is the predominant specialised training for healthcare chaplains in several national contexts. CPE is spiritual care education that uses experiential and action-reflection learning methods to train diverse participants. However, CPE is not established for chaplaincy training in England. Currently, chaplaincy education in England lacks standardisation, leading to inequalities in entry into the profession and inconsistent training and career pathways. CPE has the potential to address these issues. We examined changes associated with participating in CPE and participants' perceptions about their learning experience. We sought to evaluate the effectiveness of CPE as a viable chaplaincy education model in healthcare settings in England. Convergent mixed methods involved pre-post surveys and focus group sessions to examine the experiences and development of seven chaplains, with diverse experience levels and backgrounds, who participated in the pilot CPE unit in NHS England. We integrated thematic analysis and survey results. We identified four overarching themes: Development pathways, Catalysts for development, Advantages of CPE for chaplaincy education, and Experiences with CPE course structure. Participants developed along various pathways: confidence, reflective practice, emotional intelligence, listening and attending skills, diversity in chaplaincy care, and spiritual assessment. Survey results confirmed several themes, indicating gains in chaplaincy capabilities, emotional intelligence, and counselling self-efficacy. Participants emphasised the advantages and effectiveness of the CPE model. Quantitative and qualitative findings converged to provide rich evidence that CPE generated personal and professional development, improving chaplaincy practice. General learning pathways moved from personal development, through the interpersonal learning context, and translated into chaplain competency. Participants endorsed CPE, as a robust and effective training model for chaplaincy in the English context, for those entering the profession and experienced chaplains alike. We conceptualised preliminary models for chaplain development and learning pathways in CPE that need validation and refinement by future research.

Pathology of the Role of Civil Society in Crime Prevention in Iran's Criminal Justice System

The present study aims to analyze the pathology of the role of civil society in crime prevention in Iran's criminal justice system. A qualitative research strategy, using thematic analysis, has been employed to address the issue. Data were collected through semi-structured interviews with 12 experts in criminal law and criminology, selected via theoretical sampling. The data were analyzed using thematic analysis, specifically the thematic network analysis method, and a conceptual model was constructed based on network measurements. The findings from the qualitative research indicated that the pathology of civil society’s role in crime prevention within Iran's criminal justice system includes the following overarching themes: 1) Internal organizational challenges, including (legal and juridical issues, governmental executive issues, lack of awareness and weak cultural development concerning civil society, weak social capital, economic issues, and legal and executive redundancy and multifactorial challenges); and 2) External organizational challenges, including (structural and managerial weaknesses in civil society institutions and weak knowledge management in crime prevention). Furthermore, for "validity testing" of the constructed themes and model, two methods were used: communicative validation and audit methods. For "reliability testing," two approaches were employed: repeatability and transferability or generalizability.

Living with an ostomy: A needs assessment in pediatric inflammatory bowel disease

BackgroundInflammatory bowel disease (IBD) is a chronic, immune-mediated inflammatory condition of the digestive tract associated with substantial psychosocial difficulties. Treatment often focuses on medications but may also include surgical approaches (e.g., intestinal ostomy). Unfortunately, literature regarding the psychosocial implications of ostomy surgeries is scarce, and even less is known about adolescent experiences, which may differ markedly from adults. ObjectiveThis study aimed to explore the perspectives of adolescents with IBD and their caregivers to understand their perceived needs when they have undergone, are anticipating, or have anticipated the possibility of experiencing a stoma surgery. Study findings hoped to inform clinical practice in IBD care and beyond. MethodA purposive sample of patients and caregivers were recruited from a large pediatric hospital. Twelve patients and thirteen caregivers participated in the study. Participants completed a demographic background questionnaire and virtual semi-structured interview. Inductive content analysis was used to examine participant feedback. ResultsQualitative results identified four overarching themes and thirteen subthemes: fear of the unknown, perceived barriers, being supported, and recommendations for creating a more positive experience. Specifically, participants described the transition process from pediatric to adult care as particularly intimidating and having a supportive and inclusive handover was a helpful piece that supported the shift to adult care. ConclusionThis study reflects the importance of a holistic approach to care that attends to adolescent patients’ physical well-being and emotional and social needs. Patient-driven recommendations for enhancing age-specific care of adolescents with ostomies are provided.

Exploring the Role of Nurses in Advance Care Planning Within Long-Term Care Homes: A Qualitative Study.

Residents in long-term care homes (LTCHs) are often diagnosed with chronic, life-limiting illnesses, and it is now a common site to provide high levels of care and eventual death. There is an urgent need to address communication gaps and uncertainties surrounding resident's end of life preferences. Nurses are well situated to be key facilitators of necessary advance care planning (ACP), ensuring residents have discussions with family, substitute decision-makers and healthcare providers regarding future health and personal care preferences. However, LTCHs present unique challenges for nurses due to not only complex comorbidities but also staffing dynamics. This study explored the experiences and perceptions of Registered Nurses (RNs) and Registered Practical Nurse (RPNs) in LTCHs regarding their role in engaging residents and families in ACP discussions. Qualitative interpretive descriptive methodology was used. Data were collected from two LTCHs in Southern Ontario with a sample of 15 nurses (7 RNs and 8 RPNs). Analysis involved review of semistructured interviews, field notes, and utilizing constant comparison within an inductive approach. Power and authority dynamics in LTCH's was an overarching theme in the data, with four subthemes: (1) Nurses lacking clarity about ACP, (2) nurses' uncertainty regarding their role in ACP, (3) nurses feeling uncomfortable engaging in ACP discussions, and (4) nurses struggling to support families in ACP discussions. Recommendations for nurses, healthcare providers, LTCH administrators, and policy makers include: (1) development of policies which support, from a systemic level, nurses to feel safe while engaging in ACP; (2) reassessing LTCH's hierarchical structure, and clarifying RN, RPN, and interdisciplinary team members roles in ACP; (3) developing culture change that allows a team and person-centered approach to ACP; and (4) providing ongoing education and mentorship for nurses to manage family dynamics and expand their understanding of ACP beyond a biomedical lens.