Perspective Of Participants Research Articles

Lessons Learned From the Deployment of Registered Nurses to Surged Intensive Care Units During the COVID-19 Pandemic: A Qualitative Study.

To explore the perspectives of nurse educators, clinical nurse educators and nurse specialists with regard to supporting the deployed registered nurses in Australian intensive care units during the COVID-19 pandemic surge. A qualitative-descriptive study design was used. Intensive care nurse educators, clinical nurse educators and nurse specialists who had been involved with the preparation and support of nurses for deployment to intensive care units for COVID-19 surge were purposively recruited from around Australia. Data were collected through 18 semi-structured interviews and examined using thematic framework analysis of NVivo software. Participants described a number of challenges related to surge deployment including the varied skill sets and inadequate preparation for deployed staff, lack of a clear scope of practice and their general reluctance to deploy to intensive care units. Mixed communication from hospital managers about the mandatory or voluntary nature of deployments and the plans for return of nurses to their usual place of work were also considered problematic. Conversely, factors that supported effective deployment included consistently deploying the same staff, scope of practice guides, task cards and colour coding to identify the experience of nurses. The burden of the pandemic, including variable waves of surge, infection control complexities and fear of caring for patients with COVID-19, influenced the participants' experiences and perspectives. Additionally, there was a significant personal toll for participants because of the increased load of supervising deployed staff and concerns related to accountability for nursing care, and personal and patient safety. The deployment of nursing staff to intensive care units to support increased patient numbers is necessary during surge events. Having clarity about what role those nurses perform within intensive care units is essential in order to design training and support strategies that prepare them adequately so as not to place undue burden on an already strained intensive care nursing workforce. The toll of the COVID pandemic on ICU nurses was immense. This was further compounded by inadequate preparation and the strain of supporting deployed nurses in surged intensive care units. This research outlines the lessons learned from deploying nurses into surged intensive care units in the Australian setting. Supporting deployed nurses places a significant burden on the intensive care team; this is heavier when there is uncertainty about the scope of deployed staff and accountability for patient safety. These findings contribute to the body of evidence that will assist in for planning more effective deployment strategies for future intensive care surge events. Reporting complied with the COREQ criteria for qualitative research. There was no patient or public contribution.

Expectations and Perspectives About Infant Feeding of Their First Child Among Rural Women.

To explore expectations and perspectives related to infant feeding of their first child among rural women. Qualitative descriptive. Rural women who were first-time mothers (N= 18). We recruited participants from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics and a nurse home-visiting program in a midwestern U.S. state. Using the construct of habitus, we developed an interview guide and used semistructured interviews to explore the expectations and perspectives of participants regarding infant feeding of the first child. We analyzed the transcribed interviews using content analysis techniques to identify overall themes. We identified four overarching themes and associated subthemes that represented participants' expectations and perspectives: I'm Educated but Not So Much on Breastfeeding, This Is Small Town Culture, I Had Expectations, and This Area Lacks Resources for Mothers. Overall, participants had high expectations to breastfeed. However, most discontinued breastfeeding soon after giving birth due to a lack of pragmatic knowledge about how to breastfeed, poor understanding of infant nutritional needs in the first few weeks of life, and a nonsupportive habitus.

Initial participant perspectives about participating in an online, semi-supervised, cirrhosis-specific nutrition and exercise intervention.

In chronic diseases, there have been issues with low levels of participant adherence and retention during well-supported lifestyle behaviour change interventional studies. Theoretically informed, the objective was to explore the types of challenges participants are experiencing to inform future designs. We conducted an exploratory descriptive study in an adult cirrhosis population after the first 4-6 weeks of a 12-week semi-supervised nutrition and exercise online program. Participants in the parent feasibility study, assessing the nutrition and exercise intervention (Heal-Me), were eligible for this nested study. Heal-Me is a multimodal program that is tailorable to a participant's abilities through regular interaction with the study's registered dietician and exercise specialist. Interviews (~60 min) with participants were recorded then analysed descriptively, guided by the capability, opportunity and motivational behaviour change model. The 20 participants preferred the expert-led group online nutrition and exercise classes over independent activities such as protein tracking and the exercise videos. Social gamification (e.g., weekly polls on favourite things like movies or sports teams) contributed to the group experience. All except one person required program tailoring to address preferences, abilities and new onset health events. Findings led to the inclusion of 4 behaviour change techniques to the initial 17, whereas 2 others were expanded. While program tailoring, awareness of cirrhosis nutrition and regular interactions with staff influenced participant retention and adherence in the first 4-6 weeks of the online program.

Social relational notions of successful ageing: contesting dominant individualised conceptions of successful ageing by examining migrant intergenerational lived experiences.

Critiques of the concept of successful ageing (SA) include attention to its foundation on an individualised western medical approach that emphasizes personal choice, agency, and lifestyle. This paper aims to examine how individual notions of SA can be linked to, and co-constituted by, relational and intergenerational notions of personhood within the broader socio-economic, familial, and cultural contexts of migration. Qualitative research was conducted in Australia (2020-2021) with 42 Vietnamese migrants using ethnographic interviews and participant observation. Data analysis applied inductive reasoning and intersectional analysis to investigate the notion of SA from the perspectives of research participants. Vietnamese migrants identified three dimensions of SA as significant: family fulfilment, individual achievements, and social engagement and protection. Family fulfilment is the most important; other dimensions are rendered meaningless without it. We found out that different generations interpreted SA in varying ways. Adult children prioritize personal success, self-independence, and longevity while grandparents place greater emphasis on the success of their adult children and maintenance of intergenerational relationships. Migrant understandings of SA are deeply influenced by the socio-cultural contexts of both their homeland and current residence. The emphasis on family in shaping SA reflects a social-relational understanding that contrasts with dominant individualistic models of SA. Given the social relational dimension of SA, further research should investigate how distinct migrant experiences of SA shape access to wellbeing in later life.

Immersing Digital Technology in Empowering University Students with Future Skills: Digital Fabrication Laboratory Workshop

This study aimed to explore the perception of students in higher education regarding the role of digital fabrication laboratories in equipping students with the skills they need in the future. This study was conducted using a descriptive approach. The study was carried out through a DFL workshop involving students’ representation from the Department of Student Association from a state university in the West Java with a total population of 106 students. A purposive sampling technique was used to choose the participants, with total sample was 12 students. Data collection was carried out through survey and interviews to measure students' perspectives on the opportunities to use Digital Fabrication Laboratory in developing future skills in a workshop scheme. Quantitative data analysis was carried out using descriptive statistics using mean scores and percentages, while for the results of the interviews, using a thematic analysis. Study showed that according to participants, the Digital Fabrication Laboratory facility was able to develop several skills, namely creativity (14%), computational thinking (7%), soft skills (7%), teamwork (7%), technological literacy (22 %), entrepreneurship (14%) and digital design (29%). The results also showed that the digital fabrication laboratory has a role and benefits for students' future careers, with a mean score of 4.44 (very good). The results of the thematic analysis showed that participant perspective the advantages of DFL workshop can develop their skill namely entrepreneurship, souvenir entrepreneurship, business in Clothes Printing Properties, Gundam entrepreneurship, Support in entrepreneurship Courses, Teaching Media Supplier, so it can be concluded that students feel that the DFL workshop is useful for students' future careers.

Participant Perspectives on a Community Health Worker Intervention to Reduce Infant Mortality: A Mixed Methods Assessment of the Bronx Healthy Start Partnership.

Healthy Start is an initiative to reduce infant mortality and improve birth equity throughout the US, in large part by deploying community health workers (CHWs) to conduct home visits and provide educational and emotional support to new and expectant parents. A mixed-methods assessment of the Bronx Healthy Start Partnership (BxHSP) was conducted as part of a quality improvement initiative to understand client perspectives regarding the impact ofBxHSP on short- and intermediate-term outcomes that affect long-term well-being. Phone interviews (n = 16) and online surveys (n = 62) were conducted in English and Spanish with BxHSP participants in 2020 and 2022. The interview sample was selected purposefully; interview participants were eligible if they gave birth prior to mid-March 2020 and had received at least one CHW home visit. All individuals with open BxHSP cases (n = 379) were invited to complete the survey. Findings suggest thatBxHSP CHWs can provide vital psychosocial, material, and educational resources that help engaged participants feel supported as new parents and develop knowledge and skills related to infant care. Results further suggest that these short-term outcomes contribute to lower stress, increased self-efficacy, and health-promoting infant care practices, enabling participants to feel more confident and capable as new parents. Findings underscore how programs likeBxHSP can help address gaps in resources and improve health and well-being for pregnant and postpartum participants. Limitations include possible selection, recall, and/or social desirability biases as response rates were low and data were self-reported and retrospective. Limitations were addressed in part through triangulation of qualitative and quantitative data.

Perspectives of perinatal participants who have discontinued brief behavioural activation treatment: Insights from the SUMMIT Trial

Objective: Up to 20% of women experience symptoms of depression and anxiety during the perinatal period (1). However, as few as 12% receive effective mental health treatment due to various barriers to care (2). In this study, we examined the reasons why perinatal women with symptoms of depression and anxiety who participated in a psychotherapy clinical trial chose to discontinue treatment. The objective was to understand some of the personal and structural barriers this population experiences when accessing mental healthcare. Methods: We conducted a qualitative sub-study within the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) trial. SUMMIT is a four-arm, randomized, non-inferiority trial to test the effectiveness of behavioural activation aimed at alleviating symptoms of depression and anxiety among perinatal women. Participants were randomized by delivery mode (telemedicine vs. in-person) and provider (specialist vs. non-specialist). Of 1,183 SUMMIT participants, 225 (19%) chose to discontinue treatment, of which N=18 were contacted and agreed to be part of the current study. We conducted a content analysis to identify the most commonly reported reasons for treatment discontinuation. Results: Among 18 participants, the most highly endorsed reasons for treatment discontinuation included: transportation challenges (n=13, 72.2%), difficulty arranging childcare (n=11, 61.1%), dissatisfaction with their assigned delivery mode (n=11, 61.1%), work-family conflict (n=6, 33.3%), feeling overwhelmed (n=6, 33.3%), and health concerns or risks associated with hospital-based counselling (n=6, 33.3%). Participants also expressed dissatisfaction with the content or structure of behavioural activation (n=5, 27.8%) and the timing of treatment (received in pregnancy vs. postpartum) (n=4, 22.2%) which contributed to their discontinuation. Conclusion: Our findings provide insights into the personal and structural barriers perinatal individuals experience when accessing treatment in the context of a research setting. Perinatal participants expressed a preference for virtual mental healthcare for its convenience, demonstrating a feasible way to reduce some of the barriers to care.

'Kind of scared but happy something was detected.' Cross-sectional survey of Let's Test for HPV participants to understand perspectives on an HPV detected result.

Human papillomavirus (HPV) testing became the primary cervical screening modality in Aotearoa New Zealand in September 2023. To inform the national roll-out of HPV primary screening, a multiregion implementation study ('Let's Test for HPV') was undertaken in primary care in 2022-2023. To explore participant perspectives and information needs following receipt of an HPV detected result. An online survey completed in 2023 by 921 Let's Test for HPV participants included 95 people with an HPV detected result (10.3%). Data collection included: adequacy of information provision, receipt of results, emotional response, views on HPV primary screening and needing cervical cytology and/or colposcopy, and intent to screen again. Receipt of an HPV detected result was worrying for most people and many had unanswered questions about HPV, how HPV testing fits with cytology, implications for follow-up and outcomes. Knowledge gaps and uncertainty appeared to be linked with feeling anxious about possible outcomes and fear of a cancer diagnosis. All survey participants received recommended follow-up (cytology and/or colposcopy). Having a choice of screening test and the ability to self-test were welcomed and the majority (88%) expressed intent to screen again. These survey findings highlight the importance of giving clear information about potential outcomes at the time of screening and again when sharing results. Sensitive delivery of results, providing reassurance and answering questions are also important to mitigate fear and worry. Population-level education would help improve understanding of key messages about HPV testing and the changes to cervical screening.

Exploring the Qualitative Experiences of Administering and Participating in Remote Research via Telephone Using the Montreal Cognitive Assessment-Blind: Cross-Sectional Study of Older Adults.

The COVID-19 pandemic caused a drastic shift in the practice of research and clinical services. It has been noted that cognition measured via in-person versus remote methods differ substantially, and it is possible that subjective and experiential differences exist between modalities. The aim of the study is to explore the perceptions of both researchers and older adult participants on the experience of remotely conducted research using a cognitive screener. We conducted a thematic analysis of the experience of engaging in remote research from both the participant (n=10) and researcher (n=4) perspectives. The research interaction was framed through teleadministration of the Montreal Cognitive Assessment-Blind (suitable for telephone administration) and administration of a subsequent semistructured debriefing interview. Participant perspectives were garnered during debriefing interviews, while researcher insights were collected via self-reported qualitative field notes completed following each research session. Data aggregated into themes of barriers and facilitators from the lenses of both participants and researchers. Participants noted facilitators including short instrument length, convenience, and presession contact; barriers included the length of the interaction, some tasks being more challenging on the phone, and the potential for participant dishonesty. Research assistants noted several facilitators: instrument length, rapport building, ability to prepare for and record sessions, and comfort with the protocol; barriers were items with too many response options, telephone issues (eg, response delays), and concerns about participant comprehension. These results suggest remote telephone-delivered cognitive screening tools as a feasible and acceptable method of research inquiry. The findings provide a starting point for the inclusion of diverse populations in research to capture underrepresented groups whose input would immensely benefit our understanding of remotely delivered cognitive screening measures. Further, we offer materials (eg, checklists), which can be used in future investigations to promote future inclusive research and increase generalizability.

How feasible is nutrition intervention research in eating disorders? Lessons learnt from a pilot parallel randomised controlled trial of tyrosine supplementation in adolescents with anorexia nervosa

ObjectiveEating disorders are complex illnesses with high morbidity and mortality. Yet, there is promising evidence to support the effects of nutrition on the brain and behaviour. One proposed example is the use of tyrosine as an adjunct treatment in anorexia nervosa (AN). However, recruitment and retention in eating disorder clinical trials has posed difficulties for researchers. The aim of this study was to pilot test a parallel randomised controlled trial (RCT) of tyrosine supplementation to explore the feasibility of recruitment and retention, intervention adherence and data collection methods from the perspective of participants and researchers.MethodFeasibility was assessed using numbers participating, questionnaire completion in patients and parent/carers completing and declining participation, a researcher implementation record and clinical measures. Subjects included adolescents aged 12–17 years with AN. The study was conducted over a 12-week period, with the intervention group receiving 5 mg of L-tyrosine supplement and the control group receiving a placebo.ResultsRecruitment targets were not met and recruitment to a full RCT based on the current study protocol and recruitment sites did not prove feasible. Of the 39 approached for RCT participation, seven were recruited to the RCT (18% response rate) despite extending recruitment periods, with 100% retained and analysed. Patients or parents/carers identified barriers to study participation including burden, the need to consume tyrosine as tablets, and the use of blood, urine and psychological testing. Blood tyrosine rose markedly for subjects in the intervention group. No side effects were reported or measured.ConclusionsThis study offers a unique exploration of the feasibility of a tyrosine trial in anorexia nervosa and is of relevance to assist the success of future nutrition trials. Exploring the suitability of future study designs for nutrition intervention research is warranted.

Barriers and Facilitators Associated With Remote Concussion Physical Assessments From the Perspectives of Clinicians and People Living With Workplace Concussions: Focus Group Study.

Evaluating the clinical status of concussions using virtual platforms has become increasingly common. While virtual approaches to care are useful, there is limited information regarding the barriers and facilitators associated with a virtual concussion assessment. This study aims to identify the barriers and facilitators associated with engaging in virtual concussion assessments from the perspective of people living with workplace concussions; identify the barriers and facilitators to completing virtual concussion assessments from the perspectives of clinicians; and identify the clinical measures related to 4 clinical domains that would be most appropriate in virtual practice: general neurological examination and vestibular, oculomotor, and cervical spine assessment. We also evaluated effort. Separate online focus groups were conducted with expert concussion clinicians and people living with workplace concussions. A moderator led the focus groups using a semistructured interview guide that targeted a discussion of participants' experiences with virtual assessments. The discussions were recorded, transcribed, and analyzed by 2 reviewers using content analysis. Barriers and facilitators associated with completing the physical concussion examination were categorized based on the domain of the concussion examination and more general barriers and facilitators. Clinician-selected measures believed to work best in a virtual practice were described using frequency counts. A total of 4 focus groups with 15 people living with workplace concussions and 3 focus groups with 14 clinicians were completed using Microsoft Teams. Barriers were identified, such as triggering of symptoms associated with completing an assessment over video (mentioned 13/162 (8%) and 9/201 (4%) of the time for patient and clinician participants, respectively); challenges with location and setup (mentioned 16/162 (10%) of the time for patient participants); communication (mentioned 34/162 (21%) and 9/201 (4%) of the time for patient and clinician participants, respectively); and safety concerns (mentioned 11/162 (7%) of the time for patient and 15/201 (7%) for clinician participants). Facilitators were identified, such as having access to support (mentioned 42/154 (27%) and 21/151 (14%) of the time for patient and clinician participants, respectively); implementing symptom management strategies throughout the assessment (mentioned 11/154 (7%) of the time for patient participants); and having access to resources (mentioned 25/151 (17%) of the time for clinician participants). From the perspective of the clinician participants included in this study, the clinical measures recommended most for a virtual practice were finger to nose testing; balance testing; the Vestibular/Ocular Motor Screening tool; saccades; and cervical spine range of motion within their respective domains (ie, neurological examination, vestibular, oculomotor, and cervical spine assessment). Virtual assessments appear to be useful for both people living with workplace concussions and clinicians. While barriers were identified, such as challenges associated with exposure to screens, virtual assessments have benefits such as improved access to care. The clinician-selected measures that were considered best in a virtual practice will be investigated in an upcoming evaluative study. RR2-10.2196/40446.

Transient Ischemic Attack and Mild Stroke Participant Perspectives on Barriers and Enablers to Participation in Cardiovascular Rehabilitation

Background Exercise-based cardiac rehabilitation reduces the risk factors and recurrence of cardiovascular disease in patients with coronary heart disease. Despite similar risk factors, people with transient ischemic attack (TIA) and mild stroke do not attend cardiac rehabilitation. Cardiovascular rehabilitation (CVR), including TIA, stroke, and coronary heart disease, could be a solution for increasing participation. Perspectives from TIA and stroke survivors on barriers and enablers to participation in CVR are limited, and implementation strategies for CVR are currently unknown. Objectives We sought to determine (1) What were the perspectives of participants with TIA and mild stroke on barriers and enablers to uptake, engagement, and participation in CVR? and (2) What implementation strategies may influence people with TIA and mild stroke to participate in CVR? Methods In-depth semistructured interviews were conducted with CVR participants. Inductive thematic analysis was completed before deductively mapping themes to implementation frameworks, the Capability, Opportunity, Motivation, and Behavior Model and Theoretical Domains Framework. Results Twenty participants aged 73 ± 11 years were interviewed. Most were men, stroke survivors, tertiary educated, and retired. Six themes were generated to explain the barriers and enablers to CVR participation. Themes and subthemes mapped to 8 Theoretical Domains Framework domains and 5 Capability, Opportunity, Motivation, and Behavior constructs. Prioritizing participants' physical and social opportunities, reflective motivation, and physical and psychological capabilities may improve their participation in CVR. Conclusions Barriers and enablers to CVR participation were similar to those in the coronary heart disease population. Increasing access and availability of CVR for people with TIA and mild stroke should be prioritized for future implementation.

Visitors’ Experiences of Deyrulzafaran Monastery Through Netnography Approach

This article analyzes the experiences and perceptions of visitors to Deyrulzafaran Monastery using the netnography method. Netnography is a research method that aims to understand participants' experiences and perspectives in depth by examining content shared in online communities and social media platforms. The study reveals how the touristic experiences of Deyrulzafaran Monastery are perceived by examining visitor comments on TripAdvisor. As a result of the content analysis, the experiences of visitors to Deyrulzafaran Monastery were determined as six components. These components; unforgettable experience, satisfaction, intention to recommend and revisit, historical experience, cultural learning experience, gastronomic experience and guide features. This netnographic analysis aims to contribute to a better understanding of visitor experiences of cultural and historical sites and the development of tourism management strategies. Especially in the digital age, analyzing visitor feedback provides important information on how tourism destinations can adapt to meet visitor expectations.

Exploring Design-Based Research as a framework for addressing pedagogical problems faced by higher education

Design-Based Research presents a pragmatic approach to addressing both pedagogical problems and innovations within a rigorous framework that aims to build transferable practice. This panel discussion will explore four examples of implementing DBR in various higher education contexts and draw participants into a discussion of how they might apply DBR to address identified pedagogical problems or innovations in their own contexts. Why DBR? This panel discussion is a focal point for exploring how design-based research (DBR) in higher education in 2024, can address pedagogical problems brought about by the global pandemic and the explosion of generative artificial intelligence use in assessment and learning (For examples). In a period of continuous disruption in higher education, flexible and ethical research strategies that embrace unexpected influences in teaching and learning is paramount (Cochrane et al., 2023), leading to a new generation of educational researchers embracing DBR. Furthermore, practical examples demonstrating students as partners in curriculum design to inform ‘what works’ in practice are essential for researchers to gain confidence in adopting research-teaching-practice methods of inquiry (Bakker, 2018; Cochrane & Munn, 2020). Understanding how the processes and outputs of DBR can meet these needs is crucial to alleviating both business and educational tensions about timing, funding, resources, and workload planning (Cochrane, 2022; McKenney & Reeves, 2019; Reeves & Lin, 2020). At the core of DBR is the opportunity to explore pedagogical problems or innovation through four phases: problem analysis, develop solutions to the identified problem, explore and evaluate the impact of the design in iterative interventions in real learning situations, leading to the development of transferable design principles and theory building (McKenney & Reeves, 2019) Various research methods can be applied to progressively ask participant perspectives, including students, teachers and learning designers, on appropriate approaches or technologies to solve an identified problem (McKenney & Reeves, 2019). The intended outcome of this panel discussion is to collaborate with participants in implementing DBR in higher education in response to specific pedagogical problems identified by the participants. Beginning with a brief background to DBR followed by four examples to stimulate discussion on its application in broader contexts to address identified problems in curriculum design. Relevance to Higher Education The relevance of debating the role of design-based research in higher education in 2024 is to stimulate discussion for how this pragmatic research approach informs ‘what works’ in situated learning contexts to develop cutting edge design principles and theory that can be transferrable (Galvin & Cochrane, 2023). The methodological framework of DBR invites students, teachers, and learning designers to collaborate from the conception of a design artefact or educational approach to solve a learning problem through to iterative stages of delivery. Following a new normal in higher education where change is inevitable, and fast-paced, research design that does not shy away from the progressive and ‘messy’ elements of educational settings to improve real time learning is essential. Finding a balance between naturalistic and interventionist research methods to explore this complexity is a way forward that DBR can provide. It is acknowledged that greater understanding for the value of DBR and how to plan practical stages with multiple participants is needed for teachers, researchers, and leaders in higher education to confidently adopt this approach (Haagen-Schützenhöfer et al., 2024). Opening discussion with peers models the collaborative ethos of DBR and opens potential connections and networking avenues to establish and generate knowledge for DBR in higher education. The Panel Members The panel will be comprised of project leaders from four DBR projects: Clinical reasoning development, interdisciplinary engineering education, biomechanics, performance anxiety. These projects were introduced in a concise paper for the ASCILITE 2023 conference (Cochrane et al., 2023) and the authors are in the process of collaborating on a full journal article analysing these DBR projects (Cochrane et al., 2024) that should be published in time for the ASCILITE 2024 conference.

Participant and group facilitator perspectives on a novel culturally tailored diabetes self-management program for African Americans

BackgroundAfrican Americans with type 2 diabetes experience disparities in their care and diabetes health-related outcomes. Diabetes self-management programs such as Healthy Living with Diabetes (HLWD) are important but do not account for the unique cultural experiences of African Americans. Also, a culturally tailored program focused on addressing sociocultural beliefs and providing race-congruent peer support, Peers LEAD (Peers Supporting Health Literacy, Self-Efficacy, Self-Advocacy, and Adherence) was implemented in two midwestern cities to improve medication adherence but does not include diabetes self-management topics included in HLWD. In an attempt to fill the gaps from both HLWD and Peers LEAD, Peers EXCEL (Peers’ Experience in Communicating and Engaging in Healthy Living) was designed to integrate both programs.MethodsOur study explored the perceptions of African American participants and facilitators of the separate HLWD and Peers LEAD programs, on the proposed new Peers EXCEL program using focus groups and interviews. Findings were analyzed by research assistants trained in qualitative research using deductive and inductive open coding approaches.ResultsParticipants appreciated the cultural fit of Peers EXCEL for African American communities which is a feature that was lacking in HLWD. They shared the need to include topics such as the relationships between systemic racism and diabetes.ConclusionParticipants’ feedback of Peers EXCEL reveals the importance of including various community members’ perspectives in the design of new diabetes self-management programs tailored for African Americans.

Development of a framework of interpersonal communication skills for MPharm students: a UK eDelphi study

Abstract Introduction The importance of communication skills for pharmacists in their daily activities, particularly in patient-centred care, is paramount. Effective healthcare, including complex tasks such as health promotion and medication reviews, heavily relies on quality communication. The GPhC emphasises the importance of graduates being able to employ communication skills in various settings1 although consensus on essential communication competencies in student pharmacist education is lacking. Aim To achieve consensus on a framework of interpersonal communication competencies for MPharm students. Method With approval from Keele University’s Research Ethics Committee, a draft interpersonal communication competency framework was developed after thorough literature review. Panellists with an interest in pharmacy education (including graduates, pharmacists and non-pharmacists) were invited to participate in an online three-round modified eDelphi study. Round 1 involved participants reviewing the draft framework, providing feedback on competency relevance/ wording and identifying missing competencies. Round 2 evaluated an updated framework for competency importance, with competencies needing 80% agreement to achieve consensus. Competencies without consensus underwent Round 3 review. Feedback was provided after each round. Results Panellists from across UK came from diverse pharmacy sectors like community, hospital, primary care, academia, industry, regulatory and education. In addition, there was as considerable participant experience, knowledge and expertise, which contributed distinct insights and viewpoints. The draft framework comprised 123 competencies across four Domains: Generic Communication (sub-divided into: organisation of an encounter, initiating and closing discussions, verbal and non-verbal communication, encouragement of person involvement, and adjusting communication based on contextual or cultural factors); Patient-Specific Communication (sub-divided into: gathering patient information and shared decision making); Peer Communication, and Other Communication (e.g., written). In total, 56, 49, and 47 participants completed each of the three consecutive rounds. In Round 1, over 500 comments prompted considerable amendments, including competency additions, removals, and mergers. This led to 126 competencies being rated for importance in Round 2 and 120 competencies (95%) were deemed important by at least 80% of eDelphi participants. Alongside competency ratings, an additional 130 comments were received, offering constructive insights. Six competencies that failed to achieve consensus in Round 2 underwent review again in Round 3. Subsequently, three more competencies failed to achieve consensus, resulting in a final agreed-upon framework of 123 competencies. Discussion This is the first competency framework developed for pharmacy student education. This study underscores the importance of interpersonal communication skills in pharmacy education and the experience of participants enriched the study, providing diverse and essential perspectives that were crucial in defining these competencies. The robustness of the iterative eDelphi process was instrumental in refining these competencies through multiple rounds. Although most competencies achieved consensus, a few contentious competencies underscored the challenges of aligning participant perspectives. The finalised framework, grounded in evidence-based development and stakeholder involvement, potentially serves as a flexible foundation for structuring pharmacy education curricula, but the scope of the study may face limitations, with the range of competencies either being too broad or too narrow, which could make implementation a challenge. Future research could focus on assessing these competencies across diverse healthcare settings. Reference 1. General Pharmaceutical Council, (2017). Standards for pharmacy professionals. Retrieved from https://www.pharmacyregulation.org/sites/default/files/standards_for_pharmacy_professionals_may_2017_0.pdf.

From the Laboratory to the Real-World: The Role of Mismatch Negativity in Psychosis.

Mismatch negativity (MMN) has gained attention as a biomarker for psychosis and a translational intermediate phenotype in animal models of psychosis, including rodents and non-human primates. MMN has been linked to global functioning (Global Assessment of Functioning [GAF] score) and prognosis (psychosis onset or remission), suggesting that MMN reflects activities beyond auditory processing alone. This review examines the 45-year history of MMN from the perspective of psychiatric researchers and discusses current advances in computational and translational research on MMN, summarizing the current understanding of the MMN generation mechanism. We then address the essential question, "What do we observe through MMN?" Currently, we regard the relationship between global functioning in the real world and MMN as the key to answering this question. As a preliminary investigation, we analyzed the relationship between GAF as an objective variable and MMN, diagnosis, and basic epidemiological factors (age, sex, premorbid intelligence quotient) as explanatory variables (total n = 201, healthy controls: n = 41, patients with psychiatric disorders: n = 160) without assuming diagnostic categories. The relationship between functional outcomes and MMN was confirmed without a case-control design. Finally, we propose that new neurophysiological studies should acknowledge psychophysiological responses such as emotion, intention, and autonomic responses, as well as behavioral differences among participants beyond the dichotomy between healthy controls and patients. Measurements could be conducted in various settings from the participant's perspective. We discuss the potential for research investigating psychosis based on the interaction between individuals and the environment, using MMN as an illustrative model.

A qualitative exploration of participants' perspectives and experiences of novel digital health infrastructure to enhance patient care in remote communities within the Home Health Project.

The Home Health Project, set on Clare Island, five kilometres off the Irish Atlantic coast, is a pilot exploration of ways in which various forms of technology can be utilised to improve healthcare for individuals living in isolated communities. The integration of digital health technologies presents enormous potential to revolutionise the accessibility of healthcare systems for those living in remote communities, allowing patient care to function outside of traditional healthcare settings. This study aims to explore the personal experiences and perspectives of participants who are using digital technologies in the delivery of their healthcare as part of the Home Health Project. Individual semi-structured interviews were conducted with nine members of the Clare Island community participating in the Home Health Project. Interviews took place in-person, in June 2023. Interviews were audio-recorded and transcribed verbatim. The data were analysed inductively using reflexive thematic analysis. To identify determinants of engagement with the Home Health Project, the data was then deductively coded to the Theoretical Domains Framework (TDF) and organised into themes. Seven of the possible 14 TDF domains were supported by the interview data as influences on engagement with the Project: Knowledge, Beliefs about capabilities, Optimism, Intentions, Environmental context and resources, Social influences and Emotion. Overall, participants evaluated the Home Health Project as being of high quality which contributed to self-reported increases in health literacy, autonomy, and feeling well supported in having their health concerns addressed. There was some apprehension related to data protection, coupled with a desire for extended training to address aspects of digital illiteracy. Future iterations can capitalise on the findings of this study by refining the technologies to reflect tailored health information, personalised to the individual user.

Facilitators and barriers to uptake of digital adherence technologies in improving TB care in Ethiopia: A qualitative study.

The role of digital adherence technologies (DATs) in improving tuberculosis (TB) treatment adherence is an emerging area of policy discussion. Given that the directly observed therapy (DOT) has several shortcomings, alternative approaches such as DATs are vital to enhancing current practices by rendering person-centered models to support the completion of TB treatments. However, there is a lack of evidence that informs policy and program on facilitators and barriers to the uptake of DATs in the context of country-specific real-world situations. The purpose of this study was to explore the facilitators and barriers to the uptake of DATs by drawing from the accounts of people with TB (PWTB), healthcare workers (HCWs) and other key policy stakeholders in Ethiopia. A qualitative study was conducted to capture the perspectives of participants to help understand the contextual factors that are important in the uptake of DATs. The overall response from participants highlighted that uptake of DATs was high despite some critical implementation barriers. DATs were useful in reducing the burden of treatment management on both PWTB and HCWs, improving adherence and flexibility, and enhancing the patient-provider relationship. The relative simplicity of using DATs, positive feedback from important others, and current policy opportunities were seen as additional facilitators for the uptake of DATs in the Ethiopian context. Key barriers including network issues (mobile phone signals), lack of inclusivity and fear of stigma (as perceived by HCWs) were identified as key barriers that could limit the implementation of DATs. The findings of this qualitative study have provided a rich set of perspectives relevant to policymakers, providers and implementers in identifying the facilitators and barriers to the uptake of DATs in Ethiopia. The overall finding suggests that DATs are highly acceptable among the diverse categories of participants in the presence of critical barriers that limit uptake of DATs including poor infrastructure. However, key policy stakeholders believe that there are several opportunities and initiatives for feasible implementation, adaptation and scale-up of DATs in the current Ethiopian context.

Foodservice strategies for reducing athlete illness at the Olympic and Paralympic Games.

In 2021, infection control guidelines, including those specific to feeding environments, were introduced by the International Olympic and Paralympic Committees to reduce virus transmission at the Tokyo 2020 Summer and Beijing 2022 Winter games. This observational cross-sectional study aimed to investigate caterers' compliance to these guidelines which included measures for personal hygiene, sanitisation, and physical distancing at these events. Expert sport dietitians attending Tokyo (n = 15) and Beijing (n = 7) games were surveyed to rate 11 COVID-19 countermeasures as fully (100%), partially or non-compliant at nine dining locations across both events. Descriptive analysis of each countermeasure based on observed compliance and location was conducted and reported as a proportion of the total responses. To better understand participant perspectives of the factors influencing compliance, open responses were systematically coded into themes and sub-themes by researchers through content analysis. Themes generated from participant comments were categorised based on their relevance to specific countermeasures and locations to identify commonalities and disparities in participant experiences, perceptions, and observations. All main dining halls at both events were observed as 100% compliant to countermeasures on more occasions compared with Tokyo's venues and satellite villages. However, Beijing's three main dining halls, showed a greater compliance compared with Tokyo's main dining hall, likely due to overcrowding in Tokyo. Comments suggested that smaller dining spaces, with overcrowding, may have contributed to reduced compliance to physical distancing measures. Food safety concerns were raised about gastrointestinal distress in Beijing due to food cross-contamination. Findings suggest that the food service environment may influence caterers' abilities to comply with foodservice safety and infection control guidelines. In the post-pandemic era, enhanced quality control and standardised risk mitigation strategies are needed to improve athletes' health at international sporting events.