The current systematic review and meta-synthesis investigated the experiences of Deaf queer people, specifically, how identities in this population shift dynamically in response to their dual marginalization. Data were extracted from 27 qualitative studies, with a sample total of 176 participants. Synthesis was influenced by the Model of Multidimensional Identities to frame resulting categories and themes. Four categories were developed from the data: (1) institutional contributors to identity salience, (2) cultural moderators of institutional neglect, (3) resistance to double exclusion through community, and (4) personal navigation of a contested body. The findings capture a picture of complex discrimination, where identities are largely shaped by society's preconceived prejudices, community, and language access.

Purpose To explore how lived and care experiences of young people (aged 16–24 years) who experience chronic musculoskeletal pain (CMP) influence their choices about CMP care, and how and where a digital health solution (DHS) could support their care. Methods A cross-sectional, exploratory qualitative study involving 20 young people (16–24 years) experiencing CMP. Eight focus groups were conducted, guided by a focus group schedule. Data were analyzed using thematic analysis. Results Three main themes emerged describing young people’s experiences and CMP care choices. For each main theme we identified how a DHS could support their care: (1) “Experiences of living with and managing their CMP.” A DHS could buffer self-care needs by providing timely support and creating a sense of community. (2) “Experiences with healthcare providers and healthcare services.” An app-based DHS could potentially help to coordinate CMP care and support health services navigation. (3) “Young people’s choices about their CMP care options.” DHSs can support young people prioritize their CMP care options. Conclusions Understanding young people’s values, alongside their care needs is critical to delivering person-centred care. A tailored DHS can value-add to young people’s CMP care by helping to minimize the burden of self-care, health service navigation and interactions with healthcare providers.

ABSTRACT Background In the United Kingdom (UK), individuals of minoritized ethnic groups report poorer healthcare experiences and face disparities in health outcomes and access to healthcare services relative to their White counterparts. While it has been demonstrated that sociodemographic characteristics play important roles in the risk of developing rheumatic diseases, disease progression, and treatment journeys, there is limited understanding of the experiences of minoritized ethnic groups in the UK. This study aimed to investigate how the social and structural processes associated with ethnicity affect the medical experiences of people with systemic autoimmune rheumatic diseases in the UK. Design Qualitative data were collected between 2023 and 2025 through semi-structured interviews with N = 29 (36% South Asian, 86% female) patients and N = 16 (81% White, 50% female) clinicians. Analysis was thematic and involved immersion in the data, coding using NVivo, and discussion of themes with a multidisciplinary team including patient partners. Results Interviews generated three main themes: (1) subtle and systemic racism in care and society, (2) racialized medical and behavioural stereotyping, and (3) socio-cultural factors impacting doctor-patient communication and rapport building. Throughout each theme, participant recommendations for improving care were raised. Conclusions Our study demonstrated that the socio-structural processes related to ethnicity, namely racism, social deprivation, stereotyping and institutional bias, impact the medical experiences of SARDs patients in multitudinous ways. Some patients reported systemic and interpersonal racism, racialized stereotyping, and mistrust in care, while others listed factors that they considered were protective against discrimination, such as education and location. Socio-cultural factors, including language barriers and variations in clinician understandings of patient experiences, further impact doctor-patient interactions.

There is little known about the lived experiences of people who remain sexually abstinent until marriage, including those who have a sexual history. Furthermore, this phenomenon has not been studied among a population that faces unique challenges in forming and maintaining relationships and marriages. This study utilized phenomenology and conducted in-depth individual and dyadic interviews with 38 African-American couples (N = 76) who remained sexually abstinent for at least six months prior to marriage. This report highlights the lived experience of a couple’s journey through sexual abstinence until marriage and their perceived impact of this behavior, individually and relationally. Themes were categorized as the perceived benefits, costs, and overall impact of sexual abstinence on personal and relational development, as well as current marital satisfaction. Couples believed that abstaining before marriage allowed them to build a strong marital foundation based on communication, commitment, and God.

Abstract As data exploded with the advent of smartphones in the first decade of this century, the world entered an era of experiences. The advent of VR/AR headsets a decade later brought us into the age of experiences. VR/AR headsets have transformed the way people experience data, especially in gaming and entertainment. However, headsets in their current form factor can be cumbersome, sometimes causing fatigue with long‐duration use. They can be particularly isolating for applications that need multiple individuals to collaborate together. Spatially augmented reality (SAR) using multiple projectors aims to bring the surround, large field‐of‐view (FOV) collaborative experiences out of VR/AR headsets by merging digital content from multiple projectors with the physical environment around users. The vision is to use multiple projectors to project digital imagery on everyday surfaces surrounding users by employing cameras to understand the surface for correct merging of the digital with the physical. This paper presents a detailed state‐of‐the‐art survey of advancements in methodologies for multi‐projector aggregation to achieve SAR and state‐of‐the‐art hardware technologies (such as cameras, projectors, and interaction devices) available today to build multi‐projector‐based displays and interaction environments. Most importantly, we look at this space not only from the perspective of research and development, but also from the practical challenges and considerations in the deployment of such systems.

Working life experiences of people who stutter in Finland: Recommendations for enhancing inclusive communication at work.

IntroductionHospital care is critical when assessing the overall quality of chronic obstructive pulmonary disease (COPD) care, particularly for people living with severe COPD who are frequently hospitalised due to exacerbations. The hospitalisation experience for people with COPD is often complex, involving various interactions and has been reported to be suboptimal. A comprehensive understanding of these experiences is lacking. With the intention of informing a holistic approach in COPD hospital care, this study aimed to explore the experiences and expectations of individuals with severe COPD regarding hospital care due to exacerbations of COPD.MethodsAcknowledging the complexity of interactions within the studied scenarios, this research employed a qualitative study design, utilising co-creation workshops for data collection. A total of 13 participants were involved in the data collection process. Five people with severe COPD were recruited using purposive sampling. In addition, one family member, four healthcare practitioners, one digital health program designer, and two hospital managers were recruited through convenience sampling. Data were collected during three co-creation workshops. During each workshop, participants were divided into subgroups focused on specific topics. Relevant transcripts from these subgroup discussions were chosen for analysis, which was conducted using qualitative content analysis.ResultsThe analysis resulted in four categories that illustrate both the experiences and expectations of people with COPD regarding hospital care from admission to discharge: lack of trustworthy guidance, increased vulnerability during hospitalisation, discharge issues, and advocacy for COPD recognition. Our findings reveal some deficiencies, particularly in admission procedures, information exchange, healthcare interactions, and transitions from hospital to home. At the same time, patients also expressed appreciation for the continuous support provided by COPD nurses and home care teams.ConclusionThis study highlights the need for person-centred care in managing COPD exacerbations. It identifies key interventions such as early help-seeking, better patient education, staff training, care continuity, improved discharge services, and public awareness. Emphasising individualised experiences, it calls for familiar care settings, collaborative discharge planning, and integration of home care to enhance hospital care quality.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12890-025-04024-x.

This study explores the parenting experiences of trans people in Latin America from a feminist post/de(s)colonial perspective, theories of subalternity, and intersectionality. Using a qualitative multiple case study design, the research analyzes the challenges trans people face in exercising their parental roles, the resources they mobilize, and the tactics of agency and resistance they develop. Data were collected through semi-structured biographical interviews and the Intersectional Loom tactic, involving nine trans parents from Mexico, Chile, Venezuela, and Guatemala. Findings reveal that trans people face obstacles at socio-structural, institutional, and microsocial levels, shaped by cisheteronormative norms, and legal invisibility. Despite this, they mobilize social, legal, and personal resources, as well as relational and individual coping tactics, to affirm their identities and exercise parenting under adverse conditions. The study highlights the urgent need for comprehensive legal and social reforms in Latin America to protect and support trans parents and their families.

(1) Background: Medication shortages have become increasingly common in the UK. However, there is limited evidence regarding the experiences of people with epilepsy and their caregivers during these shortages. The aim of this study is to explore the extent and impact of ASM shortages on people with epilepsy and their caregivers across the UK. (2) Methods: A cross-sectional online survey was distributed between January and April, 2024 by epilepsy charities. Participants included people with epilepsy and caregivers. The survey collected demographic information, types of ASM respondents were prescribed, experiences of shortages, and the impact of shortages. Data were analysed descriptively, and subgroup analyses were conducted by medication type. (3) Results: A total of 1549 responded, of whom 1312 were people with epilepsy and their carers who were included in the analysis with a mean age of 43 years. A total of 941 respondents (71.7%) reported difficulty obtaining their prescribed ASM in the past year. Shortages were most frequently reported for sodium valproate (60.8%), lamotrigine (65.2%), carbamazepine (92.6%), clobazam (82.6%), topiramate (81.5%), zonisamide (74.0%), levetiracetam (62.8%), lacosamide (71.0%), and brivaracetam (70.5%). A total of 529 (40.4%) of the participants reported that stress and/or anxiety caused by medication shortages was associated with recurrent seizures. We did not ask whether patients missed medications because of these difficulties. (4) Conclusions: ASM shortages are a widespread issue for people with epilepsy in the UK, leading to treatment disruptions and psychological distress. Addressing supply change limitations and identifying effective approaches to preventing the substitution of ASMs brands by clinicians may potentially reduce this problem.

Diabetes is a major global health concern, with diabetic foot ulcers (DFUs) presenting a common complication. Interest is growing in people's lived experiences of DFUs, including their management and prevention. Typically, research has highlighted the disruptive and extended impact of DFUs, and has focused on the role of intrinsic, individual factors (e.g. knowledge, physical capabilities and personal choices) in their development and management. The influence of extrinsic, contextual factors, has received comparatively limited attention. To address this potentially important gap in the literature we set out to explore people's experiences of DFUs, using a distinctive, contextually-sensitive, analytical lens. Our analysis led us to identify three over-arching themes: a spectrum of embodied experiences of DFUs; intersection with wider experiences of ill-health; and, framing of (DFU) experiences by broader life circumstances. Within these themes, considerable diversity was evident. Broader life circumstances, in particular, shaped experiences of living with, managing, and preventing reoccurrence of DFUs in markedly different, and previously unacknowledged, ways. We conclude that experiences of DFUs are far more nuanced and contextually-mediated than previously reported, and identify important practical implications for the provision of sensitive and effective support and clinical care. Moreover, we suggest that identifying these sorts of complexities in illness experiences may require larger, and more varied samples and data-sets than have become the norm in qualitative health research, as well as more expansive disciplinary lenses.

Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. This research calls for reframing harm reduction to focus on health enhancement, optimising injecting techniques, and integrating evidence-based resources, empowering peer-led harm reduction to better support the health aspirations of this population.

This is the first study to specifically explore the experiences of people with BPD in an IPS employment program. Understanding the experiences of individuals with BPD can assist those delivering IPS employment programs to ensure that they are effectively meeting the needs of this diagnostic group.To understand the experiences and perspectives of individuals who participated in a pilot Individual Placement and Support (IPS) program for people with Borderline Personality Disorder (BPD).Data were gathered through semi-structured interviews with four people who had participated in the pilot program and analysed using reflexive thematic analysis. Participants were invited to provide feedback on draft themes, which informed the final analysis.Factors that shaped the participants' generally positive experiences of the program fell into three broad themes. 'Wanting to do it' came from having work-related goals, a perception that it was the right time and a sense of being in control. 'Somebody on your side' described participants' experience of relationship with their employment consultant being characterised by understanding, encouragement and flexibility. Finally, 'it's all in one place' centred on their experience of the integration of the mental health service and employment program as increasing trust, accessibility, and support.IPS was well accepted by participants in this study with findings highlighting factors that supported this acceptability. Further research investigating the perspectives and outcomes of IPS for individuals with BPD is suggested.

Skeletal dysplasia (SD) encompasses over 700 heterogeneous genetic conditions affecting the development, growth and maintenance of the human skeleton. Challenges regarding feeding, nutrition, and physical activity are reported across the lifespan, but the lived experience of these issues is poorly understood. This study uses a qualitative mixed methodology to explore feeding, nutrition, and physical activity from the perspectives of individuals living with SD or their parents. Three semistructured focus groups were conducted in Norway and 13 interviews in Australia. The two qualitative datasets were thematically analyzed separately, and themes were then synthesized together. Thirty-five participants with SD or their parents participated across the two sites. Six major themes were identified: (i) early life feeding, development, and activity; (ii) managing energy intake and nutrition in older children and adults; (iii) practical considerations related to food preparation; (iv) weight gain; (v) holistic health care; and (vi) physical activity in older children and adults. Subthemes identified included breastfeeding challenges, inappropriate assessment of growth and nutritional status, barriers to being physically active in adulthood, and difficulty navigating food portions. Understanding the experiences of people with SD will support and inform future codesigned tailored solutions to address feeding, nutrition, and physical activity.

Black birthing people experience disproportionately high rates of adverse maternal and infant health outcomes. Doula support is associated with improved birth outcomes and can help reduce racial disparities, yet culturally congruent doulas face hurdles practicing in the healthcare setting. This quality improvement project aimed to understand the experiences of Black doulas in Nebraska to enhance integration into healthcare systems. Three group-based interviews were conducted as part of a quality improvement project in August 2023 with six Black doulas practicing in Nebraska. Participants were recruited through community organizations and snowball sampling. Semi-structured interviews explored doula practices, barriers, motivations, and sources of support. Transcripts were analyzed using thematic analysis. Three main themes emerged: (1) Barriers inhibiting Black doulas in the healthcare setting, (2) Facilitators of a doula-friendly clinical environment, and (3) Coping strategies. Doulas described facing resistance, stereotypes, and a lack of understanding about their role from some healthcare staff, contrasted with client advocacy. Self-care strategies and peer support networks were critical for sustainable practice. Despite systemic barriers, Black doulas play a vital role in supporting Black families and addressing inequities. Recommendations include implementing doula-friendly policies, addressing bias, fostering an inclusive environment in healthcare facilities, and enhancing the integration of culturally concordant doula support to improve outcomes for Black birthing people.

This framework presents a reflexive tool to navigate epistemic partnerships, interrogating the pervasive influence of Whiteness in knowledge production within Critical Autism Studies, and Autism Studies more broadly. Grounded in countercolonial praxis, the framewok operationalizes positionality and privilege, guiding researchers through 11 interconnected questions that foster humility, amplify marginalized voices, and disrupt epistemic hierarchies. By addressing the researcher’s relationship to power, both as a potential target and as a bearer of privilege, this tool resists the colonial impulse to claim objectivity, instead embracing shared authority and relational accountability. Each question serves as a provocation, prompting continuous reflection on the ethical complexities of knowledge creation while resisting appropriation and extractivist tendencies. More than a methodological intervention, this framework embodies a living praxis—one that demands researchers to embrace discomfort and center those whose narratives have long been silenced in their research endeavors. In offering this tool, the article contributes to the broader project of epistemic justice, carving space for Critical Intersectional Autism Studies that challenge Whiteness as its invisible standard in Autism Studies. Community Brief Why is this topic important? Autism research is largely led by White scholars working in Western universities. Because of this, the experiences of non-White autistic people are often ignored or treated as secondary. This has real-world consequences—when research does not include diverse perspectives, health care, support systems, and policies fail to address the needs of many autistic people. This article highlights why race matters in autism research and provides tools to make research more inclusive and just. What is the purpose of this article? The article introduces a new way to approach autism research through an intersectional framework. This tool helps researchers think critically about who is included, who is left out, and how power shapes knowledge. The goal is to challenge the dominance of Whiteness in autism research and make sure that non-White autistic voices are not just heard, but actively centered. What personal and professional perspectives do the authors bring to the topic? The author is an autistic Latin American scholar who has firsthand experience with the ways in which Whiteness shapes academic research. Initially, they set out to study autistic women’s experiences but realized that their own research was reinforcing Whiteness as the norm. Over 4 years of fieldwork, they collaborated with non-White autistic individuals, learning from their insights and experiences. This led them to create the intersectional framework as a way to hold themselves, and other researchers, accountable. What is already known about this topic? 1. Autism studies have historically focused on White autistic people, often ignoring how race and colonial histories shape autistic experiences. 2. Many researchers talk about “intersectionality,” but they do not actually include race in their analysis. 3. Non-White autistic people face greater barriers to diagnosis, health care, and support services. 4. Academic research often takes knowledge from marginalized communities without truly collaborating with them. What do the authors recommend? The author offers a concrete tool, the intersectional framework, to guide autism researchers through ethical research practices. This framework is not just for autism research; it can be used in any field to promote ethical and accountable knowledge production. How will these recommendations help autistic adults now and in the future? 1. More inclusive research will lead to better health care, support systems, and policies that serve all autistic people. 2. Stronger collaborations between researchers and autistic individuals will lead to research that actually reflects real-world experiences. 3. More ethical research practices will ensure that autistic voices are not just included, but valued as knowledge producers. 4. A shift in power, rather than reinforcing the dominance of Whiteness, this framework challenges it and makes space for diverse perspectives.

Zacatecas is a Mexican state from where there are few studies about biodiversity, venomous ophidians and people's experience of snakebites. In the state, there are 12 species of venomous snakes distributed in three genera: Crotalus, Micruroides and Micrurus, which could represent some risk for the locals. The objective of this study was to make use of Geographic Information Systems (GIS) and programming to determine the relationship between population variables and the number of snakebites registered by the Zacatecas Health Services (SSZ) from 2007 to 2017 at the municipal level. Climatic, social and biological variables were used to gain a better understanding of the situation. It was found that men working in livestock breeding, agriculture, subsistence hunting or mining are more vulnerable, especially if older than 65. The municipalities of Concepción del Oro, Villa de Cos, El Plateado de Joaquín Amaro, Loreto and Ojocaliente exhibit the highest risk, while special monitoring must be conducted in Guadalupe, Fresnillo and Zacatecas due to their high population density, as well as in Valparaíso on account of its rich venomous ophidian fauna. Additionally, it is suggested to carry out preventive actions and detailed data gathering about snakebites to guarantee information quality. This study constitutes the first formal, detailed work about the epidemiological panorama of envenoming caused by the bite of a snake (ophidiotoxicosis) in Zacatecas from which further investigation and modelling may derive.

Rural Americans experience higher rates of perinatal depression (PND) compared to non-rural Americans yet have decreased access to treatment. To address treatment access disparities, we must build capacity for care within non-mental health settings and leverage technology. This study uses a phenomenological approach, exploring treatment experiences of rural perinatal people with PND who participated in a technology-assisted cognitive behavioral-based treatment program. Participants who completed at least one program session were invited to participate in a qualitative interview about their experience. Four core themes emerged: (1) educational value, (2) factors impacting program engagement, (3) accessibility, and (4) suggested improvements. The program offers a treatment option for rural perinatal people and presents a model for increasing access to care in rural areas.

Disasters adversely impact society on social, psychological, mental, and spiritual levels. One of the most urgent needs in the aftermath of a disaster is shelter. This includes tents, which serve as emergency shelters; containers, which function as temporary shelters; and permanent housing provided during the reconstruction phase. The temporary sheltering process presents diverse experiences for individuals affected by disasters. For persons with disabilities, this process requires particular attention in terms of design and implementation, as it directly affects their ability to access basic needs and maintain well-being. The February 6, 2023 Kahramanmaraş earthquakes in Türkiye underscored the critical importance of inclusive sheltering practices, highlighting the need to re-evaluate existing approaches concerning individuals with disabilities. This study focuses on the experiences of persons with disabilities, a particularly vulnerable group, during the temporary sheltering phase. Initially, national and international post-disaster shelter guidelines and documents addressing the needs of individuals with disabilities were reviewed. This review was supported by systematic data collection at both the national and international levels. Subsequently, the temporary sheltering experiences of persons with disabilities following the Kahramanmaraş earthquakes were analyzed. The findings include an evaluation of the temporary shelter units provided in the disaster's aftermath, assessed from the perspective of individuals with disabilities, along with recommendations proposed by the researcher. Among these, it is emphasized that shelter designs should be revised to accommodate various disability types (e.g., visual, physical, cognitive, auditory). Additionally, the accessibility and usability of social activity areas — such as those found in container cities — should be re-examined. The data indicate that disaster preparedness planning must give specific consideration to the needs of individuals with disabilities to ensure inclusive and equitable shelter solutions.

The practice of volunteering has been associated with several benefits for the population as a whole, as well as for specific population groups. In the case of people with disabilities (PwD), there is an unsolved paradox. On the one hand, volunteering is a powerful tool for capabilities development and social integration. On the other hand, few PwD are volunteers. Based on this paradox, the paper has three main objectives. Firstly to analyse the position of organisations that work directly with PwD towards inclusive volunteering. Secondly, to assess the benefits that organisations on the filed ascribe to the practice of volunteering by PwD and thirdly to examine the factors perceived by organisations as obstacles to the practice of volunteering by PwD, and secondly to. Primary data was collected through a questionnaire sent to organisations that work directly with people with disabilities in Portugal as part of their mission. The data was collected between 28 June and 6 October 2024. A total of 104 valid responses were received and analysed. The results show that organisations recognise that volunteering is under-utilised and that there are still several barriers. The main ones are the lack of opportunities for inclusive volunteering, the lack of support staff and the lack of encouragement from family members. Nevertheless, the organisations recognise the high benefits associated with volunteering by people with disabilities, with particular emphasis on access to new experiences for people with disabilities, the fact that it allows people with disabilities to feel more fulfilled and useful, and the potential in terms of exercising citizenship. Other benefits include the ability of volunteering to reduce stigma towards people with disabilities, promote socialisation, develop skills and contribute to building inclusive communities.

Recent years have seen increasing pressure on primary care workforce and appointments, with 'telephone first' introduced in the UK to manage demand and workload. Patients discuss healthcare needs via telephone with a general practitioner (GP) before being invited to make an appointment.Older people are at increased risk of inequality in accessing primary care appointments, with more long-term conditions and increased communication difficulties using telephone. These inequalities were potentially exacerbated during Covid-19. This study aimed to explore experiences of older people, carers and general practice teams in using telephone first to access appointments. Qualitative study in primary care. We conducted 48 interviews with older people/carers, and six focus groups with staff from general practices using telephone first. Practices and older patients had varied approaches to 'telephone first.' As well as adapting to the concept of triage call back, challenges for older people and their practices included changing their understanding of what constituted consultations. Trust between patients and their general practice influenced views and experiences, with acceptance of telephone first being linked to their overall trust in the general practice. We observed differing views on how telephone first worked between patients and general practices reflecting poor communication between the two groups. Systems implemented into practices need to be adequately explained regarding processes, staff roles and expectations of patients, to allow for thorough understanding, and a demystification of the unknown. Future research should examine how telephone first approaches affect older patients' health outcomes.