Nonformal education and informal learning have gradually become the main forms of lifelong learning. In order to recognize the prior learning experience of people through informal education and informal learning and motivate people's lifelong learning, constructing the framework of lifelong education qualifications in the digital age has become one of the major strategies of education development and reform in China. This paper takes Guangdong province as an example to depict and analyze the lifelong education qualifications framework system, collaborative governance mode, Specification of Competency Standards, learning outcome accreditation system, digital credit bank operation system, and recognition of qualifications and credits in the Great Bay Area to establish the three in one lifelong education institution in the digital age which consists of Qualifications Framework, learning outcome accreditation system and Credit Bank System. This lifelong learning overpass model reveals the development trend of talent training and the integration of industry and education and collaborative innovation. From the case of Guangdong, the Lifelong learning overpass construction can be more visible and realistic.

ObjectiveIt is unclear how people with osteoarthritis feel about online Tai Chi. This study aimed to explore the experiences of people with knee osteoarthritis who participated in an online unsupervised Tai Chi program.MethodsA qualitative study nested within a randomized controlled trial was conducted. Semistructured phone interviews were held with 20 participants with knee osteoarthritis who took part in a 12‐week online unsupervised Tai Chi program. Interviews explored participant experiences and were audio recorded, transcribed verbatim, and analyzed thematically using an inductive approach.ResultsFour themes (each with two subthemes) were developed: (1) online unsupervised Tai Chi offers flexibility (the ability to pause, rewind, and repeat facilitates learning; able to practice anytime, anywhere); (2) variable user experience (most found it enjoyable and calming; some found it repetitive and boring); (3) learning challenges and strategies (the lack of feedback can be challenging; practice makes better); and (4) online unsupervised Tai Chi is effective for most but not all (improved outcomes and motivated to be more active; no perceived changes in outcomes).ConclusionMost people with knee osteoarthritis reported positive experiences with a 12‐week online unsupervised Tai Chi program. The identified challenges and relevant improvements have the potential to inform modifications and refine the program before its planned public release, with the aim to enhance Tai Chi exercise accessibility and uptake among people with osteoarthritis in the broader community.

Chimeric antigen receptor (CAR) T‐cell therapy is a highly effective treatment for relapsed or refractory large B‐cell lymphoma (LBCL), but clinical experience in people living with HIV (PLWH) remains limited due to their exclusion from pivotal trials. We report the case of a 55‐year‐old man with HIV and high‐grade B‐cell lymphoma who developed severe anaphylaxis during axicabtagene ciloleucel (axi‐cel) infusion, requiring early termination after approximately 50% of the planned dose was delivered. The patient experienced only Grade 1 cytokine release syndrome and no neurotoxicity. Despite incomplete infusion, he achieved a sustained partial metabolic response on PET/CT imaging at Days +30, +60, and +110 post‐infusion. HIV remained well‐controlled throughout, and no infectious complications were observed. This case highlights both the feasibility of administering CAR T‐cell therapy in virologically suppressed PLWH and the potential for clinical benefit even with partial cell delivery. In addition, it draws attention to anaphylaxis as a rare but serious infusion‐related adverse event. To our knowledge, this is the first report of anaphylaxis to axi‐cel in a PLWH. The case underscores the need for enhanced pharmacovigilance and pre‐infusion risk assessment. It also supports growing evidence that PLWH should not be categorically excluded from CAR T‐cell access or clinical trials.

Young people face persistent challenges in accessing mental health and substance use health (MHSU) services, which have been further complicated by the COVID-19 pandemic, and are particularly pronounced among marginalized populations. We sought to understand how young people navigate MHSU services since the pandemic, focusing on their awareness of and access to care. Our project uses participatory research approaches and is comprised of two phases. This manuscript describes Phase 1, where five young people participated as research partners, informing study design and implementation. We conducted five virtual focus groups with a larger sample of young people from Ontario with MHSU lived experience, prioritizing participants from underrepresented communities. Focus groups explored their service awareness, access experiences, and improvement suggestions. Discussions were audio-recorded, transcribed, and thematically analyzed. Phase 2 will involve co-designing resources for young people based on Phase 1 findings. Our analysis of forty participants identified six interconnected domain themes (relationships and guidance, preferences and choice, convenience, self-directed information seeking, established sources, and system constraints), and fifteen sub-themes, spanning three dimensions of MHSU services (awareness, access, and improvements). We found that young people relied on informal networks (family/friends) and healthcare providers for MHSU service information and access, with trust being essential. They desired both choice in their provider and delivery method, plus the ability to research options independently before making decisions with others. While they primarily got service information from healthcare providers, online platforms, and community organizations, finding comprehensive, reliable information remained challenging. Barriers such as costs, wait times, location, and discrimination highlighted the need for affordable, accessible, and culturally responsive care to meet their diverse needs. This study revealed key insights about post-pandemic MHSU service awareness and access for young people. Participants demonstrated desires for both autonomy in service selection and guidance from trusted sources, suggesting a supported decision-making model. Recommended service improvements include centralized information resources, stronger informal referral networks, culturally responsive services and flexible delivery options. Partnership with young people throughout the research process yielded valuable perspectives that enhanced study validity. These findings will inform Phase 2-the co-design of resources addressing the information gaps and structural barriers identified by participants.

This paper explores how disability is represented in Chinese cinema today through a case study of the film Big World, which tells the story of Liu Chunhe, a young man living with cerebral palsy. The representation of disabled people in Chinese films has in the past tended to adopt a binary model of pity or inspiration but Big World shows a marked change in this trend in its treatment of the subjectivity, agency and inner world of the protagonist. It also demonstrates the other issues associated with disability in its filmic narratives, such as family dynamics, social stigma and welfare systems. That said it is shown that the representation remains limited by being perceived from non-disabled perspectives, as in support characters such as Ya Ya, whose motivation is lacking in depth. While this enhances visibility and invokes empathy, the risk with this method of representation is that it continues to alienate. Individual disability is represented in its inspirational or tragic form. Meaningful progress in the representation of disability may only come as the result of including the disabled voice in the creative process at every level, including scripting and performance. It is only through the medium of collaborative story telling that Chinese filmmakers may move beyond symbolic representation into authentic and equitable representation that truly reflects the diverse experiences of disabled people.

Iran is vulnerable to natural disasters, especially earthquakes. Frequent earthquakes in the Khoy city and followed by the devastating Van earthquake in Turkey, caused panic among the people and forced them to settle in camps. So, this study aims to explore lived experiences of people affected by the Khoy earthquake from living in temporary camps. In this qualitative study, semi-structured interviews were conducted using conventional content analysis method and purposive sampling in health centers, with 24 people affected by the earthquake in Khoy city. After obtaining written informed consent, interviews were recorded and continued until data saturation was reached. Data were analyzed using MAXQDA version 12 software. From the analysis of qualitative data, two themes were extracted: "Disruption of the normal life routine" and "life reconsideration." The three subcategories of the first them included "difficult life events," "disruption of social life routine," and "crisis mismanagement," and the three themes of life reconsideration included "struggling to adapt to harsh conditions," "changes in perceived life priorities," and "enhancing spiritual well-being." Living in temporary camps disrupted survivors' daily lives and intensified feelings of injustice and distrust due to poor crisis management. Yet, many reevaluated their life priorities and found strength in spiritual beliefs. These findings underscore the need for policymakers to implement timely, equitable, and participatory programs that support both material and psychosocial recovery. Individuals who had experienced the earthquake participated in the interviews. Their lived experiences were analyzed, and the findings of the study were subsequently reviewed and validated by the participants themselves to ensure accuracy and resonance with their perspectives.

ABSTRACT Positive behaviour support is an evidence‐based framework for people displaying behaviours that challenge, which is widely used within the United Kingdom. Few studies have investigated the experiences of people with intellectual disability, their family members, and paid staff members who receive positive behaviour support‐based interventions from intensive support teams. Individual, semi‐structured interviews were conducted with 10 adults with intellectual disability, 10 family members and 10 paid staff members who received an intervention based on a Positive Behaviour Support framework from an intensive support team in England. Participants were aged 18–74 years. Semi‐structured interviews took place within 4 months of discharge from the service. They were recorded and transcribed. Data was analysed using an Inductive/Deductive Hybrid approach. Initially inductive data analysis was conducted using Thematic Analysis. Subsequent deductive analysis mapped themes onto an existing framework of Positive Behaviour Support. Four overarching themes were created from the data, ‘Developing a therapeutic working relationship’, ‘Access to resources’, ‘Building knowledge, skills and confidence in the present’, and ‘Instilling hope and resilience for the future’. Results were compared with the Positive Behaviour Support framework and areas of convergence and discrepancy were identified. Gathering multi‐perspectival data was a strength of this study. Results from interviews largely mapped onto key components of a Positive Behaviour Support framework. Some additional relational factors were identified around developing therapeutic relationships across the system and the importance of instilling hope for change and the future. These factors may have implications for theoretical mechanisms of change and be helpful for clinicians to consider in their practise.

The transition from childhood to adulthood is a phase during which a young person needs support and guidance from their immediate surroundings. The need for help and support becomes even more significant if the adolescent has faced traumatic experiences or psychological challenges in childhood. This article examines the role of aftercare in supporting the transition to independence and adulthood for those young people who have been placed under child protection and have required psychiatric support. The article is based on qualitative narrative interview data collected in 2021-2022. We examine the role of aftercare in supporting young people as they begin their independent lives after placement in foster care, and identify key factors from the perspective of young people's experiences that contribute to effective aftercare. The study's findings highlight factors related to the skills and competencies of the workers, the structures of service implementation, and the forms of support offered, all of which affect the effectiveness of aftercare from the young people's perspective. The most crucial factors for effective aftercare identified in the study include the stability of workers, the atmosphere of interactions, the professional competence of the workers, and the possibility of receiving concrete help and support.

BackgroundVoice-hearing is increasingly being recognised as a transdiagnostic experience which is common for children and adolescents. However, little is known about how young people seek help and disclose voice-hearing within mental health services.MethodThis qualitative study explored the disclosure and help-seeking experiences of nine young people (aged 14-18) receiving care from mental health services in the UK. Semi-structured interviews were conducted and analysed using thematic analysis within a critical realist framework.ResultsTwo superordinate themes were identified: barriers to accessing help; facilitators to accessing help; and the impact of practitioner response on young people's engagement. Stigma, long waiting lists for services, and practitioners' lack of knowledge often acted as barriers to disclosure and help-seeking, whereas trust and clear communication facilitated disclosure and engagement. Participants often wished to be listened to, to be offered a more personalised approach and greater flexibility from mental health services. When practitioners demonstrated empathy and allowed trust to build in the therapeutic relationship, participants felt valued.ConclusionsFindings suggest that practitioners might need to be supported to build confidence in discussing voice-hearing with young people to facilitate therapeutic conversations about these experiences, and that offering flexible, person-centred support may support young people's engagement with mental health services.

BackgroundSpinal cord injury (SCI) is a life-altering condition, often leading to long-term disability, significantly impacting individuals worldwide. However, there is a dearth of research on the life experiences of people affected by SCI, particularly in lower-middle-income countries. Thus, this study aimed to explore the psychosocial impact of people living with SCI in Bangladesh.MethodsThis study employed a qualitative approach which included conducting 22 In-depth Interviews (IDIs) with persons with SCI in Bangladesh. Data were collected from October 2023 to December 2023 within the Spinal Cord Injuries’ Development Association Bangladesh (SCIDAB), a rehabilitation center for SCI patients. Thematic analysis was utilized for this study.ResultsUtilizing the bio-psychosocial framework, findings highlighted the biological, psychological, and social factors underlying the psychological barriers experienced by participants. Sub-themes identified included biological factors: paralysis and loss of sensation, challenges in bowel and bladder management, psychological factors: a sudden change in life, and loss of independence and autonomy; insecurity about the future, suicidal thoughts, stigmatized by society, and social isolation; and social factors: lack of support system, lack of specialized working environment, and transportation obstacles.ConclusionIndividuals living with SCI reported experiencing both significant physical and psychosocial impacts. In addition to providing effective mental health services, there is a critical need for comprehensive rehabilitation for people affected by SCI and social awareness within the community is essential to reduce stigma and foster inclusion.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-25312-5.

ABSTRACT This study aims to examine the life experiences of people who simultaneously possess disability and queer identity in Korea and to provide related policy recommendations. To confirm this, we sampled individuals who self‐identify as queer and have been diagnosed with disabilities. A total of nine research participants were interviewed in the summer of 2024, and based on the in‐depth interview content, thematic analysis was conducted utilizing a generic qualitative research method. The analysis results showed that regardless of which identity, the identification process was a confusing process, and the hateful social atmosphere operated as a powerful pressure, which made them constantly doubt themselves. To respond to this, research participants either resisted by revealing their existence or created safe spaces through solidarity with others. The results of this study argue for the necessity of a comprehensive anti‐discrimination law that can embrace everyone as a fundamental countermeasure for the protection of minorities and the eradication of the reproduction of hate, and present the need for extensive improvement of Korean social policies based on this.

Illicit anabolic-androgenic steroid (AAS) use poses physical and psychosocial risks. These issues are exacerbated by inadequate public health responses and well-meaning yet inadequately trained health workers. This study presents the development of a collaboratively designed health conversation tool, which equips health workers' with a number of questions and strategic information to promote well-informed use for people who use AAS. This qualitative, multi-stage study co-produced a health conversation, a guided conversation tool that aims to incorporate a brief assessment, knowledge provision, sharing of harm reduction strategies and advice for health workers engaging with people who use AAS in community settings. The iterative co-design process followed a five-stage pedagogical approach (ideation, planning, creation, programming and sharing), guided by semi-structured interviews with 25 people who use AAS and a workshop focus group of 6 experienced AAS peers for further refinement. Guided discussion included exploration or harms, health enhancement and required resources. Qualitative responses were synthesised via inductive analysis to identify key themes, from which the conversation was developed and then tested with the AAS peer group. There were two core findings from this research. Firstly, insights gained from people who use AAS in the key current practices related to safer use of these drugs. Secondly, based on these insights, a health conversation tool was co-produced, which encompasses a brief assessment, gauging people's experiences with AAS, confidence in their knowledge, and support systems. The tool provides health workers with a suite of harm reduction strategies to offer to people who use AAS, such as proper injection techniques, considerations regarding their usage strategy, and suggestions for health monitoring. The collaborative design process ensured the health conversation tool reflected the lived-living experiences and priorities of people who use AAS, specifically fostering trust and engagement. This peer-driven approach filled gaps in harm reduction services, promoting informed decisions regarding AAS use as well as some health strategies. Expanding the peer workforce and integrating digital platforms can enhance the reach and sustainability of tailored harm reduction interventions for AAS and other communities.

ABSTRACT Having a Type 2 Diabetes risk (i.e. prediabetes) is a call to action for health behaviour change. Physical activity can reduce one’s diabetes risk, but difficult emotions, stigma, and lack of support can prevent people with prediabetes from getting active. Self-compassion is a psychological resource that may help people cope with prediabetes and increase their physical activity. The MOVE IT program is an 8-week videoconferencing intervention that teaches people with prediabetes self-compassion and physical activity behaviour change strategies. This qualitative study aimed to explore how participants in the MOVE IT program used self-compassion to cope with their prediabetes and increase their physical activity. Participant discussions from fourteen group-based MOVE IT sessions were transcribed verbatim, representing N = 14 participants (Mage = 54 years, SDage = 7 years; 100% women). Participatory Theme Elicitation (a participatory qualitative analysis) was conducted in collaboration with five ‘Person With Lived Experience’ co-researchers who had previously completed the MOVE IT self-compassion program. Four themes were generated showing how participants mindfully reflected on their current behaviours and identified opportunities for growth (Theme 1), used self-kindness to cope with physical activity setbacks (Theme 2), took self-compassionate action to work through challenges (Theme 3), and eventually embraced self-compassion (Theme 4). By qualitatively examining participants’ experiences, this study advances the understanding of how self-compassion can be operationalised in real-world behaviour change interventions, providing insight into both the emotional and action-oriented pathways through which self-compassion supports health behaviour change among individuals with prediabetes.

ABSTRACT The narratives of people who arrived in Britain from the Caribbean islands—referred to as the ‘Windrush generation’—has tended to make invisible, if not overlooked the lived experiences of ‘Black Africans’ from the African continent between the period 1948–1973. The ‘single story’ of the ‘Windrush era’ dominates and homogenises the experiences of all Black and Brown people living in Britain. Even though Black Africans are now the largest ‘Black’ demographic group in Britain, the various ‘Windrush’ commemorations have overshadowed their presence and contributions to British society. Through oral narratives, autobiography, novels, memoirs and film, this article illustrates that while there were distinct differences in the experiences of post-war African and Caribbean people in Britain, such as reasons that brought the two groups to Britain; affiliation to African ‘identities’; there were also shared experiences of disappointed imaginings of Britain, cultural shock and institutional racism. Black British history cannot be built on people perceived as ‘Black’ living in post-war Britain as possessing a single narrative, but on myriad narratives reflecting the multiplicity of their identities, communities and experiences.

Adolescent substance use is a rising public health concern in Ghana, with limited evidence on youth perspectives regarding service availability and access. This study explores the adolescents' perspectives on the barriers to accessing substance use services in Northern Ghana. A qualitative exploratory design was employed. This study was conducted in public senior high school in the Bolgatanga Municipality of the Upper East Region of Ghana. Fifteen students aged 12 to 19 years were purposively selected with diversity in age, sex, religion, and residency status. Data were collected through in-depth interviews and analyzed thematically using Braun and Clarke's framework. Trustworthiness was ensured through member checking, peer debriefing, and audit trails. The study identified several barriers grouped under four themes as follows: stigma, fear and confidentiality concerns, accessibility and affordability challenges, service relevance and adolescent-focused, and peer factors. This study found that adolescents in Northern Ghana face significant barriers to substance abuse service use, shaped by four key themes: stigma and confidentiality concerns, accessibility and affordability challenges, lack of adolescent-friendly services, and peer influence. These barriers, rooted in systemic, structural, and sociocultural contexts, foster mistrust, limit access, and discourage help-seeking. Addressing them requires adolescent-responsive interventions that prioritize confidentiality, affordability, accessibility, and supportive care aligned with young people's lived experiences.

Abstract Applied behavior analysis is a quantitative field. We calculate frequency of responses per minute, percentage of incorrect and correct responses, percentage of agreement across raters on a regular basis. The safety in numbers can be comfortable—they are clear and objective. However, numbers do not provide the whole picture of a person’s experience. Qualitative approaches provide valuable insights into the lived experience of people. Yet, undertaking qualitative approaches can be scary for those of us in a quantitative field. The subjective data and findings can be extremely challenging to navigate. There is also the matter of feeling like an imposter or a fraud. In this personal narrative inquiry, I tell my story of embracing qualitative approaches as a behavior analyst, the challenges and the surprising discoveries of the depths this data could help us reach. The relevance of qualitative approaches lies in understanding how various qualitative methods and approaches can enhance our understanding of lived experience. Some points about qualitative research are drawn out for context, and my personal experience is explored to show the journey, joys, and challenges of discovering and embracing qualitative research as a behavior analyst.

Weight discrimination and up-to-date breast and cervical cancer screening in US women.

ABSTRACT Research studies have repeatedly reported the under-representation of rural youth in higher education, mainly focusing on their aspirations as well as opportunities and barriers to accessing university pathways. Less attention has been placed on the experiences of rural young people transitioning through higher education. In this article, we explore working-class rural youth experiences of belonging, recognition and social disrespect in a metropolitan university. Empirically, we draw on data from semi-structured interviews with rural young people attending university and living on campus. Conceptually, we draw on Axel Honneth's third form of recognition, esteem and solidarity, to examine how youth from rural and working-class backgrounds form a sense of belonging and struggle for recognition with other students and the institution. Our data shows that participants experienced social misrecognition and disrespect due to their social class and rural background. Participants negotiate feelings of exclusion and misrecognition by forming friendships and intra-solidarity with other like-minded rural and regional students. While this can be a first step to the construction of a form of belonging, we argue that the disrespect, misrecognition and external judgements of worth from others hindered rural youth's sense of belonging and recognition at university and their potential for self-realization.

Delays remain in patients receiving effective treatment strategies that have potential to clear their skin of psoriasis, improve their quality of life (QoL) and change the psoriatic disease course, which, if uncontrolled, can irreversibly alter an individual's life course (i.e. cumulative life course impairment [CLCI]). This study explored current international awareness and consideration of the potential impact of psoriasis over the life course within clinical assessments and decisions about its management. Cross-sectional surveys collated insights from people with psoriasis and healthcare professionals (HCPs) treating psoriasis (dermatologists and primary care physicians [PCPs]) across 29 countries. Data were collected from 487 people with psoriasis, 574 dermatologists and 618 PCPs. Despite people with psoriasis highlighting a range of daily activities that are 'very frequently' or 'always' affected by their psoriasis, 37% were never or rarely asked by their HCPs how the disease affects their life. Fewer than half of people with psoriasis had a high understanding of the potential future impact of psoriasis (or CLCI-contributing factors), and 44% were unaware that clear/almost clear skin is now a realistic treatment target. Almost half of HCPs considered psoriasis to be of early onset when it presented at ≤ 15years of age. Despite HCP awareness of the impact of psoriasis on QoL, many of the contributing factors to CLCI were not addressed routinely in clinical practice nor considered when deciding on treatment; 40% of dermatologists set treatment goals (such as clear skin/almost clear skin/target Dermatology Life Quality Index [DLQI]) sometimes, less frequently, or not at all. Misalignment exists in the experience of people living with psoriasis versus its assessment in clinical practice. Support is needed for assessment and monitoring of elements that may contribute to CLCI in clinical practice worldwide, to guide early psoriasis treatment decision-making to mitigate the risk for CLCI. Infographic available for this article. INFOGRAPHIC.

Globally, perinatal healthcare access, quality, and outcomes significantly vary between Indigenous and non-Indigenous childbearing people. This situation is precipitated by systemic barriers emanating from the longstanding effects of colonialization. Despite ongoing awareness of culturally safe perinatal care, Indigenous childbearing people continue to have challenging experiences. The purpose of this scoping review was to explore the perinatal healthcare experiences of Indigenous childbearing people to identify research gaps and inform future nursing/midwifery interventions to improve the challenges of engaging in perinatal healthcare in this population. The scoping review framework of Arksey and O'Malley was used in this study by searching, retrieving, and analyzing research papers from CINAHL, Ovid/Medline, PsycINFO, PubMed, and Web of Science. Thirteen peer-reviewed articles published between 2002 and 2021 were analyzed. The experiences of Indigenous childbearing people who sought care during the perinatal period had their experiences classified into positive, negative, complex, and mediating. This scoping review reiterated the need for culturally safe healthcare, preferably delivered by Indigenous healthcare professionals in healthcare facilities situated in Indigenous communities. It is crucial to further explore the perinatal healthcare experiences of Indigenous childbearing people through in-depth qualitative research to develop culturally safe interventions, especially when life-limiting illnesses or life-threatening illnesses (LLIs/LTIs) occur. Overall, completion of this scoping review revealed the need for a comprehensive healthcare system transformation that addresses the needs of childbearing Indigenous families.