Disclosure Process Research Articles

Exploring the sexual and reproductive health knowledge, practices and needs of adolescents living with perinatally acquired HIV in Côte d’Ivoire: a qualitative study

IntroductionAdolescents face unique challenges in accessing appropriate information and services regarding sexuality and reproductive health (SRH). This poor access can lead to sexual behaviours that could put them at risk of unintended pregnancies and sexually transmitted infections. Adolescents living with HIV (ALHIV) have specific SRH needs that remain unmet. We explored the SRH knowledge, practices and needs of ALHIV in Abidjan, Côte d’Ivoire.MethodsBetween April and September 2023, a qualitative study using semi-structured individual interviews was conducted with nine male and nine female ALHIV without previous pregnancies, and eight ALHIV who became pregnant. All consented and were ALHIV acquired perinatally, aged 15–19 years, informed of their HIV status, and followed in three paediatric HIV care centres in Abidjan. participating in the paediatric IeDEA West African Cohort and enrolled in the ANRS12390 OPTIMISE-AO project aimed at improving HIV disclosure process and adherence to antiretroviral treatment. A focus group discussion was conducted with five peer-educators, aged 23–31 years, participating in the OPTIMISE-AO project to gather their perspectives on adolescent SRH. Interviews were conducted in French, and a thematic analysis was performed.ResultsAll participants expressed difficulty in talking about SRH with their parents or health professionals and turned to their friends for advice. All feared transmitting HIV. One-third of female participants reported having experienced non-consensual sex and sexual violence. Participants reported low levels of condom use, despite having good knowledge of its purpose. Reasons for not using condoms included difficulties in negotiating for girls, as well as having an undetectable viral load, which was seen by adolescents as a condition for waiving condom use. As hormonal contraceptives were subject to many negative beliefs justifying their non-use, alternative methods, such as emergency contraceptive pills or traditional plants, were used to prevent pregnancy.ConclusionALHIV reported unmet SRH needs, particularly in terms of accessing reliable information and appropriate support. Integrating SRH care into paediatric HIV care, organising SRH discussion groups led by peer-educators, and improving access to a range of contraceptives may address these needs to enhance SRH outcomes for ALHIV.

"…but I know something's not right here": Exploring the diagnosis and disclosure experiences of persons living with ALS.

Amyotrophic Lateral Sclerosis (ALS), an incurable motor neuron disease, primarily affects those between the ages of 60-79, and has an approximate post-diagnosis life-expectancy of only two to five years. The condition has an unpredictable but ultimately terminal trajectory that poses challenges for patients, caregivers and healthcare providers. While the diagnosis and disclosure are critical periods for intervention and support, knowledge regarding the relational, communicational and psychodynamic forces that occur within the process of diagnostic disclosure is relatively limited. The purpose of this study was to explore the experiences of persons living with ALS in the diagnosis and disclosure of the condition, with the support of their caregivers. We conducted a focus group and in-depth individual interviews with people living with ALS (n = 9), and caregivers (n = 9). The interviews were transcribed, cleaned, and anonymized, and then entered into NVivo 11 for thematic analysis. Participants discussed the diagnostic process, including inklings and subtle changes prior to diagnosis, attempts at self-diagnosis, and the lengthy assessment process. Time was also a consideration in the diagnostic disclosure process, in which participants shared how the disclosure was the product of longstanding conversations with their care providers. It was described as rarely a shock to finally have confirmation. Participants shared their information seeking strategies and needs for a diagnosis that, for them, typically came with insufficient information on the disease, prognosis, and next steps. This project serves as a step in bridging the relevant gaps in our knowledge and understanding towards improved person-centered care practices in the diagnosis and disclosure of ALS.

Fear, stigma, hope, and desahogó: understanding the role of deportation history and familial ties on the disclosure process of immigration-related experiences

ABSTRACT Based on 75 interviews with members of undocumented and mixed-status families where someone has returned to the United States post-deportation, we examine how individuals within these households manage multiple stigmatized identities stemming from their loved one's lack of legal status and deportation record. We find that a family member's deportation history is an important marker of identity, which subsequently limits the amount of immigration-related information they share with others. The choice to conceal stems from the fear of retaliation, the stigma associated with being deported, and the hope of reuniting in the United States if deported/separated once again. Yet, disclosure often results in desahogó, a term commonly used within Latinx communities to describe a type of emotional relief that comes with being able to share previously concealed information. Examining the complexities surrounding family members’ disclosure decisions widen our understandings of the spillover effects of recent waves of mass deportation. It also offers insights into structuring research methods, institutional processes, and policy changes in ways that allow individuals to advocate for their family members in legal and social institutions.

Postpartum Depression and the Disclosure Process

Postpartum Depression and the Disclosure Process

The Roles of Understanding and Belief in Prognostic Awareness.

Conventional understanding and research regarding prognostic understanding too often focuses on transmission of information. However, merely overcoming barriers to patient understanding may not be sufficient. In this article the authors provide a more nuanced understanding of prognostic awareness, using oncological care as an overarching example, and discuss factors that may lead to prognostic discordance between physicians and patients. We summarize the current literature and research and present a model developed by the authors to characterize barriers to prognostic awareness. Ultimately, multiple influences on prognostic understanding may impede acceptance by patients even when adequate transfer of information takes place. Physicians should improve how they transmit prognostic information, as this information may be processed in different ways. A model of misunderstandings in awareness, ranging from patient understanding to patient belief, may be useful to guide future discussions. Future decision-making studies should consider these many variables so that interventions may be created to address all aspects of the prognostic disclosure process.

Sex Trafficking Prevention for Youth with Intellectual and Developmental Disabilities: Service Provider Perspectives

ABSTRACT Given the paucity of research on sex-trafficking prevention education for youth with intellectual and developmental disabilities (IDD), this qualitative study aimed to determine service providers’ (N = 22) perspectives regarding (a) topics and delivery methods to include in this programming, (b) factors that promote accessibility, and (c) challenges and recommendations associated with implementation. Individual interviews and focus groups were conducted using Zoom. For programming acceptability, participants identified challenges (e.g. misconception that individuals with IDD are asexual) and recommendations (e.g. teaching developmentally appropriate concepts in early childhood). For content and delivery, topics included consent, safety, and context/social rules. Tactical activities for self-care and sensory processing, and non-infantilizing, realistic visuals were recommended to improve accessibility. For systems involvement in disclosures and referrals, participants noted challenges (i.e. confusion about agency responsibility and information sharing) and recommendations (i.e. ensuring a clear and predictable disclosure process for youth). Findings can contribute to policy development, particularly in service provider training for responding to disclosures and clarifying funding allocation for school and community sex trafficking prevention.

Open Disclosure Among General Practitioners as Second Victim of a Patient Safety Incident: A Cross-Sectional Study in Flanders (Belgium).

The impact of a patient safety incident (PSI) on nurses and doctors in hospital settings has been studied in depth. However, the impact of a PSI on general practitioners and how those health care professionals can be supported are less clear. The objective of this study is to investigate the prevalence of GPs (in training) being personally involved in a PSI, as well as the impact, the support needed, and open disclosure in the aftermath of these PSIs. A cross-sectional study, conducted between January 3, 2022, and March 5, 2022, led to a sample of 78 GPs or GPs in training in Flanders (Belgium). Participants filled in more than 80% of a questionnaire that measured the involvement in a PSI during the prior year and their entire career, and the impact in terms of emotional symptoms, attitudes, the support needed, and open disclosure were included. In total, 78 responses of GPs (in training) filled in the questionnaire, of which 87.2% were involved in a PSI over the course of their entire career and 55.1% during the prior year. Often, such a PSI resulted in permanent patient harm or patient death. The PSI that stuck with the GPs the most had many negative consequences for the GP in question, such as hypervigilance (88.2%) and feelings of guilt (82.4%), stress (79.4%), and shame (75.0%). More than half of the respondents involved want substantive clarity (64.4%), and in case of 51.7% of the respondents, an open discussion with the patient and/or family took place afterwards. This study shows that GPs, even in training, can be negatively impacted after a PSI. Only half of the respondents were involved in an open disclosure process, but the ones involved had a positive feeling after disclosure. More support is needed for health care professionals in the aftermath of a PSI in primary care, and this support could enhance their involvement in the open disclosure process.

Discourses of (Dis)trust and Hegemonic Masculinity: Service Providers’ Perspectives on the Disclosure Process of Men Who Have Experienced Sexual Violence in Childhood

ABSTRACT In this article, we explore the discourses of service providers that influence the disclosure process for men who have experienced childhood sexual violence (CHSV). Previous research has shown that it is typical for men to take over a decade to disclose their experiences of CHSV. Disclosing to a service provider can lead to receiving necessary help, yet men who have experienced CHSV often face gendered challenges within the Finnish healthcare system. Several support organizations for sexual violence were contacted using a non-probability sampling technique to recruit participants. The data for this qualitative study were collected through semi-structured interviews with eight service providers who work with male clients. The data were analyzed using critical discourse analysis. Our findings reveal that men typically do not seek help specifically for CHSV; rather, the issue often emerges while discussing other problems. We identified two distinct discourses that affect help-seeking and disclosure of CHSV by male survivors: a) the discourse of (dis)trust, which is closely connected to whether men discuss their traumatic experiences, and b) the discourse of hegemonic masculinities, in which normative masculinities inhibit men from disclosing. We recommend increasing general awareness of CHSV through various campaigns and incorporating sexual violence education into the curricula for healthcare students.

The value-relevance of gains on bargain purchase: do actions speak louder than words?

PurposeThis paper investigates whether disclosure quality and a history of overpaying for acquisitions are associated with differences in the value-relevance of gains on bargain purchase with high disclosure prominence.Design/methodology/approachFindings are from multivariate regression results, using a sample of firms listed in South Africa from 2010 to 2019, where a mandatory earnings reconciliation provides high disclosure prominence for gains on bargain purchase.FindingsGiven high disclosure prominence, disclosure quality is not associated with differences in the pricing of gains on bargain purchase. Instead, most gains on bargain purchase are priced as future losses (unrecognised liabilities). However, when a firm has a history of overpaying for acquisitions, gains on bargain purchase are priced as transitory economic gains.Research limitations/implicationsFurther research is required to determine if overpaying for acquisitions similarly communicates the credibility of gains on bargain purchase when disclosure prominence is low.Practical implicationsDisclosure prominence can reduce disclosure processing costs and increase the value-relevance of complex acquisition accounting. High disclosure quality cannot compensate for a weak acquisition track record.Originality/valueFindings deepen our understanding of the pricing of gains on bargain purchase. This paper presents empirical results that reconcile previously conflicting theoretical views of gains on bargain purchase (as unrecognised assets or as unrecognised liabilities), by shedding light on the role that a record of overpaying for acquisitions plays in the value-relevance of gains on bargain purchase.

Shifting Under Pressure: Timing Practices within Regulatory Information Disclosure Programs

Research examines the process through which regulatory agencies and other powerful third parties publicly disseminate information about organizations in order to reduce the information asymmetry between those organizations and their dispersed or less powerful stakeholders. These disclosure programs are presumed to work by mobilizing stakeholders to pressure organizations for change. Prior studies focus on organizations’ resistance to that external pressure, often drawing from theories of institutional forces and organizational legitimacy. Instead, the present study examines the public disclosure process itself, and adapts research on organizational learning and collective attention focus to develop new theory regarding how organizations may selectively time their practices to influence these disclosures in their favor. Results suggest that organizations may respond to disclosure programs and other governance structures when actively monitored, but may drift out of compliance during intervening periods. Findings also suggest that strong governance outside of the regulatory disclosure process can help to reduce these problems. The study contributes to corporate governance, organizational learning, and other literatures by developing new theory regarding the timing of organizational responses to regulatory interventions, and by providing evidence that overlapping forms of oversight may mitigate the limitations within any one particular governance mechanism.

Conflicts of Interest in Bronchoscopy Research - Is Self-Reporting Sufficient?

Robotic assisted bronchoscopy has been enthusiastically adopted in the U.S. and transformed the management of patients with indeterminate pulmonary nodules. Unprecedented industry investments in research, development, and marketing have profoundly affected the bronchoscopy landscape, leading to concerns that conflicts of interest could influence the validity of bronchoscopy studies. Disclosures of conflicts of interest in research are predicated on open and transparent self-reporting. Are self-reported relevant conflicts of interest in articles pertaining to robotic assisted bronchoscopy accurate when compared to publicly available payments on the Centers of Medicare & Medicaid Services' Open Payments Database? All articles pertaining to robotic assisted bronchoscopy indexed on PubMed between 2016 and 2022 were screened for relevance. Articles appearing in the five journals with the most relevant publications were selected. General, research, and associated research payments reported in the Open Payments Database were recorded for each US physician-author with available data. "Relevant payments" refer to transactions made to authors by bronchoscopy-related companies. Documentation of all payments involving these companies during the three years prior to an article's submission date was obtained. These payments were compared to the self-reported conflicts of interest for each author, per article, and the number and value of payments were categorized and totaled. Twenty-seven articles were included, accounting for 75 U.S. physicians with data reported in the Open Payments Database. Of the $17 million in relevant payments reported, $9.9 million were not disclosed (57%). Sixty-eight of 75 (91%) of authors had incomplete physician disclosures. Excluding food and beverage payments, sixty authors had incomplete disclosures (80%). Relevant conflicts of interest appear to be inconsistently disclosed in publications on robotic assisted bronchoscopy, suggesting self-reporting may be an insufficient strategy. A centralized disclosure process that is automated or easier to use should be considered.

Whether and What to Tell: A Qualitative Study of HIV Disclosure Among Heterosexually Married Men Who Have Sex with Men in China

In China, HIV transmission increasingly affected men who have sex with men (MSM) and those in heterosexual marriages. This study addressed a critical gap in understanding HIV and sexual orientation disclosure within conventional heterosexual marriages, framed within a family-oriented cultural context. Heterosexually married MSM living with HIV (HIV+ MMSM) faced complex identity dynamics and interactions between “gay circles” and marital life. Such disclosure was fraught with potential repercussions, including accusations of “marriage fraud”, HIV-related stigma, and divorce. This descriptive qualitative study, conducted in 2022, aimed to explore the common factors influencing HIV status disclosure to wives among Chinese HIV+ MMSM. Sixteen semi-structured interviews were conducted to analyze the factors related to the disclosure process model. Four key themes emerged: (a) concern for wives’ well-being, (b) perceived marriage strength, (c) the degree of social support they had, and (d) a desire to maintain their status in a heterosexual society. The decision to (non)disclose was shaped by both approach-focused and avoidant-focused goals related to these four themes. The findings underscored the need for culturally sensitive strategies that balance family dynamics, stigma reduction, and HIV care management, emphasizing tailored approaches to effectively support this population.

Evolution of corporate carbon information disclosure considering the reward and punishment mechanism and new media environment

This study examines the internal logic and dynamic evolution of corporate carbon information disclosure decision making. Drawing on the game-theoretical relationship among enterprises, third-party carbon verification agencies, and local governments, we analyze the intrinsic mechanisms by which rewards, punishment, and media supervision influence corporate carbon information disclosure behavior. We further examine each participant's strategy selection process in the corporate carbon information disclosure decision making under different conditions and consider the impact of key factors on the process. The findings show that the best evolutionary stabilization strategy consists of true disclosure, compliance, and negative support. A stronger reward and punishment mechanism of carbon information disclosure helps achieve greater self-regulation and reduce false disclosure. Enterprises are increasingly choosing true disclosure as the probability of media exposure increases. Decision makers involved in the carbon information disclosure process are influenced by image loss, disclosure costs, and government regulatory costs.

Nurses and policymakers role in preparing adolescents with HIV for self-disclosure in Eswatini.

Nurses in Eswatini are best positioned to assist adolescents living with HIV to disclose their status to others. Nonetheless, it is evident that many nurses are not actively involved in the disclosure process. The aim of this study was to explore the process of nurses in preparing adolescents for self-disclosure and describe the role of policymakers in enabling adolescents to disclose their HIV status to others. The study was conducted in four facilities, one from each of the four regions of the country, after getting ethical clearance from a Public University Higher Degrees Ethics Committee and the Eswatini Health and Human Research Review Board. In-depth interviews were conducted on 28 participants: 24 nurses and 4 policymakers. The three steps of open, axial and selective coding were used to analyse data until theoretical saturation was achieved. Adolescents were assisted to disclose by providing them with HIV information to empower them, encouraged to enrol in teen club because it created a conducive environment for peer-to-peer support, and they were given ongoing psychosocial support to prepare them for self-disclosure. Adolescent HIV management workshops were not routinely done because such training relied on funders. Nurses are not preparing adolescents satisfactorily to disclose. Prioritising the training of nurses would lead to a remarkable increase in the rate of HIV self-disclosure by Swati adolescents.Contribution:This study is the first of its kind in Eswatini, and the results will contribute to the review of HIV management guidelines and promote adolescent self-disclosure.

Environmental Management Strategies for Cost-Effective Waste Management in Hospitals

General background: Waste management in hospitals is crucial due to its environmental impact. Specific background: RSU Al Islam HM Mawardi Krian struggles with waste management while adhering to PSAP No. 1 of 2010 and maintaining efficiency. Knowledge gap: Limited research exists on applying environmental management accounting and operational strategies for hospital waste management in line with accounting standards. Aims: This study analyzes the impact of environmental management accounting and strategies on waste management costs at RSU Al Islam HM Mawardi Krian, assessing compliance with PSAP standards. Results: The hospital has implemented processes of identification, recognition, measurement, recording, presentation, and disclosure per PSAP No. 1 of 2010, managing waste effectively and incurring environmental costs. Novelty: Offers insights into aligning hospital environmental cost management with government standards. Implications: Structured environmental accounting and strategies can enhance waste management, improve hospital reputation, ensure regulatory compliance, and potentially increase revenue. Highlights: RSU Al Islam HM Mawardi complies with PSAP No. 1 of 2010 in managing waste costs. Proper environmental accounting improves transparency and operational efficiency. Structured strategies can boost hospital reputation and revenue. Keywords: Environmental Management Accounting, Operational Strategies, Waste Management Costs, Hospital Compliance

Disclosure dilemma: Revealing biological paternity to family and others after unexpected direct‐to‐consumer genetic results

AbstractObjectiveThis study explores the experiences of direct‐to‐consumer (DTC) genetic test results of recipients who learn of unexpected biological paternity, not parent expected (NPE). We characterize the process of disclosing NPE discoveries, as well as the benefits and the repercussions of such disclosures on individuals, families, and others.BackgroundThe popularity of DTC genetic testing is increasing. Consequently, many discover unexpected information about their ancestry, heritage, and paternity.MethodsThis qualitative study used an inductive thematic analysis of in‐depth interviews with adults (n = 27; aged 40–70) who received DTC genetic test results revealing unexpected biological paternity.ResultsThe NPE disclosure dilemma encompasses uncertainty about narrating their discovery; gauging the dispositions of others; wondering what repercussions may arise; and managing feelings about stigma, betrayal, and anger. Culture, history, and family dynamics are vital in navigating disclosures. A desire to understand their origins, connect with new genetic families, and validate their sense of self is essential. Biological connections of kinship remain important arbiters of relatedness for many individuals.ConclusionDisclosure of NPE discoveries differs from other stigmatized identities because the secret belongs to someone else; thus, self‐disclosure affects the entire family system.ImplicationsDrawing on family systems theory and disclosure processes model, our findings provide insights into the intricate dynamics inherent in NPE disclosure.

소비자 안전보건을 위한 ESG 공시기준에의 제품안전 지표설정 연구

ESG management has now become a new management paradigm both domestically and internationally. ESG is a non-financial performance indicator to achieve corporate sustainability, and encompasses responsibilities and obligations to stakeholders. Recently, as the safety issue of overseas products imported from online shopping malls in China has emerged, the need to ensure consumer safety and health from hazardous products is increasing. Accordingly, the establishment of product safety disclosure standards for consumer protection is required in the ESG information disclosure process. In this paper, in order to establish product safety indicators for sustainability disclosure standards for ESG management, the disclosure standards of major domestic and foreign initiatives were reviewed and analyzed to examine the introduction of product safety-related indicators, and product safety indicators that can be set for consumer safety and health were developed and presented. As product safety indicators, this paper first presented the occurrence of illegal and defective products, occurrence of product accidents, block hazardous products, number of recall orders and recommendations, and recall recovery rate as indicators that can be introduced throughout the entire product life cycle. In addition, the product risk level, the number and ratio of products for which risk assessment was performed, and the methods and standards used for risk assessment were presented as indicators related to product risk that indicate the level of impact of the product on consumer safety and health. In addition, the consumer safety index was presented as an indicator related to product safety accidents that occur during the consumer product use phase. The consumer safety index is an index that allows consumers to directly feel the level of product safety due to product accidents that occur when consumers use the product. It can be said to be a product safety index from the consumer's perspective that can protect consumer safety.

Exploring Parents' Experiences and Needs During Disclosure of a Cerebral Palsy Diagnosis of Their Young Child: A Scoping Review.

Parents often perceive the news that their child has cerebral palsy (CP) as overwhelming and shocking. They are at increased risk of parental stress and mental health problems, which in turn can affect the interaction between the parent and the child. Parental mental health outcomes are known to be affected by the process of disclosure of a diagnosis. In this study, we aimed to synthesize the current knowledge about parents' experiences and needs regarding communication during the disclosure of the diagnosis of their child with (or at risk of) CP. A scoping review following the methodological steps outlined by the Joanna Briggs Institute was performed using PubMed, Embase, CINAHL and PsycINFO. We qualitatively explored parent-reported experiences and needs across included studies, using thematic analysis. A total of 19 studies were included. Six themes were identified, three in relation to experiences (i.e., preceding experiences and feelings, perceptions of the disclosure and emotional impact) and three in relation to needs (i.e., transparency in information, supportive attitude and having a say). Despite high variability across studies regarding parental needs, most studies reported the need for (i) honest and clear information, (ii) good communication skills amongst professionals and (iii) emotional and practical support after diagnosis. Our findings suggest that parents' experiences and needs in the period when their child's diagnosis of (high risk of) CP is communicated are highly variable, due to an interplay of personal and contextual factors. To facilitate good communication during disclosure, it is crucial that health care professionals assess and understand this complex process and consider parents' needs for open communication and autonomy in the process. Therefore, professionals need to attune to parents' needs and their individual preferences regarding conversations about their child with (or at risk of) CP.

Digital Security Risk Disclosure and Investment Process

Digital Security Risk Disclosure and Investment Process

Promotional Press Releases and Investor Processing Costs

Press releases are a primary disclosure channel firms use to communicate with investors. However, firms can also use press releases to self-promote to improve their public image. Promotional press releases are, on average, significantly less value relevant than those focused toward investors. They also contain more positive and emotional language as well as less specific and financially oriented language. Based on theories of disclosure processing costs and investor attention, we predict and find that firms’ recent high usage of this disclosure channel to self-promote is associated with increased investor attention and more efficient reactions to subsequent investor-focused disclosures. This effect is concentrated in less visible firms, whereas promotional press releases appear to have no effect on the pricing efficiency of more visible firms. We also provide evidence consistent with media attention being one channel through which these effects operate. Our findings deepen our understanding of how firms use press releases as a disclosure channel and contribute to the literature on disclosure processing costs. This paper was accepted by Eric So, accounting. Funding: This work was supported by resources at the Arkansas High Performance Computing Center. C. Rawson gratefully acknowledges financial support from the Sam M. Walton College of Business. B. J. Twedt gratefully acknowledges financial support from the Mays Business School. J. C. Watkins gratefully acknowledges financial support from the Mendoza College of Business.. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2023.01903 .