Supporting a child with maltreatment associated psychiatric problems (MAPP): Exploration of parent and professional experiences using multi-perspectival Interpretative Phenomenological Analysis.

Pancreatic cancer entails poor prognosis and high physical and psychosocial burden for patients and their caregivers. Supportive care needs remain insufficiently addressed. This study aimed to identify supportive care needs and potential directions for future research based on perspectives of patients, caregivers, and healthcare professionals. A qualitative design was applied using focus group interviews. Participants were patients with pancreatic cancer receiving chemotherapy ((neo)adjuvant and palliative), caregivers, and HCPs (oncologists, nurses, physiotherapists, and dieticians). Six focus group interviews were conducted, audio-recorded, transcribed, and analyzed. Identified themes were categorized, described and translated into potential research questions. Nine patients, eight caregivers, and eight health care professionals participated. Twenty-one themes were identified, organized, and consolidated into 10 themes representing patient and caregiver needs. These included: 1) Nutritional guidance beyond generic advice, 2) Information and guidance for self-management of side effects, 3) Supporting caregivers' self-care, 4) Clear information on treatment trajectory and prognosis, 5) Peer support and network, 6) Support for exercise, 7) Existential support, 8) Support and facilitation of family communication, 9) Navigating the treatment trajectory, and 10) Supporting energy management. These themes informed the development of exploratory and interventional research questions intended to guide future supportive care research. The findings highlight a broad range of supportive care needs among patients with pancreatic cancer and their caregivers. While exploratory in nature, the study identifies potential areas for future research and underscores the importance of addressing caregiver burden and family communication within supportive care interventions.

Digital interventions are potentially promising to improve accessibility and efficiency of genetic counseling services. However, current literature on user perspectives toward digital tools for cascade testing is limited. Therefore, this focus-group study aimed to gain insights into the attitude and perspectives of probands, at-risk relatives (ARR), and genetic healthcare professionals (HCP) toward digital innovations for assistance with both pretest and posttest counseling and cascade genetic testing in cardiogenetics. We conducted seven online focus groups, which were transcribed and thematically analyzed. In total, 37 individuals participated (10 probands, 11 ARR and 16 HCP). Thematic analysis of focus group transcripts showed a first theme of (1) acceptability of digital tools. Other identified themes were defined as "domains," where digital tools impact traditional, in-person clinical genetic care, being (2) family communication, (3) decision-making, (4) care relations, and (5) the genetic care system. Participants expressed a predominantly positive attitude toward the digitization of (parts of) the predictive genetic counseling journey in cardiogenetics under the condition that access to human contact is preserved. In the clinical setting of predictive counseling, efforts should be made to ensure access to genetic services for all ARR and to protect in-person involvement of HCP.

Care approaches to oral health are shaped by the perspectives of both aged care and dental care professionals. This study provides a new and comprehensive understanding of how these two professional groups conceptualise and address oral care for care-dependent older adults. Researchers conducted 13 focus group discussions with 4-6 participants each in two Danish municipalities within the Lifelong Oral Health research project: nine with aged care staff and four with managers from aged care and dental care. Two semi-structured interviews were conducted with dental care staff. The research was guided by a qualitative methodological framework using inductive thematic analysis to explore participants' experiences and perspectives. Aged care and dental care staff held varying perspectives on four distinct care approaches: (1) knowledge of oral health; (2) prioritisation of oral health; (3) care practice in relation to oral health; (4) handling refusal of oral care. In contrast to dental care staff, aged care staff had rudimentary oral health knowledge and prioritised other care tasks over oral care. Aged care staff took a rehabilitative approach to oral care, whereas dental care staff favoured a compensatory approach. Aged care staff stated that the right to self-determination overruled the duty of care presented by dental care staff when patients refused oral care. These differences affected daily oral care practices and collaboration between both staff groups, who both endorsed better collaboration. Divergent care approaches to oral care between aged care and dental care staff can hinder good oral health in care-dependent older adults. To enhance oral health in older adults, this article identifies four divergent approaches and explores how they challenge inter-professional collaboration.

The increasing cultural diversity of healthcare systems requires strategies that support effective communication and equitable care for patients from diverse cultural and linguistic backgrounds. Cultural concordance refers to situations in which patients and healthcare professionals share relevant cultural or linguistic characteristics that may facilitate communication and mutual understanding. In some healthcare organizations, this concept has been operationalized through organizational strategies aimed at aligning patients with healthcare professionals who share similar cultural or linguistic backgrounds. However, limited research has explored how these initiatives are experienced in clinical practice. The OHANA (Optimizing Healthcare through Alignment and Nurturing Across cultures) protocol was developed to investigate experiences of culturally concordant care within healthcare organizations that have implemented cultural concordance systems. This multicenter qualitative study, coordinated by the Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome in collaboration with several Italian hospitals, will explore the perspectives of both healthcare professionals and patients. Data will be collected through semi-structured interviews and analyzed using inductive qualitative content analysis to identify themes related to communication, perceived benefits, and challenges associated with culturally concordant care. The findings are expected to inform strategies to support culturally responsive healthcare. Key points:▪Multicenter qualitative study protocol exploring experiences of culturally concordant care in hospital settings.▪Investigation of perspectives from both healthcare professionals and patients involved in cultural concordance systems.▪Use of semi-structured interviews and inductive qualitative content analysis to examine how culturally concordant care is experienced in clinical practice.

This study explored how a collaborative video annotation activity in a co-located setting can mediate student teachers' joint process of noticing. Drawing on a sociocultural and interactional approach, the study examined how a group of student teachers, early in their education, attended to and interpreted video-recorded classroom events together. The findings show how the participants collaboratively established common ground, enabling joint noticing through shared attention, discussion, and the use of professional concepts and perspectives to interpret classroom events. The video annotation tool structured this collective process by requiring explicit articulation of ideas, fostering productive peer dialogue, and creating a shared record of reasoning that supported further inquiry. However, challenges also arose when shared attention and participation were difficult to sustain in this highly complex setting. We highlight the importance of scaffolding, clear guidance, and communicative norms. Overall, the study demonstrates that co-located collaborative video annotation can be a valuable pedagogical approach for stimulating noticing discourse, promoting evidence-based reasoning, and fostering relevant professional practices among student teachers. The findings suggest that implementation of co-located collaborative video annotation requires careful design and orchestration to support focus, collaboration, and meaningful engagement with complex videotaped classroom events. • Co-located collaborative video annotation can support and structure joint noticing. • Co-located annotation enables real-time negotiation of meaning among peers. • Communicative norms should be established to support a productive process.

Cancer-related pain is a prevalent and debilitating symptom that significantly impairs patients' quality of life, leading to physical discomfort as well as emotional and psychological distress. Despite the availability of effective pain control strategies, cancer pain remains inadequately managed worldwide. This challenge is multifactorial, involving barriers related to patients, healthcare providers, healthcare systems, and deficiencies in coordinated multidisciplinary care. This systematic review followed the PRISMA 2020 guidelines and was registered with PROSPERO (CRD420251027582). A comprehensive search of SCOPUS, PubMed, MEDLINE, EMBASE, ScienceDirect, the Cochrane Library, and Google Scholar was conducted for studies published between 2015 and 2025. Qualitative, quantitative, and mixed-methods studies examining barriers to cancer pain management from patient and healthcare professional perspectives were included. Study quality was assessed using the Newcastle-Ottawa Scale, and findings were synthesized narratively. A total of 244 records were identified, with 23 studies meeting the inclusion criteria after screening and eligibility assessment. Overall methodological quality was good, although most studies were cross-sectional. Four major categories of barriers were identified: patient-related, healthcare provider-related, healthcare system-related, and multidisciplinary care-related barriers. Patient-related barriers were most frequently reported fear of opioid addiction, concerns about side effects, under-reporting of pain, fatalistic beliefs, and cultural or religious influences. Provider-related barriers involved inadequate training, poor pain assessment practices, opioid-related concerns, and limited inter-professional communication. System-level barriers included restrictive opioid regulations, limited access to analgesics, staffing shortages, and lack of standardized protocols. Multidisciplinary barriers reflected poor care coordination, insufficient patient education, and lack of individualized pain management plans. Cancer pain management is hindered by interconnected barriers across patient, provider, and system levels. Addressing these challenges requires improved clinical practices, targeted professional education, balanced opioid policies, and strengthened multidisciplinary collaboration to enhance patient outcomes and quality of life.

The role of housing in patient health: Practitioner insights and protocol review.

Difficult but doable: Health professional perspectives of assessing clinical deterioration in children with dark-coloured skin.

Cardio-oncology research prioritisation in the United Kingdom: national surveys of health care professionals, patients and carers.

The development of microbial biocomposites represents a promising frontier in the design of sustainable, multifunctional, and environmentally friendly materials. This minireview synthesises recent advances (2020-2026) in the production, modification, and application of biocomposites derived from microorganisms, with a focus on bacterial cellulose (BC) and fungal mycelium. It explores their synergies with emerging approaches in synthetic biology, 3D printing, and mineral functionalisation. Key microbial systems such as Komagataeibacter spp. and Ganoderma spp. are discussed, alongside structural and functional engineering strategies including in situ hydroxyapatite mineralisation, incorporation of plant fibres, and the addition of functional nanomaterials such as graphene oxide. The review further highlights the integration of these materials into high-value applications, including osteogenic scaffolds, self-healing living materials, biodegradable packaging, and environmental remediation systems. Finally, it addresses current regulatory and technical challenges related to industrial scalability, functional stability, and batch-to-batch standardisation. This article aims to provide a critical and comprehensive perspective for researchers and professionals in applied microbiology, materials science, and industrial biotechnology, emphasising the potential of microbial biocomposites as a convergent platform at the interface of sustainability, functional innovation, and bioinspired design.

Workplace conflicts are common and complex, often leading to reduced job satisfaction, health problems, long-term absenteeism, and even job loss. When unresolved, they can seriously disrupt team dynamics and organizational functioning. Understanding the needs of employees, employers, and occupational health professionals in preventing, de-escalating, and resolving conflicts is essential for fostering healthier work environments. Therefore, this study explores the needs and challenges faced by these key stakeholders while triangulating the findings for effectively preventing, managing, and resolving workplace conflicts. A qualitative, explorative study design was used. Between June 2023 and January 2025 semi-structured interviews (n = 18) and focus groups (2x n = 9) were conducted with employees, employers, and occupational health professionals. A thematic analysis was applied to identify recurring themes in the data. The findings of this study highlight the complex and multi-layered nature of workplace conflicts. Three overarching themes were identified from the interviews: (1) Lack of mutual understanding and miscommunication hinder prevention, de-escalation and resolution of workplace conflicts; (2) opposing perspectives on workplace conflicts between employees and employers, often leading to misunderstandings and escalation; and (3) the needs for prevention, de-escalation, and resolution of conflicts. All stakeholder groups emphasized the importance of open communication, a safe and transparent organizational culture, clearly defined roles and responsibilities, approachable and well-trained managers, and accessible support systems such as clear protocols and professional guidance. These preconditions were seen as essential for enabling workplace conflicts to be addressed openly at an early stage. This is, to our knowledge, the first qualitative study integrating employee, employer, and occupational health professional perspectives on the prevention and solution of workplace conflicts in a Dutch context. The triangulation of these perspectives highlights the importance of incorporating these viewpoints when designing interventions. In developing interventions, fostering a culture of openness, safety and shared responsibility is essential for promoting workplace harmony and reducing the adverse effects of conflicts. The findings further suggest that occupational health policies could be strengthened through earlier involvement of occupational health services, clearer protocols to prevent and manage conflict-related sick leave, and the implementation of communication training focused on prevention of conflict escalation.

BackgroundOlder adults who have fallen are at an increased risk of future falls. Training cognitive and physical functions simultaneously, known as dual-task (DT) training, has been shown to improve mobility and reduce fall risks. With appropriate digital tools, such as smartphones and mobile apps, it is possible to deliver DT training in unsupervised, home-based settings, thereby increasing accessibility beyond the clinical environment.ObjectiveThis study aimed to evaluate the feasibility and acceptability of a technology-based DT training program delivered through a blended model of supervised and self-directed sessions for older adults with a history of falls. Perspectives of health care professionals working in fall-prevention services were also explored.MethodsA single-arm, nonrandomized feasibility study was conducted with 45 community-dwelling adults aged 65 years or older with a history of falls. Participants were recruited through primary care practices, secondary care fall-prevention services, and community outreach. The 24-week DT program, which integrated balance and strength exercises with cognitive training using a mobile app, was delivered in two phases: (1) for12 weeks, weekly 50-minute physiotherapist-led group classes in the community, and 2 additional 50-minute self-directed sessions at home, and (2) for 12 weeks, 3 weekly 50-minute self-directed sessions at home. Feasibility and acceptability were assessed through recruitment and retention rates, adherence, app usage, and self-reported satisfaction. Qualitative data were obtained from focus groups with 28 participants who completed the program and 16 health care professionals. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically.ResultsWe recruited 45 of the target 50 participants, with most participants (n=41) recruited through community pathways; 4 were recruited via National Health Service (NHS) pathways. Adherence was 64%, with higher adherence during phase 1 (81%) than phase 2 (50%). App usage was high (95%), and self-reported program satisfaction was moderate to high. Retention at 24 weeks was 76%, and no adverse events occurred. The qualitative findings supported the program’s feasibility and acceptability, emphasizing social connection and tailored exercises as key to adherence—especially in home-based sessions. Health care professionals identified community organizations and referral pathways as the most practical routes for implementation.ConclusionsA blended, technology-based DT training program is both feasible and acceptable for older adults at risk of falling and can be effectively delivered beyond clinical settings. Community-based recruitment outperformed NHS pathways, highlighting the value of community engagement. These findings support the feasibility and acceptability of a full-scale trial, with targeted refinements to recruitment, support structures, and delivery to maximize scalability and impact.

The global burden of obesity continues to rise, highlighting the need for patient-centered approaches to weight management. Shared decision-making is particularly important in the selection of antiobesity medications (AOMs), as treatment options differ in mechanism, effectiveness, side effects, routes of administration, and cost. Despite this preference-sensitive context, only a few patient decision aids (PDAs) have been culturally and clinically adapted for use in Asian populations. This study aims to design, develop, and evaluate a digital PDA, OptiWeight, to support shared decision-making for AOM selection, incorporating perspectives from health care professionals and patients. This mixed methods, multicenter study, conducted between August 2022 and November 2025, applied a 4-stage human-centered design process. An evidence-informed prototype was developed based on clinical guidelines, followed by 2 rounds of usability testing using think-aloud protocols to assess navigation structures, perceived usability (System Usability Scale [SUS]), and cognitive workload (NASA Task Load Index [NASA-TLX]). Semistructured interviews with health care professionals specializing in weight management, guided by the Consolidated Framework for Implementation Research, informed clinical implementation and workflow integration. Finally, patients with overweight or obesity evaluated usability, cognitive workload, and overall user experience in outpatient settings. Qualitative data were analyzed using content analysis, and 1-way analysis of variance examined changes in usability and workload across stages. A total of 174 individuals were included across all study stages (usability testing among adults: n=78; health care professional interviews: n=18; and clinical evaluation among patients: n=78). Iterative usability testing comparing system- and user-controlled navigation structures revealed complementary strengths and limitations, leading to the adoption of a hybrid navigation structure supporting both sequential guidance and flexible comparison. Additional design requirements included the use of icon arrays to enhance risk comprehension and localization features such as treatment cost displays and clarification of socially impactful side effects. Perceived usability increased from initial testing to clinical evaluation (SUS: 60.53-73.65, P<.001), meeting good usability thresholds, while cognitive workload decreased (NASA-TLX: 40.35-16.69, P<.001). Through a systematic human-centered design process integrating health care professional and patient perspectives, OptiWeight addresses the lack of culturally adapted PDAs for AOM decision-making in Mandarin-speaking populations while capturing user needs-particularly regarding navigation flexibility and risk visualization. The final tool demonstrated good usability and feasibility, and workflow considerations suggest potential for integration into routine weight-management care. Further research is needed to evaluate its impact on decision quality and real-world implementation outcomes.

Multiple gingival recessions can lead to esthetic impairments and may require surgical root coverage. Esthetic outcome measures can be assessed from both professional and patient perspectives. Several objective and subjective outcome measures have been applied for these evaluations. To systematically review and conduct a meta-analysis of the available literature on professional esthetic assessments and patient-related outcome measures (PROMs) following surgical root coverage procedures for the treatment of multiple gingival recessions. A computerized systematic search was conducted in the MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials databases up to May 2024 to identify eligible studies meeting the inclusion criteria. A total of 32 randomized controlled trials involving 1012 patients and 3589 multiple gingival recessions were included. No case-series studies meeting the inclusion criteria were retrieved. Meta-analyses demonstrated that root coverage procedures statistically significantly improved both professionally assessed and patient-reported esthetic outcomes. The overall weighted mean Root Coverage Esthetic Score (RES) was 8.31 (95% CI: 8.11-8.50), with comparable results across coronally advanced flap (CAF) and tunnel (TUN) techniques, particularly when combined with autogenous connective tissue grafts or graft substitutes. Patient-reported esthetic satisfaction, measured primarily by visual analog scales (VAS), showed a pooled mean of 8.59 (95% CI: 8.29-8.89). Mean root coverage (MRC) reached 82.6% (95% CI: 71.3-93.9), and complete root coverage (CRC) was 62.7% (95% CI: 57.0-68.4). Statistically significant reductions in recession depth (mean difference = 2.22 mm) and gains in keratinized tissue (0.74 mm), gingival thickness (0.56 mm), and clinical attachment level (2.17 mm) were observed. Postoperative pain was low across techniques (VAS 0-10 mean: 2.67; VAS 0-100 mean: 24.34). Metaregression revealed a positive association between MRC and RES (R2 = 0.345) but no significant correlation between MRC and patient esthetic perception (R2 = 0.091), underscoring the divergence between clinical and patient-reported outcomes. The results of this systematic review and meta-analysis, focusing on multiple gingival recessions, suggest that (a) CAF and TUN with the adjunctive use of autogenous graft support esthetic improvement from both professional and patient perspectives and (b) CAF and TUN with the adjunctive use of autogenous graft or graft substitutes are effective in root coverage outcomes with a minimal postoperative morbidity.

ABSTRACT Perhaps one of the biggest changes that has occurred in the settler state presently known as Canada over the past 55 years has been relations between settlers and Indigenous Peoples. But how have these changes been reflected in scholarship published in Leisure/Loisir? To address this question, the authors engaged with settler colonial theory and critical discourse analysis to examine the ways in which understandings of Indigenous Peoples have been produced over the past 49 volumes. Their findings demonstrate that, for many decades, authors mainly centred the perspectives of recreation professionals, academics and government officials, thereby reinforcing the authority and expertise of those who produced knowledge about Indigenous Peoples. More recently, there has been an increase in the production of and importance placed on research with and by Indigenous Peoples, concomitant with critiques of settler colonialism. However, despite these discursive shifts, important silences remain, particularly pertaining to Métis Peoples and Inuit.

Health care professional perspectives on vision screening in older adults who attend hospital following a fall: a focus group study.

Research on the development of prognostic biomarker-based models for genetic neurodegenerative diseases lacking disease-modifying treatments is advancing rapidly. Currently, prognostic models are being developed to predict individual disease onset and progression rates for Huntington's disease, spinocerebellar ataxia type 1, and spinocerebellar ataxia type 3. These models have potential applications in research, such as evaluating onset-delaying treatments and their timing, and in clinical practice, where they may offer personal utility to mutation carriers. However, the perspectives of healthcare professionals in genetic counselling have not yet been adequately explored. In this qualitative interview study, we interviewed 18 Dutch healthcare professionals in genetic counselling, representing the majority of the Dutch counselling practice for these conditions, to explore their views on using onset and progression predictions in clinical practice. Healthcare professionals highlighted potential benefits, such as reducing uncertainty and supporting informed life and family planning, which are among the pivotal reasons for mutation carriers to opt for predictive genetic testing. They also noted possible drawbacks, including psychological distress for mutation carriers, discussed challenges in defining clinical disease onset, and some questioned the degree of personal utility of these predictions. Finally, healthcare professionals emphasised several key conditions for implementing such prognostic models, including sufficient predictive accuracy, a narrower and more precise age range, and the need for additional counselling. This study provides insights in the perspectives, views, and concerns of the majority of healthcare professionals in the Dutch counselling practice regarding the use of onset and progression predictions. Healthcare professionals identified several potential benefits and drawbacks of onset and progression predictions and discussed the conditions necessary for their implementation. During model development and before clinical implementation, clarity is needed on how disease onset is defined in the model and what constitutes sufficient model performance. Furthermore, aligning the model with its intended goals, such as providing personal utility, and assessing the feasibility of achieving meaningful predictions are crucial steps.

The Complications of Excess Weight (CEW) Programme, funded centrally by NHS England, aims to provide innovative, person-centred, holistic care for children and young people living with severe obesity and associated complications (e.g. hypertension, type 2 diabetes, depression). Twenty-one CEW services were established across England in 2021, rising to 38 in 2024. This qualitative study aimed to gather the perspectives of senior professionals involved in the design, development, and commissioning of the CEW programme. Eleven online semi-structured interviews were completed between April and November 2024. Participants included senior officials from NHS England, the Department for Health and Social Care, the Office for Health Improvement and Disparities, specialist weight management clinicians, and a national children's charity. Interview questions examined stakeholder involvement, the policy backdrop, the intended purpose and expectations of the CEW programme, evaluation expectancies, and future directions. Data were analysed thematically. Participants described how the CEW programme was developed to meet the needs of a vulnerable population while developing a robust evidence base, aligning with aspirations of the NHS Long Term Plan. The CEW service specification was designed at a high-level to allow local flexibility in implementation and delivery approaches. Key concepts included a biopsychosocial multi-disciplinary approach to manage obesity and complications. Despite systemic challenges, the dedication of staff and involvement of patients supported CEW delivery. This study offers insight into the development of CEW services from a range of key stakeholders. The importance of public involvement to deliver a complex service within the context of perceived challenges of a fragmented and underfunded system are highlighted. There is a need for sustained investment in CEW, which incorporates a holistic multidisciplinary design to ensure equitable and effective healthcare provision for this vulnerable patient group.

This study examines evidence-based pedagogical strategies aimed at enhancing communication competence, with a particular focus on foreign language speaking skills, among Deaf and Hard of Hearing (DHH) students at the primary education level. Acknowledging the distinct linguistic, cognitive, and communicative characteristics of DHH learners, the research addresses the central question: Which instructional techniques most effectively promote the development of speaking and broader communicative abilities in this population? Employing a qualitative research design, the study engaged 55 primary-level DHH students and utilized classroom observations, student questionnaires, and semi-structured interviews with teachers and educational specialists, thereby adopting a multi-perspective methodological framework that enables the triangulation of learner, classroom and professional perspectives. The findings underscore the efficacy of multimodal and visually enriched teaching approaches, the value of differentiated, learner-centered instruction, and the importance of collaborative learning environments in supporting oral foreign language development. The research provides empirical insights into the design of inclusive and responsive language education practices for DHH learners, including those relevant to foreign language speaking skills, drawing on triangulated qualitative evidence from multiple educational stakeholders, contributing to the advancement of both academic achievement and communicative competence in diverse classroom settings.