Qualitative Evidence Research Articles

The natural gas industry, the Republican Party, and state preemption of local building decarbonization

Societal decarbonization likely requires changes to building standards encouraging electrification, partly through restricting connections to legacy utilities such as natural gas. Yet while some municipalities have taken action, an important parallel shift undermines it: more than half of U.S. states (covering 47% of the population) have, since 2020, passed state-level laws preempting municipalities from restricting utilities. We investigate the timing, content, and partisan support of these bills, examining similarity in text use across them using a plagiarism-detection tool. States passing preemption were not only more Republican but more ideologically conservative, typically featuring less professionalized state legislatures. We also examine qualitative evidence of the natural gas industry’s lobbying, showing that industry groups claimed influence over key bills (supported largely by Republican legislators). We consider the broader implications of these findings for supply-side decarbonization in a context of climate federalism under significant influence by fossil fuel industries and allied policymakers.

Intersectional Discrimination in Mental Health Care: A Systematic Review With Qualitative Evidence Synthesis.

Discriminatory practices in mental health care undermine the right to health of marginalized service users. Intersectional approaches enable consideration of multiple forms of discrimination that occur simultaneously and remain invisible in single-axis analyses. The authors reviewed intersectionality-informed qualitative literature on discriminatory practices in mental health care to better understand the experiences of marginalized service users and their evaluation and navigation of mental health care. The authors searched EBSCO, PubMed, MEDLINE, and JSTOR for studies published January 1, 1989-December 14, 2022. Qualitative and mixed-methods studies were eligible if they used an intersectional approach to examine discrimination (experiences, mechanisms, and coping strategies) in mental health care settings from the perspective of service users and providers. A qualitative evidence synthesis with thematic analysis was performed. Fifteen studies were included in the qualitative evidence synthesis. These studies represented the experiences of 383 service users and 114 providers. Most studies considered the intersections of mental illness with race, sexual and gender diversity, or both and were performed in the United States or Canada. Four themes were identified: the relevance of social identity in mental health care settings, knowledge-related concerns in mental health care, microaggressions in clinical practice, and service users' responses to discriminatory practices. Discriminatory practices in mental health care lead to specific barriers to care for multiply marginalized service users. Universities and hospitals may improve care by building competencies in recognizing and preventing discrimination through institutionalized training.

Damocles's Switchboard: Information Externalities and the Autocratic Logic of Internet Control

Abstract This paper advances a theory for the autocratic logic of internet control. Politically motivated internet control generates a positive externality for domestic data-intensive firms and a negative externality for domestic knowledge-intensive research entities. Exploiting a major internet control shock in 2014, I find that Chinese data-intensive firms gained 26 percent in revenue over other Chinese firms as the result of internet control. The same shock incurred a 10 percent decline in research quality from Chinese researchers, conditional on the knowledge intensity of their discipline. It also reduced the research quality from Chinese researchers relative to their US counterparts by 22 percent in all disciplines. Due to the positive data externality, internet control enacted to prevent domestic threats challenges the state's competing need for data sovereignty against foreign threats. Meanwhile, the state shields certain foreign knowledge-intensive actors from the negative knowledge externality to avoid the immediate economic costs they might otherwise impose. Qualitative evidence supports both implications, highlighting the centrality of short-term interests and foreign actors in autocratic decision making.

Parents' and guardians' experiences of barriers and facilitators in accessing autism spectrum disorder diagnostic services for their children: a qualitative systematic review.

The objectives of this review were to comprehensively identify the best available qualitative evidence about parents' and guardians' experiences of barriers and facilitators in accessing autism spectrum disorder (ASD) diagnostic services for their children; and to develop recommendations based on the review for addressing barriers to timely diagnosis and early intervention. Early identification of ASD is a priority because the best chance for improving symptoms occurs through early and intensive intervention. A definitive ASD diagnosis is often a prerequisite for children to access publicly funded services, yet obtaining a diagnosis in itself can be stressful, frustrating, and time-consuming for many families. It is essential to understand the barriers and facilitators parents and guardians face in accessing ASD diagnostic services for their children. This qualitative systematic review considered studies conducted worldwide that included parents and guardians of children up to 18 years of age who had accessed or who were attempting to access ASD diagnostic services for their children. This review was conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. A literature search included CINAHL (EBSCOhost), CINAHL Plus (EBSCOhost), MEDLINE (EBSCOhost), APA PsycINFO (EBSCOhost), Social Services Abstracts (ProQuest), ERIC (EBSCOhost), and Embase. Gray literature sources included ProQuest Dissertations and Theses, Google Scholar, Google, OpenGrey, other online resources (government and organizational websites), and reference lists of retrieved records. No language, date, or country limits were applied to the searches. Retrieved records from the academic databases, gray literature, and reference lists of retrieved records were screened, with potentially relevant records examined in full against the inclusion criteria. Eligible studies were critically appraised for methodological quality and those included in this review were subjected to data extraction of descriptive details and study findings relevant to the review question. Study findings were synthesized and assigned confidence scores. All reviewers agreed upon the categories and finalized synthesized findings. The 36 included studies varied in qualitative research designs with high methodological quality. There were approximately 661 eligible participants, and 55 credible and unequivocal research findings. The research findings yielded 6 categories and 3 synthesized findings with moderate confidence scores. Parents' and guardians' ability to access ASD diagnostic services for their children is affected by i) encountering health care providers who actively listened to and addressed parents' and guardians' concerns instead of dismissing them, providing a sense of support and validation; ii) facing extended waiting times and associated financial burdens resulting in frustration and associated financial impact when delays occurred; and iii) encountering health care providers lacking specialized knowledge about ASD contributing to parents' and guardians' confusion due to inaccurate or conflicting diagnoses related to ASD comorbidities. Many parents described their journey in accessing ASD assessment and diagnostic services for their children as cumbersome. Parents' and guardians' experiences were affected by the level of perceived support by and knowledge of health care providers; confusion surrounding inaccurate/mixed diagnoses related to ASD; lengthy delays; and systemic and contextual barriers in navigating the pathway to ASD assessment and diagnosis that included socioeconomic and cultural disparities. PROSPERO CRD42018100127.

A Qualitative Assessment of Adolescent Symptom Report and Caregiver Concordance Following Outpatient Surgery

Objectives: Limited data exist regarding recovery from surgery from the adolescent’s perspective, or data regarding concordance between adolescent and caregiver symptom report preventing appreciation of adolescent needs and hindering the provision of appropriate care. Methods: We conducted semi-structured interviews with adolescents ages 12-17 and a parent caregiver two weeks following a variety of outpatient elective surgeries about recovery symptoms. We used latent manifest content analysis to analyze interview data. Caregiver-adolescent response concordance was assessed using Cohen’s Kappa (κ). Results: Interviews were conducted with 31 adolescent-caregiver pairs (median age: 15y). Fifty-eight percent of adolescents and 84% of caregivers were female; 71% of adolescents were white. Twenty-three percent of children reported severe pain, some of which was not expected given the surgery. Severe pain was associated with nausea (71%, P= 0.002), pain-related sleep disturbance (86%, P= 0.007), and severe anxiety (43%, P= 0.008). Fatigue was also common (58%), but not associated with severe pain (P = 0.484) or sleep disturbance (P = 0.577). Thirty-nine percent reported anxiety; 32% experienced anger/frustration. Caregiver-adolescent concordance was only substantial for severe pain (κ = 0.71) and anger/frustration (κ= 0.67). Caregiver report also often included psychological symptoms not reported by their children, with qualitative evidence supporting caregiver accuracy. Discussion: Adolescents may experience significant physical symptoms such as pain and fatigue, even after minor surgeries. Fatigue symptoms may be unrelated to pain or sleep. Caregiver report of adolescent psychological symptoms may be necessary to gain a complete understanding of those symptoms in this population.

Sustainable innovations in developing economies: a woven theoretical approach with qualitative evidence from Uganda

PurposeThe purpose of this study is to present a theoretical framework that utilizes a success story to elucidate sustainable innovations in Ugandan financial institutions. It provides valuable insights from the standpoint of a developing African nation.Design/methodology/approachThe study utilized a qualitative methodology, specifically in-depth interviews with employees of Stanbic Bank Uganda. A story was constructed to depict their pragmatic experiences, emphasizing the contextual backdrop, actions taken, outcomes and lessons learned. The 12th participant marked the point of data collecting saturation.FindingsThe results suggest that financial institutions that use sustainable solutions are able to mitigate operational risks, cut costs, increase revenue and achieve long-term success. Institutional logics exert a significant influence on the behavior, practices and decision-making processes of individuals or organizations, hence impacting their inclination toward innovation and openness to change. While organizational resilience facilitates the ability to change, maintain excellence and remain competitive. Networks facilitate the exchange of information across institutions, enabling them to stay updated on market trends, regulatory changes and emerging risks. This, in turn, assists in making educated decisions.Originality/valueThis study is innovative in its utilization of a success story to exemplify sustainable improvements in financial institutions in Uganda. While several studies exist world over on sustainable innovations, this study is the first to use a success story and proposes a theoretical model that illustrates how institutional logics, networks and organizational resilience contribute to the development of sustainable innovations in a developing country.

Generating qualitative evidence of the validity of the Health Literacy Questionnaire Parent

Abstract Background Health literacy refers to the skills needed to access, understand, and navigate health information and services. The Health Literacy Questionnaire (HLQ) is a widely used validated measure of health literacy capturing nine distinct domains. The HLQ-Parent is a recent adaption of the HLQ which has been designed to capture the nuanced health literacy skills required by primary care givers of children. Generating qualitative evidence of validity of such tools is an important element of the validation process as it captures understanding and interpretation of items which is not achievable by quantitative methods alone. Therefore, the purpose of this study was to generate qualitative evidence of the validity of the HLQ-Parent. Methods A qualitative study implementing the HLQ-Parent during face-to-face cognitive interviews with concurrent probing was conducted. Primary carers of children aged 16 or under living in England were recruited via voluntary organisations supporting families. Qualitative data analysis was conducted on the audio recordings in the form of text summaries. Parents’ chosen HLQ-Parent responses were compared to their narrative responses and coded by the researcher as match, no match or unclear. Parents’ narrative responses were also compared to the HLQ-Parent item intent descriptions and coded as concordant, discordant, or unclear. Results Overall, participants (n = 9, mean age 40 years, 88.9% female) narrative responses matched to their chosen HLQ-Parent response, while their narrative responses were concordant with the HLQ-Parent item intent descriptions. Two participants narratives did not match their responses for the item:’ I have enough information to help me deal with my child’s health’. Conclusions The qualitative data provided evidence that participants understood and answered the HLQ-Parent items as intended. Study results contribute validity evidence for the use of HLQ-Parent to measure parental health literacy. Key messages • This study contributes evidence to the validity of the HLQ-Parent. • Qualitative methods provide valuable insights that enhance the overall understanding of health literacy measurement tools.

Health literacy from the perspectives of children and adolescents - a meta-ethnography

Abstract Background The current literature on health literacy rarely considers the views of children and adolescents. The aim of our qualitative evidence synthesis was therefore to develop a child- and adolescent-centered conceptualization of health literacy. Methods We conducted a meta-ethnography of qualitative studies. Our iterative literature search considered the literature up to November 2023. We dually screened 1596 abstracts and 97 full texts, assessed the methodological limitations of the 32 included studies, and considered 21 data-rich studies in the analysis. We extracted first- and second-order constructs, translated the studies into each other, and developed a coherent argumentation. We dually assessed the trustworthiness of the evidence. Results The resulting model comprises micro-, meso-, macro- and chronosystems. It highlights the influence of demographic, cognitive and psychological factors on the development of health literacy in children and adolescents at the micro level, the social environment, including family, friends, peers, teachers, and health professionals at the meso level, and the media and internet, the health and education system, the living environment, and the social narrative about health at the macro level. The chronosystem shows the impact of upbringing, development, and experience. Children absorb health information actively and passively, employing various strategies to evaluate its trustworthiness. They seek advice from their social environment, which acts as a source of information and influencing factor. Different types of information are weighed up and ranked before action is not taken. Conclusions Existing models of health literacy are too one-dimensional to be applied to children and adolescents and do not consider their social and living environment. The proposed model offers a comprehensive understanding of health literacy in children and adolescents. It can be used as a basis for future interventions to improve health literacy. Key messages • Health literacy of children and adolescents is significantly influenced by a combination of internal and external factors. • By incorporating the perspectives of children and adolescents, we have developed a more inclusive and nuanced understanding of health literacy.

Stakeholder perspectives on supplemental milk for infants under six months with growth faltering

Abstract Background Growth faltering is a significant public health issue among infants aged <6 months (m). Supplemental milk is commonly used for infants with growth faltering, with variations in type and duration. We synthesized qualitative evidence on stakeholder perspectives about equity, feasibility, and acceptability of the type and duration of supplemental milk for infants aged <6m with growth faltering. Methods We conducted a comprehensive search of six electronic databases in addition to manual searches to identify all qualitative studies published during January 2000-June 2022. Identified articles were screened in two stages against an inclusion criteria with titles and abstract screened first followed by full-text screening. Included studies were quality appraised using the Critical Appraisal Skills Programme checklist. The primary outcome was equity, feasibility, and acceptability of various supplemental milk for infants <6mwith growth faltering. Results Eighteen studies, reporting perspectives of mothers, fathers, grandmothers and healthcare providers were included. Studies were conducted in North America (9), Africa (5) and Asia (3) and South Australia (1). Donor human milk (DHM) (13) and infant formula(9) were the main supplementary milk reported followed by cow/goat milk (2). Key sub-themes derived were: education/awareness, socio-economic status (SES), race and religion, practicality, availability of resources, sustainability, cost, affective attitude, perceived effectiveness and ethicality. Maternal/caregiver SES was a key sub-theme across all three supplemental milk feeds, acting either as a barrier or facilitator for uptake. Conclusions DHM and infant formula were the most commonly reported supplemental feed for infants aged <6m with growth faltering. Maternal/care giver factors were perceived as key to ensure equity, feasibility, and acceptability with respect to type and duration of supplemental milk for infants aged <6m with growth faltering. Key messages • Stakeholders perceived donor human milk and infant formula as main supplemental milk for infants aged <6 months with growth faltering. • Maternal/care giver factors are key to ensure equity, feasibility, and acceptability of supplemental milk for infants aged <6 months with growth faltering.

Versatile video assignment improves undergraduates’ learning and confidence

This mixed methods study examines an explanatory video assignment designed to operationalize contemporary theory about cognition, metacognition, and inclusive teaching. This project grew from a professional learning community of post-doctoral teaching fellows who were involved in course redesign as part of a campus-wide active learning initiative. A team of pedagogical experts, teaching fellows, and faculty designed this video assignment to increase opportunities for students to share their perspectives while practicing a powerful learning strategy. Instructional teams implemented different versions of the video assignment in three courses across two departments. An experimental research component isolated the impact of the assignment on learning and confidence, and a mix of quantitative and qualitative analyses provided evidence about students’ experiences with the assignment. We found that students expressed learning and confidence gains beyond those due to typical course activities. Qualitative evidence suggested that students experienced the assignment as valuable for their learning and that the assignment enhanced self-expression. The assignment was effective in both face-to-face and remote settings, implemented either as a course requirement or extra-credit option. This versatile video assignment presents a practical way to enrich the student experience.

Incidence of and risk factors for lumbar disc herniation with radiculopathy in adults: a systematic review.

Lumbar disc herniation (LDH) with radiculopathy is associated with greater pain, disability, healthcare use, and costs compared with nonspecific low back pain. Reliable information about its incidence and risk factors were lacking. (1) What is the incidence of lumbar disc herniation (LDH) with radiculopathy in adults? (2) What are the risk factors for LDH with radiculopathy in adults? Systematic review. We searched five electronic databases from 1970 to September 2023. Eligible cohort and case-control studies were identified and independently assessed for risk of bias. A qualitative best evidence synthesis of low and moderate risk of bias studies was conducted. We critically reviewed 87 studies and synthesised data from 59 (68%) studies; 12 were of low and 47 of moderate risk of bias. The lower and upper bound limits of the 95% CIs of annual incidence estimates ranged from 0.3 to 2.7 per 1000 persons for surgical case definitions, from 0.04 to 1.5 per 1,000 persons for hospital-based case definitions, and from 0.1 to 298.3 per 1,000 persons for clinical case definitions. Factors associated with the development of LDH with radiculopathy included middle-age (30-50years), smoking, higher BMI, presence of cardiovascular risk factors (in women), and greater cumulative occupational lumbar load by forward bending postures and manual materials handling, with effect sizes ranging from ranging from 1.1 (1.0-1.3) to 3.7 (2.3-6.0). Incidence of LDH varies in different populations and according to case definition. Risk factors include individual, behavioural, and work-related variables. Our findings support the need to develop standardised case definitions that validly classify the clinical spectrum of LDH and for future low risk of bias studies examining causal relationships for LDH with radiculopathy in adults.

Factors influencing unrelated stem cell donation a mixed-methods integrated systematic review.

There is an imbalance between demand for and availability of stem cell donors worldwide. The purpose of this systematic review is to provide the first comprehensive understanding of facilitators and barriers influencing unrelated stem cell donation (USCD) in adults, through a data synthesis of qualitative and quantitative evidence. Identification of the facilitators and barriers associated with stem cell donation intention and behaviour is essential to inform the development of behaviour change interventions to meet the current demand. Four databases were searched (Embase, PsycINFO, MEDLINE and CINAHL) and the last search was in February 2021. The search was limited to studies written in English and published from 1980 to present. Screening, quality assessment, data extraction and data synthesis incorporating the COM-B model were undertaken in line with the Joanna Briggs Institute methodology for an integrated mixed-methods review. Fifty studies were included in the review, analysis and mapping produced four integrated findings. Donation-related knowledge was a facilitator and conversely, lack of knowledge was a barrier to donation related behaviours. Perceived convenience, positive social influences, religious beliefs and the accessibility of positive donation-related social norms promoted positive donation related behaviours. Altruism and sense of duty were the most commonly cited motives for donation related behaviours.Through mapping to the COM-B model, Communication/Marketing, and Service Provision are the primary policy categories that can be used to change donation related behaviours. Future interventions should focus on targeted education regarding unrelated stem cell donation and creating recruitment campaigns that emphasise the life-saving potential of donation.

Barriers and facilitators of healthcare access for long COVID-19 patients in a universal healthcare system: qualitative evidence from Austria

BackgroundLong COVID-19 challenges health and social systems globally. International research finds major inequalities in prevalence and healthcare utilization as patients describe difficulties with accessing health care. In order to improve long-term outcomes it is vital to understand any underlying access barriers, for which relevant evidence on long COVID-19 is thus far lacking in a universal healthcare system like Austria. This study aims to comprehensively identify access barriers and facilitators faced by long COVID-19 patients in Austria and explore potential socioeconomic and demographic drivers in health and social care access.MethodsApplying an exploratory qualitative approach, we conducted semi-structured interviews with 15 experts including medical professionals and senior health officials as well as focus groups with 18 patients with confirmed long COVID-19 diagnosis reflecting varying participant characteristics (age, gender, urbanicity, occupation, education, insurance status) (July-Nov 2023). Data were analysed following a thematic framework approach, drawing on a comprehensive ‘access to health care’ model.ResultsBased on expert and patient experiences, several access barriers and facilitators emerged along all dimensions of the model. Main themes included scepticism and stigma by medical professionals, difficulties in finding knowledgeable doctors, limited specialist capacities in the ambulatory care sector, long waiting times for specialist care, and limited statutory health insurance coverage of treatments resulting in high out-of-pocket payments. Patients experienced constant self-organization of their patient pathway as stressful, emphasizing the need for multidisciplinary care and centralized coordination. Facilitators included supportive social environments, telemedicine, and informal information provided by a nationwide patient-led support group. Differences in patient experiences emerged, among others, as women and younger patients faced gender- and age-based stigmatization. Complementary health insurance reduced the financial strain, however, did not ease capacity constraints, which were particularly challenging for those living in rural areas.ConclusionsThe findings of this study indicate a call for action to improve the long COVID-19 situation in Austria by empowering both providers and patients via increased information offerings, strengthened interdisciplinary treatment structures and telemedicine offerings as well as research funding. Our insights on potentially relevant socioeconomic and demographic drivers in access barriers lay the necessary foundation for future quantitative inequality research.

Contextual success and pitfalls of mHealth service for maternal and child health in Africa: An Intervention, Context, Actors, Mechanism, and Outcome (ICAMO) framework guided systematic review of qualitative evidence

IntroductionMobile health (mHealth) interventions have shown potential to improve maternal and child health outcomes in Africa, but their effectiveness depends on specific interventions, context, and implementation quality. Challenges such as limited infrastructure, low digital literacy, and sustainability need to be addressed. Further evaluation studies are essential to summarize the impact of mHealth interventions. Thus, this synthesis focuses on qualitative evidence of the impact of mHealth on maternal and child health in Africa to summarize such evidence to help policy decisions.MethodsA qualitative systematic review guided by the concepts of Intervention, Context, Mechanism, and Outcome (ICAMO) was employed in this study. The GRADE CERQual assessment and methodological constraints tools were utilized in the review to ascertain the level of confidence in the evidence and to examine the methodological limitations. The JBI checklist for qualitative research appraisal was also consulted during the review.ResultsThe current review contains 32 eligible studies from databases such as CINAHL, EMBASE, MEDLINE, Scopus, Web of Science, HINARI, and Cochrane Library. The review demonstrated substantial improvements in the HCP-woman relationship, communication system, maternal and child healthcare uptake, health-seeking behavior, and HCP skills. Economic capacities, maternal education, and the low quality of existing services challenged participants.ConclusionmHealth significantly improves maternal and child health outcomes in Africa. This review showed it can improve healthcare access, empower women, and contribute to the region's goal of universal health coverage. However, the challenges such as low partner support, high costs for services, and poor quality of current care as narrated by women need commitment from health authorities in the continent. The evidence from this review suggests that mHealth can be implemented to improve maternal and child health in Africa.Trial registrationPROSPERO: CRD42023461425.

Lived and care experiences of young people with chronic musculoskeletal pain and mental health conditions. A systematic review with qualitative evidence synthesis.

Chronic musculoskeletal pain (CMP) and coexisting mental health conditions impact young people; however, little is known about their lived and care experiences. In a prospectively registered systematic review with qualitative evidence synthesis (PROSPERO: CRD42022369914), we explored the following: (1) lived physical, psychological, and social experiences; and (2) care experiences/preferences of young people living with CMP and mental health conditions. Inclusion criteria: studies using qualitative methods; participants aged 16 to 24 years with CMP and coexisting mental health condition(s); phenomenon explored included lived and/or care experiences. Seven databases were searched (inception to 19-May-2024), study quality was assessed, data were extracted and analysed thematically, and GRADE-CERQual was used to assess confidence in findings. Twenty-two studies (23 reports) were included (>239 participants, 82% women). Lived experiences yielded 4 themes (9 findings): 2-way relationship between CMP and mental health (2 findings, low to moderate confidence); psychosocial implications of CMP (3 findings, very low-moderate confidence); uncertainty about future (2 findings, low-moderate confidence); coping with CMP and mental health conditions (2 findings, low-moderate confidence). Care experiences/preferences yielded 3 themes (8 findings): navigating healthcare systems (2 findings, moderate confidence); receiving appropriate care (3 findings, very low-moderate confidence); point-of-care experiences and care preferences (3 findings, very low-moderate confidence). Chronic musculoskeletal pain and mental health conditions are interconnected, significantly impacting young people's lives, identities, and socialisation, yet services for CMP and mental health are often inadequate and poorly integrated. The mechanisms and interplay of CMP and mental health require deeper exploration, including how young people may be better supported with personalised, holistic, developmentally and/or life-stage-appropriate integrated care.

Experiences of mental health and poverty in high-income countries during COVID-19: A systematic review and meta-aggregation

Systematic reviews have been published that explore the experiences of living in poverty, yet there are no known studies that have synthesized the findings of research exploring the experiences of mental health and wellbeing of persons living in poverty during COVID-19. To address this gap, we conducted a systematic review and meta-aggregation of qualitative evidence using the method described by the Joanna Briggs Institute (JBI) following the PRISMA guidelines. Of 8391 titles and abstracts screened, we included 23 studies in our review and meta-aggregation. In conducting our meta-aggregation, we generated three synthesized findings: 1) magnification of inequities and marginalization during COVID-19; 2) difficulty accessing resources during the lockdown; and 3) the lockdown causing changes in mental health and wellbeing. The findings of this review suggest that persons living in poverty experienced increased difficulties with mental health and well-being during COVID-19. This was largely influenced by the presence of pandemic restrictions and increasing financial precarity that resulted in rising levels of psychosocial distress. Research regarding the plight of persons living in low income is needed to inform policy and practice for future pandemics in order to decrease the vulnerability of this population. Implementing evidence-informed policies and practices that mitigate the negative psychological effects of physical distancing restrictions on persons living in poverty are needed, and these can be identified through future research efforts.

Enhancing Physical Science Education: The Integration of Digital Practical Work in Teaching Electrodynamics for Experiential Learning

Digital practical work (DPW) has emerged as a highly effective and indispensable component of science education, enhancing and extending traditional laboratory experiences. DPW aims to complement physical laboratory experiments, particularly those that teachers may find challenging to conduct or lack the confidence to perform. In this study, a content training workshop on electrodynamics was implemented to showcase DPW's effectiveness. The workshop was designed to equip in-service physical science teachers with the skills needed for integrating digital tools into their teaching methods. To gather comprehensive data, the study utilized video recordings, discussions, and evaluation reports, providing rich qualitative evidence of DPW's effectiveness. These methods captured teachers' understanding of electromagnetic concepts, their experiences, and their perceptions of DPW. The findings revealed that DPW significantly enhanced teachers' knowledge of electrodynamics and their awareness of effective digital pedagogy. The study strongly recommends integrating DPW into physical science teaching, particularly when traditional laboratory work is impractical. Unlike conventional teaching that merely transmits information, physical science education requires hands-on, practical observation to support theoretical concepts and promote meaningful learning. DPW bridges this gap, ensuring that students receive a robust and engaging science education, regardless of the constraints of the physical laboratory environment.

A Qualitative Evidence Synthesis of Continuous Subcutaneous Insulin Infusion: Acceptability, Implementation, Equity.

This work provides a synthesis of the perceptions of people with type 1 diabetes mellitus (T1DM) and healthcare professionals about the acceptability, implementation, and equity of continuous subcutaneous insulin infusion (CSII). A qualitative evidence synthesis was carried out. Three online databases (Medline, Embase, and Web of Science) were searched. Qualitative articles which were available in Spanish or English were included. A descriptive thematic synthesis was conducted according to PRISMA and ENTREQ guidelines. Thirty-two references met the inclusion criteria of the study and were included out of an initial 345 identified references. Seven main themes were identified: (a) acceptability, (b) adaptation to the insulin pump, (c) facilitators for the adequate use of insulin pump, (d) variability of acceptability, (e) barriers for the use of insulin pump, (f) feasibility and implementation considerations, and (g) equity. CSII is well accepted by most people with T1DM, with some exceptions. CSII can relieve management burden, increase autonomy and flexibility and improve family relationships. There were multiple perceived barriers to its continued use. Future studies should continue to analyze inequalities in access and use of the CSII.

Intergovernmental discontent in rural areas: A perspective from local councils in Spain during the Great Recession

Left-behind places have gained attention during the last years and among those, particular attention has been paid to rural areas, where discontent finds anchor in an articulated narrative of distinctiveness that separates rural and urban, and on which populist parties would have tapped. Thus, rural discontent can be considered a specific expression of disaffection of left-behind places, shaped and characterised by the processes and narratives that are particular to rural areas. Understanding the social justice structure of the discontent is essential to identify the critical elements contributing to a revival of rural-urban cleavages and rethink the development paths in rural areas that feel left behind.To advance on the qualitative understanding of the configuration of the left-behind places, this contribution explores discontent among rural mayors in a Spanish region -Valencia- during the Great Recession. Building on qualitative evidence and using a social justice approach, the presentation will explore the institutional factors driving rural discontent. The results describe the emergence of rural discontent rooted in perceptions of intergovernmental inequality upon redistribution, recognition and representation issues that are shaped by demographic, political and environmental features of rurality.

The Experiences and Perceptions of Telehealth in Patients Living With Advanced Chronic Obstructive Pulmonary Disease: A Qualitative Evidence Synthesis.

To systematically identify, appraise and synthesise qualitative research evidence which examined the impact of telehealth on the experiences and perceptions of patients living with advanced chronic obstructive pulmonary disease, to inform the development of patient-centred telehealth. Qualitative evidence synthesis. CINAHL, Cochrane, Embase, PUBMED, MEDLINE, EThOS, Web of Science, PsycINFO, Lenus, DART, RIAN and ProQuest were searched for primary qualitative studies undertaken between 2008 and 2023. A thematic synthesis of studies was undertaken to identify descriptive themes relating to patient views. Methodological quality was assessed using the Critical Appraisal Skills Programme framework, and confidence in review findings was assessed using the GRADE-CERQual approach. Nine studies met the inclusion criteria and were included in the final synthesis. Four analytical themes were generated (1) telehealth as a facilitator of independence, (2) the influence of patient and healthcare provider relationship on successful engagement with telehealth, (3) usability of telehealth to patients living with advanced chronic obstructive pulmonary disease and (4) trusting virtual health services and facilitating confidence in the patient/service user. Five descriptive themes emerged: (i) individualised telehealth chronic obstructive pulmonary disease care (ownership and control), (ii) managing chronic obstructive pulmonary disease exacerbations, (iii) being heard and feeling understood, (iv) telehealth as an education aid and (v) aging and virtual technology. Understanding the experiences of patients with chronic obstructive pulmonary disease and their engagement with telehealth is a necessary determinant of how best to utilise telehealth in this population and may serve to inform policymakers to further develop and implement telehealth into practice. Future research on patients and healthcare professionals' views on telehealth use in the palliative stage of this illness may also be valuable. Findings add value by providing healthcare providers with additional evidence to improve understanding of both telehealth complexity and human experiences and perceptions. It is anticipated that a deeper understanding of chronic obstructive pulmonary disease patients' experiences and perceptions will inform the development of strategies to maximise and enhance the application of patient-centred telehealth within the context of coping and living with a debilitating condition. No patient or public contribution was utilised in this study.