Separate Interviews Research Articles

Sustainable volume sweep imaging lung teleultrasound in Peru: Public health perspectives from a new frontier in expanding access to imaging.

Pulmonary disease is a common cause of morbidity and mortality, but the majority of the people in the world lack access to diagnostic imaging for its assessment. We conducted an implementation assessment of a potentially sustainable and cost-effective model for delivery of volume sweep imaging (VSI) lung teleultrasound in Peru. This model allows image acquisition by individuals without prior ultrasound experience after only a few hours of training. Lung teleultrasound was implemented at 5 sites in rural Peru after a few hours of installation and staff training. Patients were offered free lung VSI teleultrasound examination for concerns of respiratory illness or research purposes. After ultrasound examination, patients were surveyed regarding their experience. Health staff and members of the implementation team also participated in separate interviews detailing their views of the teleultrasound system which were systematically analyzed for key themes. Patients and staff rated their experience with lung teleultrasound as overwhelmingly positive. The lung teleultrasound system was viewed as a potential way to improve access to imaging and the health of rural communities. Detailed interviews with the implementation team revealed obstacles to implementation important for consideration such as gaps in lung ultrasound understanding. Lung VSI teleultrasound was successfully deployed to 5 health centers in rural Peru. Implementation assessment revealed enthusiasm for the system among members of the community along with important areas of consideration for future teleultrasound deployment. This system offers a potential means to increase access to imaging for pulmonary illness and improve the health of the global community.

Educational Loss at Times of Crisis: The Role of Games in Students’ Learning in Palestine and Iraq

This study examines the role of educational games in compensating for educational loss and their impact on students’ motivation towards learning during crises in Palestine and Iraq. Additionally, the study considers the challenges facing the employment of this strategy and ways to overcome these challenges. By performing separate open semi-structured interviews with a group of 10 educators from university professors, teachers, and educational supervisors, the study used the qualitative descriptive approach which designs multiple case studies. The results showed the prominent role that educational games play in increasing students’ motivation towards learning and compensating for educational loss through what they add to the fun and suspense in the learning process and how they shorten time and effort and help students to engage and cooperate in acquiring knowledge, skills, and values. The results also reveal common challenges that face the employment of educational games. These challenges are social, economic, technological, challenges related to school environment, and psychological challenges. The study shows the possibility of overcoming these challenges by providing funding sources, preparing plans to employ educational games, and developing teachers’ capabilities to implement them in their teaching practices.

A qualitative study to explore strategies to improve the Road to Health Application for maternal and child health outcomes in South Africa.

The Road to Health Application (RTHA) is essentially a digitalized version of the National Department of Health's Road to Health book, and a hand-printed booklet given to mothers at the birth of each baby. The RTHA, like the booklet, provides guidelines for maternal and child health outcomes, with the goal of creating a database of children and caregivers in South Africa and teaching them how to raise a healthy child. This paper explored potential barriers and enablers to using the RTHA in the South African context based on user experiences. Using a qualitative design, we conducted 50 serial interviews (two separate interviews, 1 month apart). Through convenience, sampling eligible participants were 18 years or older women who were pregnant and/or had a child under the age of 5 years. Participants included 25 existing users and 25 new users of the RTHA, who owned android smart phones at enrollment. Existing users were recruited telephonically through the National Department of Health database, and new users were approached at the antenatal care unit and wellness baby clinic (women with children under 5 years) at the Chris Hani Baragwaneth Academic Hospital. Upon enrollment, participants completed a brief survey on sociodemographics and mobile phone use, and thereafter, they had a baseline interview followed by a telephonic interview 1 month later. A semistructured interview guide was used to explore barriers, enablers, and the usability of the RTHA. Using thematic data analysis, we identified enablers and barriers to the use of the RTHA. A third (33%) of all participants reported IsiZulu as their main language of communication, and 6% of the participants reported English as their main language of communication. The RTHA was an important addition to the booklet that helped keep new mothers informed about child immunization and provided important information about healthy child rearing practices. However, multiple barriers were cited to using the RTHA; these included the fact that the app was only available in two languages, high data costs, lack of access to smart phones, and app functionalities. The enablers to using the RTHA included the accessibility of important information regarding prenatal and postnatal childcare. This study gives insight into the barriers and enablers from the end-user perspective to improve the RTHA for future use in South Africa and offers guidance on how to improve the RTHA to be more user-friendly, which could increase its usability among mothers. It further emphasizes the need to consider the challenges experienced by users in South Africa when developing future mobile health interventions to increase uptake.

“I’ll Give Them All the Time They Need”: How LGBTQ+ Teens Build Positive Relationships with Their Active, Latter-Day Saint Parents

Strong and supportive relationships with parents are key to promoting the mental health of LGBTQ+ teens. Overwhelmingly, studies have focused on ways to improve parental acceptance, largely neglecting understanding the parent–teen dyad as a unit and ignoring teens’ contributions to their relationships with their parents. To address this gap, we conducted 19 separate interviews with LGBTQ+ teens and their Latter-day Saint (LDS) parents (38 total interviews) to explore the ways that teens contributed to the development of positive relationships. Additionally, we explored teen-related factors that presented challenges to the parent–teen relationship. Thematic analyses suggested that LGBTQ+ teens engaged in several behaviors that benefitted their relationships with their LDS parents, including having authentic and meaningful conversations, fostering family connections, engaging in casual communication, being open about LGBTQ+ identity, and giving parents time and grace. Participants reported several common teen-related factors that presented challenges to the relationship, including communication and connection difficulties, challenges related to general development, and parents and teens avoiding LGBTQ+ and religious topics. Results suggest that while several of these factors may be relevant for parent–teen relationships more broadly, many were specific to LGBTQ+ teens with active, LDS parents. These findings highlight the ways that LGBTQ+ teens manage to foster positive relationships with their parents despite potential conflict between their LGBTQ+ identities and their parents’ religious beliefs.

A Qualitative Study to Inform Development of a Behavioral Intervention to Promote Food Allergy Self-Management and Adjustment among Early Adolescents.

Adolescence is a high-risk period for patients with food allergy (FA) as management responsibilities shift to the youth. This study used qualitative methods to explore FA experiences among a diverse pediatric FA population and inform behavioral intervention development. A total of 26 adolescents ages 9-14 years with IgE-mediated FA (M age = 11.92 years; 62% male; 42% Black, 31% White, 12% Hispanic/Latinx) and 25 primary caregivers (M age = 42.57 years; 32% annual income > $100,000) were recruited from FA clinics to complete separate qualitative interviews about FA-related experiences. Interviews were audio-recorded, transcribed, and entered into Dedoose, a qualitative software program. A grounded theory qualitative analytic approach was used to analyze data. Emergent themes include: 1) FA is a chronic burden that affects daily life, 2) Families experience anxiety about FA, 3) Families find it challenging to transition FA management from parent to child, 4) FA families feel the need to be prepared, 5) FA families frequently advocate for their needs, and 6) Social experiences affect the FA experience. Adolescents with FA and their caregivers experience daily stress related to their chronic illness. A behavioral intervention that provides FA education, bolsters stress/anxiety management, assists parents in transitioning FA management responsibility to the youth, teaches executive functioning and advocacy skills, and fosters peer support could help adolescents successfully cope with and manage FA in their daily lives.

Understanding Unmet Care Needs of Rural Older Adults with Chronic Health Conditions: A Qualitative Study

Rural populations experience poorer access to the necessary health services for chronic health conditions. Although studies of rural healthcare access continue to expand, most are based on quantitative data, yet normative views and lived experiences of rural adults might offer a better understanding of healthcare access and their specific unmet needs. This qualitative study sought the views of both rural-centric older people and healthcare professionals to understand health needs, barriers, and enablers of accessing health services, with a focus on chronic health condition(s). Between April and July 2022, separate in-depth interviews were conducted with 20 older people (≥60 years) in a rural South Australian community. Additionally, focus group interviews were conducted with 15 healthcare professionals involved in providing health services to older adults. Transcripts were coded using the NVivo software and data were thematically analysed. Participants described a range of unmet care needs including chronic disease management, specialist care, psychological distress, and the need for formal care services. Four barriers to meeting care needs were identified: Workforce shortages, a lack of continuity of care, self-transportation, and long waiting times for appointments. Self-efficacy, social support, and positive provider attitudes emerged as crucial enabling factors of service use among rural ageing populations. Older adults confront four broad ranges of unmet needs: Chronic disease management care, specialist care, psychological care, and formal care. There are potential facilitators, such as self-efficacy, provider positive attitudes, and social support, that could be leveraged to improve healthcare services access for older adults.

“Sex. Maybe We Should Do Things to be Healthy About It.” Adolescent-Caregiver Discussions About Sex

PurposeAdolescents are disproportionately burdened with HIV. Numerous barriers limit adolescent pre-exposure prophylaxis (PrEP) use for HIV prevention. We explored adolescent-caregiver perspectives on discussing sexual health and PrEP to inform future caregiver interventions as a possible strategy to promote PrEP use. MethodsWe conducted separate in-depth interviews with adolescents aged 14-18 living in Alabama and their parent/guardian (caregiver). Interviews explored attitudes about sex, knowledge and attitudes about HIV prevention and PrEP, and attitudes about PrEP communication within adolescent-caregiver groups. Thematic analysis of adolescent and caregiver interviews was conducted independently and then triangulated to compare shared themes. ResultsNine adolescents and seven caregivers contributed to five dyads and two triads. Adolescents had a median age of 16 years (range 14–18); five were girls (55%), and five were non-Hispanic Black (55%). Most caregivers were mothers (5, 71%), non-Hispanic Black (5, 71%), with a median age of 41 (36–56) years. All adolescents expressed willingness to involve their caregiver around PrEP use. Major themes included as follows: 1) caregiver efforts to overcome cultural taboos about sex and sexuality foster adolescents' willingness to talk with caregivers about sex; 2) evolving societal norms and reflections on their own upbringings motivate caregivers to discuss and support adolescents with sexual health; and 3) caregivers desire to engage in sexual health discussions with providers and support their teens with PrEP. DiscussionAs socio-cultural norms around sex evolve, adolescent-caregiver discussions about sexual health and PrEP may be an opportunity to increase PrEP use and reduce HIV infections among select adolescent sub-populations.

Adolescent Self-Consent for COVID-19 Vaccination: Views of Healthcare Workers and Their Adolescent Children on Vaccination Autonomy

PurposeThis study explored the perceptions of healthcare worker parents (physicians, nurses, and staff) and their adolescents (aged 12–17 years) on adolescent self-consent to COVID-19 vaccination by applying the concept of positive deviance of those already vaccinated against COVID-19. MethodsWe used a qualitative descriptive design to conduct individual, semi-structured interviews with COVID-19–vaccinated healthcare workers in Southern California and their vaccinated adolescent children. Separate interviews were conducted with parents and adolescents from November to December 2021 using digital phone conferencing software. All interviews were recorded and transcribed. Thematic and constant comparative analysis techniques were used to identify relevant themes and subthemes. ResultsTwenty one healthcare workers (9 nurses, one nurse practitioner, one technologist, and 10 physicians) and their adolescents (N = 17) participated. Three overarching themes were identified to describe participants' perspectives about adolescent self-consent for COVID-19 vaccination: (1) Family values and practices around adolescent vaccination; (2) Differences in parent and adolescent support for vaccine self-consent laws; and (3) Parent and adolescent uncertainty on readiness for vaccine self-consent laws. Adolescents largely supported self-consent while parents supported the policy if they would be able to have a discussion with their adolescent prior to the decision. DiscussionParents and adolescents supported adolescent self-consent for COVID-19 vaccination, with the reservation that adolescents should discuss the decision alongside their parents to exercise their medical autonomy with supportive guidance. Greater adolescent involvement in making decisions and providing self-consent for healthcare, including vaccines, could prepare adolescents to have a greater sense of autonomy over their health and contribute to population health measures.

"You're not gay; You're a child of god": Microaggressions experienced by LGBTQ+ teens and their parents in the Church of Jesus Christ of Latter-day Saints.

Like other teens in conservative religious environments, LGBTQ+ teens raised in the Church of Jesus Christ of Latter-day Saints (CJCLDS) likely experience unique microaggressions. Furthermore, like other conservatively religious parents of LGBTQ+ teens, active Latter-day Saint (LDS) parents who openly support their LGBTQ+ teens likely both witness microaggressions toward their teens and may personally experience microaggressions. The present study sought to understand parents' and teens' experiences of microaggressions in conservative religious contexts by focusing specifically on the microaggressions experienced by (a) LGBTQ+ teens raised in the CJCLDS and (b) their active LDS parents. Thematic analysis of separate interviews with 19 dyads of LGBTQ+ teens and their active LDS parents (38 total interviews) revealed various ways in which they experienced verbal, nonverbal, and environmental microaggressions. We highlight parents' and teens' shared experiences of microaggressions that may be uniquely related to their religious contexts, such as assumptions that LGBTQ+ teens or their parents are not faithful and exclusionary Church policies. Additionally, we identified microaggressions that specifically targeted parents of LGBTQ+ teens, such as comments suggesting parents should limit their support for their teens. Finally, we found that parents had vicarious experiences with microaggressions through witnessing or learning about microaggressions that targeted their teens. Findings highlight the ways that the religious contexts in which microaggressions occur can influence the way that microaggressions are communicated to and experienced by LGBTQ+ teens - and their parents.

Summative Entrustment Decision-Making in a National Entrustable Professional Activity-Based Residency Training Programme: Where theory meets practice

Introduction: The Entrustable Professional Activity (EPA) framework was introduced to operationalise and translate competency-based medical education into daily practice. Adoption of EPAs is recommended and supported in guidelines by educational research on trust and entrustment decision-making. However, systematic field studies evaluating the experiences of medical professionals (residents and supervisors) working with an EPA framework in daily practice are lacking. Still these evaluations are necessary to support the design and implementation of new EPA-based residency training programmes. This study provides an in-depth insight and a more comprehensive understanding of the experiences of professionals working in an EPA-based residency training programme. Methods: We conducted a qualitative study using a constructivist approach. Focus groups were used for separate interviews with residents and supervisors assessing their experiences with the first national EPA-based residency training programme in the Netherlands. Thematic analysis was used to analyse the results of the focus groups and to define relevant themes. Results: The EPA framework enabled residents to enhance and individualise their training programme. Personal leadership proved to be essential for finding a balance between the requirements of the national training programme and exploration of residents’ individual talents, experience and learning curve. Supervisors’ supportive and guiding role is crucial throughout the process of EPA acquirement. Independent from each other, supervisors and residents indicated that trust (and not exhaustive testing) is essential in the summative assessment by a Clinical Competence Committee (CCC). Supervisors see added value in the mandatory portfolio that residents compile to help them prepare for the CCC meeting. Starting to work without supervision is an important but challenging goal once an EPA has been acquired. The ability to further individualise the training programme after an EPA has been acquired, varies among residents. Discussion: We found that residents and supervisors see added value in working and learning in an EPA-based residency training programme. Awareness and encouragement of self-regulated learning skills could potentially help create a balance between programme requirements and individualisation. When discussing a portfolio, trust and gut-feelings during CCC meetings is fundamental and helpful for supervisors to get a comprehensive view of the resident’s performance. An autonomy-supportive supervision strategy could encourage and improve residents’ autonomy and practice of working without direct supervision after acquiring an EPA.

REMNANTS OF OTTOMAN LAW AND ITS APPLICATION IN CONTEMPORARY TIMES IN LEBANON AND THE ARAB WORLD

At the beginning of the sixteenth century (1516), the Ottomans controlled all the lands that are today within the Lebanese Republic, and their existence lasted for four hundred years, during which they established military, security, administrative and social systems and enacted laws to improve and organize the country. Although five centuries have passed since the Ottoman presence in Lebanon, some of these laws are still in force. Some have been amended, such as the personal status law related to Islamic Law, some administrative regulations, and the municipal ordinance that the French updated during the Mandate days (1920-1943). While Ottoman laws are still strictly enforced in Lebanon, such as the Associations Law. Two sources, one legal and the other specialized in Islamic history, confirm in two separate interviews to Anadolu Agency the importance of these laws for Lebanon since their enactment until today. "Not everything old is considered bad. For example, but not limited to, the Associations Law is an Ottoman law that enshrines freedom of association and respects Article 13 of the Constitution, and despite its promulgation in 1909, it has been considered a liberal law to date," says Appeals Lawyer Zakaria Yahya beast. Al-Ghoul added: "The Law of Associations is one of the most important laws issued during the Ottoman period. It is still in force to date, and it is the one who looks after the affairs of associations and how they are formed in Lebanon and the Arabs World. He pointed out that "there is a legislative decree issued in 1977, which is compared to the Ottoman Law of Associations as a recent law, but it allowed the pre-trial detention of journalists." He continued, "From here, this comparison makes us say that the problem does not lie in the extent of the laws' antiquity, but rather in the extent to which they meet the objectives of the current legal rules."

2018-2021 Arası Yerleşikler Gözüyle Erzincan Kızılay ve Hocabey Mahalleleri Kentsel Dönüşüm Süreci

Bu makale Erzincan’da Kızılay ve Hocabey Mahallesi kentsel dönüşüm projesi sürecinde yerleşiklerin beklentilerini ve kaygılarını ortaya çıkarmaktadır. Etnografi yöntemlerle 2018-2019 ve 2020-2021 dönemlerini kapsayacak şekilde iki ayrı mülakat yapılmıştır. Alışık hayattan ayrılmanın verdiği zorluklar ve belediyenin kısıtlamalara karşı oluşturduğu çözümler tespit edilmiştir. İlk mülakat serisinde mahalledekilerin yaşamış oldukları en belirgin iki duygu daha iyi yaşama doğru ümit ve evsiz kalma veya evin değerini alamama kaygısıdır. İkinci dönemde belediyenin atmış olduğu doğru adımlar, şeffaf şekilde bütün hane halklarıyla tek tek ilgilenmeleri bu belirsizlikleri aşılmış ve genelde tarafların memnuniyetiyle sonuçlanmıştır. Süreçte en büyük zorluk aynı parselden birden çok hak sahibinin olmasıdır. Her parsele bir daire verilmiş ve pay sahiplerine kendi aralarında antlaşması istenmiştir. Antlaşamama durumlarında herkesin pay miktarına göre nakit ödeme yapılmıştır.

1046. Assessing School-Based COVID-19 Transmission in Middle and High Schools in an Underserved Population through Qualitative Interviews

Abstract Background Case and contact investigation is a mitigation strategy to understand transmission of diseases. The goal of this study is to assess COVID-19 transmission in schools that employ contact tracing. Methods Five middle and high schools provided a list of ongoing student and staff cases and their school contacts for the 2021-22 school year. Cases were eligible for interview if they had a known positive test or were a “presumed positive” by a practitioner. Contacts were eligible if they were identified as a close contact to a case within their school. Contacts who later became a case were eligible for a separate case interview. Trained interviewers contacted eligible individuals to offer COVID-19 resources and determine interests in participating in the study. Interested cases and contacts underwent a semi-structured interview with standardized questions. Results From 5/2021-4/2022, 360 cases (45% during Omicron surge) and their 412 contacts were identified (Fig 1). Among the 111 cases interviewed, 75% were students, half were in grades 6-8 (Fig 2). 61% of the cases were vaccinated with their primary series. 92% were symptomatic and fatigue, cough, and headaches were the most common symptoms. Transmission from school occurred in 29% (Fig 3) and most commonly occurred in the classroom. Among the 68 contacts interviewed, 96% were students. The two most reported activities contacts participated in were band (n=9) and sports (n=22), 10 from playing basketball. Three contacts reported exposure to COVID-19 within the household and five contacts reported exposure outside the home or school. Conclusion Case and contact investigation can be a valuable tool to assess COVID-19 transmission in schools. Almost one-third of cases reported school exposures, a greater school transmission rate than previous reported likely do to the increased transmissibility of Omicron. Assessing transmission events with this strategy alone may be limited by its reliance on self-reports. Case investigations can help schools identify potential areas to improve in limiting school-based COVID-19 transmission. Disclosures Sara Malone, PhD, LCSW, AHRQ: Grant/Research Support|NIH: Grant/Research Support Jason Newland, MD, AHRQ: Grant/Research Support|Merck: Grant/Research Support|NIH: Grant/Research Support|PEW Charitable Trust: Grant/Research Support|Pfizer: Grant/Research Support.

Barriers and enablers of breastfeeding in mother-newborn dyads in institutional settings during the COVID-19 pandemic: A qualitative study across seven government hospitals of Delhi, India.

The COVID-19 pandemic disrupted newborn care and breastfeeding practices across most healthcare facilities. We undertook this study to explore the barriers and enablers for newborn care and breastfeeding practices in hospitals in Delhi, India for recently delivered mother (RDM)-newborn dyads during the first wave of the COVID-19 pandemic (2020) and inductively design a "pathway of impaction" for informing mitigatory initiatives during the current and future pandemics, at least in the initial months. We used an exploratory descriptive design (qualitative research method) and collected information from seven leading public health facilities in Delhi, India. We conducted separate interviews with the head and senior faculty from the Departments of Pediatrics/Neonatology (n = 12) and Obstetrics (n = 7), resident doctors (n = 14), nurses (labor room/maternity ward; n = 13), and RDMs (n = 45) across three profiles: (a) COVID-19-negative RDM with healthy newborn (n = 18), (b) COVID-19-positive RDM with healthy newborn (n = 19), and (c) COVID-19 positive RDM with sick newborn needing intensive care (n = 8) along with their care-giving family members (n = 39). We analyzed the data using grounded theory as the method and phenomenology as the philosophy of our research. Anxiety among clients and providers, evolving evidence and advisories, separation of the COVID-positive RDM from her newborn at birth, providers' tendency to minimize contact duration and frequency with COVID-positive mothers, compromised counseling on breastfeeding, logistic difficulties in expression and transportation of COVID-positive mother's milk to her baby in the nursery, COVID restrictions, staff shortage and unavailable family support in wards and nursery, and inadequate infrastructure were identified as major barriers. Keeping the RDM-newborn together, harmonization of standard operating procedures between professional associations and within and between departments, strategic mobilization of resources, optimization of human resources, strengthening client-provider interaction, risk triaging, leveraging technology, and leadership-in-crisis-situations were notable enablers. The separation of the RDM and newborn led to a cascade of disruptions to newborn care and breastfeeding practices in the study institutions. Separating the newborn from the mother should be avoided during public health emergencies unless there is robust evidence favoring the same; routine institutional practices should be family centered.

What patients and caregivers do with knowledge of Alzheimer’s disease CSF test results: Findings from the IMPACT‐AD BC study

AbstractBackgroundThe growing clinical use of the analysis of CSF amyloid‐beta peptides and tau proteins to assist in the diagnosis Alzheimer’s disease (AD) highlights an urgent need to understand the impact of this testing on patients, as well as their care partners. We aimed to address this knowledge gap by examining the perspectives of patients who underwent CSF AD biomarker testing as part of routine care, and a family member (‘care partner’).MethodWithin the ‘Investigating the Impact of Alzheimer’s Disease Diagnostics in British Columbia’ (IMPACT‐AD BC) study (NCT05002699), we conducted semi‐structured telephone interviews with patients that meet the appropriate use criteria for AD CSF biomarker testing and separate interviews with their care partner. A subset of patients (n=33) and care partners (n=31) were interviewed post‐CSF biomarker disclosure and again ∼5 months (median: 4.9 [4.2‐5.3]) after the initial interview. Thematic content analysis was performed to understand the impact of AD biomarker testing on health behaviors, financial and care planning decisions, and resources and support needs.ResultMost patients (94%) rated their decision to undergo testing as “easy”, with the remainder noting the decision was neither easy nor difficult. After result disclosure, a few patients (8%) reported feelings of concern, but the majority (80%) reported overall positive feelings from having more information about their brain health, certainty around their diagnosis, and the ability to plan ahead. Regarding actions patients planned to take after learning their test result, many expressed an intention to adopt or continue with healthy behaviors, such as exercise (42%). From the care partners’ perspective, many expressed relief at having more diagnostic certainty post‐disclosure, and that this information would help them plan for future care needs. Post‐disclosure, care partners also relayed an increased awareness of future caregiving responsibilities and the need or desire to connect with community resources to help navigate this new role. Additional analyses investigated responses based on patients’ amyloid status and disease severity.ConclusionIn summary, individuals undergoing AD CSF biomarker testing and their care partners found that CSF testing provided the information needed to help them make wellbeing decisions and plan their future.

A photo-based communication intervention to promote diet-related discussions among older adults with multi-morbidity.

Little is known about how to best communicate with older adults about dietary behaviors and related factors in complex chronic disease care. Photo-based communication could promote efficient information exchange and activate patients to effectively communicate their lived experiences. We conducted a pilot study to assess the feasibility and acceptability of a photo-based patient-clinician communication intervention to promote dietary discussions in geriatric primary care. Older adult patients with 2+ concurrent chronic conditions received in-person training on photo-taking with a smartphone before taking photos in response to the prompt, "What aspects of your everyday life affect what you eat and how much you have to eat?" Patients then shared photos and their narratives with their primary care clinician during a clinic visit. Patients and clinicians completed separate audio-recorded post-visit interviews to assess perspectives on the intervention. Interview transcripts were analyzed using a thematic analysis approach. Fourteen patient-clinician dyads completed the study. All except one patient-clinician dyad (93%) completed the intervention as trained. 93% of patients and 86% of clinicians reported that they would "definitely" or "probably" be willing to engage in a future visit with photo-sharing. Patients and clinicians shared similar perspectives on how sharing of photos during the visit enhanced communication and information exchange about dietary practices and other health-related factors, influenced clinical recommendations made during the visits, and strengthened the patient-clinician relationship. Incorporation of a photo-based patient-clinician communication intervention to promote discussions regarding diet and other health-related factors could be a patient-centered strategy to help deliver comprehensive geriatric primary care.

Health-related quality of life and caregiver perspectives in glioblastoma survivors: a mixed-methods study

BackgroundThe purpose of antineoplastic treatment of high-grade glioma (HGG) is to achieve progression-free survival with delayed neurological and cognitive deterioration. Health-related quality of life (HRQOL) has become increasingly important next...

Applicant characteristics and interview-day structure of shoulder and elbow surgery fellowships

Background: The purpose of this study was to determine the selection criteria and interview-day structure used by shoulder and elbow fellowship program directors. Methods: An anonymous 14-question survey was distributed to the program directors of the 31 American Shoulder and Elbow Surgeons (ASES) recognized orthopaedic shoulder and elbow fellowship programs. Surveys were sent via email, and responses were collected from March 31, 2021 to May 10, 2021. Results: All 31 fellowship directors responded (100%). The most valuable selection criteria for applicants were subjective measures: quality of interview, letters of recommendation, and quality of residency program. Objective criteria such as United States Medical Licensing Examination (USMLE) scores and Orthopaedic In-Training Examination (OITE) scores were less important. Fifteen (50%, 15/30) programs required applicants to have one to two publications, while 15 (50%, 15 of 30) required three to five publications. Programs most commonly interviewed 16 to 20 residents (38.7%). The interview day was a half day for the majority of programs (n=20; 64.5%), with most programs utilizing three (25.8%) or four (45.2%) separate interviews. Current fellows interviewed applicants in about half of the programs (51.6%). Conclusions: Shoulder and elbow fellowship program directors prioritize subjective over objective attributes when selecting applicants. The interview day is most commonly a half day with each applicant undergoing multiple interviews at each institution. Understanding the selection process used by shoulder and elbow fellowship directors provides a valuable resource for residents. Level of Evidence: Level V.

Couples facing the "honeymoon period" of Parkinson's disease: A qualitative study of dyadic functioning.

The public health issue of the Parkinson's disease (PD) has led to a great deal of research that has highlighted the individual challenges faced by the person with the Parkinson's disease (PwPD) and the caregiving spouse. Few studies, however, have sought to understand the functioning of couples facing PD, by differentiating each stage, each of which has its own issues. In particular, the "honeymoon period", characterized by a symptomatic respite allowed by the effectiveness of treatments for motor symptoms, has been poorly documented, especially at the dyadic level. This qualitative study, based on Interpretative Phenomenological Analysis, aimed to understand the experience of couples and their functioning at this stage. Fifteen couples participated in separate semi-structured interviews for each partner. The analyses highlighted four dyadic dynamics, which call into question the relevance of the term "honeymoon" to describe the experience of couples. While some couples appear to adjust by means of flexible functioning and a positive reinterpretation of this experience, other dyads oscillate between rigid hyperprotection in the face of perceived distress or a vicious circle of control/avoidance and, in some cases, gradually slipping towards the erosion of the relationship. These results show that the relational difficulties suffered by partners at this stage should be taken into account as soon as possible after the diagnosis. Strengthening the communication and the togetherness between partners, as well as working on dyadic emotional regulation, are particularly relevant options for these couples.

Interviews with Staci Ross and Emily Drabinski

Two separate interviews were conducted, one with Staci Ross, Cataloging/Metadata Librarian at the University Library System, University of Pittsburgh and the other with Emily Drabinski, Critical Pedagogy Librarian, CUNY. Topics covered include their careers, their work in critical librarianship, NASA, and building a community all while discussing cats.