ABSTRACT Following the outbreak of the war in Ukraine, over 170,000 Ukrainian refugees have sought protection in Italy. In response to this emergency, thousands of Italian citizens opened their homes to host them, facing various challenges such as financial strain, disrupted routines, and emotional burden. This study examines the perceived community resilience of Italian host communities during the reception of Ukrainian refugees following the Russian attack on Ukraine. We argue that community resilience offers a useful construct to understand how local communities cope with the demands of sudden large-scale reception. Based on 24 semi-structured interviews conducted between December 2022 and May 2023 with Italian hosts, thematic analysis revealed key factors shaping their experience: the definition of community, perceived social support, access to information and communication, and sense of belonging. Our findings highlight that both material resources and emotional connection to the community were key in sustaining hosts engagement. These insights can inform reception policies and support mechanisms for host communities in future emergencies related to forced migration.

This study explored Grade 9 students’ experiences and perspectives on peer teaching and its impact on their psychological well-being. Employing a qualitative interpretive case study design, twenty students from two junior secondary schools in Botswana were purposefully selected. Data were generated through participant observation and semi-structured interviews. Thematic analysis was utilized to identify key outcomes of peer teaching, which included supportive friendships, peer relationships, a sense of belonging, positive learning attitudes, increased confidence and competence, as well as feelings of happiness and gratitude. These findings underscore the potential of peer teaching to enhance psychological well-being among similar student populations in Botswana. The implementation of peer teaching in public middle schools within Botswana demonstrates its capacity to cultivate an environment conducive to supportive networks, wherein students engage in active learning and interaction within a framework of friendship. The findings provide valuable insights for policymakers and curriculum developers, emphasizing the importance of educational reforms that incorporate peer teaching as an intervention strategy to improve the psychological well-being of students at the junior secondary level. Future research should consider employing ethnographic methods, grounded theory, and the PROSPER framework to further understand the reciprocal nature of peer teaching and its impact on psychological well-being.

ABSTRACT This study explores the intersection of education and family socialization through memorable messages reported by adolescents who are estranged from their parents because of their queer identity (estranged queer adolescents [EQAs)]). Using the theory of memorable messages, 40 EQAs aged 13–19 described memorable messages they received during their estrangement process, the deficiencies in those messages, and messages they had for others. We identified five types of memorable messages: four negative (shame, violence, denial of gender, mismatched words and actions) and one positive (acceptance). EQAs reported three message deficiencies of lack of identity validation, emotional support, and protection. EQAs directed advice to parents (unconditional love and emotional responsiveness) and peers (self-acceptance and patience). Thematic co-occurrence analysis revealed a relationship between (a) the memorable message of denial of gender, (b) the perceived deficiency of support, and (c) advice for other EQAs to be patient; revealing how despite the negative memorable messages and lack of support EQAs received from their parents, they still had hope for a better future. These findings illuminate how EQAs make sense of memorable messages they received from their family and offers insights to foster more affirming environments within families and educational contexts.

The increasing use of the terms ‘complex’ and ‘complexity’ in Fire Safety Engineering (FSE) literature reflects a shifting context in the design and delivery of fire-safe buildings. Recent studies emphasize the importance of recognizing and managing complexity in building fire safety design. However, the concept of complexity remains unclear, posing challenges for fire safety professionals seeking to manage it in practice. To begin addressing this gap, this qualitative study examines how the terms ‘complex’ and ‘complexity’ are applied in peer-reviewed literature related to building fire safety design from 1946 to 2024. Using document review and thematic analysis, five themes were constructed that reflect the diverse ways authors subjectively use these terms: (1) epistemic complexity; (2) knowable technical complexity; (3) computational modelling complexity; (4) uncommon building complexity; and (5) requirement complexity. These themes are expected to help fire safety professionals reflect on the nature of complexity in design processes, reduce ambiguity, improve professional discourse, support resource planning and stakeholder engagement, and encourage the integration of sociotechnical factors in the design process. This study is a first attempt to connect complexity theory with FSE, helping clarify the concept and introduce insights from a broader discourse. • Complexity is widely used in fire safety but rarely defined or described • Peer-reviewed fire safety literature was examined and thematically analyzed • Authors use ‘complexity’ in varied, subjective ways across five distinct themes • Themes support reflection and discussion on complexity in fire safety practice

There is a recognised desire to teach amongst GP trainees yet limited formal opportunities to do this. There are known benefits of near-peer teaching to both teacher and learner, but minimal research investigating the role of GP trainees as teachers in a clinical setting. This study aims to evaluate the views of GP trainees participating in a teaching scheme piloted at the University of Manchester. This mixed-methods study was conducted over a three-year period. In years one and three, evaluation was undertaken using questionnaires comprising Likert scale items and free-text responses (n = 11). In the second year, qualitative data was collected via a focus group with GP trainees following their teaching experiences (n = 8). Subsequently, a thematic analysis was conducted. GP trainees reported benefits including improved clinical skills, job satisfaction and development of leadership skills. There was a noted impact on their teaching skills, as GP trainees demonstrated their ability to be adaptable to learners' needs and develop interactive, structured teaching sessions. The main challenges identified were organisation and time management, balancing responsibilities and adapting to student needs. Trainees unanimously felt the scheme allowed them to meet their portfolio requirements, develop their teaching skills and made them more likely to consider pursuing medical education as part of their future careers. All participants expressed a desire to continue with teaching and reported improved job satisfaction. Participation in a near-peer teaching scheme can have significant positive impacts on GP trainees' personal and professional development. Despite some challenges, trainees reported numerous benefits from undertaking the scheme. Formal teaching opportunities for GP trainees could contribute to the development of a skilled and motivated future workforce of clinician-educators in general practice.

This review synthesizes qualitative evidence on nursing students' experiences with family caregivers. Family caregivers play a pivotal role in patient care. Nursing students frequently interact with family caregivers during their clinical training, yet they report feeling unprepared. A meta-synthesis was conducted following the thematic approach of Thomas and Harden. Six databases were searched, and studies were screened and analyzed independently by two reviewers. Thematic synthesis followed a three-stage process to identify descriptive and analytical themes. The methodological rigor of included studies was assessed using the JBI Critical Appraisal Checklist, and confidence in findings was evaluated with the GRADE-CERQual framework. Six studies involving 122 participants were included. Methodological quality was generally moderate to high according to the JBI Critical Appraisal Checklist, with the strongest congruity reported in study design and data interpretation, and lower reporting related to researcher reflexivity. Two analytical themes were identified: (1) Navigating relationships through balancing support, communication, context, and culture, encompassing the descriptive themes The role of families in caregiving, Building trust through clear and tailored communication, and Cultural and contextual factors in interactions with family members; and (2) Building skills and emotional resilience, including Emotional intelligence in relationships with families and Educational gaps and the role of supervisors. According to the GRADE-CERQual framework, confidence in findings was moderate for most themes and low for cultural and contextual factors. Overall, families were recognized as essential partners in care, while students reported communication challenges, emotional demands, and reliance on supervisors to bridge educational gaps. Nursing programs should prioritize structured training in communication, emotional intelligence, and cultural competence, supported by mentorship and simulation-based learning. Further research is needed to explore students' experiences with family caregivers in different settings, educational interventions, and the impact of mentorship on students' competencies in family-centered care.

Although buprenorphine is effective and approved for treating opioid use disorder (OUD), it remains underutilized in primary care settings. This study's objective was to explore what primary care teams need to overcome barriers in treating OUD, and to assess whether those needs change after receiving education on OUD treatment. The American Academy of Family Physicians hosted a 12-month Project ECHO® educational series on OUD for primary care teams. Thematic analysis was conducted on participant responses pre- and post-series to the survey item "Please list your most pressing needs related to OUD" (N = 92). Ninety-two participants from 25 primary care practices from the US and Canada responded to the pressing needs item across both surveys. The most prevalent need reported at baseline was Education and Training, which became second to Health System Resources at endpoint. Respondents cited organizational protocols for OUD treatment as a pressing need among other Health System Resources such as support for reimbursement. Needs relating to transportation and housing; engaging patients to start and continue in OUD treatment; and addressing stigma within the community and health system were indicative of overlapping barriers. Responses from primary care teams echo previous studies on barriers to OUD treatment and provide specific, actionable insight to addressing these barriers. Actionable insights, for example, implementing health system-level OUD protocols and guidelines and promoting availability of OUD treatment and education, are ways that primary care teams could increase treatment of patients with OUD.

Tobacco smoking disproportionately affects people experiencing socioeconomic disadvantage. Improving access to effective smoking cessation programmes and medications is crucial to reducing this gap. Here, we report on a programme trialling the provision of free nicotine replacement therapy to priority populations through community pharmacies. This study evaluates the engagement and acceptability of this approach using a multiphase mixed methods design. Two groups were involved in the programme: community pharmacists (n = 8) and people who smoke cigarettes (n = 55). At the conclusion of the programme, 7 pharmacists and 10 smokers completed semi-structured interviews. Qualitative data collected through interviews were analysed using a hybrid approach of inductive and deductive thematic analysis. An inductive reflexive thematic analysis was performed first, followed by a deductive thematic analysis to code the data into the seven constructs of the Theoretical Framework of Acceptability. Analyses revealed pharmacists and smokers were mostly positive about the pilot programme. Although the burden was perceived to be considerable by pharmacists, and the self-efficacy and opportunity costs appear to have limited the engagement of some smokers in the programme. This evaluation provides insights into what works to support people from priority populations who want to quit smoking. It highlights that both engagement with and acceptability of smoking cessation support are influenced by practical considerations and the service setting. Furthermore, it highlights the important role that existing health destinations, such as community pharmacies, can play in the delivery of public health interventions.

Feeding resistance: Intersectional paths to food justice, health, and emancipation.

Veterinarians play a central role in the identification and control of Emergency Animal Diseases (EADs), yet empirical knowledge of how they experience and manage this work in practice remains limited. Ultimately, outbreak management depends on how suspected and confirmed cases are handled in everyday veterinary settings. This study explores how Swedish veterinarians experience and manage suspected and confirmed EADs in production animals, with particular attention to workload, task demands, and decision-making. The study draws on semi-structured interviews with 19 livestock and slaughterhouse veterinarians who have managed suspected or confirmed EADs leading to state-mandated interventions such as testing, movement restrictions, and culling. Data were analysed using thematic analysis. The findings are presented through three main themes. First, Organisational strain and competing demands describes how emergency disease work intensifies workload, time pressure, and non-routine administrative and practical tasks, particularly when outbreak management is added to everyday clinical responsibilities. Second, The burden of situated responsibility captures how veterinarians' on-site judgements carry far-reaching consequences and require adaptation of formal protocols to local conditions. Third, Distributing responsibility in the management of EADs shows how collegial, expert, and institutional support helps distribute responsibility and make outbreak work manageable. Overall, the study highlights how EAD management amplifies the complexity of veterinary practice and underscores that strengthening disease preparedness requires attention to the organisational conditions and support structures that enable veterinarians to carry out this work without becoming overburdened.

Harm reduction gaps in sexualized drug use among gay and bisexual men living with HIV in Colombia.

Multidisciplinary analysis of teamwork in orthopaedic trauma: How do expectations differ from reality in the operating room environment?

Despite many hospitalized children missing recommended vaccines, vaccines are rarely administered during hospitalization. Our objective was to explore the key determinants for inpatient vaccine delivery in a sample of 11 US children's hospitals. We used the Pediatric Health Information System database to identify children's hospitals in the Pediatric Research in Inpatient Setting network who were in the top tertile (n = 6) and the bottom tertile of inpatient vaccine administration (n = 5). We recruited pediatric nurses, pharmacists, and hospitalists to participate in semistructured interviews. Interview questions were based on the Consolidated Framework for Implementation Research and focused on current practices and barriers to inpatient vaccine delivery. Interviews were conducted via telephone or teleconferencing and were recorded and transcribed. Two reviewers independently coded transcripts using thematic analysis; a third reviewer resolved discrepancies, as needed. We conducted 36 interviews: 10 hospitalists, 14 nurses, and 12 pharmacists. Several themes emerged as key determinants for inpatient vaccine delivery, including the following: 1) timing: vaccine administration happened predominately at discharge, which at times jeopardized vaccine delivery; 2) access: vaccinating during hospitalization was particularly important when children had difficulty accessing primary care or when traditional health care services were disrupted, eg,during the COVID-19 pandemic; and 3) workflow: vaccine-related workflow is often not standardized and lacks ownership. Despite variability in vaccine administration across children's hospitals, there are many common barriers and determinants. Solutions that address these barriers and meet the needs of multidisciplinary clinicians are essential to improve inpatient vaccine delivery.

Collaborative testing (CT) and its implementation into nurse practitioner (NP) programs is not well understood. Given the adoption of competency-based learning in nursing curricula, a pilot of CT in an NP program was implemented at a large, urban university. Over two years, CT was applied in three NP courses using integrated testing software. Students from two family NP cohorts (N2023 = 36 and N2024 = 34) who participated in the CT modality were evaluated for their feedback. The aim was to evaluate examination score outcomes and the student experience with the CT modality. Reported findings include examination scores from two NP courses and cross-sectional survey results with quantitative and qualitative findings. The mean examination score change from individual to weighted total was 6.3% in the 2023 cohort and 2.69% in the 2024 cohort. Students were surveyed with a questionnaire on their experience with CT at the completion of three courses. A means analysis shows high scores of student experience with CT and a paired t -test indicates a difference between the cohorts ( p < .0001). An analysis of one qualitative question through thematic analysis is presented, and findings show students have a positive experience in relation to knowledge retention, decreased test anxiety, and peer collaboration. Minimal barriers were identified in the execution or delivery of CT. Our findings indicate that CT may be efficiently implemented into NP courses, improve student outcomes and experience, and support competency based education.

Rhythm in dance movement therapy: A thematic analysis toward a conceptual definition

Identification of challenges to implementation of infection control guidance in primary care during COVID-19 incidents: Lessons for pandemic planning.

The place and role of economic language and economic appraisal in environmental decision-making: Lessons from the implementation of the Marine Strategy Framework Directive (MSFD) in France

"There is a soil shortage in delivering services for fathers": Qualitative inquiry into service challenges and opportunities for fathers with disabled children: The practitioners' perspectives.

Early childhood education and care (ECEC) centres are an ideal setting to promote key healthy eating and active living (HEAL) practices. Redesigning messages around such practices to be digital could help engage ECEC educators and assist with long-term implementation and reach. The aim of this study was to evaluate the potential impact of a HEAL-focused video initiative (Small Bites for Big Steps) on precursors to behaviour change including educators' self-efficacy, perceived behavioural control and behavioural intentions and the acceptability of the videos. A pilot randomised controlled trial was conducted with early childhood educators (56% aged 25-44 years, 98% female). Participants randomised to the intervention group received on average 3-4 weekly videos promoting HEAL practices, whilst participants in the control group maintained usual practice. Educators' self-efficacy, perceived behavioural control, and behavioural intention were assessed using questionnaires at baseline and post-intervention (9 weeks). Data were analysed using Mann Whitney U tests in SPSS and thematic analysis. Acceptability data were collected using questionnaires, focus groups, interviews, and Vimeo analytics. One hundred and six educators from 16 ECEC services were recruited. Exploratory efficacy analysis found significant improvements from baseline to post-intervention between groups for healthy eating/drinking perceived behavioural control. At post-intervention, there was a significant difference between intervention and control groups for healthy eating/drinking behavioural intention, physical activity behavioural intention, and overall behavioural intention. No significant between group differences were observed for changes in perceived behavioural control relating to physical activity or for any self-efficacy measures. Educators valued the content, length and approach of the videos. Limitations identified from the qualitative data included technical difficulties and cultural appropriateness. This video-based intervention positively influenced educators' perceived behavioural control and behavioural intentions, key precursors to behaviour change. The video suite was acceptable to educators. SO WHAT?: Redesigning HEAL messages into video resources may support ECEC educators to promote and implement these practices to young children and their families/carers.

Parental education has been highlighted as an effective intervention for children, young people and families. However, no parental education interventions are underpinned by occupational therapy (OT) theory. This study aimed to understand the perspectives of parents/carers of children with neurodevelopmental disorders on the acceptability and design of a parental educational intervention underpinned by OT theory. 23 parents/carers of children aged between 5 and 11 years who had a diagnosis of Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder and/or Developmental Coordination Disorder participated in one of three online 90-minute focus groups. Participants were presented with a draft of the proposed intervention and engaged in a facilitated discussion about the acceptability and feasibility of the intervention. Data were analysed using thematic analysis. Four themes were generated: (1) Parents want to develop skills to support their child, (2) parents also need support, (3) there are barriers to reaching parents and (4) parents need an inclusive environment to promote their learning. Parents/carers acknowledged the benefits of the intervention, highlighting the importance of focusing on supporting parents as well as their children. They also raised potential barriers to participation, which included time and money, and emphasised the importance of designing the group with inclusivity as a central principle.