Interview Transcripts Research Articles

Coping with an awake brain tumour resection in patients and their primary contacts: a qualitative study

Abstract Background The diagnosis and awake removal of a brain tumour is a major life event. A better understanding of the needs of this group of patients and their primary contacts in the perioperative trajectory can further improve care. Methods Adult patients who underwent an awake craniotomy in the Erasmus MC, the Netherlands, and their primary contacts were interviewed 1-2 weeks prior to surgery and 2-4 weeks after surgery. Semi-structured interviews on the impact of the diagnosis on their lives and coping mechanisms with the AC-procedure were conducted. Interview transcripts were analyzed in accordance with the principles of grounded theory. Results 21 patients and 19 primary contacts were interviewed at least once during this period. Analyses and coding of the transcripts resulted in a conceptual model, distinguishing coping with the disease and coping with specific procedure of awake craniotomy. In general, participants tended to rely on their pre-existing ways of coping. Situation specific coping mostly referred to perceiving control, and related to that, trust in the medical team. Conclusion Patients with a brain tumour and their primary contacts perceive coping with the AC-procedure as a part of coping with the disease. Although the procedure may be perceived as stressful, at the same time it offers hope and prospect. In coping with the specifics of the AC-procedure, we found that feeling in control and as an extension of that, trust in the AC-team were key aspects.

Project Based Learning to Improve the Learning of English Writing Skill Among Students of XI TKJ 1 Class at SMK Politeknik YP3i Banyumas (A Classroom Action Research at XI Graders of SMK Politeknik YP3i Banyumas in Academic Year 2024/2025)

This research was aimed to enhance the learning of students’ Narrative genre writing skill at SMK Politeknik YP3i Banyumas by using Canva as a technology through Project Based Learning (PJBL) as the instructional media and approach. This research was a classroom action research carried out in two cycles and each cycle had three meetings with the steps of the research consisting of planning, action, observation and reflection. The subjects were 36 students of XI TKJ 1. The data were collected by observing the instructional process, conducting a pre-test and a post-test, conducting an interview, and taking photographs. The instruments for collecting the data were observation checklists, answer sheet, and interview guides. The data were analyzed qualitatively. The observation checklists and interview transcripts were analyzed qualitatively through data collection, data reduction data display, and drawing conclusion. The validity of the research was through process validity, democratic validity, dialogic validity, catalytic validity and outcome validity. The result showed that Project Based Learning (PJBL) effectively enhanced the students’ learning of English writing skill about Narrative genre writing. The use of canva as a technology was through PJBL showing the improvement that the students were accustomed to having writing practice with the process of writing within. It made quite much improvement on the students’ writing learning process in terms of participation, involvement, and achievement. Students should learn individually and in group and produce the real product from their learning and they study involving technology. Based on the enhancement result, the researcher suggested that the teacher could implement canva as a technology through PJBL simultaneously as an effort to enhance students’ Narrative genre writing skill.

Igniting the fire and seeing through the smoke: Enabling medical students to see themselves as future clinical academics

Purpose Lack of recruitment to clinical academic careers is of concern, and may be linked to lack of awareness and promotion of this pathway in undergraduate medical education. Our study explored undergraduate experiences which support academic career progression and potential barriers to pursuing Specialised Foundation roles in the United Kingdom. Methods We adopted a constructivist lens and conducted interviews with specialised foundation programme (SFP) doctors and final year students who had applied for SFP positions. We analysed interview transcripts using reflexive thematic analysis. Results We recognised four key stages which stimulated and supported students in pursuing a clinical academic career: (1) Lighting the inner spark; (2) Igniting the fire; (3) Feeding the fire; and (4) Seeing through the smoke. Although students showed a strong inner drive, meaningful undergraduate experiences and positive interactions with academics were crucial for sparking academic interests. Participants were more often inspired by their extra-curricular activities than core undergraduate education. Conclusions Early positive experiences are needed for students to overcome stereotypes and consider clinical academic careers. Medical schools should raise awareness of clinical academic careers early on, ensure all students have opportunities to participate in relevant activities with academic teams, and develop medical educators and researchers who can engage and inspire others.

Paediatric Nurses' Personal Accounts of Being Told Not to Disclose Information to Children With Serious Illness-An Interpretative Phenomenological Study.

To explore the experiences, and perceptions of nurses who are told to withhold clinical information from children diagnosed with serious illnesses. An interpretative qualitative phenomenological design was used for the study. Sampling was purposive and data were collected using semi-structured interviews from nurses working in a paediatric setting within the preceding 5 years. Nurse-participants described their personal experiences of withholding situations ('non-disclosure directives'). Their accounts of specific examples of situations ('personal accounts') were extracted from the interview transcripts and analysed using inductive content analysis to identify patterns and concepts within the descriptions. Data management was supported using Dedoose. Nurse-participants were interviewed face-to face and online between November 2019 and December 2020. Twenty-six Australian nurses who have cared for seriously ill children within the preceding 5 years participated in the study. Thirty-nine accounts of non-disclosure situations (personal accounts) were extracted from interview transcripts. Four types of non-disclosure were identified in the personal accounts: withholding information, temporary withholding, lying and combined withholding/lying. The inductive content analysis identified three key aspects of nurse-participants' accounts: beliefs and perceptions (about the child and parents), the nature of the experience and feelings about the experience. Moral distress occurred when nurses' actions conflicted with their moral values in response to a non-disclosure directive, particularly when asked to directly lie to children. Nurses felt disempowered by the parent's authority and the institutional hierarchy that limited their ability to participate in discussions where a non-disclosure directive was given. Nurse-participants were afforded a platform for reflection which proved valuable in allowing them to process their experiences in a non-disclosure situation. Nurses directed to withhold medical information from children should be afforded opportunities for reflection to mitigate moral distress. Nurses should be included in the planning of ethically appropriate responses to withholding directives.

“They talk about it like it's an overdose crisis when in fact it's basically genocide”: The experiences of Indigenous peoples who use illicit drugs in Vancouver's Downtown Eastside neighbourhood

Indigenous Peoples who use illicit drugs (IPWUID) are disproportionately represented among toxic drug poisoning deaths in Canada. These drug-related harms are framed by the historical and ongoing trauma related to settler colonialism and are acutely visible in Vancouver, Canada's Downtown Eastside - a low-income neighbourhood that is an epicenter of the drug poisoning crisis and characterized by entrenched poverty, substance use, violence, and homelessness. This study was undertaken to examine the experiences and perspectives of IPWUID in the Downtown Eastside regarding the drug poisoning crisis and the responsiveness of harm reduction programs within the context of settler colonialism. Indigenous-led qualitative interviews were conducted with 16 IPWUID recruited by Indigenous peer researchers. Indigenous ways of knowing were embedded throughout the entire research design to ensure research was culturally congruent. Interview transcripts were analyzed thematically and interpreted by drawing on concepts of social violence and racial capitalism. Our analysis reviewed three key themes that centered the experiences of IPWUID in Vancouver's Downtown Eastside in relation to the drug poisoning crisis: (1) that the drug poisoning crisis is understood as a form of genocide toward Indigenous Peoples; (2) that the crisis is experienced within the context of pervasive distrust and adversarial relationships with police rooted in structurally racist experiences of place-based policing practices; and (3) that there is a desire for culturally-safe harm reduction care with Indigenous representation, cultural integration, and that addresses inequities and injustice stemming from colonialism and structural racism. Findings demonstrate how responses to the drug poisoning crisis among IPWUID need to respond to social and materials conditions perpetuated by colonialism and racial capitalism, while also centering IPWUID through the development and implementation of Indigenous-led and culturally safe harm reduction approaches.

A mixed-methods survey and focus group study to understand researcher and clinician preferences for a Journal transparency Tool

Transparency within biomedical research is essential for research integrity, credibility, and reproducibility. To increase adherence to optimal scientific practices and enhance transparency, we propose the creation of a journal transparency tool (JTT) that will allow users to obtain information about a given scholarly journal’s operations and transparency policies. This study is part of a program of research to obtain user preferences to inform the proposed JTT. Here, we report on our consultation with clinicians and researchers. This mixed-methods study was conducted in two parts. The first part involved a cross-sectional survey conducted on a random sample of authors from biomedical journals. The survey asked clinicians and researchers about the inclusion of a series of potential scholarly metrics and user features in the proposed JTT. Quantitative survey items were summarized with descriptive statistics. Thematic content analysis was employed to analyze text-based responses. Subsequent focus groups used survey responses to further explore the inclusion of items in the JTT. Items with less than 70% agreement were used to structure discussion points during these sessions. Participants voted on the use of user features and metrics to be considered within the journal tool after each discussion. Thematic content analysis was conducted on interview transcripts to identify the core themes discussed. A total of 632 participants (5.5% response rate) took part in the survey. A collective total of 74.7% of respondents found it either ‘occasionally, ‘often’, or ‘almost always’ difficult to determine if health information online is based on reliable research evidence. Twenty-two participants took part in the focus groups. Three user features and five journal tool metrics were major discussion points during these sessions. Thematic analysis of interview transcripts resulted in six themes. The use of registration was the only item to not meet the 70% threshold after both the survey and focus groups. Participants demonstrated low scholarly communication literacy when discussing tool metric suggestions. Our findings suggest that the JTT would be valuable for both researchers and clinicians. The outcomes of this research will contribute to developing and refining the tool in accordance with researchers and clinicians.

Patient safety incidents in anaesthesia: a qualitative studyof trainee experience from a single UK healthcare region.

Anaesthetic training has always had patient safety as part of the curriculum. However, there is limited emphasis on what happens when things do not go to plan. Our aims were to understand the impact of involvement in patient safety incidents on anaesthetic trainees in our region, to describe the range of support currently offered and put forward suggestions for improvement. An initial electronic survey was sent to all anaesthetic trainees in a single UK healthcare region to capture qualitative and quantitative information on patient safety incidents. After completing the questionnaire, participants were asked to consent to involvement in a semi-structured interview to provide a more detailed understanding of the impact of safety incidents. Data were analysed from the questionnaires and interview transcripts using descriptive statistics and thematic analysis. Thirty-four completed questionnaires were analysed revealing 27 trainees had been involved in a patient safety incident. Ten semi-structured interviews were conducted and six themes were identified: team dynamics (including adequacy of staffing and supportive departmental culture); context of the event; reflex immediate support post-event; working environment pending completion of the investigation; personal impact (including physical and mental health); and suggestions for future support. This study has shown the significant impact of safety incidents on anaesthetic trainees in one training region in the UK and highlights the importance of implementing early, tailored debriefs led by trained facilitators, the value of a supportive work environment and the need to raise awareness of system-based approaches to learning from incident investigations. Further research should guide the format and delivery of support for trainees to provide more helpful and timely interventions after patient safety incidents and reduce the risk of future harm to both patients and trainees.

Contextual barriers to infection prevention and control program implementation in hospitals in Latin America: a mixed methods evaluation

BackgroundInfection prevention and control (IPC) programs are essential to prevent and control the spread of multidrug-resistant organisms in healthcare facilities (HCFs). The current implementation of these programs in Latin America remains largely unknown.MethodsWe conducted a mixed-methods evaluation of IPC program implementation in HCFs from Guatemala, Panama, Ecuador, and Argentina, March-July 2022. We used the World Health Organization (WHO) IPC Assessment Framework (IPCAF) survey, a previously validated structured questionnaire with an associated scoring system that evaluates the eight core components of IPC (IPC program; IPC guidelines; IPC education and training; healthcare-associated infection [HAI] surveillance; multimodal strategies; monitoring and audit of IPC practices and feedback; workload, staffing, and bed occupancy; and the built environment and materials and equipment for IPC). Each section generates a score 0–100. According to the final score, the HCF IPC program implementation is categorized into four levels: inadequate (0–200), basic (201–400), intermediate (401–600), or advanced (601–800). Additionally, we conducted semi-structured interviews among IPC personnel and microbiologists using the Systems Engineering Initiative for Patient Safety model to evaluate barriers and facilitators for IPC program implementation. We performed directed content analysis of interview transcripts to identify themes that focused on barriers and facilitators of IPC program implementation which are summarized descriptively.ResultsThirty-seven HCFs (15 for-profit and 22 non-profit) completed the IPCAF survey. The overall median score was 614 (IQR 569, 693) which corresponded to an “advanced” level of IPC implementation (32% [7/22] non-profit vs. 93% [14/15] for-profit HCFs in this category). The lowest scores were in workload, staffing and bed occupancy followed by IPC training and multimodal strategies. Forty individuals from 16 HCFs were interviewed. They perceived inadequate staffing and technical resources, limited leadership support, and cultural determinants as major barriers to effective IPC guideline implementation, while external accreditation and technical support from public health authorities were perceived as facilitators.ConclusionsEfforts to strengthen IPC activities in Latin American HCFs should focus on improving support from hospital leadership and public health authorities to ensure better resource allocation, promoting safety culture, and improving training in quality improvement.

Promoting Health and Wellbeing Through Non-Clinical Arts Programming: Multi-Stakeholder Perspectives From the Veterans Health Administration.

While the value of art therapy is well-established and arts are increasingly leveraged to promote health and wellbeing more broadly, little is known about the impacts of non-clinical arts programs. In this preliminary investigation, we sought to fill this gap by exploring diverse stakeholders' perspectives on the impacts of non-clinical arts programming on Veterans receiving care at the Veterans Health Administration (VA). Semi-structured qualitative interviews with Veterans, VA staff, and community partners. Interviewees were recruited from 7 VA medical centers that have recently implemented non-clinical arts programming to promote Veterans' health and wellbeing, some of them in partnership with community organizations. 33 individuals were interviewed, including 9 Veterans, 14 VA staff, and 10 community partners involved in non-clinical arts program implementation. Interview transcripts were analyzed using iterative rounds of qualitative content analysis. The following impacts on Veterans were described: (1) mental health improvements, (2) renewed sense of purpose; (3) increased social connectedness, (4) improved self-esteem, and (5) self-driven engagement in art activities. Non-clinical arts programming was perceived by diverse stakeholders to offer important benefits for Veterans' health and well-being. Offering non-clinical arts programming inside and outside healthcare facilities' walls is a promising direction for the field of public health undergoing a shift towards holistic approaches to improving individual and population health outcomes.

Integrating community health workers into HIV care clinics: a qualitative study with health system leaders and clinicians in the Southern United States

BackgroundCommunity health workers (CHWs) can support patient engagement in care for a variety of health conditions, including HIV. This paper reports on the experiences of HIV clinics and health departments that integrated CHWs into their health systems as part of a capacity-building initiative to address HIV-related disparities in the United States.MethodsSemi-structured interviews were conducted with key informants (n = 14) in two Ryan White HIV/AIDS program jurisdictions: Mississippi (jurisdiction covers the entire state) and the city of New Orleans, Louisiana. This work was part of a larger evaluation of an initiative that used a Learning Collaborative model to facilitate the implementation of evidence-informed interventions to address HIV care continuum gaps in four jurisdictions. The two jurisdictions that focused on integrating CHWs into HIV care clinics and support service agencies were selected for this sub-analysis. Interview participants included HIV clinic leaders and staff, health department leaders, and other Learning Collaborative leaders. Interview transcripts were coded and analyzed for themes related to the acceptability, feasibility, and perceived impact of CHW integration.ResultsOverall, participants expressed interest in having support from CHWs at HIV clinics and service agencies to assist with patient retention and engagement efforts. However, there were challenges integrating CHWs into existing systems (e.g., gaining access to electronic health records, changing policies to conduct home visits, and clarifying roles and scope of work). Negotiating contracts and accessing funding for CHW positions presented major challenges that often contributed to turnover and conflicts around scope of practice. When health departments leveraged existing funding streams to support CHW positions, the clinics and agencies where the CHWs worked had limited flexibility over the hiring process.ConclusionsOur findings reinforce the value and acceptability of CHWs as part of the workforce in HIV clinical and support service settings; however, integrating CHWs into clinics and service agencies required effort. Training the CHWs was not sufficient; other staff and clinicians had to understand the role of CHWs to facilitate their integration into health systems. Resources are needed to support organizations in incorporating CHWs effectively, and long-term, flexible sources of funding are necessary for these positions.

The Experiences of Iranian Middle and Lower Class Living in Inflationary Conditions

One of the most important economic problems in Iran is inflation. The aim of this study was to explore the social consequences of inflation in the lives of middle-class and lower-class people. Some of the questions addressed in this study are: how do participants experience inflation? How do they make a living? What problems are they facing? what are the consequences of inflation for participants? We used a constructivist qualitative approach and grounded theory method. Participants were sampled purposively with different social groups. A total of 27 interviews with participants who belong to the middle-class and lower-class in three cities in Iran in Isfahan, Yazd and Tehran were performed. Data collection was performed through semi-structured interviews. The interview transcripts were analyzed using grounded theory coding. After analyzing the data, 8 main categories were explored which include: Limitations in relationships, Mental Threat, Frustration, make ends meet, Early Adulthood, Family quarrel, profit-making and Anomy. According to the results, participants are in a bad situation in terms of economy. Inflation and financial problems have had the pervasive impact on the people, especially those who have had a steady and low income.

“There's a lot of factors”: Researcher reflections on using I-Poetry to empathetically understand vaccine hesitant individuals

Background: Despite higher vaccination rates compared to other age groups, many US older adults remain under-vaccinated against preventable diseases leading to increased risk of serious illness, hospitalization, or death posed from disease. This study investigates the underlying reasons for older adults not getting vaccinated. Methods: From a larger interview study conducted in North Dakota, eight older adults (Mean Age = 73) were identified as being vaccine hesitant. Participants were asked, “How do you decide about whether or not to get a specific vaccine?” Then, participants' responses were analyzed using the I-poetry qualitative methodology, which involves creating a poem from interview transcripts to capture the essence of participants' experiences. Results: Poetic findings clarify interacting sources of immunization unease and highlight potential intervention avenues for medical professionals. Specifically, the poetic analysis revealed themes of mistrust in the healthcare system, preference for natural immunity, and concerns about vaccine side effects. The study suggests that healthcare professionals should consider using empathetic communication strategies to address vaccine hesitancy in older adults. Conclusions: Understanding vaccine hesitancy as a tapestry instead of individual factors may be more useful for older adults who culminate their hesitant beliefs from prior life experiences. Additionally, to improve trust in healthcare providers, it is suggested that more first-person narratives of older adult experiences are used and solicited by healthcare providers. Possible interventions are discussed.

"I'm not the one with cancer but it's affecting me just as much": Aqualitative study of rural caregivers' experiences seeking and accessing support for their health and wellbeing while caring for someone with cancer.

Caregivers provide vital support to people with cancer but often report feeling unsupported themselves. This study investigated rural caregivers' experiences seeking support for their health and wellbeing while caring for someone with cancer. Through semi-structured interviews, 20 rural caregivers described their experiences seeking and accessing support for their own health and wellbeing while caring for someone with cancer, including what support was, or would have been, helpful. Interview transcripts were analysed using content analysis to identify the type and source of support sought and what aspects of the support were helpful or unhelpful. Health and wellbeing support was sought across medical and psychosocial domains. Caregivers' responses reflected both facilitators and barriers to support-seeking and benefits and challenges of accessing support. Facilitators to support-seeking included telehealth options and being involved in patient care discussions, as this helped caregivers know what to expect in their role. Barriers included social isolation while travelling for treatment and caregivers' needs for support not being acknowledged or understood by medical staff or social networks. Benefits of accessing support included help with managing daily responsibilities and being linked with additional services. Challenges included delays in receiving support, inadequate duration of support, and lack of lived experience among care providers. To optimise rural caregivers' access to support for their health and wellbeing, support services should be prompt and flexible in delivery, simple to navigate, integrated with patient care, improve caregivers' coping ability, provide access to additional supports, and reduce caregiver burden.

Nurse leaders’ recommendations for implementing LGBTQ+ inclusive practices in health systems: A qualitative descriptive study

BackgroundDiscrimination against lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse (LGBTQ+) individuals in healthcare settings remains a priority issue. Nurse leaders, who oversee the largest healthcare workforce, are critical in implementing inclusive practices to address LGBTQ+ discrimination, yet implementing LGBTQ+ inclusive practices and effective strategies is inconsistent. This qualitative descriptive study explored nurse leaders’ perceptions of LGBTQ+ inclusive practices across the United States to inform recommended strategies within health systems. MethodsTwenty-one nurse leaders (e.g., chief nurse executives) from diverse healthcare settings (e.g., children's hospitals and public health centers) in 12 states across the United States participated in semi-structured interviews from October to December 2023. Interview transcripts were analyzed using content analysis to (1) describe nurse leaders’ definitions of LGBTQ+ inclusive practices and (2) identify effective strategies for their implementation. ResultsNurse leaders defined LGBTQ+ inclusive practices to include delivering culturally responsive and competent care, fostering safe and affirming environments, integrating inclusivity into daily interactions and organizational culture, and supporting the needs of both LGBTQ+ staff and patients. Key implementation strategies included fostering a flexible organizational culture through open communication; a diverse workforce; and inclusive mission statements, policies, and strategic plans. Supportive infrastructure involved effective LGBTQ+ training and adapting electronic health record systems to include information on sexual orientation and gender identity. Active and interdisciplinary engagement from staff and leadership, as well as systematic data collection on patient and staff experiences, were essential for driving inclusivity. The advocacy highlighted included legislative support, discourse within the nursing profession, and the incorporation of LGBTQ+ inclusion into healthcare regulations and accreditation standards. Additionally, multisectoral partnerships with LGBTQ+ health experts and external organizations, along with multilevel evaluations, were recommended to develop tailored interventions and promote LGBTQ+ inclusive practices. ConclusionImplementing LGBTQ+ inclusive practices in healthcare is a multifaceted effort influenced by strategies at various levels. Promoting a supportive organizational culture, establishing comprehensive support structures, encouraging active engagement, and fostering community partnerships can address the needs of LGBTQ+ individuals more effectively. Future implementation efforts should tailor strategies to accommodate variability across healthcare settings and regions, ensuring that practices are both adaptable and sustainable.

공교육에서 ‘에듀테크 활용 맞춤형 학습’의 의미와 실행방안 탐색

This study explores the meaning and implementation strategies of using EduTech for personalized instruction in the context of public education. Through an analysis of existing research and focus group interviews conducted in three sessions with elementary and middle school teachers and experts, open coding, nominalization, and categorization were applied to responses and interview transcripts. In addition, a keyword network analysis was conducted using UCINET. Results indicate that EduTech and differentiated instruction emerged as central concepts for personalized learning, with both high frequency and centrality. Although diversity appeared with lower frequency, it ranked as a top keyword in terms of centrality, highlighting the importance of considering student diversity and instructional diversification when designing personalized learning approaches using EduTech. The study suggests that differentiated instruction is a practical approach to using EduTech for personalized learning in public education. It also proposes an instructional diversification strategy that aims to reflect the characteristics and levels of learners, with the overall goal of effectively supporting all students.

Discoveries or doubts: a qualitative study of the transformative potential of portfolio meetings.

To adapt to medical school, students need to change their approaches to learning and study. Transformative learning through critical reflection on disorienting learning experiences supports perspective change to direct new activity. We explored how portfolio meetings support changes in students' perspectives towards learning and study during the transition to studying medicine. This qualitative mixed methods study explored changes in medical students' perspectives before and after two portfolio meetings with a mentor during the first year of medicine. Adopting a constructionist approach, we analyzed interview transcripts and written reflections from a diverse sample of students using reflexive thematic analysis. The findings were integrated during analysis. Transformative learning theory was our interpretive lens. Our analysis revealed five themes. Two themes represented students' initial apprehension about portfolio meetings: The Disclosure Dilemma and A Question of Priorities. The theme "Seeing the Big Picture" described new perspectives from reflection on learning while preparing for meetings. Clarity from Dialogue described changed perspectives to learning and study after meetings. In the theme Dialogue Disappointment, meetings perceived as unhelpful led to persisting doubts about the value of portfolio meetings. Transformative learning was evident when students described new insights into their learning leading to goal-setting and new study strategies. When initial meetings were helpful, doubts about portfolio meetings were dispelled, enhancing student engagement in future meetings. Not all meetings were transformative, highlighting the importance of student and mentor preparation and training. Further research is needed to determine whether early portfolio experiences shape later engagement in clinical contexts.

Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.

Many cisgender women in the US who have experienced incarceration are at substantial risk for HIV acquisition after they return to the community. Various network interventions have been leveraged for HIV prevention in this population. The objective of this study was to identify network and relationship determinants of influence on HIV prevention decisions, including PrEP. We conducted interviews with a network mapping exercise with participants recruited from the social and sexual networks of women who had experienced incarceration. Participants enumerated important individuals in their lives from the past six months and provided demographic and relationship data as well as whether each relationship influenced their HIV prevention decisions. We abstracted network data from the interview transcripts and described the data set using descriptive statistics and network density graphs. To measure associations between characteristics at each level and whether a relationship was considered influential regarding PrEP decision-making, we use multiple logistic regression with random intercepts for each respondent. We interviewed 32 participants, average age 33.5 years (SD = 8.98), majority female (n = 28, 87.5%), white (n = 23, 71.8%), heterosexual/straight (n = 25, 78.1%), and with a personal history of incarceration (n = 29, 90%). They reported 253 relationships (119 family, 116 friend, 18 sexual relationships). Most adult network members had used drugs or alcohol (n = 182, 80.9%), and of those, 30.8% had used them with the participant (n = 53). The mean network size was 7 (SD = 4) and network density was 52.2%. In the full model, significant positive predictors of an influential relationship included participant non-heterosexual identity (OR 27.8), older average age in the network (OR 3.9 per standard deviation), and being a current or prior sexual partner (OR 10.1). Significant negative predictors included relationships with individuals who use or had used drugs (OR 0.28), longer average relationship duration in the network (OR 0.09) and being in a network with at least one sexual partner (OR 0.2). There are significant positive and negative determinants of relationship influence related to PrEP at individual-, dyad-, relationship-, and network-levels. These support using nuanced network approaches to behavior change that respect and leverage the diversity of relationships that comprise the social networks of women who have experienced incarceration.

Space for Self-Care? Adolescents’ Rationales for Being Physically Active

Guided by Foucault’s theorization of power, self and strategies for self-care, the study aimed to characterize adolescents’ rationales for being physically active as the outcome of their negotiations with dominant discourses. Using stratified random sampling method, a sample of 291 adolescents (female = 161, age 11–14) was selected from 24 middle schools. With the Free and Reduced Meals (FARMS) rates ranging from 22% to 78%, the schools were drawn from six school districts that served urban, suburban, and rural communities. Photo-elicited semi-structured interviews were conducted. Discourse analyses were performed on the interview transcripts. Students identified health, body image, and physical capacities, in this order of significance, as leading rationales for physical activity participation. The finding indicates that students had been heavily influenced by dominant discourses, especially healthism, discourse on body image, and athleticism/ablism. Nevertheless, most students’ rationales for physical activities did not contain stereotypical and judgmental binary ideals based on which these dominant discourses were constructed. A small number of students demonstrated the potential of engaging self-care practices—reflectively and flexibly adopting discourses for their own needs. The findings suggest educators and practitioners help adolescents to disrupt the discourses of binaries for self-care.

Competency mapping among Rashtriya Bal Swasthya Karyakram nurses in Kerala

Background: In India, birth defects, nutritional deficiencies, disabilities, and developmental delays among children cause significant public health challenges. The Ministry of Health and Family Welfare, aims to address these issues through the Rashtriya Bal Swasthya Karyakram (RBSK) program. RBSK nurses are the crucial part of this program. They screen the children between zero to eighteen years as a part of early intervention. This study mainly aimed to map the competencies among RBSK nurses from randomly selected districts of Kerala. Methods: This qualitative study employed key informant interviews with the state nodal officer, district early intervention centre managers, and district coordinators; and in-depth interviews (IDIs) with RBSK nurses, as well as report and document review. Inductive coding was applied to two selected interview transcripts from each district, followed by deductive coding with the rest of the transcribed data to derive themes. Results: The findings are presented using the ‘core competencies of public health professionals’ as revised and adopted by the council on linkages between academia and public health practice in 2021. RBSK nurses in Kerala exhibited proficiency in multiple domains, including knowledge of child health issues, clinical skills, communication, patient education, care for vulnerable population, organizing activities, electronic health record usage, multitasking, teamwork, and problem-solving skills. Conclusions: This dedication and proficiency demonstrated by RBSK nurses in Kerala, serve as a global model for emphasising the importance of early intervention and comprehensive care for children.

“The mushroom was more alive and vibrant”: Patient reports of synthetic versus organic forms of psilocybin

AbstractInterest in psychedelic research in the West is surging, however, clinical trials have almost exclusively studied synthetic compounds such as MDMA, ketamine, DMT, LSD, ibogaine, and psilocybin. To date, few clinical trials have utilized whole mushroom/plant material like Psilocybe mushrooms, Iboga, or Ayahuasca. Individuals participating in the Roots To Thrive Psilocybin-Assisted Therapy for End of Life Distress program were administered synthetic psilocybin, whole Psilocybe cubensis, and mycological extract on separate occasions and post-treatment interview transcripts were qualitatively analyzed to discern themes and patterns. There was broad consensus that all three forms were helpful and similar, all generating visual and perceptual distortions, emotional and cognitive insight, and mystical experiences. However, synthetic psilocybin was said to feel less natural compared to organic forms, and the overall quality of experience of synthetic psilocybin was inferior to the organic forms. Research should be conducted with whole psychedelic mushrooms and extract in addition to synthetic psilocybin given this preliminary data, especially when considering that medicine keepers around the world have utilized whole mushrooms and plant material for millennia.