Zika Virus Infection Knowledge and Communication Preferences Among Women of Reproductive Age in Central Brooklyn, New York: A Thematic Analysis.

The 2016 outbreak of Zika virus (ZIKV) infected millions and resulted in thousands of infants born with malformations. Though the clusters of severe birth defects resulting from this outbreak have subsided, ZIKV continues to be a concern throughout much of Latin America and the Caribbean. Travel and sexual intercourse remain the dominant transmission risk factors for women of reproductive age and their partners. This is particularly true for communities in Brooklyn, New York, that comprise large immigrant and foreign-born populations. Practitioners of public health understand little about how women at risk for ZIKV are most likely to receive information about the virus or who they trust most to provide that information. In the context of five focus group discussions, this study explored the knowledge and communication preferences of 20 women of reproductive age in Central Brooklyn. Results derived from a thematic analysis suggest that while most women are familiar with mosquitos as ZIKV vectors, knowledge of sexual transmission is considerably lower. Many respondents believe that only women who are pregnant or trying to become pregnant are at risk, and public health agencies, such as the U.S. Centers for Disease Control and Prevention, remain the most trusted sources of information. These findings can support more effective communication about the risks of ZIKV infection and other vector-borne diseases to women in New York City and similar urban communities.

Assessment of visuospatial functions in post-Covid 19 patients: beyond the traditional paradigm.

Several studies indicate that some cognitive changes occur after COVID-19. Visuospatial alterations have been reported in 24% to 40%. These alterations may be useful as early biomarkers of neurodegenerative disease. Thus, we can emphasize the importance of visuospatial processes in cognition through quantitative and qualitative analysis of performance on the Clock Test (CDT) and the Rey-Osterrieth Complex Figure (FCRO). Our objective was to describe the performance of post COVID 19 patients in visuospatial tests, with different degrees of respiratory impairment and to perform a qualitative analysis of the performance to check its relationship with alterations in attention and executive functions. This will allow highlighting the executive component of the performance of the CDT and ROCF and differentiate patients with possible cognitive impairment. 77 patients with SARS-CoV-2 infection were evaluated (3 months post-infection) with a complete neuropsychological battery and MRI. Overall, there is a significant difference between FCRO and CDT, with FCRO having only 9% change and CDT having 51.9% change. Regarding the correlations observed between groups (VM Inv, VM non I and non hospitalized) the highest correlations were observed between Boston with FCRO copy (r=0.497; p=0.001) and with FCRO memory (r=0.429; p=0.001). Comparing the performance between groups by severity, significant differences were observed only in the TMT A (13.706 p=0.001) and B (9.583 p=0.008) tests and in the phonological fluency letter A (13.445 p=0.001), we observed that the group of non-hospitalized patients had a better performance. Neuropsychological deficits often have a direct impact on daily life by affecting the ability to learn and adapt. Thus, a useful strategy for the neuropsychological characterization of post-COVID-19 patients is the qualitative analysis of visuospatial abilities in conjunction with executive functions that cannot be analyzed in isolation.

My feed is what I eat? A qualitative study on adolescents' awareness and appreciation of food marketing on social media.

BACKGROUND: Adolescents spend much of their time online and hence are exposed to a lot of non-core (energy-dense, nutrient-poor) social media food marketing (SMFM). This may influence their dietary choices and health. This present study aimed to investigate adolescents' perceptions towards SMFM; that is, their recognition and appreciation of SMFM. METHODS: Semi-structured one-on-one interviews were conducted with Dutch adolescents aged 13-16 years (n = 16), on Skype. Examples of food promotions on Instagram, Snapchat, TikTok and YouTube were discussed with adolescents. RESULTS: Adolescents' reasons for recognising and appreciating or liking SMFM were often related to the level of product integration. Factors that determined participants' recognition of SMFM included product focus (e.g., brand or product prominence), sponsorship disclosure, type of content (paid, influencer and peer-generated content) and promotional strategy (e.g., discounts, promotional texts, layout). Participants' appreciation of SMFM was determined by the format of a post (image, video, text, pop-up), trustworthiness of the source (brand, celebrity, friend/peer), type of product promoted (core, non-core) and appearance or layout of a post (e.g., professionalism, appeal). CONCLUSIONS: The present study contributes to the ongoing debate on how to increase adolescents' resilience to commercial messages that promote non-core foods. Adolescents mostly enjoy watching non-core video content from peers or influencers and do not perceive this as food marketing. It is recommended that future studies investigate the effects of earned social media marketing formats (i.e., unpaid peer and influencer endorsements) promoting non-core foods on adolescents' dietary intake, and how they can be made more critical towards such types of SMFM.

Catastrophic healthcare expenditure and caregiver burden in pediatric chronic kidney disease - a mixed methods study from a low resource setting.

BACKGROUND: Caregivers of children with chronic kidney disease (CKD) in low resource settings must provide complex medical care at home while being burdened by treatment costs often paid out-of-pocket. We hypothesize that caregiver burden in our low resource setting is greater than reported from high income countries and is associated with frequent catastrophic healthcare expenditure (CHE). METHODS: We conducted a mixed-methods study of primary caregivers of children with advanced CKD (stage 3b-5) in our private-sector referral hospital in a low resource setting. We assessed caregiver burden using the Pediatric Renal Caregiver Burden Scale (PRCBS) and measured financial burden by calculating the proportion of caregivers who experienced CHE (monthly out-of-pocket healthcare expenditure exceeding 10% of total household monthly expenditure). We performed a qualitative reflexive thematic analysis of caregiver interviews to explore sources of burden. RESULTS: Of the 45 caregivers included, 35 (78%) had children on maintenance dialysis (25 PD, 10 HD). Mean caregiver burden score was 141 (± 17), greater than previously reported. On comparative analysis, PRCBS scores were higher among caregivers of children with kidney failure (p = 0.005), recent hospitalization (p = 0.03), non-earning caregivers (p = 0.02), caring for > 2 dependents (p = 0.009), and with high medical expenditure (p = 0.006). CHE occurred in 43 (96%) caregivers of whom 37 (82%) paid out-of-pocket. The main themes derived relating to caregiver burden were severe financial burden, mental stress and isolation, and perpetual burden of concern. CONCLUSION: Parents of children with CKD experienced severe caregiver burden with frequent CHE and relentless financial stress indicating an imminent need for social support interventions.

Computational vs. qualitative: analyzing different approaches in identifying networked frames during the Covid-19 crisis.

Despite the increasing adaption of automated text analysis in communication studies, its strengths and weaknesses in framing analysis are so far unknown. Fewer efforts have been made to automatic detection of networked frames. Drawing on the recent developments in this field, we harness a comparative exploration, using Latent Dirichlet Allocation (LDA) and a human-driven qualitative coding process on three different samples. Samples were comprised of a dataset of 4,165,177 million tweets collected from Iranian Twittersphere during the Coronavirus crisis, from 21 January, 2020 to 29 April, 2020. Findings showed that while LDA is reliable in identifying the most prominent networked frames, it misses to detects less dominant frames. Our investigation also confirmed that LDA works better on larger datasets and lexical semantics. Finally, we argued that LDA could give us some primary intuitions, but qualitative interpretations are indispensable for understanding the deeper layers of meaning.

Intersecting Substance Use Disorder and Unmet Social Needs in Rural Pregnant Women.

OBJECTIVE: To describe the unique challenges faced by rural pregnant women with intersecting substance use disorder (SUD) and unmet social needs. DESIGN: Secondary qualitative data analysis with an analytic expansion approach. SETTING: Hospital system in northern New England. PARTICIPANTS: Four rural women with food insecurity who were in recovery for SUD. (Three were pregnant and one had given birth in the past 15 weeks.) METHODS: In the primary qualitative descriptive study, we interviewed 14 women about their experience of food insecurity during the perinatal period, including facilitators and barriers to being screened for food insecurity and other social needs during prenatal care and accessing referrals. This secondary analysis centered on the perspectives of four participants who reflected specifically on receiving material and mental health support through the integration of prenatal care and SUD treatment. RESULTS: Rural women with SUD who experience social needs during pregnancy have difficulty accessing appropriate prenatal care and maintaining treatment engagement due to intersecting factors (e.g., food and housing insecurity and transportation) and psychological (e.g., mental health challenges, social isolation, and stigma) factors. Participants emphasized the importance of integrating social support within prenatal and substance use care to promote physical and mental health and engagement in SUD treatment. CONCLUSION: In line with The Joint Commission's 2022 policy recommendations for universal social determinants of health screening, we support one-stop clinical and social care for pregnant women who face intersecting barriers to health, such as SUD and unmet social needs. Nurses can play an important role in care coordination for people with complex medical and social determinants of health screening needs. This approach is especially relevant to rural areas, where food, housing, and transportation insecurity rates are greater than nonrural areas.

Nurse-sensitive quality and benchmarking in hospitals striving for Magnet® or Pathway® designation: A qualitative study.

AIM: To examine if and how selected German hospitals use nurse-sensitive clinical indicators and perspectives on national/international benchmarking. DESIGN: Qualitative study. METHODS: In 2020, 18 expert interviews were conducted with key informants from five purposively selected hospitals, being the first in Germany implementing Magnet® or Pathway®. Interviews were analyzed using content analysis with deductive-inductive coding. The study followed the COREQ guideline. RESULTS: Three major themes emerged: first, limited pre-existence of and necessity for nurse-sensitive data. Although most interviewees reported data collection for hospital-acquired pressure ulcers and falls with injuries, implementation varied and interviewees highlighted the necessity to develop additional nurse-sensitive indicators for the German context. Second, the theme creating an enabling data environment comprised building clinicians' acceptance, establishing a data culture, and reducing workload by using electronic health records. Third, challenges and opportunities in establishing benchmarking were identified but most interviewees called for a national or European benchmarking system. CONCLUSION: The need for further development of nurse-sensitive clinical indicators and its implementation in practice was highlighted. Several actions were suggested at hospital level to establish an enabling data environment in clinical care, including a nationwide or European benchmarking system. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Involving nurses in data collection, comparison and benchmarking of nurse-sensitive indicators and their use in practice can improve quality of patient care. IMPACT: Nurse-sensitive indicators were rarely collected, and a need for action was identified. The study results show research needs on nurse-sensitive indicators for Germany and Europe. Measures were identified to create an enabling data environment in hospitals. An initiative was started in Germany to establish a nurse-sensitive benchmarking capacity. PATIENT OR PUBLIC CONTRIBUTION: Clinical practitioners and nurse/clinical managers were interviewed.

Anxiety on the internet: Describing person, provider, and organization online posts.

Anxiety is a pervasive phenomenon in contemporary society. With increased internet use in recent years, more people in the general population are seeking and providing help and participating in community online. The goal of our study was to evaluate the content of internet narratives among those who post about anxiety and determine what stakeholder groups are saying online. We used the bifurcated method; it is a multi-method (qualitative) approach with inductive, thematic analyses, and with quantification of content-related words via a computer program that crawls websites and counts the occurrences of specified terms (for cross-checking purposes). Themes of posts and webpages about anxiety were: using/reporting treatment strategies (83.3% saturation), providing help (77.8% saturation), telling personal stories (72.2% saturation), seeking help (61.1% saturation), and illustrating interpersonal impact (50% saturation). We argue that anxiety stakeholders may take part in health co-inquiry online (i.e., cooperating with others) in many of the same ways that they might collaborate in person. We recommend that clinicians query their clients about use of the internet in ways related to their anxiety (e.g., seeking information/treatment strategies, offering help to others, telling their personal stories, etc.) so that they might help them process what they experience online.

In the COVID-19 era, anxiety has increased in the general population (Shigemura, Ursano, Morganstein, Kurosawa, & Benedek, 2020; Wang et al., 2020).Daily use of the internet in the general population is extensive (Gangamma et al., 2022).Clients in therapy may use the internet in ways that interact with their clinical conditions, e.g., finding information, seeking support, providing others with information, searching/accessing services/treatment.It is vital for therapists to inquire in ways that improve their understanding of their clients' uses of the internet.

A Qualitative Investigation of Factors Influencing the Integration of Complementary and Integrative Healthcare Recommendations in the Daily Lives of Patients with Cancer.

BACKGROUND: Many patients diagnosed with cancer use complementary and integrative healthcare (CIH) approaches to manage their cancer- and treatment-related symptoms and improve their well-being. Evidence suggests that counseling on CIH can improve health outcomes and decrease healthcare costs by increasing patient activation. This qualitative study explores the experiences of cancer patients who underwent interprofessional counseling on CIH to gain insights into how these patients were able to integrate recommended CIH measures into their daily lives while undergoing conventional cancer treatment. METHODS: Forty semi-structured interviews were conducted with cancer patients participating in the CCC-Integrativ study and its process evaluation. The interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis following Kuckartz and Rädiker. A purposeful sampling strategy was used to achieve a balanced sample regarding gender, age, cancer diagnosis, and treatment approach. RESULTS: Most patients with cancer reported largely implementing the CIH recommendations. Participants acknowledged the efficacy of CIH recommendations in managing their symptoms. They felt strengthened and empowered to actively take part in their healthcare decisions. However, the patients encountered obstacles in incorporating the recommended CIH applications into their daily routines. These challenges encompassed the effort required for treatment application (e.g., baths, compresses), limitations imposed by the cancer disease (e.g., fatigue, pain), difficulties acquiring necessary materials, associated costs, and lack of infrastructure for CIH. Facilitators of CIH implementation included the availability of easily manageable CIH measures (e.g., herbal teas), informative materials on their application, distribution of samples, family support, and a high level of self-efficacy. The patient-centered approach and strong patient-provider partnership within the counseling context were perceived as empowering. Participants expressed a desire for a consistent point of contact to address their CIH concerns. CONCLUSIONS: The findings underscore the benefits of CIH counseling for cancer patients' symptom management and overall well-being. Healthcare professionals providing CIH counseling to patients with cancer may recognize the barriers identified to better support their patients in the regular use of CIH.

Qualitative and quantitative simulation of best management practices (BMPs) for contaminated megasite remediation using the SiteWise™ tool.

Remediation activities, particularly in megasites, may induce substantial secondary environmental impacts that must be addressed for green and sustainable remediation (GSR) practices. Only limited studies are available quantitatively assessing the environmental footprint and environmental benefits of implementing Best Management Practices (BMPs) in megasite remediation. This study used the SiteWise™ tool, a quantitative environmental footprint assessment for scenario simulation and benefit quantification of BMPs, on a contaminated megasite in Hebei Province, China. We observed a considerable environmental footprint and energy from the remediation. Taking the final implementation alternative (Alt 1) as an example, which is characterized by combining multiple remediation techniques, the greenhouse gas (GHG) emissions reached 113,474 t, the energy used was 2,082,841 million metric British thermal units (MMBTU), and other air pollutant emissions (NOx, SOx, and PM10) amounted to 856 t. Further BMP analyses highlighted the benefits of substituting the conventional solidification/stabilization agent with willow woodchip-based biochar, which could reduce GHG emissions by 50,806 t and energy used by 926,648 MMBTU. The overall environmental benefits of implementing all applicable BMPs in the remediation were significant, with a 66.85%, 50.15%, and 56.05% reduction in GHG emissions, energy used, and other air pollutants, respectively. Our study provides insights into quantifying the environmental footprint and exploring emission reduction pathways for contaminated megasite remediation. It also offers a feasible path for quantifying the environmental benefits of BMPs, promoting the development of GSR of contaminated sites.

Impact of pandemic mobility restrictions on kidney transplant patients' experience: lessons on quality of care.

BACKGROUND: Patient perspectives on their post-operative health are acknowledged as valuable healthcare outcomes and should be scrupulously considered when designing interventions for patient-centered healthcare. Yet, following the COVID-19 lockdown and in the absence of standardized guidelines on how to best provide virtual chronic care to kidney transplant recipients, little is known about how this unique population coped and managed to comply with public health indications during confinement. METHODS: This study addresses this shortcoming by examining the experiences of patients from a tertiary hospital in Spain during the initial weeks of the lockdown decreed by the national government. Specifically, we focus our attention on the perceptions and experiences of these patients by retrieving robust qualitative and quantitative data: the former based on a thematic analysis of focus group transcripts, the latter obtained from a large-scale survey. RESULTS: Our findings identify opportunities for improvement in the quality of care and point to the provisions that might be made when facing future pandemics or lockdown-requiring situations. CONCLUSIONS: As healthcare services navigate evolving landscapes, our findings on the experience of kidney transplant recipients should enable hospital services to improve the quality of care they are able to provide to such patients during periods of restricted mobility, especially those associated with future disease emergencies, and considering that home confinement is often part of the natural course of post-operative care of these patients.

Qualitative and quantitative analysis of electrons donated by pollutants in electron transfer-based oxidation system: Electrochemical measurement and theoretical calculations.

In order to gain a profound understanding of the fate of pollutants in advanced oxidation processes (AOPs), this study analyzed the electron contribution of pollutants qualitatively and quantitatively which rarely reported before. The rich electron transfer system was constructed by mesoporous carbon nitride (MCN) coupling with persulfate (PS) driven by visible light and the sulfanilamide antibiotics (SULs) were used as target contaminants. Firstly, the qualitative analysis of electron transfer in the system was confirmed systematically. The electron flow direction tested by i-t curves indicated that PS absorbed electrons, while SULs released electrons. The flow rate of electrons was also accelerated after the addition of SULs. The fitting curve between the kinetics and the peak potential difference tested by CV curve showed that the larger potential difference, the slower rate of oxidative degradation. Secondly, the quantification of electron transfer was achieved through theoretical calculations to simulate the interactions of the 'catalyst-oxidant-antibiotic' system. After the addition of SULs, the adsorption energy of the 'catalyst-oxidant-antibiotic' system was enhanced and the bond length of the peroxide bond was stretched. Notably, the electron transfer analysis results showed that the charge of SULs was around 0.032-0.056e, indicating that SULs pollutants played the role of electron contributors in the system. The oxidative degradation pathway included the direct cracking of S-N bond, shedding of marginal groups, ring-opening and hydroxyl addition reaction. This study clarified the electronic contribution of SULs in the oxidation system, providing necessary theoretical supplement for the analysis of the transformation of pollutants in AOPs.

College Women's Perceptions of a Friend-Based Intervention to Prevent Alcohol-Involved Sexual Assault.

Sexual assault (SA), particularly alcohol-involved SA, remains prevalent among college women. Because SA often begins in social contexts, bystander intervention has become a popular approach to prevention. Bystander interventions train individuals to intervene on behalf of others, including strangers, despite research indicating that intervention is more likely to occur when the bystander has a relationship with the target. Shifting the focus to friends as potential bystanders capitalizes on the qualities of relationship and responsibility that facilitate intervention. College women (N = 35) participated in focus groups (N = 8) during which they viewed a video prototype of a friend-based motivational interviewing (FMI) intervention session conducted with a friend dyad and provided feedback about the relevance and feasibility of using such an approach to reduce SA among friends who drink together in social settings. Content analysis of focus group transcripts yielded three themes: a) Friends as Natural Bystanders; b) The Role of Alcohol in Intervention, and c) Receptivity to FMI intervention. Women indicated that they feel responsible for keeping their friends safe, and that this sense of responsibility facilitates helping behaviors. Women also described ways through which alcohol intoxication can affect helping behavior. Women expressed enthusiasm for the FMI intervention approach and identified its emphasis on friendship and flexible approaches to personal safety as strengths. Findings highlight the promise of FMI intervention approaches that capitalize on the strengths of women's friendship to create safety goals that align with participants' values and overcome barriers to intervention, including alcohol intoxication.

The Healthy Start scheme in England "is a lifeline for families but many are missing out": a rapid qualitative analysis.

BACKGROUND: Healthy Start (HS) is a government scheme in England, Wales and Northern Ireland that offers a financial payment card and free vitamins to families experiencing low income. Pregnant women and families with children < 4 years can use the HS card to buy fruit, vegetables, cow's milk, infant formula and pulses. HS was fully digitalised in March 2022. While digitalisation has improved the user experience for many families, in the context of the cost-of-living crisis and increasing dietary inequalities, it is important to understand why HS is not reaching more families. This study aimed to (i) assess the perceptions and experiences of HS from stakeholders across the system including those who promote, implement and are eligible for HS, and (ii) identify recommendations to improve the scheme's effectiveness and uptake. METHODS: The study design was a post-implementation rapid qualitative evaluation using stakeholder interviews. Data were collected between January and June 2023 via semi-structured interviews (50% online; 50% in person) with 112 stakeholders, including parents (n = 59), non-government organisations (n = 13), retailers (n = 11) and health and community professionals (n = 29) at national and local levels. Findings were confirmed by a sub-sample of participants. RESULTS: Six core themes cut across stakeholders' perceptions and experiences, and stakeholders collectively outlined seven recommendations they felt could be acted upon to maximise uptake and efficiency of HS, with actions at both national and local levels. A novel finding from this study is that raising awareness about HS alone is unlikely to result automatically or universally in higher uptake rate. Recommendations include: continuing to provide this scheme that is universally valued; the need for many families to be provided with a helping hand to successfully complete the application; reframing of the scheme as a child's right to food and development to ensure inclusivity; improved leadership, coordination and accountability at both national and local levels. CONCLUSIONS: HS provides benefits for child development and family wellbeing. The study's recommendations should be actioned by national and local governments to enable all families eligible for the scheme to benefit from this nutritional safety net.

Promising directions for human-robot interactions defined by older adults.

Introduction: Older adults are engaging more and more with voice-based agent and social robot technologies, and roboticists are increasingly designing interactions for these systems with older adults in mind. Older adults are often not included in these design processes, yet there are many opportunities for older adults to collaborate with design teams to design future robot interactions and help guide directions for robot development. Methods: Through a year-long co-design project, we collaborated with 28 older adults to understand the key focus areas that older adults see promise in for older adult-robot interaction in their everyday lives and how they would like these interactions to be designed. This paper describes and explores the robot-interaction guidelines and future directions identified by older adults, specifically investigating the change and trajectory of these guidelines through the course of the co-design process from the initial interview to the design guideline generation session to the final interview. Results were analyzed through an adapted ethnographic decision tree modeling approach to understand older adults' decision making surrounding the various focus areas and guidelines for social robots. Results: Overall, over the course of the co-design process between the beginning and end, older adults developed a better understanding of the robot that translated to them being more certain of their attitudes of how they would like a robot to engage with them in their lives. Older adults were more accepting of transactional functions such as reminders and scheduling and less open to functions that would involve sharing sensitive information and tracking and/or monitoring of them, expressing concerns around surveillance. There was some promise in robot interactions for connecting with others, body signal monitoring, and emotional wellness, though older adults brought up concerns around autonomy, privacy, and naturalness of the interaction with a robot that need to be further explored. Discussion: This work provides guidance for future interaction development for robots that are being designed to interact with older adults and highlights areas that need to be further investigated with older adults to understand how best to design for user concerns.

Prompts, Pearls, Imperfections: Comparing ChatGPT and a Human Researcher in Qualitative Data Analysis.

The impact of ChatGPT and other large language model-based applications on scientific work is being debated across contexts and disciplines. However, despite ChatGPT's inherent focus on language generation and processing, insights regarding its potential for supporting qualitative research and analysis remain limited. In this article, we advocate for an open discourse on chances and pitfalls of AI-supported qualitative analysis by exploring ChatGPT's performance when analyzing an interview transcript based on various prompts and comparing results to those derived by an experienced human researcher. Themes identified by the human researcher and ChatGPT across analytic prompts overlapped to a considerable degree, with ChatGPT leaning toward descriptive themes but also identifying more nuanced dynamics (e.g., 'trust and responsibility' and 'acceptance and resistance'). ChatGPT was able to propose a codebook and key quotes from the transcript which had considerable face validity but would require careful review. When prompted to embed findings into broader theoretical discourses, ChatGPT could convincingly argue how identified themes linked to the provided theories, even in cases of (seemingly) unfitting models. In general, despite challenges, ChatGPT performed better than we had expected, especially on identifying themes which generally overlapped with those of an experienced researcher, and when embedding these themes into specific theoretical debates. Based on our results, we discuss several ideas on how ChatGPT could contribute to but also challenge established best-practice approaches for rigorous and nuanced qualitative research and teaching.

"There's always something, and then there's more": a qualitative examination of how virtual peer led self-management can create community around the evolving SCI experience.

Introduction: Self-management programs for spinal cord injury (SCI) are a growing adjunct to traditional healthcare services aiding individuals with SCI in learning and managing symptoms and medical care. A benefit of self-management programs is that they can be facilitated by peers, offering a unique lived experience of adjusting to and managing SCI. While a growing body of literature highlights the effectiveness of peer led programs, there is limited understanding of how individuals engage with peer programs or critical components of peer support. The current study seeks to understand how individuals engaged with peers in the context of a self-management program. Methods: Secondary qualitative analysis of online forum posts resultant from a peer led self-management course for SCI. Results: Content analysis revealed several themes of how participants engaged with members of the group, including skill building, resource sharing, and problem solving. A process level theme of emotional connection to others living with similar SCI-related challenges was defined as "bearing witness." Participants commented frequently that groups were the first time they engaged with a community with lived experience, and shared experience was frequently highlighted in the responses from individuals as one of the most unique and important aspects of the intervention. Discussion: Themes identified suggest that bearing witness was a critical component of peer led intervention. While self-management content provided structure for engagement and discussion, participants report that connectedness and shared experience made content more impactful and relevant. Future research should examine if alignment of peer and participant experience increases the impact of interventions and explore if this theme is important for other chronic medical populations.

Towards a shared understanding of the learning health system in a large academic-based health system: A qualitative analysis.

Healthcare delivery is currently undergoing major structural reform, and the Learning Health System (LHS) has been proposed as an aspirational model to guide healthcare transformation. As efforts to build LHS take considerable investment from health systems, it is critical to understand their leaders' perspectives on the rationale for pursuing an LHS and the potential benefits for doing so. This paper describes the qualitative analysis of semi-structured interviews (n = 17) with health system leaders about their general perceptions of the LHS, description of key attributes and potential benefits, and perception of barriers to and facilitators for advancing the model. Participants universally endorsed the goal of the local health system aspiring to become an LHS. Participants identified many recognized attributes of LHS, though they emphasized unique attributes and potential benefits. There was also heterogeneity in participants' views on what to prioritize, how to structure the local LHS within existing initiatives, and how new initiatives should be implemented. Improving conceptual clarity of attributes of the LHS would improve its potential in guiding future reform.

Intimate Partner Sexual Violence: A Phenomenological Interpretative Analysis Among Female Survivors in France.

Despite its prevalence, intimate partner sexual violence (IPSV) remains a concealed and poorly understood form of violence against women. Although it is associated with numerous detrimental effects on mental health, very little is known about the subjective meaning of IPSV for survivors. This study addresses this gap by exploring IPSV from the perspective of female survivors within the context of their relationship with a male partner, using interpretative phenomenological analysis. This study seeks to provide a detailed examination of the personal experience of IPSV and to illuminate its meaning from a personal standpoint. We conducted in-depth interviews with seven IPSV survivors who were recruited after filing a complaint for intimate partner violence (IPV) in France. In total, five superordinate themes were identified: (a) "Setting the stage" describes how the complex dynamics preceding IPSV influence self-representation; (b) "Feeling like I'm nothing" describes the emotional experience of IPSV; (c) "Trying to get it, not getting it" describes how IPSV generates intense cognitive load; (d) "Looking back, developing a theory" describes how IPSV is interpreted retrospectively after breaking up with a violent partner; and (e) "Today: living with it" describes how IPSV affects the present. This study highlights how emotional distress and cognitive uncertainty are present on the way to IPSV, through IPSV, and even after filing charges and separating from the violent partner. Additionally, it shows that survivors attribute IPSV to a sense of individual vulnerability related to romantic love, hope, and traumatic childhood history. This study presents unique findings as it is the first one to explore the lived experience of IPSV among a sample of French IPV survivors.

More than just joy: A qualitative analysis of participant experiences during nitrous oxide sedation.

BACKGROUND: Nitrous oxide use is shifting from general anesthesia to sedation and pain control. Interest in novel uses of nitrous oxide in psychiatry is also growing. Thus, understanding the consequences of using nitrous oxide remains relevant. Previous quantitative research might not have fully captured the whole spectrum of nitrous oxide, whereas qualitative analysis can provide a more comprehensive description. This qualitative study aims to describe the subjective experiences of nitrous oxide use in healthy volunteers who have no prior history of recreational substance misuse. METHODS: Twenty healthy male volunteers inhaled 50% nitrous oxide for 20 min. Females were excluded due to higher incidence of nausea with nitrous oxide. Afterwards, all participants answered an open-ended question about their experiences during sedation. The answers were then analyzed with inductive qualitative content analysis to identify emergent subcategories, categories, and overarching themes. RESULTS: We identified two themes: nitrous oxide is mind-altering and produces sensory overload. The mind-altering properties were represented by dreamlike states and heightened emotions. Dreamlike states comprised changes in consciousness and scary, bizarre, or transcendental dreams. Pleasant dreams were not reported. Heightened emotions included euphoria, anxiety, and fear of losing control. Sensory overload consists of distorted perception, bodily sensations, and a heightened sense of surroundings. CONCLUSIONS: Experiences under nitrous oxide sedation are extremely variable and not always pleasant. These findings can improve our understanding of the likes/dislikes of patients undergoing nitrous oxide sedation. Further qualitative studies should focus on the experiences of other groups, such as children or women in labor.