Qualitative case study on the disability acceptance experiences of soldiers with disabilities.

PURPOSE: This study comprehensively examines the disability acceptance experience of individuals who become disabled following accidents in the military after enlistment. METHODS: In-depth interviews and participative observation of two soldiers with disabilities are conducted. Data sources encompass the transcripts from these interviews, relevant news videos, and articles on the participants. A qualitative case study approach is applied to conduct both "within-case" and "cross-case" analyses. RESULTS: Although the two participants survived a crippling accidents, their military units did not actively attempt to resolve the accident. They grappled with despair and found it challenging to accept their new status as individuals with disability. Over time, they noticed changes in their personal relationships and started considering themselves burdens on their caregivers. However, despite encountering psychological challenges, which were marked by repeated setbacks and disappointments, the soldiers consistently made determined efforts to realize their objectives. Moreover, they strove to lead purposeful lives despite suffering the adversities caused by their disabilities. CONCLUSIONS: This study is the first in-depth examination of the disability acceptance experiences of soldiers with disability. The insights gleaned from our in-depth interviews will help formulate psychological and physical support systems for such individuals.

Electrifying Consequences: Posterior Reversible Encephalopathy Syndrome After an Electric Shock Injury.

Reversible posterior leukoencephalopathy syndrome, often referred to as posterior reversible encephalopathy syndrome (PRES), is a disorder characterized by acute cerebral dysfunction and is seen in conjunction with vasogenic edema on brain imaging. Headaches, visual issues, seizures, abnormal mentation, disturbances in awareness, and focal neurological symptoms are its defining features. In this case report, we present a 40-year-old male patient who developed PRES after experiencing a high-voltage electric shock.

Minors' and guardian access to and use of a national patient portal: A retrospective comparative case study of Sweden and Finland.

BACKGROUND: Approaches to implementing online record access (ORA) via patient portals for minors and guardians vary internationally, as more countries continue to develop patient-accessible electronic health records (PAEHR) systems. Evidence of ORA usage and country-specific practices to allow or block minors' and guardians' access to minors' records during adolescence (i.e. access control practices) may provide a broader understanding of possible approaches and their implications for minors' confidentiality and guardian support. AIM: To describe and compare minors' and guardian proxy users' PAEHR usage in Sweden and Finland. Furthermore, to investigate the use of country-specific access control practices. METHODS: A retrospective, observational case study was conducted. Data were collected from PAEHR administration services in Sweden and Finland and proportional use was calculated based on population statistics. Descriptive statistics were used to analyze the results. RESULTS: In both Sweden and Finland, the proportion of adolescents accessing their PAEHR increased from younger to older age-groups reaching the proportion of 59.9 % in Sweden and 84.8 % in Finland in the age-group of 17-year-olds. The PAEHR access gap during early adolescence in Sweden may explain the lower proportion of users among those who enter adulthood. Around half of guardians in Finland accessed their minor children's records in 2022 (46.1 %), while Swedish guardian use was the highest in 2022 for newborn children (41.8 %), and decreased thereafter. Few, mainly guardians, applied for extended access in Sweden. In Finland, where a case-by-case approach to access control relies on healthcare professionals' (HCPs) consideration of a minor's maturity, 95.8 % of minors chose to disclose prescription information to their guardians. CONCLUSION: While age-based access control practices can hamper ORA for minors and guardians, case-by-case approach requires HCP resources and careful guidance to ensure equality between patients. Guardians primarily access minors' records during early childhood and adolescents show willingness to share their PAEHR with parents.

Tooth autotransplantation outcomes using platelet-rich fibrin: A promising approach; case study.

BACKGROUND: Autogenous tooth transplantation refers to a surgical procedure involving the relocation of a tooth within the same individual. Incorporating platelet-rich fibrin (PRF) in this procedure holds the potential to improve healing, accelerate recovery, and optimize treatment outcomes. METHODS: In this article, the authors illustrate a PRF-based approach for autogenous tooth transplantation through two case scenarios. These cases outline the surgical steps of tooth transplantation and demonstrate the potential role of PRF in enhancing soft tissue healing. Furthermore, the article provides insights from a long-term follow-up spanning over 7 years. RESULTS: Tooth transplantation in young adults is promising but depends on factors such as root development stage and donor tooth size matching. Including PRF may improve healing, at least in the short term, due to its rich concentration of growth factors and cytokines, promoting effective tissue regeneration. CONCLUSIONS: Autogenous tooth transplantation has shown to be a viable treatment option for replacing the missing dentition. Adding PRF to the autogenous tooth transplantation procedure may speed up and enhance the treatment outcome. While the favorable results of these cases might be partially attributed to the use of PRF, the contribution of PRF to the healing process of tooth transplant remains conjectural and requires validation through additional research. KEY POINTS/HIGHLIGHTS: Tooth autotransplantation can be performed in younger patients without requiring root canal treatment, while also potentially benefiting from the incorporation of platelet-rich fibrin (PRF).

Analysis of the fatigue status of medical security personnel during the closed-loop period using multiple machine learning methods: a case study of the Beijing 2022 Olympic Winter Games.

Using machine learning methods to analyze the fatigue status of medical security personnel and the factors influencing fatigue (such as BMI, gender, and wearing protective clothing working hours), with the goal of identifying the key factors contributing to fatigue. By validating the predicted outcomes, actionable and practical recommendations can be offered to enhance fatigue status, such as reducing wearing protective clothing working hours. A questionnaire was designed to assess the fatigue status of medical security personnel during the closed-loop period, aiming to capture information on fatigue experienced during work and disease recovery. The collected data was then preprocessed and used to determine the structural parameters for each machine learning algorithm. To evaluate the prediction performance of different models, the mean relative error (MRE) and goodness of fit (R2) between the true and predicted values were calculated. Furthermore, the importance rankings of various parameters in relation to fatigue status were determined using the RF feature importance analysis method. The fatigue status of medical security personnel during the closed-loop period was analyzed using multiple machine learning methods. The prediction performance of these methods was ranked from highest to lowest as follows: Gradient Boosting Regression (GBM) > Random Forest (RF) > Adaptive Boosting (AdaBoost) > K-Nearest Neighbors (KNN) > Support Vector Regression (SVR). Among these algorithms, four out of the five achieved good prediction results, with the GBM method performing the best. The five most critical parameters influencing fatigue status were identified as working hours in protective clothing, a customized symptom and disease score (CSDS), physical exercise, body mass index (BMI), and age, all of which had importance scores exceeding 0.06. Notably, working hours in protective clothing obtained the highest importance score of 0.54, making it the most critical factor impacting fatigue status. Fatigue is a prevalent and pressing issue among medical security personnel operating in closed-loop environments. In our investigation, we observed that the GBM method exhibited superior predictive performance in determining the fatigue status of medical security personnel during the closed-loop period, surpassing other machine learning techniques. Notably, our analysis identified several critical factors influencing the fatigue status of medical security personnel, including the duration of working hours in protective clothing, CSDS, and engagement in physical exercise. These findings shed light on the multifaceted nature of fatigue among healthcare workers and emphasize the importance of considering various contributing factors. To effectively alleviate fatigue, prudent management of working hours for security personnel, along with minimizing the duration of wearing protective clothing, proves to be promising strategies. Furthermore, promoting regular physical exercise among medical security personnel can significantly impact fatigue reduction. Additionally, the exploration of medication interventions and the adoption of innovative protective clothing options present potential avenues for mitigating fatigue. The insights derived from this study offer valuable guidance to management personnel involved in organizing large-scale events, enabling them to make informed decisions and implement targeted interventions to address fatigue among medical security personnel. In our upcoming research, we will further expand the fatigue dataset while considering higher precisionprediction algorithms, such as XGBoost model, ensemble model, etc., and explore their potential contributions to our research.

Studying Adherence to Reporting Standards in Kinesiology: A Post-publication Peer Review Brief Report.

To demonstrate how post-publication peer reviews-using journal article reporting standards-could improve the design and write-up of kinesiology research, the authors performed a post-publication peer review on one systematic literature review published in 2020. Two raters (1st & 2nd authors) critically appraised the case article between April and May 2021. The latest Journal Article Reporting Standards by the American Psychological Association relevant to the review were used: i.e., Table 1 (quantitative research standards) and Table 9 (research synthesis standards). A standard fully met was deemed satisfactory. Per Krippendorff's alpha-coefficient, inter-rater agreement was moderate for Table 1 (k-alpha = .57, raw-agreement = 72.2%) and poor for Table 9 (k-alpha = .09, raw-agreement = 53.6%). A 100% consensus was reached on all discrepancies. Results suggest the case article's Abstract, Methods, and Discussion sections required clarification or more detail. Per Table 9 standards, four sections were largely incomplete: i.e., Abstract (100%-incomplete), Introduction (66%-incomplete), Methods (75%-incomplete), and Discussion (66%-incomplete). Case article strengths included tabular summary of studies analyzed in the systematic review and a cautionary comment about the review's generalizability. The article's write-up gave detail to help the reader understand the scope of the study and decisions made by the authors. However, adequate detail was not provided to assess the credibility of all claims made in the article. This could affect readers' ability to obtain critical and nuanced understanding of the article's topics. The results of this critique should encourage (continuing) education on journal article reporting standards for diverse stakeholders (e.g., authors, reviewers).

Evolution of Food and Nutrition Policy: A Tasmanian Case Study from 1994 to 2023.

Food security is a concept with evolving definitions and meanings, shaped by contested knowledge and changing contexts. The way in which food security is understood by governments impacts how it is addressed in public policy. This research investigates the evolution of discourses and practices in Tasmanian food and nutrition policies from 1994 to 2023. Four foundational documents were analysed using qualitative document analysis, revealing persistent food insecurity issues over three decades. The analysis identified a duality in addressing the persistent policy challenges of nutrition-related health issues and food insecurity: the balancing act between advancing public health improvements and safeguarding Tasmania's economy. The research revealed that from 1994 to 2023, Tasmania's food and nutrition policies and strategies have been characterised by various transitions and tensions. Traditional approaches, predominantly emphasising food availability and, to a limited extent, access, have persisted for over thirty years. The transition towards a more contemporary approach to food security, incorporating dimensions of utilisation, stability, sustainability, and agency, has been markedly slow, indicating systemic inertia. This points to an opportunity for future policy evolution, to move towards a dynamic and comprehensive approach. Such an approach would move beyond the narrow focus of food availability to address the complex multi-dimensional nature of food security.

Ovarian vein thrombus in a pediatric patient: A case study.

Acute abdominal pain is a very common chief complaint in the pediatric population, accounting for 5-10% of emergency department (ED) visits. Etiology differentiation is determined by complete history and physical examination, basic laboratory studies, and a variety of imaging study options. In this case report, we present an 8-year-old female with an unusual etiology of acute lower abdominal pain. She presented with tachycardia, hypertension, and bilateral lower quadrant abdominal tenderness without peritonitis. Laboratory studies were unremarkable and appendix ultrasound was indeterminate. CT with contrast revealed right ovarian vein thrombosis. Hematology evaluation did not reveal hypercoagulability. She was discharged on rivaroxaban, which was discontinued after a 3 month course and negative follow-up MRI. Ovarian vein thrombosis (OVT) most commonly develops in the peripartum time frame, with an estimated 20%-40% of cases not related to pregnancies. However, patients with nonpregnancy related OVT were determined to be significantly older than patients with pregnancy related OVT. This case report demonstrates the youngest documented case of OVT. This patient was not in the peripartum period and did not have any identifiable risk factors. Given this unprovoked OVT in a pediatric patient, in patients presenting with abdominal pain with unspecified etiology, advanced imaging studies may be helpful in establishing a diagnosis.

Cost saving analysis of prediabetes intervention modalities in comparison with inaction using Markov state transition model-A multiregional case study.

BACKGROUND: Prediabetes management is a priority for policymakers globally, to avoid/delay type 2 diabetes (T2D) and reduce severe, costly health consequences. Countries moving from low to middle income are most at risk from the T2D "epidemic" and may find implementing preventative measures challenging; yet prevention has largely been evaluated in developed countries. METHODS: Markov cohort simulations explored costs and benefits of various prediabetes management approaches, expressed as "savings" to the public health care system, for three countries with high prediabetes prevalence and contrasting economic status (Poland, Saudi Arabia, Vietnam). Two scenarios were compared up to 15 y: "inaction" (no prediabetes intervention) and "intervention" with metformin extended release (ER), intensive lifestyle change (ILC), ILC with metformin (ER), or ILC with metformin (ER) "titration." RESULTS: T2D was the highest-cost health state at all time horizons due to resource use, and inaction produced the highest T2D costs, ranging from 9% to 34% of total health care resource costs. All interventions reduced T2D versus inaction, the most effective being ILC + metformin (ER) "titration" (39% reduction at 5 y). Metformin (ER) was the only strategy that produced net saving across the time horizon; however, relative total health care system costs of other interventions vs inaction declined over time up to 15 y. Viet Nam was most sensitive to cost and parameter changes via a one-way sensitivity analysis. CONCLUSIONS: Metformin (ER) and lifestyle interventions for prediabetes offer promise for reducing T2D incidence. Metformin (ER) could reduce T2D patient numbers and health care costs, given concerns regarding adherence in the context of funding/reimbursement challenges for lifestyle interventions.

Design and performance evaluation of an off-grid hybrid solar system in a remote location: A case study of Legundi Island.

Legundi Island, located in Lampung Bay, Indonesia, has high solar energy potential but still relies on Diesel Power Plants. This research aims to design a hybrid Solar Power Plant and Diesel Power plant system that is environmentally friendly and reliable. Analysis was conducted using the Homer software. •This research designs a hybrid Solar Power Plant system with a capacity of 170.2 kWp and a battery of 1,036 kWh, integrated with three existing Diesel Power Plants units with a capacity of 200 kW.•This system can generate electricity of 296,391 kWh/year with a renewable energy fraction reaching 79.9% and an electricity surplus of 0.988%.•Fuel consumption decreased by 79.3% compared to the existing Diesel Power Plant system.

Communicative practices and perceptions towards stuttering people in South Africa.

BACKGROUND:  A few studies have explored the life experiences of people who stutter. Research has shown that stuttering affects a significant number of people in the population. OBJECTIVES:  The study was designed to explore the experiences of people who stutter and the perception of stuttering in South Africa. METHOD:  Four people who identified as South Africans who stutter participated in this study. The primary investigator conducted semi-structured interviews with each of the participants. In addition, a questionnaire was administered to 20 acquaintances of all the participants. Transcriptions of interviews and results of questionnaires were analysed for major and minor themes. RESULTS:  Results of this study suggest different perceptions by those who stutter and those acquainted with them. The findings of the study show that people who stutter experience communication barriers, so they adopt certain strategies to manage and cope with their speech disorder. The findings showed that stuttering has a pervasive impact on the lives of people who stutter and how they view themselves, considering negative societal views. CONCLUSION:  Evaluation of the results from the study reveals that although stuttering is a common speech disorder, many people who are less informed about it harbour various stereotypes and myths that stigmatise stuttering. This study concludes by outlining recommendations for creating awareness of stuttering. It suggests vigorous campaigns aiming at promoting a multilevel approach that extends beyond the mere social and professional understanding of stuttering but addresses the inherent perceptions, myths, and stereotypes around stuttering.Contribution: Experiences of people who stutter and perceptions towards stuttering can help to better understand the speech disorder and overcome myths and stereotyping of stuttering.

Prolonged exposure treatment for post-traumatic stress disorder: Single case studies in a sample of adults with mild intellectual disabilities.

BACKGROUND: Post-traumatic stress disorder (PTSD) is common in adults with intellectual disabilities. Often there are additional disorders such as substance use, mood and anxiety disorders. The current study focuses on the feasibility and initial efficacy of prolonged exposure (PE) for PTSD in adults with mild intellectual disabilities. The secondary effect of PE on additional mood, anxiety and substance use disorders is also examined. METHODS: A single case experimental design (N = 12) with an A (baseline)-B (intervention) phase including a follow-up measurement after 3 months was conducted. Time series and single time points measurements were performed. RESULTS: Six participants dropped-out. The results showed a significant decrease in PTSD symptoms and a significant decrease in additional symptoms (social avoidance, anxiety and stress), among participants who completed treatment. CONCLUSION: PE appears to be a feasible and effective treatment for PTSD in some adults with mild intellectual disabilities. Suggestions emerge from this study to make standard PE treatment more appropriate for adults with mild intellectual disabilities. Further research is needed to reduce drop-out in trauma treatment. Some suggestions for this are made in this study. Treatment of PTSD with PE did not appear to affect comorbid mood disorders. Further research is needed.

Psychobiography in sociocultural context: the application of culture-based theories of psychology on a culturally diverse historic subject pool.

In recent years the historical subject base in psychobiography has expanded from a traditional focus on White (Caucasian) subjects to a broader more culturally inclusive population of significant personalities throughout history. A critical component of strong multicultural psychobiography is the inclusion of anchoring theories of psychology that are rooted in socio-cultural-political context. To psychologically profile culturally diverse individuals with only traditional Western theories of psychology and psychiatry (e.g. medical models, psychodynamic, existential, cognitive-behavioral) limits the ability of the research to accurately capture the erlebnis (lived experience) of extraordinary individuals in proper cultural context. This article reviews specific psychological theories that have recently set a foundation for more nuanced and culturally contextualised psychological profiles of historic personalities who represent diverse racial/ethnic/cultural backgrounds. Among the theories covered are the Integrated African Psychology Perspective (IAPP), an Indigenous (Native American) model of psychobiography, as well as theories and models on Psychological Nigrescence (Black racial identity development), Intersectionality, Politicised Collective Identity (PCI), Queered Black Racial Identity Development (QBRID), and Adultification of Black Children, among others. Examples of applications of these culture-centered theories to psychobiography, drawn from the present authors recently completed psychobiographies, as well as from other researchers internationally, are presented.

Adopting, implementing and assimilating coproduced health and social care innovations involving structurally vulnerable populations: findings from a longitudinal, multiple case study design in Canada, Scotland and Sweden.

BACKGROUND: Innovations in coproduction are shaping public service reform in diverse contexts around the world. Although many innovations are local, others have expanded and evolved over time. We know very little, however, about the process of implementation and evolution of coproduction. The purpose of this study was to explore the adoption, implementation and assimilation of three approaches to the coproduction of public services with structurally vulnerable groups. METHODS: We conducted a 4 year longitudinal multiple case study (2019-2023) of three coproduced public service innovations involving vulnerable populations: ESTHER in Jönköping Region, Sweden involving people with multiple complex needs (Case 1); Making Recovery Real in Dundee, Scotland with people who have serious mental illness (Case 2); and Learning Centres in Manitoba, Canada (Case 3), also involving people with serious mental illness. Data sources included 14 interviews with strategic decision-makers and a document analysis to understand the history and contextual factors relating to each case. Three frameworks informed the case study protocol, semi-structured interview guides, data extraction, deductive coding and analysis: the Consolidated Framework for Implementation Research, the Diffusion of Innovation model and Lozeau's Compatibility Gaps to understand assimilation. RESULTS: The adoption of coproduction involving structurally vulnerable populations was a notable evolution of existing improvement efforts in Cases 1 and 3, while impetus by an external change agency, existing collaborative efforts among community organizations, and the opportunity to inform a new municipal mental health policy sparked adoption in Case 2. In all cases, coproduced innovation centred around a central philosophy that valued lived experience on an equal basis with professional knowledge in coproduction processes. This philosophical orientation offered flexibility and adaptability to local contexts, thereby facilitating implementation when compared with more defined programming. According to the informants, efforts to avoid co-optation risks were successful, resulting in the assimilation of new mindsets and coproduction processes, with examples of how this had led to transformative change. CONCLUSIONS: In exploring innovations in coproduction with structurally vulnerable groups, our findings suggest several additional considerations when applying existing theoretical frameworks. These include the philosophical nature of the innovation, the need to study the evolution of the innovation itself as it emerges over time, greater attention to partnered processes as disruptors to existing power structures and an emphasis on driving transformational change in organizational cultures.

IJCH - COVID-19 in the Arctic: special issue.

The Circumpolar region, comprising the Arctic territories encircling the North Pole, is home to diverse Indigenous cultures facing unique socio-economic challenges. Indigenous communities such as the Inuit, Sámi, Athabaskan, Gwitchin, and Russian Arctic groups exhibit rich traditions and adaptive practices tied to their environments. Environmental diversity, from icy tundra to boreal forests, influences livelihoods and biodiversity, while significant socio-economic disparities persist, impacting access to healthcare, education, and economic opportunities. Against this backdrop, the global COVID-19 pandemic accentuated the intersection of environment, culture, and health in remote Arctic regions, presenting distinct challenges and opportunities. Initiated by a collaborative research project led by Fulbright Arctic Initiative Alumni, this special issue of the International Journal of Circumpolar Health explores the impacts of COVID-19 on Arctic Indigenous and rural communities. Building on previous work and recommendations, the issue features community case studies, highlighting community experiences and collaborative approaches to understand and address the pandemic's effects. The authors highlight both positive and negative societal outcomes, presenting community-driven models and evidence-based practices to inform pan-Arctic collaboration and decision-making in public health emergencies. Through sharing these insights, the special issue aims to privilege local and Indigenous knowledge systems, elevates community responses to complex and multifaceted challenges, and contributes to the evidence base on global pandemic response.

An environmental justice fictional case study for engaging non-majors in human biology.

The impacts of climate change are and will continue to be far-reaching, and environmental justice communities are disproportionately impacted due to environmental racism and related forms of oppression. Vision and Change in Undergraduate Biology Education encourages that the connection between science and society be explicitly taught in science classrooms. Here, I describe a fictional case study where students decide how to allocate a budget at a non-profit organization tasked with mitigating environmental issues in a town that contains environmental justice communities. Students are each assigned a role in the community and must reach a consensus on their budget in small groups before the whole class votes on a consensus budget. Afterward, students perform a metacognitive activity that encourages them to reflect on the human health impacts of their decisions and how their role impacted their decision-making process. Quantitative and qualitative feedback from students shows that by the end of the course, students appreciate the importance of science literacy in understanding global issues and that they are able to connect environmental justice to their lives and coursework. This case study helps fill an unmet need in climate change education by allowing students to practice empathy in topics related to climate change and environmental justice.

A case study to engage students in the research design and ethics of high-throughput metagenomics.

Case studies present students with an opportunity to learn and apply course content through problem solving and critical thinking. Supported by the High-throughput Discovery Science & Inquiry-based Case Studies for Today's Students (HITS) Research Coordination Network, our interdisciplinary team designed, implemented, and assessed two case study modules entitled "You Are What You Eat." Collectively, the case study modules present students with an opportunity to engage in experimental research design and the ethical considerations regarding microbiome research and society. In this manuscript, we provide instructors with tools for adopting or adapting the research design and/or the ethics modules. To date, the case has been implemented using two modalities (remote and in-person) in three courses (Microbiology, Physiology, and Neuroscience), engaging over 200 undergraduate students. Our assessment data demonstrate gains in content knowledge and students' perception of learning following case study implementation. Furthermore, when reflecting on our experiences and student feedback, we identified ways in which the case study could be modified for different settings. In this way, we hope that the "You Are What You Eat" case study modules can be implemented widely by instructors to promote problem solving and critical thinking in the traditional classroom or laboratory setting when discussing next-generation sequencing and/or metagenomics research.

When one tool is not enough: An integrative psychotherapeutic approach to treating complex PTSD.

Complex posttraumatic stress disorder (CPTSD) is a term representing the psychopathological implications of exposure to chronic, inter-personal trauma. These include the main symptoms of PTSD, as well as changes in identity, emotion regulation, and inter-personal relationships. Self-harm and dissociation (i.e., disintegration of mental processes) are also quite common in CPTSD. Considering this complex and often severe clinical picture, mental health professionals often find it difficult to effectively treat CPTSD. In this paper, we present an integrative approach to the treatment of CPTSD based on a combination of techniques from several psychotherapy approaches. The case described here illustrates the need for therapeutic flexibility and eclecticism when treating individuals exposed to chronic trauma. We show the advantages of flexible therapeutic attunement, which enables the therapist to respond to the changing need of the patient, as well as her fluid clinical picture and symptom manifestation. The case also illustrates how interventions taken from psychodynamic therapy, Dialectical behavior therapy, and Eye Movement Desensitization and Reprocessing may be applicable in various stages of treatment, alleviating the patient's distress in several psychological and physical domains.

Challenges for Nurse Anesthetists Reentering Practice Following Substance Use Disorder Treatment.

Substance use disorder (SUD) is a persistent, relapsing condition that is present in approximately 10% of anesthesia providers, who, compared with other healthcare providers, face a greater risk of developing an SUD by virtue of constant access to medications. The ability of certified registered nurse anesthesiologists (CRNAs) to obtain or maintain employment after treatment for SUD treatment is not well documented. The purpose of this qualitative study was to explore challenges encountered by CRNAs in recovery as they attempt to reenter practice following SUD treatment. The phenomenon was explored through multiple-case study, using qualitative semistructured interviews with participants in four cases: CRNAs in recovery, CRNA colleagues, CRNA employers, and professional health program employees. Thirty-six participants conveyed their perspectives about challenges that CRNAs in recovery face upon reentry into practice following SUD treatment. The Worker Well-Being conceptual model was used to guide this study. The study revealed that more SUD education is a key facilitator for reentry, risk of relapse was a major concern, and stigma was the most significant barrier for CRNAs in recovery. Stigma persists as a considerable barrier in many facets of SUD, contributing to an increase in shame associated with having the disease.