Rapid detection of fertilizer information based on Raman spectroscopy and machine learning.

The rapid detection of fertilizer nutrient information is a crucial element in enabling intelligent and precise variable fertilizer application. However, traditional detection methods possess limitations, such as the difficulty in quantifying multiple components and cross-contamination. In this study, a rapid detection method was proposed, leveraging Raman spectroscopy combined with machine learning, to identify five types of fertilizers: K2SO4, (CO(NH2)2, KH2PO4, KNO3, and N:P:K (15-15-15), along with their concentrations. Qualitative and quantitative models of fertilizers were constructed using three machine learning algorithms combined with five spectral preprocessing methods. Two variable selection methods were used to optimize the quantitative model. The results showed that the classification accuracy of the five fertilizer solutions obtained by random forest (RF) was 100 %. Moreover, in terms of regression, partial least squares regression (PLSR) outperformed extreme learning machine (ELM) and least squares support vector machine (LSSVM), yielding prediction Rp2 within the range of 0.9843-0.9990 and a root mean square error in the range of 0.0486-0.1691. In addition, this study evaluated the impact of different water types (deionized water, well water, and industrial transition water) on the detection of fertilizer information via Raman spectroscopy. The results showed that while different water types did not notably affect the identification of fertilizer nutrients, they did exert a pronounced effect on the quantification of concentrations. This study highlights the efficacy of combining Raman spectroscopy with machine learning in detecting fertilizer nutrients and their concentration information effectively.

Feasibility of qualitative identification of some metal elements in rice grains using laser desorption ionization-time of flight mass spectrometry.

Rice is one of the popular foods in the world, and the identification and measurement of the concentration of metal elements in therein is necessary for food safety. To this end, this work investigated the feasibility of using laser desorption ionization time-of-flight mass spectrometry (LDI-TOF-MS) for the qualitative identification of metal elements present in rice. The effect of different sample preparation methods (solvation of rice powder in water, acid digestion, and rice tablet) and laser wavelength on the mass spectral pattern of rice was investigated. Based on the experimental results, LDI-TOF-MS proves to be a reliable method for the qualitative identification of the metal elements in rice. It was determined that the rice sample prepared as a tablet and using visible laser radiation, are the most suitable choice for the identification of metallic elements using LDI-TOF-MS. The mass spectrum of rice was experimentally modeled using starch and theoretically simulated.

Bridging the Telehealth Digital Divide With Collegiate Navigators: Mixed Methods Evaluation Study of a Service-Learning Health Disparities Course.

BACKGROUND: Limited digital literacy is a barrier for vulnerable patients accessing health care. OBJECTIVE: The Stanford Technology Access Resource Team (START), a service-learning course created to bridge the telehealth digital divide, trained undergraduate and graduate students to provide hands-on patient support to improve access to electronic medical records (EMRs) and video visits while learning about social determinants of health. METHODS: START students reached out to 1185 patients (n=711, 60% from primary care clinics of a large academic medical center and n=474, 40% from a federally qualified health center). Registries consisted of patients without an EMR account (at primary care clinics) or patients with a scheduled telehealth visit (at a federally qualified health center). Patient outcomes were evaluated by successful EMR enrollments and video visit setups. Student outcomes were assessed by reflections coded for thematic content. RESULTS: Over 6 academic quarters, 57 students reached out to 1185 registry patients. Of the 229 patients contacted, 141 desired technical support. START students successfully established EMR accounts and set up video visits for 78.7% (111/141) of patients. After program completion, we reached out to 13.5% (19/141) of patients to collect perspectives on program utility. The majority (18/19, 94.7%) reported that START students were helpful, and 73.7% (14/19) reported that they had successfully connected with their health care provider in a digital visit. Inability to establish access included a lack of Wi-Fi or device access, the absence of an interpreter, and a disability that precluded the use of video visits. Qualitative analysis of student reflections showed an impact on future career goals and improved awareness of health disparities of technology access. CONCLUSIONS: Of the patients who desired telehealth access, START improved access for 78.7% (111/141) of patients. Students found that START broadened their understanding of health disparities and social determinants of health and influenced their future career goals.

Hip fracture has profound psychosocial impacts: a systematic review of qualitative studies.

BACKGROUND: Hip fracture is a common and serious traumatic injury for older adults characterised by poor outcomes. OBJECTIVE: This systematic review aimed to synthesise qualitative evidence about the psychosocial impact of hip fracture on the people who sustain these injuries. METHODS: Five databases were searched for qualitative studies reporting on the psychosocial impact of hip fracture, supplemented by reference list checking and citation tracking. Data were synthesised inductively and confidence in findings reported using the Confidence in the Evidence from Reviews of Qualitative research approach, taking account of methodological quality, coherence, relevance and adequacy. RESULTS: Fifty-seven studies were included. Data were collected during the peri-operative period to >12 months post fracture from 919 participants with hip fracture (median age > 70 years in all but 3 studies), 130 carers and 297 clinicians. Hip fracture is a life altering event characterised by a sense of loss, prolonged negative emotions and fear of the future, exacerbated by negative attitudes of family, friends and clinicians. For some people after hip fracture there is, with time, acceptance of a new reality of not being able to do all the things they used to do. There was moderate to high confidence in these findings. CONCLUSIONS: Hip fracture is a life altering event. Many people experience profound and prolonged psychosocial distress following a hip fracture, within a context of negative societal attitudes. Assessment and management of psychosocial distress during rehabilitation may improve outcomes for people after hip fracture.

Clinicians' experience of barriers and facilitators to care delivery of an extracorporeal cardiopulmonary resuscitation service for out-of-hospital cardiac arrest: a qualitative survey.

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) survival in the UK remains overall poor with fewer than 10% of patients surviving to hospital discharge. Extracorporeal cardiopulmonary resuscitation (ECPR) is a developing therapy option that can improve survival in select patients if treatment begins within an hour. Clinicians' perspectives are a pivotal consideration to the development of effective systems for OHCA ECPR, but they have been infrequently explored. This study investigates clinicians' views on the barriers and facilitators to establishing effective systems to facilitate transport of OHCA patients for in-hospital ECPR. METHODS: In January 2023, Thames Valley Air Ambulance (TVAA) and Harefield Hospital developed an ECPR partnership pathway for conveyance of OHCA patients for in-hospital ECPR. The authors of this study conducted a survey of clinicians across both services looking to identify clear barriers and positive contributors to the effective implementation of the programme. The survey included questions about technical and non-technical barriers and facilitators, with free-text responses analysed thematically. RESULTS: Responses were received from 14 pre-hospital TVAA critical care and 9 in-hospital clinicians' representative of various roles and experiences. Data analysis revealed 10 key themes and 19 subthemes. The interconnected themes, identified by pre-hospital TVAA critical care clinicians as important barriers or facilitators in this ECPR system included educational programmes; collectiveness in effort and culture; teamwork; inter-service communication; concurrent activity; and clarity of procedures. Themes from in-hospital clinicians' responses were distilled into key considerations focusing on learning and marginal gains, standardising and simplifying protocols, training and simulation; and nurturing effective teams. CONCLUSION: This study identified several clear themes and subthemes from clinical experience that should be considered when developing and modelling an ECPR system for OHCA. These insights may inform future development of ECPR programmes for OHCA in other centres. Key recommendations identified include prioritising education and training (including regular simulations), standardising a 'pitstop style' handover process, establishing clear roles during the cannulation process and developing standardised protocols and selection criteria. This study also provides insight into the feasibility of using pre-hospital critical care teams for intra-arrest patient retrieval in the pre-hospital arena.

A qualitative analysis to identify the issues of tuberculosis management in tribal areas of Rajasthan.

BACKGROUND: Tuberculosis (TB) is a disease with social issue. Tribal people are disproportionately affected by TB. There is a scarcity of data on issues of TB management among the tribal groups of India. The objective of this study was to get in-depth understanding of the issues hindering TB management among the tribal communities of Rajasthan, India. METHODS: We conducted qualitative study involving in-depth interviews with purposively selected healthcare service providers of the selected tribal areas of Rajasthan. Beside this, in-depth interviews and focus group discussions were also conducted among the purposively selected tribal people of these tribal areas. Data was collected using predesigned interview guides and a focus group discussion guide in their local setting in the local language. Information obtained were transcribed and translated into English language before analysing. Translated data was then coded and thematically organized. Inductive coding was used to identify emerging themes and sub-themes relevant to issues that occur during TB management. RESULTS: Several locally relevant issues were identified which negatively affected TB management in tribal areas of Rajasthan, India. Substance abuse, lack of awareness, discriminative behaviour, poor accessibility, exposure to mine dust, economic burden, migration, lack of training, irregular disbursement of incentive and staff behaviour emerged as major issues. CONCLUSION: This study identified the issues which hamper TB management in tribal population of Rajasthan, India. Result of this study can be useful in designing a tribal-centric approach to adequately manage TB among tribal population of Rajasthan.

Knowledge, perceptions, and experiences of e-cigarettes among young adults in Cape Town, South Africa: Insights from focus groups to inform regulations and prevention strategies.

INTRODUCTION: E-cigarettes have rapidly gained a market share in South Africa and globally. Concerns have been raised over the growing popularity of e-cigarettes among young people, who are frequently drawn to these novel products and are especially targeted by marketers. Using a qualitative method, this study aimed to gain insight into young adults' knowledge, experiences, and perceptions of e-cigarette use in Cape Town, South Africa. METHODS: We conducted five focus groups (FGs) among students of the University of Cape Town (n=48; 46% females; 54% males; aged 18-25 years). These FGs, which included both e-cigarette users and non-users, were audio-taped, transcribed verbatim, and analyzed thematically using Nvivo 12 software. RESULTS: Despite their lack of information about the chemical constituents of e-cigarettes and their harm, participants perceived them as healthier than combustible cigarettes. Participants equated the pleasant smell and environmental friendliness of e-cigarettes with safety. The absence of e-cigarette regulation was interpreted as evidence of their safety. Participants indicated that the lack of anti-e-cigarette indoor policies, the deceptive marketing regarding their safety, and their low price compared to combustible cigarettes, had key roles in increasing young people's use of e-cigarettes. CONCLUSIONS: Findings highlight factors at multiple levels contributing to e-cigarette use among young people in South Africa. Comprehensive strategies for e-cigarette regulation and prevention are needed. Potential strategies include increasing knowledge of e-cigarette harms through evidence-based communication campaigns and strengthening e-cigarette regulations by limiting e-cigarette advertisements, banning vaping in public places, and reducing the flavors used in e-cigarettes.

We Hope You're Listening: Qualitative Study of Advice Given by Individuals with Parkinson's Disease.

BACKGROUND: Patient-centered care for persons with Parkinson's disease (PwPD) is associated with positive outcomes, but is lacking in current healthcare systems. OBJECTIVE: In this qualitative study, we solicited advice from PwPD to medical professionals, family members/friends, and newly-diagnosed PwPD. METHODS: Through an online survey, 275 PwPD answered open-ended questions asking for their advice. Responses were analyzed using content analysis. Interrater reliability was 94.5%. RESULTS: Three qualitative themes were identified. First, participants advised enhancing care and communication, with healthcare professionals balancing clinical constraints with compassion, and family/friends balancing support with appreciating autonomy of PwPD. The second theme was empowering PwPD through increasing their knowledge of the disease and care options. The third reflected the importance of focusing on well-being and connection. CONCLUSION: The results highlight several gaps in meeting the needs of PwPD in healthcare settings and personal relationships, underscoring the importance of integrating their perspectives in shaping approaches to care.

Healthcare Professionals' Perspectives on Dignity in Dementia: A Qualitative Analysis.

In dementia care, the concept of dignity has garnered substantial attention from both researchers and policymakers. However, the concept often remains vague and open to interpretation, potentially leading to misunderstandings and suboptimal care for people with dementia. As healthcare professionals occupy a critical role in upholding dignity, exploring their viewpoints on this complex concept is paramount. In this study, we explore Danish healthcare professionals' views on the dignity of people with dementia and discuss these perspectives against existing theoretical accounts. We employed thematic analysis of data collected during facilitated discussions with a total of 99 healthcare professionals, including nurses and healthcare workers, during which we posed the question, "What is dignity to you?" and documented their perspectives. Through a systematic process of data coding and interpretation, we identified recurring patterns in their responses. This approach allowed us to uncover the depth and complexity of their viewpoints, providing valuable insights into the multifaceted nature of dignity as perceived by healthcare professionals. Our findings revealed that healthcare professionals possessed a nuanced understanding of dignity, recognizing both a subjective element and a universal aspect applicable to all individuals, aligning with theoretical interpretations. However, conceptual ambiguity remained a challenge.

Lived experiences of children who stutter in their own voices.

INTRODUCTION: Significant research has explored the lived experiences of adults who stutter, but less research exists regarding the lived experiences of children who stutter. The opinions and ideas of children who stutter may differ from those of adults, making it important for clinicians and researchers to obtain information directly from children who stutter. Asking children directly can lead to treatment outcomes and research questions that better align with the children's needs and values. METHOD: Interviews with 18 children who stutter (9 girls/9 boys) ages 8-17 were sourced from the Voices of Children Who Stutter database located at Talkbank.org. Interview questions asked the children about living with a stutter, participating in stuttering support organizations (SSOs), and their perspectives on treatment. Qualitative, phenomenological analysis was performed on their answers following standardized qualitative procedures. RESULTS: Analysis of 910 total utterances yielded 7 themes and 9 subthemes. Themes indicated that the children: (a) had significant knowledge regarding their own stuttering, (b) had opinions regarding what constituted worthwhile treatment outcomes, (c) were clear about desirable clinician characteristics for working with kids who stutter, and (d) saw the benefits of being part of a community. CONCLUSIONS: Themes revealed that overall, children who stutter exhibit deep understanding regarding their experiences with stuttering, which clinicians can harness in person-centered goal setting. Additionally, the participants express the importance of participating in stuttering support organizations.

Early return to work is possible after transoral robotic surgery (TORS) in carefully selected patients with oropharyngeal squamous cell carcinoma.

INTRODUCTION: The aims of this study were to investigate the rate and time to return to work (RTW) after transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) and to explore the impact of disease or work-related factors leading to variations in RTW outcomes. METHODS: Cross-sectional survey of disease, socioeconomic, work-related and health-related quality of life (HR-QOL). Qualitative analysis of responses for facilitators and barriers to RTW. RESULTS: A total of 47 participants employed at diagnosis were included in the study, with an average age 56 years. Median survey time 3.2 years. 22 participants underwent TORS only with 25 undergoing TORS with adjuvant therapy. 93.6 % had stage 1 disease. 95.7 % of participants RTW after TORS with a mean time of 13.6 weeks. Patients returned earlier after TORS alone compared to those requiring adjuvant treatment (10 weeks vs. 17 weeks; p = 0.13) Overall high HR-QOL metrics for all patients, with those undergoing adjuvant having significantly poorer outcomes for the dry mouth/sticky saliva (9.1 vs 41.3, p=<0.001) items. Qualitative analysis of free text responses showed facilitators and barriers to RTW fell under four main categories: physical, phycological/emotional, financial and workplace. CONCLUSION: High rate of RTW amongst patients after TORS, which is the highest reported amongst head and neck cancer literature to date. Participants returned earlier after surgery only compared to adjuvant treatment, but both groups reported high HR-QOL metrics. Physical effects of treatment, including fatigue and oral dysfunction were some of the main barriers to RTW; whereas flexible working arrangements and support from employer/colleagues were major facilitators.

Motivation for patient engagement in patient safety: a multi-perspective, explorative survey.

BACKGROUND AND OBJECTIVES: Despite increasing calls for more patient engagement in patient safety, limited knowledge remains on what actually motivates key stakeholders in healthcare to promote patient engagement. We therefore set out to survey key stakeholders of patient engagement in patient safety (i.e., patients, healthcare professionals, and managers). We aimed to identify and explore stakeholder's distinct and shared motives for patient engagement. METHODS: A stepwise Delphi method was applied, utilizing semi-structured online interviews for determination of stakeholder motives for patient engagement in patient safety. In a subsequent online survey, statements were evaluated and identified. 34 subject-matter experts from all relevant stakeholder groups completed the online interviews and 33 the online survey. We used content analysis approaches for qualitative and descriptive analyses for quantitative measures. Further, we evaluated the consensus on distinct and shared motives across stakeholder groups. RESULTS: Seven key motives for patient engagement in patient safety were identified. Major motives attributed to patients were: (1) To improve experiences and care outcomes for oneself, as well as (2) for future patients, (3) to express gratitude and appreciation, (4) to cope successfully with treatment-related emotions. A motive shared by patients and professionals was (5) to contribute actively to improved delivery of healthcare. To optimize patient safety, costs, and care processes (6) was shared by professionals and managers. Lastly, (7) to improve patient-provider relationships was jointly shared by all stakeholder groups. For four motives (1, 2, 6, 7) consensus was established. CONCLUSIONS: In order to unlock the full potential of future interventions in patient engagement, a deeper understanding of stakeholder motives is essential. We identified a set of distinct and shared motives for patient engagement across relevant stakeholder groups. Our findings may inform future interventions in patient engagement that take account of the motivational foundations and aspirations of all stakeholders who are key for the success for collaborative patient safety and care improvements. TRIAL REGISTRATION: ID DRKS00031837 (Date May 8, 2023).

Identification of bile acids in snake bile by hydrogen/deuterium exchange mass spectrometry and quantitative structure-retention relationship analysis.

Natural bile acids, a class of steroids with a valeric acid side chain at the C-17 position, present significant challenges in separation and analysis due to structural similarities, isomerism, and large polarity differences. Therefore, advanced analytical methods are essential for the accurate identification and quantification of bile acids. This study conducted a comprehensive qualitative analysis of bile acids by integrating liquid chromatography-tandem mass spectrometry (LC-MS/MS), hydrogen-deuterium exchange tandem mass spectrometry (HDX-MS/MS), and quantitative structure-retention relationship (QSRR) methods. Firstly, LC-MS/MS conditions were optimized to enhance chromatographic separation and improve the reliability of characteristic fragment ions. MS/MS fragmentation rules for bile acids were derived from the mass spectral data of bile acid standards and validated through HDX-MS/MS experiments. Secondly, potential bile acids in snake bile were identified based on these validated fragmentation rules, and a QSRR model was established to predict the retention times of the proposed structures. Thirdly, HDX-MS/MS was applied to assist in identifying bile acid isomers. Finally, a total of 150 bile acids, including 11 free bile acids (free BA), 5 glyco-bile acids (GBA) and 134 tauro-bile acids (TBA), were detected in snake bile. Thirteen bile acids were accurately characterized by comparing their retention time and MS/MS spectra with standards. Forty-nine bile acids were reasonably annotated using the QSRR model and HDX-MS/MS. This study is notable for being the first to utilize the QSRR and HDX-MS/MS techniques for the annotation of bile acids in snake bile, providing a robust framework for the structural elucidation of these compounds.

Patient Perspectives in the Diagnosis and Treatment of Gallstone Disease: A Qualitative Analysis.

INTRODUCTION: Gallstone disease is one of the most common surgical diagnoses in the United States. Notably absent from the literature is the patient's perspective on priorities in management. Understanding patient values will assist surgeons and systems in achieving high-quality, patient-focused care for biliary disease. METHODS: Patients who underwent elective or urgent cholecystectomy were invited to participate in a semistructured interview to assess their experience. Interviews were performed over the phone or in person and recordings were transcribed. Each transcription was analyzed independently by two authors using the MAXQDA software, and a mixed deductive-inductive approach was used to develop themes. Anonymized quotes were used to illustrate themes and subthemes regarding the patient's experiences and priorities surrounding gallstone disease. RESULTS: A total of 29 interviews were completed. Most participants were female, but represented a diverse racial and educational group. The most common diagnosis was acute cholecystitis (48%), and 76% of patients underwent an emergency operation. Patients indicated that their main priority regarding treatment was prompt pain control with definitive management so they could return to their previous quality of life. Most patients wanted face-to-face communication with the surgical team both pre and postoperatively. Patients wished they had more information about postoperative care and expectations in the preoperative setting. CONCLUSIONS: Patients' priorities in their care for gallstone disease are centered around definitive management and quality of life. Improvements in communication were identified regarding meeting the surgeon, and postoperative communication. These results can inform surgeons how to prioritize patient perspectives in an acute care surgical system that was not designed with patient input.

I simply have more of a role as a human being. Psychotherapists' Experience Delivering Psychotherapy to Nursing Home Residents with Depression.

BACKGROUND AND OBJECTIVES: The lack of psychotherapy in nursing homes can be explained by organisational obstacles but also by practitioners' reservations about this patient group and setting. This study aimed to inform practice by qualitatively exploring the experiences of psychotherapists delivering cognitive behavioural therapy (CBT) to residents of nursing homes diagnosed with depression. RESEARCH DESIGN AND METHODS: Semi-structured interviews with six psychotherapists, who had delivered treatment within the DAVOS project (Depression in the nursing home: a cluster-randomized stepped-wedge collaborative case management approach to improve treatment) were recorded, transcribed, and analysed using a deductive-inductive content analysis. RESULTS: Therapists experienced various difficulties, including practical (e.g., multi-professional collaboration) and existential issues (e.g., confrontation with their own mortality). Participants described correcting some stereotypical images of older people (in need of care) through their work within the DAVOS project. However, evidence of ageism was still included in their reports. In the interviews, psychotherapists more experienced with older patients addressed more existential issues, whereas more novice therapists tended to focus more on practical difficulties. DISCUSSION AND IMPLICATIONS: To ensure a more effective implementation of psychotherapeutic treatment in nursing homes, it appears necessary to address important contextual factors that facilitate interdisciplinary collaboration, interference free treatment rooms and tele-assisted sessions. Further, more setting-specific training, targeted supervision regarding death and suicide, and interventions that address stereotypical images of age and older people in residential care are needed.

Exploring Levels of Interspecies Interaction: Expectations, Knowledge, and Empathy in Human-Dog Relationships.

This exploratory study examines the complex dynamics of human-dog relationships and their impact on interspecies communication. Twelve human-dog dyads were studied using narrative interviews to explore how people perceive their relationships with their dogs. In addition, the dyads engaged in a cooperative task to observe interaction dynamics during everyday activities. This study shows that individual expectations frame interactions and that traditional notions of dog ownership are evolving into more family-like relationships. Effective communication relies on a nuanced mix of verbal and non-verbal cues, with empathy emerging as a fundamental element guiding these interactions. Our findings underline the profound influence of human expectations, knowledge and empathy on communication with dogs. They also highlight the critical role of compatibility between human and dog dyads, and emphasize that such compatibility is a key determinant of satisfaction in interspecies relationships. These findings contribute to a deeper understanding of how human factors modulate communication and satisfaction in human-animal interactions.

LC-MS based strategy for chemical profiling and quantification of dispensing granules of Ginkgo biloba seeds.

Ginkgo biloba seeds have been used as a traditional Chinese medicine for hundreds of years to treat diseases such as cervicitis, cough, asthma and other lung diseases. As a novel form, the dispensing granules (GSDG) of Ginkgo biloba seeds have been widely employed in clinic. However, its chemical profiling is not yet clear, which has restricted in-depth research in many fields. In this study, a high performance liquid chromatography coupled with quardrupole time-of-flight mass spectrometry method was used for the component characteration with the help of accurate molecular weights, fragmentation pathways, reported data, literatures and even some reference standards. Furthermore, in multiple-reaction monitoring mode, a high performance liquid chromatography coupled with quadrupole linear ion trap mass spectrometry method was developed and applied for simultaneous determination of the bioactive phytochemicals. As a result, a total of 56 components in GSDG were identified including 12 amino acids, 9 organic acids, 6 nucleosides and nucleobases, 6 flavonoids, 5 vitamins, 5 terpenoid lactones, 4 carbohydrates and 9 other compounds As for quantitative analysis, glutamic acid, asparatic acid, histidine, ginkgolide A, ginkgolide B, ginkgolide C, ginkgolide J, eucomic acid, N-(N-glucopyranosyl)-indoleacetylaspartate and N-(N-glucopyranosyl)-indoleacetylglutamate were selected as the analytes for quanlity marker of GSDG. After necessary validation tests, the developed quantitative method was successfully put into use for 10 batches of GSDG. In all batches, N-(N-glucopyranosyl)-indoleacetylaspartate was the richest phytochemical with the amount of 17.3-25.7 mg/g while ginkgolide J (0.0197-0.0335 mg/g) was determined to be the poorest. The study is supposed to exhibit a comprehensive chemical profiling and to provide some strong basis for preparation technology, quality control and even for action mechanism of GSDG, this novel form of Chinese medicine.

A Qualitative Assessment of Reasons for Living and Dying in the Context of Feeling Trapped Among Adults in the United Kingdom.

OBJECTIVE: Contemporary approaches to suicide assessment and treatment incorporate reasons for living (RFL) and reasons for dying (RFD). This study qualitatively explored individuals' self-described RFL and RFD in the context of suicidal thinking and behaviors. METHOD: Within a community United Kingdom (UK) sample, adults (N = 331, aged 16+) responded to eight open-ended questions probing their experiences of suicide, defeat, and entrapment. Utilizing these data, which were collected from a larger online survey examining risk and protective factors for suicidal behaviors, this study explored RFL and RFD within these narratives. After the research team established an initial code book, RFL and RFD codes were subsequently analyzed through inductive and deductive thematic analyses. RESULTS: The present study identified five complimentary RFD-RFL themes: (1) Hopelessness-Hopefulness, (2) Stress of Responsibilities-Duty to Responsibilities, (3) Social Disconnection-Social Connection, (4) Death as Sin-Desire for an Afterlife, and (5) Temporary Escapes as Coping-Entrapment (i.e., a lack of escape). Three subthemes within the RFD theme Entrapment were General/Unspecified, By Feelings, and Within Self. CONCLUSIONS: Identified themes reflect the existing quantitative RFL and RFD literature. The identified RFL and RFD themes are discussed with reference to their clinical applications in advancing suicide-specific assessments and interventions. We propose a dimensional framework for RFD and RFL which informs future suicidal behaviors research and practice.

The study highlights the complex co-existence of reasons for dying and reasons for living.Reasons for living and dying should be explored in parallel in a therapeutic setting.The relative value placed on RFL/RFD by the individual should also be considered.

The transition from children to young people living with home mechanical ventilation.

PURPOSE: This study aimed to examine how young people living with Home Mechanical Ventilation experience the transition from childhood to young adulthood in relation to everyday life, perceived health and transition into adult professional healthcare. METHODS: Nine young adults (three females and six males aged 18-31) were interviewed, and data was primary analysed using phenomenological hermeneutics. In the actual study, data was reworked using secondary analysis as described by Beck. Two interviewees were ventilated invasively and six non-invasively, and one was treated with continuous positive airway pressure (CPAP). RESULTS: The results are presented in two main categories. First; moving towards adulthood; and second, To handle changes in health and healthcare contacts. The study highlights the importance of ongoing social relations and being part of a socializing and physically active community. The transfer from paediatric to adult healthcare was solid and worked out well but was a process in which the participants struggled to find their own voice. CONCLUSIONS: The transition into adulthood is a sensitive and challenging time for young people with HMV, but stable, close relationships and a well-organized transfer can enable this group to feel safe and able to find and use their own voice.

'It was hell on earth': perspectives of people living with celiac disease on diagnostic delay.

BACKGROUND: Celiac disease (CD) is underdiagnosed and associated with diagnostic delays. This has long-term consequences for the health and well-being of people living with the condition. Little is known about the qualitative configurations of the assessment processes of people living with CD. METHODS: Using a thematic network analysis of 24 in-depth interviews, this study explored the experiences of people living with CD related to their assessment processes leading to being diagnosed. RESULTS: A significant diagnostic delay (up to 26 years) was evident in many interviews. Factors contributing to diagnostic delay included limited knowledge about CD among general practitioners (GP) and in the general population, categorisations of symptoms as 'typical' or 'atypical' and psychosomatic explanations of symptoms. Diagnostic delay resulted in (1) decreased psychological well-being due to severe symptoms, changes in self-perception and self-blame; (2) decreased physiological well-being due to comorbidities; and (3) mistrust in the healthcare system, leading to an increase in informants' responsibility for expediting their assessment processes. This suggested the presence of a neoliberal tendency because informants felt they were primarily responsible for their assessment processes. CONCLUSIONS: We encourage the implementation of initiatives to increase awareness of CD among GPs as well as more consistent and frequent use of the screening guideline due to variations in its clinical presentation. Increased awareness and consistency could reduce variations in assessment processes given GPs' varying knowledge about the condition.