Aim/purpose The purpose of this article is to discuss the psychosocial and emotional outcomes of an introductory health science workshop designed to support and assist incoming health science students before starting their university study.   Background For the past two decades, a South Australian university offered an on-campus face to face workshop titled ‘Preparation for Health Sciences’ to incoming first-year students from eleven allied health programs such as Nursing, Physiotherapy and Medical Imaging. While many were locals, a good number came from regional and rural areas, and many were international students also. They consisted of both on-campus and off-campus students.   The workshop was created as a new learning environment that was available for students of diverse age groups, educational and cultural backgrounds to prepare them to study sciences. The content of the four-day workshop was developed in consultation with the program directors of the allied health programs. The objectives were to: introduce the assumed foundational science knowledge to undertake health sciences degree; gain confidence in approaching science subjects; experience lectures and laboratory activities; and become familiar with the University campus and its facilities. The workshop was delivered a week before the orientation week, before first-year formal teaching weeks. The topics covered were enhancing study skills, medical and anatomical terminology, body systems, basic chemistry and physics, laboratory activities, and assessment of learning.   Methodology In order to determine the outcomes of the workshop, a survey was used requiring participants to agree or disagree about statements concerning the preparatory course and answer open-ended questions relating to the most important information learned and the best aspects of the workshop. Several students piloted this questionnaire before use in order to ascertain the clarity of instructions, terminology and statements. The result of the 2015-2018 pre- and post-evaluation showed that the workshop raised confidence and enthusiasm in commencing university and that the majority considered the workshop useful overall. The findings of the survey are drawn upon to examine the psychosocial and emotional impacts of the workshop on participants. Using secondary qualitative analysis, the researchers identified the themes relating to the psychosocial and emotional issues conveyed by the participants.   Contribution The contributions of the article are in the areas of improving students’ confidence to complete their university degrees and increasing the likelihood of academic success. Findings Of the 285 students who participated in the workshops from 2015 to 2018, 166 completed the survey conducted at the conclusion of the initiative, representing a 58% response rate. The workshops achieved the objectives outlined at the outset. While there were many findings reported (Thalluri, 2016), the results highlighted in this paper relate to the psychosocial and emotional impacts of the workshop on students. Three themes emerged, and these were Increased preparedness and confidence; Networking and friendships that enhanced support, and Reduced anxiety to study sciences. Some drawbacks were also reported including the cost, time and travel involved. Recommendations for practitioners Students found the introductory workshop to be psychosocially and emotionally beneficial. It is recommended that the same approach be applied for teaching other challenging fields such as mathematics and physics within the university and in other contexts and institutions. Recommendations for researchers Improving and extending the workshop to provide greater accessibility and autonomy is recommended. A longitudinal study to follow up the durability of the workshop is also proposed. Impact on society The impacts in the broader community include: higher academic success for students; improved mental health due to social networking and friendship groups and reduced anxiety and fear; reduced dropout rate in their first year; greater potential to complete educational degrees; reduced wastage in human and financial resources; and increased human capital. Future research Addressing the limitations of cost, time and travel involved, and following-up with the participants’ academic and workplace performance are future directions for research.

Aim/Purpose. The problem statement in the proposed study focuses on that, despite the growing recognition that teenagers need to undergo security awareness training, little is known about the impacts security training experts believe implementing a mandatory gamified security awareness training curriculum in public middle schools will have on the long-term security behavior of students in Texas. Background. This study was guided by the research question: What are the impacts security training experts believe implementing a mandatory gamified security aware-ness training curriculum in public middle schools will have on the long-term security behaviors of students in Texas? The study gathers opinions from experts on the impacts of security awareness training on students. Methodology. Our research used semi-structured interviews with twelve experts chosen through the use of purposive sampling. The population for the study consisted of experts in the fields of security awareness training for and teaching middle school-aged children. Candidates were recruited through the Cyber-Texas Foundation and snowball sampling techniques. Contribution. The research contributed to the body of knowledge by using interviews to explore the impacts of security awareness training on middle school students based on the opinions and views of the teachers and instructors who work with middle school students. Findings. The findings of this study demonstrate that middle school is an ideal time to provide cybersecurity training and will impact student behaviors by making them more conscious of cyber threats and preparing them to be more tech-savvy professionals. The research also showed that well-designed cybersecurity games with real-world application combined with traditional teaching techniques can help students develop positive habits. The research also suggests that teachers possess the skills to teach cybersecurity classes and the classes can be integrated into the current school day without the need for any significant changes to existing daily schedules. Recommendations for Practitioners. A well-design gamification-based curriculum implemented in Texas Middle Schools, combined with traditional teaching techniques and repeated over an extended time period, will impact students’ behaviors by making them more able to recognize and respond to cyber risks and will transform them into more secure and tech-savvy members of society. Recommendations for Researchers. The research shows middle school instructors and technology experts believe the implementation of a security awareness training program in middle schools is both possible and practical, while also beneficial to the students. The recommendation is to encourage researchers to explore ways to build curricula and games capable of appealing to students and implementing the instruction into school programs. Impact on Society. Demonstrating that training provided in middle school will make lasting impacts and improvements to student behaviors benefits children and their families in the short-term and workplaces in the long-term. The development of a more security-conscious workforce can reduce the significant number of data breaches and cyber attacks resulting from the poor security habits of companies’ users. Future Research. Future research that will add significant value to the body of knowledge includes testing the effectiveness of habit-shaping games to determine whether existing long-term games maintain student interest. Qualitative studies could interview parents of teenagers using habit-shaping games to determine the effectiveness of the applications. Another qualitative study could interview teachers to determine how teachers’ ages affect their comfort level teaching technology classes. Both studies could provide valuable insights into how to implement security awareness training in schools.

Collaboration technologies enable people to communicate and use information to make organizational decisions. The United States Navy refers to this concept as information dominance. Various collaboration technologies are used by the Navy to achieve this mission. This qualitative descriptive study objectively examined how a matrix oriented Navy activity perceived an implemented collaboration technology. These insights were used to determine whether a specific collaboration technology achieved a mission of information dominance. The study used six collaboration themes as a foundation to include: (a) Cultural intelligence, (b) Communication, (c) Capability, (d) Coordination, (e) Cooperation, and (f) Convergence. It was concluded that collaboration technology was mostly perceived well and helped to achieve some levels of information dominance. Collaboration technology improvement areas included bringing greater awareness to the collaboration technology, revamping the look and feel of the user interface, centrally paying for user and storage fees, incorporating more process management tools, strategically considering a Continuity of Operations, and incorporating additional industry best practices for data structures. Emerging themes of collaboration were collected to examine common patterns identified in the collected data. Emerging themes included acceptance, awareness, search, scope, content, value, tools, system performance, implementation, training, support, usage, structure, complexity, approach, governance/configuration management/policy, and resourcing.

Washington — A new video is aimed at helping organizations – particularly those in health care – understand the qualitative fit testing process.

Children's Geographies; 04/01/2023
(AN 163915536); ISSN: 14733285
Academic Search Premier

Children's Geographies; 08/01/2023
(AN 167303407); ISSN: 14733285
Academic Search Premier

Publication date: February 2025 Source: Evaluation and Program Planning, Volume 108 Author(s): Syka Iqbal, Macarena Chepo, Marc Hébert, Cecilia Vindrola-Padros Read the full article ›

The post To scope or not to scope? The benefits and challenges of integrating scoping studies in rapid qualitative research and evaluation was curated by information for practice.

Cancer affects not only the person with the disease but those around them. Being a family member is described as strenuous and, often, associated with stress, anxiety and feelings of loneliness. There is a hei… Read the full article ›

The post Together but still alone – A qualitative study exploring how family members of persons with incurable oesophageal or gastric cancer manage everyday life was curated by information for practice.

Nordic Studies on Alcohol and Drugs, Ahead of Print. Aim: The aim of this study was to identify and elucidate the differences between highly affiliated and low/non-affiliated participants in Alcoholics Anonymous (AA) meetings. Methods: A qualitative study of 24 participants was conducted in Romania between March and June 2021. Data were collected by means of […]

The post Affiliation to the Alcoholics Anonymous (AA) community: A qualitative study on differences between highly affiliated and low/non-affiliated individuals was curated by information for practice.

The post The role and value of counsellors in the treatment journeys of people with tuberculosis and their families: Qualitative insights from the South Fly District of Papua New Guinea was curated by information for practice.

The Dutch Euthanasia law permits euthanasia in patients with advanced dementia lacking decisional capacity based on advance euthanasia directives. Nevertheless, physicians encounter difficulties assessing the … Read the full article ›

The post A qualitative focus group study on legal experts’ views regarding euthanasia requests based on an advance euthanasia directive was curated by information for practice.

Effective medication management is crucial for ensuring timely pain and symptom control at the end of life. Dying in pain is a major concern for patients, yet some find less effective pain control at home. Fam… Read the full article ›

The post Family caregivers’ administration of medications at the end-of-life in China: a qualitative study was curated by information for practice.

The post Qualitative Study About Psychedelics Using in Psychiatric Disorders (PSYCHEQUALI) was curated by information for practice.

Abstract Objectives Higher education students experience elevated levels of suicidal ideation, but often face barriers in accessing support. The Mental Imagery for Suicidality in Students Trial (MISST; ISRCTN13621293; NCT05296538) tested the feasibility and acceptability of a six-session imagery-based approach called Broad-Minded Affective Coping (BMAC). This qualitative evaluation explored the experiences of MISST participants and staff. […]

The post A qualitative study exploring participants experiences of the Mental Imagery for Suicidality in Students Trial was curated by information for practice.

This workshop will introduce students to qualitative data analysis using MAXQDA software. Students will learn how to import and organize their text data; develop and implement thematic “codes” to classify text segments and discover emergent patterns; and build their empirical “story” by writing analytic memos and synthesizing codes. We will also explore several tools in MAXQDA that help researchers “see” and chart patterns in their data.

Background:

Certain health-related risk factors require legal interventions. Medical-legal partnerships (MLPs) are collaborations between clinics and lawyers that address these health-harming legal needs (HHLNs) and have been shown to improve health and reduce utilization.

ABSTRACTPolitics is one of the critical factors that influence health policy agendas. However, scholarly efforts, especially in low- and middle-income countries, rarely focus on how politics influence health policy agenda-setting. We conducted a qualitative document review to examine the factors that led to developing the free primary health care policy for maternal health in Papua New Guinea. We also discuss mechanisms through which national politics, as an overriding factor, influenced the development of the policy. The review draws on Kingdon’s multiple-stream model for agenda-setting and incorporates theoretical insights from Fox and Reich’s framework for analyzing the politics of health reform for universal health coverage in low- and middle-income countries.

BackgroundIncident benzodiazepine prescriptions in primary care for anxiety decreased between 2003 and 2018. However, from 2008, incident prescribing of benzodiazepines for anxiety increased among those aged 18–34 years. There are increasing concerns around prescribing of benzodiazepines. Further, although guidelines state benzodiazepines should only be prescribed short term, in 2017, 44% of incident prescriptions were prescribed for longer than the recommended duration of 2–4 weeks.AimTo understand when and why GPs prescribe benzodiazepines for anxiety in young adults.Design and settingA qualitative study was undertaken using in-depth interviews with 17 GPs from 10 general practices in South West England.MethodInterviews were conducted by telephone or videocall. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and data analysed using reflexive thematic analysis.ResultsGPs described caution in prescribing benzodiazepines for anxiety in young adults, but thought they had an important role in acute situations. GPs described caution in prescribing duration, but some thought longer-term prescriptions could be appropriate. In light of these views, some GPs questioned whether primary care needs to revisit how clinicians are using benzodiazepines. GPs perceived that some young adults requested benzodiazepines and suggested this might be because they wanted quick symptom relief. GPs noted that refusing to prescribe felt uncomfortable and that the number of young adults presenting to general practice, already dependent on benzodiazepines, had increased.ConclusionPatient-driven factors for prescribing benzodiazepines suggest there are current unmet treatment needs among young adults with anxiety. Given increases in prescribing in this age group, it may be timely to revisit the role of benzodiazepines in the management of people with anxiety in primary care.

BackgroundBetween 2003 and 2018, incident prescriptions of beta-blockers for anxiety increased substantially, particularly for young adults. National Institute for Health and Care Excellence guidance for anxiety does not recommend beta-blockers, probably due to a lack of evidence to support such use. Recent reports have highlighted the potential risks of beta-blockers.AimTo understand when and why GPs prescribe beta-blockers for people with anxiety.Design and settingIn-depth interviews with 17 GPs in Bristol and the surrounding areas.MethodInterviews were held by telephone or video call. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.ResultsMany GPs viewed beta-blockers as ‘low risk’, particularly for young adults. Some GPs viewed beta-blockers as an alternative to benzodiazepines, acting quickly and not leading to dependence. GPs reflected that some patients appeared to want an ‘immediate fix’ to their symptoms, which GPs thought beta-blockers could potentially offer. This is salient in light of substantial waiting lists for talking therapies and delays in antidepressants taking effect. GPs described how some patients seemed more willing to try beta-blockers than antidepressants, as patients did not perceive them as ‘mental health drugs’ and therefore viewed them as potentially more acceptable and less stigmatising. Further, GPs viewed beta-blockers as ‘patient-led’, with patients managing their own dose and frequency, without GP input.ConclusionMany GPs believe that beta-blockers have a role to play in the management of anxiety. Given recent increases in the prescribing of these drugs in primary care, there is a need to assess their safety and effectiveness as a treatment for people with anxiety disorders.

BackgroundThere has been significant investment in pharmacists working in UK general practice to improve the effective and safe use of medicines. However, evidence of how to optimise collaboration between GPs and pharmacists in the context of polypharmacy (multiple medication) is lacking.AimTo explore GP and pharmacist views and experiences of in-person, interprofessional collaborative discussions (IPCDs) as part of a complex intervention to optimise medication use for patients with polypharmacy in general practice.Design and settingA mixed-method process evaluation embedded within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) trial conducted in Bristol and the West Midlands, between February 2021 and September 2023.MethodAudio-recordings of IPCDs between GPs and pharmacists, along with individual semi-structured interviews to explore their reflections on these discussions, were used. All recordings were transcribed verbatim and analysed thematically.ResultsA total of 14 practices took part in the process evaluation from February 2022 to September 2023; 17 IPCD meetings were audio-recorded, discussing 30 patients (range 1–6 patients per meeting). In all, six GPs and 13 pharmacists were interviewed. The IPCD was highly valued by GPs and pharmacists who described benefits, including: strengthening their working relationship; gaining in confidence to manage more complex patients; and learning from each other. It was often challenging, however, to find time for the IPCDs.ConclusionThe model of IPCD used in this study provided protected time for GPs and pharmacists to work together to deliver whole-patient care, with both professions finding this beneficial. Protected time for interprofessional liaison and collaboration, and structured interventions may facilitate improved patient care.

BACKGROUND

For many patients with post–COVID-19 condition (long COVID), primary care is the first point of interaction with the health care system. In principle, primary care is well situated to manage long COVID. Beyond expressions of disempowerment, however, the patient’s perspective regarding the quality of long COVID care is lacking. Therefore, this study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long COVID.

Stanford, California : Stanford University Press, 2008.

Berlin ; Boston : De Gruyter, [2023]

Abingdon, Oxon ; New York, NY : Routledge, 2022.

Los Angeles : SAGE, [2020]

Harlow, England : Pearson, [2021] 2021

We present a sound and complete method for the verification of qualitative liveness properties of replicated systems under stochastic scheduling. These are systems consisting of a finite-state program, executed by an unknown number of indistinguishable agents, where the next agent to make a move is determined by the result of a random experiment. We show that if a property of such a system holds, then there is always a witness in the shape of a Presburger stage graph: a finite graph whose nodes are Presburger-definable sets of configurations. Due to the high complexity of the verification problem (non-elementary), we introduce an incomplete procedure for the construction of Presburger stage graphs, and implement it on top of an SMT solver. The procedure makes extensive use of the theory of well-quasi-orders, and of the structural theory of Petri nets and vector addition systems. We apply our results to a set of benchmarks, in particular to a large collection of population protocols, a model of distributed computation extensively studied by the distributed computing community.

Chengchun Shi, Rui Song, Wenbin Lu.

Source: The Annals of Statistics, Volume 47, Number 4, 2348--2377.

Abstract:
Precision medicine is an emerging medical paradigm that focuses on finding the most effective treatment strategy tailored for individual patients. In the literature, most of the existing works focused on estimating the optimal treatment regime. However, there has been less attention devoted to hypothesis testing regarding the optimal treatment regime. In this paper, we first introduce the notion of conditional qualitative treatment effects (CQTE) of a set of variables given another set of variables and provide a class of equivalent representations for the null hypothesis of no CQTE. The proposed definition of CQTE does not assume any parametric form for the optimal treatment rule and plays an important role for assessing the incremental value of a set of new variables in optimal treatment decision making conditional on an existing set of prescriptive variables. We then propose novel testing procedures for no CQTE based on kernel estimation of the conditional contrast functions. We show that our test statistics have asymptotically correct size and nonnegligible power against some nonstandard local alternatives. The empirical performance of the proposed tests are evaluated by simulations and an application to an AIDS data set.

Cross-sectional studies have demonstrated associations between the white matter injury and cognitive impairment in very preterm born children. Longitudinal studies confirmed the relationships between cerebral MRI at term and neurodevelopmental outcomes at up to 2 years old.

White matter injury (but not gray matter injury) on term MRI predicted cognitive impairments of very preterm born infants at 9 years old. Qualitative assessment of white matter signal intensities showed limited predictive values of cognitive impairments. (Read the full article)

Obesity is a growing concern for Mexican-American adolescents, with both behavioral and cultural variables that are related to the increasing trend.

These results highlight a patient-centered view of the emotional and physical burden of obesity in female Mexican-American adolescents, the families’ personal struggles with weight-related conditions, and the challenge of balancing family needs with those specific to the adolescent. (Read the full article)

Rates of human papillomavirus (HPV) vaccination lag behind other adolescent vaccines. Research indicates that provider recommendation is the key to improving HPV vaccination rates and that most adolescents who are unvaccinated received other vaccines, indicating missed opportunities for HPV vaccination.

This study explores in-depth the content of provider–patient conversations that either create or prevent opportunities for HPV vaccination. Effective and ineffective conversations are presented with the goal of providing practical tools to improve communication regarding HPV vaccines. (Read the full article)

BACKGROUND Trauma—emotional, physical, and psychological—is common and associated with increased risk behaviors, low rates of care engagement and viral suppression, and overall poor health outcomes for people living with HIV (PLWH). This article presents the results of 15 in-depth, semi-structured interviews with PLWH in the Southeastern United States in which participants identified a trauma and described its long-lasting impact on their lives. Participants' trauma narratives described a wide range of traumas, including childhood sexual abuse, the loss of a loved one, and their HIV diagnosis.

METHODS Systematic qualitative analysis was used to delineate beliefs about causes, symptoms, treatments, quality of life, and health implications of trauma.

RESULTS: Fifteen participants completed semi-structured interviews that lasted on average 32 minutes. Participants described a wide spectrum of personal trauma that occurred both prior and subsequent to their HIV diagnosis. The types of trauma identified included physical, sexual, and psychological abuse inflicted by intimate partners, family members, and/or strangers.

LIMITATIONS A chief limitation of this study is selection bias. Additionally, the participant selection and content of the trauma narratives might have been affected by the surrounding context of the parent study centered on HIV, aging, and psychosocial stress. It is also difficult to interpret the distinction between discrete trauma experiences and the diagnosis of HIV, leading to potential information bias.

CONCLUSION This study highlights the importance of social support in coping with trauma and the effect of trauma on health-related behaviors. It also illustrates the need for additional research on the topic of trauma and trauma-informed care for PLWH. Understanding how different types of trauma affect individuals' lives is necessary to inform recommendations to provide better care for PLWH.

Radiohybrid PSMA (rhPSMA) ligands, a new class of theranostic prostate-specific membrane antigen (PSMA)–targeting agents, feature fast ¹⁸F synthesis and utility for labeling with radiometals. Here, we assessed the biodistribution and image quality of ¹⁸F-rhPSMA-7 to determine the best imaging time point for patients with prostate cancer. Methods: In total, 202 prostate cancer patients who underwent a clinically indicated ¹⁸F-rhPSMA-7 PET/CT were retrospectively analyzed, and 12 groups based on the administered activity and uptake time of PET scanning were created: 3 administered activities (low, 222–296 MBq; moderate, 297–370 MBq; and high, 371–444 MBq) and 4 uptake time points (short, 50–70 min; intermediate, 71–90 min; long, 91–110 min; and extra long, ≥111 min). For quantitative analyses, SUV_mean and organ- or tumor-to-background ratio were determined for background, healthy organs, and 3 representative tumor lesions. Qualitative analyses assessed overall image quality, nonspecific blood-pool activity, and background uptake in bone or marrow using 3- or 4-point scales. Results: In quantitative analyses, SUV_mean showed a significant decrease in the blood pool and lungs and an increase in the kidneys, bladder, and bones as the uptake time increased. SUV_mean showed a trend to increase in the blood pool and bones as the administered activity increased. However, no significant differences were found in 377 tumor lesions with respect to the administered activity or uptake time. In qualitative analyses, the overall image quality was stable along with the uptake time, but the proportion rated to have good image quality decreased as the administered activity increased. All other qualitative image parameters showed no significant differences for the administered activities, but they showed significant trends with increasing uptake time: less nonspecific blood activity, more frequent background uptake in the bone marrow, and increased negative impact on clinical decision making. Conclusion: The biodistribution of ¹⁸F-rhPSMA-7 was similar to that of established PSMA ligands, and tumor uptake of ¹⁸F-rhPSMA-7 was stable across the administered activities and uptake times. An early imaging time point (50–70 min) is recommended for ¹⁸F-rhPSMA-7 PET/CT to achieve the highest overall image quality.

ABSTRACTIntroduction:Multimonth dispensing (MMD) of antiretroviral therapy (ART) is a differentiated model of care that can help overcome health system challenges and reduce the burden of HIV care on clients. Although 3-month dispensing has been the standard of care, interest has increased in extending refill intervals to 6 months. We explored client and provider experiences with MMD in Malawi as part of a cluster randomized trial evaluating 3- versus 6-month ART dispensing.Methods:Semi-structured in-depth interviews were conducted with 17 ART providers and 62 stable, adult clients with HIV on ART. Clients and providers were evenly divided by arm and were eligible for an interview if they had been participating in the study for 1 year (clients) or 6 months (providers). Questions focused on perceived challenges and benefits of the 3- or 6-month amount of ART dispensing. Interviews were transcribed, and data were coded and analyzed using constant comparison.Results:Both clients and providers reported that the larger medication supply had benefits. Clients reported decreased costs due to less frequent travel to the clinic and increased time for income-generating activities. Clients in the 6-month dispensing arm reported a greater sense of personal freedom and normalcy. Providers felt that the 6-month dispensing interval reduced their workload. They also expressed concerned about clients' challenges with ART storage at home, but clients reported no storage problems. Although providers mentioned the potential risk of clients sharing the larger medication supply with family or friends, clients emphasized the value of ART and reported only rare, short-term sharing, mostly with their spouses. Providers mentioned clients' lack of motivation to seek care for illnesses that might occur between refill appointments.Conclusions:The 6-month ART dispensing arm was particularly beneficial to clients for decreased costs, increased time for income generation, and a greater sense of normalcy. Providers' concerns about storage, sharing, and return visits to the facility did not emerge in client interviews. Further data are needed on the feasibility of implementing a large-scale program with 6-month dispensing.

BackgroundAutistic people are at increased risk of developing mental health problems. To reduce the negative impact of living with autism in a non-autistic world, efforts to improve take-up and access to care, and support in early years, which will typically start with a GP appointment, must be grounded in the accounts of autistic young adults.AimTo explore how autistic young adults understand and manage mental health problems; and to consider help seeking as a focus.Design and settingA cross-sectional, qualitative study. Autistic participants were purposively selected to represent a range of mental health conditions including anxiety and depression. A subsample were recruited from a population cohort screened for autism in childhood. The study concerns access to primary care.MethodNineteen autistic young adults without learning disabilities, aged 23 or 24 years, were recruited. In-depth, semi-structured interviews explored how they understood and managed mental health problems. Data were analysed thematically.ResultsYoung adults preferred self-management strategies. Multiple factors contributed to a focus on self-management, including: beliefs about the aetiology of mental health difficulties and increased vulnerability with the context of a diagnosis of autism, knowledge of self-management, and a view that formal support was unavailable or inadequate. Families had limited awareness of professional support.ConclusionYoung autistic adults without learning disabilities, and their families, may hold erroneous beliefs about autism and mental health. This may affect help seeking and contribute to an exacerbation of symptoms. GPs need to be alert to the fact that autistic young adults in their care may be experiencing mental health difficulties but may not recognise them as such.

BackgroundUrinary tract infections (UTIs) are one of the most common bacterial infections managed in general practice. Many women with symptoms of uncomplicated UTI may not benefit meaningfully from antibiotic treatment, but the evidence base is complex and there is no suitable shared decision-making resource to guide antibiotic treatment and symptomatic care for use in general practice consultations.AimTo develop an evidence-based, shared decision-making intervention leaflet to optimise management of uncomplicated UTI for women aged <65 years in the primary care setting.Design and settingQualitative telephone interviews with GPs and patient focus group interviews.MethodIn-depth interviews were conducted to explore how consultation discussions around diagnosis, antibiotic use, self-care, safety netting, and prevention of UTI could be improved. Interview schedules were based on the Theoretical Domains Framework.ResultsBarriers to an effective joint consultation and appropriate prescribing included: lack of GP time, misunderstanding of depth of knowledge and miscommunication between the patient and the GP, nature of the consults (such as telephone consultations), and a history of previous antibiotic therapy.ConclusionConsultation time pressures combined with late symptom presentation are a challenge for even the most experienced of GPs: however, it is clear that enhanced patient–clinician shared decision making is urgently required when it comes to UTIs. This communication should incorporate the provision of self-care, safety netting, and preventive advice to help guide patients when to consult. A shared decision-making information leaflet was iteratively co-produced with patients, clinicians, and researchers at Public Health England using study data.

BackgroundInfection is common in older adults. Serious infection has a high mortality rate and is associated with unplanned hospital admissions. Little is known about the factors that prompt older patients to seek medical advice when they may have an infection.AimTo explore the symptoms of infection from the perspective of older adults, and when and why older patients seek healthcare advice for a possible infection.Design and settingA qualitative interview study among adults aged ≥70 years with a clinical diagnosis of infection recruited from ambulatory care units in Oxford, UK.MethodInterviews were semi-structured and based on a flexible topic guide. Participants were given the option to be interviewed with their carer. Thematic analysis was facilitated using NVivo (version 11).ResultsA total of 28 participants (22 patients and six carers) took part. Patients (aged 70–92 years) had experienced a range of different infections. Several early non-specific symptoms were described (fever, feeling unwell, lethargy, vomiting, pain, and confusion/delirium). Internally minimising symptoms was common and participants with historical experience of infection tended to be better able to interpret their symptoms. Factors influencing seeking healthcare advice included prompts from family, specific or intolerable symptoms, symptom duration, and being unable to manage with self-care. For some, not wanting to be a burden affected their desire to seek help.ConclusionTailored advice to older adults highlighting early symptoms of infection may be beneficial. Knowing whether patients have had previous experience of infection may help healthcare professionals in assessing older patients with possible infection.

BackgroundIn the context of a variable condition such as asthma, patient recognition of deteriorating control and knowing what prompt action to take is crucial. Yet, implementation of recommended self-management strategies remains poor.AimTo explore how patients with asthma and parents/carers of children with asthma develop and establish recommended self-management strategies for living with asthma, and how clinicians can best support the process.Design and settingA qualitative study in UK primary care.MethodPatients with asthma and parents/carers of children with asthma from 10 general practices were purposively sampled (using age, sex, and duration of asthma) to participate in focus groups or interviews between May 2016 and August 2016. Participants’ experiences of health care, management of asthma, and views on supported self-management were explored. Interviews and focus group sessions were audio-recorded and transcribed verbatim. Iterative thematic analysis was conducted, guided by the research questions and drawing on habit theory in discussion with a multidisciplinary research team.ResultsA total of 49 participants (45 patients; 4 parents/carers) took part in 32 interviews and five focus groups. Of these, 11 reported using an action plan. Patients learnt how to self-manage over time, building knowledge from personal experience and other sources, such as the internet. Some regular actions, for example, taking medication, became habitual. Dealing with new or unexpected scenarios required reflective abilities, which may be supported by a tailored action plan.ConclusionPatients reported learning intuitively how to self-manage. Some regular actions became habitual; dealing with the unexpected required more reflective cognitive skills. In order to support implementation of optimal asthma self- management, clinicians should consider both these aspects of self-management and support, and educate patients proactively.

Background:

Patients with multimorbidity often require services across different health care settings, yet team processes among settings are rarely implemented. We explored perceptions of specialists and family physicians collaborating in a telemedicine interprofessional consultation for patients with multimorbidity to better understand the value of bringing physicians together across the boundaries of health care settings.

Mitchell, Marilyn L

Belk, Russell W