Team-based rehabilitation after traumatic brain injury: a qualitative synthesis of evidence of experiences of the rehabilitation process

Objective: To synthesize and explore experiences of the rehabilitation process for adults with traumatic brain injury receiving team-based rehabilitation. Data sources: A qualitative evidence synthesis was conducted according to the "Enhancing transparency in reporting the synthesis of qualitative research" (ENTREQ) Guidelines, of qualitative studies published in 5 databases in 2000–21. Study selection and data extraction: Screening, selection of relevant studies, assessment of methodological limitations, systematic qualitative content analysis and assessment of confidence with GRADE-CERQual [AQ5] were carried out by independent researchers. Data synthesis: The 10 included studies revealed how people with traumatic brain injury perceived that they struggled on their own for a long time to adapt their daily life. They experienced that access to team-based rehabilitation was scarce and that the interventions offered were neither individually tailored nor coordinated. A respectful attitude from professionals and individually adapted information facilitated their rehabilitation process. Conclusion: This qualitative evidence synthesis indicates areas for improvement and a need to develop person-centred team-based rehabilitation for adults with traumatic brain injury, in terms of accessibility, coordination, continuity, content and participation. Given the limited opportunities for team-based rehabilitation after hospital discharge, further research is needed to understand how rehabilitation can support the adaptation of daily activities.

Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence

Background The food environment within and surrounding homes influences family dietary habits with socio-economic areas at a nutritional disadvantage. Families’ perception of the food environment and how it influences their food decisions is less clear. This rapid review aimed to synthesise qualitative evidence of parental perspectives of the food environment and their influence on food decisions among disadvantaged families. Method Qualitative and mixed-methods peer-reviewed journal articles published after 2000, that explored the perspectives of low-income parents in relation to their food environment and how this impacted food decisions for families with children aged 2-17 years, were included in this review. Embase, Scopus and PsycINFO were the databases chosen for this review. Search strategies included seven concepts related to family, food, perceptions, influences, environment, socio-economic status and study type. Two independent reviewers screened sixty-four studies. Thematic synthesis was employed. Results Two thousand one hundred and forty five results were identified through database searching and 1,650 were screened. Fourteen articles that originated from the US, Australia and the UK were included in this review. No articles were excluded following quality appraisal. Child preferences, financial and time constraints, and location and access to food outlets were barriers to accessing healthy food. Parental nutrition education and feeding approaches varied but positive outcomes from interventions to address these behaviours will be short-lived if inequities in health caused by poverty and access to affordable and healthy food are not addressed. The reliance on social support from families or government sources played an important role for families but are likely to be short-term solutions to health and nutritional inequities. Conclusions This qualitative evidence synthesis provides an insight into the perceptions of low-income parents on the factors influencing food decisions. Findings have implications for public health and the development of effective strategies to improve the dietary habits of children of disadvantaged families. Sustainable changes to dietary habits for families on low-income requires policy responses to low income, food access and to the high cost of healthy foods.

Making Space for Qualitative Evidence in Global Maternal and Child Health Policymaking

The success of health interventions often hinges on complex processes of implementation, the impact of sociopolitical and cultural contexts, resource constraints and opportunity costs, and issues of equity and accountability. Qualitative research offers critical insights for understanding these issues. “Qualitative evidence syntheses” (or QES)—modeled on quantitative systematic reviews—have recently emerged as an important vehicle for integrating insights from qualitative evidence into global health policy. However, it is challenging to integrate QES into policymaking in ways that are both acceptable to the often-conservative health policy world and consonant with social science’s distinctive methodologies and paradigms. Based on my experiences participating in and observing numerous guideline working group meetings and interviews with key informants, this chapter offers an auto-ethnographic account of an effort to integrate QES into the World Health Organization’s global OptimizeMNH guidelines for task shifting in maternal and newborn health (MNH). It is based on my experiences participating in and observing numerous guideline working group meetings as well as interviews with several key informants. Advocates of QES were successful in helping to make a place for qualitative evidence in this global guideline. Their work, however, required a delicate balance between adopting quantitatively inspired methods for evidence synthesis and innovating new methods that would both suit the project needs and be seen as legitimate by qualitative researchers. This case study of the development of one WHO guideline does not signal a revolution in knowledge production, but it does show there remains room—perhaps growing room—for a more expansive vision of what forms of knowledge need to be on the table when developing global health policy.

Understanding Political Consumerism, Political Participation, and Their Antecedents

Political consumerism is a form of self-expression where consumers boycott or buycott a brand, company, or a product. The increase in the amount of these actions in recent years has led scholars and marketers improve their understanding of how and why consumers engage in political consumerism and what its predecessors are. By employing a wide scale survey among 360 participants in Turkey, this study presents empirical and qualitative evidence for boycott behavior and investigates how other forms of political participation and individual level characteristics have an effect on political consumerism. Results suggest main reason for boycott behavior in Turkey is due to political reasons and conservatism as an individual level value orientation has a negative effect on boycott behavior. In addition, online activism and voting participation behaviors have positive effects on political consumerism.