COVID-19 Pandemic Adversely Affects the Provision of Desired Newborn Circumcision: Perinatal Physician Perspectives

Over half of boys in the United States undergo circumcision, which has its greatest health benefits and lowest risks when performed during the newborn period under local anesthesia. The COVID-19 pandemic has affected delivery of patient care in many ways and likely also influenced the provision of newborn circumcisions. Prior to the pandemic, we planned to conduct a qualitative study to ascertain physician perspectives on providing newborn circumcision care. The interviews incidentally coincided with the onset of the pandemic and thus, pandemic-related changes emerged as a theme. We elected to analyze this theme in greater detail. Semi-structured interviews were conducted with perinatal physicians in a large urban city from 4/2020 to 7/2020. Physicians that perform or counsel regarding newborn circumcision and physicians with knowledge of or responsibility for hospital policies were eligible. Interviews were transcribed verbatim and qualitative coding was performed. Twenty-three physicians from 11 local hospitals participated. Despite no specific COVID-19 related questions in the interview guide, nearly half of physicians identified that the pandemic affected delivery of newborn circumcision care with 8 pandemic-related sub-themes. The commonest sub-themes included COVID-19 related changes in: (1) workflow processes, (2) staffing and availability of circumcision proceduralists, and (3) procedural settings. In summary, this qualitative study revealed unanticipated COVID-19 pandemic-related changes with primarily adverse effects on the provision of desired newborn circumcisions. Some of these changes may become permanent resulting in broad implications for policy makers that will likely need to adapt and redesign the processes and systems for the delivery of newborn circumcision care.

Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis

Background Disease-modifying anti-rheumatic drugs (DMARDs) are the cornerstone of rheumatoid arthritis (RA) treatment. However, the full benefits of DMARDs are often not realized because many patients are sub-optimally adherent to their medication. In order to optimize adherence, it is essential that healthcare professionals (HCPs) understand patients’ barriers and facilitators for medication use. Insight in these barriers and facilitators may foster the dialogue about adequate medication use between HCPs and patients. What HCPs perceive as barriers and facilitators has, so far, scarcely been investigated. This study aimed to identify the perceptions of HCPs on patients’ barriers and facilitators that might influence their adherence. Methods This qualitative study was performed using semi structured in-depth interviews with HCPs. An interview guide was used, based on an adjusted version of the Theoretical Domains Framework (TDF). Thematic analysis was conducted to identify factors that influence barriers and facilitators to DMARD use according to HCPs. Results Fifteen HCPs (5 rheumatologists, 5 nurses and 5 pharmacists) were interviewed. They mentioned a variety of factors that, according to their perceptions, influence DMARD adherence in patients with RA. Besides therapy-related factors, such as (onset of) medication effectiveness and side-effects, most variation was found within patient-related factors and reflected patients’ beliefs, ways of coping, and (self-management) skills toward medication and their condition. In addition, factors related to the condition (e.g., level of disease activity), healthcare team and system (e.g., trust in HCP), and social and economic context (e.g. support, work shifts) were reported. Conclusions This study provided insights in HCPs’ perceptions of the barriers and facilitators to DMARD use patients with RA. Most factors that were mentioned were patient-related and potentially modifiable. When physicians understand patients’ perceptions on medication use, adherence to DMARDs can probably be optimized in patients with RA leading to more effectiveness of treatment outcomes.

Psychospiritual impact of COVID-19: Africentric Perspectives

This study sought to find out the psychospiritual impact of COVID-D as a result of the imposition of preventive measures. The study was carried out in the Mezam Division of the North West Region of Cameroon. A mixed research approach was used for the study with the aid of a questionnaire and an interview guide. A convenient sampling technique was chosen for the study based on the availability of the 50 respondents chosen for the study, using the snowball technique. The results of the study reveal that the most acceptable preventive measures that people complied to were personal hygiene (100%), taking of African traditional concoction treatments (100%) and prayers to God (100%). Psychologically, 60% of the respondents expressed symptoms of anxiety, while 30% expressed symptoms for stress and 20% expressed symptoms of depression. Spiritually, all 50 respondents (100%) indicated that their spiritual activities have been disrupted by the pandemic, which poses a real problem for an African oriented society where religion and spiritual activities are common. In conclusions, it was evident that psychospiritual dissonance including mixed and faulty beliefs on those claiming to provide solutions complicated peoples’ understanding of the realities of the situations.

Pengalaman Ibu Hamil Di Wilayah Kerja Puskesmas Wangi-Wangi Selatan Kabupaten Wakatobi (Studi Pada Ibu Yang Tidak Emesis Gravidarum)

Kehamilan merupakan suatu peristiwa transisi sosial dan psikologis yang amat kritis. Berdasarkan tinjauan keilmuan, kehamilan merupakan proses fisiologis dan normal, yang tidak hanya berhubungan dengan aspek biologis saja, namun berhubungan dengan aspek sosial, budaya, psikologikal, emosional dan spiritual seorang perempuan dalam kehidupan. Penelitian ini bertujuan untuk mengetahui pengalaman berupa, stres, emosi, kecemasan, dan depresi pada ibu yang tidak emesis gravidarum di wilayah kerja puskesmas wangi-wangi selatan kabupaten Wakatobi. Metode penelitian kualitatif. Data berupa wawancara mendalam (Indepth-Interview) dan observasi dengan menggunakan pedoman wawancara (interview-guide). Pengambilan sampel menggunakan teknik purposive sampling dan diperoleh sampel sebanyak 10 informan ibu hamil tidak emesis gravidarum. Metode analisis data dalam penelitian ini menggunakan analisis taksonomi (taxonomi analysis). Hasil penelitian pengalaman ibu hamil didapatkan stres berdasarkan usia ibu dengan usia diatas 20 tahun mudah stres dibanding dibawah 20 tahun disebabkan status ekonomi dan pekerjaan sehingga menyebabkan ibu sering melamun dan menyendiri. Emosi berdasarkan paritas multigravida lebih sensitif dibanding primigravida disebabkan jumlah anak dan permasalahan rumah tangga yang terjadi antara suami dan istri, membuat ibu marah atau menangis. Terdapat dua kecemasan mengenai keadaan janin dan persalinan berupa rasa takut dengan umur kehamilan 12-24 minggu dan 34-36 minggu. Depresi yang menunjukkan bahwa ibu yang tidak emesis gravidarum terbebas dari depresi. Diharapkan peneliti selanjutnya meneliti pengalaman ibu hamil yang tidak emesis gravidarum.

The Influence of Terrorism Activities on Muslim-Christian Relations in Garissa County, Kenya

Terrorism is no doubt a global problem of the 21st century and as evidenced by the continued terror attacks, the menace is causing major global security distress. In Kenya terrorism has among other things considerably affected the Muslim-Christian relations in the country. Despite vast literature on terrorism and interreligious relations, there are limited research on the influence of terrorism on Muslim-Christian relations in Garissa County, Kenya hence this study. The general objective of this study was to examine the influence of terrorism on Muslim-Christian relations in Garissa County, Kenya. The study employed both descriptive and explanatory design. The target population of the study was 199,469 from Garissa County from which a sample of 384 respondents were obtained through purposive sampling. Data was collected from primary sources using; questionnaires, interview guide and focus group discussions as well as secondary sources, through literature review. The findings revealed that, terrorist selective attacks of Christians and the use Islamic concept of jihad during attacks have created suspicion and mistrust among the Muslims and Christians in the area. The study concludes that unless the misunderstanding of the concept of Jihad is demystified, the Muslims-Christians relations will significantly be affected as the terrorist will continue propagating their attacks as an Islamic concept of jihad. The study recommends that Muslim leaders needs to demystify the concept of Jihad in order to restore Muslim-Christian relations. Also, the Government security agencies and civil society, Muslim leaders, and Christians should continually organize awareness campaigns in the region to create alertness about the terrorist’s schemes.

Bereavement among Adolescents with Intellectual Disability: A Qualitative Study

The current study was conducted to explore the bereavement (experienced loss of a loved one through death within time frame of 0–3 years span). Seven adolescents (10–19 years old) with intellectual disability were included in the study. Semi-structured interviews were conducted through interview guide which was prepared with the help of Piaget’s theory of cognitive development concept related to death. Data was analyzed with content analysis and six major themes were derived, that is, meaning of death, death rituals, religious concepts related to death, reasons of death, grieving perception, and coping with grief. Mostly, concepts were explained under the light of religious preaching and their introjection in the lives of adolescents with intellectual disability. Current study helped in exploration of experiential phenomenon of loss in adolescents with intellectual disability.

“Intertwined Lives”

Sibling relationships are complex and unique, often spanning a range of deep emotions. The experiences of children with disabilities and their siblings are arguably seldom documented, particularly in the Global South. The aim of this chapter was to uncover the narratives of young children with disabilities and their siblings in Sri Lanka. Ten dyads of children with disabilities and their siblings and one quartet of siblings were included in this study. Opportunities were offered to the participants to engage in conversation aided by kinetic family drawings. An interview guide was used to support this process. The participant data were analyzed through the lens of the “lived experience” of family dynamics in the tradition of interpretative phenomenological analysis. This chapter will discuss the two complex broad themes of a surrogate parenting role and normative sibling relationships, which at times converge and at times diverge.

Critical Ethnography in a Language Classroom

The chapter discusses a critical mini classroom ethnography as a pedagogical tool for educators working with multilingual learners in K-12 or adult settings. Critical classroom ethnography and culturally responsive instruction in language teaching are discussed. For practicing language educators, a questionnaire, an interview guide, and a reflection template are offered. For pre-service teachers, a structured observation template is included. The suggested tools are discussed in relation to equitable and inclusive educational practices to help develop critical ethnographic skills as they pertain to critically reflective observation which can be utilized by all teachers. The chapter concludes with a discussion of how the mini classroom ethnography's use by a candidate in a language teacher preparation program in the US led to the process of critical and linguistic self-reflection and transformation towards becoming a more culturally responsive and inclusive practitioner.

FAKTOR PENYEBAB KESALAHAN SISWA SMK DALAM MENYELESAIKAN SOAL CERITA PADA MATERI PELUANG

It is not easy for students to understand the questions in the form of stories so that errors often occur in the process of solving problems. This study aims to describe the factors that cause vocational students' errors in solving story problems based on Anne Newman. This research is a qualitative research. The instrument used in this research is a test which consists of 3 questions and an interview guide. The subjects in this study were students of class XII TKJ SMK Patria Gadingrejo. Analysis of the data using the analysis of the location of student errors based on Anne Newman's procedure, namely a) reading the problem, understanding the problem, b) transforming the problem, c) process skills, and d) writing the final answer. The factors that cause student errors at each stage are: 1) misunderstood the problem, the cause of which is the lack of understanding and thoroughness of students; 2) problem transformation errors, the reason is that students do not master the concept and do not have mastery of the material; 3) process skill errors, the cause of which students are wrong in doing the initial steps of work; 4) errors in writing the final answer, the reason is that students are not accustomed to writing conclusions.

Persistent Barriers to Colorectal Cancer Screening Completion Amid Centralized Outreach: A Mixed Methods Study

Purpose To understand patient experiences and persistent barriers to colorectal cancer (CRC) screening amid centralized outreach at urban family medicine practices. Approach Following a pragmatic trial assessing mailed fecal immunochemical test (FIT) outreach, we invited a subset of participants to complete a semi-structured qualitative interview and structured questionnaire. Setting Single urban academic healthcare system. Participants Sixty patients who were eligible and overdue for CRC screening at the time of trial enrollment. Method Using Andersen’s Behavioral Model, we developed an interview guide to systematically assess factors shaping screening decisions and FIT uptake. Close-ended responses were analyzed using descriptive statistics. Qualitative data were analyzed using the constant comparative method. Results Most participants (82%) self-reported that they had ever completed any modality of CRC screening, and nearly half (43%) completed the mailed FIT during the trial. Most patients (60%) preferred FIT to colonoscopy due to its private, convenient, and non-invasive nature; however, persistent barriers related to screening beliefs including fear of test results and cancer treatment still prevented some patients from completing any form of CRC screening. Conclusions Mailed FIT can overcome many structural barriers to CRC screening, yet clear communication and follow-up amid centralized outreach are essential. For some patients, tailored outreach or navigation to address screening-related fears or other screening beliefs may be needed to ensure timely completion of CRC screening.