A guide to understanding social science research for natural scientists

Benefits, challenges, and strategies related to using presumptive recommendations for HPV vaccination: A qualitative study with rural and non-rural-serving primary care professionals

HPV vaccination coverage remains far below the national target of 80% among US adolescents, particularly in rural areas, which have vaccine uptake rates that are 10% points lower than non-rural areas on average. Primary care professionals (PCPs) can increase coverage by using presumptive recommendations to introduce HPV vaccination in a way that assumes parents want to vaccinate. Through semi-structured interviews, we explored PCPs' experiences and perceptions of using presumptive recommendations in rural- and non-rural-serving primary care clinics in North Carolina. Thematic analysis revealed that most PCPs in rural and non-rural contexts used presumptive recommendations and felt the strategy was an effective and concise way to introduce the topic of HPV vaccination to parents. At the same time, some PCPs raised concerns about presumptive recommendations potentially straining relationships with certain parents, including those who had previously declined HPV vaccine or who distrust medical authority due to their past experiences with the healthcare system. PCPs dealt with these challenges by using a more open-ended approach when introducing HPV vaccination to parents. In conclusion, our findings suggest that PCPs in both rural and non-rural settings see value in using presumptive recommendations to introduce HPV vaccination, but to adequately address concerns and ensure increased HPV vaccine uptake, PCPs can use simple and culturally sensitive language to ensure fully informed consent and to maintain parental trust. And to further strengthen HPV vaccine discussions, PCPs can utilize other effective HPV communication techniques, like the Announcement Approach, in discussing HPV vaccinations with hesitant parents.

Sexual Health Education Experiences and Recommendations from the Perspective of LGBTQ+ Youth

Despite the well-known benefits of comprehensive sexual health education, the majority of school sexual health education curricula in the United States (U.S.) is non-comprehensive and excludes LGBTQ+ students. This exclusion may contribute to poor health outcomes in LGBTQ+ youth, with some research beginning to document these experiences and provide recommendations for curricula changes. Using a sample of LGBTQ+ youth across the U.S. (ages 13-17; N = 809), this study characterizes youths' sexual health education experiences and provides curricula recommendations using a mixed methods approach. Quantitative analyses revealed that LGBTQ+ content is often excluded from sexual health education, particularly topics surrounding sexual orientation and gender identity, which youth wanted to learn more about. Furthermore, participants identified several extracurricular sources of sexual health education, including online spaces, friends, and personal experiences, which were often preferred. Qualitative analyses suggested that LGBTQ+ youth described their sexual health education as exclusive of LGBTQ+ content, often being based in abstinence, religious principles, or described as oppressive (e.g. hearing LGBTQ+ negative remarks) or suppressive (e.g. skipping required LGBTQ+ content). LGBTQ+ youth also provided recommendations for future curricula. Findings can inform curricula development and implementation, as well as policy change, to ascertain that all youth have access to inclusive and comprehensive sexual health education.

Phenomenography: A useful methodology for midwifery research

AIMS

To outline the theoretical, philosophical, and major assumptions associated with phenomenography and then address the application of a phenomenographical approach within the context of midwifery research.

BACKGROUND

Phenemonography is a little-known qualitative research approach amongst the main design traditions of phenomenology, grounded theory, case study, and ethnography more typically used within midwifery research. Phenomenography aims to describe the qualitatively different ways that people perceive, conceptualize, or experience a phenomenon. Phenemonography has a distinctly different approach from other qualitative methods as it places emphasis on the 'collective' meaning over individual experience.

METHODOLOGY

Phenomenography, as an approach, rests within the interpretivist paradigm recognizing that there are multiple interpretations of reality. Phenomenography emphasizes the various ways that people experience the same phenomenon, including both the similarities and differences. The second-order perspective embraced by phenomenography suggests that the researcher directs themselves towards people's understanding of the world; essentially the world is described as it is understood rather than as it is. It is the reporting about how these different realities appear at a collective level that is the output of phenomenographic research.

FINDINGS

A framework for conducting phenomenographic research is illustrated by outlining the steps within the methodological approach required to undertake a research study using phenemonography.

CONCLUSION

Phenomenography is a qualitative research approach that can usefully be applied in many midwifery contexts where a collective understanding of a phenomena is required. Using a phenomenographic approach can provide the midwifery profession with knowledge about variations in how women and midwives think, and how aspects of different phenomena are experienced in within a midwifery setting.

"It's my calling", Canadian dog rescuers' motives and experiences for engaging in international dog rescue efforts

The importation of rescue dogs has become an increasingly common occurrence in recent years, often involving industrialized countries as the ultimate destination. However, international dog rescue activities have attracted considerable criticism from the veterinary community and the public due to the associated zoonotic disease and public health risks, as well as the potential poor behaviour of international rescue dogs. The Government of Canada has also recently placed a temporary suspension on all commercial dog imports from non-rabies free countries due to the growing concerns of the zoonotic disease risks. To understand the perspectives and experiences of stakeholders involved in dog import activities in Canada, we interviewed nine members in leadership positions of Canadian-based international dog rescue organizations. Thematic analysis of interview dialogue yielded three themes: 1) Motive, which described the reason behind participants' involvement in international dog rescue; 2) Challenge, which described the major difficulties faced in participants' dog rescue work; 3) Duty, which described participants' beliefs on responsible dog rescue practices. Members of international dog rescue organizations described being driven by strong desires to provide animal and humanitarian aid. However, local dog rescue efforts were constrained by logistical and societal barriers unique to the Canadian context. Additionally, the current study revealed both similarities and differences in occupational experiences between international dog rescue organizations and other animal care professions. Specifically, difficulties with the emotional burden associated with caregiving professions was also present within dog rescue work. However, international dog rescue members also experienced additional challenges due to the stigma surrounding international dog rescue operations. Further research on attitudes held by other stakeholders involved in dog import activities, as well as members of Canadian communities needing dog rescue aid may provide meaningful inputs on how to better support and facilitate local and international dog rescue efforts.

Where exactly do the social and behavioural sciences fit in One Health?

At its core, One Health promotes multidisciplinary cooperation amongst researchers and practitioners to improve the effectiveness and management of complex problems raised by the interplay of human, animal and environment interactions. Contemporary One Health literature has identified reducing disciplinary barriers as key to progress in the field, along with addressing the notable absence of social sciences from One Health frameworks, among other priorities. Efforts to position social scientists as experts on behaviour change and health decision-making has helped to articulate a concrete role for progressing One Health collaborations. Yet, there are other equally valuable functions the social scientist has in understanding complex systems, like One Health. We make explicit the multiple and diverse knowledge contributions the social sciences and humanities can make to progressing the One Health agenda. Articulating these more clearly invites a broader set of interdisciplinary perspectives to One Health discussions, allowing for stronger connections between sectors, actors, disciplines, and sub-systems. This perspective piece identifies a range of entry points for researchers and practitioners to better utilize the potential contributions social sciences and humanities scholars can make to One Health goals.

Facilitators and barriers to "Positive Outcomes" from cognitive-behavioral therapy, according to young people: A thematic synthesis

OBJECTIVE

This qualitative review sought to explore how young people (YP) conceptualize positive outcomes from cognitive-behavioral therapy (CBT) and what YP perceive to be the facilitators and barriers to positive outcomes.

METHODS

A systematic literature search was conducted in June 2021 using six online databases. Studies were included if qualitative data were collected from participants who were aged up to 25, had internalizing mental health difficulties, and had received in-person CBT from trained practitioners.

RESULTS

Nineteen studies were included. The Gough Weight of Evidence framework was used to assess methodological and topical quality and relevance. A thematic synthesis identified 34 conceptualizations of positive outcomes, 57 facilitators, and 49 barriers. Descriptive and analytical themes were identified. In line with the review's pragmatic perspective, the latter were worded as practice recommendations: acknowledge YP's perspectives on outcomes, teach tangible CBT techniques, balance autonomy and support, frame CBT as "upskilling," explore nuanced barriers to engagement, and consider the power of group dynamics.

CONCLUSIONS

This review established the range of YP's views about positive outcomes from CBT, as well as facilitators and barriers to achieving these. Findings should prompt CBT practitioners to reflect and consider how their practice might be shaped through reports from YP as experts by experience.

Equity-related 'knots' in theory of change development: Conceptualization and case illustrations

Theory of change (ToC) is an approach widely used to guide planning, implementing, and evaluating change initiatives. While there is substantial guidance, there has been little attention on equity within ToC research and practice. We propose and illustrate the metaphor of 'knots' to frame practical and ethical challenges that arise when centering equity within ToC processes. Drawing on our experiences using a ToC approach in two case examples, we identify and illustrate five equity-related knots: (a) clarify root causes, pathways, and success; (b) facilitate participation across power and perspective differences; (c) integrate research evidence and practitioner knowledge; (d) represent complex change visually; and (e) creatively navigate constraints. We show why framing these as knots can help practitioners make wise judgments within the circumstances and close with recommendations for including knots in ToC processes, reporting, and guidance.

Wilding cities for biodiversity and people: a transdisciplinary framework

Accelerating urbanisation and associated lifestyle changes result in loss of biodiversity and diminished wellbeing of people through fewer direct interactions and experiences with nature. In this review, we propose the notion of urban wilding (the promotion of autonomous ecological processes that are independent of historical land-use conditions, with minimal direct human maintenance and planting interventions) and investigate its propensity to improve biodiversity and people-nature connections in cities. Through a large interdisciplinary synthesis, we explore the ecological mechanisms through which urban wilding can promote biodiversity in cities, investigate the attitudes and relations of city dwellers towards urban wild spaces, and discuss the integration of urban wilding into the fabric of cities and its governance. We show that favouring assembly spontaneity by reducing planting interventions, and functional spontaneity by limiting maintenance practices, can promote plant diversity and provide ecological resources for numerous organisms at habitat and city scales. These processes could reverse biotic homogenisation, but further studies are needed to understand the effects of wilding on invasive species and their consequences. From a socio-ecological perspective, the attitudes of city dwellers towards spontaneous vegetation are modulated by successional stages, with grassland and woodland stages preferred, but dense shrubby vegetation stages disliked. Wild spaces can diversify physical interactions with nature, and enrich multi-sensory, affective and cognitive experiences of nature in cities. However, some aspects of wild spaces can cause anxiety, feeling unsafe, and the perception of abandonment. These negative attitudes could be mitigated by subtle design and maintenance interventions. While nature has long been thought of as ornamental and instrumental in cities, urban wilding could help to develop relational and intrinsic values of nature in the fabric of cities. Wildness and its singular aesthetics should be combined with cultural norms, resident uses and urban functions to plan and design urban spatial configurations promoting human-non-human cohabitation. For urban wilding to be socially just and adapted to the needs of residents, its implementation should be backed by inclusive governance opening up discussion forums to residents and urban workers. Scientists can support these changes by collaborating with urban actors to design and experiment with new wild spaces promoting biodiversity and wellbeing of people in cities.

Impact of community-based employment on Aboriginal and Torres Strait Islander wellbeing, aspirations, and resilience

BACKGROUND

This study evaluated a research project that provided employment in an Aboriginal and Torres Strait Islander community-based setting and supported participants to identify and achieve their goals and aspirations. The evaluation examined changes in personal, relationship, community and cultural strengths and resources and explored empowerment and resilience, in terms of promoting wellbeing.

METHODS

Ten Aboriginal people employed as life coaches and peer researchers participated in semi-structured interviews and also completed the Aboriginal Resilience and Recovery Questionnaire at the beginning of their employment and 6-months after employment. Interviews with the 10 participants explored changes in their wellbeing, relationships, resilience, opportunity to lead, aspirations, goal setting skills, connection to culture and community, and empowerment.

RESULTS

Participants personal strengths, and cultural and community strengths, sub-scale scores showed improvements across the 6-month period, however these changes were not statistically significant. Using reflexive thematic analysis, we generated five themes including Aspirations; Personal capabilities; Constraints to wellbeing; Community engagement and cultural connection; and Employment facilitators. Overall, participants identified that despite the challenges of their work and the additional challenges posed by the COVID-19 lockdowns, they were able to develop their skills to set and achieve goals. They reported feeling empowered and proud of their work, and engaged more frequently with their communities and culture.

CONCLUSIONS

The study outcomes evidence the role of employment in an Aboriginal and Torres Strait Islander community-based project in strengthening wellbeing, enhancing resilience, and supporting participants to advance their personal goals and aspirations. These findings reinforce the importance of supporting the aspirations and employment of Aboriginal and Torres Strait Islander Peoples through employment.

Employee Experiences Providing Nutritional Care during the COVID-19 Pandemic

Nutritional care is a critical, yet often overlooked component of quality care in long-term care (LTC) that is linked to culture, socialization, and residents' psychological and physiological well-being. Given that several COVID-19 infection control protocols affected nutritional care, this study aimed to understand employees' experiences of these changes. Seven semi-structured interviews were conducted with Saskatchewan healthcare employees from several disciplines, all of whom had a role in supporting nutritional care in LTC. The resulting interview transcripts were analyzed using reflexive thematic analysis. Three main themes characterized the interviewees' reflections: regression to an institutional mealtime environment, unrealistic expectations, and concern for residents. Given the centrality of nutritional care to quality of life, strategies tailored to support staff in providing relationship-centered nutritional care must be further articulated to maintain standards of care for LTC residents in future outbreaks and epidemics.

Facilitators and barriers to the implementation of pain neuroscience education in the current Lebanese physical therapist health care approach: a qualitative study

PURPOSE

The purpose of this paper was first to gain an in-depth understanding of the barriers and facilitators to implementing the BPS model and pain neuroscience education in the current Lebanese physical therapy health care approach and explore its acceptability.

METHOD

A qualitative semi-structured interview using purposive sampling was conducted with eight Lebanese physical therapists practising in different governorates. The transcribed text from the interviews was analyzed using inductive thematic analysis.

RESULTS

Two topics were generated and constructed by the researchers: (1) "barriers to the implementation of pain neuroscience education, with subthemes including (a) "current health care approach," (b) "basic curriculum and continuing education," (c) "patients' barriers"; (2) "facilitators to the implementation of pain neuroscience education," with subthemes containing (a) "interest in the BPS model, (b) "therapeutic alliance," and (c) "motivation for future training on BPS approach."

CONCLUSION

The analysis of the results showed that Lebanese physical therapists currently hold a strong biomedical view of chronic pain, assessment, and treatment. However, despite the presence of barriers and challenges, they are aware and open to consider the implementation and future training about the BPS model and pain neuroscience education in their approach.IMPLICATIONS FOR REHABILITATIONThe exploration of potential barriers and facilitators to the bio-psychosocial model and pain neuroscience education implementation may provide an opportunity for better development and design of a culturally sensitive pain neuroscience education material for Arab-speaking and Lebanese physical therapists.The exploration of barriers and facilitators to the implementation of pain neuroscience education will help to improve pain education and ensure better clinical pain management.The most important barriers were the dominant characteristic of the Lebanese physical therapist's health approach, which is focused on a biomechanically oriented model, and their lack of knowledge to approach chronic pain from a biopsychosocial perspective.

Methodological advice for the young at heart investigator: Triangulation to build better foundations

In medicine and science, one is typically taught the main theories in a discipline or field along with standard models before receiving more instructions on how to apply certain methods. The aim of this work is not to address one method, but rather methodology, the study and evaluation of methods, by taking a philosophy of science detour. In this, a critique of biomedicine will be used as a starting point to address some positions regarding reductionism, specifying notions such as systems and mechanisms, as well as regarding the mind-body problem discussing psychosomatic medicine and psychoneuroimmunology. Some recommendations to make science more pluralistic, robust and translationally-relevant will then be made as a way to foster constructive debates on reductionism and the mind-body problem and, in turn, favor more interdisciplinary research.

An Evolving Understanding of Sense of Place in Social-Ecological Systems Research and the Barriers and Enablers to its Measurement

Social-ecological systems (SES) are changing more in the Anthropocene than ever before. With this also comes a change in Sense of Place (SoP), that is, the emotional bond that a person (or group of people) has with a place. This impacts how individuals and groups interact with a place (i.e., their behaviours) and respond to disturbance or change (i.e., their adaptive capacity). To understand how SoP is changing across space and time and to be able to compare this across social-ecological contexts, we must first take stock of how SoP is conceptualised so as to understand how to capture and measure the phenomena in a meaningful way (e.g., to inform policy). Based on in-depth qualitative interviews with leading SoP researchers (n = 17 from 8 countries) this paper aims to identify: (1) the current breadth of theoretical conceptualisations for SoP; (2) the methodologies that have been used to measure SoP in different contexts and settings; and (3) the barriers and (4) enablers to the use of different methodologies. Results show that there has been a change in how SoP has been conceptualised over time, whereby it was traditionally considered as something singular and limited, towards something much more dynamic. Results also show that diverse methods (both quantitative and qualitative) have been used to measure SoP, but the choice of method is often a result of resource constraints that limit research design. These findings suggest that broader collaboration among stakeholders and increased interdisciplinarity would undoubtedly lead to improved outcomes in our understanding of SoP, specifically how it is changing in response to anthropogenic pressures, and how the results can be integrated into policy and practice to support environment conservation and management. It is hoped these findings can help establish a community of practice around how we conceptualise SoP, and hence understand it, to create space for methodological integration and shared learnings as a field.

"That's too stereotypical … I don't want that to be how I identify": Identity and body-related sport experiences of racialized young women athletes in Canada

There is minimal research on the sport experiences of racialized young women athletes in Canada. When studying racialized groups, an inclusive and meaningful approach to research is necessary because ethnicity and race are integral to understanding identity, diversity, discrimination, and overall experiences in sport. The purpose of this qualitative description study was to explore the identities and body-related sport experiences of racialized young women athletes in a variety of sports in Canada. Eight racialized young women athletes (ages 14-18 years; Mage = 16.63, SD = 1.19) participated in multiple semi-structured one-on-one interviews and reflexive photography. A reflexive thematic analysis was conducted, and three overarching themes were generated that describe the athletes' identities and body-related sport experiences: (a) Who I am vs who they say I am; (b) My unique body in sport; and (c) The importance of representation. From these findings, three critical factors - intersectionality, discrimination, and diversity - are examined that influence the quality of sport experiences for racialized young women athletes in Canada.

Oncology residents' experiences of decision-making in a clinical learning environment: a phenomenological study

Oncology residents routinely engage in ethically complex decision-making discussions with patients, while observing and interacting with their teaching consultant. If clinical competency in oncology decision-making guidance is to be taught deliberately and effectively, it is necessary to understand resident experiences in this context to develop appropriate educational and faculty development initiatives. Four junior and two senior postgraduate oncology residents participated in semi-structured interviews during October and November 2021 which explored their experiences of real-world decision-making scenarios. Van Manen's phenomenology of practice was used in an interpretivist research paradigm. Transcripts were analysed to articulate essential experiential themes, and composite vocative narratives were created. Three essential themes were identified: (1) residents often endorsed different decision-making approaches than supervising consultants, (2) residents experienced inner conflict, and (3) residents struggled to find their own approach to decision-making. Residents experienced being torn between a perceived obligation to defer to consultant directives, and a desire for increasing ownership of decision-making while not feeling empowered to discuss their opinions with the consultants. Residents described their experiences around ethical position awareness during decision-making in a clinical teaching context as challenging, with experiences suggesting moral distress combined with inadequate psychological safety to address ethical conflicts and unresolved questions of decision ownership with supervisors. These results suggest the need for enhanced dialogue and more research to reduce resident distress during oncology decision-making. Future research should be aimed at discovering novel ways in which residents and consultants could interact in a unique clinical learning context including graduated autonomy, a hierarchical gradient, ethical positions, physician values, and sharing of responsibility.

"What Can I Do to Not Have This Life"? A Qualitative Study of Paternal Postnatal Depression Experiences among Fathers in the United Kingdom

Understandings of paternal postnatal depression (PND) in fathers from the United Kingdom (UK) have received limited attention, particularly in view of changing dynamics of contemporary parenthood. To rectify this, eight UK fathers with PND took part in one-to-one interviews, with Interpretative Phenomenological Analysis used to understand their lived experiences. Our findings demonstrate that UK fathers with PND experienced extremely distressing emotions, including anger and misery, after their babies are born. Their working practices were highly relevant to their fatherhood, with working considered a key responsibility and a source of stress, but also a "legitimate" escape from the home. Fathers' relationships with their partners were experienced as less intimate and conflicted. Fathers often hid their feelings to protect their partners, but also reported their partners as being aware of their challenging and difficult emotions. Healthcare providers should be professionally curious about fathers' mental health and consider the assistance of mothers in identifying cases of paternal PND.

Taming a 'fuzzy beast'? Stakeholder perspectives on Antarctic science-policy knowledge exchange practices in New Zealand

Antarctic environmental change is accelerating with significant regional and global consequences making it critically important for Antarctic research knowledge to inform relevant policymaking forums. A key challenge is maximising the utility of evidence in decision-making, to which scholars have responded by shifting away from linear science-policy arrangements towards co-production alternatives. As an Antarctic Treaty Consultative Party (ATCP), New Zealand (NZ) is responsible for facilitating knowledge exchange (KE) among Antarctic science and policy actors at national and international levels. However, at present, we have few metrics for assessing the success of science-policy dialogues. Furthermore, studies on the Antarctic science-policy interface have so far primarily focused on the international perspective. This paper is the first to examine domestic stakeholder perspectives regarding Antarctic KE using NZ as a case study. We report on the findings of two workshops involving over 60 NZ Antarctic stakeholders in 2021 that aimed to explore the various elements of NZ's Antarctic science-policy interface and identify barriers or drivers for success, including future opportunities. Our results indicate that there is a desire to shift away from the current linear approach towards a more collaborative model. To achieve this, stakeholders share an understanding that KE practices need to become more equitable, inclusive and diverse, and that the policy community needs to play a more proactive and leading role. Described as a 'fuzzy beast', the NZ Antarctic science-policy interface is complex. This study contributes to our understanding of Antarctic KE practices by offering new guidance on several key elements that should be considered in any attempts to understand or improve future KE practices in NZ or within the domestic settings of other ATCPs interested in fostering science-policy success.

'Change talk' among physicians in small group learning communities: An ethnographic study

INTRODUCTION

Physicians face uncertainties in complex clinical environments. Small group learning initiatives allow physicians to decipher new evidence and address challenges. This study aimed to understand how physicians in small learning groups discuss, interpret and assess new evidence-based information to make decisions for practice.

METHODS

An ethnographic approach was used to collect data from observed discussions between practising family physicians (n = 15) that meet in small learning groups (n = 2). Physicians were members of a continuing professional development (CPD) programme that provides educational modules with clinical cases and evidence-based recommendations for best practice. Nine learning sessions were observed over 1 year. Field notes documenting the conversations were analysed using ethnographic observational dimensions and thematic content analysis. Observational data were supplemented with interviews (n = 9) and practice reflection documents (n = 7). A conceptual framework for 'change talk' was created.

RESULTS

Observations elucidated the following: Facilitators played a significant role in leading the discussion by focusing on practice gaps. As group members shared approaches to clinical cases, baseline knowledge and practice experiences were revealed. Members made sense of new information by asking questions and sharing knowledge. They determined what information was useful and whether it applied to their practice. They reviewed evidence, tested algorithms, benchmarked themselves to best practice and consolidated knowledge before committing to practice change(s). Themes from interviews emphasised that sharing of practice experiences played an integral part in decisions to implement new knowledge, helped validate guideline recommendations and provided strategies for feasible practice changes. Documented practice reflections regarding decisions for practice change(s) overlapped with field notes.

CONCLUSION

This study provides empirical data on how small groups of family physicians discuss evidence-based information and make decisions for clinical practice. A 'change talk' framework was created to illustrate the processes that occur when physicians interpret and assess new information to bridge gaps between current and best practices.

Perseverance, partnerships and passion: ingredients for successful local government policy to promote healthy and sustainable diets

BACKGROUND

Local government authorities are well-placed to invest in evidence-based food policies that promote a population-wide shift to healthy and sustainable diets. This study describes the contextual factors that facilitated or impeded policy-making related to healthy and sustainable diets within a 'best-performing' local government in Victoria, Australia.

METHODS

Guided by the Consolidated Framework for Implementation Research (CFIR), data from semi-structured interviews with individuals involved in developing the City of Greater Bendigo's Food System Strategy were analysed using the seven-stage Framework Method.

RESULTS

Semi-structured interviews (n = 24) were conducted with City of Greater Bendigo employees (n = 15) and key stakeholders working for local organisations (n = 6) or at a state or national level (n = 3). Interviewees mostly held positions of leadership (n = 20) and represented diverse areas of focus from health (n = 7), food systems (n = 4) and planning and public policy (n = 3). Data analysis revealed 12 cross-cutting themes; eight facilitating factors and four impeding factors. Facilitating factors included perseverance, community engagement, supportive state policy, effective leadership, a global platform and networks, partnerships, workforce capacity and passion, and the use of scientific evidence. Impeding factors included access to secure, ongoing financial resources, prohibitive state and federal policy, COVID-related disruptions to community engagement and competing stakeholder interests. Overall, this study suggests that the City of Greater Bendigo's success in developing an evidence-based local food system policy is built upon (i) a holistic worldview that embraces systems-thinking and credible frameworks, (ii) a sustained commitment and investment throughout the inner-setting over time, and (iii) the ability to establish and nurture meaningful partnerships with community groups, neighbouring local government areas and state-level stakeholders, built upon values of reciprocity and respect.

CONCLUSIONS

Despite insufficient resourcing and prohibitive policy at higher levels of government, this 'best performing' local government in Victoria, Australia developed an evidence-based food system policy by employing highly skilled and passionate employees, embracing a holistic worldview towards planetary health and harnessing global networks. Local government authorities aspiring to develop integrated food policy should nurture a workforce culture of taking bold evidence-informed policy action, invest in mechanisms to enable long-standing partnerships with community stakeholders and be prepared to endure a 'slow-burn' approach.

How equestrians conceptualise horse welfare: Does it facilitate or hinder change?

More than ever the welfare of horses in equestrian sport is in the spotlight. In response to this scrutiny, one peak body, the Federation Equestre Internationale (FEI) has created an Equine Ethics and Wellbeing Commission to protect their sport's longevity. However, for welfare-based strategies to be successful, the conceptualisation of horse welfare must align across various stakeholders, including the general public. The value-laden nature of welfare makes agreement on its definition, even among scientists, difficult. Given little is known about how equestrians conceptualise horse welfare, we interviewed 19 Australian amateur equestrians using a semi-structured format. Systems thinking and the Five Domains Model provided the theoretical framework and informed our methods. Using reflexive thematic analysis, three themes were identified: (1) good horse welfare is tangible; (2) owners misinterpret unwanted horse behaviour; and (3) equestrians publicly minimise horse welfare issues but are privately concerned. Our results highlight participants' conceptualisations of horse welfare do not align with the Five Domains Model; participants' ideal of prioritising horse welfare does not align with their practice; and there is inconsistency between what participants share publicly and what they think privately about horse welfare. These findings can inform the development of programmes to improve ridden horse welfare throughout the horse industry. As a starting point, programmes that provide a safe space for equestrians to explore their private horse welfare concerns, and programmes that build a partnership mindset to facilitate knowledge exchange between all stakeholders are needed.

The graduate dietitian experience of employment and employability: A longitudinal qualitative research study from one Australian university

AIMS

Diet-related chronic disease contributes significantly to the global burden of disease. Dietitians are best placed to address this disease burden, yet graduate dietitians may struggle to find employment. This study aimed to explore dietetics graduates' experiences of employment and employability, up to 6-month post-degree completion.

METHODS

Secondary data analysis of in-depth qualitative interview data and longitudinal audio-diaries was undertaken. An interpretivist approach was employed whereby knowledge was viewed as subjective and multiple realities exist. A total of five entrance interviews, 31 audio-diaries and three exit interviews, from nine graduates were included in the analysis. This comprised 12 h of longitudinal audio data. Thematic analysis was undertaken using a framework analysis method.

RESULTS

Four key themes were identified: (1) The tumultuous process of applying for jobs demonstrated that graduates struggled with repeated rejections. (2) The uncertain journey to employment indicated that job-seeking was a limbo stage marked by uncertainty. (3) Feeling the pressure showed that graduates experienced pressure from multiple sources. (4) Enhancing employability explained that graduates were not prepared for available employment opportunities, but utilised resources to increase their employability.

CONCLUSION

Diverse placement experiences may better prepare graduates for available employment opportunities. To enhance employability, it may be beneficial to assist students to develop job-seeking skills, and to engage in networking and volunteering experiences during their education.

Invited review: Qualitative research in dairy science-A narrative review

The use of qualitative research in dairy science has increased considerably in recent years, providing the opportunity to inform research and practice. This review aims to enhance the accessibility of qualitative research among a range of audiences and specifically: (1) provide an overview of what qualitative research is and the value it can bring to scientific inquiries in the dairy context, (2) illustrate the emergence of qualitative dairy science research in the past 15 to 20 years, (3) outline the role of the researcher and key philosophical assumptions underlying qualitative research, (4) describe qualitative research approaches and methods used in dairy science research, and (5) highlight key aspects of qualitative inquiry used to ensure research trustworthiness. Qualitative approaches in dairy science enable researchers to understand myriad topics including stakeholder relationships, decision-making, and behaviors regarding dairy cattle management, animal welfare, and disease prevention and control measures. Approaches that were used often for qualitative data collection were individual interviews and focus groups, and variations of thematic analysis were common analytical frameworks. To assess public values, attitudes, and perceptions, mixed methods questionnaires that combined quantitative data with qualitative data from open-ended questions were used regularly. Although still used infrequently, action research and participatory approaches have the potential to bridge the research-implementation gap by facilitating group-based learning and on-farm changes. Some publications described the philosophical assumptions inherent to qualitative research, and many authors included reflexivity and positionality statements. Although a comprehensive description of strategies to meet trustworthiness criteria for qualitative research was uncommon, many publications mentioned certain aspects of trustworthiness, such as member checking, researcher triangulation, and the recording of reflexive notes. Qualitative research has been used to deepen our understanding of phenomena relevant to the dairy sector and has opened the door for a broad array of new opportunities. In addition to having merit on its own, qualitative research can guide, inform, and expand on quantitative research, and an understanding of the core pillars of qualitative research can foster interdisciplinary collaborations.

A critical assessment of a protected area conflict analysis based on secondary data in the age of datafication

Recently, a global trend towards a broader use of secondary data in social sciences has been reinforced by the COVID-19 pandemic. This evoked doubts about the validity of the results unless restrictive assessment procedures are implemented. To address this need in the field of protected area (PA) conflict analysis, we propose a three-fold approach (theory-, method-, and cross-scale simulation-driven) to assess the usefulness of the utilized state register dataset and the indicator analysis methodology for the multi-level recognition of PA conflict determinants. With the ultimate aim to inform case study selection, we processed 187 relevant indicators from the official Statistics Poland register for a Lesser Poland region. We distinguished five types of PA conflict determinants in Lesser Poland ('urbanity', 'agriculture', 'tourism', 'small-scale entrepreneurship', and 'sprawl') and respective groups of 15 clusters comprising local-level units. For one cluster, we juxtaposed the obtained results with secondary data from another source (Internet content) and for a specific PA (Tatra National Park). Although the reported conflict issues corresponded to the indicator-derived descriptors of the cluster, in the theory-driven phase of the assessment, the state register failed to address the key prerequisites of PA conflicts. We have demonstrated that, in crisis conditions such as COVID-19, the proposed method can serve as a proxy for a multi-level recognition of PA conflict potentials, provided that it synthesises the results of different methodological approaches, followed by in-person interviews in the selected case studies.

Facing financial barriers to healthcare: patient-informed adaptation of a conceptual framework for adults with a history of cancer

Background

Cancer-related financial hardship is associated with negative clinical outcomes, which may be partially explained by cost-related delayed or forgone care in response to financial barriers. We sought to understand patient experiences facing financial barriers to medical care following a cancer diagnosis.

Methods

We conducted virtual, semi-structured interviews in Fall 2022 with 20 adults with a history of cancer who had experienced cancer-related financial hardship in the prior year. We used template analysis within a pragmatic paradigm, combining constructivist and critical realist theoretical perspectives, to analyze interview transcripts and adapt an existing conceptual framework of financial barriers to care.

Results

The majority of interviewees identified as women (70%), non-Hispanic white (60%), and reported an annual household income of <$48,000 (60%). As interviewees sought to overcome financial barriers, they described substantial frustration at the limitations and complexities of United States health and social care systems, resulting in a reliance on a fragmented, uncertain resource landscape. The administrative burden resulting from bureaucratic systems and the advocacy responsibilities required to navigate them ultimately fell on interviewees and their caregivers. Thus, participants described their ability to overcome financial barriers as being influenced by individual and interpersonal factors, such as social support, comfort asking for help, time, prior experience navigating resources, and physical and mental health. However, participants noted health system organizational factors, such as whether all new patients proactively met with a social worker or financial navigator, as having the potential to lessen the administrative and financial burden experienced.

Conclusion

We present an adapted conceptual framework outlining multi-level factors influencing patient experiences coping with financial barriers to medical care. In addition to influencing whether a patient ultimately delays or forgoes care due to cost, financial barriers also have the potential to independently affect patient mental, physical, and financial health.

Transformative potential of conservation actions

Transformative change can help achieve the 2050 vision of biodiversity, but concrete ways to achieve it are only being discovered. To contribute to the understanding of the practical options for concrete action to foster, accelerate and maintain the transformative change, we assessed the leverage potential of existing conservation actions using the Meadows' Leverage points framework. We took the actions from the Conservation Actions Classification by the Conservation Measures Partnership. The outcome is a scheme that evaluates at which leverage points, from simple parameters to paradigms, the different conservation actions have potential to make an impact, and thus impact systemic change. We found that all conservation actions have potential to leverage systemic transformative change, with varying coverage of the leverage points. All leverage points were addressed by several actions. The scheme could be used both as an interim tool for evaluating transformative potential in different broad datasets, but also help with planning of new conservation policies, interventions and projects. We hope our work could be a first step toward standardization and broader adoption of assessing leverage in conservation research and practice, achieving broader socio-ecological system leverage with conservation tools.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10531-023-02600-3.

What does One Health want? Feminist, posthuman, and anti-colonial possibilities

What does One Health want? Despite its touted interdisciplinarity, to date there has been limited engagement with the social sciences and humanities - in particular with streams of critical social theory that enable a response to this question. In this paper we draw on the critical social sciences to consider how One Health is defined, conceptualized, and positioned, and discuss what we see as vital challenges within One Health that both limit its potential for meaningful change and contribute to a potential for ongoing harm - namely, medicalization, anthropocentrism, and colonial-capitalism. We then advance three areas in the critical social sciences that hold potential for addressing these challenges - feminist, posthuman, and anti-colonial approaches. By doing so we seek to encourage a deeper transdisciplinarity within One Health - one that is open to a genuine engagement with insights from critical social theory and a re-orientation towards more creative and radical re-imaginings in the service of wellbeing for diverse peoples, animals, other beings, and the land.

Using a mixed methods grounded theory methodology to explain neonatal nurses' professional quality of life

BACKGROUND

Nurse researchers are constantly seeking novel methods of maintaining philosophical congruence while advancing their knowledge of the human condition using paradigmatically diverse means.

AIM

To provide an overview of the research philosophies underpinning the mixed methods grounded theory (MM-GT) methodology, illustrate its optimal use and introduce a quality-appraisal tool being developed with reference to extant literature.

DISCUSSION

The utility of MM-GT has been effectively demonstrated in the nursing and health literature. Yet, there are examples of how it has been under-used and sub-optimally applied. This article includes a two-phase MM-GT study protocol guided by a pragmatic research philosophy and best practice recommendations that aims to explain neonatal nurses' professional quality of life.

CONCLUSION

Optimal use of MM-GT's five essential components - purposive sampling, constant comparative methods with iterative coding and analysis, theoretical saturation, memoing and theory development - combine to produce high-quality, defensible research outputs and new nursing theory.

IMPLICATIONS FOR PRACTICE

Research outputs, such as publication and presentation, expounding the multifactorial influences affecting neonatal nurses' professional quality of life will not only benefit the neonatal nursing community but also contribute to the corpus of nursing and midwifery research and enhance the health, well-being and retention of nurses and midwives more broadly.

Quality and constructed knowledge: Truth, paradigms, and the state of the science

CONTEXT AND TRUTH

Education is a social science. Social science knowledge is related to its context of origin. The concept of global 'truth' in education is therefore of limited use when truth is tempered by context. The wider applicability of our knowledge can only be judged if we look at the context in which that knowledge was produced and the assumptions that underpin it. This calls into question the idea that educational research is a quest for global 'truth', although in relation to programme evaluation, truth tied to context is an aim. An analysis is presented of the effects of social construction on research and evaluation processes, on the selection of paradigms, reporting and interpreting findings, and on the ethics of all this.

QUALITY AND IMPROVEMENT

Quality improvement is based on information selected, constructed and interpreted by those who gather, analyse or use it. The strength, and not the weakness, of our knowledge is that it is socially constructed, contextual and of its time. Increasingly looking for our own truth about educational quality, and not importing the truth of others, is crucial to the state of the science. In terms of quality development, using others' findings must be based on informed local judgement. In social science, those judgements are linked to social context and their associated ideologies.

IMPLICATIONS FOR FUTURE WORK

The hallmark of social science is not a narrowing of focus and the search for one truth, but is a broadening of concepts, theories, paradigms, reported experience and method, and an intention for each to tell their own truth well. This will lead to a wealth of diverse views and analysed experience. The science of medical education must seek many truths.

From burden to benefit: a multi-site study of the impact of allied health work-based learning placements on patient care quality

Allied health clinical placements take place within an increasingly overstretched health care system where demand for services often exceeds availability of resources. Within this environment, student placements are often perceived as an additional burden to an already overwhelmed workforce. This study explored whether the quality of patient care was enhanced when services were re-designed using a collaborative partnership approach to more purposefully integrate students into delivery of care. Using an embedded multiple case study design, data were collected through focus groups and interviews, patient experience surveys, and secondary administrative data sources. Cases were across physiotherapy and occupational therapy in six different hospital settings. Perception of care provided by students was viewed positively by all stakeholders, including patients. Perceived health outcomes of faster improvement of health condition, improved mobility and function identified through our qualitative findings were supported by quantitative service delivery markers such as increased therapy sessions, more patients being discharged home instead of to other care facilities and reduced length of stay. Health care providers and students alike perceived improvements in service efficiencies whilst maintaining high quality care. This study has provided preliminary evidence towards improved patient care when a partnering approach is adopted whereby students are intentionally integrated into services that otherwise might not have been delivered. Furthermore, it has shifted the associated narrative from students as additional burden to students as benefit.

Interviews with Indian Animal Shelter Staff: Similarities and Differences in Challenges and Resiliency Factors Compared to Western Counterparts

Simple Summary

Previous knowledge about animal sheltering systems and perspectives of staff working in animal shelters has been centered around Western countries. However, staff in Indian shelters must tackle different kinds of problems, such as care of free-ranging dogs. We conducted interviews with ten participants working in animal shelters in India to begin to gain an understanding of their experiences. Participants reported that inadequate funding, community conflict, and too many animals in need created a challenge for animal shelter work. However, flexibility and positive relationships in their workplace, feelings of duty to animals, and understanding animal needs were identified as positive factors. The perspectives of Indian animal shelter staff showed that certain issues are similar to those encountered in Western shelters; however, other issues are specific to social, political, and cultural influences. Context specific research in animal sheltering is needed to gain a broader world understanding of human–animal relationships.

Abstract

Animal shelters in India are at the forefront of efforts to improve free-ranging dog welfare and tackle animal overpopulation. In terms of cultural and political context, access to resources, and public health challenges, they operate in a very different environment than Western counterparts. Despite these distinctions, current sheltering literature is largely centered around countries such as the United States. The goal of this exploratory study was to examine the experiences of Indian animal shelter staff. Researchers conducted ten semi-structured interviews, in a mix of Hindi and English, with managers, veterinary nurses, and animal caretakers from three shelters. Using thematic analysis, shelter challenges as well as resiliency factors that enable staff to cope with these challenges were identified. Key challenges were inadequate funding, community conflict, and high intake numbers. Resiliency factors included flexibility, duty of care, co-worker relationships, and understanding animal needs. The results of this qualitative study revealed that the experiences of shelter staff are shaped by social, political, and cultural factors and that there is a need for further, context specific research on Indian sheltering rather than only relying on Western perspectives.

Blocked chains of governance: Using blockchain technology for carbon offset markets?

Information and communication technology (ICT) plays a critical role in environmental governance; however, research into power in governance has not focused on the impact of ICT. In this study, we analyze the use of blockchain in a voluntary carbon offset market using the “Four Faces of Power” (compulsory, institutional, structural, and productive) conceptual framework to determine how ICT can change the power dynamics within a network of stakeholders. Proponents have proposed that blockchain technology can solve several issues that carbon marketplaces and offsets face, such as cybersecurity, traceability, and financial liquidity. Despite these proposals, there is little scholarship on existing cases using blockchain in carbon offsets. We found that the use of blockchain technology by the company Veridium changed the compulsory and institutional power dynamics within the network of stakeholders it was a member of. Veridium’s choice to use blockchain technology was likely the result of structural and productive power dynamics surrounding the technology at the time. The power dynamics changed because the use of blockchain for Veridium’s carbon offset market caused additional stakeholders to join the network of stakeholders. The new stakeholders held greater compulsory and institutional power than Veridium. This research contributes to the limited scholarship focused on ICT and power in environmental governance. Empirically it contributes to the ongoing discussion around the possibilities of blockchain technology for climate policy.

Study to Identify and Evaluate Predictor Factors for Primary Open-Angle Glaucoma in Tertiary Prophylactic Actions

The aim of this study is to develop a predictive model with several explanatory variables that can guide ophthalmologists to make a more objective assessment of the evolution of open-angle glaucoma (OAG) during tertiary prevention. Objectives: The evaluation of risk factors and different predictors of symptom progression between patients with POAG and non-glaucoma patients (NG), as well as between primary open-angle glaucoma with high intraocular pressure (POAG) and primary open-angle glaucoma with normal intraocular pressure (NTG), in tertiary prophylactic activities. Methods: This research is an analytical epidemiological study of a prospective cohort. For the study, we took into account personal medical history, physical ophthalmological examination, intraocular pressure (IOP) values, and visual field (VF) parameters, examined with the Opto AP-300 Automated Perimeter using the “fast threshold” strategy. The results of gonioscopy were inconsistently recorded; they were not considered in the study due to missing values, the processing of which would have seriously distorted the statistical analysis. Ophthalmological examination was completed with a dichotomous questionnaire entitled “Symptom Inventory”, made according to the accusations of patients resulting from a “focus group” study. The study was carried out in the ophthalmology office within the Integrated Outpatient Clinic of the Emergency Clinical Hospital of Oradea, Bihor County (IOCECHO) between January−December 2021. The threshold of statistical significance was defined for p value < 0.05. The obtained results were statistically processed with specialized software SPSS 22. Results: The study included 110 people, of which 71 (64.54%) had POAG (IOP > 21 mmHg) and 39 people (35.46%) had NTG (IOP < 21 mmHg), the two groups being statistically significantly different (χ2 = 9.309, df = 1, p = 0.002). For the POAG group, glaucomatous loss was early, AD < −6 dB, according to the staging of glaucomatous disease, HODAPP classification. In addition, the groups of POAG and NTG patients was compared with a group of 110 NG patients, these three groups being statistically significantly different (χ2 = 34.482, df = 2, p = 0.000). Analysis of confounding factors (age, sex, residence, marital status) shows a statistically significant relationship only for age (F = 2.381, df = 40, p = 0.000). Sex ratio for the study groups = 5.11 for OAG and =5.87 for NG. After treatment (prostaglandin analogues and neuroprotective drugs) IOP decreased statistically significantly for both POAG and NTG. Conclusions: this study identified possible predictors of OAG, at the 5% level (risk factors and symptoms as independent variables) using a dichotomous questionnaire tool with a complementary role in tertiary prophylactic activities. The implementation of the focus group interview results as a socio-human research technique will be supportive to clinicians.

Social science for conservation in working landscapes and seascapes

Biodiversity is in precipitous decline globally across both terrestrial and marine environments. Therefore, conservation actions are needed everywhere on Earth, including in the biodiversity rich landscapes and seascapes where people live and work that cover much of the planet. Integrative landscape and seascape approaches to conservation fill this niche. Making evidence-informed conservation decisions within these populated and working landscapes and seascapes requires an in-depth and nuanced understanding of the human dimensions through application of the conservation social sciences. Yet, there has been no comprehensive exploration of potential conservation social science contributions to working landscape and seascape initiatives. We use the Smithsonian Working Land and Seascapes initiative – an established program with a network of 14 sites around the world – as a case study to examine what human dimensions topics are key to improving our understanding and how this knowledge can inform conservation in working landscapes and seascapes. This exploratory study identifies 38 topics and linked questions related to how insights from place-based and problem-focused social science might inform the planning, doing, and learning phases of conservation decision-making and adaptive management. Results also show how conservation social science might yield synthetic and theoretical insights that are more broadly applicable. We contend that incorporating insights regarding the human dimensions into integrated conservation initiatives across working landscapes and seascapes will produce more effective, equitable, appropriate and robust conservation actions. Thus, we encourage governments and organizations working on conservation initiatives in working landscapes and seascapes to increase engagement with and funding of conservation social science.

What makes a perinatal woman suicidal? A grounded theory study

BACKGROUND

Suicide is a leading cause of maternal death during pregnancy and up to a year after birth. Psychological and psychosocial risk factors for maternal suicide ideation and behaviour have been identified but do not account for why mothers begin to experience suicidal thoughts. Qualitative research offers a way of identifying what might drive mothers to initially consider suicide and then go on to act on such thoughts; crucial for the development of assessments to identify, and interventions to target, maternal suicide ideation and behaviour. We aimed to develop a grounded theory outlining what makes women think about suicide and/or engage in suicidal behaviour during pregnancy and the first 12 months following birth?

METHOD

Semi-structured interviews were conducted with 12 mothers in the UK who had suicidal thoughts during pregnancy and/or the first year following birth. A constructivist approach to grounded theory was adopted which guided the data collection and analysis processes.

RESULTS

We developed a model outlining the theorised process of psychological factors that culminates in mothers experiencing suicidal thoughts and then making a suicide attempt during the perinatal period. The process was initiated when mothers felt attacked by motherhood which led to feeling like a failure, self-identifying as a "bad mother" and subsequent appraisals of entrapment and/or defeat. When nothing resolved the distress and as mothers collated reasons for why they perceived they needed to die, suicidal behaviour became a viable and appealing option. We theorised that mothers might make a suicide attempt when they entered a state of intense "darkness" brought on by a trigger, followed by a temporary lapse in the conflict between the desire to live and desire to die and an opportunity to attempt.

CONCLUSIONS

Participants stressed the rapid onset of suicidal thoughts. We suggest that healthcare professionals enquire about the mother's feelings towards the baby and of isolation, how she views herself as a mother, feelings of entrapment and defeat during routine contacts to aid identification and prevention of suicidal ideation/behaviour. Suggested interventions to prevent suicidal thoughts and behaviour include helping women manage their expectations for pregnancy and the postpartum period.

Power, politics, and culture of marine conservation technology in fisheries

The term conservation technology is applied widely and loosely to any technology connected to conservation. This overly broad understanding can lead to confusion around the actual mechanisms of conservation in a technological system, which can result in neglect and underdevelopment of the human dimensions of conservation technology. Ultimately, this hinders its effectiveness as technological fixes for conservation problems. Through a process of concept mapping based on key case studies and literature, I devised precise definitions of marine conservation technology and technological marine conservation system. Concerns about the use of marine conservation technologies included unintended consequences, halfway technologies that address the symptoms but not the causes of problems, and misguided techno-optimism (i.e., technology is a panacea that can solve any problem). Technology and technological systems can have power, politics, and culture, and these characteristics can influence the contextual fit of a technology, requiring that technology be thoughtfully created or adapted to the circumstances in which it will be used. Power, politics, and culture inherent in technology can also influence the distribution of conservation risks and benefits and potentially widen gaps in wealth, privilege, opportunities, and justice. Addressing these concerns can potentially be achieved through the better integration of social sciences in marine conservation technology and technological marine conservation system design and development and the application of the social-ecological-technological systems framework. This framework melds key concepts from the socioecological systems framework and science and technology studies. It recognizes as and elevates technology to be a central actor that can shape societies and the natural world. Such a framework incorporates broader understanding, so that the values and concerns of society are more effectively addressed in the creation and implementation of marine conservation technologies and technological marine conservation systems.

Isolation, marginalisation and disempowerment - understanding how interactions with health providers can influence smoking cessation in pregnancy

Background

Maternal smoking during pregnancy can lead to serious adverse health outcomes for both women and their infants. While smoking in pregnancy has declined over time, it remains consistently higher in women with lower socioeconomic circumstances. Furthermore, fewer women in this group will successfully quit during pregnancy.

Aim

This study explores the barriers to smoking cessation experienced by socially disadvantaged pregnant women and investigates how interactions with health providers can influence their smoking cessation journey.

Methods

Women (either pregnant or birthed in the previous 10 years, who smoked or quit smoking in pregnancy) were recruited from a metropolitan public hospital antenatal clinic in South Australia and community organisations in surrounding suburbs. Seventeen women participated in qualitative semi-structured small focus groups or interviews. The focus groups and interviews were recorded, transcribed and thematically analysed.

Findings

Four interconnected themes were identified: 1) smoking embedded in women’s challenging lives and pregnancies, 2) cyclic isolation and marginalisation, 3) feeling disempowered, and 4) autonomy and self-determination. Themes 3 and 4 are characterised as being two sides of a single coin in that they coexist simultaneously and are inseparable. A key finding is a strong unanimous desire for smoking cessation in pregnancy but women felt they did not have the necessary support from health providers or confidence and self-efficacy to be successful.

Conclusion

Women would like improvements to antenatal care that increase health practitioners’ understanding of the social and contextual healthcare barriers faced by women who smoke in pregnancy. They seek improved interventions from health providers to make informed choices about smoking cessation and would like women-centred care. Women feel that with greater support, more options for cessation strategies and consistency and encouragement from health providers they could be more successful at antenatal smoking cessation. If such changes were made, then South Australian practice could align more with best practice international guidelines for addressing smoking cessation in pregnancy, and potentially improve outcomes for women and their children.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-04720-0.

Social Needs Resource Connections: A Systematic Review of Barriers, Facilitators, and Evaluation

INTRODUCTION

Healthcare organizations increasingly are screening patients for social needs (e.g., food, housing) and referring them to community resources. This systematic mixed studies review assesses how studies evaluate social needs resource connections and identifies patient- and caregiver-reported factors that may inhibit or facilitate resource connections.

METHODS

Investigators searched PubMed and CINAHL for articles published from October 2015 to December 2020 and used dual review to determine inclusion based on a priori selection criteria. Data related to study design, setting, population of interest, intervention, and outcomes were abstracted. Articles' quality was assessed using the Mixed Methods Appraisal Tool. Data analysis was conducted in 2021.

RESULTS

The search identified 34 articles from 32 studies. The authors created a taxonomy of quantitative resource connection measures with 4 categories: whether participants made contact with resources, received resources, had their social needs addressed, or rated some aspect of their experience with resources. Barriers to resource connections were inadequacy, irrelevancy, or restrictiveness; inaccessibility; fears surrounding stigma or discrimination; and factors related to staff training and resource information sharing. Facilitators were referrals' relevancy, the degree of support and simplicity embedded within the interventions, and interventions being comprehensive and inclusive.

DISCUSSION

This synthesis of barriers and facilitators indicates areas where healthcare organizations may have agency to improve the efficacy of social needs screening and referral interventions. The authors also recommend that resource connection measures be explicitly defined and focus on whether participants received new resources and whether their social needs were addressed.

Ontological Awareness in Food Systems Education

We observe efforts in Sustainable Food Systems Education and Critical Food Systems Education literature to employ education in ways that seek social and environmental transformation of food systems. Here, we argue that forms of food systems education that are disconnected from awareness of their ontological roots are destined to reproduce the same food systems with the same consequences for life on Earth. This theoretical paper invites discussions that unpack “habits of being” underpinning modern/colonial conceptualizations of food system issues, transformation efforts, and pedagogies. We note the risk of reinscribing, within food systems education, specific onto-epistemological norms and values that are the root of multiple crises facing food systems (separability, global capital, nation-states, humanism). Using the metaphor of the “house that modernity built,” we invite scholars, teachers, learners, and other practitioners to bring explicit attention to how the ontology of Western modernity arises in discourses on food systems and is reproduced through food systems education. We begin by describing this ontological position and its dominance, situating how contemporary transformations in food systems education neglect ontological foundations, and enumerating a set of harms arising from this disavowal. As a beginning, we suggest that fields related to food systems are a compelling place to interrupt a habit of being that denies and disavows even the presence of ontological positions. Food systems educators within postsecondary institutions are entreated to develop their analyses and pedagogical approaches toward a more just and sustainable future that denaturalizes harmful and falsely universalized ontological foundations.

In Vitro Technology in Plant Conservation: Relevance to Biocultural Diversity

Plant diversity is critical to the functioning of human societies, and evidence shows that plant conservation success is driven by integrative approaches that include social and biological factors. Plants have a unique capacity to reproduce asexually, and propagation practices can yield large numbers of plantlets. These plantlets can be used in several ways to fulfil conservation goals including the repopulation of regions with declining densities of threatened species that hold cultural meaning. However, the potential of in vitro technologies in the conservation of plants that hold cultural meaning is understudied. In this paper we focus upon the roles of in vitro technologies in the conservation of plants relevant to biocultural environments and provide an overview of potential knowledge gaps at the interface of in vitro and plants used traditionally, including those meaningful to Indigenous Peoples. We conclude that in vitro technologies can be powerful tools in biocultural conservation if they are deployed in a manner respectful of the socio-cultural context in which plants play a role, but that further research is needed in this regard. We suggest several epistemological points to facilitate future research.