Search Results (3,103)

Background: Patellofemoral pain (PFP) is a prevalent overuse injury among recreational cyclists worldwide. Despite its ubiquity, little is known about the lived experiences of people with PFP, especially in Saudi Arabia, where healthcare and cultural factors may have a specific impact on how the condition is managed. The aim of this study was to explore the lived experiences of recreational cyclists with patellofemoral pain in Al Madinah, Saudi Arabia. Method: A qualitative, descriptive design using reflexive thematic analysis was employed. Eleven male recreational cyclists aged 28–44 years diagnosed with PFP were purposely recruited from Al Madinah Physical Therapy Centre. Female participants were excluded due to cultural constraints regarding sports participation. The participants consented to participate in the study and to be audio recorded. Data were collected through semi-structured interviews using an interview guide. The interview data were transcribed verbatim and thematically analysed using Atlas.ti, version 24. Results: The thematic analysis revealed six themes highlighting the multidimensional impact of PFP. The participants described localised mechanical impairment with rapid onset during activity and persistent symptoms lasting up to two weeks. Pain was exacerbated by eccentric loading and cycling-specific stressors, such as uphill riding, leading to significant anxiety and avoidance behaviours. To maintain activity, these cyclists employed adaptive strategies, including bike modifications and self-management. Notably, PFP imposed substantial cultural and social burdens, hindering spiritual practices, specifically Salah (prayer) postures, professional duties, and family caregiving. While the participants demonstrated resourcefulness through a hybrid of physiotherapy and independent research, pharmacological relief was viewed as a transient solution. Conclusions: Patellofemoral pain imposes significant multidimensional burdens on recreational cyclists in Al Madinah, which are exacerbated by cultural practices. Physiotherapy offers targeted interventions for pain relief, functional restoration, and participation enhancement, necessitating the need for culturally sensitive management programmes. Full article

This study explores parents’ perspectives on self-determination for individuals with intellectual disabilities in the Saudi Arabian context. Using a qualitative approach, semi-structured interviews were conducted with six parents of individuals aged 15 to 34 years, and data were analyzed thematically. Findings reveal a clear tension between parents’ endorsement of self-determination as a valued goal and their emphasis on protection, safety, and family responsibility. Parents supported autonomy through structured choices, gradual skill-building, and daily routines, while restricting higher-stakes decisions due to concerns related to vulnerability and limited institutional and community support. These practices reflect culturally grounded caregiving responsibilities rather than resistance to self-determination. This study highlights the central role of families in shaping self-determination opportunities and underscores the influence of sociocultural values and systemic constraints. Implications emphasize the need for culturally responsive parent training, stronger school–family collaboration, and expanded community-based opportunities that support autonomy within safe environments. Full article

The role of metapragmatics in maintaining interactional coherence and achieving intersubjectivity has been variously underscored in the last three decades. In particular, raising metapragmatic awareness has become increasingly salient in research on intercultural communication and foreign/second language teaching. However, the topic has not been hitherto discussed in connection with heritage languages, and this is a gap that the present paper aims to fill. Based on interviews with Greek Melburnians who belong (in triads or dyads) to the same family but to different generations, a typology of metapragmatic awareness indicators encountered in the data is presented. Quantitative examination of one type of indicators—those oriented towards the addressee—indicates a decrease in their use across three generations. Similarly, examination of the variants of second-person pronouns and/or verb endings (the T/V distinction) brought to the fore alternations in the T and V forms, indicative of linguistic insecurity, as well as an increasing preference for the informal variants across three generations. The qualitative analysis of extracts from the interviews shed further light on the insecurity regarding the T/V distinction. Overall, the results point to changes in the communicative style of Greek Melburnians, namely away from positive politeness features (typical of the Greek society) towards English interactional norms, and the fostering of a hybrid communicative style—in alignment with their hybrid identities. It is suggested that politeness issues be integrated into the teaching of Greek as a heritage language. Full article

Infertility affects 10–30% of couples globally, with significant psychological and social impacts in sub-Saharan Africa, where fertility is closely tied to identity and social status. To explore how couples’ understanding of infertility causes influences their treatment-seeking behaviours and healthcare decision-making processes in Ghana, this cross-sectional qualitative study used in-depth interviews with 24 married participants (nine dyads and six individuals) experiencing current or past infertility in Greater Accra, Ghana, from August to October 2023. Data were analysed using thematic analysis with NVivo version 15. Couples demonstrated comprehensive knowledge of infertility causes spanning medical, spiritual, cultural, and lifestyle factors, although they lacked knowledge of clinical diagnostic criteria. Three main treatment pathways emerged: medical/orthodox, herbal, and spiritual interventions, pursued either sequentially or concurrently. Decision-making was influenced by internal factors (treatment effectiveness, financial constraints, and safety concerns) and external factors (family influence and peer testimonials). Four distinct navigation strategies were identified: informed notification, trial periods and evaluation, parallel relationship management, and strategic sequencing. Couples experiencing infertility are sophisticated healthcare consumers who skilfully navigate pluralistic healthcare systems through strategic decision-making. Rather than representing non-compliance, their multimodal approaches reflect rational responses to structural constraints and cultural values. Healthcare systems should recognise and accommodate these navigation strategies to improve therapeutic relationships and outcomes. Full article

This study documents the ethnomedicinal knowledge of Konak (Malatya, Eastern Anatolia, Türkiye), a region with rich plant diversity but no prior comprehensive research. The aim of the study is to systematically document and analyze the ethnomedicinal practices of Konak village, focusing on plant taxa (species, subspecies and varieties) used, preparation methods, and therapeutic applications. Data were collected through semi-structured interviews with 68 local informants. Quantitative analysis was performed using Informant Consensus Factor (F_IC) and Use Value (UV) indices. Plant specimens were collected, identified, and deposited in the herbarium. The study documented 86 plant taxa from 35 families used in 230 therapeutic applications. Lamiaceae, Asteraceae, and Rosaceae were the most represented families. High F_IC values were recorded for colds (F_IC = 0.95), stomach pain (F_IC = 0.92), and inflammation (F_IC = 0.90), indicating strong community consensus. The most frequently cited species were Origanum vulgare subsp. gracile, Mentha spp., and Rosa canina. There are novel or locally specific uses, with 13 taxa having no previously recorded ethnomedicinal applications in the reviewed literature. The findings reveal Konak as a significant repository of ethnomedicinal knowledge. High-F_IC taxa represent prime candidates for phytochemical and pharmacological research to validate traditional uses and support evidence-based phytotherapy. This study enriches regional ethnopharmacological data and highlights candidate taxa for pharmacological validation. Full article

With the growing demands and expectations associated with professionalised youth sport environments, there is an increasing need for psychosocial development initiatives to support young athletes and their healthy progression. The aim of this study was to extend and investigate the application of the 5Cs framework, a prominent psychoeducational approach in sport psychology, to a youth tennis Talent Development Environment (TDE). Using a collective case study design, five athletes, their parents and two coaches (n = 12) participated in a season-long multimodal 5Cs intervention programme at a British Regional Player Development Centre (RPDC). The 30-week programme was delivered by an embedded sport psychology practitioner (SPP) and incorporated a blocked educational curriculum supported by a range of athletes, coach and parent development strategies. Post-intervention semi-structured interviews were conducted with all participants, with reflexive thematic analysis leading to three overarching themes. Findings highlighted the positive influence of the programme, with perceptions of the framework’s effectiveness associated with its specificity to tennis and individual athlete needs, the collaboration of all stakeholders across the TDE and the use of developmentally accessible and innovative strategies enabling evidence of athlete improvements. Researchers, practitioners and sport organisations are encouraged to consider these impact factors in terms of supporting the development, performance and well-being of athletes and their families in competitive youth sport contexts. Full article

Unsafe behaviors remain a major contributor to workplace accidents within broader safety-management systems. Acknowledging the essential influence of organizational and leadership factors, this study focuses on systematically identifying and prioritizing individual-level determinants of unsafe behavior through an integrated qualitative–quantitative methodology to clarify their specific role within the wider safety framework. Grounded Theory analysis of semi-structured interviews with 40 industry professionals yielded a conceptual model encompassing demographic characteristics, general health, individual competencies, personality traits, and psychological factors. Subsequently, the Fuzzy Delphi Method, applied with 20 domain experts, validated and ranked these determinants. The analysis highlighted risk perception as the most influential factor, followed by work experience, skill level, knowledge, and risk-taking propensity, whereas variables such as family welfare, substance use, and self-display exhibited relatively minor effects. These findings reveal the multidimensional nature of unsafe behavior and underscore the importance of focusing on high-impact personal attributes to enhance workplace safety. By recognizing that many individual factors are shaped by organizational and psychosocial conditions, the study provides evidence-based insights for developing integrated safety management and targeted intervention strategies in industrial settings. Full article

Background: Food insecurity among college students is a multidimensional challenge shaped by individual, interpersonal, institutional, community, and policy factors. Although many campuses require or provide meal plans, students may experience food insecurity when barriers related to agency (choice and autonomy), utilization (nutrition security), and availability persist. This study explored how undergraduate students at a private, urban U.S. university experience and navigate the multiple dimensions of food insecurity. Methods: We conducted in-depth, semi-structured interviews via Zoom between December 2024 and January 2025 with n = 22 undergraduate students recruited based on food security status, determined by a Fall 2024 longitudinal survey using the USDA Six-Item Short Form. Transcripts were double-coded by trained research assistants in ATLAS.ti using an inductive codebook. Thematic analyses followed a phronetic, iterative approach, organizing findings within a socio-ecological determinants framework and comparing themes by food security status. Results: We identified nine themes across four domains (individual, interpersonal, institutional and community, and political). At the individual level, constrained personal resources for groceries and cooking, time scarcity leading to skipped meals, and health impacts that detracted from academics emerged as key themes. Interpersonally, reliable family financial support was protective and informal support from peers/coaches filled gaps sporadically for some. At the institutional and community level, dining hall hours misaligned with student schedules, perceived limited variety and nutrition quality reduced food agency and utilization, and transportation impeded use of the sole grocery partner accepting university meal plan benefits. Notably, meal plans including unlimited meal swipes provided stable access but did not guarantee food security when food agency and utilization barriers persisted. Many students relied on campus events for free food; formal assistance (e.g., food pantry) was largely underused. At the policy level, Supplemental Nutrition Assistance Program (SNAP) awareness and enrollment was limited among our sample. Conclusions: Meal plan access alone is insufficient to ensure food security. Campus strategies should extend beyond access to prioritize flexibility, variety, and alignment with students’ schedules and preferences, while strengthening communication and eligibility support for external benefits. Future work should design and evaluate interventions that integrate all dimensions of food security and address institutional policies affecting students’ basic needs. Full article

Background/Objectives: Emerging evidence suggests that multiple micronutrient supplements (MMS) provide additional benefits for maternal and neonatal health compared with iron and folic acid (IFA) supplements. To achieve effective coverage, acceptability, and adherence—and to inform a nationwide rollout of MMS—it is essential to understand the context-specific factors that shape implementation. This study evaluated the pilot implementation of MMS in Rwanda to identify key enablers, areas for improvement, and challenges related to antenatal care (ANC) attendance and MMS use. Methods: Data were collected through a survey of 3257 women who attended ANC services, seven focus group discussions with 35 ANC attendees, and key informant interviews with 20 ANC nurses and 21 community health workers. Results: Pregnant women reported high ANC attendance (74%) and MMS consumption (79%), largely driven by strong motivation and awareness of MMS benefits. Strategies to remember daily intake and to manage side effects supported adherence, as did reminders, motivation, and information from family members and healthcare providers. Limited patient-centered counselling, financial constraints, barriers to accessing ANC services, and product stock-outs were key areas for strengthening service delivery in Rwanda. Conclusions: Sustaining high ANC attendance and MMS adherence as the program transitions from the pilot phase to national scale-up is essential. Improving counseling quality and strengthening supply chains may reinforce ANC services and support sustained MMS adherence, with benefits for maternal and child health. Full article

Family caregivers provide up to 90% of care in Alberta’s communities and play an essential role in sustaining the province’s health and social care systems, yet they remain under-recognized and insufficiently supported. To address this gap, we co-designed the Alberta Family Caregiver Strategy and Action Plan (2024–2025), a provincial framework developed through participatory research and collective impact methods. Guided by principles of co-production, equity, and lived experience, the project engaged over 500 stakeholders, including caregivers, healthcare providers, educators, employers, and policymakers, through Phase 1 interviews (health/community leaders, n = 44; Family and Community Support Services (FCSS), n = 47; navigation experts, n = 9), Phase 2 co-design team consultations, and Phase 3 sector roundtables (n = 52). Using reflexive thematic analysis, we identified four foundational caregiver strategies, Recognition, Partnership, Needs Assessment, and Navigation, and four enabling conditions: Education, Workplace Supports, Policy and Research and Data Infrastructure. These elements were synthesized into an eight-priority Alberta Caregiver Strategy and Action Plan Framework, a practical way to connect validated priorities with coordinated, measurable implementation across settings. Participants emphasized four key enablers essential to making caregiver inclusion more feasible and sustainable: education, workplace supports, policy infrastructure, and research and evaluation. Findings highlight strong cross-sector consensus that caregiver inclusion must be embedded into routine practice, supported by consistent policy, and reinforced through provincial coordination with local adaptation. The Alberta Family Caregiver Strategy provides a practical, evidence-informed plan for transforming fragmented supports into a coherent, caregiver-inclusive ecosystem that strengthens both caregiver well-being and system sustainability. Full article

Background/Objectives: Children with developmental disabilities (DD) may experience feeding problems that increase their risk of malnourishment. However, data concerning factors linked to feeding problems in children with DD are lacking. The present study aimed to investigate feeding problems and their associated factors in children with DD who are fed orally. This cross-sectional study included data from 160 children with DD aged 2–18 years, recruited from 9 disability centers and schools located in Madinah, Saudi Arabia. Methods: A total of 666 envelopes were distributed randomly to children to take home. Caregivers were asked to provide sociodemographic, health, and nutrition information. Feeding problems were assessed using a validated screening tool for eating/feeding problems (STEP-AR), which included 17 items divided into 5 subdomains (Aspiration risk, Food refusal, Food selectivity, Nutrition behaviors, and Skill). Phone interviews were conducted with caregivers within two weeks of data collection for dietary assessment. Results: The most frequently reported feeding problems involved feeding skills and food selectivity, with 39.3% unable to feed themselves, 33.1% showing overeating behavior, and 31.2% exhibiting pica-like behavior. Chewing difficulties (28.7%), limited food intake (25.6%), and swallowing challenges (21.2%) were moderately reported, while aspiration-related problems were less common. Multiple linear regression analysis revealed significant positive associations between feeding problems and caregiver education level, family income, caregiver’s relationship to the child, and the child’s living arrangement. Dietary intake was not associated with feeding problems. Conclusions: The findings of this study indicate a range of feeding problems and key sociodemographic factors associated with feeding problems in children with DD. These results highlight the need for targeted interventions such as behavioral support and caregiver education to effectively address and manage feeding challenges in children. Full article

Background/Objectives: Von Hippel–Lindau (VHL) disease is a rare autosomal dominant hereditary disorder. Central nervous system hemangioblastomas are one of the most common tumor types associated with VHL disease. Although these tumors are histologically benign, delayed diagnosis and treatment may result in severe neurological dysfunction, permanent disability, and even death. However, little is known about the experiences of patients with VHL disease. The aim of this study was to gain a better understanding of the illness experiences and psychological responses of patients with VHL disease accompanied by central nervous system hemangioblastomas. Methods: A qualitative study based on a semi-structured guide was conducted. Twelve participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method. Results: Four themes and their subthemes were identified: 1. powerlessness—unpredictable disease progression and uncontrollable continuity; 2. negative emotional experiences—guilt and self-blame, depression, and low self-esteem; 3. compromise—acceptance of fate, positive outlook, and sense of hope; and 4. persistent worry—worries about family members, anxiety regarding finances and employment, and uncertainty regarding the future. Conclusions: This study identified four major themes in the illness experiences of patients with VHL disease accompanied by central nervous system hemangioblastomas, which provided deep insights into the care needs of individuals with VHL disease. Healthcare providers should develop effective measures to enhance patients’ ability to maintain a good quality of life and confront the future with resilience. Full article

Knowledge related to the use of plants and mushrooms in the Baranja region of Croatia was documented through semi-structured interviews of 105 informants in 12 villages. We found 117 plant species and 7 mushrooms with medicinal uses. Rosaceae, Lamiaceae, and Asteraceae were the families with the most species, while Sambucus nigra, Chamomilla recutita, and Taraxacum officinale were the most frequently mentioned species. Leaves, fruits, and flowers were the most commonly used plant parts, predominantly prepared as infusions, syrups, and tinctures. Plants were mainly used to treat digestive and respiratory ailments, with the highest informant consensus recorded for ear, eye, and respiratory disorders. The results emphasize the persistence of rich ethnobotanical knowledge in the study area and highlight the importance of preserving this cultural and biological heritage for future generations. Full article

Objectives: This study aims to explore the facilitators and barriers in the process of using AI agents for disease management in older COPD patients. Methods: Based on the normalization process theory, a descriptive qualitative study was used to conduct semi-structured interviews with 28 older patients with COPD recruited from June to August 2025 in a Class A tertiary hospital in Wuxi, Jiangsu Province. Results: A total of 28 interviews were conducted. Four themes (Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring), nine subthemes (recognition of intelligent technology;supported by policy discourse and the background of national-level projects; the creation of a family atmosphere; recommendations from HCPs; relief and social connection; new “doctor”–patient relationship and communication; eliminate the burden and return to life; benefit and value perception; right self-decision by AI) in facilitators and nine subthemes (privacy conflicts and trust deficiency; blurred boundaries of human–machine responsibility and authority; non-high-quality services are chosen reluctantly; technical anxiety; lack of motivation for continued engagement; extra burden; limitations of the physical environment; human–machine dialogue frustration; a sense of uncertainty about the future of AI) in barriers were extracted. Conclusions: This study identified key factors influencing the use of AI agents in chronic disease management in older patients with COPD. The results provide directions for improving the implementation and sustainable use of AI health technologies. Full article

From an interbehavioral and contingential perspective, family dialogues about sexuality are understood as patterns of verbal interaction regulated by social, gender, and caregiving contingencies rather than as individual attitudes or intentions. Background: This study analyzes the functional conditions under which family dialogues about sexuality occur between mothers and their adolescent sons and daughters, considering caregiving roles and gender norms that regulate these interactions. The research aimed to identify the functional relations between communicative practices and the social contingencies that maintain or inhibit them. Methods: A qualitative approach grounded in interbehavioral psychology was employed, using semistructured interviews with 40 mothers of students from a public middle school in Puebla, Mexico. Data were analyzed through contingency analysis, distinguishing micro- and macrocontingential systems related to family sexual education. Results: Results show that, although patterns of avoidance and discourse displacement toward schools or peers persist, families exhibit increasing openness toward comprehensive sexuality education and recognize its preventive value against violence, adolescent pregnancy, and misinformation. Functional delegation and adolescent mediation of dialogue were identified, along with emerging inclusive macrocontingencies linked to the acceptance of diverse families and LGBTIQ+ themes. Conclusions: It is concluded that households function as self-regulated interbehavioral systems in which historical and gender contingencies restrict sexual dialogue, yet gradual functional changes toward respect, inclusion, and shared educational responsibility are observed. Full article