This article examines how the use of "draw and tell" as a research method can support adolescents in communities experiencing high levels of socio-economic disadvantage to articulate complex educational trajectories that are often underrepresented in academic literature. The paper presents the findings of qualitative data gathered as part of a wider research study situated in the Irish context which utilizes a multiple case-study approach to examine the role of literacy as a socio-cultural practice in students' educational trajectories from primary school to higher education. The study involved forty-one young people (aged 10-17) attending urban primary and secondary schools identified by the Irish government as experiencing the highest levels of socio-economic disadvantage under the Delivering Equality of Opportunity in Ireland (DEIS) program. "Draw and tell" sessions invited students to depict and narrate their experiences of using literacy skills such as reading, writing and speaking in school. "Draw and tell" sessions were audio-recorded and analyzed thematically using a reflexive, inductive approach. Three interrelated themes emerged within the findings: (1) "draw and tell" functioned as a catalyst for communication and empowerment, enabling students to use drawings as low-stakes mediating artifacts through which they could express complex feelings and emotions; (2) "draw and tell" acted as a tool for students to explore their sense of identity and belonging across the continuum of education; and (3) "draw and tell" provided a medium for young people to conceptualize care in education, highlighting their experiences of both instructional and relational forms of care. The findings demonstrate that "draw and tell" can democratize the research space with adolescent research participants, enabling agency to be redistributed in ways that conventional interview or survey approaches can fail to allow for. The paper argues for wider use of creative, youth-centered methodologies in research and policy in order to better understand and address the cumulative nature of educational inequality in communities experiencing high levels of socio-economic disadvantage.
Adolescents with intellectual disabilities are at increased risk of experiencing and displaying inappropriate sexual behaviours, while parents in culturally sensitive settings often lack adequate guidance for managing them. This study examined how Indonesian parents recognise and manage inappropriate sexual behaviours among adolescents with intellectual disabilities within culturally embedded contexts. A qualitative descriptive design with a case-study orientation was employed. Semi-structured interviews were conducted with 10 mothers of adolescents with intellectual disabilities in Indonesia between October and December 2024. Data were analysed using reflexive thematic analysis to examine emotional responses, behavioural management strategies, and parents' support needs. Parents reported diverse inappropriate sexual behaviours occurring during daily routines and described difficulty distinguishing normative from problematic actions. Emotional reactions included shame, panic, fear of judgment, and anxiety about exploitation, shaped by cultural and religious expectations of modesty. Parents resorted to reactive strategies such as correction, supervision, environmental control, and consistent reinforcement, but lacked structured guidance and culturally appropriate resources. They expressed strong needs for hands-on training, clear behavioural criteria, visual teaching tools, and coordinated support between families and schools. The findings highlight the emotional and cultural complexity of parental responses to inappropriate sexual behaviours and underscore the need for culturally grounded, family-centred interventions. Strengthening parental capacity through tailored training and collaborative frameworks is essential to improving behavioural management and safeguarding adolescents with intellectual disabilities.
The history of AIAN people in the US has been told many times, but Western academic researchers have failed to shift that history into wisdom and uncover teachings for living in the present day. The aim of this paper is to document Indigenous elders' childhood experiences and stories, and to record the wisdom they wish to pass on to the next generation in an accessible, written form. This study used elder-centered research methods situated within a postcolonial paradigm. Methods centered on the lived experience and values of Indigenous people and a three-step process of identifying data, developing a methodology, and validating wisdom messages in a visual model. Participants were recruited for this study through existing connections and prior research experience. Inclusion criteria for participants were: (1) elder status in their community/Tribe, (2) willingness to share a story from childhood and wisdom, and (3) validate stories and the visual model presented in this manuscript. There were two open-ended questions asked during the information gathering interviews: (1) "Tell me a story from your childhood," and (2) "What is some wisdom you want to pass on?" Fourteen stories (vignettes) are presented in this section along with a visual model that highlights primary messages (themes). Past, present, and future messages from stories are illustrated using an Indigenous Life Course timeline against the backdrop of colonial events and American Indian policy. This study supported the transmission and continuation of Indigenous knowledge systems, lifeways, practices, traditions, values, and experiences that are often lost or never recorded. This study illuminates the life stories of elders who possess deep resilience and strength and have experienced the devastating impacts of colonialism and the loss of land, language, values, and family systems. Combined, these wisdom messages have the potential to heal individuals, inform community-based programs, and elevate Indigenous knowledge in public health. Elders' deep wisdom and legacy are reflected in what they wanted to share with readers, a call to action about how to live: Keep Praying. You Have A Voice. Go Back to the Old Ways, Share Your Stories About How to Live, Walk in Beauty. Love Your Family, Limit Technology, Protect the Land, and Medicines. Deal with Pain, Practice Ceremony and Self-care, Live in Balance. Pray, Help People, Commit to Something. Practice Ceremony, Forgive, Heal from Losses, Be Generous, Help Others, Seek Happiness.
Artificial intelligence is quietly reconfiguring the landscape of drug discovery. It sharpens the search for new targets, refines lead compounds, and helps tailor clinical trial designs. Behind these advances sits a family of methods-convolutional, recurrent, and graph neural networks, generative adversarial networks, variational autoencoders, diffusion models, and Transformers-that has found its way into every stage of the pipeline. Tasks that once demanded years of trial and error, from pulling meaningful features out of molecules to predicting drug-target affinity and crystal structures with polymorph stability, now run faster and often with greater accuracy. This early insight lets researchers flag solid-form properties that influence bioavailability and manufacturability, trimming timelines and, in principle, lifting success rates. To map a field that keeps shifting shape, we searched PubMed, Web of Science, Scopus, and Google Scholar for peer-reviewed reports published between January 2007 and April 2026. The story the clinical cases tell is double-edged: one AI-discovered candidate has reached Phase IIa with encouraging efficacy, another stalled in Phase I when safety signals surfaced. AI can catch adverse effects earlier in toxicity assessments, yet nagging hurdles endure-biological complexity, patchy data, and a shortage of scientists fluent in both machine learning and pharmaceutics. Digging ourselves out will demand data standardization, nimble regulatory frameworks, and cross-disciplinary training. Weaving multimodal data together with explainable AI is becoming non-negotiable for transparency and regulatory confidence. The technology is now stretching into complex systems like Traditional Chinese Medicine and natural product screening. As AI continues to mature, it will reshape drug development in ways we are only beginning to grasp, but one truth remains stubborn: clinical translation still rests on rigorous experimental evidence.
Ongoing calls for more inclusive, child-centered research practices have led social work, psychology, and medical researchers to develop child-sensitive approaches when working with younger populations, especially disabled, neurodiverse, gender-creative, or other explicitly minoritized children. Using the theoretical frameworks of being and becoming, growing sideways, and queer potentiality, this article provides a practical guide for designing and implementing Make-and-Tell, an arts-based method that prioritizes children's agency and inclusivity. Drawing on two studies I conducted with children ages five to ten years old, many of whom were neurodiverse and all of whom identified as gender-creative, I outline step-by-step procedures, strategies for addressing common challenges, and reflections on ethical and practical considerations. This guide is intended to support researchers in creating child-oriented research protocols that accommodate the specific ages, abilities, and needs of participants.
Dental anxiety in children is a multifactorial condition influenced by biological, psychological, and environmental determinants. It is commonly associated with uncooperative behavior, compromised treatment outcomes, and negative attitudes toward dental care. To address these challenges, a wide range of non-pharmacological behavior management techniques have been developed and applied in pediatric dentistry, including Tell-Show-Do (TSD) and Audiovisual Distraction (AVD), both of which aim to reduce dental anxiety and enhance cooperative behavior during treatment. Despite their extensive clinical use, comparative evidence on their effectiveness in Greek pediatric patients remains limited. A prospective, non-randomized, comparative exploratory study was conducted in a private dental clinic in Athens, Greece, involving 50 children aged 4-15 years, who were allocated to the TSD or AVD group using a non-randomized allocation procedure intended to balance group sizes; allocation concealment was not implemented. Children's anxiety and cooperative behavior during dental treatment were assessed in real time by an observer not involved in the clinical procedure, using the Venham Behavior Rating Scale (VBRS) and the Venham Clinical Anxiety Scale (VCAS). Demographic and procedural variables were also collected. Statistical analysis was performed using descriptive statistics and the Mann-Whitney U test, with significance set at p < 0.05. Between-group differences were reported with effect sizes (Cliff's delta) and 95% confidence intervals to quantify magnitude and precision. Fifty children (mean age 9.8 ± 2.5 years) participated in this study. Both techniques were associated with low anxiety levels and improved cooperation during dental treatment. No statistically significant associations were observed in this sample; however, the study may be underpowered to detect small-to-moderate effects, estimates were imprecise, and residual confounding could not be excluded. No statistically significant between-group differences were detected in this small, non-randomized clinic sample; equivalence cannot be inferred. These findings contribute population-specific data from Greek children that may support individualized behavior management in routine clinical settings and guide future, larger comparative studies.
Dental anxiety significantly affects the delivery of dental care in children, often leading to poor cooperation. Behavior management techniques such as Tell-Show-Do (TSD), Reverse TSD (RTSD), and RTSD with Filmed Modeling (RTSD + FM) are commonly used to reduce anxiety and improve co-operation, but limited evidence exists comparing their effectiveness in highly anxious children. To evaluate and compare the effectiveness of TSD, RTSD, and RTSD with FM in reducing dental anxiety among children aged 4-8 years. This randomized controlled trial included 45 anxious children aged 4-8 years (Venham's Picture Test [VPT] ≥4) who were randomly assigned to three groups: TSD, RTSD, and RTSD + FM ( n = 15 each). Pulse rate, oxygen saturation, and dental anxiety (VPT) were recorded before and after treatment, and data were analyzed using the one-way ANOVA, Kruskal-Wallis, and post hoc tests. Subsequent to the intervention, all three groups showed statistically significant decrease in VPT scores and pulse rate. While RTSD and RTSD + FM demonstrated greater mean VPT reductions than TSD, RTSD had the largest mean pulse rate reduction. However, neither the VPT score nor the pulse rate showed statistically significant intergroup differences. In children aged 4-8 years, TSD, RTSD, and RTSD + FM all significantly reduced dental anxiety. Although RTSD methods showed greater numerical reduction, the difference was not statistically significant, indicating that all three techniques are effective for managing dental anxiety.
This study examined how county-level decision-making shaped implementation and accessibility of an opioid-settlement-funded health vending machine (HVM) in California. We conducted approximately 250 hours of ethnographic fieldwork and qualitative interviews with 17 HVM users. Using constructivist grounded theory, we analyzed the data to explore how structural and political dynamics influenced program awareness and engagement. Three themes emerged: (1) county leadership placed the HVM in a low-visibility location to minimize anticipated political and organizational backlash to harm reduction; (2) additional implementation decisions, including minimal signage and a high-barrier registration model further limited awareness and engagement; and (3) these overlapping barriers constrained participants' ability to obtain health supplies, undermining the intervention's ability to achieve its goals. Structural constraints, agency-level discretion, and fears of political and social backlash significantly reduced the effectiveness of an opioid-settlement-funded HVM. Even when funds are allocated for evidence-based strategies, implementation shaped by stigma or risk aversion may restrict access for people who use drugs. Transparent processes, accountability, and meaningful community involvement are essential to ensure settlement investments advance their goals of reducing overdose and infectious disease harms.
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Background: US service members and Veterans are at elevated risk for firearm suicide. Understanding to whom they disclose suicidal thoughts and/or plans is important to inform suicide prevention efforts. Aims: To better understand the extent to which military and Veteran firearm suicide decedents disclose their suicidal thoughts to others as well as how disclosure differ by sex and race. Methods: This study uses a subset of data from the National Violent Death Reporting System (NVDRS) to better understand frequency of disclosure of suicidal thoughts and/or plans among military service members and Veterans who died by firearm suicide, and explore which sources were disclosed to. Results: A total of 28,600 individuals with a history of military service died by firearm suicide from 2013 to 2021, and 21.2% disclosed suicidal thoughts and/or plans in the month prior to their death. The most common disclosure source was a family member (30.5%). Limitations: Limitations include missing data and an inability to distinguish between those with current and former military status. Conclusions: Findings suggest that the majority of military and Veteran firearm suicide decedents do not disclose suicidal thoughts in the month prior to their death. Those who do make disclosures tend to choose nonprofessional sources. Given this, community-based primary suicide prevention efforts may be key in helping reduce firearm suicide risk.
Sibling sexual behaviour and abuse (SSB/A) is common and has adverse effects not only to the child who is harmed and the child responsible, but the whole family unit is deeply impacted. The study aimed to understand how SSB/A is experienced by parents and what impact SSB/A has on parents. A secondary qualitative design was used to examine 22 narrative stories written by parents (primarily mothers) about their experience of SSB/A that were submitted to #SiblingsToo, a Canadian organisation dedicated to raising awareness of SSB/A. Thematic analysis was used to analyse all narratives. SSB/A produces multifaceted disruption across the family system, with parents describing emotional, relational and practical consequences in the aftermath of disclosure or discovery. Parents framed SSB/A as an event that changed their understanding of their family, forcing them to renegotiate family roles, restructure daily routines and confront intense feelings of guilt, shame, fear and self-blame, exacerbated in some circumstances by gendered expectations. Parents also reported the burden of navigating divided loyalties, while trying to maintain safety, stability and emotional availability. The strain of these competing demands frequently intersected with challenges in accessing professional support, particularly where services were experienced as inadequate, retraumatising, or focused primarily on the harmed child. This study contributes important new insights into the experiences of parents whose families have been affected by SSB/A. Through a collection of written narratives, the findings demonstrate that SSB/A constitutes a family-level negative impact that reshapes parents' emotional landscapes, daily routines, relationships and caregiving roles.
In this narrative medicine essay, a pediatric hospital medicine and pediatric infectious disease physician stilled by an Achilles tendon rupture compares his wish to expedite healing with pushing early-career physicians, a push that can delay recovery and careers, respectively.
HIV pre-exposure prophylaxis (PrEP) is not widely available in India. We explored the needs and perspectives of men who have sex with men (MSM) and transgender persons about PrEP in Delhi, India. We accessed these key populations through targeted intervention (TI) projects for HIV prevention in Delhi. We conducted three focus group discussions (FGD) with community members, and four in-depth interviews (IDI) with key informants. We coded them using deductive and inductive reasoning, including constructs from the information-motivation-behavioural skills model for HIV prevention. Eleven MSM and 16 transgender persons (median age 24 years) participated in FGDs. Participants were mostly unaware of PrEP and considered condoms the mainstay of HIV prevention. Upon explaining PrEP, they considered adopting it as additional protection. Participants stressed the need to disseminate information about it through social media and dating apps. Motivation to adopt PrEP could be influenced by long-term partners, side effects, privacy and stigma. Adherence and concomitant condom use would be behavioural challenges. Affordability could be a barrier for access. For PrEP scale-up in India, the health system would need to communicate risks and benefits to key populations, integrate PrEP with HIV preventive services, consider product preferences, and ensure financial support and confidentiality.
Pollinators, both wild and managed, form diverse associations with plants and microbes which affect the wellbeing of the plants and the pollinators. The method by which these associations are sampled impacts our understanding of the system. The common ways to understand pollinator-plant or pollinator-plant-microbe associations are to observe flower visits of insects, or to collect foraging individuals and identify the pollen and microbes they carry. Honey bees offer a test case for methods of sampling these associations. Hives of managed honey bees host thousands of pollinator individuals together with jointly-collected nectar which is turned into honey. Previous studies have used DNA preserved in honey to infer honey bee associations with plants and microbes. Here, we sampled honey, individual bees while they were foraging, and groups of bees from inside the hive. We identified plants and microbes on the surface of the bees or in the honey using DNA metabarcoding - expecting that bees sampled singly or in groups would reveal a subset of the associations recorded in the communal honey deposits. However, we found that each sample type revealed different aspects of the richness and community composition of plants and microbes encountered by bees. Both honey samples and hive bees had more plant and microbial taxa per sample than samples of individual bees. Though individual bees are subsets of the larger colony, pollen and microbe associations recovered from individual bees did not represent a subsample of associations recovered from groups of hive bees or from honey. Thus, while each sampling technique provides information about honey bee ecology, they are not equivalent. DNA in honey represents time-integrated associations between bees and the surrounding ecosystem; the hive bees provide a snapshot of current colony-level associations, and individual foraging bees capture intraspecific variation in foraging preferences and microbe exposure.
Arthroscopic-assisted lower trapezius tendon transfer has emerged as a compelling joint-preserving solution for massive irreparable posterosuperior rotator cuff tears, yet the field has lacked a robust framework for interpreting what constitutes a meaningful patient outcome after this procedure. Establishing procedure-specific minimal clinically important difference and patient acceptable symptom state thresholds in this setting is both timely and necessary. When such thresholds are derived, however, they must be understood as cohort-specific constructs that cannot be universally applied across patient populations, institutions, or surgical techniques. The teres minor remains a critical variable in outcome prediction, and its preoperative trophicity should be a central element of the shared surgical decision-making process.
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