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Socioecological Stressors During COVID-19 Among Urban Refugee Youth in Kampala, Uganda: A Qualitative Descriptive Analysis
Get PDFLimited studies have examined pandemic-related stressors among urban refugee youth in low and middle-income humanitarian countries (LMICs), such as Uganda. We explored the lived experience of COVID-19-related stressors among urban refugee youth in Kampala, Uganda. We analyzed qualitative data (text messages, WhatsApp chats, photos) collected in an interactive mobile health intervention with 346 refugee youth aged 16–24 in Kampala. Findings revealed stressors across socioecological levels: individual (e.g., financial-related distress), social (e.g., limited social interactions), community (e.g., food insecurity), and policy (e.g., unprecedented lockdowns). Findings can inform social work organization pandemic preparedness strategies for economic empowerment and social cohesion with youth
Students’ Motivation for Online Learning of English as a Second Language Through the Lens of the Self-Determination Theory
Get PDFLearning English as a second language (ESL) can be challenging for students, so it is essential to keep them motivated. One way to motivate students is through electronic programs (e-programs) that can enhance their motivation to learn. This research examined student learning motivation through the lens of the self-determination theory (SDT), with 39 preparatory-year students participating and learning in a blended context. Nine students were interviewed regarding their motivation to learn English using the electronic program, and both quantitative and qualitative research methods were used to examine participants’ motivation to learn English in that context. The quantitative results indicated that each of the six motivational components levels were normal, with only the competence satisfaction domain significantly differing based on English ability. In addition, research results indicated that only autonomy satisfaction showed significant differences among preparatory-year students due to technology ability. Qualitative results revealed both positive and negative perceptions of the e-program among preparatory-year students, with positive aspects enhancing students’ ESL learning experience while negative aspects helped contribute to dissatisfaction and frustration in motivational domains. We recommend that e-programs adopt the positive properties revealed by the present study, as the inclusion of these activities involves different aspects of language, and—at the same time—tries to overcome its negative properties. It was found that limiting student freedom is specifically related to open-ended questions
Falls Prevention in a Psychiatric Setting
Get PDFThe project is a staff education initiative designed to improve the knowledge of psychiatric mental health clinicians regarding fall prevention. The gap in practice was the staff’s knowledge deficit in fall prevention. The staff’s knowledge deficits result in inconsistent prevention strategies. The practice-focused question guiding the project was: Among psychiatric mental health clinicians, does participation in an evidence-based fall prevention education program increase knowledge of fall prevention strategies as compared to pre- to post-education? The purpose of the project was to improve clinician knowledge of psychiatric-specific fall risks and evidence-based prevention strategies. The analytical strategies utilized in the project included pre- and post-surveys assessing knowledge (multiple-choice) and self-reported confidence (Likert scale 1–5). The major product for the project was the implementation of structured staff education programs, which included the use of PowerPoint presentations, brief booster sessions, and interactive modules. The utilized descriptive statistics measured changes in the staff’s knowledge. Results showed a mean knowledge score increase from 3.2/5 to 4.6/5, and confidence scores increased from a mean of 2.8 to 4.4, indicating measurable gains in their understanding of fall prevention strategies. Recommendations included integrating the programs into the orientation of new staff and periodic refreshers for the current staff. The project supports the utilization of evidence-based nursing practice, promotes patient safety, and supports equity, inclusion, and diversity through standardizing
Exploring the Impact of Antidiscrimination Laws on Child-Welfare Workers Working With LGBTQ Foster Youth
Get PDFLesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are overrepresented in the foster care system and have unique needs compared to their peers. In the state of Virginia, there is an antidiscrimination policy that protects LGBTQ foster youth; however, it is unclear how this impacts child welfare workers. Past literature has explored the needs of LGBTQ youth, the experiences of foster parents, and policy implications, but not the impact of antidiscrimination laws on child welfare workers. The purpose of this generic qualitative study was to explore the understanding of child welfare workers’ knowledge, integration, training, and implications of Virginia’s antidiscrimination laws regarding LGBTQ foster youth. Roe’s narrative policy framework was used to evaluate child welfare workers\u27 narratives on the macro, meso, and micro levels. Starting with convenience sampling and then using snowball sampling, 10 child welfare workers, who were current employees of the Virginia Department of Social Services and had experience in foster care, were recruited to participate in semi-structured interviews. Data analysis followed Saldaña’s inductive coding process, utilizing both first- and second-cycle coding to uncover four main themes: knowledge of policy but inability to articulate it, resources needed, the impact of federal, state, and local politics, and training experiences. The findings of this study can be used to promote positive social change by informing policymakers and leaders on the importance of implementing training related to Virginia’s antidiscrimination law, thereby potentially creating more competent child welfare workers
A Qualitative Study of Medical Cannabis Policy for Multiple Sclerosis in Kansas and Colorado
Get PDFMedical cannabis may alleviate symptoms associated with multiple sclerosis (MS), yet access to cannabis-based treatment (CBT) remains inconsistent across U.S. states. The research problem was that state policy variation and administrative implementation produce inequitable access and clinical uncertainty for individuals with MS and for clinicians and policymakers responsible for compliant care decisions. Existing literature on cannabis for MS primarily addresses symptom relief, including spasticity reduction, pain relief, and improved sleep quality; however, access policies vary by state. The purpose of this qualitative systematic review was to synthesize evidence on policy and administrative barriers shaping access to medical cannabis for MS by comparing Kansas (CBT prohibition) and Colorado (CBT legal). Interest group theory guided the analysis of stakeholder influence and regulatory environments that shape physician engagement and access conditions. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures, 17 sources, including scholarly articles and legislative testimony published between 2015 and 2025, were identified, screened, and thematically analyzed. Six themes emerged linking legal context, knowledge gaps, professional division, education, documentation/communication, and policy learning/standards to MS-specific access. Findings reflected legislative and administrative ambiguity and interest-group pressures shaping clinical decision-making related to CBT for MS and other conditions. Implications for positive social change include strengthening policy advocacy and clinician education in jurisdictions where CBT remains illegal for MS symptoms to reduce disparities and support equitable MS care
HIV Pre-Exposure Prophylaxis Uptake and Continuation Among 15-24-year-old Women in Mulago, Uganda
Get PDFYoung women in Uganda face disproportionately high HIV risk compared to the general population. While pre-exposure prophylaxis (PrEP) demonstrates proven effectiveness, poor uptake and nonadherence limit its potential impact. This study examined the relationship between perceived HIV susceptibility, PrEP benefits, behavioral risk factors, service delivery models, and PrEP uptake and continuity among young women aged 15–24 in Uganda, guided by the health belief model. Data were ed from surveillance records at Mulago National Referral Hospital’s STI clinic from January 2024 to September 2025. Of N=23,765 young women screened (median age 21 years; 98.9% single or separated; 48.7% with primary education), 99.5% accessed screening through community-based services. However, only 3,958 (16.7%) initiated PrEP. Perceived HIV susceptibility was negatively associated with PrEP uptake (aOR = 0.60, 95% CI 0.55–0.65). All sociodemographic characteristics except marital status were significantly associated with PrEP uptake. HIV and STI incidence rates were 1.10 (95% CI 0.71–1.71) and 7.52 (95% CI 6.35–8.92) per 100 person-years at-risk, respectively. STI incidence was 61% (aIRR = 1.61, 95% CI 1.14-2.29) higher among participants with post-primary education than among those with primary education or less. Participants who were not married had a three-fold increase (aIRR = 3.25, 95% CI 1.32-7.99) in HIV incidence compared to those who were married. Only 117 (25%) were active on PrEP after 12 months, equivalent to a continuity rate of 6.48 (95% CI, 5.41 –7.77) persons per 100 person-years. The identified gaps indicate the need to strengthen PrEP adherence support and address misconceptions about HIV risk among young women in Uganda
Polypharmacy in the Geriatric Population
Get PDFThe project entailed the development and review of a clinical practice guideline (CPG) for reducing polypharmacy in the geriatric patient population. Polypharmacy is associated with increased risk of adverse drug events (ADEs) such as drug-drug interactions, poor adherence to pharmacotherapy, and increased risk of falls. Additionally, polypharmacy tends to increase high hospitalization rates and emergency department (ED) visits. From a nursing practice perspective, polypharmacy worsens patient outcomes and increases nurses’ workload and healthcare costs for patients. The purpose of this project was to develop a CPG with evidence based recommendations on how to reduce polypharmacy among older adults. The practice-focused question was “What evidence based on content expert review using the AGREE II tool, supports the quality and usability of the clinical practice guideline to reduce polypharmacy among geriatric patients in an outpatient mental health clinic?” The CPG was presented to six healthcare experts who, using the AGREE tool, found the six domain averages were between 6.39 and 6.71 and stated the guideline was well-developed and included clear recommendations that were relevant to nursing practice. These included steps nurses should follow while initiating polypharmacy management, screening patients for polypharmacy, deprescribing medications, and providing follow-up and monitoring. Therefore, the adoption of the proposed guideline into nursing practice can help promote individualization of psychotherapy and, in turn, enhance equity and inclusivity in geriatric care
Enhancing RN Confidence in Early Recognition and Treatment of Sepsis
Get PDFBackground: Sepsis is a leading cause of mortality in U.S. hospitals, with delays in recognition and treatment significantly contributing to poor patient outcomes. Nurses are essential to early identification and timely intervention; however, gaps in confidence and preparedness persist, particularly among newly hired staff. Traditional educational approaches may be insufficient to support rapid clinical recognition and evidence-based management. Purpose: This staff education project evaluated whether participation in a virtual sepsis escape room during general nursing orientation improved newly hired nurses’ confidence in early identification and treatment of sepsis. Methods: A virtual escape room was integrated into an existing general nursing orientation program at a healthcare organization. Newly hired inpatient nurses participated in the intervention during their first week of orientation. Learner confidence was measured using pre- and post-intervention Likert-scale surveys assessing sepsis recognition, initiation of appropriate interventions, application of the sepsis bundle, communication with the healthcare team, and clinical reasoning. A total of 122 learners completed the pre-intervention survey, 121 participated in the virtual escape room, and 116 completed the post-intervention survey. Results: Pre-intervention data demonstrated low baseline confidence in sepsis identification and management. Post-intervention results showed increased confidence across all domains. Mean confidence scores increased from 2.88 pre-intervention to 3.60 post-intervention (+0.72). The greatest improvement was observed in initiating appropriate interventions for patients with suspected sepsis (+0.88). Performance data from the virtual escape room demonstrated high accuracy in early identification of patient deterioration but lower accuracy in evidence-based treatment components, including fluid resuscitation and escalation of care. Conclusion: Implementation of a virtual sepsis escape room during nursing orientation significantly improved learner confidence in early recognition and management of sepsis. Gamification-based education represents a feasible, and sustainable strategy for staff development that supports clinical competency, critical thinking, and timely evidence-based care. This approach has the potential to improve patient outcomes and reduce health disparities by promoting consistent early identification and prompt treatment across diverse patient populations
Investigating Sex Offenders’ Experience of Being Registered as a Sex Offender
Get PDFIn society, sex offenders are subject to unforeseen consequences of the sex offender registry. The purpose of this qualitative study was to investigate how the sex offender registry contributes to the mental distress of registered sex offenders and their concerns about recidivism. This study addressed a gap in understanding the sex offender registry experiences from the offender’s perspective. The research question addressed how adult male registrants describe their experiences of mental distress associated with registration and how they perceive registration as shaping their risk of reoffending. The theoretical framework was John Braithwaite’s reintegrative shaming theory, with a specific focus on disintegrative shaming, which refers to society labeling a person based on previous behavior. For recruitment, 513 postcards were sent to registered male sex offenders in Ohio. The study used a semi-structured interview with a homogenous sample of adult male registered sex offenders who had only adult victims and who had been on the registry for at least 6 months. Interpretative phenomenological analysis was used to analyze the participants’ interviews. This led to four themes: hardships, mental distress, social treatment, and support system. The findings suggest unintended collateral consequences, isolation, and psychological harm that undermine reintegration. Policy responses may be more effective if they differentiate risk, reduce blanket restrictions, and invest in community support. If parole/probation officers are better informed about the hardships that offenders face, even those indirectly caused by their efforts to ensure public safety, this could lead to changes in their current policies and procedures, as well as how they manage specific requirements
Graduates’ Perceptions of Their High School Career Technical Education Work-Based Learning Experiences
Get PDFLittle is known about how career and technical education (CTE) work-based learning (WBL) programs support student academic achievement and workforce outcomes. Guided by Kolb’s experiential learning theory, the purpose of this basic qualitative study was to explore high school graduates’ perceptions of their CTE WBL experiences and to identify how completing a CTE WBL program supported and hindered their academic and workforce achievement. Ten graduates of CTE WBL programs were recruited via postsecondary CTE school outreach, Facebook, and LinkedIn groups and participated in a semistructured interview. Thematic analysis using open coding was conducted. The data analysis resulted in three identified themes encapsulating recent CTE WBL graduates’ perceptions: (a) instructional design translated into applied learning that bridged classroom and workplace; (b) WBL experiences catalyzed growth in resilience, critical thinking, and motivation; and (c) WBL equipped them with portable skills and credentials for workforce entry. These findings indicate positive personal, academic, and vocational outcomes for CTE WBL graduates. The implications for positive social change may include enabling practitioners to better inform CTE WBL students about success habits to maximize individual learning and encouraging intentional use of Kolb’s experiential learning theory to strengthen teaching and learning practices to improve systemic coordination and alignment between CTE programs and WBL sites