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Context: Rural women in the United States experience disparity in breast cancer diagnosis and treatment when compared to their urban counterparts. Given the 11% chance of lifetime occurrence of breast cancer for women overall, the continuum of breast cancer screening, diagnosis, treatment, and recovery are of legitimate concern to rural women and their primary care providers.Purpose: This analysis describes rural primary care providers' perceptions of the full spectrum of breast cancer screening, treatment, and follow-up care for women patients, and it describes the providers' desired role in the cancer care continuum.Method: Focus group interviews were conducted with primary care providers in 3 federally qualified community health centers serving a lower income, rural population. Focus group participants (N = 26) consisted of 11 physicians, 14 nurse practitioners, and 1 licensed clinical psychologist. Data were generated from audiotaped interviews transcribed verbatim and investigator field notes. Data were analyzed using constant comparison and findings were reviewed with a group of rural health professionals to judge the fit of findings with the emerging coding scheme.Findings: Provider relationships were characterized as being with women with cancer and comprised an active behind-the-scenes role in supporting their patients through treatment decisions and processes. Three themes emerged from the interview data: Knowing the Patient; Walking Through Treatment With the Patient; and Sending Them Off or Losing the Patient to the System.Conclusions: These findings should be a part of professional education for rural practitioners, and mechanisms to support this role should be implemented in practice settings.

The study employed a qualitative multiple case study approach to investigate second-grade students’ perceptions of their classrooms’ physical learning environment. Data were collected through interviews, participant-generated photographs, and observations. Participants in the study were 16 students in four classrooms in three school districts. A physical learning environment tool, Assessing the Pillars of the Physical Environment for Academic Learning (APPEAL), developed by Evanshen and Faulk and published in 2019, was used to select classrooms to participate in the study. According to the scale, the top-scoring classrooms were more learner-centered (more constructivist) than the lowest-scoring (more traditional) classrooms. Generally, participants believed that classroom physical learning environments that were best for them were meaningful, offered easy access to resources and materials, and provided active learning and social engagement opportunities. Both physical and emotional comfort were important to participants. There were more similarities than differences between the participants’ perceptions in the classrooms that scored highest on the APPEAL and the classes that scored lowest. The findings suggested that young children’s perceptions of the environment can be influenced by their experiences or contexts and their differences. The results encourage teachers of young children to think about their students as actively affected by their environment and challenge them to design classroom physical learning environments that support the diverse needs of students within these spaces.

Background: There are many individuals living with chronic illness and therefore follow one or more prescribed drug therapies. It is shown that over 50 percent of these are not adherent to their prescriptions and that low adherence is a growing problem across the world. Earlier research indicates that low adherence leads to decreased health and reduced quality of life. Aim: The aim was to find factors affecting adherence among individuals with chronic illness. Method: A literature study based on empirical qualitative research. The articles were analysed in accordance with Friberg's five step model. Results: Four categories emerged from the analysis of the articles; personal factors, social factors, health care factors and therapy related factors. Individuals' adherences depend on different internal and external factors. Individuals' own ability to follow routines were the most appearing factor for high adherence. Lack of trust in health professionals was the most appearing factor because of low adherence. Other appearing and affecting factors were social support, trust in healthcare and severe side effects. Conclusion: Adherence is a common and complex issue. There are many facilitators and barriers affecting adherence. Increased awareness of different factors can help health professionals to promote high adherence among individuals with chronic illness. / Många personer i världen lever med en eller flera kroniska sjukdomar och behandlas därför med läkemedel. Definitionen av adherence innebär i vilken utsträckning en person är följsam till sin läkemedelsbehandling. Tidigare forskning påvisar att endast 50 procent är följsamma till förskrivna ordinationer. Låg följsamhet är ett växande problem inom Sverige, men även globalt. I resultatet påvisades att en persons motivation, kunskap och förmåga att kunna ta eget ansvar över sin behandling var viktiga faktorer för långvarig och hög följsamhet. Ett socialt stöd från familj och närstående var betydande för hög följsamhet. Religiösa traditioner och stigmatisering i samhället visade sig ofta ha en negativ påverkan på följsamhet. Vårdrelaterade faktorer som påverkade följsamhet var exempelvis information, kommunikation, förtroende för vårdpersonal och behandling samt vårdtillgänglighet. Läkemedelsrelaterade biverkningar var ett bekymmer för upprätthållandet av följsamhet. I analysen som gjordes enligt Fribergs femstegsmodell framkom att faktorer som påverkar följsamhet inte skiljer sig märkbart över världen. Ökad kunskap hos personer och vårdpersonal om hur följsamhet till läkemedelsbehandling påverkas av olika faktorer kan främja följsamhet. Hög följsamhet bidrar till förbättrad hälsa och ökad livskvalitet hos personer med kronisk sjukdom. Det leder även till färre sjukdomsrelaterade komplikationer och färre vårdtillfällen på sjukhus. I resultatdiskussionen framkom att 'förmåga till följsamhet' och 'tillit till vård och behandling' visade sig vara betydelsefulla faktorer som påverkade följsamhet.

Research indicates that the application of historical empathy, defined as using historical evidence to reconstruct past perspectives, engenders critical thinking in students. There is lack of research on the level of comprehension and use of historical empathy as an instructional strategy by high school history instructors. The purpose of this qualitative study was to explore teachers' comprehension and application of historical empathy in 2 high schools. This study was grounded in Edmund Husserl's concept of intersubjectivity, which suggests that apperception facilitates the grasp of multiple perspectives. Research questions addressed history teacher comprehension and employment of historical empathy as a tool to improve students' understanding of multiple historical perspectives. All 7 local history teachers participated in this case study. Data collection included classroom observations that were followed by semi-structured teacher interviews to discuss what was observed. Six themes resulted from open, axial, and selective coding of field notes and interview transcriptions. These themes indicated that participants were unfamiliar with historical empathy, emphasized the necessity of emotion in learning, perceived the need to help students understand historical actors, stressed the need for artifacts and site visits to generate context, and used analogies to develop perspectives. These themes informed the project of a position paper recommending professional development for teachers in historical empathy. Increasing awareness of and developing empathetic instructional strategies within the classroom can foster positive social change by engendering apperceptive skills among local history students and has broader potential to increase the efficacy of museum education and heritage programs.

The problem is children from low socioeconomic status households are often underrepresented in gifted and talented programs. Only a small percentage of these students is selected to participate in the district's gifted program. The purpose of the study was to help appropriately identify and include low SES children in the district's gifted program. The social constructivist foundation was applied for a better understanding of how the environment affects a child's learning and how social factors contribute to cognitive development, which could possibly alter the perceptions of how successful children can be. The guiding questions revolved around the teachers' perceptions of elementary (K-6) gifted and talented program's identification process in finding all children in need of advanced curriculum and instruction regardless of socioeconomic status level. A qualitative case study is designed to collect data from 6 elementary gifted and talented teachers from 1 district. Information was gathered through interviews, then transcribed and through the lens of the social constructivist framework, axial coding followed as well as use of open coding. Through the field notes some strengths, weaknesses, and recommendations were gathered about the gifted program. The identified the codes used supported answering the research question and subquestions. This project study has the potential to create social change by guiding teachers to understanding all children, regardless of their background, can learn through developing a stronger identification process and more locations to grow awareness of the opportunity.

Since the 1990s, homelessness has increased in Canada. The existing strategies of the government and public health service providers to manage the situation have had limited success. Researchers have noted the lack of including those experiencing homelessness to better understand and find a solution to homelessness. The purpose of this phenomenological study, driven by the social cognitive theory, was to understand homelessness from the perspectives of people who do not have homes. Data were collected from open-ended interviews with a purposeful sample of 15 individuals who are homeless. Summarizing and analyzing the interviews, several themes emerged after interview data were transcribed via hand coding and analyzed using cognitive data analysis. The prominent themes were: lack namely, money, home, privacy, and support; discrimination of all kinds; mental illness and addiction; the need for a review of housing policy that specifically addresses rent, mortgage qualification criteria and house tax, and to create awareness of government support systems and the services that they provide. Public health service providers and designated authorities can use the findings of this study to understand the phenomenon from the perspective of people who are experiencing homelessness, and in turn can use that understanding to influence improved homelessness reduction strategies that could improve the lives of those experiencing homelessness and their communities. Since homelessness is a public health issue, effectively bringing it under control could create a positive impact on the health and safety of the public.