Women with a history of Gestational diabetes mellitus (GDM) have a high risk of developing Type 2 diabetes mellitus (T2DM) in their future life. Lifestyle interventions are known to reduce this progression. The success of a lifestyle intervention mainly depends on its feasibility. Therefore, this study aimed to evaluate the feasibility of a lifestyle intervention programme aimed to attenuate the development of T2DM in mothers with a history of GDM. This qualitative phenomenological study was carried out in selected Medical offices of Health (MOH) areas in Sri Lanka. Postpartum mothers with a history of GDM who have undergone a comprehensive, supervised lifestyle intervention program for 1 year, their family members, and public health midwives (PHM) were recruited for this study. Focus group discussions (FGD) were carried out with mothers and PHM while In-depth interviews (IDI) were conducted with family members. Framework analysis was used for the analysis of data. A total of 94 participants (45 mothers, 40 healthcare workers, and 9 family members) participated in FGDs and IDIs to provide feedback regarding the lifestyle intervention. Sixteen sub-themes emerged under the following four domains; (1) Feelings and experiences about the lifestyle intervention programme for postpartum mothers with a history of GDM (2) Facilitating factors (3) Barriers to implementation and (4) Suggestions for improvement. Spouse support and continued follow-up were major facilitating factors. The negative influence of healthcare workers was identified as a major barrier to appropriate implementation. All participants suggested introducing continuing education programmes to healthcare workers to update their knowledge. The spouse\'s support and follow-ups played a pivotal role in terms of the success of the programme. Enhancing awareness of the healthcare workers is also essential to enhance the effectiveness of the programme. It is imperative to introduce a formal intervention programme for the postpartum management of mothers with a history of GDM. It is recommended that the GDM mothers should be followed up in the postpartum period and this should be included in the national postpartum care guidelines.

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Long-acting injectable pre-exposure prophylaxis for HIV prevention (LAI-PrEP) was approved for use in the United States in 2021, yet little is known about perceptions of LAI-PrEP among transgender and nonbinary young adults, a group that faces substantial barriers to HIV prevention. We investigated US transgender and nonbinary young adults\' perceptions of and attitudes toward LAI-PrEP and how perceived advantages and disadvantages of LAI-PrEP related to the PrEP continuum of care. We conducted semi-structured interviews with 31 transgender and nonbinary young adults who reported oral PrEP use or were PrEP-eligible. We analyzed responses using both a deductive RADaR approach, to identify LAI-PrEP perceptions relevant to the PrEP continuum of care, and an inductive thematic analysis to explore key themes. In this study, all PrEP-experienced and most PrEP-naïve participants indicated an interest in LAI-PrEP, citing advantages over daily oral medication (e.g., fewer adherence challenges). Three key themes emerged: (1) Some participants linked perceived advantages of LAI-PrEP to experiences with gender-affirming care (e.g., familiarity with needles via hormone use). (2) Participants weighed trade-offs and contextual factors that influenced their LAI-PrEP preferences (e.g., interest contingent on whether location for receiving injection was geographically accessible). (3) Participants envisaged alternative delivery methods that could enhance LAI-PrEP acceptability and uptake (e.g., home injection). HIV prevention programs should incorporate the insights of transgender and nonbinary young adults to ensure that emerging HIV prevention technologies are accessible and responsive to the needs and concerns of people of all gender modalities.

The paper presents the results of in-depth interviews and a questionnaire survey of the Russian cites administration representatives about cities resilience under the sanctions pressure and COVID-19. The survey was conducted by the Center for Territorial Changes and Urban Development of IPEI RANEPA in March-May 2023, it was attended by representatives of the administration of more than 50 cities of the Russian Federation. We found overall situation as stable: social programs are being implemented in full, unemployment is decreasing, construction of municipal facilities continues, problems with failures in the supply of spare parts, equipment and components are being solved. At the same time, the sanctions have affected the urban economy in completely different ways: while in some cities show significant negative effect, in others the impact of sanctions is insignificant. Cites face number of new challenges: disruption of supply chains, refusal to supply paid equipment, inability to find analogues of imported equipment with the necessary characteristics, rising prices for spare parts. components and construction materials, the rupture of established sales channels to unfriendly countries, a drop in municipal budget revenues, etc. The heads of the city administration work overtime to solve emerging problems, organize interaction between enterprises, establish and deepen business contacts with friendly countries, put forward proposals to improve the situation at the federal level. New tasks successfully solved, although it requires serious efforts. To respond to new challenges, we need a new, more decentralized and local-oriented style of public administration, a process of well-established feedback.

OBJECTIVE: What meanings do donor conceived young adults give to direct-to-consumer DNA testing, and how does direct-to-consumer DNA testing relate to their lived experiences?
METHODS: Thirty-three young adults participated in in-depth interviews in November 2020 and September 2021 as part of a study of donor conceived people in the UK that focuses on the period of young adulthood. All participants were aged between 18 and 31 years, had been conceived by sperm donation at a time of legal donor anonymity, and were mainly resident in the UK. Interviews were analysed using reflexive thematic analysis.
RESULTS: Nineteen participants (58%) had used at least one direct-to-consumer DNA test, and 14 (46%) had not. Three participants (9%) had learned about their donor conception inadvertently through a direct-to-consumer DNA test. Twelve participants (36%) had matched with their donor, someone conceived using the same donor, or both. Four related themes that capture participants\' perspectives and experiences of direct-to-consumer DNA testing were identified: ruptures, disclosures, webs and temporalities.
CONCLUSIONS: To the authors\' knowledge, this is the first study to evidence both active interest and disinterest in direct-to-consumer DNA testing among individuals who are donor conceived. The meanings ascribed to, and uses of, direct-to-consumer DNA testing vary significantly among donor conceived young adults. Findings relating to the relationship between \'informal\' and \'formal\' information systems, and the absence of guidance and support for those using direct-to-consumer DNA tests, should be considered carefully by practitioners, regulatory bodies and policymakers going forward.

OBJECTIVE: Patients with anorectal malformation (ARM) and Hirschsprung\'s disease (HD) live with long-term impact of these diseases even into adulthood. We aimed to explore the physical, social and emotional impact of these diseases in adolescents and young adults to develop best practices for transition care.
METHODS: We conducted one-on-one in-depth interviews with ARM and HD patients aged  ≥ 11 years who had undergone surgery at four tertiary referral centers. All interviews were audio-recorded and transcribed verbatim. We analyzed transcripts for recurring themes, and data were collected until data saturation was reached. Three researchers independently coded the transcripts for major themes using thematic analysis approach.
RESULTS: We interviewed 16 participants (11 males) between October 2022 and April 2023. Ages ranged from 11 to 26 years. Five major themes emerged: (1) personal impact (subthemes: physical, emotional and mental health, social, school), (2) impact on family, (3) perceptions of their future (subthemes: relationships, career, state of health), (4) sources of support (subthemes: family, peers, partner), and (5) transition care (subthemes: concerns, expectations). Only females expressed concerns regarding future fertility.
CONCLUSIONS: This study highlights the evolving problems faced by adolescents and young adults with ARM and HD, especially gender-specific concerns. Our findings can inform efforts to provide individualized care.

The COVID-19 pandemic has significantly affected the higher education sector in Singapore. Existing tertiary studies seeking to understand the intraperiod response to COVID-19 often focus on single institutions, jurisdictions or stakeholder groups. This study is the first in-depth qualitative multi-stakeholder examination of the higher education environment in Singapore during the COVID-19 pandemic. It explored the perceptions of the quality of digital pedagogy during COVID-19, how universities have adapted because of the pandemic, and how leaders, teaching staff and students have been affected by the management and educational changes via 13 semi-structured interviews across six Singapore higher education institutions. Through purposive sampling, we explore current stakeholder perceptions, structural education changes, and personal learning and teaching impacts of COVID-19. Applying Braun and Clarke\'s approach to thematic analysis, we inductively uncovered four major themes: the Singapore government\'s approach to COVID-19 and its effects on delivery; academic leadership approaches; education technology; and well-being. This article is critical as a key foundation to understand how Singapore is responding with unique geopolitical differences. We discuss the practical implications of our research for current university faculty and students during and beyond the pandemic, and outline opportunities for future research.

UNASSIGNED: To identify the representative attributes of the five elements of a person with a qualitative methodology and provide the basis for the clinical diagnosis and treatment of \"people with the five elements in traditional Chinese medicine (TCM).\"
UNASSIGNED: Data collected from the literature review, two sessions of brainstorming of experts with related experience in \"people with the five elements in TCM\" from October 2020 to December 2020, and six rounds of in-depth interviews with 30 participants who had various attributes of the five elements from March 2021 to October 2021 were analyzed. Triangulation was used in this study, and theming and synthesizing were used to analyze the data.
UNASSIGNED: A total of 31 experts and 30 interviewees participated in this study. The median age of the experts and interviewees were 48.0 and 38.5 years, respectively; 51.66% and 54.8% of experts and interviewees, respectively, were men. The descriptors of facial diagrams of \"people with the five elements in TCM\" were complexion, shape, distribution state of facial bones, convergence trend of facial muscles, and facial expression. A theoretical model of \"people with the five elements in TCM\" was shaped based on these findings.
UNASSIGNED: The study suggests a possibility for bridging the gap between personality and bodily state, identifying an avenue for personality research from the perspective of TCM.

The Chinese government has invested significant resources to build many rural healthcare stations. However, in the face of convenient medical paths and accessible medical resources, the utilization rate of health services for older adults in rural areas is surprisingly low. This study explored why health-seeking behavior among older adults in rural China was not active.
Data were collected through participatory rural appraisal (PRA) with 108 participants in 12 villages in southern China. Daily schedule and social and resource mapping were employed to outline the range of activities and the routine of the older adults, as well as in-depth interviews to understand the logic of their healthcare choices. Data collected were analyzed by content analysis.
Three themes were generated: (1) perceptions of health status (being healthy or sick): the rural older adults used the ability to handle routine chores as a measure of health status; (2) prioritization of solving symptoms over curing diseases: the older adults preferred the informal self-medication to cope with diseases, as long as there were no symptoms and no pain; (3) \'unpredictable\' troubles: they tended to favor the \'optimal\' solution of keeping their lives in order rather than the best medical treatment options.
This study showed that the medical practices of the rural elderly were profoundly influenced by their perceptions of health and their life experiences. In the face of diseases, they tended to keep their lives in order, preferring self-treatment practices that address symptoms or selectively following medical advice rather than medical and science-based clinical solutions. In the future, the construction of rural health care should focus on changing the \'inaccessibility\' of healthcare resources at the subjective level of the rural elderly and develop culturally adaptable health education.

COVID-19 was concerning for older adults because they faced greater health risks from the virus and generally experience higher rates of isolation and loneliness. Single older adults are of particular concern because they also lack a cohabiting partner for social connection, so they may face greater levels of loneliness. Many older adults have been using technology to develop and maintain social connections, including romantic connections, to mitigate these feelings of loneliness and isolation. This research explores how feelings of loneliness connect to use of online dating sites during a pandemic, how older adults decided to and rationalized dating at a time when meeting in-person and social interactions were discouraged and dangerous, and how experiences differed between men and women. I interviewed 50 men and 50 women, ages 60-83, about their experiences seeking partners and dating during the pandemic. All respondents were single, heterosexual, and recruited from online dating websites, but varied by race, education level, marital experience, employment status, and geographic location. Single older adults relied on feelings of loneliness and isolation, the ubiquity of online dating sites, and particularly for women, adherence to safety measures while on a date as motivation for seeking and meeting romantic partners during a pandemic. Single older adults seeking new romantic interactions during a pandemic, when health risks were greater, illustrates the importance of intimate relationships even into older age and how loneliness and isolation are powerful drivers in seeking romantic relationships.