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Narratives of everyday disease management challenges noted by participants were analyzed for cultural themes.
While we did examine the scale alpha for nurses and physicians separately to ensure it was reasonable for both groups, this finding speaks to challenges noted by others when selecting one instrument to survey multiple disciplines or work areas [ 58].
The greatest storage challenges noted by both patients and caregivers included the need to plan for refrigerating FVIII products when travelling and carrying an insulated tote bag when leaving the house.
These challenges, noted by researchers both in LMICs and providing distance support from a HIC, are partially overcome both by initiatives to enhance access to research (see the Global Open Access Portal [ 16] signposted by an experienced LMIC reviewer) and by international collaboration within review teams.
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Another challenge noted by many students was the insufficient time for Hong Kong and Taiwan students to know each other and cultivate friendship.
A 2013 challenge noted by Écrans, a French website run by Libération, challenged competitors to convince astronauts on the International Space Station to take a photo holding a sign with their team's name.
Low utilisation of mainstream services is a significant barrier to improving adolescent SRH, a challenge noted by the Ministry of Health [ 14, 15].
The second pressing challenge noted by The Global Initiative on Out of School Children is the poor quality of the education offered in many schools; a challenge that is often referred to as a 'learning crisis'.
One challenge noted by young adults in the Posttransition group was bearing the immense responsibility of diabetes management without easy access to this "backup" or hands-on support, and several pretransition parents expressed worries about their child losing this support as a young adult (Table 2, Quotes 14 and 15).
Health care providers would similarly benefit from learning more about women's life circumstances and challenges, as noted by several other authors in the context of type 2 diabetes [ 69, 70].
These challenges were persistently noted by participants who felt called upon to cope with this change in communal meals.
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