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Purpose: In addition to becoming familiar with the life changing event of having a chronic illness and exploring its meaning in daily life, people with relapsing-remitting Multiple Sclerosis (RRMS) are faced with important decisions about immunomodulating treatment. Biomedical research on the use of Disease Modifying Therapies (DMTs) mostly focuses on adherence, conceptualized and understood as a behavioral act leading to a desired outcome. Less attention has been paid to the meaning for a person with RRMS of starting and continuing the use of DMTs. Studies on the experiences of people with RRMS taking orally administered DMTs are lacking. The aim of this phenomenological study was to examine the experiences of people with RRMS taking oral medication. Methods: The study was guided by Interpretative Phenomenological Analysis (IPA) and Phenomenology of Practice. 25 persons with RRMS participated in in-depth interviews. Results: In general, participants of this study find themselves in alternating phases that vary by degree of experienced unfamiliarity or familiarity with concern to one's illness, one's changing body, and one's new life. The meaning of taking medication is closely related to these phases. Conclusions: Adherence serves a purpose in the lifeworlds of participants. Medication is the embodiment of this purpose. The pill has inherent meaning.

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Background: Aphasia can have major consequences for participation. In line with other initiatives around the world, in the Netherlands aphasia centres provide support to people with aphasia and their relatives in the chronic phase to bridge the gap between therapy, rehabilitation, and participation in daily life. Although there is greater focus on participation in health care, the concept of participation is complex and not well-defined. Aims: The purpose of this paper is to understand the value and meaning of the aphasia centres in the Dutch context. We focus on the emic perspectives of people with aphasia and their relatives: how do aphasia centres contribute to building up a meaningful life with aphasia in the chronic phase and how do the centres support them to participate? Hence, this study also contributes to the understanding of the concept of participation and its meaning. Methods and procedures: This qualitative study used a naturalistic case study design in order to get an rich and multi-layered understanding of the context of aphasia centres. Within this context we focused on the experiences and perspectives of people with aphasia and their relatives. To secure involvement of people with aphasia themselves, research methods were attuned to their abilities to participate, and included participant observations, interviews, focus group meetings, and creative methods. Outcomes and results: Aphasia centres help people with aphasia to overcome isolation. They bring new goals and perspectives and help people find new meaning in life. They are experienced as a safe place to learn, overcome shame, and build self-confidence. Working in groups is a valuable element, providing a mutual sense of belonging. Also, people experience they can have a meaningful contribution by helping others. Relatives underscore these values and also feel supported in building up their life with their partner. Conclusions: Aphasia centres are a first step to overcome isolation and bear a first step towards participation in itself. They contribute to overcome barriers to relate to others by building self-confidence and overcome shame. This is a big step stone towards participation in the context outside the centre. From the perspectives of clients and relatives, participation is linked to the concept of being and belonging. At the same time, clients feel it is hard to meet societal norms of participation, framed as paid work, ARTICLE HISTORY

Background During the coronavirus disease (COVID-19) pandemic, key persons who were formally or informally active in community organisations and networks, such as sports clubs or cultural, educational, day care and healthcare facilities, occupied a key position between governments and citizens. However, their experiences, the dilemmas they faced and the solutions they generated when implementing COVID-19 measures in their respective settings are understudied. Aim We aimed to understand how key persons in different community organisations and networks experienced and responded to the COVID-19 measures in the Netherlands. Methods Between October 2020 and December 2021, the Corona Behavioural Unit at the Dutch national public health institute, conducted qualitative research based on narratives derived from 65 in-depth interviews with 95 key persons from 32 organisations and networks in eight different sectors. Results Firstly, key persons enhanced adherence and supported the resilience and well-being of people involved in their settings. Secondly, adherence was negatively affected where COVID-19 measures conflicted with important organisational goals and values. Thirdly, small changes and ambiguities in COVID-19 policy had substantial consequences, depending on the context. Fourthly, problem-solving was achieved through trial-and-error, peer support, co-creation and transparent communication. Lastly, the COVID-19 pandemic and measures highlighted inequalities in access to resources. Conclusion Pandemic preparedness requires organisational and community preparedness and a multidisciplinary public health approach. Structural engagement of governments with key persons in community organisations and networks is key to enhance public trust and adherence to pandemic measures and contributes to health equity and the well-being of the people involved.