Search results for: qualitative health research

Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Maha Mourad, Fady Todros

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The objective of this research is to find an explanatory model to define the most important variables and factors that affect the acceptance of Mobile Internet in the Egyptian market. A qualitative exploratory research was conducted to support the conceptual framework followed with a quantitative research in the form of a survey distributed among 411 respondents. It was clear that relative advantage, complexity, compatibility, perceived price level and perceived playfulness have a dominant role in influencing consumers to adopt mobile internet, while observability is correlated to the adoption but when measured with the other factors it lost its value. The perceived price level has a negative relationship with the adoption as well the compatibility.

Keywords: innovation, Egypt, communication technologies, diffusion, innovation adoption, emerging market

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Authors: Gus Salazar, Jeremy Bekker, Lauren Linford, Jared Warren

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Positive psychology practices allow for its principles to be applied to all people, regardless of their current level of functioning. To increase the dissemination of these practices, interventions are being adapted for use with digital technology, such as mobile apps. However, the research regarding positive psychology mobile app interventions is still in its infancy. In an effort to facilitate progress in this important area, we 1) conducted a qualitative review to summarize the current state of the positive psychology mobile app literature and 2) developed research-supported recommendations for positive psychology app development to maximize behavior change. In our literature review, we found that while positive psychology apps varied widely in content and purpose, there was a near-complete lack of research supporting their effectiveness. Most apps provided no rationale for the behavioral change techniques (BCTs) they employed in their app, and most did not develop their app with specific theoretical frameworks or design models in mind. Given this problem, we recommended four steps for effective positive psychology app design. First, developers must establish their app in a research-supported theory of change. Second, researchers must select appropriate behavioral change techniques which are consistent with their app’s goals. Third, researchers must leverage effective design principles. These steps will help mobile applications use data-driven methods for encouraging behavior change in their users. Lastly, we discuss directions for future research. In particular, researchers must investigate the effectiveness of various BCTs in positive psychology interventions. Although there is some research on this point, we do not yet clearly understand the mechanisms within the apps that lead to behavior change. Additionally, app developers must also provide data on the effectiveness of their mobile apps. As developers follow these steps for effective app development and as researchers continue to investigate what makes these apps most effective, we will provide millions of people in need with access to research-based mental health resources.

Keywords: behavioral change techniques, mobile app, mobile intervention, positive psychology

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Authors: Aikaterini Tavoulari, Michael Proulx, Karin Petrini

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Objective: This study aims to explore the unique challenges faced by young individuals with vision impairment (VI) during key life transitions, utilizing a community-based participatory research (CBPR) approach to identify limitations and positive aspects of existing support systems, with a focus on accessibility and diversity. Design: The study employs a qualitative CBPR design, engaging young participants with VI through online and in-person working groups over six months, prioritizing their active involvement and diverse perspectives. Methods: Twenty-one young individuals with VI from across the UK and with different VI conditions were recruited to participate in the study via a climbing and virtual reality event and stakeholders’ support. Data collection methods included open discussions, forum exchanges, and qualitative questionnaires. The data were analyzed with NVivo using inductive thematic analysis to identify key themes and patterns related to the challenges and experiences of life transitions for this diverse population. Results: The analysis revealed barriers to accessibility, such as assumptions about what a person with VI can do, inaccessibility to material, noisy environments, and insufficient training with assistive technologies. Enablers included guidance from diverse professionals and peers, multisensory approaches (beyond tactile), and peer collaborations. This study underscores the need for developing accessible and tailored strategies together with these young people to address the specific needs of this diverse population during critical life transitions (e.g., to independent living, employment and higher education). Conclusion: Engaging and co-designing effective approaches and tools with young people with VI is key to tackling the specific accessibility barriers they encounter. These approaches should be targeted at different transitional periods of their life journey, promoting diversity and inclusion.

Keywords: vision impairement, life transitions, qualitative research, community-based participatory design, accessibility

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Authors: Ivy Jeralyn T. Andres, Eva B. Macugay

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Using a descriptive research design utilizing the Research and Development (R&D) methodology, this study focused on the development of Reproductive Health Education (RHE) Toolkit for Science Teachers that provides a guide in teaching reproductive health. Based on the findings, the teacher-respondents identified nine topics that can be included in the development of the RHE toolkit. The topics included are The Male Reproductive System, The Female Reproductive System, The Roles of Hormones in Male and Female Reproductive System, Menstrual Cycle, Fertilization, Pregnancy and Childbirth, Breastfeeding, Human Reproductive and Developmental Concerns and Reproductive Health Management and Diseases. The developed RHE Toolkit is remarked as very highly valid and very highly acceptable learning material. The validators and evaluators acknowledged the developed RHE toolkit as clear, creative, and academically useful supplemental material for educating reproductive health. Moreover, it follows the principles of SMART objectives, factual, timely, and relevant content for both learners and the community as a whole. Science teachers should employ the RHE Toolkit in teaching reproductive health education into their respective classes. It is also suggested that the developed RHE toolkit can be implemented to elementary pupils and the community, particularly in rural areas.

Keywords: reproductive health education, toolkit, science teachers, supplemental material

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Authors: Zeynep Karacor, Rahime Hulya Ozturk

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In recent years, the rise of population density and the problem of aging population took attention to the health expenditures. In Turkey, some regulations and infrastructure changes in health sector have occurred. These changes are called Health Transformation Program. The productivity of health services, patient satisfaction, quality of services are tried to be improved with this program. Some radical changes are applied in Turkish economy in this context. The aim of this paper is to present the effects of Health Transformation Program on health expenditures. In the first part of the paper, some information’s about health system and applications in Turkey are discussed. In the second part, the aims of Health Transformation Program are explained. And in the third part the effects of Health Transformation Program on health expenditures are examined.

Keywords: health transformation program, Turkey, health services, health expenditures

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Authors: Samia Jamshed Nauman Majeed

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Purpose: Globally, the pandemic of COVID -19 has created a massive distraction for educational reforms influencing learning options, education access, and outcomes of students in more than 190 countries which has carved marks in history. To explore the challenges and complications confronted by students and faculty members while ensuring access to online education, qualitative research was conducted. Methodology: For this purpose, a series of focus group discussions were conducted in different regions of Pakistan, which revealed interesting findings shared by Panelists, which include Vice-Chancellors, Rectors, and Deans of different private and public sector universities of Pakistan. The qualitative research aims to explore the challenges and success factors of online educations by students with diverse backgrounds of higher education institutions to maximize student educational outcomes. Findings: The findings revealed several challenges and opportunities when it comes to online education for students of higher education institutions. Simultaneously, the researchers discovered the key success factors necessary for online education. Lastly, the paper presents the research limitations and future research recommendations to streamline online education in a better way ensuring the students' success. Originality: The pandemic has forced the closure of social, business, and educational activities, which has drastically influence the quality of education with its subsequent impact on the economy. In response, numerous universities across the globe are forced to suspend their educational activities by closing the universities. Though online education has been adopted worldwide by the universities, which brought numerous issues for academia, particularly for underdeveloped countries, and Pakistani higher education reforms are no exception to this.

Keywords: online education, higher education institutions, COVID-19, challenges, key success factors

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Authors: Maryam Nakhaei, Hamid Reza Khankeh, Mitra Moodi, Leila Daddoust

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Although individuals (men and women) experience disasters in different ways, because of important women’s roles in the family, we aim to shed more light on their issues in doing family. In this report, we present an overview of the main qualitative and quantitative findings of different projects have been conducted in the regions affected by disaster in Iran. This paper explores women’s needs and experiences after disaster at the family level in 'disaster response behavior', 'personal health' including reproductive health and needs of pregnant women, 'livelihood responsibilities', and 'marital relationships'. This clarification can help not only to ensure that their needs are adequately addressed but also to plan family based strategies which consider their strengths.

Keywords: disaster, family, women, Iran

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Authors: Eko Nursanty, Joesron Alie Syahbana, Atik Suprapti

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Tourist gaze is a set of experiences that experienced by a tourist in attempt to familiarize himself with the certain local tourism site’s condition. It is started from looking for information prior arriving at the location, then during the visit and gaining unique experience with the local inhabitant, and then experiencing the ingenuity of the location, finally to bring impression that keeps on attaching despite leaving from it. This research attempted to grab the message of tourist gaze in the process of structuring which is conducted in the global tourism in the cities in Indonesia, particularly Solo as the study case of the research. The method employed is the field observation of qualitative research. The expected result is to relate the tourist gaze theory with the development of ongoing global tourism.

Keywords: tourist gaze, tourism, city branding, Solo

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Authors: Yuki Hara

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Healthy assets are recognized as important for all people in the world through experiencing COVID-19. Each part of life and work is important to be changed against the preceding wide-spreading of COVID-19. Furthermore, it is necessary to innovate the whole structure of a city upon the sum of the parts. This study aims at creating a comprehensive strategy from a small practice of making healthier lives with collaborating local actors for a city. This paper employs action research as the research framework. The core practice is the 'Ken’iku Festival' at Ken’iku Festival Committee. The field locates the urban-rural fringe in the northwest part of Fujisawa city, Kanagawa prefecture, Japan. The data is collected through the author's practices for three years from the observations and interviews at meetings and discussions among stakeholders, texts in municipal reports, books, and movies, 3 questionnaires for customers and stakeholders at the Ken’iku Festival. These data are analysed by qualitative methods. The results show that couples in their 40s with children and couples or friends over the 70s are at the heart of promoting healthy lifestyles. In contrast, 40% of the visitors at the festival are the people who have no idea or no interest in healthier actions, which the committee has to suggest healthy activities through more pleasing services. The committee could organize staff and local actors as the core parties involved through gradually expanding its tasks relating to the local practices. This private sectoral activity from health promotion is covering a part of the whole-city planning of Fujisawa municipality by including many people over organisations into one community. This paper concludes from local practice networking through the festival that a comprehensive strategy for a healthy city is both a practical approach easily applied to each partner and one of the holistic services.

Keywords: communal practice network, healthy cities, health & development, health promotion, with and after COVID-19

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Authors: Rizky Kertanegara

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Reception studies is one of the cultural studies lately evolved in the realm of communication science. This qualitative study was pioneered by Stuart Hall who initiated the dominant, negotiation, and opposition of audience reading to the text of the media. In its development, this reception studies is developed by Kim Christian Schroder become multidimensional reception studies. In this update, Schroder aware that there has been a bias between readings made by the informant with readings conducted by researchers over the informant. Therefore, he classifies the reception into two dimensions, namely the dimension of reading by informants and implications dimensions conducted by researcher. Using Schroder approach, these studies seek to describe the reception of adolescent girls, as research subjects, to the elements contained sexual openness in the music video Cinta Laura as the object of research. Researcher wanted to see how they interpret the values of Western culture based on the values of their culture as a teenager. Researchers used a descriptive qualitative research method by conducting in-depth interviews to the informants who comes from a religious school. The selection of informants was done by using purposeful sampling. Collaboration with the school, the researchers were able to select informants who could provide rich data related to the topic. The analysis showed that there is permissiveness informants in addressing sexual openness in the music video. In addition, informants from Catholic schools were more open than the informant derived from Islamic schools in accepting the values of sexual openness. This permisiveness is regarded as a form of self-actualization and gender equality.

Keywords: cultural studies, multidimensional reception model, sexual openness, youth audience

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Authors: Atousa Khodadadyan, Gabe Mythen, Hirbod Assa, Beverley Bishop

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Risk assessment and the knowledge provided through this process is a crucial part of any decision-making process in the management of risks and uncertainties. Failure in assessment of risks can cause inadequacy in the entire process of risk management, which in turn can lead to failure in achieving organisational objectives as well as having significant damaging consequences on populations affected by the potential risks being assessed. The choice of tools and techniques in risk assessment can influence the degree and scope of decision-making and subsequently the risk response strategy. There are various available qualitative and quantitative tools and techniques that are deployed within the broad process of risk assessment. The sheer diversity of tools and techniques available to practitioners makes it difficult for organisations to consistently employ the most appropriate methods. This tools and techniques adaptation is rendered more difficult in public risk regulation organisations due to the sensitive and complex nature of their activities. This is particularly the case in areas relating to the environment, food, and human health and safety, when organisational goals are tied up with societal, political and individuals’ goals at national and international levels. Hence, recognising, analysing and evaluating different decision support tools and techniques employed in assessing risks in public risk management organisations was considered. This research is part of a mixed method study which aimed to examine the perception of risk assessment and the extent to which organisations practise risk assessment’ tools and techniques. The study adopted a semi-structured questionnaire with qualitative and quantitative data analysis to include a range of public risk regulation organisations from the UK, Germany, France, Belgium and the Netherlands. The results indicated the public risk management organisations mainly use diverse tools and techniques in the risk assessment process. The primary hazard analysis; brainstorming; hazard analysis and critical control points were described as the most practiced risk identification techniques. Within qualitative and quantitative risk analysis, the participants named the expert judgement, risk probability and impact assessment, sensitivity analysis and data gathering and representation as the most practised techniques.

Keywords: decision-making, public risk management organisations, risk assessment, tools and techniques

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Authors: Risheka Suthantirakumar, Eilish Pearson, Jacqueline Woodman

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Background: Previous research has found a variety of rates and reasons for choosing medically unindicated elective repeat cesarean section (ERCS). Understanding the frequency and reasoning of ERCS, especially when unwarranted, could help healthcare professionals better tailor their advice and service. Therefore, our study conducted meta-analyses and qualitative analyses to identify the reasons and rates worldwide for choosing this procedure over the trial of labor after cesarean (TOLAC), also referred to in published literature as vaginal birth after cesarean (VBAC). Methods: We conducted a systematic review of published literature available on PubMed, EMBASE, and science.gov and conducted a blinded peer review process to assess eligibility. Search terms were created in collaboration with experts in the field. An inclusion and exclusion criteria were established prior to reviewing the articles. Included studies were limited to those published in English due to author constraints, although no international boundaries were used in the search. No time limit for the search was used in order to portray changes over time. Results: Our qualitative analyses found five consistent themes across international studies, which were socioeconomic and cultural differences, previous cesarean experience, perceptions of risk with vaginal birth, patients’ perceptions of future benefits, and medical advice and information. Our meta-analyses found variable rates of ERCS across international borders and within national populations. The average rate across all studies was 44% (CI 95% 36-51). Discussion: The studies included in our qualitative analysis demonstrated similar repetitive themes, which give validity to the findings across the studies included. We consider the rate variation across and within national populations to be partially a result of differing inclusion and eligibility assessment between different studies and argue that a proforma be utilized for future research to be comparable.

Keywords: elective cesarean section, VBAC, TOLAC, maternal choice

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Authors: Carolina Alcântara, Ileno Costa

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This study had the objective to systemize the main psycho-social and socioeducational aspects that related with the psychic suffering of adolescents in conflict of law and freedom privation. This research wanted to verify the signals and symptoms identified trough themselves perceptions related to their condition of health/insanity. In a similar way, it was objectified to know the opinions of the ambient conditions of the institution the use of the currently available resources for Health Service and Educational Service. The methodological proposal is based on the quant-qualitative analysis of interviews half-structuralized carried through with 36 teenagers was using psychiatric medication continuously. The data had pointed the experiences of sleeplessness and nightmares, associates or not with experiences of loss of reality (hallucinations) had constituted the illness most frequent. The self-punishment behavior appeared at second place. With regard to the ambient factors, it was verified that institution had, in general way, guaranteed the physical integrity and the maintenance of the health. Amongst the current available resources of Health Service, the administration of anticonvulsivants, in association with other psychotropic drugs has been widely used. The school was viewed as important device of available in the institution. By means of the adolescent’s understanding who do not like to go to the school, they don’t disqualify the knowledge, in contrast, they wanted for knowledge, however, they were frustrated for not having their educational supplies adequately, affirming that the school is weak or they do not learn. Finally, among the possible conclusions guided for the Winnicott’s thought, it was observed that institution in analysis is a representative of the paternal function. However, to begin the self-cure process is necessary that formation of therapeutical bonds. The group of teachers is identified as the main tool of change.

Keywords: serious psychic suffering, adolescent in conflict with the law, delinquency, privation of freedom

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Authors: Ashimolowo Olubunmi

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Contraception use helps prevent pregnancy as well as health-related challenges, most especially among youths and girls. Our communities are bedeviled with many problems, including rape, defilement, neglect by the spouse, and intimate partner violence. Current interventions target only adults, with most facilities having youth and unfriendly adolescent services. To further support the need for this research, especially with our target beneficiaries, the partnership embarked on qualitative evidence-finding research through focus group discussions and in-depth-interview in Abeokuta and Ibadan (the capital cities of Ogun). The Focus Group Discussion (FGD) sessions were held in the state with adolescents (10-18 years) and young women (18-30 years). The result revealed that teenagers and youths who receive formal and sexual education on abstinence, and birth control methods, are likely to have healthier sexual behaviours through the promotion of abstinence and the use of condoms and other forms of contraceptives at their first intercourse, thereby protecting themselves against HIV/AIDs (Human Immunodeficiency Virus/Acquired immunodeficiency syndrome. The result further revealed that parents do not discuss issues around Adolescent and Sexual Reproductive Health (ASRH) with their adolescent girls, leading to gaps in knowledge of ASRH. Stakeholders’ involvement and trust are low. Respondents noted that there were few outreaches on ASRH and that youth-friendly adolescent centres are not common in the community. Respondents noted that there were few outreaches on ASRH organised within the community. Also, youth-friendly services were not common. There is a need to work with all stakeholders to promote those foundational life skills on pubertal changes, menstruation, and sexual life to prepare youths and girls for challenges ahead through sex education; we should work to institutionalize youth and adolescent-friendly Sexual and Reproductive Health (SRH) in our communities.

Keywords: contraception, family planning, focus group discussion, adolescents

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Authors: Felix Y. Mahenge, Abiud L. Kaswamila, Davis G. Mwamfupe

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Grapevine is a drought resistant crop, although in recent years it has been observed to be affect by climate change. This compelled investigation of grapevine farmers’ adaptation strategies to climate change in Dodoma, Tanzania. A mixed research approach was adopted. Likewise, purposive and random sampling techniques were used to select individuals for the study. About 248 grapevine farmers and 64 key informants and members of focus group discussions were involved. Primary data were collected through surveys, discussions, interviews, and observations, while secondary data were collected through documentary reviews. Quantitative data were analysed through descriptive statistics by means of IBM (SPSS) software while the qualitative data were analysed through content analysis. The findings indicate that climate change has adversely affected grapevine production leading to the occurrence of grapevine pests and diseases, drought which increases costs for irrigation and uncertainties which affect grapevine markets. For the purpose of lessening grapevine production constraints due to climate change, farmers have been using several adaptation strategies. Some of the strategies include application of pesticides, use of scarers to threaten birds, irrigation, timed pruning, manure fertilisers and diversification to other farm or non-farm activities. The use of pesticides and industrial fertilizers were regarded as increasing human health risks in the study area. The researchers recommend that the Tanzania government should strengthen the agricultural extension services in the study area so that the farmers undertake adaptation strategies with the consideration of human health safety.

Keywords: grapevine farmers, adaptation, climate change, human health

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Authors: Musa Alghamdi

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Although Saudi students’ motivation to learn English language as a foreign language in Saudi Arabia have been investigated by a number of studies; these have appeared almost completely as using the quantitative research paradigm. There is a significant lack of research that explores the Saudi students’ motivation using qualitative methods. It was essential, as an investigator, to be immersed in the community to understand the individuals under study via their actions and words, their thoughts, views and beliefs, and how those individuals credited to activities. Thus, the study aims to explore the Saudi students’ motivation to learn English language as a foreign language in Saudi Arabia employing qualitative methodology via applying ethnography. The study will be carried out in Saudi Arabia. Ethnography qualitative approach will be used in the current study by employing formal and informal interview instruments. Gardner’s motivation theory is used as frameworks for this study to aid the understanding of the research findings. The author, an English language lecturer, will undertake participant observations for 4 months. He will work as teaching-assistant (on an unpaid basis) with EFL lecturers in different discipline department at a Saudi university where students study English language as a minor course. The researcher will start with informal ethnographical interview with students during his existence with the informants in their natural context. Then the researcher will utilize the semi-structural interview. The informal interview will be with 14-16 students, then, he will carry out semi-structural interview with the same informants to go deep in their natural context to find out to what extent the Saudi university students are motivated to learn English as a foreign language. As well as, to find out the reasons that played roles in that. The findings of this study will add new knowledge about what factors motivate universities’ Saudi students to learn English language in Saudi Arabia. Very few chances have given to students to express themselves and to speak about their feelings in a more comfortable way in order to gain a clear image of those factors. The working author as an EFL teacher and lecturer will provide him secure access into EFL teaching and learning setting. It will help him attain richer insights into the nature EFL context in universities what will provide him with richer insights into the reasons behind the weakness of EFL level among Saudi students.

Keywords: motivation, ethnography, Saudi, language

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Authors: Amira A. Alshowkan, Aleya M. Gamal

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Background: Patient safety is a vital element in providing high quality health care. In psychiatric wards, numerous of physical and emotional factors have been found to affect patient safety. In addition, organization, healthcare provider and patients were identified to be significant factors in patient safety. Aim: This study aims to discover nurses' perception of patient safety in psychiatric wards in Saudi Arabian. Method: Date will be collected through semi-structure face to face interview with nurses who are working at psychiatric wards. Data will be analysed thought the used of thematic analysis. Results: The results of this study will help in understanding the psychiatric nurses' perception of patient safety in Saudi Arabia. Several suggestions will be recommended for formulation of policies and strategies for psychiatric wards. In addition, recommendation to nursing education and training will be tailored in order to improve patient safety culture.

Keywords: patient safety culture, psychiatric, qualitative, Saudi Arabia

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Authors: Lorenza Sganzetta, Nunzia Borrelli

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The research intends to reflect on the current mapping of the Food Strategies, on the reasons why in the planning objectives panorama, such sustainability priorities are located in those geographic areas and on the evolutions of these priorities of the Mediterranean planning dispositions. The whirling population growth that is affecting global cities is causing an enormous challenge to conventional resource-intensive food production and supply and the urgent need to face food safety, food security and sustainability concerns. Urban or Territorial Food Strategies can provide an interesting path for the development of this new agenda within the imperative principle of sustainability. In the specific, it is relevant to explore what ‘sustainability’ means within these policies. Most of these plans include actions related to four main components and interpretations of sustainability that are food security and safety, food equity, environmental sustainability itself and cultural identity and, at the designing phase, they differ slightly from each other according to the degree of approximation to one of these dimensions. Moving from these assumptions, the article would analyze some practices and policies representatives of different Food Strategies of the world and focus on the Mediterranean ones, on the problems and negative externalities from which they start, on the first interventions that are implementing and on their main objectives. We will mainly use qualitative data from primary and secondary collections. So far, an essential observation could have been made about the relationship between these sustainability dimensions and geography. In statistical terms, the US and Canadian policies tended to devote a large research space to health issues and access to food; those northern European showed a special attention to the environmental issues and the shortening of the chain; and finally the policies that, even in limited numbers, were being developed in the Mediterranean basin, were characterized by a strong territorial and cultural imprint and their major aim was to preserve local production and the contact between the productive land and the end consumer. Recently, though, Mediterranean food planning strategies are focusing more on health related and food accessibility issues and analyzing our diets not just as a matter of culture and territorial branding but as tools for reducing public health costs and accessibility to fresh food for everyone. The article would reflect then on how Food Safety, Food Security and Health are entering the new agenda of the Mediterranean Food Strategies. The research hypothesis suggests that the economic crisis that in the last years invested both producers and consumers had a significant impact on the nutrition habits and on the redefinition of food poverty, even in the fatherland of the healthy Mediterranean diet. This trend and other variables influenced the orientation and the objectives of the food strategies.

Keywords: food security, food strategy, health, sustainability

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Pornnapat Berndt

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The purpose of this research is to explore challenge and opportunities to establish cultural learning center of Wayang Artwork for creative tourism within the house of Mr. Sa-ngat Jaiprom. To accomplish the goals and objectives, qualitative research will be applied. The research instruments used are observation, questionnaires (pretest and posttest), basic interviews, in-depth interviews and interviewed of key local informants. The study also uses both primary data and secondary data. From research result, it is revealed that the sample groups more realized valuable heritage value after learning about the history of wayang and the way to practices. The sample group indicated that it not too difficult for them to carving Wayang artwork as they have knowledge about Thai art before. However, in their opinion, they comment that it might difficult for others who have no basic knowledge to learn to carve wayang artwork.

Keywords: creative tourism, local community, cultural learning center, wayang artwork  

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Authors: Abrar Al-Enzi

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Despite being frequently used everyday in the Arab World, Wasta, which is seen as a type of social capital, has received little attention from previous scholars, even in the Middle East. In simple words, Wasta basically means granting deserved or undeserved privileges to others through personal contacts. This paper suggests that Wasta is an important determinant of how some employees get recruited and turn to Wasta for privileges and favors in organizations. It is said, that Wasta accelerates career advancement and other work practices for employees, whether they deserve it or even are suitable for it or not. The overall goal of this paper is to see how Wasta influences human resource management practices by viewing the history of Wasta, the importance of using it, and how it affects employees as well as organizations in terms of recruitment and work practices. Accordingly, the question that will be addressed is: Does Wasta influence human resource management, knowledge sharing and innovation in Kuwait, which in turn affects employees’ commitment within organizations? Therefore, a mixed method sequential exploratory research design will be used to explore the research topic through initial exploratory interviews, paper-based and online surveys (Quantitative method) and semi-structured interviews (Qualitative method). The reason behind such a choice is because both qualitative and quantitative methods complement each other when combined by providing a clearer picture of the topic.

Keywords: human resource management practices, Kuwait, social capital, Wasta

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Authors: Yanting Cao

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The UK has strong economic growth, which attracts other countries to invest there through globalization. This research process will be based on quantitative and qualitative descriptive analysis using interviews. The secondary analysis will involve a case study approach to understand the important aspects of leadership skills. The research outcomes will be identifying the strength and weaknesses of the leadership skills of UK automobile manufacturing enterprises and suggest the best practices adopted by the respective countries for better results.

Keywords: engineering management, leadership, Industrial project management, Project managers, automobile manufacturing

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Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

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Authors: S. Nikpour, S. Vahidi, H. Haghani

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Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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Authors: Dhriti Kirpalani

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The survey aims to explore the impact of Instagram on the perception of lifestyle aspirations (such as social life, fitness, trends followed in fashion, etc.) and perception of self in relation to an idealized lifestyle: Amidst today's media-saturated environment, university students are constantly exposed to idealized portrayals of lifestyles, often leading to unrealistic expectations and dissatisfaction with their own lives. This study investigates the impact of media on university students' perceptions of their own lifestyle, the discrepancy between their self-perception and idealized lifestyle, and their mental health. Employing a mixed-methods approach, the study combines quantitative and qualitative data collection methods to understand the issue comprehensively. A literature review was conducted in order to determine the effects of idealized lifestyle portrayal on Instagram; however, less attention has been received in the Indian setting. The researchers wish to employ a convenience sampling method among undergraduate students from India. The surveys that would be employed for quantitative analysis are Negative Social Media Comparison (NSMCS), Lifestyle Satisfaction Scale (LSS), Psychological Well-being Scale (PWB), and Self-Perception Profile for Adolescents (SPPA). The qualitative aspect would include in-depth interviews to provide deeper insights into participants' experiences and the mechanisms by which media influences their lifestyle aspirations and mental health. With the aim of being an exploratory study, the basis of the idea is found in the social comparison theory described by Leon Festinger. The findings aim to inform interventions to promote realistic expectations about lifestyle, reduce the negative effects of media on university students, and improve their mental health and well-being.

Keywords: declined self-perception, idealized lifestyle, Instagram, Indian university students, social comparison

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Annette Cosgrove

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The objectives of this research study is to examine the impact of professional development in Technology Enhanced Learning (TEL) and the digitisation of learning in teaching communities across multiple higher education sites in the ATU (Atlantic Technological University *) ( 2020-2025), including the proposal of an evidence based digital teaching model for use in a future pandemic. The research strategy undertaken for this PhD Study is a multi-site study using mixed methods. Qualitative & quantitative methods are being used in the study to collect data. A pilot study was carried out initially , feedback collected and the research instrument was edited to reflect this feedback, before being administered. The purpose of the staff questionnaire is to evaluate the impact of professional development in the area of TEL, and to capture the practitioners views on the perceived impact on their teaching practice in the higher education sector across ATU (West of Ireland – 5 Higher education locations ). The phenomenon being explored is ‘ the impact of professional development in the area of technology enhanced learning and on teaching practice in a higher education institution.’ The research methodology chosen for this study is an Action based Research Study. The researcher has chosen this approach as it is a prime strategy for developing educational theory and enhancing educational practice . This study includes quantitative and qualitative methods to elicit data which will quantify the impact that continuous professional development in the area of digital teaching practice and technologies has on the practitioner’s teaching practice in higher education. The research instruments / data collection tools for this study include a lecturer survey with a targeted TEL Practice group ( Pre and post covid experience) and semi-structured interviews with lecturers.. This research is currently being conducted across the ATU multisite campus and targeting Higher education lecturers that have completed formal CPD in the area of digital teaching. ATU, a west of Ireland university is the focus of the study , The research questionnaire has been deployed, with 75 respondents to date across the ATU - the primary questionnaire and semi- formal interviews are ongoing currently – the purpose being to evaluate the impact of formal professional development in the area of TEL and its perceived impact on the practitioners teaching practice in the area of digital teaching and learning . This paper will present initial findings, reflections and data from this ongoing research study.

Keywords: TEL, DTL, digital teaching, digital assessment

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Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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Authors: Liesbeth Van Kelst, Jozefiene Jansens

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Background: All care providers within mother and child care are confronted, at some point in their career, with the care for parents who (will) lose or have lost a baby. Obtaining the correct attitude and communicating well during these difficult moments are aspects that many healthcare provides continue to struggle with. Parents still encounter well-intentioned but inappropriate communication from healthcare providers. Aim: To study how communication, both verbal and non-verbal, around the death of a baby during pregnancy, birth, or in the first ten days postnatal was experienced by parents and healthcare providers. Methods: A qualitative study using grounded theory principles was conducted. Data were collected through 22 individual face-to-face in-depth interviews with parents who had lost a baby (n = 12) and intramural caregivers, such as midwives, nurses, gynecologists and neonatologists (n=10). In the first phase, data were analyzed within each group separately (parents and healthcare providers) and in the second phase, findings from both groups were compared and analyzed according to meta-synthesis principles. Results: The themes that emerged from the data demonstrated congruent experiences between the group of the parents and the health care providers. Both strengths and weaknesses in current care were named and suggestions for appropriate communication were formulated. Conclusion: Since most health care providers only occasionally care for parents with a deceased baby, a communication tool can optimize communication between healthcare professionals and parents who lose a baby. This is very important as the words which are said at this difficult period last a lifetime in the heads of parents.

Keywords: communication, death, perinatal loss, stillbirth

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