Collaborative Support Research Articles

Ragi Revolution: Enhancing Dietary Practices through Nutritional Education and Local Food Systems Implementation

Ragi (Eleusine coracana), commonly known as finger millet, is a nutrient-rich cereal that remains underutilized in modern diets despite its high calcium, iron, and dietary fiber content. This examines how ready-to-eat ragi-based supplementary foods, combined with effective nutrition education, can drive behavioral changes to incorporate ragi into daily diets and local food systems. The increasing availability of ready-to-eat ragi products offers an accessible solution for improving nutrition, but challenges remain in terms of consumer acceptance due to unfamiliarity and taste preferences. This paper focuses on the role of nutrition education in reshaping dietary behaviour, emphasizing case studies that demonstrate the effectiveness of targeted interventions in promoting ragi consumption. Additionally, it explores strategies for integrating ragi into public nutrition programs and sustainable food systems, highlighting the importance of community-driven efforts and public-private partnerships. The review also discusses the role of policy support and multi-stakeholder collaboration in fostering ragi’s cultivation and incorporation into local food systems. By examining behavioural change strategies such as social marketing and culturally sensitive approaches, this paper presents a roadmap for promoting ragi as a key component of sustainable diets and public health interventions.

Navigating Voluntarily Stopping Eating and Drinking in Hospice Settings: A Multidisciplinary Approach.

This article explores current global research on voluntarily stopping eating and drinking (VSED) and presents a detailed, deidentified case study of a patient who elected VSED in a hospice setting in the Southeastern United States. It highlights the collaborative efforts of health care professionals in effectively supporting the patient and family, sharing multiple perspectives from various health care team members who cared for the patient and family. It offers evidence-based recommendations to guide health care teams through the ethical, medical, and emotional challenges of VSED, ensuring compassionate and competent care. The article emphasizes the importance of structured protocols and empathetic care in hospice settings, advocating for the education and preparation of health care teams and families to address the complex challenges associated with VSED. By promoting open communication, interdisciplinary collaboration, and comprehensive support, hospices can respect the autonomy of patients and families choosing VSED, ensuring a compassionate and dignified end-of-life experience.

Opportunities of integrated care to improve equity for adults with complex needs: a qualitative study of case management in primary care

BackgroundPeople living in precarious socio-economic conditions are at greater risk of developing mental and physical health disorders, and of having complex needs. This places them at risk of health inequity. Addressing social determinants of health (SDH) can contribute to reducing this inequity. Case management in primary care is an integrated care approach which could be an opportunity to better address SDH. The aim of this study is to better understand how case management in primary care may address the SDH of people with complex needs.MethodsA case management program (CMP) for people with complex needs was implemented in four urban primary care clinics. A qualitative study was conducted with semi-structured interviews and a focus group with key informants (n = 24). An inductive thematic analysis was carried out to identify emerging themes.ResultsPrimary care case managers were well-positioned to provide a holistic evaluation of the person’s situation, to develop trust with them, and to act as their advocates. These actions helped case managers to better address individuals’ unmet social needs (e.g., poor housing, social isolation, difficulty affording transportation, food, medication, etc.). Creating partnerships with the community (e.g., streetworkers) improved the capacity in assisting people with housing relocation, access to transportation, and access to care. Assuming people provide their consent, involving a significant relative or member of their community in an individualized services plan could support people in addressing their social needs.ConclusionsCase management in primary care may better address SDH and improve health equity by developing a trusting relationship with people with complex needs, improving interdisciplinary and intersectoral collaboration and social support. Future research should explore ways to enhance partnerships between primary care and community organizations.

Holistic Learning Models in Remote Areas: Enhancing Student Motivation through Local Wisdom, Parental Collaboration, Teacher Capacity, and Government Support

Holistic Learning Models in Remote Areas: Enhancing Student Motivation through Local Wisdom, Parental Collaboration, Teacher Capacity, and Government Support

Health information system support for collaboration between physicians and registered nurses: National cross-sectional user experience surveys from 2010 to 2023

Health information system support for collaboration between physicians and registered nurses: National cross-sectional user experience surveys from 2010 to 2023

Barriers and facilitators to conducting randomised controlled trials within routine care of neurorehabilitation centres: a qualitative study

BackgroundRandomised controlled trials (RCTs) are considered the gold standard for generating clinical evidence. The focus on high internal validity in RCTs challenges the external validity and generalisability of findings, potentially hindering their application in routine care. In neurorehabilitation, limited literature addresses conducting RCTs feasibly and efficiently. We investigated barriers and facilitators to conducting RCTs within routine care of neurorehabilitation centres from the perspective of stakeholders in neurorehabilitation in Germany and Austria.MethodsWe conducted semi-structured interviews with stakeholders in neurorehabilitation from four centres in Germany and Austria, informed by the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation and Behaviour model (COM-B). Employing a hybrid approach, the interview analysis integrated both deductive, theory-driven analysis based on the TDF domains and COM-B model and inductive, reflexive thematic analysis.ResultsTwelve stakeholders (4 physicians, 4 therapy managers, 4 therapists; 5 females, 7 males; with research experience spanning 0–40 years) were interviewed. Key barriers to conducting RCTs in neurological rehabilitation centres include limited financial, human, and time resources, high clinical workloads, and a lack of interest of some therapists. Ineffective leadership, perceived lack of research expertise, and communication issues were also significant barriers. Social influence factors such as lack of employer support and inadequate training access further contributed to the challenges. Additionally, barriers included insufficient research infrastructure, limited space, internal power struggles, and rigid cost bearer specifications. Key facilitators included physicians’ and therapists’ motivation to advance the field, contribute to knowledge, and to prioritise patient health. Support from supervisors, joint decision-making, and efficient organisation were crucial facilitators. Flexible therapy planning, mutual support, and interdisciplinary collaboration also played important roles.ConclusionOur results suggest that increasing professional development and understanding, along with providing adequate financial, human, time, and spatial resources to support research endeavours, implementing effective communication strategies to enhance interdisciplinary collaboration and coordination among team members may contribute to increased motivation and facilitate RCTs within the setting of neurorehabilitation centres.Trial registrationThis study was prospectively registered with the German Clinical Trials Register (08.04.2021 DRKSID DRKS00024982).

Challenges and Opportunities in the Adoption of Flexible Manufacturing Systems in Indian Manufacturing Industries

The manufacturing sector is increasingly adopting automation technologies to enhance productivity and flexibility. Among these technologies, Flexible Manufacturing Systems (FMS) offer substantial benefits, such as reduced lead times, improved production flexibility, and lowered operational costs. Despite its advantages, FMS adoption in Indian manufacturing industries has been slow due to several barriers, including high capital costs, technological complexity, and inadequate government support. This study investigates the current status of FMS adoption in India, identifies the key barriers hindering its implementation, and proposes a decision-making model to facilitate its wider adoption. The research gap highlights the lack of a comprehensive framework to quantify the barriers and assess the performance of FMS adoption. To address this, a two-phase Analytic Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) methodology was used. This approach allowed for the classification and prioritization of barriers, as well as the development of a model for FMS selection based on statistical analysis. A case study was conducted using this methodology to evaluate various FMS models and provide a systematic decision-making framework for manufacturers. The results revealed that the most significant barriers to FMS adoption in India include high upfront costs, insufficient infrastructure, and the challenges posed by rapidly advancing FMS technology. By applying the AHP-TOPSIS approach, this study offers insights into overcoming these barriers and presents actionable recommendations for manufacturers and policymakers. The findings emphasize the need for increased government support and industry collaboration to accelerate FMS adoption in India. This research contributes to the development of a structured decision-making framework, which could help manufacturers implement FMS more effectively, thereby enhancing competitiveness in an increasingly dynamic global market. Keywords— Flexible Manufacturing Systems, Barriers to FMS, Indian Manufacturing, AHP-TOPSIS, Decision-Making Model

Effects of Collaborative Support on Learning in Serious Games for Programming

This study examines the effectiveness of a collaborative support method in enhancing programming learning outcomes in a serious game. The game Code Hasp was developed to facilitate the comparison between two support methods, worked examples and a collaborative peer support approach. A total of 111 elementary school students participated, divided into two groups. The experimental group received collaborative support from teammates alongside worked examples, while the control group relied solely on worked examples. Pre- and post-test results and in-game data revealed that the collaborative support method improved learning efficiency and problem-solving skills. A notable effect of the process was the emergence of a leadership role in most collaborative groups. The game’s support design and shared goal structure mitigate potential problems associated with unbalanced participation. These findings suggest that collaborative support systems in serious games are a promising strategy for promoting engagement and improving learning outcomes in programming education.

Future actions and a call for ongoing support

Abstract The EUVABECO project is currently piloting a suite of innovative tools, including decision support systems, targeted screening tools, electronic vaccine leaflets, disease simulators, and cross-border vaccination cards. These tools have shown great promise in transforming vaccination practices within individual healthcare settings, contributing to building vaccine confidence and increasing protection against vaccine-preventable infections across the life course. As EUVABECO progresses to the crucial phase of implementing these pilots, active collaboration and sustained support from the multiple actors of the vaccine ecosystem in the implementing countries are essential. To ensure these tools are effectively adapted across different MS, they must be customised to meet local needs and the specific requirements of diverse healthcare environments. This involves integrating feedback from initial deployments. More than just a technical implementation, this phase is about fostering and maintaining robust partnerships with key stakeholders such as healthcare providers, policymakers, and National Immunization Technical Advisory Groups (NITAGs). The success of the EUVABECO project depends on continuous engagement and the sharing of knowledge and resources among all partners involved. This presentation seeks to reinforce the call for ongoing commitment and collaboration from existing stakeholders and to encourage new partners to join this transformative effort. This will foster a more harmonized approach to vaccination policies. Together, we aim to build a more resilient public health infrastructure, enhancing the preparedness and responsiveness to current and future vaccination challenges, ultimately improving resilience to health threats across the European Union.

Technological Innovation for Sustainable Supply Chain Management in the Food Industry

This study explores the critical role of technological innovations—specifically blockchain, Internet of Things (IoT), and artificial intelligence (AI)—in enhancing sustainable supply chain management within Malaysia's food industry. As the industry faces increasing pressure to adopt sustainable practices due to environmental concerns, regulatory demands, and consumer expectations, these technologies offer significant potential for improving traceability, reducing waste, and optimizing operational efficiency. The research highlights how blockchain enhances transparency and ethical sourcing, IoT enables real-time monitoring to minimize waste, and AI optimizes demand forecasting and inventory management, reducing overproduction and resource waste. However, the study also identifies substantial barriers to the adoption of these technologies, particularly for small and medium-sized enterprises (SMEs). These challenges include high implementation costs, a shortage of skilled labor, and concerns over data security and privacy. To address these issues, the study recommends starting with pilot projects to mitigate risks, investing in continuous workforce training, enhancing data security measures, and leveraging government support and industry collaborations. By overcoming these challenges, Malaysia's food industry can effectively integrate these innovations, leading to more sustainable, efficient, and resilient supply chains. This research underscores the importance of strategic planning and continuous improvement in fully realizing the benefits of technological advancements, thereby positioning Malaysia’s food industry as a leader in sustainable practices within the global market.

Assessment of the use of Open Educational Resources at five European Library and Information Science higher education institutions during and post-COVID-19 pandemic.

This article presents an analysis of the impact of Open Educational Resources (OER) during the COVID-19 pandemic, as well as their potential use in the post-pandemic, in Library and Information Science (LIS) higher education institutions. The research explored how OER were used and created, what were the main barriers and drivers in practice and some main lessons learned that can help to improve the quality and increase the use of OER beyond times of crisis. The research was based on fieldwork carried out in the LIS departments of the universities of Barcelona (Spain), Hildesheim (Germany), Osijek and Zagreb (Croatia) and the University of Library Studies and Information Technologies in Sofia (Bulgaria). The methodology approach was qualitative and was based on interviews with faculty and focus groups with students. Results show that faculty members were still hesitant to adopt OER since they generally did not consider them. Moreover, those who did use them did so on their own initiative and as additional resources. We discuss the different speeds of OER implementation that have been observed depending on the faculty's prior level of knowledge, and on whether their institutions and countries are prepared to support the use of OER. The promotion of post-pandemic OER involves greater capacity building, as well as collaboration and institutional support. Students' attitudes about the usefulness of OER focus on their availability. The large number of teachers and students who participated in the study, as well as the international scope of the study, constitute a strength in the treatment of a topic such as the use of OER where the user perspectives and LIS context have been little addressed in the literature.

Implementing a Hospital-Wide Programme Using iPARiHS to Prevent and Manage Incontinence-Associated Dermatitis and Improve Hospital-Acquired Pressure Injuries.

To outline the implementation of a hospital-wide programme using the Integrated Promoting Action on Research Implementation in Health Services framework to prevent and manage incontinence-associated dermatitis and improve hospital-acquired pressure injuries. This is an empirical research study using mixed methods. The study, conducted across surgical, medical and critical care wards between June and October 2023, aimed to address knowledge gaps, enhance clinical practice and evaluate the effectiveness of interventions. The implementation strategy included education modules, engagement of staff through focus groups and targeted interventions such as individualised toileting plans and structured skin care regimens. Data collection involved audits, incident reporting and clinician knowledge surveys. Findings indicate a reduction in hospital-acquired incontinence-associated dermatitis and pressure injuries postimplementation, with observed improvements in clinician knowledge. However, challenges including workload, skill mix and resource limitations were identified as barriers to implementation. The sustainability and scalability of the programme were emphasised, with ongoing monitoring and evaluation essential for long-term success. This study underscores the importance of evidence-based interventions, interdisciplinary collaboration and leadership support in improving patient outcomes and reducing healthcare costs associated with preventable skin injuries. Further research is needed to assess implementation in community settings and scale up interventions across healthcare networks. Analysing a hospital-wide programme using the Integrated Promoting Action on Research Implementation in Health Service framework to prevent and manage incontinence-associated dermatitis and improve hospital-acquired pressure injuries, could help identify the challenges for delivering patient-centred care. No patient or public involvement. To describe the implementation study, we referred to the StaRI Guideline. This intervention study was applied to the whole population and was therefore not a trial and did not require trial registration. The study was considered low risk and the Human Research Ethics Application (HREA) was approved.

There Is More to Avatars Than Visuals: Investigating Combinations of Visual and Auditory User Representations for Remote Collaboration in Augmented Reality

Supporting remote collaboration through augmented reality facilitates the experience of co-presence by presenting the collaborator’s avatar in the user’s physical environment. While visual user representations are continuously researched and advanced, the audio configuration – especially in combination with different visualizations – is rarely considered. In a user study (n = 48, 24 dyads), we evaluate the combination of two visual (Simple vs. Rich Avatar) with two auditory (Mono vs. Spatial Audio) user representations, to investigate their impact on user’s overall experience, performance, and perceived social presence during collaboration. Our results show a preference for rich auditory and visual user representations, as Spatial Audio supports completion of parallel tasks and the Rich Avatar positively influence user experience. However, the Simple Avatar draws less attention, which potentially benefits task efficiency, advocating for simpler visualizations in performance-oriented settings. Our findings contribute to a deeper understanding of how visual and auditory user representation combinations impact remote collaboration in augmented reality.

Have my back as I get back to work-Experiences of stakeholder support in returning to work after sick leave due to chronic pain: A qualitative interview study.

Chronic pain (pain > 3 months) is a disabling condition affecting around one fifth of the population. Chronic pain significantly affects a person's psychological and physical health and often interferes with the ability to work. It is one of the most common reasons for extended sick leave and persons with chronic pain often have difficulties returning to work. Interpreting the experiences of currently available is necessary in order to facilitate a return to working life. Therefore, this study aimed to describe and interpret the meaning of support during the return-to-work process for persons on sick leave due to chronic pain. A qualitative interview study was conducted with 14 participants (12 women and 2 men) who experienced sick leave due to chronic pain. The participants were recruited through patient organizations focusing on pain or pain-related conditions. Collected data was analyzed using a phenomenological hermeneutical approach. Have my back as I get back to work was the theme of the analysis, along with six subthemes. Being able to work was important for the participants. However, they often experienced returning to work was a battle for support, dealing with fragmentized backing from the involved stakeholders. Participants with access to collaborative support involving competent care, recognition and the possibility to influence their work felt valuable and capable as persons and workers. Thus, they were provided conditions allowing a successful re-entry into the workplace. Our findings contribute to an enhanced understanding of the importance of stakeholder support in persons with chronic pain re-entering the workplace after an extended break due to sick leave. Through an inclusive, collaborative and flexible approach involving all stakeholders working towards the same goal, a person with chronic pain can feel supported in developing and cultivating the capabilities necessary to manage life and work.

A Review of Language Curriculum Development in Multilingual Classrooms

Integrated curriculum models in language teaching have gained prominence as educators seek to provide holistic, interdisciplinary learning experiences that improve both language proficiency and content knowledge. These models emphasize the meaningful application of language skills across various subjects, promoting deeper student engagement and critical thinking. However, the implementation of integrated curricula presents challenges related to teacher collaboration, resource availability, and institutional support, especially in traditional educational settings. This review aims to analyze the effectiveness of integrated curriculum models in language teaching by synthesizing findings from empirical studies and theoretical discussions. The study examines how these models influence language learning outcomes, foster critical thinking, and address the practical challenges faced by educators. Both qualitative and quantitative studies were included, covering various educational levels and cultural contexts. The findings indicate that integrated curriculum models enhance language proficiency, particularly in communicative and academic skills, while simultaneously improving student engagement and content mastery. Effective implementation depends on strong teacher collaboration and institutional support. However, barriers such as inadequate resources and lack of training often hinder the success of these models. In conclusion, integrated curriculum models offer substantial potential for improving language education, but their success requires careful planning and sufficient support. Future research should focus on long-term outcomes and the adaptation of these models to diverse educational contexts to maximize their impact.

Maritime Supply Chain Optimisation: A Case Study of Blockchain Integration in Port Logistics Management

This research examines the potential for maritime supply chain optimisation through the integration of blockchain technology in port logistics management. In the era of global digitalisation, the maritime sector faces challenges to improve operational efficiency and transparency. This study uses a case study approach to evaluate the implementation of blockchain in one of Indonesia's major ports. The research methodology involved qualitative and quantitative analyses, including interviews with key stakeholders, direct observation of logistics processes, and analysis of historical port operational data. The blockchain system was implemented over a six-month period, and its performance was compared with conventional logistics management systems. Key challenges identified include the need for a large initial investment, resistance to change from some stakeholders, and the need for industry-wide standardisation of blockchain protocols. This research demonstrates the great potential of blockchain technology in optimising maritime supply chains. Recommendations for further implementation and future research are discussed, with an emphasis on the importance of industry collaboration and regulatory support to accelerate the adoption of this technology in the maritime sector.

Exploring Implementation Processes of a Multicomponent Family Support Intervention in Intensive Care Units (FICUS) Study: A Mixed-Methods Process Evaluation.

To investigate the experience with and progress of the implementation of a Family Support Intervention (FSI) into adult intensive care units (ICUs) as part of the cluster-randomised FICUS trial. A mixed-methods process evaluation using a multiple case study approach guided by the normalisation process theory. This study took place between June 2022 and July 2023 in eight Swiss ICUs randomised to the intervention arm. A tailored implementation strategy was used to introduce the multicomponent FSI, consisting of a new family nursing role and a family care pathway, into interprofessional ICU teams. Participants were 40 ICU key clinical partners. Qualitative data were collected twice, early (3-6 months) and mid-implementation (9-12 months), using small group interviews. A questionnaire with psychometric measures (Acceptability of Intervention Measure, Feasibility of Intervention Measure, Intervention Appropriateness Measure, Normalisation Measure Development Questionnaire) was administered at mid-implementation. RITA pragmatic rapid thematic analysis and descriptive statistics were used to analyse the data. Qualitative and quantitative results were then compared across ICUs (cases). Findings indicated the desired progress of the FSI integration overall and across cases, with high acceptability and appropriateness ratings but only moderate to high feasibility scores. Study-related barriers were noted in all ICUs (i.e., FSI delivery as part of a clinical trial). Implementation barriers included family nurses' limited capacity and clinician's attitudes towards the FSI. Leadership support and interprofessional collaboration were identified as facilitators. Case-based, integrated findings yielded two implementation pathways, namely early and protracted adopters. Implementation barriers were related to the feasibility of FSI delivery within the study context that required a high degree of standardisation and protocol adherence. Implementation progress was shaped by an interprofessional culture of family care, sufficient staff and time resources, and leadership support. The study's findings will inform future implementation of complex health interventions in ICUs. Good reporting of a Mixed-Methods Study (GRAMMS). Within the FICUS trial, a patient and family advisory board with a patient expert, three family members and a patient with own lived experience of critical care collaborate with the research team.

Promoting Health for a vulnerable Family with Relationship Challenges. Exploring the Community Nurse's Role

Background: In today's dynamic social landscape, families often encounter a myriad of challenges that can impact their overall health and well-being. Among these challenges, relationship difficulties within the family unit stand out as a significant concern, with potential repercussions for the physical, emotional, and psychological health of its members. Aim: This case study article delves into the intricate dynamics of promoting health within a vulnerable family facing significant relationship challenges. The focus of this study is to explore the pivotal role of the community nurse in addressing the unique needs of such families. Materials and Methods: A qualitative research approach was employed to comprehensively investigate the experiences of a vulnerable family navigating relationship challenges. Data collection involved in-depth interviews, direct observations, and document analysis. Thematic analysis was used to extract meaningful patterns and insights from the collected data. Results: The findings underscored the crucial influence of the community nurse in fostering the health and well-being of the vulnerable family. Through tailored interventions, collaborative support, and sensitive communication, the community nurse played a pivotal role in addressing the family's relationship challenges and promoting their overall health. Conclusions: This study sheds light on the significance of the community nurse's involvement in enhancing the health outcomes of families facing relationship challenges. The role of the community nurse emerges as an essential component in fostering resilience and facilitating positive changes within the family unit.

Literature Study: The Role of Health Cadres in Stunting Prevention to Support the Realisation of Sustainable Development Goals (SDG's)

Introduction: Stunting is one of the chronic nutritional problems of global concern, including in the Sustainable Development Goals (SDG's) agenda. In Indonesia, stunting is still a major health problem and contributor to child morbidity and mortality. To overcome this problem, prevention efforts are needed that involve various parties, including health cadres at the community level. This study aims to analyze the role of health cadres in stunting prevention to support the realization of the Sustainable Development Goals (SDG's). Methods: This study used a literature study by collecting and reviewing previous research, especially looking for information about the involvement of the role of health cadres in stunting prevention. Results: Health cadres have a role and function as the main driver at the community level to provide education, monitor children's nutritional status, and conduct nutrition intervention activities. Through increased capacity and knowledge, health cadres can help reduce the prevalence of stunting and support the achievement of the SDGs, namely ending hunger and ensuring healthy lives and well-being for all. Conclusion: Support and commitment from all parties are needed to strengthen the role of health cadres in supporting the realization of the SDGs. With the right support and good collaboration, this program can have a significant impact in improving the health and welfare of the community.

Adverse childhood experiences and profiles of healthy orthorexia versus orthorexia nervosa: towards an explanatory model of orthorexia as a multidimensional eating style

BackgroundOrthorexia is a complex phenomenon comprising distinct dimensions, including orthorexia nervosa (ON) and healthy orthorexia (HO). However, little is known about the factors influencing these dimensions, their disparities, and the psychological factors underlying orthorexia behaviours.ObjectivesThis study aims to explore ON versus HO dimensions and the predictive role of adverse childhood experiences (ACEs) in a nationally representative sample of Polish individuals. In addition, we aim to investigate the mediating roles of alexithymia, embodiment, and experiential avoidance levels in this association.MethodsA representative sample of Polish adults (n = 3557) participated in this study. Dimensions of orthorexia (HO, ON) were assessed using the Teruel Orthorexia Scale, while ACEs were evaluated using the Adverse Childhood Experiences Questionnaire. Levels of alexithymia were measured using the Toronto Alexithymia Scale, experiential avoidance through the Acceptance and Action Questionnaire, and embodiment intensity via the Experience of Embodiment Scale.ResultsCluster analysis identified two distinctive orthorexia profiles in the whole sample, i.e., HO (n = 469) and ON (n = 1217), alongside three intermediate HO/ON profiles (n = 1871). The number of ACEs predicted ON tendencies as opposed to HO behaviours in participants. The mediating role of alexithymia, experiential avoidance, and embodiment in the association between ACEs and ON was also observed.ConclusionsOur study suggests that orthorexia is a multidimensional eating style shaped by socio-cultural factors. Adverse childhood experiences may be related to ON behaviours by mediating psychological factors such as experiential avoidance, alexithymia, and embodiment. Effective education and collaborative support are necessary for addressing ON tendencies.