Qualitative Comparative Study Research Articles

The impact of persistent precarity on patients' capacity to manage their treatment burden: A comparative qualitative study between urban and rural patients with multimorbidity in South Africa.

People living with multimorbidity in low-and middle-income countries (LMICs) experience a high workload trying to meet the demands of self-management. In an unequal society like South Africa, many people face continuous economic uncertainty, which can impact on their capacity to manage their illnesses and lead to poor health outcomes. Using precariousness - the real and perceived impact of uncertainty - as a lens, this paper aims to identify, characterise, and understand the workload and capacity associated with self-management amongst people with multimorbidity living in precarious circumstances in urban and rural South Africa. We conducted qualitative semi-structured interviews with 30 patients with HIV and co-morbidities between February and April 2021. Patients were attending public clinics in Cape Town (Western Cape) and Bulungula (Eastern Cape). Interviews were transcribed and data analysed using qualitative framework analysis. Burden of Treatment Theory (BoTT) and the Cumulative Complexity Model (CuCoM) were used as theoretical lenses through which to conceptualise the data. People with multimorbidity in rural and urban South Africa experienced multi-faceted precariousness, including financial and housing insecurity, dangerous living circumstances and exposure to violence. Women felt unsafe in their communities and sometimes their homes, whilst men struggled with substance use and a lack of social support. Older patients relied on small income grants often shared with others, whilst younger patients struggled to find stable employment and combine self-management with family responsibilities. Precariousness impacted access to health services and information and peoples' ability to buy healthy foods and out-of-pocket medication, thus increasing their treatment burden and reducing their capacity. This study highlights that precariousness reduces the capacity and increases treatment burden for patients with multimorbidity in low-income settings in South Africa. Precariousness is both accumulative and cyclic, as financial insecurity impacts every aspect of peoples' daily lives. Findings emphasise that current models examining treatment burden need to be adapted to accommodate patients' experiences in low-income settings and address cumulative precariousness. Understanding treatment burden and capacity for patients in LMICs is a crucial first step to redesign health systems which aim to improve self-management and offer comprehensive person-centred care.

Global citizenship education practices in Singapore and Australia: Tensions between educational and market rationales

This article draws on a qualitative comparative research study of global citizenship education (GCE) in two primary schools, an international school in Singapore and an independent school in Australia. This paper focuses on the implementation of GCE within the two specific school contexts, Singapore and Australia, examining the tensions which existed between neo-liberal market rationales and the critical democratic ideologies at each site. The paper explored in-depth how the neo-liberal market agenda influenced and shaped the societal imaginaries specifically in relation to their GCE commitments. Despite each schools’ commitments to critical democratic GCE ideals, they were very mindful about being distinctive and remaining competitive within their respective educational markets. To that extent, the schools were neo-liberal market actors. Empirical data shows the complexity of a more hybridised or a continuum existence between these two ideologies, thus providing a more nuanced insight of the binary within the school sites.

Overview of Stator Slot-Opening Permanent Magnet Machines

In the past few decades, the stator permanent magnet (PM) machines have attracted much research attention because of their reliable rotor structure, high power density, wide speed range, and strong fault-tolerant ability. Among the recently proposed stator PM machine topologies, the stator slot-opening PM (SS-PM) machines are becoming increasingly popular because of their higher stator space utilization and robust rotor structure. According to the SS-PM magnetization direction, the SS-PM machines can be classified into three categories, namely, the tangentially magnetized stator slot-opening PM (TMSS-PM) machines, the radially magnetized stator slot-opening PM (RMSS-PM) machines, and the compound magnetized stator slot-opening PM (CMSS-PM) machines. The associated working principle and electromagnetic performance of different SS-PM machines can be diverse. Therefore, this article gives an overview of SS-PM machines in terms of machine design, working principle, and machine performance. A qualitative performance evaluation and comparative study of SS-PM machines are presented, and the future challenges and potential opportunities in the SS-PM machine design are discussed.

Adoption of C-reactive protein point-of-care tests for the management of acute childhood infections in primary care in the Netherlands and England: a comparative health systems analysis

BackgroundThe use of point of care (POC) tests varies across Europe, but research into what drives this variability is lacking. Focusing on CRP POC tests, we aimed to understand what factors contribute to high versus low adoption of the tests, and also to explore whether they are used in children.MethodsWe used a comparative qualitative case study approach to explore the implementation of CRP POC tests in the Netherlands and England. These countries were selected because although they have similar primary healthcare systems, the availability of CRP POC tests in General Practices is very different, being very high in the former and rare in the latter. The study design and analysis were informed by the non-adoption, abandonment, spread, scale-up and sustainability (NASSS) framework. Data were collected through a review of documents and interviews with stakeholders. Documents were identified through a scoping literature review, search of websites, and stakeholder recommendation. Stakeholders were selected purposively initially, and then by snowballing. Data were analysed thematically.ResultsSixty-five documents were reviewed and 21 interviews were conducted. The difference in the availability of CRP POC tests is mainly because of differences at the wider national context level. In the two countries, early adopters of the tests advocated for their implementation through the generation of robust evidence and by engaging with all relevant stakeholders. This led to the inclusion of CRP POC tests in clinical guidelines in both countries. In the Netherlands, this mandated their reimbursement in accordance with Dutch regulations. Moreover, the prevailing better integration of health services enabled operational support from laboratories to GP practices. In England, the funding constraints of the National Health Service and the prioritization of alternative and less expensive antimicrobial stewardship interventions prevented the development of a reimbursement scheme. In addition, the lack of integration between health services limits the operational support to GP practices. In both countries, the availability of CRP POC tests for the management of children is a by-product of the test being available for adults. The tests are less used in children mainly because of concerns regarding their accuracy in this age-group.ConclusionsThe engagement of early adopters combined with a more favourable and receptive macro level environment, including the role of clinical guidelines and their developers in determining which interventions are reimbursed and the operational support from laboratories to GP practices, led to the greater adoption of the tests in the Netherlands. In both countries, CRP POC tests, when available, are less used less in children. Organisations considering introducing POC tests into primary care settings need to consider how their implementation fits into the wider health system context to ensure achievable plans.

Healthcare professionals’ perception of barriers and facilitators for care coordination of older adults with complex care needs being discharged from hospital: A qualitative comparative study of two Nordic capitals

BackgroundThe handover of older adults with complex health and social care from hospital admissions to homebased healthcare requires coordination between multiple care providers. Providing insight to the care coordination from healthcare professionals’ views is crucial to show what efforts are needed to manage patient handovers from hospitals to home care, and to identify strengths and weaknesses of the care systems in which they operate.ObjectiveThis is a comparative study aiming to examine healthcare professionals’ perceptions on barriers and facilitators for care coordination for older patients with complex health and social care needs being discharged from hospital in two capital cities Copenhagen (DK) and Stockholm (SE).MethodSemi-structured interviews were conducted with 25 nurses and 2 assistant nurses involved in the coordination of the discharge process at hospitals or in the home healthcare services (Copenhagen n = 11, Stockholm n = 16). The interview guide included questions on the participants’ contributions, responsibilities, and influence on decisions during the discharge process. They were also asked about collaboration and interaction with other professionals involved in the process. The data was analysed using thematic analysis.ResultsMain themes were communication ways, organisational structures, and supplementary work by staff. We found that there were differences in the organisational structure of the two care systems in relation to integration between different actors and differences in accessibility to patient information, which influenced the coordination. Municipal discharge coordinators visiting patients at the hospital before discharge and the follow-home nurse were seen as facilitators in Copenhagen. In Stockholm the shared information system with access to patient records were lifted as a facilitator for coordination. Difficulties accessing collaborators were experienced in both settings. We also found that participants in both settings to a high degree engage in work tasks outside of their responsibilities to ensure patient safety.ConclusionsThere are lessons to be learned from both care systems. The written e-communication between hospitals and home health care runs more smoothly in Stockholm, whereas it is perceived as a one-way communication in Copenhagen. In Copenhagen there are more sector-overlapping work which might secure a safer transition from hospital to home. Participants in both settings initiated own actions to weigh out imperfections of the system.

How to become an excellent pediatric resident: a qualitative comparative study from China

BackgroundCompetency-oriented medical education has become a global trend. However, most current studies focus on the independent effects of various competencies and lack an examination of the combined effects. Therefore, the purpose of this study was to explore the competency configurations of excellent pediatric residents and general pediatric residents and to provide a scientific reference for the talent training and career development of pediatric residents.MethodsBehavioral event interviews were conducted with 23 pediatric residents at a children's hospital in Beijing in July and August 2019. Two researchers coded the interview data to summarize the competency of pediatric residents. The research group scored the performance of 23 pediatric residents in various aspects of competency and used the crisp-set qualitative comparative analysis method to explore the competency configurations of excellent pediatric residents and general pediatric residents.ResultsThis study concludes that pediatric residents should have six core competencies: professional spirit, clinical skills, communication ability, learning ability, mental capacity and research ability. There are 4 combinations of competencies for becoming an excellent pediatric resident: the clinical type, scientific research type, all-around development type and high emotional intelligence type. In addition, there are 3 combinations of competencies for becoming a general pediatric resident: the comprehensive ability deficiency type, lack of professionalism and mental capacity type, lack of communication ability type.ConclusionsThere are differences in competence between excellent and general pediatric residents. Excellent pediatric residents do not need to possess all competencies but should specialize in clinical practice, scientific research or communication skills. This study suggests that training in mental capacity, professional spirit and communication ability should be strengthened during pediatric resident training. Pediatric residents should make career development plans according to their actual situation, and hospitals should arrange suitable positions according to the characteristics of pediatric residents.

CORR Insights®: A Qualitative Study of Psychosocial Factors in Patients With Knee Osteoarthritis: Insights Learned From an Asian Population.

CORR Insights®: A Qualitative Study of Psychosocial Factors in Patients With Knee Osteoarthritis: Insights Learned From an Asian Population.

Educational (mis)match in the context of new manufacturing: A qualitative comparative analysis study in five European countries

AbstractThe article examines the interplay between shop‐floor employees' educational levels, and firms' training strategies (expressed by the breadth of the training, the extent of the advanced IT training, and skills development in collaboration with local or national technical schools), leading to multinational companies' educational (mis)match in the context of the new model of manufacturing, known as ‘Industry 4.0.’ Following a survey of 26 senior managers from different companies operating in four advanced manufacturing industries (biotech, engineering, fashion and new materials) in five European countries (Germany, Italy, Spain, Sweden and the UK), a fuzzy‐set qualitative comparative analysis (fs/QCA) is applied. The results suggest several equifinal paths to corporate educational (mis)match. The findings reveal the need for a more hybridised coexistence between tertiary education and training activities, which can emerge from the cooperation of local actors (education/training institutions and businesses together). Tertiary education, training programmes focused on advanced IT skills, and collaborating with local knowledge providers can reinforce the effect; indeed, their presence (singly or in combination) intensifying the achievement of high levels of educational match. In the absence of these conditions (singly or in combination), a broad training programme can act as a counterbalance and vice versa. Policymakers should put in place tools to enable more inclusive access to collaborations between local businesses and knowledge providers, promoting an upgrade of educational programmes to develop shop‐floor workers who are more digitally aware, and better prepared to successfully undertake non‐routine cognitive tasks. This would foster the self‐sustainability and flourishing of advanced manufacturing in high‐income countries.

A hybrid controller method with genetic algorithm optimization to measure position and angular for mobile robot motion control.

Due to the complexity of autonomous mobile robot's requirement and drastic technological changes, the safe and efficient path tracking development is becoming complex and requires intensive knowledge and information, thus the demand for advanced algorithm has rapidly increased. Analyzing unstructured gain data has been a growing interest among researchers, resulting in valuable information in many fields such as path planning and motion control. Among those, motion control is a vital part of a fast, secure operation. Yet, current approaches face problems in managing unstructured gain data and producing accurate local planning due to the lack of formulation in the knowledge on the gain optimization. Therefore, this research aims to design a new gain optimization approach to assist researcher in identifying the value of the gain's product with a qualitative comparative study of the up-to-date controllers. Gains optimization in this context is to classify the near perfect value of the gain's product and processes. For this, a domain controller will be developed based on the attributes of the Fuzzy-PID parameters. The development of the Fuzzy Logic Controller requires information on the PID controller parameters that will be fuzzified and defuzzied based on the resulting 49 fuzzy rules. Furthermore, this fuzzy inference will be optimized for its usability by a genetic algorithm (GA). It is expected that the domain controller will give a positive impact to the path planning position and angular PID controller algorithm that meet the autonomous demand.

Social support and very young adolescent girl's knowledge on sexual relationships: A comparative qualitative study of Girl Only Clubs' participants and non-participants in rural Malawi.

Early sexual relationships are associated with an increased risk of acquiring sexually transmitted diseases including HIV/AIDs, teenage pregnancies, and unsafe abortions among other negative health outcomes. Understanding sexual relationships among very young adolescents (VYAs) is important to equip them to protect themselves from negative sexual health (SH) outcomes. DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) is an HIV prevention initiative that provided an evidence-based core package of interventions to VYAs to prevent HIV acquisition in 15 countries in sub-Saharan Africa. The Girl Only Club (GOC) was the primary context for the interventions. Our objective in this study was to explore if there was any difference in social support (SS) received concerning sexual relationships between the VYA girls who attended GOCs and those who did not. In-depth interviews were conducted with 43 VYA girls, aged 10-14 years, in two rural southern districts, Zomba and Machinga, in Malawi. Twenty-three VYA girls were participants in GOCs and 20 VYA girls did not participate. A thematic, descriptive approach that involved a constant comparative analysis guided the data analysis, and Nvivo 12 software was used. In both study sites available SS concerning sexual relationships is informational support including information from parents, older relatives, and friends. However, club participants differed from non-club participants in sexual and reproductive health (SRH) knowledge and use. Club participants reported consulting others on decision-making and information on sexual relationships; receiving detailed SH information from clubs; condom use due to education received from the clubs; quitting sexual relationships; and correcting misinformation with club information. GOC participants received more SS which made them more knowledgeable and better at handling sexual relationship issues than those not in clubs. Interventions that integrate SS including social asset building and safe spaces are critical for VYA SRH programming.

Affordances and constraints of the teacher-to-teacher online marketplace of ideas: understanding early career elementary teachers’ perceptions

Recognizing the role that online platforms hold in education, this study explores how three early career elementary teachers perceive the affordances and constraints of online curriculum sharing platforms. Using pedagogical design capacity as a theoretical framework, we engaged in a comparative qualitative case study to examine the ways early career teachers in differing contexts approach platforms like TeachersPayTeachers and Instagram. Findings emphasize the participants’ perceived affordances and constraints of these platforms and the curricular materials found in these spaces. Additionally, we identify three distinct points of interest for the teaching profession and future research to better understand teachers’ use of these platforms and the application of their pedagogical design capacity when working to supplement and design curriculum.

A comparative study: Accreditation of universities' disaster risk management for health promotion.

Risk management processes accreditation in emergencies and disasters can determine the effectiveness and efficiency of these processes. Universities, as the highest level of education, should provide a safe environment for educational services and activities of these people. The present study aimed to review and compare different accreditation models for emergencies and disaster risk management in selected countries. Reaching other accreditation models together and identifying their similarities and differences, along with considering the implementation of each model, can significantly help the countries which aim to design and develop a risk management accreditation model or upgrade their models. In this qualitative comparative study, the US, UK, Canada, Australia, Japan, and South Africa were selected based on research criteria. A literature review compared university emergency and disaster risk management accreditation models. The obtained data were collected in a researcher-made matrix, and a content analysis method was used for data analysis. Differences and similarities of selected countries in the fields of accreditation program(s), accreditation institute, start year, obligation, accredited organizations, number of criteria, criteria titles, accreditation focus, accreditation stages, number of stages, scoring method, and ranking method were compared. Designing a local model for the accreditation of disaster risk management in universities based on the crisis management system in each country can lead to improving the level of responsiveness and quality of services in emergency situations and health promotion.

Navigating the micro-politics of major system change: The implementation of Sustainability Transformation Partnerships in the English health and care system.

To investigate how health and care leaders navigate the micro-politics of major system change (MSC) as manifest in the formulation and implementation of Sustainability and Transformation Partnerships (STPs) in the English National Health Service (NHS). A comparative qualitative case study of three STPs carried out between 2018-2021. Data collection comprised 72 semi-structured interviews with STP leaders and stakeholders; 49h of observations of STP executive meetings, management teams and thematic committees, and documentary sources. Interpretative analysis involved developing individual and cross case reports to understand the 'disagreements, 'people and interests' and the 'skills, behaviours and practice'. Three linked political fault-lines underpinned the micro-politics of formulating and implementing STPs: differences in meaning and value, perceptions of winners and losers, and structural differences in power and influence. In managing these issues, STP leaders engaged in a range of complementary strategies to understand and reconcile meanings, appraise and manage risks and benefits, and to redress longstanding power imbalances, as well as those related to their own ambiguous position. Given the lack of formal authority and breadth of system change, navigating the micro-politics of MSC requires political skills in listening and engagement, strategic appraisal of the political landscape and effective negotiation and consensus-building.

Management of patients with acute radiation dermatitis. Current trends and clinical examples

Nowadays radiotherapy is one of the main methods of cancer treatment. According to the WHO, more than 50% of patients with diagnosed malignancies need radiation therapy. However, there are a number of side effects of the latter, which are as much the task of the radiotherapist as the actual treatment of the tumor. Skin reactions are one of the most common side effects of radiation therapy, affecting up to 85-95% of patients. Radiation dermatitis is a unique pathology compared to other forms of skin damage, such as traumatic, because the radiation spreads from the epidermis to the deep tissue layers consistently. Such skin reactions can cause some discomfort in cancer patients and even real problems, including interruptions in treatment, decreased aesthetic appeal and decreased quality of life. Recent technological advances and new radiodermatitis treatment regimens represent an opportunity to alleviate the side effects of radiation therapy. Despite a variety of techniques for conservative treatment of radiation dermatitis, the most severe cases may require complex surgical reconstruction of the damaged skin, which is why correction and prevention of skin reactions is a priority in patient care. Despite the large number of trials in this area, there are few qualitative comparative studies that can provide a clear picture of the efficacy of individual radiodermatitis-relieving agents. This literature review reviews the current agents used to treat and prevent acute radiation dermatitis, as well as their mechanisms of action. Three electronic databases, including PubMed, Cochrane, and Embase, were used to find information for the systematic review.

The "autonomy" of developing countries in the Olympic Movement: Assessing the fate of sports governance transplants in the Global South.

The International Olympic Committee (IOC) imposes very specific ideas on sports governance, more precisely on sports autonomy, on countries joining the Olympic Movement. Given that the idea of sports autonomy originated in the Global North, this article introduces the concept of governance transplants to evaluate the impact that being part of the Olympic Movement has on domestic sports governance in Global South developing countries. The article explores the extent to which the IOC is successful in implementing the norms and regulations on sports autonomy as a governance transplant at the national level in countries from the Global South that are part of the Olympic Movement. The article employs a comparative qualitative case study research design that explores the relations of the IOC, National Olympic Committees (NOCs), and national governments in Botswana, Guatemala and Sri Lanka. Research relies on a mix of document analyses and expert semi-structured interviews conducted during field trips to those countries. Interviews were transcribed and analyzed by means of thematic analysis. The analyses focus on domestic policies and contexts, formal and institutional compliance with sports autonomy, provision of public funding, and participation in national sport policy-making. Findings suggest that national structures and legacies have an impact on the way in which the autonomy of sport, as the governance transplant, is translated in those three countries. Although national governments enjoy some agency in "translating" governance transplants, results also suggest that misfits and tensions persist between governmental and sport stakeholders at the national and international level. Such misfits might force the IOC, as a private transnational regulator, to adopt a more pragmatic view on the enforcing of its governance transplants. The results are of relevance to existing discussions on global sports governance and debates as to whether the countries in the Global North might be able to impose their views and their governance transplants if the Global South gets a greater say in transnational sports governance.

The Impact Of Covid-19 On Operational Costs At Communication And Informatics Services In Parepare City

The purpose of this study was to analyze the impact of the operational costs at Communication and Informatics Services in Parepare City before and during the Covid-19 pandemic. This type of research was a comparative qualitative descriptive study by conducting analysis to look for existing phenomena. The results of this study indicate that the amount of expenses increases. Judging from the amount of expenses that are large compared to the allocated budget, the Communication and Informatics Serviceswas experiencing a deficit. One reason is that part of the budget has been diverted to the handling of the Covid-19 disaster. This was done to align with regional financial capabilities in anticipating and strengthening programs deemed capable of tackling Covid-19. To overcome the deficit, it can be done by reducing subsidy expenditures, saving every routine expenditure, evaluating expenditures based on priorities and reducing costs for ineffective programs.

The influence of governance structure on local resilience: Enabling and constraining factors for climate change adaptation in practice

Across the globe, the need to adapt is urgent. Coastal communities are particularly vulnerable to climate stressors such as rising sea levels and erosion, while more extreme and variable weather events interact to accentuate risk. While local governments are increasingly recognized as a central local actor in climate adaptation, research continues to focus on resilience at municipal or national levels of government, limiting circumstances for analysis of differing governance structure. Regional government structure can vary drastically, offering a novel opportunity to explore the effects of governance structure on local capacity for resilience. Framed through a resilience lens, this comparative qualitative study analyzes adaptation within two distinct regional governments, finding that unique structural attributes of regional governments can enable or constrain climate adaptation planning. For instance, increased adaptive capacity, through greater access to critical resources, can facilitate action. In contrast, implementation can be constrained by regional agent priorities and a lack of adaptation consideration in granular planning tools. This study sheds light on how to better utilize strengths of regional governments, and how to integrate interventions within broader policy frameworks to overcome common adaptation barriers.

Implementing Equity and Equality at the Frontline in Two Contrasting Welfare-To-Work (WTW) Organizations in California

ABSTRACT This study provides a comparative qualitative case study on two welfare-to-work (WTW) offices with a different understanding of equity and equality. By analyzing organizational documents (n = 27), manager interviews (n = 10), observations of worker-client interactions (n = 13) and worker interviews (n = 13), we find cross-case and within-case variation on frontline worker practices. In the equality-oriented organization, workers acknowledge structural differences, but their practices are more focused on gender- and color-blind equality in treatment. In the equity-oriented organization, we find that more workers implement equity practices. Our findings suggest that organizational context interplays with the practices and beliefs of frontline workers; hence, shaping the fairness of client treatment.

Structures of Loyalty: A Comparative Study of Jewish and Palestinian Evangelicals' Acquiescence to Fundamentalist and Authoritarian Values

This is a qualitative comparative study of two evangelical movements in Israel and in the West Bank: the Israeli Messianic (IM) movement and the Palestinian Evangelical (PE) movement. Through interviews on how informants understand the Middle Eastern conflict, our aim is (1) to compare the prevalence of fundamentalist/authoritarian (F/A) values in the IM and PE movements and (2) to understand how a particular socio-political context —Israel and the West Bank—might affect the acquiescence to a F/A mindset amongst the two movements. To accomplish this, we created a F/A construct that measures five values: literalism, social withdrawal, authoritarian aggression, authoritarian submission, and conventionalism. We found that the IM scores higher on all five F/A values. To explain the difference, we point out the importance of structures of loyalty: the difference in how IMs and PEs connect to key societal groups affects the way they acquiesce to fundamentalist and authoritarian values.

TOWARDS SUSTAINABLE DEVELOPMENT: EVALUATION OF SPATIAL PLANNING REGENCY/MUNICIPALITY IN WEST JAVA PROVINCE, INDONESIA

Spatial planning performance indicators are related to sustainability. This approach combines quantitative and qualitative data to see the sustainability of regional spatial planning based on land and policies. This study aims to: (1) Analysis of the sustainable development index (IPB) and (2) Analysis of causal conditions of spatial planning performance assessment per regencies/municipalities based on IPB. The approach used is IPB, geographic information system, multi-value qualitative comparative analysis and literature study. The highest score of IPB is Bandung Municipality. The income per capita, education and welfare of the Municipality of Bandung are higher than in other regions. Considering the distribution of IPB scores and their constituent variables, subsequent analysis shows the need to differentiate between regencies and municipalities. Regional sustainability in this regency offers high compatibility between spatial planning policies and forest area status policies have extensive vegetation cover and small land-use diversity. Whereas in urban areas, it shows the opposite. This article can answer the sustainability of spatial planning policies and differentiate between regencies and municipalities—the use of mvQCA is a new approach to spatial planning evaluation.