Cultural Considerations Research Articles

The Significance and Impact of Disasters on the Development of the Counseling Profession

<p>災難是人們生活中難以承受的意外事件。每次災難會帶來破壞與傷痛，可是也帶來重生與希望；災難對諮商專業帶來了許多挑戰，同時也帶來學習的課題與發展的契機。本文旨在探討災難對諮商專業發展所造成的影響，並深刻思考其中蘊含的意義與重要的議題，本文先依歷史的軌跡敘述臺灣對諮商專業發展有關的重要災難事件，其次探索其帶來的影響與意義，再探討災後心理救援經驗與通訊心理諮商應用，最後再針對其中涉及的文化與倫理考量進行討論，以期能就災難與諮商所涉及的相關議題進行深入而完整的探討。災難與諮商交織的不只是實務操作經驗的議題，其實也涉及專業發展、科技運用、文化議題與倫理考量。</p> <p> </p><p>Disasters, being an unexpected occurrence in people’s lives, bring destruction and pain as well as rebirth and hope. Disasters have brought several challenges to the counseling profession, such as in learning topics and development opportunities. This article aimed to explore the impact of disasters on the development of the counseling profession and to assess its implications and important issues. First, it described the important disaster events related to the development of the counseling profession in Taiwan based on historical trajectories. Second, we explored its impact and significance; then, we discussed the experience of post-disaster psychological rescue and the application of telecounseling. Finally, we discussed the cultural and ethical considerations involved, aiming to provide an in-depth and complete discussion of the issues involved in disaster counseling. Disasters and counseling are intertwined with issues in practical experience and professional development, technology use, cultural issues, and ethical considerations.</p> <p> </p>

Examining the Role of Organizational Culture on Citizenship Behavior: The Mediating Effects of Environmental Knowledge and Attitude Toward Energy Savings

Workplace energy conservation is vital for sustainability, as it reduces environmental harm, lowers greenhouse gas emissions, and conserves natural resources. Such procedures lead to significant financial savings, adherence to environmental standards, enhanced corporate social responsibility, and improved organizational citizenship behavior (OCB). This study investigated the impact of organizational culture (OCULT) on OCB, with environmental knowledge (EK) and attitude toward energy savings (ATES) as mediating factors. Components of the theories of planned behavior and value-belief-norm were evaluated through a structural equation model, showing that OCULT influences OCB through EK and ATES, suggesting OCULT’s direct and indirect effects on OCB. The degree to which EK and ATES mediate these effects varies, emphasizing the importance of a strong OCULT in fostering an environmentally conscious workplace. Specifically, the findings reveal that OCULT is responsible for positively impacting ATES and EK, with path coefficients of 0.587 and 0.661, respectively. OCB is positively influenced by it (coefficient of 0.228). The research indicates that knowledge is vital in improving organizational behaviors, with a significant correlation between EK and OCB (coefficient of 0.675). Mediation analysis indicates that EK mediates the relationship between OCULT and OCB (standardized estimate of 0.344), and that ATES and EK together can enhance OCB (standardized estimate of 0.078), demonstrating a robust and meaningful causal effect mediating this link. This outcome is the product of the mutually beneficial interaction among various variables. This study highlights the importance of integrating cultural considerations into knowledge management to foster a more engaged and proactive workforce, which will enhance organizational performance. As a practical implication, managers should promote energy-saving behaviors and nurture a supportive OCULT to enhance OCB. Incorporating sustainability into core organizational strategies will result in a dedicated workforce actively participating in OCB and energy-saving initiatives.

Parameters Identification Related to Design of Customer Relationship Management Structure for Health Tourism Facilitators in Iran: A Case Study of Iran

The Health Tourism Industry is burgeoning within Iran, presenting promising opportunities. Despite its relative infancy in the country, this sector predominantly comprises Small and Medium Enterprises (SMEs). These entities encounter a spectrum of challenges as they navigate the path to growth, with Customer Relationship Management (CRM) emerging as a prominent concern. Effective management of customer relations necessitates a comprehensive understanding of their diverse needs and challenges, spanning from initial engagement to the culmination of the relationship. Designing an effective CRM structure requires a meticulous exploration of these facets throughout the customer journey. In our study, we conducted a literature review to explore these challenges and employed a qualitative approach, conducting semi-structured interviews with seven Iranian health tourism facilitators. Through framework analysis, we identified key insights into CRM challenges and strategies. Our thematic analysis revealed seven pivotal themes germane to CRM within Iranian health tourism facilitation: Initial customer engagement; Transformation of information between customers and health tourism facilitator; Data assessment and Challenges in information exchange; Perception of service quality factors; Cultural and national considerations; Monitoring and oversight; and Stress mitigation strategies Keywords: customer relationship management, health tourism, health tourism facilitators, health care, customer journey

Employer–Domestic Worker Dynamic in Kolkata: From Maternalism to Transactionalism

Domestic workers used to be treated virtually as members of the family in South Asian contexts, with much evidence of various forms of exploitation. Presently, the increasing prevalence of formal patron–client dynamics among part-time domestic labourers in urban India takes specific hybrid forms that require further research. The article examines to what extent efforts to establish purely commercial arrangements in the domestic service sector may avoid traditional forms of exploitation. Or do more formal professional relationships still tend to benefit employers more, allowing them to assign additional tasks without offering corresponding extra benefits? The findings identify that establishing and maintaining purely professional relationships remains challenging in India due to deep-rooted ethical and cultural considerations and adaptability issues. Employers often unwittingly perpetuate traditional personalised domestic work settings. The article shows how both sides in this complex relationship struggle to identify and practice new modalities of fair interaction.

Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder impacting women's health and quality of life. This scoping review explores the use of the Internet of Things (IoT) in PCOS management. Results were grouped into six domains of the IoT: mobile apps, social media, wearables, machine learning, websites, and phone-based. A further domain was created to capture participants' perspectives on using the IoT in PCOS management. Mobile apps appear to be useful for menstrual cycle tracking, symptom recording, and education. Despite concerns regarding the quality and reliability of social media content, these platforms may play an important role in disseminating PCOS-related information. Wearables facilitate detailed symptom monitoring and improve communication with healthcare providers. Machine learning algorithms show promising results in PCOS diagnosis accuracy, risk prediction, and app development. Although abundant, PCOS-related content on websites may lack quality and cultural considerations. While patients express concerns about online misinformation, they consider online forums valuable for peer connection. Using text messages and phone calls to provide feedback and support to PCOS patients may help them improve lifestyle behaviors and self-management skills. Advancing evidence-based, culturally sensitive, and accessible IoT solutions can enhance their potential to transform PCOS care, address misinformation, and empower women to better manage their symptoms.

The varying effects of benefit types on community members' views of whether they gain from wildlife

AbstractCommunity‐based conservation (CBC) is a popular governance approach that asks rural populations to sustainably manage local wildlife resources. CBC programs often rely on the distribution of wildlife benefits to communities to foster tolerance of wildlife, with the idea that those benefits can offset costs arising from human‐wildlife conflict. A survey of residents in four Namibian CBC areas found that different benefit types varied significantly in their relationship with whether respondents felt that wildlife improved their lives. Some higher monetary value benefits evidenced a negative and/or non‐significant relationship with respondents' perceptions, whereas meat‐based benefits were associated with a greater likelihood of residents feeling that they benefited from wildlife. These findings suggest that the impact of different benefit types in CBC programs may depend on a host of cultural/social, psychological, and community‐specific factors. From a practical standpoint, the form of direct monetary benefits may matter, and cultural considerations likely play an important role in determining which and when specific benefits are more effective.

Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change.

Traditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework, an under-studied topic particularly salient in low- and middle-income countries (LMICs) such as Peru. To inform such interventions, we sought to identify key health systems barriers to hypertension care in Puno, Peru. A participatory stakeholder workshop (October 2021) and 21 in-depth interviews (October 2021-March 2022) were conducted with 55 healthcare professionals (i.e., doctors, nurses, midwives, dentists, nutritionists), followed by a deductive qualitative analysis of transcripts and notes. Participating healthcare providers indicated that low prioritization and lack of national policies for hypertension care have resulted in limited funding and lack of societal-level prevention efforts. Additionally, limited cultural consideration, both in national guidelines as well as by some providers in Puno, results in inadequate care that may not align with local traditions. Providers highlighted that patient care is also hampered by inadequate distribution and occasional shortages of medications and equipment, as well as a lack of personnel and limited opportunities for training in hypertension. Multiple incompatible health information systems, complicated referral systems, and geographic barriers additionally hinder continuity of care and care seeking. Insights gained from health providers on the healthcare system in Puno provide essential contextual information to inform development of organizational-level strategies necessary to improve provider and patient behaviors to achieve better hypertension care outcomes.

‘I don’t want to be seen as period prone’: An exploration of psychological strategies used across the menstrual cycle

Despite increased attention on the menstrual cycle in sport, research has focused largely on physiological changes, with relatively little consideration for fluctuations in psychological responses and coping strategies used in training and competition. This study's primary focus was to explore athlete's coping strategies throughout the menstrual cycle. Participants ( n = 12) took part in a focus group or interview, facilitated by reflections from a diary and mapping exercise. Reflexive thematic analysis was used to analyse the data, generating three themes: Impact of symptoms, coping strategies, and contextual constraints. Participants had increased awareness of physiological over psychological fluctuations, and associated symptoms were considered to impact practicalities of sport and performance. Participants used avoidance, acceptance, and planning to cope with the impact of menstrual symptoms. Coping options were influenced by contextual constraints, including the level of competition and type of sport. The findings showed that some participants lacked menstrual health literacy, especially in relation to psychological fluctuations. Continued efforts to raise awareness around the psychological symptoms of the menstrual cycle and its impact on performance and well-being are needed, not only for the athlete but importantly for the coaching population too. Specifically, consideration of the sporting culture and the space in which athletes feel they can communicate their coping strategies could be pivotal in moving forwards to help develop ‘period pro’ athletes.

The Effectiveness of aHospital Ethics Committee in a Non-Western Country: Lessons from a Ten-Year Experience.

Hospital ethics committees (HECs) arerelatively new in non-Western countries. This article examines the effectiveness of a HEC established in Bursa/Turkey over ten years, aiming to contribute insights for the wider implementation and enhancement of HECs. The evaluative methodology combines quantitative and qualitative approaches to assess its effectiveness. Patients are the primary users of the HEC, although applications from physicians, hospital managers, and the Patient Rights Board are also observed. Surgical specialities account for the majority of applications, particularly from obstetrics and gynecology, anesthesiology, and emergency medicine. The study identifies the types of applications, with malpractice claims, ethical inquiries, and access-related complaints being the most common. Despite many healthcare professionals encountering ethical dilemmas, the HEC was underutilized for consultations due to factors such as low awareness, perceived autonomy challenges, and skepticism regarding its efficacy. Additionally, the study describes how HEC recommendations contribute to policy development, addressing organizational issues and promoting ethical practices. The decision-making process within the HEC was also scrutinized, emphasizing the necessity of a structured methodology for moral deliberation. Concerns are raised about committee members lacking specific training in ethical analysis, potentially resulting in biases and suboptimal decisions. Contextual factors, including institutional culture and economic considerations, are also recognized for their influence on decision-making. This analysis highlights the multifaceted nature of HECs and the challenges they face in achieving effectiveness. It underscores the need for standardized measures, improved training for committee members, and contextual awareness to enhance the impact and functionality of HECs in healthcare institutions.

Designing Cultural Adaptations of Caregiver-Implemented Interventions for Latinx Caregivers of Children Who Use Augmentative and Alternative Communication: Key Considerations.

Caregivers play a critical role in their children's development and serve as their primary communication partners. Family interactions provide the most naturally occurring opportunities for children with complex communication needs to learn language in the context of family routines. A growing body of research suggests that caregivers can effectively support their children's use of augmentative and alternative communication (AAC) systems when provided with appropriate training and coaching through caregiver-implemented interventions (CIIs). However, the efficacy of these interventions remains untested among culturally and linguistically diverse caregivers. Given the increasing diversity in the United States, there is a pressing need to develop CIIs that align with the cultural and linguistic preferences of diverse families. Using the Ecological Validity Framework and the Checklist for Cultural Adaptations, this tutorial explores considerations for culturally adapting caregiver-implemented AAC interventions for Latinx caregivers of children with AAC needs. The aim is to ensure that interventions are relevant, meaningful, and respectful of cultural and linguistic practices. Through carefully crafted cultural adaptations, interventions can achieve greater acceptance by caregivers. This tutorial suggests a series of cultural adaptations to ensure accessibility, sustainability, and success of caregiver-implemented AAC interventions for Latinx caregivers of children with AAC needs. By incorporating cultural and linguistic considerations into the intervention design, we can enhance its acceptability among Latinx caregivers. This, in turn, can lead to improved outcomes in AAC implementation within the home environment.

From Insights to Impact: Understanding Cancer Screening Choices through Mixed-Methods.

The main objective of this comprehensive mixed-methods investigation conducted in Jordan were to explore and understand men's engagement in cancer screening. The research employed a mixed-methods approach, combining a survey with 209 participants and focus group interviews with 30 individuals. The survey involved quantitative data collection methods to gather information on cancer screening participation rates among men in Amman. Focus group interviews were conducted to collect qualitative data on the factors influencing cancer screening utilization among men in Amman. The study revealed a notably low participation rate, with less than 37% of men engaging in cancer screening. The diminished involvement was attributed to several factors, including health illiteracy, language barriers, restricted access to health-related information and screening services, and cultural considerations. Based on the findings, the research strongly advocates for tailored interventions that are culturally specific. The emphasis is on the importance of training community health workers to address the identified challenges and enhance both cancer prevention awareness and screening accessibility in Jordan.

Mindfulness-Based Education: Exploring Cultural and Age-Related Perspectives Through Course Design

This study delves into the complexities of designing and implementing mindfulness education tailored to children and adolescents. Using basic theories of cognitive development such as Piaget's stages and Vygotsky's socio-cultural theories, the mindfulness classroom was designed to accommodate age-specific cognitive abilities and resulted in a curriculum design model that can be flexibly utilized to develop self-regulation skills and relate to activities that are critical in childhood, with the theory of mindfulness, present-focused activities, meditation activities, and perceptual activities that can be utilized as habits in real life. Through a combination of theoretical present-focused activities, meditation-related activities, perception-related activities, and activities that can be utilized in real life as habits, students develop self-regulation skills that are consistent with the cognitive flexibility that is essential in development. Sensory-related activities reinforce the integration of mindfulness into daily life. Working together to ensure accessibility in low socioeconomic status environments promotes inclusivity classroom, the study took place in a collective Chinese culture, but consideration of individualistic culture is also essential, and curricula tailored to the socio-emotional challenges of different ages need to be continually refined. Future research should explore cultural adaptation and expand the diversity of participants for a more inclusive understanding. In conclusion, this study advocates for mindfulness curricula to be synchronized with cognitive development, emphasizing that curricula should be designed with age-appropriate content, meditative practices, and real-life connections and adapted to different cultural backgrounds, socioeconomic backgrounds, and student populations with special needs.

Feasibility and Acceptability of a Prospective Syphilis Sexual Network Study for Sexual Minority Men.

In preparation for a prospective syphilis network study of sexual minority men, we conducted a mixed-methods formative study with the following objectives: a) assess acceptability of respondent driven sampling (RDS), b) assess acceptability of study procedures, c) social network seed selection, and d) pilot an ecological momentary assessment (EMA) study to assess social networking, sexual and substance use behavior. We conducted in-depth interviews with eight providers serving sexual minority men and five focus group discussions with 34 sexual minority men, prioritizing four target populations: young Black sexual minority men, 2) on PrEP, 3) living with HIV, 4) not engaged in care. The 4-week EMA pilot was conducted with 40 sexual minority men. EMA survey responses were analyzed to evaluate how different compensation levels influenced response rates. Brief exit surveys were used to assess EMA app acceptability. Primary themes identified through qualitative data collection: 1) importance of developing trust and maintaining confidentiality during proposed recruitment activities, 2) importance of compensating participants appropriately for study activities, and 3) cultural considerations for increasing visibility and participation of young Black sexual minority men. All EMA participants reported being "completely comfortable" reporting sexual behavior through the app. Most (78%) preferred the app to in-person interviews. Several participants identified technical issues with the app, including not receiving push notifications and spontaneous closure. This mixed-methods formative study allowed for adjustments to and tailoring of the planned network study, including recruitment protocols, compensation type and amount, and EMA survey wording and response items.

Investigating the influence of weirs and small dams on coarse sediment connectivity in low-energy rivers: A case study of the orne and vire rivers in Normandy, France

The removal of weirs has become emblematic of efforts to restore the good ecological status of rivers in France (Water Framework Directive -WFD- in 2006; the French Eel national management plan in 2007); however, it is increasingly facing opposition for the recreational and cultural considerations it brings (Germaine and Lespez, 2017). Previous studies have highlighted that bedload can pass through or over these weirs, although they acknowledged the difficulty in applying their conclusions to all geographic contexts. In this context, we aimed to determine the influence of these structures on the bedload connectivity in low-energy, highly human modified rivers. In this way, the objective of this study is threefold: generate knowledge about the mobility of a potential bedload in low-energy, highly anthropized contexts, better understand the influence of weirs and dams on these bedlaod dynamics, and identify the associated morphological changes. We monitored the bedload fraction of the Orne and Vire rivers (France) for 4 years using 848 pebbles equipped with passive transponders injected upstream of 2 dams and 4 weirs of different size and 2 reference sites where a weir or dam had been removed. While tracers' mobility was low (∼3–5 m yr−1 for T < 2 yrs), it was highly influenced by the presence of transverse structure (shorter distances and frequency of mobilization), even small ones. After 4 years of monitoring, no tracers crossed any of the weirs. This reduction in mobility was also due to decrease of shear stress within the reservoir as well as the physical barrier created by the weir. This interruption in bedload continuity resulted in a downstream coarsening of bed material downstream of the weirs but not at sites that had been restored for several years. Ultimately, the results of this study contribute to the scientific debate by focusing on two river reaches that have been greatly influenced by human activities for centuries.

Assessing urban family physician program challenges in Iran: the insurance organizations’ perspective(2021)

BackgroundThe Family Physician Programme is a key health reform in Iran that faces significant challenges in urban areas, particularly in Mazandaran and Fars provinces The study aims to critically evaluate the challenges encountered in the Urban Family Physician Program, with a particular focus on the perspectives of insurance organizations.MethodsA qualitative approach was adopted, involving semi-structured interviews with 22 experts and managers from basic health insurance funds. Snowball sampling facilitated participant selection, and interviews proceeded until saturation. Data analysis utilized content analysis and Atlas-T software, adhering to COREQ criteria.ResultsImplementation problems of the urban family physician program were categorized into ten Categories and 22 Subcategories, including financing, stewardship, human resources, structure, culture, information system, payment, monitoring and control, the function of insurance organizations, and implementation.ConclusionThe urban family physician program’s implementation challenges, as viewed by health insurance organizations, underscore the necessity for strategic decision-making in financing, payment models, electronic system integration, structural adjustments, comprehensive monitoring, evaluation, cultural considerations, and appropriate devolution to insurance entities.

Depression Among LGBT Adults in Relation to Societal Stigma and Discrimination

This study has conducted a comprehensive analysis of the association between depression and 13 social stigma and discrimination among LGBT adults from India. The data was conducted using the Google form, a user-friendly and dynamic online data collection tool, to collect data from 46 adults between the ages of 21 and 30 years old. The discrimination and stigma scale DISC-12, which evaluates the extent to which an individual is subject to prejudice and stigmatization based on sexual orientation, was used to measure the prevalence of depression in the study population. The aim of the study is to gain a better understanding of the relationship between discrimination and stigma and depression in the LGBT community. This research has revealed a strong correlation between depression and unfair treatment, halting self-reflection and depression, stopping self-and unfair treatment, overcoming stigma and depression, and positive treatment and stigma. The findings of this research have implications for individuals, healthcare professionals, policy makers, and society at large. Recommendations for future research include long-term longitudinal studies, intersectionality, cultural considerations, mental health promotion strategies, social support groups and parental support groups.

Nutritional Status, Eating Behaviors, and Gastrointestinal Symptom Cluster Among Children Receiving Cancer Chemotherapy in Thailand: A Descriptive Study

Background: Most children undergoing chemotherapy for cancer experience gastrointestinal (GI) tract symptoms that affect their eating habits, nutritional status, and quality of life (QOL). Previous research on the connections between these factors has primarily focused on Western countries. As a result, there is limited understanding of these issues among Thai children. Objective: To describe GI symptoms, eating, nutritional status, and QOL for Thai children with cancer. Methods: This descriptive study used multiple methods. Quantitative data were collected through (1) standardized measures of GI symptoms and QOL and (2) extraction of medical history and clinical data from the child’s medical records, then analyzed using descriptive statistics. Qualitative data were collected with semistructured interviews with each child, then their parent, and analyzed using a directed content analysis. Results: Sixteen child-parent dyads participated in this study. Most children exhibited reduced food intake and weight loss, primarily attributed to GI symptoms and environmental factors. Underreporting of symptoms was identified, contributing to suboptimal symptom management. Clinician-recommended low-bacterial diets posed challenges to maintaining children’s food intake. Additionally, hospital food with repetitive menus and plain flavors was generally undesirable for children during hospitalization. Conclusions: Multifaceted factors influencing the nutritional status and QOL of children with cancer within the unique care context of Thailand were identified. Implications for Practice: The study findings inform the development of multi-level interventions targeting to optimize eating, nutritional status, and QOL for children with cancer. What is Foundational: The model, informed by cultural considerations, could be adapted for research in other countries with distinctive cultures.

Redesigning Resettlement Homes for Internally Displaced Persons (IDPs) in Borno State

This study proposes a culturally informed redesign of resettlement homes for Internally Displaced Persons (IDPs) in Borno State, Nigeria. The existing housing designs often overlook the cultural values and nuances of the Kanuri people, the predominant ethnic group in the region. The research utilizes a mixed-methods approach, incorporating qualitative insights from interviews and focus groups with Kanuri community members, and data from surveys assessing current housing satisfaction, combining traditional Kanuri architectural features, spatial layouts, and social practices to create culturally responsive resettlement homes. This design intervention aims to enhance the emotional well-being, social cohesion, and resilience of IDPs in their new settlements. The study explores the impact of culturally sensitive design on the emotional well-being, social cohesion, and resilience of IDPs in their new settlements. Results indicate that incorporating traditional Kanuri design principles can significantly enhance the liveability and acceptance of resettlement homes, fostering a supportive environment that respects and preserves cultural identity. The findings underscore the importance of cultural considerations in architectural design for displaced populations, advocating for policies and practices that prioritize cultural relevance in housing solutions. This paper contributes to the broader discourse on humanitarian architecture and the role of culturally responsive design in improving the quality of life for displaced communities.

Workforce estimate to treat mental disorders in the Kingdom of Saudi Arabia

BackgroundMental, neurological, and substance abuse (MNS) disorders describe a range of conditions that affect the brain and cause distress or functional impairment. In the Middle East and North Africa (MENA), MNS disorders make up 10.88 percent of the burden of disease as measured in disability-adjusted life years. The Kingdom of Saudi Arabia (KSA) is one of the main providers of mental health services and one of the largest contributors to mental health research in the region. Within the past decade, mental health resources and services has increased.MethodsWe employ a needs-based workforce estimate as a planning exercise to arrive at the total number of psychiatrists, nurses, and psychosocial care providers needed to meet the epidemiological need of mental health conditions of the population of KSA. Estimates for a potential mental health workforce gap were calculated using five steps: Step 1—Quantify target population for priority mental health conditions. Step 2—Identify number of expected cases per year. Step 3—Set target service coverage for each condition. Step 4—Estimate cost-effective health care service resource utilization for each condition. Step 5—Estimate service resources needed for each condition.ResultsThe planning exercise indicates an epidemiologic need for a total of 17,100 full-time-equivalent (FTE) health care providers to treat priority MNS disorders. KSA appears to have a need-based shortage of 10,400 health workers to treat mental disorders. A total of 100 psychiatrists, 5700 nurses, and 4500 psychosocial care providers would be additionally needed (that is, above and beyond current levels) to address the priority mental health conditions. The shortfall is particularly severe for nurses and psychosocial workers who make up 98.9 percent of the shortfall. This shortage is substantial when compared to other high-income countries. Overall, the workforce needed to treat MNS conditions translates to 49.2 health workers per 100,000 population.ConclusionChallenges to addressing the shortfall are Saudi specific which includes awareness of cultural customs and norms in the medical setting. These challenges are compounded by the lack of Saudi nationals in the mental health workforce. Saudi nationals make up 29.5 percent of the physician workforce and 38.8 percent of the nursing workforce. Policymakers and planners supplement this shortfall with non-Saudi providers, who must be mindful of Saudi-specific cultural considerations. Potential solutions to reducing the shortfall of mental health care workers includes nurse task shifting and training of general practitioners to screen for, and treat, a subset of MNS disorders.

Implementing Agile Practices for Sustainable Business Expansion: A Literature Study Approach

This study contributes to the existing literature by providing a systematic review and synthesis of current research on agile practices specifically aimed at sustainable business expansion. It aims to identify key success factors, challenges, and strategic implications of implementing agile methodologies across different organizational contexts. This study employs a qualitative research approach to investigate the implementation of agile practices for sustainable business expansion. Qualitative methods are chosen to explore and analyze the complexities, nuances, and contextual factors associated with agile methodologies across diverse organizational settings. This research adopts a literature study approach, focusing on synthesizing and analyzing existing qualitative studies, case studies, and theoretical frameworks related to agile practices in business contexts. In conclusion, the adoption of agile practices is pivotal for sustainable business expansion in today's competitive landscape. By embracing agile methodologies, organizations can enhance their responsiveness to market changes, improve collaboration across teams, and accelerate innovation cycles. However, successful implementation requires careful consideration of organizational culture, leadership commitment, and ongoing training and development. Moving forward, further empirical research and longitudinal studies are needed to explore the long-term impacts and scalability of agile practices across diverse business environments.