Practitioners In Countries Research Articles

Mental Health and Psychosocial Support During COVID-19: A Review of Health Guidelines in Sub-Saharan Africa.

The COVID-19 pandemic brought in its wake an unforeseen mental health crisis. The World Health Organization published a guideline as a way of supporting mental health and psychosocial well-being of different groups during this pandemic. The impact of the pandemic has pushed governments to put measures in place to curb not only the physical health of individuals but their mental health and psychosocial well-being as well. The aim of our paper was to review mental health guidelines of some Sub Saharan African (SSA) countries: (i) to assess their appropriateness for the immediate mental health needs at this time, (ii) to form as a basis for ongoing reflection as the current pandemic evolves. Guidelines were retrieved openly from internet search and some were requested from mental health practitioners in various SSA countries. The authors designed a semi structured questionnaire, as a self-interview guide to gain insight on the experience of COVID-19 from experts in the mental health sector in the various countries. While we used a document analysis approach to analyze the data, we made use of the Mental Health Preparedness and Action Framework to discuss our findings. We received health or mental health guidelines from 10 SSA countries. Cameroon, Kenya, South Africa, Tanzania, and Uganda all had mental health guidelines or mental health component in their health guidelines. Our experts highlight that the mental health needs of the people are of concern during this pandemic but have not been given priority. They go further to suggest that the mental health needs are slightly different during this time and requiring a different approach especially considering the measures taken to curb the spread of disease. We conclude that despite the provision of Mental Health and Psychosocial Support guidelines, gaps still exist making them inadequate to meet the mental health needs of their communities.

Gender budgeting in the crossroad of gender policy and public financial management: The Finnish case

IMPACT Finland has been using gender budgets (GB) for over 10 years; however, very little is known internationally about the Finnish GB experience. Finland’s experience provides several lessons for GB practitioners in other countries. It highlights the importance of clear national gender equality goals for effective GB implementation, as well as the need to pay attention to mid-term fiscal frameworks. It also shows how the lack of feminist economic expertise and a clear conceptual framework can reduce GB to technical processes and calculations, and the importance of outside-government actors drawing attention to the gendered impacts of economic policies. ABSTRACT The paper analyses the implementation of gender budgeting (GB) in Finland. It contributes to GB literature through shedding light on the dynamics of politicization and depoliticization in GB implementation, as well as the complex position of GB between gender equality policy and public financial management. The paper provides new insights on what the shift towards mid-term budgetary frameworks means for GB, which to date have been missing from the GB literature. It also addresses the relationship of gender mainstreaming and GB, as well as the role of civil society in re-politicizing GB through drawing attention to the impacts of economic policies.

Strategic Pathways to Scale up Forest and Landscape Restoration: Insights from Nepal’s Tarai

Deforestation and forest degradation mostly caused by human interventions affect the capacity of the forest ecosystem to provide ecosystem services and livelihood benefits. Forest and landscape restoration (FLR) is an emerging concept that focuses on the improvement of the ecosystem as well as the livelihood of the people at the landscape level. Nepal has successfully recovered degraded forest land mainly from the hilly region through forest restoration initiatives, especially community-based forestry. However, the Tarai region is still experiencing deforestation and forest degradation. This study navigated the gaps related to forest restoration in the existing policies and practices and revealed that the persistence of deforestation and forest degradation in Tarai is a result of a complex socioeconomic structure, the limitations of the government in implementing appropriate management modality, unplanned infrastructure, and urban development. We suggest that forest restoration should focus on ecological and social wellbeing pathways at the landscape level to reverse the trend of deforestation and forest degradation in the Tarai regions of Nepal. The study provides critical insight to the policymakers and practitioners of Nepal and other countries (with similar context) who are engaged in forest/ecosystem restoration enterprise.

Evaluation of Science Communication: Current Practices, Challenges, and Future Implications

Scientifically substantiated evaluations are pivotal to ensuring the effectiveness and improvement of the growing number of science communication projects. Yet current evaluation practices are still lacking in various respects. Based on a systematic review of evaluation reports, an online survey of, as well as discussion rounds with science communication practitioners in the German-speaking countries, we discuss three main challenges of science communication evaluation: (1) There is a conflation of impact goals and measurable project objectives as well as a lack of precise definitions of objectives and target groups, which complicates the assessment of the projects' success. (2) Although many evaluations highlight the impact-oriented interest of those responsible, the methods chosen rarely allow scientifically valid evaluations of effects. The lack of comparative reference points and the partially unsuitable use of self-report measures are key issues in this regard. (3) The fact that few evaluation processes are made transparent and that formative evaluation designs are a rarity indicates a tendency to understand evaluations as the final ‘success story’ of a project rather than a learning process. This stands in the way of a constructive discussion of the actual impact of science communication. Our exploratory insights contribute to an understanding of the weaknesses of science communication evaluation and needs in the field. They also provide impulses for future improvements in the field for the stakeholders in practice, research, funding, and science management.

Requirements Engineering: An Industrial Survey in the Gulf Cooperation Council Countries

Requirements engineering (RE), the process of defining the requirements of a system, is critical to the successful implementation of software projects. Although many studies have been globally conducted on the different facets of RE in software engineering, studies explicitly focusing on the countries of the Gulf Cooperation Council (GCC) have been scarce. GCC-specific RE research studies are needed because of the unique cultural characteristics and common work ethics in GCC countries. Besides, the investigation of the state of RE practices in the countries of the GCC is crucial as the globalization of software development becomes imminent. This study compares the state of RE practices within the six countries of the GCC, namely, the Kingdom of Saudi Arabia (KSA), the United Arab Emirates (UAE), Qatar, Kuwait, Bahrain, and Oman, using six RE factors. To understand commonalities and differences in the RE practices and methods, 163 software practitioners in GCC countries are surveyed in this study. The results show that the RE practices are relatively similar among the six countries, with subtle differences. Initiating software-related projects with unclear requirements and undefined project scopes are the two major limitations of the RE practices among the survey participants. The results of this study contribute to providing project managers and system analysts, who are working globally and within the GCC countries, with valuable decision-making tools to help them consider the identified RE techniques, methods, and challenges and their related risks early in their software development projects

Blue\u2013Green Infrastructure for Flood and Water Quality Management in Southeast Asia: Evidence and Knowledge Gaps

In Southeast Asia, projections of rapid urban growth coupled with high water-related risks call for large investments in infrastructure—including in blue–green infrastructure (BGI) such as forests, parks, or vegetated engineered systems. However, most of the knowledge on BGI is produced in the global North, overlooking the diversity of urban contexts globally. Here, we review the literature on BGI for flood risk mitigation and water quality improvement in Southeast Asian cities to understand the scope of practical knowledge and identify research needs. We searched for evidence of local types of BGI in peer-reviewed and grey literature and assessed the performance of BGI based on hydrological, societal, and environmental metrics. The body of literature on BGI in Southeast Asia is small and dominated by wealthier countries but we found evidence of uptake among researchers and practitioners in most countries. Bioretention systems, constructed wetlands, and green cover received the most attention in research. Evidence from modelling and laboratory studies confirmed the potential for BGI to address flooding and water quality issues in the region. However, practical knowledge to mainstream the implementation of BGI remains limited, with insufficient primary hydrological data and information on societal and environmental impacts. In addition, the performance of BGI in combination with grey infrastructure, under climate change, or in informal settlements is poorly studied. Future research and practice should focus on producing and sharing empirical data, ultimately increasing the regional knowledge base to promote efficient BGI strategies.

The prevalence, severity and chronicity of abuse towards older men: Insights from a multinational European survey.

Elder abuse is a growing public health question among policy makers and practitioners in many countries. Research findings usually indicate women as victims, whereas male elder abuse still remains under-detected and under-reported. We aimed to investigate the prevalence, severity and chronicity of abuse (psychological, physical, physical injury, sexual, and financial) against older men, and to scrutinize factors (e.g. demographics) associated with high chronicity of any abuse. Randomly selected older men (n = 1908) aged 60-84 years from seven European cities (Ancona, Athens, Granada, Kaunas, Stuttgart, Porto, Stockholm) were interviewed in 2009 via a cross-sectional study concerning abuse exposure during the past 12 months. Findings suggested that prevalence of abuse towards older men varied between 0.3% (sexual) and 20.3% (psychological), with severe acts between 0.2% (sexual) and 8.2% (psychological). On the whole, higher chronicity values were for injury, followed by psychological, financial, physical, and sexual abuse. Being from Sweden, experiencing anxiety and having a spouse/cohabitant/woman as perpetrator were associated with a greater "risk" for high chronicity of any abuse. For men, severity and chronicity of abuse were in some cases relatively high. Abuse towards older men, in the light of severe and repeated acts occurring, should be a source of concern for family, caring staff, social work practice and policy makers, in order to develop together adequate prevention and treatment strategies.

An overview of Portulaca oleracea: Phytochemistry and pharmacological activities

Purslane (Portulaca oleracea L.) is an annual herbaceous plant belongs to the family Portulacaceae. These plants have various pharmacological properties, including antioxidant, anti-inflammatory and analgesic activities and a variety of phytochemicals. Purslane is a medicinal herb, which is frequently used by the traditional practitioners in Algeria, north afreca and many other countries of the world for the treatment of various diseases. Findings suggest that purslan possesses many important phytochemical and pharmacological activities. According to scientific reports, P. oleracea contains most of the principal active molecules such as phenolisc compoubds, tannins, reducing sugars, steroids, glycosides, flavonoids, especially alkaloids of various kinds, such as trigonelline, sildenafil, indole and norharman. Pharmacological investigations suggest that the plant has antioxidant, antidiarrheal, anti-inflammatory and, analgesic activities. In conclusion, P. oleracea may be one of the best sources of plant-based drugs.

Barriers to the use of trained interpreters in consultations with refugees in four resettlement countries: a qualitative analysis using normalisation process theory

BackgroundIncreasing numbers of primary care practitioners in refugee resettlement countries are providing care to refugees. Access to trained interpreters is a priority for these practitioners, but there are many barriers to the implementation of interpreted consultations in routine care. There is a lack of international, theoretically informed research. The purpose of this paper is to understand barriers to interpreter use in primary care consultations in four resettlement countries using Normalisation Process Theory.MethodWe conducted a cross-sectional online survey with networks of primary care practitioners (PCPs) who care for refugees in Australia, Canada, Ireland and the US (n = 314). We analysed qualitative data from the survey about barriers to interpreter use (n = 178). We completed an inductive thematic analysis, iteratively developed a Normalisation Process Theory (NPT)-informed coding frame and then mapped the emergent findings onto the theory’s construct about enacting interpreted consultations.ResultsIn all four countries, the use of an interpreter presented communication and interaction challenges between providers and patients, which can impede the goals of primary care consultations. Primary care practitioners did not always have confidence in interpreted consultations and described poor professional practice by some interpreters. There was variation across countries, and inconsistency within countries, in the availability of trained interpreters and funding sources.ConclusionThere are shared and differential barriers to implementation of interpreted consultations in a consistent and sustained way in the four countries studied. These findings can be used to inform country-specific and international level policies and interventions focusing on improving skills and resources for interpreted consultations to improve implementation of interpreted primary care consultations.

Paediatric Diagnostic Reference levels in low Resource Settings: A Guide for developing Country Practitioners with excerpts from ICRP 135

Background: The practical implementation of Diagnostic Reference Level in pediatric imaging is a complex task due to their unique individuality in terms of high sensitivity to radiation, varying body sizes and presenting pathology. Hence, good knowledge of medical technology, skill to perform patient dosimetry and to analyze mage quality is required.
 Purpose: To provide a guide on the methodological requirements for the establishment of Paediatric Diagnostic Reference Levels (PiDRLs) based on the revised and updated guidelines from the current ICRP publication 135 on Diagnostic Reference Levels (DRLs).
 Materials and method: An extensive review of the ICRP report Publication 135 on Diagnostic Reference levels in medical imaging with a focus on paediatric imaging and other related studies were undertaken. 
 Results: The ICRP report 135 updates and refines the recommendations of 2001. It highlights that the application of DRLs in paediatrics alone is not sufficient for the optimization of protection. Image quality must be evaluated. Quantities used for DRLs should be appropriate to the imaging modality being evaluated, assess the amount of ionizing radiation applied to perform a medical imaging task, and be measured directly. For interventional procedures, the complexity of the procedure may be considered in setting DRLs. DRLs shall not be used for individual patients or as trigger (alert or alarm) levels for individual patients. Appropriate weight bands (generally with 5 or 10 kg intervals) are recommended for establishing paediatric DRLs and should be promoted.
 Conclusion: The amount of radiation used for examinations of children can vary tremendously due to the great variation in patient size and weight from neonates to adult-sized adolescents. This variation in patient radiation dose is appropriate. However, variation in patient doses due to inappropriate technique or failure to child-size the imaging protocol is not appropriate. This forms the basis of the new ICRP guideline and should form the basis of developing PiDRLs.

Recall intervals for oral health in primary care patients.

Recall intervals for oral health in primary care patients.

Systematic review: Effects of sustained nurse home visiting programs for disadvantaged mothers and children.

To systematically evaluate published experimental studies of sustained nurse home visiting (SNHV) programs. This review summarizes the evidence and identifies gaps in the literature to inform practice, policy, and future research. Restricted systematic review with narrative summary. Databases searched were Medline, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials. Year of publication was originally restricted from 2008 to the date of search (13 February 2018, with supplementary searches conducted to identify more recent publications (up to 2019). Several reputable evidence clearinghouses were also searched. Studies were included if they used a randomized or cluster-randomized controlled trial to evaluate a home visiting program that: (a) targeted disadvantaged mothers; (b) commenced during pregnancy or prior to the child's first birthday; (c) had an intended duration of at least 12months from the time of enrolment; and (d) was substantively delivered by nurses or midwives. Meta-analyses and reviews of studies meeting these criteria were also included. A quality appraisal was conducted for all studies. Of 1,393 total articles, 30 met inclusion criteria. Seven specific SNHV programs were identified. Each demonstrated evidence of a positive statistical effect on at least one child or maternal outcome. Sustained nurse home visiting programs benefit disadvantaged families, though effects vary across outcomes and subgroups. Further research is needed to discern the critical components of effective programs. As SNHV programs have gained policy appeal, the need to evaluate the evidence-base supporting such interventions has become imperative. The findings of this review will assist policy-makers and practitioners in high-income countries to make evidence-informed decisions about which programs are best suited to addressing specific maternal and child outcomes for disadvantaged families. This should in turn ameliorate some of the inequalities in child development that have significant social and economic costs.

Career counselling with life design in a collectivist cultural context: An action research study

Large-scale macro forces are restructuring forms of work in urban India creating the need for alternative methods of career counselling. This research explores the application of a US-based approach to constructing careers i.e. Life-Design Career Counseling (i. e., LDC) with two mid-career professionals in India. Data consisted of client responses to different narrative career counselling exercises such as a lifeline activity, a career construction interview and semi-structured feedback interviews. Action research's focus on reflexivity helped integrate theory with practice to contribute to knowledge production and meaningful innovations within practice. Findings from this research underscored the importance of relationship, reflection and sense-making and the need for India to utilise a culturally resonant career intervention. The study holds value for career professionals, in India and beyond where LDC is still unexplored. Moreover, LDC practitioners in non-Western countries and collectivist societies will benefit from a contextual adaptation that encourages focus on client learning.

Muslim auditors’ ethics

The article discusses Islamic ethics and the impact it has on the professional ethics of Muslim auditors. Based on studies of the available literature on the subject and the Qur’an, the paper identifies the source of Muslim ethics and indicates that its perspective is slightly different from the perspectives known in the West. It also identifies the ethical principles which should be followed by a Muslim auditor. The analysis of the sources indicates that Islamic ethics and the understanding of certain principles and rules in Mus-lim countries differ (for cultural and religious reasons) from the perspective commonly adopted in other countries, hence the belief that it is necessary to create their own code of ethics for professionals, such as auditors. Attempting to assess how cultural norms affect professional ethics, based on a selected example of professional audit practitioners in Muslim countries, the article may be a prelude to further research in this direction, not necessarily in relation to the Islamic cultural circle.

Lifestyle Risk Factors for Type 2 Diabetes Mellitus and National Diabetes Care Systems in European Countries.

Background. Diabetes is increasing by 3.09% per year in males and 1.92% in females. Lifestyle risk factors are related to diabetes. The aim of this work is to highlight within EU-28 countries the distribution percentages of some lifestyle risk factors and some components of diabetes health care. Methods. A literature search was conducted to highlight the presence of diabetes registries, which are fundamental tools for disease surveillance and health planning; the presence of a national diabetes plan (NDP); the care setting; and methods used for reimbursement of drugs, devices, and coverage of any comorbidities associated with diabetes. A multiple correspondence analysis (MCA) was carried out to evaluate the possible associations between the variables considered. Results. The highest percentages of diabetes (>10%) are registered in Bulgaria, Malta, and Hungary. Concerning the prevalence of overweight, no European country shows overall percentages of less than 50%. Regarding obesity, 57% of countries show prevalence rates of 25%. The record for physical inactivity belongs to Malta, with 45% of individuals being inactive. The percentage of physical inactivity for females is higher than for males across Europe. In total, 57% of the countries have an insurance-based health system, while 12 countries have public national health systems. Further, 57% of countries have an NDP, while 42% of the EU countries have established a prevalence register for diabetes. Conclusions. Prevalence rates for type 2 DM in the range of 8–9% are noted in 50% of EU-28 countries. In total, 21 out of EU countries show a high prevalence rate for overweight, while 7% of EU-28 countries have an obesity prevalence rate of 25%. Diabetes treatment is entrusted to general practitioners in most countries. The results of this work highlight the differences between countries, but also between genders.

Refining e-shoppers’ perceived risks: Development and validation of new measurement scale

Due to the rapid expansion of perceived e-shopping risks, and highly isolated and inconsistent presentation of literature about this concept, understanding e-shopper's behavior has become more difficult. In this regard, this study brings together different views, evidences and facts about perceived e-shopping risks from both scholars and practitioners of South-East Asian and Western countries. It then interprets the information in the form of a new scale which offers more adequacy, assemblage and uniformity than the existing models of perceived risks of e-shoppers. The new scale of construct has 11 dimensions comprising a pool of 38 items, which has been empirically validated through the data collected from 537 Malaysian e-shoppers. The dimensions are: high price risk, deception risk, transaction failure risk, dissimilar product risk, incapable service risk, illegitimate product risk, isolation risk, unease risk, displeasure risk, prior-purchase time delays risk, and post-purchase time delays risk. The theoretical and managerial implications and research limitations have also been discussed.

Child development assessment: Practitioner input in the revision for Griffiths III.

The input from practitioners in developmental assessment test revision is a crucial and leading component of the project. This paper highlights six key phases of the Griffiths III revision process and the value of having a guiding plan that includes test practitioner input. The revision of the Griffiths III consisted of six separate phases that were supported by practitioner and user input and feedback. These six phases and practitioner views ensured that the necessary core constructs and new areas for item development were included in the revised version. These processes also underscored the construct development and task review, item design, piloting and standardization of the revised version, as well as its production, release and subsequent training methods. The six guiding phases provided a methodologically robust frame to the revision process. Practitioners valued an overall developmental measure with discrete data about and within the 'avenues of learning' allowing them to analyse a child's strengths and weaknesses. Communication with practitioners across the world demonstrated the wide disparity of culture and environments that the Griffiths Scales are deployed in. It is not possible to design a revised scale that is appropriate for all areas of use, so in this revision process, it was decided to design the scales as culturally fair as possible and support practitioners in other countries to translate and validate the scales for use. The revision of the Griffiths III found test users to be valuable sources of information on the basis of their experiences with the test and professional knowledge. Creating a continuous feedback mechanism within a phased process provided opportunities for the revision team to engage meaningfully with the data being obtained as well as test users to advance the scope and quality of the test. Revision teams are encouraged to consider the process and engagement methods explored in this study during their projects.

Visual Acuity and Refractive Error Improvement in Keratoconic Patients: A Low-Income Context Management Perspective.

IntroductionVisual acuity (VA) and refractive error (RE) remain important parameters in the management of keratoconic (KC) patients. Despite rapid amelioration in capacity of diagnostic equipment, these remain inaccessible to the majority of practitioners in low-income countries. Notwithstanding limitations, practitioners are expected to utilize existing resources to satisfactorily manage their increasing numbers of keratoconic patients.PurposeTo determine the changes in visual acuity and refractive errors with diagnostic and management options available in low-income contexts.MethodsA descriptive, retrospective chart analysis of medical records dating back 5 years was employed in this study. Records of patients prescribed with corneal rigid gas permeable (RGP) and scleral lenses were analyzed. Data on age, gender, stage of keratoconus, pre-, and post-visual acuities and refractive errors, mode of correction and lens parameters were evaluated.ResultsA total of 124 medical records were analyzed. Males comprised 58.9% and females 41.1% of the total sample, with a mean age 20.86 ± 9.50 years. The mean unaided VA in logMAR notation was 1.0±0.19, while corrected VA was 0.18±0.17. There was a significant improvement (p=0.001) in VA with corneal RGP contact lenses (mean 0.19±0.17) as compared to unaided VA (mean 1.29±0.20). Scleral lens VA also improved from a median of 1.06 to −0.01 logMAR; p=0.001. The mean RE before RGP contact lens fitting was −9.43±2.37 diopters (D) which improved to −0.41±0.78D. RE reduced significantly (p=0.001) after fitting with both corneal RGP lenses (from a mean of −9.80±4.46D to −0.45±0.80D) and scleral lenses (from a median of −8.00D to −0.02D).ConclusionSignificantly improved visual acuity and refractive error status were achieved with all KC patients. Despite the diagnostic equipment and contact lenses design limitations, practitioners in low-income contexts can fit the relatively more affordable corneal RGP lenses to positively impact the daily living experiences of their KC patients.

Affordable and Cutting Edge Innovation: Is Phronesis the Answer?

Within innovation, systems based literatures focus on pursuit of cutting edge innovation and its impact on growth. They however do not closely examine resource scarce developing country contexts. Social innovation literature focused on such resource scarce contexts argues against cutting edge innovation instead advocating for affordability and access. As such for developing country practitioners, these schools of thought set up an impossible trade-off between affordability and cutting edge innovation. This paper through a study of three innovations in the medical field, proposes phronetic innovation as the mechanism to resolve the trade-off. Phronesis through its value driven situated action, redefines problems, resources, opportunities and constraints and enables innovators to raise beyond the scarcities they face in their situations.

Minor surgery in general practice in Ireland- a report of workload and safety

BackgroundThe provision of minor surgical services is an established part of the task profile of general practitioners (GPs) in many countries in Europe and elsewhere. This study aimed to collect data on the clinical process and outcomes for specified minor surgical procedures undertaken in Irish general practice by GPs experienced in minor surgery in order to document the scope and safety of minor surgery being undertaken.MethodsOver a six-month period, 24 GPs in 20 practices recorded data on a pre-determined list of procedures undertaken in adults (aged 18 and older); procedures for ingrown toenails were also recorded for those aged 12–18 years. Clinical data were rendered fully anonymous by the participating GPs, entered onto the Excel database template and returned to the project team monthly.ResultsOn average, each practice undertook 212 procedures in a six-month period. The four most frequent procedures include two relatively non-invasive procedures (cryosurgical ablation of skin lesions and aspiration and/or injection of joints) and two more invasive procedures (full thickness excision of skin lesion and shave, punch or incisional biopsy). Overall, 83.8% of relevant specimens were submitted for histology. Combining benign and malignant cases, there was an overall 87% clinical and histological concordance; 85% of malignancies were suspected clinically. A complication was recorded in 0.9% after 1 month.ConclusionsIrish GPs with experience in minor surgery can provide a range of surgical services in the community safely.