Framework Analysis Research Articles

14 - Do current electronic bladder diary Apps provide data suited for clinical use? Evaluation using a Validated Framework Analysis.

14 - Do current electronic bladder diary Apps provide data suited for clinical use? Evaluation using a Validated Framework Analysis.

New Modes of Practice: A Framework Analysis of School Nurses' Accounts of Working With Children and Young People During COVID-19.

To identify new and accelerated modes of practice used by school nurses during the COVID pandemic. To create a quick reference infographic bringing together experiential evidence on the range and considerations regarding different modes of practice for use by the school nursing community of practice. A descriptive qualitative secondary data analysis of open-ended questions in a survey, and focus groups with school nurses. The pragmatic aim was to focus on changes in school nurse modes of practice to ensure continued engagement with children and young people, and school nurses' experience of the benefits and challenges of these modes of practice. Data were collected from 98 school nurse participants across a United Kingdom-wide survey (n78) in April to May 2022, and focus groups (n20) in June to July 2022, within the School Nursing in the Time of COVID project. Data from the seven open-ended questions in the survey and four questions from the focus group were analysed using the framework approach. Modes of practice fell into two categories: individual assessment and support (video-calling platforms, telephone contact, virtual messaging, walk-and-talks and home visits) and group support (wellbeing approaches, social media). Considerations for these modes rooted in school nurses' experience are described. Interpretations were used to create the summarising evidence-based infographic as a quick reference resource for school nurses. There was no 'one size fits all' approach. The modes used by school nurses were adopted or developed out of necessity or resource availability and in response to the specific needs of individuals or groups. The developed infographic provides a quick reference guide to deliver the expressed need for knowledge exchange within the school nursing community by participants in the original studies and can be used to inform current school nurse practice. The developed evidence-based infographic has stand-alone value. It has the potential to raise awareness of the range of different strategies that can be used to facilitate and/or enhance engagement with children and young people, equip school nurses with knowledge to foster innovative and responsive practice and aid critical reflection in a complex post-pandemic landscape. The infographic is a unique resource and is a first step in knowledge exchange based on experiential learning. The resource will be used as the foundation for future work to develop a co-created training resource for school nurse students (undertaking the Specialist Community Public Health Nurses course) and/or continuing professional development resource for established school nurses. This study has been conducted and reported in accordance with COREQ guidelines for qualitative research. A consultation group was closely involved with the planning, conduct and analysis of the original studies. This group consisted of representatives from professional organisations SAPHNA (School and Public Health Nurses Association) and the CPHVA (Community Practitioners' and Health Visitors' Association), a school nurse and a member of the public. SAPHNA have continued in their consultative role for this study and has provided content and usability feedback regarding the infographic. Early findings have been presented to the SN community of practice, and feedback invited, through presentation separately at the CPHVA and SAPHNA annual conference.

Exploring the experience of participants in a pilot scheme to recognise teaching excellence in healthcare: A mixed methods approach.

BackgroundWithin healthcare settings, practice-based healthcare professionals are expected to teach, supervise, assess and/or support learners in their respective disciplines. Ongoing development opportunities focusing specifically on teaching skills and support of students are varied and there are no mandatory requirements for practice-based healthcare professionals to develop formal teaching qualifications, despite their direct involvement with learners. ObjectiveTo explore the experience of participants in a pilot scheme to recognise teaching excellence in healthcare. DesignA mixed methods approach was used. Setting(s)One inner-city integrated health care system in the UK. ParticipantsThis study involved eleven participants in total: seven applicants who successfully completed the award and four mentors who supported them throughout the application process. Mentors were all Advance HE Fellowship holders employed within one National Health Service (NHS) organisation and one Higher Education Institution situated within the Northwest of England. MethodsData collection methods included an online anonymised survey followed by individual semi- structured interviews. Quantitative data were analysed descriptively, and qualitative data were analysed using framework analysis principles. ResultsThe findings indicated that participants (applicants and mentors) found the overall experience positive and rewarding. The main positive aspects of taking part were:I. Increased confidence and sharing of teaching experienceII. Increased reflection and use of pedagogyIII. Formation of a teaching community of practiceIV. Perceived teaching career progression opportunitiesThe application process appeared to act as a catalyst towards re-engagement with underpinning pedagogy when considering the suitability and utility of effective teaching approaches for learners in practice. It also helped to promote a teaching community of practice where mentors were able to ‘pay forward’ and support practice colleagues to be recognised for their teaching roles.The main challenges were the competing demands on applicants’ time and the self-directed approach required to complete the award application. ConclusionGaining recognition of teaching excellence through an award scheme such as Advance HE Fellowship can foster a sense of empowerment, recognition and reward for educators who work with learners undertaking Higher Education Programmes, irrespective of the setting where teaching and learning takes place. However, without wider organisation support and resources, the benefits of such schemes can be diminished. RegistrationN/A Tweetable abstractWith institutional support, Advance HE Fellowships offer accessible recognition for healthcare educator's commitment to teaching excellence @AdvanceHE @NHSE_WTE

The quantum yield of O(1S) in CO2 photolysis retrieved from the Martian atmosphere

Photochemistry studies the interactions between light and molecules. Ultraviolet radiation interacts with the atmosphere, and due to its energy, it can dissociate, excite, or ionize its constituents, which initiate other processes. A good knowledge of the interaction between photons of different energies with molecules and atoms is crucial for accurately modeling the atmospheric physics and for climate predictions. Despite its importance, photo-fragment dynamics lacks data because the experimental setup is difficult. We used the upper Martian atmosphere as a natural laboratory to measure the quantum yield O(1S) from CO2 + hv as a function of wavelength. We analyzed 4 years of continuous remote-sensing observations from the NASA MAVEN/IUVS spectrograph within a Bayesian framework analysis tool. We retrieved the quantum yield for the first time through its entire production spectral range, ≈80–126 nm, and achieved uncertainty from 10% to 20% on average. While at Lyman-α (121.6 nm), we achieved a precision of 2% by taking advantage of the properties of the upper Martian atmosphere.

Psychedelic-related deaths in England, Wales and Northern Ireland (1997–2022)

BackgroundPsychedelic drugs are increasingly visible in society once more, but their risks and adverse effects have received less attention than perhaps they should. While fatalities associated with psychedelics appear rare, a systematic approach to characterising their aetiology is required to inform harm minimisation efforts. AimsThis study aimed to analyse prevalence and characteristics of psychedelic-related deaths in England, Wales, and Northern Ireland, between 1997 and 2022. MethodsWe analysed coroner reports submitted to the National Programme on Substance Use Mortality where psychedelic serotonergic agonist drugs were involved in the death, and conducted a thematic framework analysis to explore potential factors associated with their occurrence. ResultsWe identified 28 cases where psychedelics were implicated (75 %, N = 21) or potentially implicated (25 %, N = 7) in the death; 19 of these involving psychedelic tryptamines (LSD 39 %, N = 11; Psilocybin 21 %, N = 6; DMT 7 %, N = 2), and 9 psychedelic phenethylamines (incl. NBOMes 18 %, N = 5). Most deaths were deemed accidental by the coroner (86 %, N = 24), including both traumatic injuries and drug toxicities; most cases involved multiple implicated drugs (68 %, N = 19); and most of the deceased were under 30 years of age (82 %, N = 23). Thematic framework analysis identified nine themes in the deaths across three categories. ‘Polysubstance use’ was the most common theme (82 % of cases, N = 23/28), followed by a suboptimal ‘physical environment’ (70 % of cases where this information was available, N = 14/20). ConclusionsThe profound and often unpredictable effects of psychedelics pose a unique profile of risks and adverse reactions. Nevertheless, psychedelic-related deaths remain very rare in comparison to other recreational drugs, and frequently involve polydrug use. Implications for harm reduction and policy are discussed.

The transformative role of the European Union on Turkish civil society a legal framework analysis from recognition to protection

Under the influence of the European Union (EU), the legal framework of civil society in Turkey has undergone significant changes. However, have the normative framework and policy demands of the EU been able to play a transformative role in shaping the legal organization of civil society in Turkey? In this study, we aimed to examine the transformative role of the EU in shaping the legal structure of civil society in Turkey. In the study, the Turkey Progress Reports published by the EU since 2005 were systematically examined, and the legal development of civil society was analyzed. The transformative role of the EU in shaping the legal structure of civil society in Turkey is of critical importance for democratization and strengthening the rule of law in the country. Efforts to align with EU standards have increased the legal recognition and protection of civil society in Turkey. Additionally, the financial and technical support provided by the EU has encouraged legal reforms aimed at enhancing the capacity of civil society organizations in Turkey. Nevertheless, further steps are necessary to fully strengthen and protect the legal structure of civil society.

Assessing Privacy Policies and App Settings for User Data Protection: A Data Subject‐Centered Framework Analysis of TikTok in the U.S. and Europe (2023–2024)

ABSTRACTThis study examines the extent to which TikTok's privacy policies and app settings in the U.S. and Europe protect the rights entailed in the data subject‐centered framework. Using a case study approach, we analyze current policy documents and app settings to identify the alignment of TikTok's policies with the GDPR perspective. Our findings reveal that current policies and settings fall short in key areas. First, TikTok policies lack details related to managing and protecting sensitive data. Second, the policies neglect to discuss the responsibilities of social media companies when such data is utilized by unspecified third parties. Furthermore, there is a noticeable deficiency in the U.S. regarding detailed in‐app privacy notices and setting options, especially in terms of managing location data and advertisements. Additionally, there is a need for explanations on how specific settings impact users. Lastly, a critical demand exists for default settings, including those for advertisements, to enhance data protection.

Content and timing of the 6-8 week maternal postnatal check: a mixed methods study.

Since 2020, the General Medical Services contract requires GP practices in England to offer women a GP appointment 6-8 weeks after birth: the '6-8 week postnatal check' or 'consultation'. Historically, provision of checks was variable, and women still frequently report poor experiences. To explore GPs' and women's perspectives of the 6-8 week postnatal check, including key components and timing. Mixed methods study: focus groups of GPs and women, and an online survey of GPs in England. Focus groups explored GPs' and women's experiences of postnatal consultations. An online survey explored GPs' clinical approach, organisation, and improvement potential. Quantitative analysis examined associations between demographics and clinical approach. Thematic framework analysis was used for qualitative data. 18 women and 14 GPs participated in focus groups. 671 GPs completed the survey. Mental wellbeing and contraception were reported as important topics, although some women were not asked about mental health. GP survey responses indicated most recommendations from national guidance were 'always' or 'very often' covered by most, but not all GPs. Clinical coverage was higher for GPs who used clinical templates, had awareness of guidance, were female or a parent. Many GPs (n=326, 49%) needed more time than was allocated for the consultation: (n=524, 78% allocated<15 minutes; n=351, 52% completed in<15 minutes). This study suggests GPs are allocated insufficient time for postnatal consultations, with substantial variation in practice. Specifying consultation duration and consideration of template usage in policy may improve care and outcomes for women.

Metabolic Monitoring for Children and Adolescents Prescribed Second-Generation Antipsychotics: A Qualitative Study with Child Psychiatrists.

Introduction: Professional guidelines recommend that providers routinely monitor children prescribed second-generation antipsychotics (SGA) to reduce the risk of adverse metabolic events associated with the medication. Despite this guidance, many studies show low rates of monitoring compliance. In this study, we interviewed child psychiatrists for their views of possible barriers to monitoring. Methods: Semi-structured qualitative interviews, developed according to the Regehr model of influences upon patient-provider decision making, were conducted with child and adolescent psychiatrists in current practice and recruited by convenience and snowball sampling. Interviews were conducted through internet video meetings and were recorded. Interview data were analyzed following Framework Analysis qualitative methods. Results: We recruited and completed interviews with 17 psychiatrists. Patient-level barriers included travel difficulties, limited family time for health care appointments, patient fear of blood draws, and more. Provider-level barriers included professional judgment versus guideline guidance, perceived family burden, assumption of low-risk, short-term SGA use, and more. Organizational level barriers included lack of organizational mandates or incentives, limited appointment time per patient, lack of care coordination, lack of co-located labs, personnel turnover, and more. Barriers at the social and cultural level include stigma and low health literacy. Conclusion: These practicing prescribers provided a wide range of possible barriers to metabolic monitoring in children and adolescents prescribed SGAs. The next step is to explore which may be present in certain settings, and to pilot quality improvement interventions. Addressing barriers can reduce risk of metabolic disorders arising from long-term use of SGAs in children and adolescents.

Experiences with home monitoring technology in older adults with traumatic brain injury: a qualitative study

BackgroundHome monitoring systems utilising artificial intelligence hold promise for digitally enhanced healthcare in older adults. Their real-world use will depend on acceptability to the end user i.e. older adults and caregivers. We explored the experiences of adults over the age of 60 and their social and care networks with a home monitoring system installed on hospital discharge after sustaining a moderate/severe Traumatic Brain Injury (TBI), a growing public health concern.MethodsA qualitative descriptive approach was taken to explore experiential data from older adults and their caregivers as part of a feasibility study. Semi-structured interviews were conducted with 6 patients and 6 caregivers (N = 12) at 6-month study exit. Data were analysed using Framework analysis. Potential factors affecting acceptability and barriers and facilitators to the use of home monitoring in clinical care and research were examined.ResultsHome monitoring was acceptable to older adults with TBI and their caregivers. Facilitators to the use of home monitoring were perceived need for greater support after hospital discharge, the absence of sound and video recording, and the peace of mind provided to care providers. Potential barriers to adoption were reliability, lack of confidence in technology and uncertainty at how data would be acted upon to improve safety at home.ConclusionsRemote monitoring approaches are likely to be acceptable, especially if patients and caregivers see direct benefit to their care. We identified key barriers and facilitators to the use of home monitoring in older adults who had sustained TBI, which can inform the development of home monitoring for research and clinical use. For sustained use in this demographic the technology should be developed in conjunction with older adults and their social and care networks.

Assessing Business Viability for a Production Joint Venture in the Indonesian Medical Device Industry

Research Aims: This study examines the viability of a joint venture between Daenamic Health Inc., a South Korean medical device manufacturer, and PT. Kenari Jaya Perkasa, an Indonesian medical device importer, to establish a local production facility for high-end medical devices in Indonesia. Design/methodology/approach: The research follows a structured approach involving the analysis of business model compatibility, external market dynamics, and the financial and operational viability of the joint venture. Employing qualitative analysis from discussions, VRIO Framework, and quantitative analysis from Analytic Hierarchy Process (AHP), the study evaluates market conditions and strategic fit between the partners. Research Findings: Findings indicate that Daenamic Health Inc. and PT. Kenari possess complementary strengths, forming a synergistic partnership poised to become a leading local brand for high end medical technology, as well as enabling access to more export market. Motivated by the need to reduce Indonesia's dependency on import, especially highlighted during the COVID-19 pandemic, this venture aligns with government policies to enhance local manufacturing and healthcare infrastructure. However, challenges such as navigating regulatory landscapes, managing a layered cost structure, and training local human capital must be addressed. Theoretical Contribution/Originality: Preliminary assessment for the joint venture’s establishment helps the partners to comprehensively assess their internal situation both as individual business and as future partners, prior to capitalizing the opportunity that comes with Indonesia’s vision towards healthcare self-sufficiency. As a result, partners’ synergistic strengths and aligned individual business needs positions the venture for competitive pricing and expansion in Southeast Asia and beyond. Keywords: Medical Devices; Joint Venture; Local Manufacturing; Market Dynamics; Strategic Fit

A feasibility trial of olanzapine for young people with Anorexia Nervosa (OPEN): clinicians’ perspectives

BackgroundThe OPEN feasibility trial testing olanzapine in anorexia nervosa (AN) in young people (YP) was not successful due to poor recruitment. This study aims to understand clinicians’ views and experiences of using olanzapine in AN and the challenges in implementing the trial in National Health Service (NHS) clinical settings.MethodsWe conducted qualitative interviews with eating disorders (ED) clinicians involved with the study (n = 11). Framework analysis was applied to qualitative data to identify barriers and facilitators to recruitment and study implementation. A web-based semi-structured Qualtrics survey was administered to ED clinicians (n = 24). Findings from the survey were used to corroborate and expand on the information derived from qualitative interviews.ResultsQualitative analysis identified four main themes: (1) Acknowledging Service User (SU) / Family Concerns, (2) Prioritising person-centred care, (3) Limited Service Capacity and (4) Study eligibility criteria. Subthemes are outlined accordingly. Clinicians appeared confident addressing SU concerns around olanzapine in clinical discussions, but timing was critical, and olanzapine was considered one aspect of treatment that needed to align with their holistic approach. Service pressures restricted opportunities for recruitment and the ability to offer regular review. At the same time, some YP were ineligible for the trial, as they were already taking olanzapine, or needed to be prescribed it more promptly than the study procedures allowed. Survey findings underlined confidence in prescribing and informing on olanzapine, the various possible benefits of olanzapine besides weight gain, and the importance of therapeutic alliances and informed consent. Both data sets highlight the need for further evidence on long-term safety, side effects and efficacy of olanzapine use for AN. Where clinical service capacity is at a premium, research implementation is not prioritised, particularly in intensive clinical settings.ConclusionsFindings provide first-hand insight into individual and systemic challenges with research implementation in the NHS, which need to be considered when designing future clinical research studies. We emphasise a person-centred approach when discussing olanzapine to consider a holistic recovery from AN beyond weight-gain as an isolated outcome for improvement.

Navigating the long journey of heart failure-experiences of Māori and Pacific peoples.

Māori and Pacific peoples in Aotearoa New Zealand experience significant inequities in heart failure rates, treatment and outcomes compared to NZ Europeans. We aimed to understand the experiences of Māori and Pacific people living with heart failure as they navigated care across primary and secondary settings. This research involved a secondary analysis of data collected in a wider qualitative study investigating evidence-practice gaps of cardiovascular care experienced by Māori and Pacific people. From the wider pool of semi-structured interviews, we identified 24 people (seven Māori and 17 Pacific peoples, 23 from the North Island) living with heart failure, and applied template and framework analysis to explore their distinct experiences. Two major themes identified related to participants: 1) Condition-need for more support to understand and self-manage their heart failure condition, and 2) Journey-desire to feel well-connected to the health system in their heart failure journey. Addressing heart failure inequities for Māori and Pacific peoples requires that providers engage in clear and meaningful communication to support patient self-management. Strengthening pathways for Māori and Pacific patients and whānau (families) between primary and secondary services is required to reduce their likelihood of becoming disconnected from care.

A mixed methods, cluster randomized control trial to examine assistive technology use to support early literacy in preschool children with disabilities

This mixed methods study examined the impact of a multi-faceted professional development (PD) program for preschool teachers and classroom assistants on teacher-supported assistive technology (AT) use and early literacy development of children with disabilities. Four special education preschools were randomized into intervention (2 schools, 9 teachers, 50 children) and waitlist control (2 schools, 17 teachers, 42 children) groups. The 24-week PD included online modules, coaching, and AT device kits. Pre-post gains in children’s AT use and early literacy skills were analyzed using χ2 and repeated measures ANOVA. Teacher interviews and reflective commentaries were analyzed using Framework Analysis methodology. From pre- to post-test, the percent of children in the intervention group using some form of AT rose from 36 to 80%. The percent of children using AT in the control group went from 45 to 62%. The difference in change between the two groups was statistically significant, χ 2 = 13.93, p=.001. Gains in early literacy skills were not significantly different across groups, F(1,90)=0.010, p=.922. Analysis of the qualitative data revealed three themes: the positive impact of AT on child engagement and participation, the importance of individualizing AT for each student, and barriers teachers faced in AT implementation. The PD program had a positive effect on children’s AT use but not on gains in early literacy. Teachers’ comments highlighted the nuanced relationship between AT use and literacy outcomes, suggesting the need for more targeted implementation of AT during literacy activities.

The risk tolerance and decision-making processes of Australian women regarding medication trials in pregnancy.

Pregnant women have historically been excluded from participation in medication trials, in part due to the perceived risks of drug exposure to mothers and fetuses. However, little is known about pregnant women's attitudes toward risk and participation in such trials. To address this knowledge gap and to identify factors that influence trial participation. Australian women over the age of 18, currently pregnant or within six months of delivery, were recruited to participate in an online survey (n = 623) and follow-up interviews (n = 11). The survey investigated willingness to participate in five hypothetical drug trial scenarios of varying risk. Demographic and obstetric information, including COVID-19 vaccination status, was also collected. The impact of these factors on trial participation was analysed using ordinal regression. Interviews were subjected to thematic framework analysis using a priori and emergent themes. Nearly half of the respondents (48%) indicated a willingness to participate in at least one of the hypothetical trials. As trial risk increased participation likelihood decreased, especially if the risk was to the fetus, regardless of benefits to the mother. COVID-19 vaccination status and medication hesitancy were predictors of an unwillingness to participate. Three broad themes emerged from the qualitative data: risk-benefit analysis, quality of evidence, and trust. Overall, participants expressed a positive attitude toward research and medication trials during pregnancy, but were concerned about fetal risk. The findings of this study may help enhance trial design and the participation of pregnant women in medication trials.

In Pursuit of a Person-Centered Approach to Care Delivery: A Qualitative Descriptive Study of the Patient Experience of a Long-Term Conditions Clinic in General Practice.

Innovative ways of working are emerging in health care to meet the complex needs of people living with multiple long-term conditions. While these initiatives are often measured for their health and economic outcomes, few studies prioritize the patient experience. This qualitative descriptive study is one of a few studies exploring the patient experience of attending a dedicated long-term conditions annual review clinic in a primary care setting in England. The service model aims to provide a person-centered, holistic approach to the management and support of people living with multiple long-term conditions. The study presents findings from in-depth interviews with 12 participants. Data analyzed through framework analysis revealed four themes relating to the patient experience: the clinic as a place, continuity, staying healthy, and partnership opportunities. Results highlight the challenges to providing personalized care. We found that attendance at the clinic prompted self-care behaviors, however, patients wanted a more holistic, integrated, and consistent service that provided continuity of therapeutic relationships that involved them in decision-making and care planning. We conclude that the experience of patients in this study suggests this service model can enable patients to manage their health and improve well-being, however, while a person-centered philosophy may underpin service models, our research shows that ensuring this philosophy is born out in service delivery and recognized by patients is problematic. Therefore, service providers need to recognize the values and perspectives of patients, aligning these with the design and delivery of services.

Proposed Strategy for Maintaining A Small-Family-Business Enterprise in a Competitive Property Market

This study addresses the growing challenges faced by small family businesses in the competitive property market by proposing strategic interventions specifically designed to sustain and enhance the viability of Allure Realty Group, a family-run enterprise established in 2012 in Jabodetabek. With increasing complexity in the property sector due to urbanization, shifting consumer demands, and stringent regulatory environments, the research aims to develop a robust strategic framework. The methodology involves a combination of qualitative and quantitative approaches, including surveys and interviews, to identify key problems and collect data. Analytical tools such as the Marketing Mix 7P, VRIO Framework, and STP Analysis for internal factors, and PESTLE Analysis, Porter’s Five Forces, Competitor and Customer Analysis for external factors are used to conduct SWOT and TOWS analyses for strategic development. The study hypothesizes that targeted strategies will significantly improve the business's resilience and competitiveness in the market. Key objectives include identifying challenges faced by Allure Realty Group, developing strategies to address these issues, and implementing actions to improve operational efficiency, customer satisfaction, and market expansion. The expected outcomes are enhanced operational frameworks, increased customer satisfaction, and a larger market share, contributing to the business's long-term sustainability. This research contributes to business management theory by providing insights into strategies for small family businesses in rapidly evolving markets. The findings aim to bridge traditional business values with modern management practices, offering valuable guidance for both academic researchers and business practitioners in navigating the complexities of the property industry.

Extrapolation Framework and Characteristic Analysis of Load Spectrum for Agriculture General Power Machinery

As a crucial step in food production, tillage and land preparation play a pivotal role in achieving sustainable crop production and improving the soil environment. However, accurate assessment of the load that agricultural machinery implements during the operation process has always been a vexing problem that needs urgent solutions. In this paper, an extrapolation and reconstruction framework for the time-domain load is constructed based on the probability-weighted moments (PWM) estimation and the peaks-over-threshold function, and the load spectrum is obtained for agriculture general power machinery. Firstly, the load acquisition system was developed, the traction resistance and output torque of the tractor were measured, and the collected load signals were preprocessed. Next, the mean excess function and PWM estimation are introduced to select the optimal threshold and generalized Pareto distribution (GPD) fitting parameters and the extreme load distribution that exceeds the threshold range is fitted. The extreme points in the original data are replaced by generating new extreme points that follow the GPD distribution, and the extrapolation of the load spectrum is achieved. Finally, the real extrapolated load spectrum was validated based on statistical characteristics and rainflow counting analysis, and the correlation coefficient between the fitting data and the extreme load samples was greater than 0.99. It can retain the load sequence characteristics of the original load to a great extent, truly reflecting the load state during the operation of agricultural machinery. Meanwhile, the characteristics of the load spectrum can be accurately obtained, such as extreme, mean, and amplitude values, and the real load during deep loosening and rotary tillage are accurately described. The values provide more authentic and reliable data support for the subsequent selection of optimal operating parameters, reliability design of the power transmission system, and the life assessment of the agricultural implements.

Protocol for a mixed-methods exploratory investigation into the role of health information technology for the provision of cancer care in Indonesia

Background Cancer and its management can incur high costs, high risks and high demand. In Indonesia, there remains gap in the availability of national cancer data despite the establishment of a National Committee for Cancer Control. Multiple pilot projects have been developed by the Ministry of Health to improve the delivery of care, including interventions utilising digital health approaches and integrated referral information systems. However, it is not yet clear to what extent these approaches influence patient management or the experience of cancer patients themselves. This research aims to explore the current role of health information technology (HIT) in the provision of services and treatments for patients with cancer from primary to tertiary healthcare centres in Yogyakarta, Indonesia. Methods The study will adopt an observational mixed-methods single case study design of health facilities involved in the delivery of cancer services in a sub-national health system. We will collect data through face-to-face interviews with a range of health professionals involved in the delivery of cancer care. Patients will be interviewed to share their views and experiences of the existing cancer referral system and communication with health facilities. Alongside interviews, we will undertake an analysis of routine data from participating health facilities to assess gaps in existing information systems. Data analysis will include framework analysis for qualitative data alongside descriptive analyses of quantitative data. Findings will be used to inform conceptual maps to be presented as part of Theory of Change workshops focused on understanding how the existing cancer referral system works, why and for whom, with a focus on future refinement and intervention development. Conclusion Our findings will inform critical thinking around the design, implementation, adaptation, and evaluation of existing systems. Through early engagement and participation of key stakeholders and project partners, we intend that findings will have immediate utility.

The The perception of success in learning English as an L2 in the era of globalization – a multilingual student perspective

Resorting to ecolinguistic theories, underscoring the concept of (trans)languaging and methodologies highlighting the need for analytical contextualization (Steffensen, Fill, 2014), the author presents the understanding of success in learning English as an L2 among selected multilingual students of Applied Linguistics at his home university, for whom knowledge of English and other languages is to be a final product of a professional character. Data has been elicited via focus group interview methodology (Parker, Tritter, 2006; Lankiewicz, 2023) with the use of a semi-structured interview and thematic framework analysis. The research findings suggest that English occupies a special place in students’ plurilingual repertoires and its pluricentric character helps them to be legitimate L2 users of their linguistic repertoires who do not measure their success by native speaker standards. The research undertaken offers insights into the process of the language learning evaluation of multilinguals via including their full linguistic repertoires to account for language learning processes.