Official Position Research Articles

The fragmentation of democratic and ‘adat’ institutions in Aceh’s political elite after Helsinki: The failure of the concept of institution of social cohesion

This article analyzes the modes of organizing the political realm of society in Aceh, especially after the signing of the Helsinki MoU in 2005 by representatives of the Indonesian government and GAM as the two parties most interested in the social organization of Acehnese society. The post-conflict social and political phenomenon in Aceh is the fragmentation between democratic and customary institutions that can be directly observed by the public through their competition in local government elections. Former GAM leaders have chosen to revive Majelis Wali Nanggroe and Gampong as customary and cultural institutions to help the government organize the lives of Acehnese people post-conflict. This paper contends that the various relationships and networks of relationships present in institutional formations are understood and explained through the different rules and frameworks that define and regulate them. Data sources were collected through in-depth interviews with several key informants, such as former GAM members, DPRA members, university rectors, local Aceh mass media editors, and socio-political observers, field observations for eighteen days (5–22 August 2018), and literature studies. This qualitative research uses a new institutionalism approach that focuses on the dynamics of the social structure of Acehnese society, which was largely controlled by GAM before the Helsinki MoU and began to loosen after the elections and even formed fragmentation among former combatants in the struggle for leadership in local government institutions. This article finds that GAM elite divisions and conflicts after the conflict for official government positions occurred due to the absence of imagination of modes of organizing society that was able to connect structurally and functionally formal and informal institutions. Pragmatically, GAM leaders and negotiators tend to maintain identity politics as a resistance movement against the central government and at the same time, they continue to run governance in a special autonomy model that gives them a lot of constitutional, institutional and symbolic freedom.

Chinese reporting on the Ukraine war.

During the first months of the Russia-Ukraine conflict, the attitude of the Chinese authorities was the object of much speculation. This paper sheds light on the Chinese official position by examining how the Chinese global channel CGTN presented the main actors and actions in the conflict over the first three months. By conducting a corpus assisted discourse study of all the reports published about the conflict on CGTN from February to May 2022, and comparing them with two similar corpora from international news providers Al Jazeera and Euronews, we identify the main trends in representation of nations, leaders and actions in all three channels. We trace how CGTN negotiated the discursive dilemma posed by China’s neutral position and consider how it used reporting on this conflict to pursue certain strategic goals, possibly with a view to influencing public opinion in areas of the world where audiences may be receptive to stances that are not overtly pro-Russian yet are sceptical of the West.

Evolution of hospital clinical pharmacy services in Finland in the period 2017–2022: the third nationwide follow-up survey

Background and objectivesPharmacists’ involvement in patient care became more common in Finnish hospitals during the period of 2011–2016. The first national survey was conducted in 2011 and repeated using the...

Equitable writing classrooms and programs in the shadow of AI

Each year, in TA orientation, in the practicum course, and in professional development sessions, I ask TAs and instructors to consider what is, for me, the key question at the heart of our work as writing teachers: what do we owe our students? And a related and equally important question: what do we owe ourselves? In 2024, just over two years into the public existence of OpenAI's ChatGPT, the contexts for these questions are perhaps more complicated than ever, but I think the answers are mostly the same: we owe our students equitable classrooms, space to try and to fail, compassion and care, and authentic engagement. We owe them the rights our discipline affirmed almost fifty years ago when CCCC adopted Students’ Right to Their Own Language as the official position of the largest organization of writing teachers in the world. This article reviews an approach to the current Generative AI moment that is rooted in these commitments and reflects an approach I call “informed refusal,” which allows us to acknowledge the existence of generative AI without requiring students to use generative AI products. We can continue to teach critical literacies and attend to the things that make first-year writing classrooms unique, especially our attention to individualized feedback on students’ writing and our attention to helping students build self-efficacy via sustainable writing processes and reflective habits of mind. At the same time, I argue against the adoption of detectors and other writing surveillance technologies because of the ways that such tools reinforce overly simplistic notions of plagiarism (Moore-Howard) and can harm our relationships with students.

When Should Sustainability Have A C‐Suite Seat? An Empirical Study on the Environmental and Organizational Correlates of Chief Sustainability Officer Positions

ABSTRACTThis study follows a theory‐based approach to examine both environmental and organizational factors related to chief sustainability officer (CSO) positions. We argue that the creation of CSO positions is driven by a combination of external and internal factors, and yet to date there has been limited research that integrates both perspectives to examine the presence and authority of CSO roles. Using a sample of S&P 500 firms, we found that the presence of CSO positions was related both externally to environmental conditions such as regulatory pressures and industry dynamism, and internally to organizational choices such as board‐level sustainability committees and internationalization. We also found that CSO authority was positively related to the organizational factors but not the environmental variables. This study complements existing CSO research by examining the factors linked to CSO presence and authority. The findings may assist researchers and practitioners in better understanding the effectiveness of CSO roles.

Multi-criteria assessment of ICT development in public administration in Poland

Information and communications technology (ICT) has become a stimulus for socioeconomic change and created new prospects for the development of e-government, thereby ushering in a new era in the provision of public services. With the development of ICTs, new ways of delivering public services are increasingly popular, and new opportunities that offer a chance to improve the professional position of public officials are emerging. Therefore, the main aim of this study is to assess the development of ICT technologies in state and local government entities in Poland. A review of the literature on the subject using the triangulation method allowed one to bring closer the considerations on the development of e-government services in Poland and the world, and the implementation of ICT tools in public administration entities. Based on an index analysis, the access of public administration entities and their employees to the Internet and ICTs and the development of public services provided electronically were assessed. The results of the study showed that the COVID-19 pandemic has accelerated changes in access to e-government services and the growth of remote work. It has highlighted the need to equip workers and train them properly. The analysis of the EGDI index places Poland in 34th place among UN countries in 2022. Concerning EU countries, Poland was ranked 17th for OSI and 16th for HCI and TII. In turn, our research using multicriteria analysis methods allows us to conclude that public administration activities in Poland should be directed at local units. The use of linear ordering measures in the research (TOPSIS, VIKOR, and Hellwig) allowed us to establish a ranking of individual levels of public administration in Poland for the development of ICT technologies. The leader in the ranking according to all three methods is the marshal offices. The last position in the ranking according to the VIKOR method is shown by municipal offices, according to the TOPSIS and Hellwig methods, they are in the penultimate position. Keywords: ICT; TOPSIS; Hellwig, VIKOR, public administration units, Poland

2024 Position Statement on the Use of Different Diagnostic Methods for Sleep Disorders in Adults - Brazilian Sleep Association.

Introduction The current document represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the application of different sleep studies and provides specific recommendations for the use of different types of polysomnography (PSG) and respiratory polygraphy. Materials and Methods The present document was based on existing guidelines. The steering committee discussed its findings and developed recommendations and contraindications, which were refined in discussions with the advisory committee. Adaptations were made based on professional experience, pathophysiological knowledge, and theoretical reasoning, especially to cover topics not discussed in previous guidelines or to adapt recommendations to the context and current practices in Brazil. Results A total of 55 recommendations were made, covering the following domains: professional requirements for the requisition and interpretation of sleep studies ( n = 7); eligibility for different sleep studies ( n = 9); diagnosis of sleep-disordered breathing (SDB; n = 5); diagnosis of SDB in special conditions ( n = 3); diagnosis of SDB in association with other sleep disorders and comorbidities ( n = 3); sleep studies on the follow-up of patients with SDB ( n = 9); sleep studies for positive air pressure titration ( n = 3); diagnosis of other sleep disorders ( n = 10); and sleep studies on other conditions ( n = 6). Conclusion The selection of the type of sleep study should be made carefully, considering resource constraints, clinical suspicion of moderate or severe obstructive sleep apnea (OSA), and individual patient needs, among other factors. It is crucial that health professionals receive appropriate training and board certification in sleep science, thus being able to determine the most suitable diagnostic method, understand their indications and limitations, and assure an accurate diagnosis for each patient.

2024 Standardization of Polysomnography Reports - A Consensus of the Brazilian Sleep Association.

Introduction The absence of standardized reporting for sleep medicine exams across different laboratories can lead to misinterpretation, diagnostic inconsistencies, and suboptimal treatment strategies. This document seeks to establish guidelines for the development of sleep study reports, covering recordings from studies of types 1 to 4, and represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the standardization of polysomnography (PSG) and cardiorespiratory polygraphies. Materials and Methods The recommendations for the items to be reported in PSG records were developed by means of a Delphi study, comprised of two voting rounds. In each round, participants had to vote regarding the appropriateness of items to be reported in type-1 to -4 sleep studies, rating them as recommended , optional , or not recommended . The consensus threshold was set at 66% in each voting round, or 75% for the combined responses of recommended and optional . Results The panel was comprised of 29 experts. After 2 voting rounds and subsequent deliberations by the steering committee, 352 items were included in the final set of recommendations. Consensus was achieved for 339 items (96.3%), of which 145 (41.2%) were classified as recommended , 154 as optional (43.8%), 35 as not recommended (9.9%), and 5 as not allowed (1.4%). No consensus was reached for 13 items (3.7%). The items recommended in this consensus are detailed in the main text. Conclusion These guidelines provide comprehensive recommendations for reporting diagnostic tests in sleep medicine.

American Geriatrics Society position statement: Making medical treatment decisions for unrepresented older adults

AbstractThis paper is an official position statement of the American Geriatrics Society (AGS) and updates the 2017 AGS position statement, Making Medical Treatment Decisions for Unbefriended Older Adults. In this updated position statement, the term “unbefriended” is replaced by “unrepresented” as a term that is more value‐neutral, more accurately describes the circumstance in which a person without medical decision‐making capacity does not have recognized surrogate representation, and better aligns with increasingly preferred terminology as reflected in recent medical literature. We define unrepresented older adults as those who (1) lack decisional capacity to provide informed consent for a particular medical treatment, (2) have not executed an advance directive that addresses the medical treatment at hand and lack capacity to do so, and (3) lack representation from a surrogate decision‐maker (i.e., family, friend, or legally authorized surrogate). Making medical decisions on behalf of unrepresented older adults is exceptionally challenging and, given demographic trends, is likely to become increasingly common in the years ahead. The process of arriving at treatment decisions for this population should follow standards of procedural fairness and include capacity assessment, search for potential surrogates, team‐based efforts to determine the patient's values and preferences, and steps to guard against bias. Proactive measures are needed to identify older adults at risk for becoming unrepresented. This position statement also calls for national efforts to reduce state‐to‐state variability in legal approaches for unrepresented patients.

Disrespect and Coercion: Unpacking Variations in China’s Sanctions Rhetoric

Abstract Under what conditions does China openly acknowledge the use of unilateral sanctions against other countries? China is notorious for maintaining an official position that it is against using unilateral sanctions on the international stage. Yet, as recent events have also indicated, China has grown more proactive and obvious in its reliance on these unilateral measures. By considering China’s changing approach to publicly acknowledging its use of sanctions, this paper recognizes that China’s sanctions practice appears to be more complicated. It also recognizes that the seemingly contradictory practices of relying on vagueness and explicitly acknowledging sanctions coexist, forming China’s complex sanctions behavior. This paper turns to the concept of disrespect to explain China’s complex sanctions acknowledgement rhetoric. When China feels that it has been gravely disrespected, China tends to be more explicit in publicly acknowledging the use of sanctions. To test this hypothesis, this paper looks at the cases of China’s use of sanctions towards targeted actors during (1) Nancy Pelosi’s visit to Taiwan in 2022, (2) Japan’s nationalization of the Diaoyu/Senkaku islands in 2012, and (3) the Standoff between the Philippines and China at the Huangyan Dao/Scarborough Shoal in 2012. In the first two cases where conditions for salient disrespect were met, China’s sanctions use was explicit and discernible. The Philippines’ case, on the other hand, shows that China’s vague rhetoric coincides with relatively moderate perceptions that it was disrespected. This paper highlights the importance of status, emotions, and constructed meanings in shaping China’s foreign policy by underscoring disrespect as a possible explanatory variable to China’s changing sanctions rhetoric.

Association of Emotional Intelligence With Pharmacy Students’ Leadership and Academic Performance

ObjectiveThis study aimed to examine the association between emotional intelligence, leadership involvement, and academic performance among student pharmacists. MethodsThis was a retrospective, observational study that included all second-year student pharmacists in the 2022–2023 and 2023–2024 academic years. Emotional intelligence was assessed using the emotional quotient (EQ) inventory, version 2.0 (EQ-i 2.0), with results reported for 15 skills of EQ. Leadership involvement was collected from student organizations as the number of officer positions held by each student throughout the Doctor of Pharmacy curriculum. Academic performance was reported as the cumulative grade point average (GPA). The primary end point was the mean EQ-i 2.0 skill results compared between students with < 2 and ≥ 2 leadership positions. The secondary end point was mean EQ-i 2.0 skill results of students with GPA < 3.5 and GPA ≥ 3.5. Bivariate logistic regression was used to analyze each outcome. ResultsAll 214 s-year students in both cohorts completed the assessment. Students who held ≥ 2 leadership positions, on average, had a higher social responsibility score than students with < 2 positions. Students with GPA ≥ 3.5 had an assertiveness score lower than students with GPA< 3.5. ConclusionThe results indicated that students with higher social responsibility as an EQ skill were reported to have increased leadership involvement. Students with lower assertiveness as an EQ skill were reported to have GPA ≥ 3.5. These findings demonstrate the importance of emphasizing social responsibility in the pharmacy curriculum.

The Approach of Finland and Sweden to the Soviet and Nazi Occupations of the Baltic States in 1940–1944.

The rapid change in the status of the Baltic States at the beginning of the 1940s, led to erratic and mixed reactions of the outside world, while the struggle of dependent nations for their statehood established a certain place for the Baltic States in the international community. The study analyses the attitude of two Nordic countries – Sweden and Finland – to the three countries that lost their independence during the period of the first two occupations in 1940–1944. So far, historians have not analysed this topic. Looking back on this relatively recent period of history, which was particularly difficult for the Baltic States, and at the position of the Nordic countries would allow to better assess cooperation opportunities of the countries of the Baltic Sea region arising in the twenty-first century and determine the importance of the Baltic States in cross-border relations in the Baltic Sea region. The aim of the study is to analyse in detail the official position of Finland and Sweden, and the attitudes of their peoples towards the Baltic States during the period of the first two occupations. The key focus of the study is analysis of the problem of recognition of the Soviet occupation and the annexation of the Baltic States by the Nordic countries. An important part of the analysis involves the study of the correspondence of Lithuanian diplomats working in the Nordic countries: this would allow a better understanding of public sentiment in Finland and Sweden regarding the two occupational regimes in the Baltic countries. The first part of the article deals with the official approach of the Finnish and Swedish governments towards Soviet occupation and annexation of the Baltic States. The analysis of the sources, political reasoning, historiography of Lithuania and foreign countries, and the press of the Nordic countries reveals that Sweden recognised the incorporation of Lithuania, Latvia and Estonia into the Soviet Union de facto by signing several agreements with Moscow. Meanwhile, Finland, due to unfavourable relations with the Soviet Union, was reluctant to give an assessment of the changed status quo of the Baltic States. The Finnish government maintained a policy of tacit non-recognition of the annexation of the Baltic States. The second part of the study explores the approach of the Nordic countries towards the Nazi occupation of the Baltic States. Finland and Sweden treated the Nazi actions in the east of the Baltic Sea region as a result of the unpredictable progress of WWII. A certain interest in the problems of the occupied Baltic States on the part of Swedish and Finnish society is revealed by publications in the Nordic press. They question the fate of the three Baltic States in a fragmented manner. The last part of the study examines the approach of the Nordic countries towards the three occupied Baltic States on the basis of correspondence of Lithuanian diplomats residing in the Nordic countries. After the Soviet occupation these Lithuanian diplomats stayed in the Nordic countries and assessed public opinions prevailing in Sweden and Finland towards the occupation. The study reveals that in Sweden, in June 1940, the actions of the Soviet Union in Lithuania, unlike those in Latvia and Estonia, were not treated as occupational. The fellow feelings expressed by representatives of the Swedish government to the Baltic States were personal in nature and did not affect the official position of Sweden. Between 1941 and 1944, Finnish society was also friendly to the three Baltic States. This was expressed in negative statements against the occupation of the Baltic States carried out by the Soviet Union. The Finnish and Swedish press paid only fragmentary attention to the issue of enforcement and change of occupational regimes in the east of the Baltic Sea region.

„Abdicato episcopatu, uxorem duxi“ Der Fall Dudith (1567) und die Wahrnehmung der Interkulturalität auf Mikroebene

AbstractThis paper reinterprets the famous letter of abdication of Andreas Dudith (1533–1589) from the perspective of interculturality. The paper examines the circumstances that led Bishop and Imperial Envoy Andreas Dudith to relinquish his prestigious office and influential political position as a result of doctrinal conflicts within Christianity. He remained a Christian, yet his life was centered elsewhere. He proceeded to construct a novel, academically engaged lifestyle, characterized by a comprehensive outlook. In the interval between two markedly disparate life phases, the resigning bishop interrogates the motives underlying his erstwhile clerical status, as well as the establishment and mission of the Church.

The Gaza Crisis and the Indian Exceptionalism

India’s attitude on the ongoing Israel-Hamas conflict marks a significant departure vis-à-vis India’s own position toward the Israeli-Palestinian conflict as well as the general view of the Global South. Its prime focus has been on the terrorist nature of the October 7 violence and the resolution of the conflict through the two-state solution. Both these positions exhibit the sympathy of the Indian government toward Israel, and despite reservations and criticisms, the domestic reaction to the official position has been more muted than in the past.

The Titular War of the Moscow State with the Grand Duchy of Lithuania at the Turn of the 16th – 17th Centuries: Communication and Pragmatic Aspect

Purpose. The struggle for the royal title recognition was one of priorities in the foreign policy of the Moscow State in diplomatic relations with the Grand Duchy of Lithuania (GDL) at the turn of the 16th – 17th centuries. The purpose of the article is to identify the communication and pragmatic features of the controversy about the title «tsar» betweenthe Russian monarch Boris Godunov and the Lithuanian ambassadors, which was preserved in the documents of the embassy of the GDL’s Chancellor Lew Sapieha to Moscow (1600–1601).Results. The main communication strategy of Boris Godunov in obtaining the recognition of the royal title was ration-al argumentation: succession by the right of inheritance and conquest, recognition by Christian and Muslim rulers, observance of the necessary rituals and diplomatic protocol. However, the key arguments of the Russian monarch were regarded by the Lithuanian side as a manipulative influence attempt, since they did not have sufficient documentary and factual confirmation. In turn, Lithuanian ambassadors also used verbal manipulation: deliberate substitution of the meaning of words, appeal to «God’s justice» and opponent’s emotions.Conclusion. Despite the failure to achieve recognition of the royal title, the analyzed polemics played an important role in the development of Russian diplomatic communication, since: 1) it let clearly formulate the official position of the Russian government and systematize relevant arguments in favor of the royal title, 2) stimulated the search for new communication strategies and tactics to legitimize the royal title in foreign policy relations with the GDL.

Can ChatGPT help patients understand radiopharmaceutical extravasations?

A previously published paper in the official journal of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) concluded that the artificial intelligence chatbot ChatGPT may offer an adequate substitute for nuclear medicine staff informational counseling to patients in an investigated setting of 18F-FDG PET/CT. To ensure consistency with the previous paper, the author and a team of experts followed a similar methodology and evaluated whether ChatGPT could adequately offer a substitute for nuclear medicine staff informational counseling to patients regarding radiopharmaceutical extravasations. We asked ChatGPT fifteen questions regarding radiopharmaceutical extravasations. Each question or prompt was queried three times. Using the same evaluation criteria as the previously published paper, the ChatGPT responses were evaluated by two nuclear medicine trained physicians and one nuclear medicine physicist for appropriateness and helpfulness. These evaluators found ChatGPT responses to be either highly appropriate or quite appropriate in 100% of questions and very helpful or quite helpful in 93% of questions. The interobserver agreement among the evaluators, assessed using the Intraclass Correlation Coefficient (ICC), was found to be 0.72, indicating good overall agreement. The evaluators also rated the inconsistency across the three ChatGPT responses for each question and found irrelevant or minor inconsistencies in 87% of questions and some differences relevant to main content in the other 13% of the questions. One physician evaluated the quality of the references listed by ChatGPT as the source material it used in generating its responses. The reference check revealed no AI hallucinations. The evaluator concluded that ChatGPT used fully validated references (appropriate, identifiable, and accessible) to generate responses for eleven of the fifteen questions and used generally available medical and ethical guidelines to generate responses for four questions. Based on these results we concluded that ChatGPT may be a reliable resource for patients interested in radiopharmaceutical extravasations. However, these validated and verified ChatGPT responses differed significantly from official positions and public comments regarding radiopharmaceutical extravasations made by the SNMMI and nuclear medicine staff. Since patients are increasingly relying on the internet for information about their medical procedures, the differences need to be addressed.

Громадська думка в Україні та Росії: ефекти повномасштабної війни, факторна зумовленість і вплив на політичні рішення

The paper compares the impact of public opinion about the war on political decisions in Ukraine and Russia. The research question is relevant in two senses. First, Ukraine defends itself against Russia’s unprovoked aggression. Second, Ukraine’s President Zelensky was elected in 2019 on the promise to develop direct democracy and various mechanisms of public participation in the political process, and that actualizes research of public opinion. The author used the data of the results of mass surveys conducted in the two belligerent countries in 2023 and 2024 by the Kyiv International Institute of Sociology and the Levada Center. Answers to an open-ended question and two closed-ended questions were analyzed using content analysis and regression analysis. It is demonstrated that public opinion in Ukraine had its own dynamics and changed independently of the official position of the authorities. Changes in the public opinion in 2024 were particularly noticeable, and the perception of potential territorial concessions illustrates this tendency. Advantages and disadvantages of the independence of public opinion at wartime are considered. It is proposed to consider more active counterpropaganda efforts targeting Russia’s population, where the minor changes in public opinion and the authorities’ position were in the same direction; and rallying around the flag effect continued during the analyzed period.

Transparency in action or political fiction? The pre-inquiry phase of the UK COVID-19 Inquiry

AbstractThis article examines how public inquiries come into being through a detailed analysis of the pre-inquiry phase of the UK COVID-19 Inquiry. We focus on two key points of contestation—around the timing of the inquiry and its terms of reference—and suggest that what is at stake during the pre-stage of an inquiry is its ontological and epistemological orientation. Our analysis traces the emergence of two distinct positions during this phase: a grassroots position (conceiving of the inquiry as a response to the experience of collective grief) and an official position (conceiving of the inquiry as a means of learning lessons). Particular attention is given to the latter position and what it reveals about the rhetorical function of transparency in confirming a political commitment to institutional accountability, at the same time as working towards a particular conception of the inquiry as a practical task, expansive in remit, and future oriented.

Zbyt długi żywot ustawy o pracownikach urzędów państwowych

In 1982, the Act on State Office Employees was passed. Despite the establishment of the civil service, which, according to Art. 153 of the Constitution should serve government administration offices, the 1982 Act is still in force, although its repeal has been announced many times. This is mainly because the 1982 Act, unlike the Civil Service Act, does not provide for a public procedure for equal recruitment for vacant official positions, which allows all political decision-makers to fill these positions through their discretion. However, this constitutes a violation of Art. 60 of the Constitution, which provides citizens with equal access to public service. The data collected under the Act on Access to Public Information shows that the number of people subject to the 1982 Act is very large and, moreover, that numerous important positions in the offices of the supreme state administration bodies are filled on its basis. This is to the obvious detriment of the public interest, especially since the 1982 Act does not contain a whole range of legal structures and requirements intended to ensure professional, reliable and impartial operation of the administration, as required by Art. 153 of the Constitution. The article contains a polemic with arguments about the need for special trust in employees, pointing out their extra-legal nature, as well as the dangers resulting from these assumptions. The thesis is the need to repeal the 1982 Act as soon as possible, as it has already been announced many times.

Getting time and building trust: unveiling the systemic, relational, and personal factors influencing clinical pharmacy service implementation in South Africa, a qualitative study

BackgroundWhile multidisciplinary teams with clinical pharmacists improve medication use and outcomes, their integration in South Africa faces limitations. A lack of dedicated positions and healthcare professionals’ misunderstanding restrict ward activities and hinder full collaboration, limiting their potential to optimize patient care. This study addresses a gap by exploring how perceived healthcare professionals’ understanding of clinical pharmacists’ roles impacts their motivation and service implementation. Understanding these dynamics, particularly in resource-constrained settings, is crucial for optimizing integration and healthcare delivery.MethodsAdopting a constructivist approach, this qualitative study was conducted using focus group discussions. Through purposive sampling clinical pharmacists were recruited across South Africa’s public healthcare sector. A semi-structured guide based on previous findings explored how the perceived understanding around clinical pharmacy impacts service delivery and work motivation. Transcripts were analyzed using thematic analysis, guided by the Self-Determination Theory framework. Thematic analysis employed an inductive approach, following an initial preliminary analysis of open and selective coding to develop a coding framework.ResultsClinical pharmacists (n = 16) reported various challenges impacting service implementation and motivation. Two main themes were identified: (1) Time: Dedicated ward time is crucial for both the proper implementation of clinical services, as well as the clinical pharmacists’ motivation; and (2) Trust: Clinical pharmacists experience a lack of trust amongst healthcare professionals in the value of clinical pharmacy services. The themes illustrated mechanisms at work at three levels: systemic (lack of dedicated positions), inter-relational (healthcare professional’s misconceptions), and personal (thwarted autonomy).ConclusionsSystemic challenges, like the absence of official positions present the biggest obstacle, affecting support, scope of practice, and healthcare professional interactions. While systemic changes are crucial for full integration of clinical pharmacists, in resource-constrained settings fostering autonomous motivation is equally important. This study emphasizes the need for a multi-faceted approach, including policy changes, international collaboration, interprofessional education, and interventions to empower clinical pharmacists for proactive service delivery. By addressing these interconnected challenges, healthcare systems can leverage the full potential of clinical pharmacists, ultimately improving healthcare delivery and patient outcomes.