Perceptions Of Key Stakeholders Research Articles

Exploring Inpatient Unit Nurses’ Experience with Emergency Department Crowding, Access and Flow, and Associated Patient Outcomes

Background: Emergency department crowding and hospital access and flow are complex and long standing issues that negatively impact healthcare delivery. This study aims to address these issues through the perspectives of inpatient unit nurses. Strategies to alleviate ED crowding are supported by research exploring ED staff perspectives; however, a paucity of research exists addressing the perceptions of inpatient unit nurses and other key stakeholders. Methods: The research aims were addressed using qualitative method. Semi-structured virtual interviews were completed with eleven inpatient unit registered nurses from two hospital sites. A 17-question interview tool facilitated the collection of data. Results: Three main themes emerged from the data analysis. Inpatient unit nurses identified ED crowding, hospital access and flow, and site congestion as key areas of concern. In addition, the influence of understaffing was viewed as a contributor to ED crowding, resulting in negative outcomes for patient care. Conclusion: This study is the initial step to understanding different experiences, perceptions and knowledge on emergency department crowding and access and flow processes. Further research exploring diverse viewpoints on this topic is necessary given the interconnected organizational structure of healthcare today and how key stakeholders, outside of the emergency department, strongly influence access block and ED outflow.

Inclusion of people with disabilities in Chilean health policy: a policy analysis

BackgroundAround 18% of the population in Chile has disabilities. Evidence shows that this population has greater healthcare needs, yet they face barriers to accessing healthcare due to health system failures. This paper aims to assess the inclusion of people with disabilities in health policy documents and to explore the perceptions of key national stakeholders regarding the policy context, policy processes, and actors involved.MethodsA policy content analysis was conducted of 12 health policy documents using the EquiFrame framework, adapted to assess disability inclusion. Documents were reviewed and rated on their quality of commitment against 21 core concepts of human rights in the framework. Key national stakeholders (n = 15) were interviewed, and data were thematically analysed under the Walt and Gilson Policy Analysis Triangle, using NVivo R1.ResultsCore human rights concepts of disability were mentioned at least once in nearly all health policy documents (92%). However, 50% had poor policy commitments for disability. Across policies, Prevention of health conditions was the main human rights concept reflected, while Privacy of information was the least referenced concept. Participants described a fragmented disability movement and health policy, related to a dominant biomedical model of disability. It appeared that disability was not prioritized in the health policy agenda, due to ineffective mainstreaming of disability by the Government and the limited influence and engagement of civil society in policy processes. Moreover, the limited existing policy framework on disability inclusion is not being implemented effectively. This implementation gap was attributed to lack of financing, leadership, and human resources, coupled with low monitoring of disability inclusion.ConclusionsImprovements are needed in both the development and implementation of disability-inclusive health policies in Chile, to support the achievement of the right to healthcare for people with disabilities and ensuring that the health system truly “leaves no one behind”.

Shared Decision-Making for Patients with Stroke in Neurocritical Care: A Qualitative Meta-Synthesis.

Decision-making for patients with stroke in neurocritical care is uniquely challenging because of the gravity and high preference sensitivity of these decisions. Shared decision-making (SDM) is recommended to align decisions with patient values. However, limited evidence exists on the experiences and perceptions of key stakeholders involved in SDM for neurocritical patients with stroke. This review aims to address this gap by providing a comprehensive analysis of the experiences and perspectives of those involved in SDM for neurocritical stroke care to inform best practices in this context. A qualitative meta-synthesis was conducted following the methodological guidelines of the Joanna Briggs Institute (JBI), using the thematic synthesis approach outlined by Thomas and Harden. Database searches covered PubMed, CIHAHL, EMBASE, PsycINFO, and Web of Science from inception to July 2023, supplemented by manual searches. After screening, quality appraisal was performed using the JBI Appraisal Checklist. Data analysis comprised line-by-line coding, development of descriptive themes, and creation of analytical themes using NVivo 12 software. The initial search yielded 7,492 articles, with 94 undergoing full-text screening. Eighteen articles from five countries, published between 2010 and 2023, were included in the meta-synthesis. These studies focused on the SDM process, covering life-sustaining treatments (LSTs), palliative care, and end-of-life care, with LST decisions being most common. Four analytical themes, encompassing ten descriptive themes, emerged: prognostic uncertainty, multifaceted balancing act, tripartite role dynamics and information exchange, and influences of sociocultural context. These themes form the basis for a conceptual model offering deeper insights into the essential elements, relationships, and behaviors that characterize SDM in neurocritical care. This meta-synthesis of 18 primary studies offers a higher-order interpretation and an emerging conceptual understanding of SDM in neurocritical care, with implications for practice and further research. The complex role dynamics among SDM stakeholders require careful consideration, highlighting the need for stroke-specific communication strategies. Expanding the evidence base across diverse sociocultural settings is critical to enhance the understanding of SDM in neurocritical patients with stroke.Trial registration This study is registered with PROSPERO under the registration number CRD42023461608.

Stakeholder Perspectives on Tourism Infrastructure Development in Kashmir Valley

This study provides a rigorous evaluation of tourism infrastructure in the Kashmir Valley, concentrating on the perceptions of key stakeholders within the tourism sector. The research encompasses a detailed assessment across five major tourism destinations, evaluating a spectrum of factors including the diversity of tourism products, the region's dependency on tourism, and patterns of visitor influx. By applying an extensive analytical framework, this study identifies and elucidates critical weaknesses in the infrastructure’s performance, examining the challenges through a scientifically robust approach. Data were meticulously collected and analysed to ascertain the current state of tourism infrastructure, revealing significant deficiencies and operational inefficiencies that impede effective performance. The study's findings underscore the pressing need for strategic interventions tailored to address specific infrastructural shortcomings, geographical peculiarities, and the distinctive requirements of various tourism sites in the Kashmir Valley. This approach not only highlights the inadequacy of current infrastructure but also emphasizes the necessity of aligning infrastructure development with the region's diverse tourism landscape. The study's conclusions advocate for targeted policy recommendations aimed at enhancing infrastructure capabilities and operational efficiency. By ensuring that infrastructure development is both sufficient in quantity and appropriately aligned with regional tourism demands, the research aims to foster sustainable growth and resilience in the tourism sector of Kashmir Valley. This comprehensive analysis contributes to a deeper understanding of the interplay between tourism infrastructure and industry performance, offering valuable insights for policymakers and stakeholders engaged in tourism development.

Diversity and practice: local decision-making practices on multi-cultural diets for British Muslim school children (BMSC) and implications for social justice.

British Muslim School Children (BMSC) are required to follow special halal dietary requirements in accordance with their religion, which is often not accounted for in British schools. This often leaves BMSC limited to a vegetarian diet while at school, despite this not being their chosen diet or preference. This study explores the perceptions of key stakeholders regarding fairness and accessibility of school meals for BMSC, as well as discussing school food provision for those maintaining a religious diet in light of social justice. This is in the context of limited knowledge previously being explored in the North East of England regarding procurement and decision-making at a systems level to cater for BMSC. A qualitative research design was conducted. A total of 62 participants (39 BMSC, 15 parents, and 8 school and catering staff) took part in a semi-structured interview or focus group. Participants were recruited from six schools, with these schools selected based on their differing levels of BMSC in attendance. This project took place between March 2022 and October 2023. Results suggested that where schools already catered for diverse food requirements, inclusive of BMSC dietary needs, food choices were still limited in the options and amount available. School and catering staff stated that cost implications contributed to their menu development process. Despite this, there was an evident willingness to learn about the cultural food options and how these can be implemented in future school menus. Suggestions discussed included an increase in the use of halal meat in order to provide a more inclusive school food experience for BMSC.

Stakeholders' views on the global guidelines for the sustainable use of non‐native trees

Abstract A large number of non‐native trees (NNTs) have been introduced globally and widely planted, contributing significantly to the world's economy. Although some of these species present a limited risk of spreading beyond their planting sites, a growing number of NNTs are spreading and becoming invasive leading to diverse negative impacts on biodiversity, ecosystem functions and human well‐being. To help minimize the negative impacts and maximize the economic benefits of NNTs, Brundu et al. developed eight guidelines for the sustainable use of NNTs globally—the Global Guidelines for the Use of NNTs (GG‐NNTs). Here, we used an online survey to assess perceptions of key stakeholders towards NNTs, and explore their knowledge of and compliance with the GG‐NNTs. Our results show that stakeholders are generally aware that NNTs can provide benefits and cause negative impacts, often simultaneously and they consider that their organization complies with existing regulations and voluntary agreements concerning NNTs. However, they are not aware of or do not apply most of the eight recommendations included in the GG‐NNTs. We conclude that effectively managing invasions linked to NNTs requires both more communication efforts using an array of channels for improving stakeholder awareness and implementation of simple measures to reduce NNT impacts (e.g. via GG‐NNTs), and a deeper understanding of the barriers and reluctance of stakeholders to manage NNT invasions. Read the free Plain Language Summary for this article on the Journal blog.

Perceptions on the distribution, threats, strandings, and conservation of the Antillean manatee (Trichechus manatus manatus) in the Río Dulce National Park, Izabal, Guatemala

The Antillean manatee in Guatemala faces multiple threats resulting from habitat loss and human interactions such as motorboat collisions and poaching. While some conservation efforts have been initiated in Río Dulce National Park (RDNP), there is a lack of studies examining the current perceptions of threats to the species. This knowledge gap may hinder the development of effective conservation strategies that consider both the species and local communities. Our objective was to analyze the perceptions of key local stakeholders concerning the Antillean manatee, including its distribution, threats, attention to strandings, and the current status of conservation in the protected area of RDNP. From July to October 2019, we conducted 50 semi-structured interviews with technicians and river users, such as fishermen and boat captains. Additionally, we held two workshops: one aimed at developing a participatory mapping exercise and another to validate the information. Each workshop was divided into two groups: one for technicians and another for river users. A total of 68 people participated in the workshops, the majority of respondents were male (n = 47), ranging in age from 19 to 71, and predominantly local to the area. Their activities in the river included fishing, biological monitoring, transportation, and providing tourism services. Perceived threats to the Antillean manatee included motorboat collisions, poaching, bycatch, habitat degradation, and water pollution. The focus groups also identified key observations, such as mother-calf sightings, specific areas of risk for manatee-boat collisions, areas with a higher presence of aquatic vegetation, and additional threats such as habitat degradation and poaching. Our results demonstrate that stakeholders possess a fundamental understanding of the manatee, its threats, and its distribution. They also highlight a noticeable lack of knowledge, specifically regarding the attention given to manatee strandings. It is recommended that conservation strategies include environmental education adapted to local conditions, as well as the promotion of manatee studies and their dissemination at the local level, including attention to strandings in the area.

An assessment of barriers to digital transformation in circular Construction: An application of stakeholder theory

The construction industry faces the rising challenge of circularity, and digital transformation emerges as a pivotal solution. However, limited stakeholder involvement impedes the adoption of digital transformation. The existing literature does not analyze stakeholders' perceptions of digitalization adoption barriers. Therefore, this study investigates the barriers hindering digital transformation in circular construction by examining the varied perceptions of key stakeholders. The study contributes to aligning stakeholders' interests and leads to targeted and effective interventions, enhancing the likelihood of successful adoption. Using the Stakeholder Theory, the study identified contractors, investors, clients, waste managers and government as the most influential stakeholders in circular construction. This study explores skill and knowledge barriers, market barriers, regulatory barriers, organizational and cultural barriers, and financial and resource barriers as key dimensions hindering digital circular practices. The study integrates the fuzzy Delphi method, fuzzy decision-making trial and evaluation laboratory, and analytical network processing to address uncertainties and interrelationships among barriers. The findings indicate that stakeholders hold differing perceptions regarding the most critical barriers; however, there is a consensus that critical aspects are skill and knowledge, organizational and cultural, and regulatory barriers. Practical barriers include lack of government support, resistance to change, lack of feasibility information, lack of training capabilities, and poor digital literacy. The study provides theoretical and practical implications, informing future research and interventions to develop targeted strategies and initiatives.

Moving beyond COVID-19: Break or continuity in the urban mobility regime?

Upon its irruption in early 2020, the COVID-19 pandemic spurred a flurry of reflection on its potential long-term effects on urban mobility. Despite widespread speculation about the likely permanent impacts of the pandemic on urban mobility, few academic accounts have re-examined the extent to which these speculations were warranted once the pandemic is over. To this end, the present article explores the retrospective perceptions of key stakeholders regarding the long-term impacts of the pandemic on the urban mobility regime, through a qualitative case study of the Barcelona Metropolitan Region, involving 22 semi-structured interviews. Approaching urban mobility through the lens of sociotechnical regimes and the multilevel perspective (MLP), we identify key perceived changes to the urban mobility regime in the aftermath of the pandemic, as well as four main obstacles to effecting transformative change towards sustainable urban mobility during the “window of opportunity” created by the pandemic. Our findings suggest that the pandemic has generally not led to significant changes in the urban mobility regime, with two key exceptions: the normalisation of teleworking, and the consolidation of tactical urbanism approaches to street redesign. These findings confirm the obduracy of the existing urban mobility regime, while pointing to promising inroads which might result in the transformation or destabilization of the current regime.

Evolution of Maotai Wine Packaging Design in Maotai Town Guizhou China

Packaging design has become a critical tool for marketers and producers in the wine industry. Consumer behavior is influenced by the effectiveness of design and development strategies, and therefore the study focuses on the changes in the packaging design of Maotai wine. This study intends to explore the evolution of Maotai wine packaging design in Maotai Town, Guizhou, China, known as the production site of Maotai wine. To satisfy the objectives of the study, a qualitative study was developed so that researchers could gain an in-depth understanding of the phenomenon. Semi-structured interviews were conducted with designers and marketers in Maotai Town, Guizhou, China. This flexible approach allowed the evaluation of the perceptions of key stakeholders in the design and marketing of Maotai wine can be captured. The findings of the study offer substantial insights and strategies which can be applied to the design of culturally significant products. The findings offer insights into the overall strategy and vision used by Maotai in the packaging and preparation of Maotai wine. This study, therefore, intended to contribute to a broader understanding of the significance of packaging design along with shedding light on the factors that have impacted Maotai wine packaging design over the years, such as innovation, tradition, and consumers.

Perceptions of key stakeholders on peer led strength building program for suicide prevention among young adolescents: A qualitative study from Karnataka, India.

Adolescent suicides are a significant public health concern in India and understanding the intersecting perspectives becomes imperative for the prevention of various mental health concerns. Assessing perceptions of various key stakeholders, that is, mental health experts, school and college teachers, and District Mental Health Program staff about peer-led strength building programs for suicide prevention. A cross-sectional qualitative design using two Focus Group Discussions (FGDs) with mental health experts and teachers and one FGD with DMHP staff was conducted. The sample comprised 45 participants from Bengaluru urban district. The data were analyzed manually by the method of direct content analysis, and themes were determined using existing literature. The teachers and the DMHP highlighted the need for an intensive training program/module that is necessary to be developed in order to train the peer leaders first. The mental health experts opined that creating a network will help in easy identification of the cases and appropriate treatment could be provided without delays. This study indicated that suicide is a preventable public health emergency and inaccessibility to existing as well as proper support systems was perceived as a major concern. Therefore, peer-led programs are beneficial in steering and improving help seeking behavior in suicidal adolescents.

Analysis of factors and solutions to poor supply chain quality in a manufacturing organisation

Background: With about 55% of operating costs in manufacturing organisations coming from costs of supply chains, coupled with a 6% increase in supply chain costs incurred by a manufacturing organisation during the financial year 2021–2022, supply chain managers need to ascertain factors contributing to high supply operating cost and ascertain suitable strategies to lower supply chain management cost.Objectives: The purpose of this study is to unveil the factors and the solutions to poor supply chain quality in a steel product manufacturing organisation.Method: A qualitative approach conducted via an interview guide was used in this study. Perceptions of key supply chain stakeholders within a steel product manufacturing organisation formed the basis of the exploring factors contributing to poor supply chain quality and the solutions thereof. The Pareto chart was created to ascertain the critical factors that contribute to poor supply chain quality.Results: The study revealed that inventory stock-out, management decisions, process deviations, longer lead times, suppliers and unreliable enterprise resource planning (ERP) system issues contributed to poor supply chain quality.Conclusion: Supply chain managers should make use of strategies such as safety and consignment stock policy, just-in-time (JIT) system, supplier evaluation exercise for supplier selection, localisation of the sourcing of raw materials, customised ERP systems, job rotation and dashboards, with a view to improve visibility and efficiency of supply chain processes.Contribution: The study serves as a knowledge advisor to supply chain managers, on the critical factors contributing to poor supply chain quality, and the solutions thereof.

Enhancing SMCs’ competitiveness through improving material supply chain management practice

Construction material shortages have emerged as a critical issue in developing nations, resulting in increased project costs and delays. This situation strains the construction industry’s (CI) ability to meet growing demands and remain competitive in the global market. Small and medium contractors (SMCs), who heavily rely on the availability and accessibility of construction materials, are disproportionately affected by this challenge, making it a matter of utmost concern. This study aims to identify the challenges faced, develop management mechanisms to enhance the supply chain management (SCM) of construction materials in the Ethiopian CI and provide a comprehensive improvement framework. The study employed semi-structured interviews to collect the perceptions of key industry stakeholders. Thematic analysis was utilized to facilitate a holistic understanding of the participants’ viewpoints. The findings reveal major challenges such as inadequate supply chains, poor communication and coordination, and lack of standardization and certification practices. Furthermore, the importance of collaboration among diverse stakeholders, research and development, and the adoption of standardization and certification practices was highlighted. The proposed framework underscores the roles of stakeholders and offers valuable insights by delineating areas for improving SCM within the CI.

Sexual harassment and sexual assault in the Western Australian mining industry: a qualitative examination of the perceptions of key stakeholders.

The prevalence, pervasiveness, and minimization of sexual harassment and sexual assault (SHSA) within the Western Australian mining industry has been revealed in recent Australian reports and inquiries. However, there remains a gap in scholarship focusing on SHSA within the mining sector, specifically that engages with mining employees to understand this issue. This study aimed to fill this gap by exploring the experiences and perspectives of Western Australian mining employees in relation to SHSA. Through qualitative research methods, stakeholders (n = 30) from various industry roles (e.g., front-line operations, administrative staff) participated in semi-structured interviews. A deductive thematic analysis was conducted to analyze the data. The study revealed diverse perspectives of SHSA among participants, highlighting how this issue is understood, addressed, and discussed within the workplace. While some participants recognized positive shifts in workplace culture, it became apparent that additional efforts are needed to tackle the underlying and persistent factors that contribute to sexism, misogyny, and, ultimately, SHSA. Participants shared their perspectives regarding strategies and initiatives that could effectively combat SHSA within the industry. This study constitutes a significant contribution to the limited body of research on SHSA in the Western Australian mining sector, offering valuable insights and recommendations for future prevention initiatives.

Exploring stakeholder perceptions of implementing a pharmacist-led anticoagulation clinic in primary care settings: a cross-sectional study.

Anticoagulation therapy is crucial for managing various cardiovascular and thrombotic conditions; however, optimal delivery remains challenging in primary care. Pharmacist-led anticoagulation services have emerged as a potential strategy for enhancing patient care and outcomes in such settings. Understanding the perspectives of key stakeholders is critical for successful implementation. This study aimed to explore the perceptions of key stakeholders involved in the implementation of pharmacist-led anticoagulation clinics in primary care settings. A cross-sectional study was conducted using structured, pilot-tested questionnaires between August and October 2023. Patients receiving warfarin, pharmacists, and physicians working across various primary healthcare centres were invited to complete an online survey. Each group of stakeholders had individualised questionnaires to assess their perceptions and expectations with regard to developing pharmacist-led anticoagulation clinics in primary care. Descriptive statistics were used to analyze the data. The response rates for the survey were 29.4% for physicians, 10.4% for patients, and 48.6% for pharmacists. Participants expressed positive perceptions toward pharmacist-led anticoagulation clinics, acknowledging benefits such as improved access to care, enhanced medication management, and increased patient education. The respondents expressed confidence in the expertise and skills of pharmacists in this role. However, healthcare providers strongly agree that pharmacists should receive additional training specific to anticoagulation management. Establishing standardised protocols and fostering interprofessional collaboration were identified as the main facilitators for practical implementation. Broad support exists for pharmacist-led anticoagulation clinics in primary care, though additional pharmacist training and accountability concerns need to be addressed for successful implementation.

Exploring Barriers and Facilitators That Influence Uptake of Oral Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Bulawayo, Zimbabwe: Key Stakeholder's Perspectives.

The world has been on the path to ending HIV and AIDS as a global threat by 2030; despite these efforts, the rate of new HIV infections among men who have sex with men remains very high. This study sought to explore the perceptions of key stakeholders on the potential barriers and facilitators of pre-exposure prophylaxis use among this key population. An exploratory, descriptive (through interviews) qualitative study was conducted on 10 key informants who were purposively selected and snowballed based on their knowledge and experience toward pre-exposure prophylaxis programming among men who have sex with men. The interviews were recorded, transcribed verbatim, coded, and thematically analyzed on MAXQDA. Stated barriers were stigma, lack of information, wrong messaging around pre-exposure prophylaxis, hearing negative things about the pills, the burden of taking pills daily, negative attitudes from health care providers, non-friendly health care facilities, pre-exposure prophylaxis not being affordable, and lack of flexibility and privacy from public hospitals. Identified facilitators were correct messaging on pre-exposure prophylaxis, long-lasting injectable pre-exposure prophylaxis, improved packaging, de-stigmatization, more friendly facilities, differentiated service approach, community groups, engagement, and partnership. To address these barriers and leverage the facilitators, it is imperative to have accessible, affordable services, non-judgmental health care providers, and peer support networks to empower men who have sex with men to make informed decisions regarding their sexual and reproductive health. Continued efforts to remove barriers and promote facilitators are crucial for maximizing the potential of pre-exposure prophylaxis as an effective HIV prevention tool among this population.

Team Around the Patient: multi-professional opportunities to support care delivery in hospitals.

Background: Demands on healthcare are outstripping the resources available. Many organisations are struggling to recruit sufficient registered nursing staff to maintain service delivery and are re-evaluating how safe, high quality, sustainable care could be provided. The concept “Team Around the Patient” being piloted in Hywel Dda University Health Board seeks to understand who can provide what care outside of traditional workforce models. The objective of this study is to examine perceptions of key health board stakeholders of the Team Around the Patient model of care and establish research priorities, and to design and test a workforce analysis model to test the implementation of Team Around the Patient. The model will be designed for use in adult, acute inpatient hospital wards.
 Methods: Before implementing the Team Around the Patient on select adult surgical and medical wards semi structured interviews were undertaken with key health board stakeholders to gather their understandings and perspectives on the concept, and create a working definition. A purposive approach was taken to engage a range of professional opinions including corporate and operational nursing, patient experience, allied health professionals, workforce and operational development. Interview topics included opportunities, quality indicators, barriers and enablers and organisational impacts. Ethical approval was provided by Swansea University and through The Integrated Research Application System (IRAS). Interviews were recorded, transcribed and thematically analysed. 
 Results: In total 15 participants were interviewed. High level findings show support for the concept, with many participants identifying the potential new roles to be included. Key quality indicators such as inpatient falls, medication errors, pressure damage, length of stay, complaints and staff experience were identified as being important measures for this concept. Challenges associated with introducing new roles were mainly associated with workforce culture, delegation and finance. 
 Conclusion: The results indicate overall support for “Team around the Patient” as a model of care which will help to alleviate issues surrounding skill shortages, while introducing more collaborative, inter-professional working. Further research is underway to gain wider perspectives of the concept from national and international experts in the fields of health care, academia and policy makers. The next stage of the research will include observational studies of health care delivery in practice to test the model of workforce analysis. The aim will be to identify opportunities for non-nursing staff groups to support care delivery where a gap in practice, or inefficiencies in the timely delivery of care, has been identified.

When child trafficking and informal fostering intersect

Informal fostering is an important tradition for many communities in Sub-Saharan Africa. However, the intersections of poverty and social circumstances may increase the risk of exploitation for informally fostered children. We used mixed methods to estimate the prevalence of child trafficking within informal child fostering placements in Sierra Leone, to document vulnerability factors and explore perceptions of key stakeholders. Data were collected through 1) a household survey (N= 3,070), 2) interviews (N= 41) with young adults who experienced child trafficking in informal fostering, parents of children who experienced trafficking in foster placements, and key informants, and 3) focus groups with community members (N= 23). We found that informal fostering increases the likelihood for children to experience trafficking. Although there are significant associations between child trafficking and informal fostering, social (gender and cultural traditions) and economic factors (poverty and school access) appear to be drivers for both. Our results suggest that strengthening poverty reduction measures, expanding opportunities for schooling and vocational training for children and young adults, and improving safety for children in informal fostering arrangements through reporting and monitoring are essential to mitigate the high rates of child trafficking in Sierra Leone, and to ensure children’s well-being in informal fostering placements.

Experiences of using artificial intelligence in healthcare: a qualitative study of UK clinician and key stakeholder perspectives

ObjectivesArtificial intelligence (AI) is a rapidly developing field in healthcare, with tools being developed across various specialties to support healthcare professionals and reduce workloads. It is important to understand the...

An innovative tool to assess the functional resilience of a school system: learning from the COVID-19 pandemic

IntroductionPreparing the school system for a future crisis requires the ability to examine the effectiveness of schools’ functioning during distant learning and their level of preparedness for future crises. Functional resilience (FR) is defined as the ability to maintain vital operational continuity in the face of disturbance. The study objectives included to develop a FR index of schools and to evaluate and validate it.MethodsTo enable examination of the study objectives, the study design included tool development, followed by a validation process among 20 content experts. Concurrently, an eDelphi process for building an inclusive index, based on various components of resilience was conducted. The final study tool consists of four tailored questionnaires to examine perceptions of key stakeholders, i.e.- teachers, principals, parents, and highschool students regarding communication, psychosocial aspects, perceived stress, infrastructure, resources, pedagogic support, digital literacy, and perceived FR. Using an internet panel, the tool was disseminated cross-sectionally among the four groups of stakeholders.ResultsThe results showed high reliability of most of the scales developed. Furthermore, a high consensus level was reached on the relative importance of each component/ stakeholder to the schools FR. The findings further suggest that there were no significant differences in the composite FR score based on characteristics such as school type/ size/geographic location. However, the findings revealed interesting variations among stakeholders, with findings suggesting greater vulnerability among some.DiscussionTo increase resilience and preparedness for future adversities that school systems may face, it is recommended to periodically incorporate an assessment based on a structured tool.