Professional Perspectives Research Articles

Experiences of the COVID-19 pandemic on child and adolescent psychiatric wards: multi-methods investigation.

Child and adolescent mental health service in-patient beds are unevenly spread throughout England. Where demand outstrips bed availability, young people may be admitted at-distance or to adult psychiatric wards. The COVID-19 pandemic added pressures to already overstretched services. Understanding experiences during this period is vital to inform strategies for future emergencies. To investigate the impact of the COVID-19 pandemic on admissions to local, at-distance or adult psychiatric units, from the perspectives of young people, parents/carers and healthcare professionals. Multi-methods data were collected from February 2021 to September 2022, as part of the Far Away from Home research programme. A 13-month national surveillance study collected information about admissions to general adolescent units >50 miles from home, out-of-region or to adult psychiatric units. Free-text data from respondents (n = 51) were analysed using content analysis. Interviews with young people (n = 30), parents/carers (n = 21) and healthcare professionals (n = 68) were analysed using thematic analysis. Restrictions during the COVID-19 pandemic affected young people's contact with others; the requirement to self-isolate on admission and following overnight leave felt distressing, and visiting was limited. This disincentivised overnight leave, leading to some discharges being delayed and others feeling rushed and high risk. The COVID-19 pandemic also accelerated the introduction of virtual meetings, enabling community teams and families to be more involved in therapies, meetings and decision-making. Restrictions imposed during the COVID-19 pandemic were often negatively perceived. However, the increased use of technology was felt to be positive, widening inclusion and mitigating some negative effects of distance on admissions.

Self protective health care in childhood cancer survivors from the perspective of survivors, parents, and professionals: a qualitative study.

Childhood cancer survivors experience many health problems that they must protect themselves from their destructive physical and psychological effects. Understanding experiences of children about self-protective care will help health care providers manage long-term care plans. Therefore, this study was conducted with the aim of exploring self-protection care in childhood cancer survivors. This is a phenomenological study that was conducted in the clinics and cancer care centers of Urmia and Khoy in Iran. 27 participants were selected by purposive sampling until data saturation. The data was collected using a semi-structured and in-depth face to face interview. Content analysis approach used for data analysis and MAXQUDA 10 software used for data management. Data analysis led to the emergence of "self-protection health care" as a main category, two categories "maintaining physical health" and "keeping a strong mindset" and 9 sub-categories including "abstain activities that may cause harm", "refusing contact with others for possible infection", "monitoring symptoms and side-effects of cancer coming back", "avoiding unhealthy diet", "knowing about cancer from similar others", "keep away negative thoughts and emotions", "drawing on spiritual resources", "creating a bridge to life again" and "being healthy for the sake of one's family". According to the results of this study, self-protection is one of the most important cares for childhood cancer survivors. Over time, the influence of the clinical team and parents on children's health care diminishes. Therefore, they should promote their health and well-being behaviors and use a variety of protective approaches to self-care.

Designing the Virtual Museum with Animal Crossing: New Horizons

Abstract In the 2020 video game Animal Crossing: New Horizons, the player builds the collection of the impressive Animal Crossing Museum (ACM). Exploring the visitor experience of this video game museum’s art wing from the perspective of museum professionals allows for the discovery of inventive ways to deepen connection with museum patrons in the virtual space. The ACM is more successful at engaging visitors than traditional virtual museums. It meets visitor needs by offering an immersive, interactive experience, and depends on direct action from the visitor to expand and grow its collection and space. By taking lessons from the player interaction design of the ACM, virtual museums can be designed to meet the psychological needs of visitors and build long-lasting relationships between the visitor and the institution. From the text, this essay proposes seven lessons for designing virtual museums: start with visitor experience at the center of virtual museum design, allow the visitor to collaborate on the creation of the virtual museum, make the virtual museum a habit with intermittent rewards and increased access over time, build social interaction into the virtual museum, add an avatar, show off curator personality, and address colonial roots of museums.

Perspectives of Australian healthcare professionals towards gamification in practice.

Gamification may be an effective tool in motivating sustained behaviour change. This study aimed to explore perspectives of Australian-based healthcare professionals, including dietitians, towards gamification in their practice when assisting patients/clients to achieve health-related goals. Semi-structured online interviews were conducted with healthcare professionals. Data was audio-recorded, transcribed verbatim, de-identified and thematically analysed to identify key themes and inform the creation of personas. Six dietitians, two psychologists, two exercise physiologists, one medical specialist, with 1-24 years of work experience, participated. Most participants (n = 7, 64%) were unable to articulate a definition of gamification, however, when offered more context, they could identify examples. Overall, participants were positive towards gamification, regardless of prior experience/exposure. Three themes emerged; (1) Variable familiarity with gamification, (2) Context matters, (3) Barriers hinder engagement/adoption. Stage of career rather than profession influenced participants' views of gamification, as reflected in three characterising personas; 'Joel: Early-Career, Progressive', 'Bella: Mid-Career, Stable' and 'Sam: Advanced-Career, Expert'. Findings suggest that gamification is not widely used in health practice in Australia. Concerns about participation costs and data privacy are adoption barriers. Promotion of the effectiveness of gamification as a valuable adjunct tool to encourage behaviour change needs support from peak bodies. Embedding gamification in university curricula could better prepare graduates to engage with gamification in future practice. Further research capturing more diverse healthcare professionals' perspectives is required to fully understand the potential of gamification to change health behaviours, and to design feasible gamified solutions.

Discrimination experiences of transgender individuals in healthcare: an interview study on the perspective of health professionals specializing in the treatment of transgender individuals

BackgroundExperiences of discrimination in healthcare lead to poorer mental and physical health for transgender individuals. There is evidence that trans-specialists, i.e. health professionals specializing in transgender care, are an important source of discrimination experienced by transgender individuals in healthcare. In this qualitative interview study, we explored the reasons for this possibly surprising finding by analyzing subjective views of trans-specialists on various issues related to discrimination of transgender individuals.MethodsWe conducted 20 semi-structured, qualitative, exploratory interviews with healthcare professionals specializing in transgender care. Interview questions were developed based on an extensive literature analysis and results of previous research on the topic. The interviews were conducted online, were digitally recorded and transcribed. Data analysis was conducted using the methods of content analysis and thematic analysis.ResultsThe interviewees had great difficulty giving a consistent definition of the concept of gender identity. Most of them saw it as a self-determination of a transgender individual. Although herewith emphasizing the autonomy of transgender individuals, most trans-specialists felt that they had to be convinced of their patient’s transsexuality to carry out treatment. Most trans-specialists reported having had doubts about whether some transgender individuals were suffering from gender incongruence or not. There was also ambiguity among interviewees about whether transsexuality is a mental illness.ConclusionsWe were able to identify specific topics that can cause discrimination experiences on the part of transgender individuals in their contact with trans-specialists. These include the vagueness of the construct of gender identity and the ambivalence between respect for the autonomy of transgender individuals and the validation of the diagnosis “transsexuality”. Also, uncertainties regarding the classification of transsexuality as a mental illness can lead to experiences of discrimination. Furthermore, our results imply that trans-specialists might remember own discriminatory behavior less than it actually took place. Our results can contribute to the development of specific measures to avoid discrimination experiences of transgender individuals in contact with trans-specialists. These should include a reflection on one’s own gender identity and training on mechanisms of discrimination.

Protocol for Surveying Participants and Professionals’ Experiences in an International Kidney Transplant Clinical Trial

Background Therapeutic misconception is a phenomenon in which participants or researchers misunderstand the nature and purpose of a clinical trial, believing that the primary goal of the trial is to provide them with individualized therapeutic benefit rather than to generate generalizable knowledge that will benefit future patients. Therefore, the perspectives of participants and researchers on these issues are central to improving the quality of health research to increase participant awareness and avoid therapeutic misconceptions. Objective The main objective of this study is to explore the views and experiences of patients and healthcare professionals regarding their participation in a clinical trial, the TTVguideIT randomized controlled trial, as part of the EU funded TTVguideTX project. The study was designed to identify therapeutic misconceptions of participants and health care professionals, assess their experiences with the informed consent process and their concerns regarding privacy and data protection. Methods This study is based on two distinct questionnaires, one intended for the professionals involved in the TTVguideIT clinical trial and the other for the patients. The questionnaires can be completed both online and on paper, allowing each individual to choose the format that suits them best. The questionnaires are written in the languages of the six participating countries, namely German, Spanish, French, Dutch, and Czech. Conclusion This study may help future research design and implementation to include participants' and professionals perspectives on the informed consent process and privacy and data protection, and aspects aimed at minimizing therapeutic misconceptions.

Co-creating an appreciative working climate: discussing reasons for appreciation, forms and roles from a communication perspective

PurposeIn recent years, various socio-political developments have led to changes in the labor market that place high demands on both employees and organizations. Research has shown that strong employee–organization relationships depend partly on employees’ perceptions of appreciation at work for which different communicators are attributed with responsibility. This study draws conclusions for the role of internal communication professionals in co-creating an appreciative working climate by exploring employees’ expectations on what they want to be appreciated for, by identifying forms of appreciation and by stressing the contribution of communication professionals in meeting these expectations.Design/methodology/approachThe results base on three focus groups conducted in January 2023 with employees without leadership responsibility working in large Austrian organizations.FindingsThe analysis yields to two areas – “personal characteristics and qualities” and “work-related behaviors” – where employees expect appreciation. In six categories we capture forms of appreciation that reflect employees’ expectations and perceptions. Most of the forms can and should be addressed by managers within an organization—internal communication professionals should follow a communicative professional logic and act as strategic partners and resource providers, enablers and role models.Research limitations/implications(1) What do employees expect to be appreciated for? (2) What forms of appreciation do employees expect? (3) What role do internal communication professionals seize in co-creating an appreciative working climate?Practical implicationsBased on social exchange theory, resource theory and the job-demands resource (JD-R) model, this study conceptualizes appreciation as a prototypical generic socioemotional resource at work that is communicative in nature, and key to both motivation and health.LimitationsThere is a need to capture the perspective of managers and internal communication professionals on employees’ expectations in order to deepen the debate about communication responsibilities, practice and critical aspects of appreciation. Furthermore, a comparison of different work cultures (e.g. Asia) and other institutionalized work forms (e.g. start-ups, small enterprises, public agencies) would advance the debate.Originality/valueThe study provides in-depth knowledge of reasons for and forms of appreciation from an employee’s perspective, which is considered relevant to discuss communication responsibilities in light of dependencies.

Paediatric systemic inflammatory response syndrome (SIRS) and the development of patient-specific therapy: ethical perspectives through experts’ opinions

BackgroundResearch for personalised therapies concerning the Systemic Inflammatory Response Syndrome (SIRS) in children involves the utilisation of OMICS technologies and Artificial Intelligence (AI).MethodsTo identify specific ethical challenges through the perspective of healthcare professionals, we conducted 10 semi-structured interviews. The development of interview questions for the interviews was preceded by a systematic review of the scientific literature. To address the complexities of paediatric emergency research, informed consent, and data processing, experts with expertise in paediatric intensive care, computer science, and medical law were sought. After the transcription and anonymisation, the analysis followed established guidelines for qualitative content and thematic analysis.ResultsInterviewees highlighted the intricacies of managing consent in personalised SIRS research due to the large amount and complexity of information necessary for autonomous decision-making. Thus, instruments aimed at enhancing the understanding of legal guardians and to empowering the child were appreciated and the need for specific guidelines and establishing standards was expressed. Medical risks were estimated to be low, but the challenges of securing anonymisation and data protection were expected. It was emphasised that risks and benefits cannot be anticipated at this stage. Social justice issues were identified because of possible biases within the research population. Our findings were analysed using current ethical and legal frameworks for research with a focus on the particularities of the patient group and the emergency background. In this particular context, experts advocated for an enabling approach pertaining to AI in combination with OMICS technologies.ConclusionAs with every new technological development, ethical and legal challenges cannot be foreseen for SIRS-personalised treatment. Given this circumstance, experts emphasised the importance of extending the ethics-legal discourse beyond mere restrictions. The organisation of supervision should be reconsidered and not limited only to the precautionary principle, which per se was seen as impeding both the medical progress and clinical flexibility. It was noted that the establishment and monitoring of guidelines were emergent and should evolve through an interdisciplinary discourse. Therefore, it was recommended to enhance the qualifications of physicians in the field of computer science, impart ethics training to AI developers, and involve experts with expertise in medical law and data protection.

Editorial: Digital health applications: acceptance, benefit assessment, and costs from the perspective of patients and medical professionals

Editorial: Digital health applications: acceptance, benefit assessment, and costs from the perspective of patients and medical professionals

Digital Leadership and Professional Commitment to Enhance Teacher Innovativeness as a Priority Strategy

This research aimed to determine priority strategies for increasing teacher innovativeness in the digital era from digital leadership and professional commitment perspectives. The research employed a mixed methods research approach with four stages: theme exploration, model design, data collection, and analysis/product creation. The study population was teachers in Indonesia, and the sample comprised 623 teachers. The study results show that the priority strategy to increase the innovativeness of teachers is divided into two perspectives: digital leadership and professional commitment. Priority strategies from a digital leadership perspective are as follows: digital competitive and intelligent capabilities, digital communication skills, strengthening digital resilience, the ability of educational innovativeness, and monitoring school performance digitally. Priority strategies from a professional commitment perspective are as follows: involvement in the decision-making process, abilities in evaluation and reflection, improving self-competence, ability to prepare to overcome educational challenges, and teacher discipline in their duties. The results imply that academic institutions need to strengthen digital leadership and professional commitment to promote the innovativeness of teachers in the digital era.

Perspectives of patients, partners, primary and hospital-based health care professionals on living with advanced cancer and systemic treatment

Abstract Purpose An emerging group of patients lives longer with advanced cancer while receiving systemic treatment. This study aimed to investigate psychosocial aspects of living longer with advanced cancer, and experiences with psychosocial care, from the perspectives of patients, partners, and health care professionals (HCPs). Methods From May to December 2020, participants were purposively selected. In-depth, semi-structured interviews were conducted by video or phone call, containing open questions regarding psychosocial aspects and psychosocial care in oncology. The data was analysed following thematic analysis, leading to overarching psychosocial themes and indications for optimal organisation of psycho-oncological care. Results Fifteen patients, seven partners and eleven HCPs were interviewed. The main psychosocial aspects were increasing loss in several life domains, complexity of making life choices, ongoing uncertainty, and fluctuating fear and hope. Partners were affected by their loved ones’ condition and reported to put themselves second for longer periods of time, while sometimes missing adequate support. HCPs were challenged by addressing the altering psychosocial needs of patients, and tools to identify those in need for psychosocial support are currently lacking. Conclusions Living longer with advanced cancer presents unique challenges for patients and their partners, as well as for HCPs in delivering optimal psychosocial care. Implications for Cancer Survivors Identifying and addressing patients’ psychosocial needs from an early stage on, appointing a central hospital-based contact person, limiting the waiting time between scans and consultations, and addressing the partners’ wellbeing are suggestions to organise optimal psychosocial support in advanced cancer.

Design Principles for a Higher Education Course Focusing on Lifelong Learning

Lifelong learning for solving work assignments is essential for societal and personal development. Higher education is one natural part of lifelong learning and, therefore, needs to be re-focused from solely younger students to include professionals and their development goals. One problem related to giving a course for professionals is their struggle between work assignments and the course. Focusing on the added perspective of professionals for higher education, this study presents five design principles for courses for professionals. Design principles are guidelines based on experience and iterative development in higher education. The empirical data comes from a course in digitalisation and digital transformation, which was given thrice. The course participants were professionals from private and public organisations in Sweden. The empirical data originates from the professionals who made a check-in, mid-term evaluation, and evaluation after the course, resulting in 75 entries. Two researchers analysed the first two course entries inductively, forming the foundation for the first round of design principles. The course design for the third round was then revised according to its weaknesses. Based on the strengths and weaknesses found in empirical material from all three courses, the current design principles are professional pathways referring to new knowledge directly linked to real-world applications, knowledge evolution, meaning gradual integration of knowledge using seminars and examination assignments, preparedness protocol focusing on updated information and structured templates for the seminars. Further, the design principle of collaborative connection includes discussion where professionals exchange experiences, and the last principle, learning fusion, directs toward blended learning by combining face-to-face seminars and films. The revised course design, according to the design principles, implied that the number of professionals graduating and their grades increased. The findings of this study add theoretically to existing knowledge and practical implications by providing design principles that higher education teachers and other stakeholders can use to design or revise professional development courses. The design principles could be used stand-alone or combined to increase professionals' learning and satisfaction.

3.N. Round table: Health inequalities over life-course between people with & without childhood social care experience

Abstract The burden of ill health is not carried equally, children and young people with experiences of childhood social care (CSC), e.g. kinship, foster, residential or ‘out-of-home’ care, are affected by multiple cumulative disadvantages and experience high inequalities in health compared to the rest of the population. CSC, and the adversities often associated with it, are linked to health problems that persist into adulthood and adversely affect education, employment, and the future European society. Public and policy interest in improving outcomes for CSC recipients has increased markedly, as has research on the association between CSC and life outcomes. But current research is siloed, with limited comparative perspective and has not led to a strong evidence base to inform policy and practice. Wider international networks to connect research, practice and policy are needed to change this. The objective of the workshop is to bring together evidence on health inequalities between people with and without CSC experience across Europe. The panel will set the scene for the discussion by raising questions that stem from their work for the audience to respond. We will ask the audience to engage with these questions based on their experience (e.g. academic, clinical or other professional). The real-time reactions will be collected via Mentimeter during presentations, moderated and fed back to the audience and panel for discussion. This will allow us to collect diverse responses across countries and from different professional perspectives, providing learning and insights for both the panel and audience. The added value of a EUPHA workshop is the high-profile European level attention on this population. A spotlight on CSC experiences bringing together evidence from topic experts and health practitioners committed to improving childhood health inequalities across Europe and will foster a strong foundation for future collaborations and comparative research. The format is interactive and will include an introductory video of lived experiences of CSC to put a human face on this topic. We will then hear 4x5 minute expert presentations from social epidemiologists, health and social care professionals (20m) followed by a moderated discussion with the audience (35m). The presentations cover research across Europe, consider how inequalities accumulate across the life course to place children in care settings and identify where gaps in services fail children. MA sets the scene by asking what the international evidence is telling us about the health of people with CSC experiences. VS explores the accumulation of disadvantage across the life-course and intergenerational experiences of CSC. HF uses the Swedish example to ask why welfare services are not meeting the health needs of children. Finally, SS will consider solutions: what additions support is required for health practitioners dealing with children in care settings and what can/cannot be achieved from within the doctor’s office? Key messages • Participants will gain new insights on the health of children with social care experience from each other by sharing evidence and discussing key questions from diverse perspectives across Europe. • The workshop provides a foundation for participants to build future international networks and comparative research that will lead to a strong evidence base to inform policy and practice.

Patient-reported outcomes of chimeric antigen receptor T-cell therapy in hematologic malignancies: a systematic review and meta-analysis

Few studies evaluated patient-reported outcomes (PROs) for patients with hematologic malignancies receiving with Chimeric Antigen Receptor T (CAR-T) cell therapy. We performed a systematic review and meta-analysis to evaluate the benefits of CAR-T cell therapies focused on PROs. A systematic literature searched from PubMed, Cochrane, and the Web of Science from inception to September 2023. Study selection and data extraction were conducted independently by two reviewers based on pre-specified criteria. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist was used to evaluate the methodological quality of the included studies. The random-effects model was employed to calculate the combined effect and 95% Confidence intervals. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and the protocol was registered with PROSPERO (CRD42024586706). We identified 20,110 studies. Of those, 15 studies with 16 different PRO measures (PROMs) were included in the meta-analysis. CAR-T cell therapy improved PROs in the six domains of general health status, pain, fatigue, depression, social function, and cognitive function: from the general health status (SMD: 0.57, 95% CI: 0.34 to 0.81) to cognitive function (SMD: 0.25, 95% CI: 0.14 to 0.37). The current meta-analysis shows that CAR-T cell therapy produces clinically meaningful differences in PROs. These results suggest that the professional perspective and patient values and preferences should be weighed equally when considering CAR-T cell therapy for hematologic malignancies.

Reflecting (on) power?Critical reflections by healthworkers in Germany on racial power and privilege

Abstract Background Healthcare users have increasingly reported on experiences of racial discrimination in healthcare encounters in Germany (Aikins et al. 2020). While research on the experiences of racialised users predominates, examining the perspectives of white professionals, especially those holding positions of authority, regarding their internalised stereotypes and discriminatory practices is also crucial. This study therefore investigated the prevalence of conscious or unconscious biases related to critical whiteness and anti-racism among healthcare workers (doctors, nurses and therapists) and how these attitudes shaped their professional practice. Methods Problem-centred expert interviews (Döringer 2021) with 20 healthcare professionals from medicine, nursing, and therapeutic professions working in hospitals or rehabilitation facilities across three German federal states. Data were analysed using documentary method (Bohnsack 2002). Results Respondents exhibited varying degrees of reflective abilities, and there are limited opportunities for structured self-reflection focused on recognizing and addressing racism. The research interview constituted a much-needed space for such reflection. Those who are sensitised about their own positions of privilege often are so due to external influences and personal trajectories (teenaged children, trade union activism) rather than through the values or structures of their institutions. Unconscious racism nonetheless still manifests, demonstrating the need to create more inclusive environments where critical self-reflection on racism is encouraged. Conclusions To effectively combat racism, German healthcare institutions must systematically implement anti-racist and intersectional interventions. This also entails creating spaces for reflection where staff can openly examine and acknowledge their own biases, fostering an environment conducive to collective action for promoting anti-racist workplace practices. Key messages • Opportunities for self-reflection critical of racism should also be offered across institutions in order to ensure trusting, non-hierarchical spaces. • Reflections on one’s own social positioning and privileges are not common in all circles, so the necessity of this attitude should be communicated in an error-friendly manner.

Decoding healthcare strategies: providing comprehensive care for type II diabetes in Ecuador

Abstract Background Diabetes is a major global health challenge, impacting millions and disproportionately affecting low- and middle-income countries (LMICs), where approximately three-quarters of affected individuals reside. Despite abundant guidance on diabetes management, most evidence is derived from high-resource settings, potentially impeding effective application in low-resource settings. This study explored issues related to the application of the current clinical practice guidelines (CPG) for diabetes management in Ecuador, from the perspective of local health professionals. Methods We developed 5 focus groups in Quito, the capital of Ecuador, in a low-income district. The groups included doctors, nurses, and health promoters; they discussed four sections of the CPG concerning their daily practice. Qualitative results are contrasted with quantitative research based on patient records. Results The Ecuadorian health system considers patients with diabetes a priority group, yet a patient may wait up to 4 months to receive their first appointments and once they receive their diagnosis several criteria set out in the CPG are not followed due to lack of time and resources, particularly the delivery of multidisciplinary attention. Access to specialized consultations, such as an ophthalmological assessment is severely restricted, and it can take up to a year to get an appointment. Clinicians expressed difficulties in adapting the nonpharmacological recommendations to different socioeconomic backgrounds, while at times, prescription choices are determined by medicine stock regardless of the patient’s actual needs. Conclusions Healthcare professionals have developed a series of ad-hoc strategies to ensure healthcare for their patients, pointing out the difficulties of applying CPG within a health system that lacks basic resources. Healthcare is intertwined with social inequalities among the Ecuadorian population that have worsened since the covid19 pandemic. Key messages • We identified significant challenges in applying the CPG in low resource settings. Clinicians adapt by introducing novel ways to overcome limitations at times to the detriment of the patient’s health. • CPGs need to be tailored to the context considering socioeconomic realities of the population and limited resources in the health setting.

Empowerment and interprofessional collaboration in health promotion centre Murska Sobota

Abstract Background Health promotion centres (HPCs) were introduced in Slovenian primary health care centres to provide interventions against risk factors for noncommunicable diseases (NCDs). HPCs integrate a multidisciplinary and community-based primary care approach to the prevention of NCDs and provide free lifestyle intervention programmes. This study aims to explore the perspectives of health care professionals on promoting health of local community members, as well as their perceptions of interprofessional collaboration in HPCs. Methods Two group discussions were conducted with a total of 11 health care professionals at the HPC Murska Sobota. Data collection was accompanied by a dual role interpreter in accordance with the principles of cross-language qualitative research. The data was transcribed, semantically translated and thematically analysed. Results Health care professionals emphasize the importance of health-related empowerment of individuals for the success of health promotion activities and therefore for the improvement of individuals’ quality of life. This is based on shared decision-making, self-management and educational measures in a combination of population- and individual-based approaches. The need for efficient interprofessional communication, characterized by a flat hierarchy, is stressed. Structured cooperation with other health care facilities, as well as close collaboration with communities and local media, are described as crucial for reaching all individuals and promoting health equity. Conclusions Interprofessional collaboration, health-related empowerment of individuals and collaboration with local communities are fundamental for the success of health promotion activities, achieving health equity and preventing NCDs. Understanding how these activities are implemented from the health care professionals’ perspective can help other health facilities developing and improving local health promotion strategies. Key messages • Slovenian health care professionals see interprofessional collaboration as fundamental for the implementation of health-promotion strategies. • Health-related empowerment of individuals and collaboration with local communities play an important role in achieving health equity in health promotion activities.

Ways of self-renewal of kindergarten teachers in forest kindergartens change

ABSTRACT The study examined the self-renewal and conceptual change kindergarten teachers in Israel, underwent from a professional career perspective in the process of implementing the transition to a forest kindergarten model. Educator’s career consists of four consecutive stages: entry, building, mid-career, and the late career. In education, self-renewal is a phenomenon characteristic in the mid-career stage. Self-renewal has scarcely been studied in early childhood educators. This article examines self-renewal based on interpretations of interviews with 19 kindergarten teachers in Israel who responded to an institutional initiative to create forest kindergartens. Results show three ways that mid-career kindergarten teachers used to update their pedagogical knowledge and reframe their educational perceptions. Self-renewal reflects the professional kindergarten teachers’ background based on their past experiences and aspects of entrepreneurial behavior. The article can help policymakers improve early childhood education and launch new enterprises.

Transferable skills in tourism and hospitality

A multi-stage, multi-method approach using participatory research methodology that considers the perspectives of tourism and hospitality professionals, and academic experts is used to develop an integrated model of transferable skills gained by working in the industry. Grounded in career construction theory, this study is anticipated to provide a comprehensive understanding of essential skills in the tourism and hospitality industry. It also aims to reshape the image of working in the industry into a more positive one, emphasizing the opportunities of the sector not only as a career but also as a steppingstone to learn transferable skills needed in different sectors, and ultimately contribute to the long-term and sustainable development of the tourism and hospitality sector.

Bridging The Gap Between Maritime Education and Industry Needs: Enhancing Human Resource Development

This research explores the critical need for maritime vocational education to align more closely with the evolving demands of the maritime industry, particularly in the areas of technological integration, environmental compliance, and industry collaboration. By analyzing the qualitative perspectives of maritime professionals, educators, graduates, and senior government officers, the study identifies key gaps in the current educational framework. The findings highlight the moderate effectiveness of existing programs, with strengths in regulatory knowledge and industry-academia partnerships, but weaknesses in preparing students for advanced technological systems and practical environmental challenges. The study emphasizes the need for curriculum modernization, increased hands-on training, and deeper, long-term industry partnerships to equip future maritime professionals with the skills necessary to navigate a rapidly changing sector. Ultimately, this research provides actionable insights for improving the responsiveness and agility of maritime vocational schools, ensuring that graduates are better prepared for the technological, regulatory, and environmental challenges facing the maritime industry.