Practice Improvement Research Articles

Subverting Racialized Mobility Regimes: Ethical Research with Migrant Youth in an Age of Securitization

In France, minoritized migrant youth—a term encompassing various legal statuses and migration trajectories—are subject to systems of surveillance that include racialized policing, school securitization policies, and programs to counter extremism. These institutional practices are complemented by hostility within everyday public spaces and broader systems of representation. Together, institutional and everyday forms of surveillance constitute racialized mobility regimes for migrant youth within and beyond educational spaces. For researchers who work with migrant youth, such landscapes pose ethical demands—what forms of critical awareness, anticipatory planning, and improvisatory practices are necessary to mitigate harms resulting from participation in their projects? Drawing upon an autoethnographic revisiting of a 16-month digital storytelling engagement with newcomer migrant and refugee youth in two French high schools, I discuss the creation of a “youth researcher” pass in anticipation of the racialized surveillance confronting migrant youth in France. Informed by the works of Walter Benjamin and Michel de Certeau on mobility, storytelling, and facsimiles, as well as political developments in France, I argue that in settings in which migrant presence is deemed a threat, researchers must unapologetically opt for an ethical stance that takes protection of participants’ humanity—rather than legality—as its core aim.

Empowering rural women through sustainable menstrual hygiene practices for enhanced reproductive health

Objectives: To assess menstrual hygiene practices in Aandhi village, Rajasthan, and evaluate the impact of educational interventions on menstrual health. Material and Methods: A survey was conducted with 3290 males, 2994 females, and 242 senior citizens using structured questionnaires. Educational interventions promoting hygienic menstrual practices were implemented. Results: Findings revealed poor menstrual hygiene practices, with 75% disposing of products improperly. Post-intervention, there was a significant improvement in hygiene practices and awareness. Conclusion: The study emphasizes the need for better menstrual hygiene education, proper waste disposal systems, and access to sustainable menstrual products in rural India.

Attempts to Train Literacy and Numeracy through STEM-based Learning Media Making Training for Science Teachers in Muaraenim Regency

This training aims to train literacy and numeracy through making STEM-based learning media on renewable energy material. In addition, teachers are expected to be able to provide innovation in media making, which can be implemented in science learning. The method used in this activity is Participatory Action Research (PAR). Several steps are taken to achieve the set goals, namely 1) giving a pretest or initial test, 2) implementing the service, and 3) giving a final test and evaluation and reflection. This activity was attended by 30 participants who were science teachers and members of the Science MGMP. The results showed that the percentage for the pretest score with 30 participants obtained an average of 47.6%, and the posttest score obtained an average of 93.20%, for a Gain score of 87%. This value represents the interpretation of the practical improvement category. Based on the results of the questionnaire on the level of satisfaction with the implementation of the service, it can be indicated that all teachers feel delighted with the training assistance service activities. This training activity has provided practical solutions to facing the challenges of 21st-century learning, especially in areas with limited facilities.

Exploring the Role of Early Diagnosis of Hearing Loss in Children and Its Impact on Educational Outcomes, Language Development, and Social Integration in Special Education Settings

The study explores the impact of early diagnosis of hearing loss on children's educational outcomes, language development, and social integration in special education settings. The research involved 150 children with early hearing loss, comparing the differences between early diagnosis (0-2 years) and late diagnosis (more than 2 years after birth). A quantitative research design was employed, using standardized test scores, teacher assessments, speech development tests, and social interaction surveys for data collection. The findings show that early diagnosis positively influences academic performance, language development, and peer interactions. Children diagnosed early demonstrated better academic outcomes (p < 0.05), more advanced language skills (p < 0.05), and improved social interactions (p < 0.05) compared to those diagnosed later. A strong positive correlation was found between early diagnosis and the effectiveness of support services (r = 0.65, p < 0.05). These results emphasize the importance of early intervention and robust support systems for children with hearing loss, highlighting the need for expanded newborn hearing screening programs and improvements in educational practices. Further research is recommended on long-term outcomes, the role of assistive technologies, and the influence of family involvement on improving outcomes following early diagnosis.

Burnout among medical residents: key drivers and practical mitigating strategies.

Burnout is a prevalent phenomenon in medicine, affecting >50% of physicians and up to 60% of medical residents. This has negative consequences for both doctors' mental health and job satisfaction as well as patient care quality. While numerous studies have explored the causes, psychological effects, and workplace solutions, we aim to practicalize the issue from the perspectives of residents by discussing three key drivers of burnout and offering actionable, multipronged strategies that may be able to tackle these root causes effectively. From review of relevant literature and personal reflections/experiences, we identified three key factors that contribute to resident burnout, namely, (i) inherent physician attributes, (ii) mismatched expectations of the medical profession, and (iii) stressful nature of clinical work and residency training for junior physicians. We offer practical strategies that can be implemented by various stakeholders in a concerted manner to target these three areas, namely, to inculcate and foster accurate perception of the medical profession at the outset, develop psychological strength/resilience among medical residents, and make practical improvements to working and training environments.

USE OF TECHNOLOGIES AND THEIR EFFECT ON THE DEVELOPMENT OF BEEF CATTLE FARMING

Growth of the global population and the consequent demand for food put pressure on the agricultural sector, especially beef cattle farming, to increase production sustainably. This paper explores the use of emerging technologies such as remote sensing, Internet of Things (IoT), and artificial intelligence (AI) to enhance productivity, improve animal welfare, and reduce environmental impact. Remote sensing uses electromagnetic waves to monitor vegetation, while RGB and multispectral sensors provide detailed data on plant health. IoT, through interconnected devices, monitors animal health and water resource management. AI enhances data analysis, enabling accurate predictions and continuous improvements in management practices. These integrated technologies promote a more sustainable and efficient cattle industry.

Creating better internships by understanding mentor challenges: findings from a series of focus groups

BackgroundDespite demands to make higher education more relevant beyond academia, and a growing body of work testifying to the benefits of work-relevance programs (e.g., work-placements, or internships) for both students and the companies that host them, there is limited information available for those aiming to optimize these programs. For example, few have explored the challenges and needs of internship supervisors. Here, we focus on the experiences of supervisors in biology and geology programs across three Norwegian institutions. Specifically, through a series of focus groups, we asked internship supervisors about their motivations for serving as student mentors, any challenges they had faced, and what higher-education institutions could do to better prepare them for hosting students at their workplaces.ResultsKey challenges faced by supervisors include the need to tailor placements to individual student needs and capabilities, navigating the constraints imposed by academic structures, and addressing communication gaps between students, institutions, and workplace supervisors. Internship supervisors suggest enhancing communication strategies to better define roles and expectations, increasing support and training for supervisors, and establishing clearer, more collaborative frameworks for setting learning objectives with students.ConclusionsThe supervisors’ suggestions aim to ensure that internships are mutually beneficial, supporting both students' educational outcomes and the workplace needs. By focusing on the supervisor's perspective, we provide valuable insights into one aspect of implementing effective and rewarding internships (i.e., supervisor preparation), thereby suggesting pathways for future improvements in these high-impact educational practices.

Mus(ick)ing on pedagogical relations as the art of encounter

This article comprises a lyrical exposition of the ‘in-betweenness’ that underlies pedagogical relations and musical practice. The latter comprises making, performing, teaching, and indeed listening to music, phenomena encapsulated in the term ‘musicking’, first coined by the musicologist Christopher Small in 1999. Improvisatory practice is inscribed into the very process of writing as a means of mainstreaming the power of connection; and troubling the notion of seeking as the hallmark of ‘poor pedagogy’ (Masschelein, 2010) or weak education (Ingold, 2018). Drawing inter alia on a scintillating improvisational performance by the musician Bobby McFerrin, we argue that pedagogical relations, construed as the art of encounter, are about finding rather than seeking. Finding implies experiencing a sense of connection, ‘that feeling of landing in the present tense’, of being immersed in whatever occupies you, paying close attention to the details of experience’ (Tempest, 2020, p. 5). This is a far cry from education in a major key, the secure territory of understanding that is premised on codified knowledge that pre-empts attention or marginalises it altogether. We draw on examples from music education to explore the deleterious effects of power dynamics. We end with a rallying cry for education as a common chorus.

Evaluating a transitional housing program for people who use substances (PWUS) who experience homelessness and live with a mental health issue: a mixed-methods study protocol in Sudbury Ontario

BackgroundA new transitional housing program was established in Sudbury, Ontario, Canada, in response to the escalating global prevalence of substance use and homelessness, and the specific challenges faced in Northern Ontario. This protocol outlines a comprehensive program evaluation to assess its impact on patient outcomes, healthcare utilization, and client perspectives.MethodsWe will conduct a parallel mixed-method study that includes the analysis of single-center-level administrative health data and primary data collection. This includes a longitudinal observational study (target n = 1,200), pre- and post-admission quantitative interviews (target n = 40), and qualitative interviews (target n = 40). We will implement a participatory approach to this evaluation collaborating with people who use substances, frontline staff, and decision-makers. Data analysis methods include a range of statistical techniques, including logistic regression models, Cox proportional hazards models, Kaplan-Meier curves, Generalized Estimating Equations, and thematic qualitative analysis, ensuring a robust evaluation of patient outcomes and healthcare utilization.DiscussionThis protocol underpins a comprehensive assessment aimed at providing insights into the program’s effectiveness in addressing substance use-related challenges, reducing healthcare disparities, and improving patient outcomes, such as stable housing and increased social capital. All study procedures adhere to the ethical principles outlined in the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. Findings will be disseminated progressively through established committees and working groups and subsequently published in peer-reviewed journals. Anticipated outcomes include informing evidence-based healthcare decision-making and driving improvements in addiction treatment practices within healthcare settings.

Qualitative Study on the Use of Red Scarves by Young Pioneers

The Chinese Young Pioneers is a grassroots mass organization specifically established for Chinese children and youth, with the main goal of guiding them to learn the core values of communism and striving to shape them into active contributors and successors to the future socialist and communist cause. The red scarf, as a symbol of the Young Pioneers, carries glorious historical memories and serves as a distinct identity symbol for its members, which should be properly cherished. Wearing a red scarf not only enhances the organizational identity and sense of belonging of Young Pioneers, but also plays a positive role in promoting their understanding and acceptance of collectivist values. The red scarf is not only an external unified form, but also carries the deeper meaning and value of education. This study focuses on the phenomenon of abnormal and standardized behavior in the use of red scarves by young pioneers in the current context of ethnic minority areas in China. By observing and analyzing the specific usage of red scarves by Young Pioneers in ethnic regions, the aim is to reveal the multiple factors that lead to the improper use of red scarves and explore the complex socio-cultural roots behind it. Further propose relevant strategies from an educational perspective to standardize the use of red scarves by Young Pioneers, aiming to promote the comprehensive improvement of Young Pioneers' educational practices, and hoping to stimulate extensive thinking on how to optimize Young Pioneers' educational methods.

A tutor training framework for radiographers: Basic concepts to effectively train future generations of professionals

IntroductionClinical practice is crucial for the professional development of radiographers. To effectively benefit from their training, students need guidance from well-trained and competent tutors. However, the literature lacks evidence of training programs specifically designed for radiographer tutors. This study aims to suggest a novel framework able to identify the key elements of a successful tutor training curriculum for radiographers. MethodsThrough a literature review on the topic of tutor training in the healthcare sector, a novel tutor training framework specifically for radiographers was developed. This model is structured into two main components: knowledge development and skill acquisition. The framework emphasizes four key topics: understanding the essence of tutoring; conducting briefing, debriefing, and providing feedback; addressing students' psychosocial challenges; conducting simulations and role plays. It concludes with a skill test. ResultsThe proposed curriculum highlights the importance of tutors understanding their roles and responsibilities, as well as the significance of providing feedback and conducting briefing activities. Noteworthy additions to this pioneering model include an in-depth examination of the psychosocial challenges faced by students during their training and the introduction of role-playing activities. These activities help tutors develop empathy and better understand the students' perspectives and needs, therefore optimizing the tutoring experience. ConclusionThis framework outlines the fundamental principles that tutors should incorporate into their daily tutoring activities to maximize student learning and engagement. Emphasis is placed on understanding the psychological challenges faced by students, which can help tutors tailor their teaching to better meet students' needs. Implication for practiceThe proposed framework wills to promote significant improvement in the clinical practice of future professionals through the optimization of tutors' competencies.

Improving School Mental Health via National Learning Collaboratives With State and Local Teams: Components, Feasibility, and Initial Impacts.

School systems need practical and effective quality improvement strategies to advance school mental health promotion, prevention, and treatment services. Collectively, these efforts can be used to promote child and adolescent mental health, well-being, and academic success. The current study reports on the feasibility, initial impacts of, and recommendations from a national, multi-level learning collaborative conducted by the National Center for School Mental Health, University of Maryland School of Medicine and administered throughout the United States. The mixed-methods evaluation results support the feasibility of a learning collaborative and reinforce its positive initial impact on comprehensive school mental health system change. Participants indicated comprehensive school mental health quality improvements such as collaboration across diverse partners and spread of evidence-informed best practices that support high-quality services for students. The multi-level learning collaborative model is promising for future efforts to advance the dissemination of comprehensive school mental health systems and other state and local system change efforts. School mental health learning collaboratives may help address the ongoing youth mental health crisis by promoting high-quality mental health supports and services for youth.

Leveraging Bayesian Network to Improve the Marine Insurance’s Condition Survey Form for Passenger Vessel

Abstract To prevent the losses caused by accidents in passenger vessel, marine insurance is becoming one of the alternative solutions for the vessel’s owner to retain their financial capability. One of the most essential phases in marine insurance is survey inspection, which utilises survey condition forms as guidance. However, the current form is not designed explicitly for particular vessel types, leading to inaccurate insurance assessment. The primary objective of this study is to identify and develop an adaptive and comprehensive condition survey form for passenger vessels in Indonesia by incorporating a qualitative and quantitative risk assessment, which will be the cornerstone of this study. The Bayesian Network (BN) approach was utilised to analyse several factors that lead to a sinking accident. Twenty-one accident data from Indonesian passenger vessels were utilised as base data for generating the conditional probability. The results indicated that vessel structural defect and unqualified crew are the two most significant factors contributing to the sinking accident’s critical events, such as loss of stability and buoyancy. A practical improvement for the existing survey form has been proposed, which will benefit marine surveyor companies by enhancing the safety and accuracy of ship assessment.

Acute diarrhoeal disease among under-five children presenting at a paediatric referral Facility in Lagos, Nigeria

Background: The morbidity and mortality from acute diarrhoeal disease remain significantly high especially in low and middle income countries. Aim: This study was carried out to determine the prevalence of acute diarrhoea, and the associated risk factors among under-five children seen at a paediatric referral facility in Lagos, Nigeria. Methods: This was a cross-sectional descriptive study of under-five children who presented with acute diarrhoeal disease at the Children Emergency Room and General Out-Patient Clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, South-Western Nigeria. Information was obtained on socio-demographic characteristics, environmental/ hygienic practices, feeding practices and immunization status. Results: The prevalence of acute diarrhoea was 400 of 4836(8.3%) under-five children. Three hundred and ninety-five (73.7%) of these children were aged less than two years. The identified associated risk factors for acute diarrhoea among children aged less than two years were use of feeding bottles (OR 12.4; 95% CI 1.8-7.2; p= 0.000), failure to complete immunization(OR 13.0; 95% CI 3.1-43.3; p= 0.000), attendance of crèches (OR 47.1; 95% CI 15.6-141.1; p= 0.000), failure to exclusively breastfeed (OR 6.7; 95% CI 1.3-6.7; p= 0.010) and malnutrition (OR 3.9; 95% CI 1.0-20.3; p= 0.049). Conclusions: Acute diarrhoea remain a significant public health burden affecting majorly children aged less than two years. Efforts at prevention of diarrhoeal disease burden should focus on improvement of hygienic and feeding practices.

A comprehensive experience-based framework of actionable priorities to enhance Canada’s health and social care system: discussions with older persons, clinicians, managers, and decision-makers using nominal group technique

BackgroundExisting frameworks of older persons’ experiences in health and social care systems are usually based on single stakeholder perspectives and focused on limited aspects that are independent from one another. This study aimed to describe such experiences from the perspective of diverse stakeholders and develop a comprehensive experience-based framework for actionable priorities to enhance Canada’s health and social care system.MethodsWe adapted a nominal group technique with a qualitative approach. We formed four groups of stakeholders (4 older persons, 7 clinicians, 5 managers, 4 decision-makers) in the province of Quebec. First, participants individually completed a questionnaire to rank the six domains of an international set of metrics of quality of care for older persons in terms of their importance. Then, we conducted a remote discussion with each stakeholder group, obtained consensus on the priority domains, and explored personal/professional experiences explaining prioritization processes and what changes are needed. An inductive-deductive thematic analysis was conducted to develop a framework for actionable health and social care priorities.ResultsThe framework included six key categories revolving around a core category of ‘health equity’. (1) ‘Access to services and care’ focused on improved accessibility of healthcare navigators, primary and home care services, and end-of life care. (2) ‘Respect for older persons’ involved individuality and uniqueness, daily needs, advocacy in defence of vulnerability, and decision-making valuing care preferences. (3) ‘Involvement of family and friends’ encompassed formal recognition, responsibilities, and trajectories associated with caregiving. (4) ‘Communication and education’ consisted of adaptive communication between older persons, caregivers, and professionals and societal-level education and awareness-raising. (5) ‘Coordination and integration of care’ comprised health and social services organization, cross-sectoral approaches, and interdisciplinary collaboration. (6) ‘Responsiveness to evolving needs’ of older persons involved timely response to health transitions and promoting holistic approaches.ConclusionsThis study illustrates the complex challenges of caring for older persons. The framework suggests several areas for improvement in care practices and policies for older persons and caregivers. Proposed intervention targets include public healthcare system navigators, standardized goals of care practices respecting persons’ wishes, formal recognition of caregiver contributions, society-level education, cross-sectoral initiatives, and holistic approaches.

Positive Psychological Effects of BDSM Practices and Their Implications for Psychological and Psychotherapeutic Work: A Systematic Literature Review

In the context of the frequent stigmatisation of BDSM practices, the aim of this review was to identify potential positive effects of BDSM practices on the psychological functioning of individuals. Additionally, the factors and mechanisms underlying these positive effects will be highlighted to guide improvements in psychological and psychotherapeutic practices. After a systematic review of 181 articles, 9 studies were identified that examined the positive effects of BDSM practices. It was found that these practices positively impact self-awareness, authenticity, and a departure from adult responsibilities. Additionally, they can improve partner relationships by enhancing communication skills, negotiation abilities, and trust. Positive effects are contributed by BDSM practices through physical touch, open communication, and the formation of a community that provides safety and well-being for its members. Furthermore, research reports the possibility of transcendental states of consciousness among participants, which bring positive effects on psychological, emotional, and physical levels.

Transient Energy Growth in a Free Cylindrical Liquid Jet

The stability and behavior of jet flows are critical in various engineering applications, yet many aspects remain insufficiently understood. Previous studies predominantly relied on modal methods to describe small perturbations on jet flow surfaces through the linear superposition of modal waves. However, these approaches largely neglected the interaction between different modes, which can lead to transient energy growth and significantly impact jet stability. This work addresses this gap by focusing on the transient growth of disturbances in jet flows through a comprehensive non-modal analysis, which captures the short-term energy evolution. Unlike modal analysis, which provides insights into the overall trend of energy changes over longer periods, non-modal analysis reveals the instantaneous dynamics of the disturbance energy. This approach enables the identification of transient growth mechanisms that are otherwise undetectable using modal methods, which treat disturbance waves as independent and fail to account for their coupling effects. The results demonstrate that non-modal analysis effectively quantifies the interplay between disturbance waves, capturing the nonlinearity inherent in transient energy growth. This method highlights the short-term amplification of disturbances, providing a more accurate understanding of jet flow stability. Furthermore, the impact of dimensionless parameters such as the Reynolds number, Weber number, and initial wave number on transient energy growth is systematically analyzed. Key findings reveal the optimal conditions for maximizing energy growth and elucidate the mechanisms driving these phenomena. By integrating non-modal analysis, this study advances the theoretical framework of transient energy growth, offering new insights into jet flow stability and paving the way for practical improvements in fluid dynamic systems.

Beyond Tuskegee: A contemporary qualitative assessment of barriers to research participation among Black women.

Health care inequities have partially contributed to the existing racial gaps in health. Despite having lower incidence rates of breast cancer, Black women have a 41% higher mortality rate than White women. Black individuals remain underrepresented in research. Diversity in research is paramount to the improvement of clinical care practices and subgroup-specific guidelines. Black women from various community venues across geographic regions of the United States were invited via email, online fliers, social media platforms, and word of mouth to participate in focus groups. Six online focus groups of six to 10 Black women aged 25-65 years (N=38) with and without a history of cancer were conducted with an in-depth semistructured discussion guide. Most participants were college educated (32 of 38; 84.2%), aged 50 years or older (31 of 38; 81.6%), and had an annual income of $50,000 or more (26 of 38; 68.4%). Several barriers to research participation were identified. They included a lack of empathy and respect in health care settings, apprehension regarding the sharing of personal information, mistrust of medical research, and logistical/technical barriers. Alternatively, building individual and community trust and communicating the value of conducting research beneficial to the Black community were viewed as facilitators to research participation. Successful engagement of Black women in research requires the acknowledgment and consideration of the numerous barriers that affect their ability to participate. Black women are more inclined to participate in research when the research team is knowledgeable, has experience within their communities, and engages trusted community partners. Additionally, the research must be meaningful and impactful to future generations of Black women.

Promoting healthy practices among schools and children in rural bangladesh: a randomised controlled trial of skill-based health education

BackgroundPoor child health and hygiene practices are persistent issues in resource-constrained settings, particularly in low-income countries. This study assessed the impact of skill-based health education (SBHE) on school and child hygiene practices in rural Bangladesh.MethodsA cluster-randomised-controlled intervention with cross-cutting/factorial design was conducted in 180 randomly selected primary schools, stratified by school type, in Jhenaidah District, Bangladesh. Weekly SBHE sessions were delivered to half of the schools by locally recruited para-teachers for one year. A cross-cutting soap provision treatment was given monthly to half of the SBHE-treatment schools and half of the SBHE-control schools. Treatment assignment was masked to all baseline and endline surveyors. Data were collected at both the school and child levels, with child-level data aggregated at the school level. Outcome measures were grouped into five thematic families. The primary outcome families were school hygiene practice & maintenance, school-aggregated child handwashing and school-aggregated child dentalcare. Utilising the difference-in-differences estimator with seemingly unrelated regression, we estimated the average treatment effect for each family of multiple outcomes. The intervention spillover effect to neighbouring schools along with the time-period effect were also evaluated. The project’s cost-effectiveness was additionally assessed.ResultsOur findings revealed that SBHE had a positive impact on primary outcomes related to healthy practices and behavioural changes, resulting in a 0.32SD improvement in school hygiene practices and maintenance (p < 0.001), a 0.47SD increase in child handwashing (p < 0.001), and a 0.43SD enhancement in child dentalcare (p < 0.01). Despite its imperfect implementation, the provision of soap itself showed no significant effect. Furthermore, significant spillover effects of healthy practices were observed in neighbouring non-treatment schools. The cost-effectiveness analysis indicated that our SBHE program was cost-effective.ConclusionsOur study provides compelling evidence of the positive impact of SBHE on school hygiene and child health practices in rural Bangladesh, with notable spillover effects. The cost-effectiveness analysis underscores the value of SBHE, affirming its potential as an effective intervention method in improving school health and hygiene practices in primary schools and beyond.

Festschrift for Mike Jackson: Applying critical systems thinking through phronetic pluralism: Learning from human learning systems and the adaptive learning pathway

AbstractContemporary governance challenges require both systemic leadership and adaptive learning to navigate effectively. Yet systems theory and systems thinking remain on the relative margins of management praxis, subject to accusations of theoretical remoteness or impracticality. In this paper, we explore how concepts central to Critical Systems Theory (CST) can be impactfully carried into practice. We discuss the genesis and operation of Human Learning Systems (HLS), a recent complexity‐informed development in public service reform, and the Adaptive Learning Pathway (ALP) for systemic leadership, as two such exemplars. Through these two illustrative cases, we highlight the significance of pragmatism and pluralism in applying CST in practitioner‐orientated and policy contexts and consider the implications for knowledge production and academic relevance. We describe how a spirit of ‘phronetic pluralism’ may act as an appropriate translational device for integrating systems theory in practice and help realise practical improvements in the public policy and management landscape.