The acquisition of knowledge, skills and positive attitudes in managing people with disabilities (PWD) is essential to ensuring the provision of high-quality professional services. This study was undertaken to determine perceptions of PWD among Malaysian students enrolled in clinical healthcare programmes and its correlation with educational experiences. A self-administered online survey, utilising a content- and face-validated questionnaire, developed from previous literature, was conducted on all final year medical, dental, pharmacy, physiotherapy, occupational therapy, nursing, medical laboratory technology, medical imaging, optometry and nutrition/dietetics students of a Malaysian institution. Quantitative data was analysed via ANOVA, Chi-Square and Fischer's exact tests (significance value p < 0.05). The majority of students have previously managed patients with physical, intellectual and mental/psychological disabilities, but not those with visual and hearing impairments. There was an insignificant difference in contact with and attitude towards PWD among students representing the different programmes. Students of various programmes noted significant differences in experiences in managing patients with physical, intellectual, visual and hearing disabilities, as well as comfort level in managing patients with physical, intellectual and mental/psychological disabilities. Most dental, physiotherapy, occupational therapy and nursing students felt that they received adequate training in managing PWD. Students who perceived that they received adequate training noted positive experience and comfort in managing all of the different PWD groups (p < 0.05). The findings of this study provide useful information for the various programmes in developing an effective curriculum that prepares its graduates to manage PWD in a competent manner.

In knowledge-intensive professions such as auditing, positive workplace relationships are essential to effective performance. Yet, the specific mechanisms through which ethical leadership encourages critical, collaborative behaviours, such as knowledge sharing, remain underexplored. This study addresses this gap by examining how organisational justice and interpersonal trust serve as dual pathways that translate ethical leadership into the sharing of knowledge within audit teams. Using a cross-sectional survey design, data were collected from 232 auditing professionals in Iran and analysed via Structural Equation Modelling (SEM). The results confirm that ethical leadership is significantly associated with promoting knowledge sharing. More importantly, this relationship is robustly mediated by both organisational justice and trust, revealing a dual-channel mechanism through which leadership exerts its influence. The primary contribution of this research lies in empirically demonstrating this integrated model, illustrating that ethical leaders foster collaboration not only through direct influence but by systematically cultivating a fair and trustworthy work environment. For audit firms and similar professional service organisations, these findings highlight the practical importance of developing leaders and HR policies that explicitly and consistently prioritise fairness and trust-building to strengthen team dynamics and enhance the flow of knowledge.

Background Against the backdrop of an accelerating aging population, notable disparities exist in the demand for care services among the older adult. Objective This study aims to elucidate the heterogeneous preferences and willingness-to-pay for care services among self-caring older adults and those with varying levels of functional disability, in order to provide evidence-based insights for optimizing resource allocation. Methods A discrete choice experiment (DCE) was designed, incorporating five core attributes: service content, delivery mode, provider type, cost, and payment mechanism. Using stratified random sampling, 600 self-caring and functionally impaired older adult individuals (Barthel Index ≤ 60 for the functionally impaired) from an urban city were enrolled. After excluding incomplete responses, 579 valid questionnaires were analyzed, comprising 218 self-caring, 231 moderately disabled, and 130 severely disabled older adults. Data analysis was performed using a conditional logit model. Results The conditional logit model analysis revealed that the level of disability significantly influenced service preferences. Moderately disabled individuals exhibited significant preferences for service upgrade packages (β = 0.164) and partial reimbursement (β = 0.329), with a willingness-to-pay (WTP) of 149.37 CNY for the upgrade package. In contrast, severely disabled individuals demonstrated significant preferences for institutional care (β = 0.153) and partial reimbursement (β = 0.308), exhibiting a WTP for institutional care as high as 899.56 CNY, which is eight times that of the self-caring group (111.59 CNY). All groups expressed aversion to care provided by nursing aides (β = −0.331 to −0.617), requiring compensation ranging from 322.47 CNY (self-caring) to 1949.40 CNY (severely disabled) to accept such services. Conclusion This study demonstrates that the level of disability is a key determinant of care preferences among the older adult, characterized by an evolution in demand from “life support” to “professional medical care.” We recommend establishing a tiered care system: providing a “home-based + upgraded services” model as the core for moderately disabled individuals, and creating a service network dominated by “institutional + professional medical care” for the severely disabled, complemented by a sliding-scale payment mechanism that prioritizes coverage for professional services under long-term care insurance. This approach aims to achieve precise allocation of care resources. The findings provide crucial evidence for the accurate provision of care services in an aging society, contributing to the policy goal of “aging with security.”

Abstract Distrust is an inevitable yet often overlooked feature of relationships in professional service firms (PSFs), where simultaneous demands to collaborate and compete produce a coopetitive paradox shaping everyday organizational life. Drawing on 50 in‐depth qualitative interviews using the critical incident technique, we examine how professionals attribute meaning to the development of distrust in their working relationships. The analysis identifies three recurring loci—readings of character and conduct (internal), signals from structures, processes, and cultures (external), and interactional cues in day‐to‐day exchanges (relational)—which often braid together into compound explanations for distrust that travel and endure. In high pressure, identity‐sensitive PSFs, coopetition heightens this braiding, making small ambiguities easier to read as self‐interest and harder to reverse. The study clarifies how distrust functions as an active, socially embedded process of meaning‐making and why it proves so durable in coopetitive settings.

Navigating the Zhongkao: How perceived parental expectations shape adolescents' transition choices in China.

Children's involvement in technology-facilitated violence (TFV) in the context of intimate partner violence (IPV): Experiences of professionals working with victims of violence in Finland.

ObjectivesThis scoping review addresses the underexplored issue of abuse of people with mental illnesses by healthcare professionals. We mapped the existing literature to establish the nature, prevalence, contributing factors and experiences of this abuse.DesignScoping review based on the Joanna Briggs Institute framework.Data sources and study selectionWe searched MEDLINE, CINAHL Complete, PsycINFO, ProQuest, Web of Science, Cochrane Central Register of Controlled Trials and Ichushi-Web during the period from 3 July to 22 August 2024. Eligible studies reported abuse of people with mental illnesses by healthcare professionals, with no restrictions on year or language.Data extraction and analysisTwo reviewers independently extracted data from the selected articles. The data were synthesised to examine prevalence, associated factors and experiences of people with mental illnesses.FindingsOf 5793 records, 61 met the inclusion criteria, with 32 from the USA and Japan (16 from each). Abuse types reported across 17 countries included physical, psychological, sexual and economic abuse, neglect and human rights violations. Histories of physical and sexual abuse were frequently reported as possible contributing factors to further abuse. Recommendations for prevention were identified at multiple levels, including individual care, organisational and institutional systems, and broader policy and society.ConclusionsThis review mapped the literature on abuse by healthcare professionals in mental health services and identified critical research gaps, including a lack of methodologically robust studies. Further research is needed to build an evidence base for prevention strategies and to establish institutional safeguards.

This paper examines how professional dominatrices in the Czech Republic construct symbolic boundaries in their online profiles in relation to other forms of sex work and how they sometimes construct BDSM (bondage, discipline, dominance, submission, sadism, and masochism) services as separate (post-sexual) practices that differ from traditional sex work. It focuses on the online self-presentation of women providing paid professional BDSM services in the Czech Republic. An analysis of 70 profiles of professional dominatrices on an online platform specialising in BDSM services was conducted, and the profiles were classified using Bourdieu’s theory of symbolic boundaries into four categories reflecting varying levels of symbolic differentiation. Complementing this approach, a Foucauldian-inspired discourse analysis identified five key discourses as articulated in the textual self-presentations of the profiles, focusing on biopower, knowledge, ethics, discipline, and the symbolic distinction of BDSM services from other commercial forms of sexual labour. Conducted in the first half of 2025, this study demonstrates how professional dominatrices actively construct and maintain symbolic boundaries through the language used within their profiles, contributing to post-sexual discourses in BDSM services and to distinctive forms of discursive and symbolic differentiation.

Karyamekar Village, Garut Regency, has significant potential in natural and cultural tourism; however, the quality of tourism services provided by the community has not been optimal. The main problems include limited knowledge and skills in providing services, low understanding of tourism service standards, and insufficient guidance in managing village tourism destinations. This community service program aims to improve tourism service quality through training and direct mentoring for the community and tourism managers. The methods include participatory training, material delivery, discussions, service simulations, and field mentoring. The training focused on service excellence, effective communication, service ethics, cleanliness and comfort of tourist destinations, and the application of Sapta Pesona. The results indicate increased knowledge, skills, and awareness of the community in delivering professional tourism services, which positively impact tourist satisfaction and support sustainable village tourism development.

A high rate of food insecurity among college students has been documented in various studies. Knowledge gaps exist regarding food insecurity and cultural food access among international college students. We explored the demographic correlations of food insecurity and cultural food access and affordability for international college students. cross-sectional online survey from November 2 to 16, 2022. A public university in the southwestern United States. Three hundred and thirty-five international undergraduate and graduate students. About 22% of the sample reported high food security, 18% marginal food security, 30% low food security, and 31% very low food security. Twenty-seven percent reported that they were able to find cultural foods at the university and 29% reported that they were able to afford the cultural foods available on campus. Enrollment status, primary caregiver status, housing location, and vehicle ownership predicted food security status. Region of origin, gender, being a primary care giver for an adult with special needs, and vehicle ownership were associated with access to cultural foods. Region of origin, being a primary caregiver for children, housing location, and vehicle ownership were associated with being able to afford cultural foods on campus. The predictors differ between undergraduate and graduate international students. Researchers and student services professionals who develop programs and resources to support international students should consider differences within the group of international students, especially differences by region of origin and degree status (undergraduate vs. graduate) and work to ensure students have access to reliable transportation.

Purpose: The study examined gender and leadership in the public health sector to understand equality practices and the extent to which women are being considered for top leadership roles in the MoH. Methodology: A mixed-method cross-sectional study design was used, including document reviews. A total of 402 respondents (grade 9-14 civil servants) completed the online survey, and 18 purposively selected individuals were interviewed. SPSS version 25 and Braun and Clarke’s (2006) step-by-step framework for performing thematic analysis were used for the quantitative and qualitative analyses, respectively. Findings: There is a perception among the participants that women are inadequately considered for senior and top management positions in the MoH. There is a significant relationship between gender and perceptions about women being considered for leadership positions, X2 (3, N = 402) = 8.88, p &lt; .05. However, the relationship between gender and the other variables (professional roles and service grade) shows no statistically significant difference (p &gt; 0.05). Participants shared practices they perceived as barriers to women’s advancement to leadership positions. The findings from documents review in relation to gender representation across the various functional roles in the MoH, however, revealed significant effort by the leadership to close the gender gap in compliance with the mandated 30% women’s representation by 2023 GEWE Act. Overall, women account for 34% and 22% in the senior management level and the top management level, respectively. The political leadership has a 33% female representation, while the professional and administrative leadership remains male-centric, with no female representation. The proportion of females that are currently serving as directors and program managers are 29% and 47% respectively. The least represented roles by women are the District Medical Officer and Medical Superintendents, with only 12% and 14% female representation, respectively. Despite the perceived barriers to women’s career and leadership advancement in the MoH, the 2023 GEWE Act is considered an opportunity towards bridging the gender gap in the public health sector. It is imperative that gender equality and women’s empowerment initiatives go beyond token measures and result in meaningful and measurable changes in advancing women to top leadership positions not only in the public health sector, but also in all government ministries, department, and agencies. Unique Contribution to Theory, Practice, and Policy: Utilizing Acker’s Gendered Organizational Theory, this study examined the barriers and opportunities for women’s career advancement to senior leadership positions in the public health sector. This is the first study in post-war Sierra Leone to examine the gender landscape in the MoH. This study is significant to policy and practice for providing insights on the barriers and facilitators for women’s career advancement in the MoH. The study findings demonstrate the importance of multi-level strategies that address the entrenched gender norms and systemic barriers that undermine women’s career advancement to senior leadership positions in the public health sector.

In this article we explore education-focused staff’s journeys with Scholarship of Teaching and Learning (SoTL). We interviewed both Education Track academic and Professional Services Colleagues who teach within a Higher Education setting and have successfully engaged with SoTL. In doing so, we briefly explore SoTL’s journey from Boyer’s initial conception until today. It is in this context that we situate colleague’s experience with SoTL. We follow a narrative approach, in which we use anonymised participant’s stories in order to foreground the ways in which theoretical concepts (e.g. intrinsic motivation) manifests in one’s personal and professional journey. More specifically, we found that SoTL can be interpreted in various ways based on colleagues' interests, discipline and career path; namely Scholarship as vocation, expertise, innovation, and/or fulfilment.

Assessing the Gaps in Medical Student Usages of Professional Interpreter Services When Caring for Patients With Limited English Proficiency

The option to switch patients to more cost-effective biosimilar insulins has been available since 2014, and the market share for these medicines has been slowly increasing since then. This scoping review aimed to identify the current knowledge around stakeholder perception and experience of biosimilar insulin switches. A systematic search strategy of the published literature was conducted using several bibliographic databases including PubMed, Web of Science and CINAHL Ultimate to identify relevant articles. A grey literature search and reference scouring were also employed. A thematic analysis of the literature was then conducted to identify and synthesize findings in a narrative format. The search identified a total of 184 records, with 20 deemed eligible for inclusion. These comprised research studies, reviews, guidance and opinion pieces with several themes identified, including healthcare professional, patient and health service administrator perspectives. Healthcare professional concerns about switching established patients, as well as patient perceptions and experiences, were highlighted as key barriers to biosimilar insulin adoption, although patients expressing strong opinions against switching were in the minority. The established nature and proven efficacy of the reference products served as a barrier to patient acceptance. Financial considerations, especially in the context of publicly funded healthcare systems, and factors expected to facilitate biosimilar insulin switches were also identified as key themes. There is considerable uncertainty about how stakeholders perceive biosimilar insulin switches, particularly managed switch programmes. Almost no literature related to the experience of stakeholders who have already engaged in biosimilar insulin switching was identified. More research is needed to provide guidance on how healthcare systems can implement biosimilar insulin switch programmes in a manner acceptable to healthcare professionals and patients.

In 2024, a second brand of injectable semaglutide was marketed, authorized for the indication of weight loss, along with the first tirzepatide. Both are indicated as an adjunct to a low-calorie diet and increased physical activity for weight control, including weight loss and maintenance, in adults with a BMI greater than 27. In Community Pharmacy, we have a Professional Pharmaceutical Service in Nutrition, and it is of interest to study and compare the outcomes obtained by patients using these drugs versus those who only adopt lifestyle changes in diet and physical activity. This is especially relevant after observing that several patients had stopped attending the Nutrition Service, arguing that maintaining diet and increasing physical activity required too much effort, and that they would instead request a prescription for one of these drugs from their primary care physician.A protocol was therefore designed to conduct a research study during 2026 to allow follow-up of patients treated with injectable semaglutide and tirzepatide, since during the dispensing of these medicines it was detected that patients lacked knowledge regarding possible adverse effects and the dietary and physical activity habits they should maintain during treatment. The most frequent adverse effects are gastrointestinal: nausea, vomiting, diarrhea, constipation, abdominal pain; others may also appear such as headache, dizziness, and fatigue, and cases of retinopathy, hypotension, cholelithiasis, and hair loss, among others, have been reported.Data collection will take place during 2026 through various questionnaires and/or interviews with patients who agree to participate in the study. Different questionnaires will be developed to collect important information at each phase of treatment, as well as the outcomes obtained in terms of weight loss and lifestyle habits adopted after initiating pharmacological treatment, in order to perform a statistical analysis of the variables.The main objective of the research will be to assess the results obtained over one year regarding weight loss in patients treated with semaglutide or tirzepatide, as well as adverse effects and, where applicable, rebound effect, and to compare them with the results obtained in other patients from the nutrition service who are not receiving these treatments. With the data obtained, statistical analyses will be carried out to describe the sample, using absolute and relative frequencies for qualitative variables, and means and standard deviations for quantitative ones. Chi-square tests will also be used to compare proportions regarding weight loss, adverse effects, weight maintenance or rebound, and dietary and exercise habits adopted by patients treated with semaglutide or tirzepatide compared with those not using these drugs.In addition, potential DRPs (Drug-Related Problems) and NMOs (Negative Medication Outcomes) will be studied, and health education will be provided, emphasizing the importance of acquiring healthy dietary and physical activity habits.

Combining Professional Development Activities and Service Learning/Community Service: A Scholarship-Based Project Impacting Engineering College Students

IntroductionEffective home care is critical to preventing complications and promoting recovery after Coronary Artery Bypass Grafting (CABG) surgery. In low- and middle-income countries like Pakistan, limited professional home care services place the responsibility for post-CABG care largely on family caregivers (FCGs), often without training or support. Understanding their challenges is essential for improving recovery outcomes.ObjectiveThis study aimed to explore the challenges faced by FCGs in providing post-CABG care at home after hospital discharge.MethodsThis qualitative exploratory descriptive study included 19 FCGs of Post-CABG patients, purposively recruited from cardiac outpatient department in a public hospital in Pakistan. Data were collected through face-to-face semi-structured interviews and analyzed using Creswell's content analysis.ResultsSix categories emerged: learning curve and adaptation, lack of information and guidance, physical and emotional strain, financial strain, hospital and healthcare challenges, and family support. FCGs felt unprepared for managing diet, wound care, and pain, while reporting fatigue, emotional distress, and high costs. Though family support offered some relief, gaps in medical support, communication barriers, and difficulties with follow-up intensified their burden.ConclusionFCGs of post-CABG patients in Pakistan face significant informational, emotional, physical and financial challenges worsened by healthcare system gaps. Nurses can play a central role by providing structured predischarge education, ongoing follow-up and culturally appropriate, family-centered support to strengthen FCGs capacity and improve patient recovery.

Comparison of posttraumatic stress disorder symptom structure models in Black/African American and European American patients receiving public mental health services.

This article analyzes the real estate boom in Mazatlán, Sinaloa, highlighting the key factors that have driven the city’s recent urban and tourism development. The study examines the impact of national and foreign investment, infrastructure improvements, and public policies that have encouraged market expansion. It also explores the most effective marketing strategies used by real estate companies, emphasizing digital transformation, brand building, and personalized customer experiences. The findings suggest that competitiveness in Mazatlán’s real estate market largely depends on technological innovation, professional service standards, and adaptation to emerging consumer trends. Mazatlán is projected to remain one of the most promising real estate investment destinations on Mexico’s Pacific coast.

This study examined the implementation and effectiveness of indirect assessment methods in personal income tax administration, with particular emphasis on regulatory frameworks and opportunities to enhance tax audit effectiveness. The research employed a statistical analysis, case study examination, and comparative assessment of implementation practices across different jurisdictions. The study primarily focused on Latvia's experience as a representative EU member state, analysing data from 2020-2024 on tax administration performance indicators and audit outcomes. The findings revealed that the successful implementation of indirect methods requires integrating advanced technological capabilities with appropriate legal frameworks. At the same time, effectiveness varies significantly across economic sectors and taxpayer categories. The research demonstrated that jurisdictions investing in digital infrastructure and staff expertise achieved 23.4% higher voluntary disclosure rates and improved assessment accuracy by 16.8%. Analysis of the Latvian experience showed that properly adapting international best practices to local conditions increased detection rates by 81.2% in 2024, with particularly strong results in the professional services and retail trade sectors. The study identified key success factors, including data quality, staff competency, and technological infrastructure. An analysis of implementation costs revealed significant variations in resource requirements, with initial technology investments ranging from 2.5 to 3.5 million EUR, yielding average returns of 185% over five years. The research demonstrated that jurisdictions with integrated tax administration systems had 15-20% higher success rates in implementing indirect assessment methods than those with fragmented systems.