Qualitative Component Research Articles

Peer-led versus instructor-led structured debriefing in high-fidelity simulation: a mixed-methods study on teaching effectiveness.

Debriefing is the essential element of simulation teaching. Peer-led structured debriefing simulations could be a suitable approach because of the peers' similarity in age and experience to the students. The purpose of this study was to compare the teaching effectiveness of peer-led debriefing versus instructor-led debriefing in high-fidelity simulation scenarios. The study used a mixed-method approach, integrating quasi-experimental and qualitative components. A total of 88 third-year nursing students were randomly distributed into the instructor-led or peer-led group, with equal sample sizes in both cohorts. The study compared knowledge acquisition, simulation performance, student satisfaction and self-confidence in learning, and debriefing experience between the two groups. In addition, interviews were conducted with students in the peer-led group after the course. The scores of students' simulation performance scale were higher in the peer-led group than in the instructor-led group, and both groups made significant gains in knowledge. The peer-led group and instructor-led group demonstrated similar performance in terms of knowledge, simulated performance, reporting experience, student satisfaction, and learning confidence. The semi-structured interview results indicated that students in the peer-led group expressed approval of peer facilitators. Our study demonstrated that students in the peer-led group showed better performance in the simulation, and both groups demonstrated improved knowledge. Thus, with the premise of peers receiving training, the peer-led simulation teaching method can be regarded as a supplementary strategy for simulation teaching to enrich the form of simulation teaching and improve the effectiveness of simulation teaching.

Awakening Community Resilience: Strengthening Post-Crash Support for Road Traffic Accident Victims through Sarvodaya's Community-Based Initiatives (A Case Study)

Introduction: The provision of crash care presents a pressing health concern globally, with community-based initiatives offering a cost-effective approach to interventions. The objective of this study was to elucidate the potential community-based initiatives to enhance post-crash support for victims of road traffic accidents, specifically focusing on the efforts of Sarvodaya: a non-governmental organization in Sri Lanka.Methods: This case study employed a mixed-method approach, incorporating both quantitative and qualitative components. Data collection was done using self-administered questionnaires and Key Informant Interviews. Purposive sampling was done to identify informants (n=37) for the questionnaire survey.Results: While the informants had mixed perceptions of Sarvodaya's present initiatives to support post-crash care, the REACT – Community Life Saver initiative garnered majority for its potential to address the needs of the Road Traffic Accident victims. Community engagement was deemed insufficient, underscoring the need for enhanced awareness programs. Collaboration with existing resources, including Community Lifesaver Programs and the Red Cross, was identified as pivotal. Strategies for community-based interventions, including awareness campaigns, first aid training, improved emergency response systems, and victim advocacy, were prioritized for implementation. Implementation challenges such as resource constraints, behavioural issues of both drivers and pedestrians, communication gaps, and policy-legal concerns were highlighted. Addressing these challenges is crucial for the effective support of Road Traffic Accident (RTA) victims at the community level.Conclusion and recommendations: The study concludes that Sarvodaya has the potential to spearhead community-based initiatives aimed at enhancing post-crash support for road traffic accident victims, pending the effective resolution of identified constraints.

Fertility awareness, perceived factors and approaches to improve contraceptive uptake among sexually active adolescent girls in Phalombe, Malawi: a mixed-methods study.

Healthcare practitioners and policymakers in Sub-Saharan Africa face a significant health challenge due to the insufficient fertility awareness and other perceived health outcomes in contraceptive use among adolescent girls. This has resulted in a rise in unplanned pregnancies and other adverse fertility-related health consequences for adolescent girls in Malawi. Consequently, this research examines fertility awareness, perceived factors, and strategies in contraceptive adoption among adolescent girls in Malawi's Phalombe district. The study utilized a mixed-methods approach, with the quantitative component employing structured questionnaires administered in person to collect data from school-going adolescent girls in three traditional authorities in Phalombe district, Malawi. The research employed multivariate logistic regression analysis, and its findings were corroborated with qualitative data obtained through focus group discussions involving adolescent girls in the same environment. The majority of adolescent females were unaware that their fertile period occurs in the middle of their menstrual cycle, indicating a lack of knowledge regarding their reproductive health. The study examined data from 102 sexually active adolescent females in the quantitative component and 72 adolescent girls in the qualitative component. For the quantitative strand, participants' ages ranged from 13 to 19years, with a mean age of 16.5 and a standard deviation of 1.5. In the qualitative portion, the study conducted interviews with adolescent females aged between 10 and 19years, with a median age of 15years. Services that were not tailored to youth needs served as barriers to contraceptive use. Factors that facilitated contraceptive use included a preference for receiving contraceptives from peers, which was associated with a higher probability of usage (AOR: 4.80, 95% CI 1.31-17.32). Moreover, adolescent females who were identified as Catholic (AOR: 14.01, 95% CI 2.50-78.47) or belonged to other Christian denominations (AOR: 5.85, 95% CI 1.20-28.25) exhibited a greater likelihood of using contraceptives compared to their Muslim counterparts. The focus group discussions suggested making contraceptives available in educational institutions, analogous to the distribution of iron supplements. Adolescent girls in the Phalombe district seemingly have low awareness and knowledge of their fertility, which may lead to unintended pregnancies. Adolescent girls are unable to access modern contraceptives, and there is a need for youth-friendly structures when delivering contraceptive services. Additionally, participants indicated that community midwives and health surveillance assistants should provide contraceptives within the communities to reduce distance.

Prospective Preference Assessment for the Psilocybin for Enhanced Analgesia in Chronic nEuropathic PAIN (PEACE-PAIN) Trial

ABSTRACT Background Negative perceptions of psilocybin and challenges of participant enrollment may represent barriers to conducting a randomized controlled trial examining psilocybin for chronic neuropathic pain. Aim Prior to trial initiation, we aimed to examine patient attitudes toward the trial via a prospective preference assessment. Methods Twenty-six patients with chronic neuropathic pain participated in a prospective preference assessment comprising quantitative (survey) and qualitative (interview) components. Content analysis was used to inductively and deductively identify factors that would motivate or discourage participation in the proposed trial. Demographics, clinical characteristics, and perceptions of psilocybin were collected to explore differences in characteristics between patients who were willing and unwilling to participate. Results Survey results showed that most participants (76.9%) were willing to participate in the PEACE-PAIN trial. “Willing” participants reported higher prior psychedelic use (75%) as compared to the “maybe willing” (0%) and “not willing” participants (0%). Interviews indicated that the top two factors that motivated participation included the need for new treatment options (31.7%) and benefits to personal pain management (31.7%). The top two discouraging factors included practical difficulties of research participation (16.7%), and adverse events associated with psilocybin (16.7%). Conclusions The PEACE-PAIN trial study design is supported by patient survey responses but may benefit from modifications, namely incorporating thorough discussions of the current evidence for efficacy, safety, tolerability, and approaches to address adverse effects of psilocybin. Additionally, the interest in participation by individuals with prior psychedelic use holds important methodological implications for the inclusion/exclusion criteria of the trial.

"Hit a bottleneck": a convergent mixed-methods approach to the Influencing factors and experience of fertility intention among mothers of childbearing age with two children in mainland China.

Fertility rates have been decreasing both worldwide and in China. Although current policies have been aimed at raising the birth rate in China, their overall effects have been unclear. Therefore, exploration of fertility intention and related influencing factors is crucial. This study used a convergent parallel mixed methods combining descriptive and cross-sectional designs with a framework analysis. Convenience sampling was used to select mothers of childbearing age with two children (n = 603), living in Guangdong Province, China. Participants completed an online questionnaire investigating sociodemographic characteristics, as well as determinants and attitudes regarding the third-child fertility intention. Correlation coefficients and multivariate regression analyses were used to present quantitative findings. Eleven interviews were conducted, and a framework analysis method was used for data analysis. The results for the qualitative and quantitative study components were analyzed separately and were subsequently integrated through side-by-side comparison and joint display. Attitudes toward fertility intention were negative, and the rate of fertility intention was 10.4% in Guangdong Province. In the quantitative component, women's age, perceived value of having a third child, and attitudes were found to be factors promoting the intention to have a third child, whereas monthly family income, grandparents' health status, and policy support were found to be factors hindering the intention to have a third child. Four major themes emerged regarding the perceptions and experiences regarding fertility intention in the qualitative component. After integrated analysis, younger age, knowledge regarding policy support, and access to childcare support were found to be factors significantly affecting the intentions of mothers with two children regarding having a third child. Fertility issues require continued attention. Our findings provide a reference for optimizing existing policies to increase fertility intentions. Providing policy support, such as public childcare support, flexible working hours for mothers, affordable childcare, and greater psychological support, would enable mothers to improve their parenting. In addition, increasing the dissemination of knowledge regarding policies is necessary to improve the level of public understanding and promote fertility intention.

Gendered experience of military service in the Armed Forces of Ukraine (on the example of a military unit X 0000)

Over the past 10 years, the Ukrainian state has provided opportunities for women to serve in the army on an equal basis with men at the legislative level. Meanwhile, the army may still be identified as a maledominated institution, as Ukrainian servicewomen still face challenges during their service because of their sex.The empirical frame of the study was a case study (containing qualitative and quantitative components) of the experience of military service in the military unit X 0000. Based on the analysis of secondary sources and our own empirical research, we managed to identify gendered challenges specific to the experience of servicewomen in the Armed Forces, including during the Russian-Ukrainian war.The key gendered challenges of serving in the military unit X 0000 for women were vertical and horizontal gender segregation; the need to correspond with masculine standards and to combine the status of a military with the status of a woman, wife, and mother that sometimes have opposite role expectations, which can lead to role conflict; the need to combine childcare and household duties with work; stereotypes about servicewomen that exist within and outside the army; sexism and violence (psychological abuse and sexual harassment). The case study results allowed us to confirm empirically, illustrate with examples, and clarify the range of gendered challenges in the army, outlined in the analysis of secondary sources.The study highlights the special challenges for military women that arise during the period of Russia’s full-scale invasion of Ukraine. For example, women, unlike men, may be protected and prevented from working in ‘male’ positions. The article also shows that servicewomen may themselves uphold traditional gender roles, try to conform to patriarchal norms, and oppose gender equality. All this leads to the reproduction of gender inequality in the army.

Patient experiences of treatment-resistant depression (TRD): A systematic review and qualitative meta-synthesis

Treatment-resistant depression (TRD) occurs when depressive symptoms persist after a patient has tried at least two antidepressants at an appropriate dose for an adequate length of time, as judged by their clinician. Understanding what it is like to live with and seek care for TRD can inform treatment planning and contribute to health technology assessments for depression-related therapies. Our objective was to systematically review this evidence through an investigation of qualitative literature about the experiences of people who have TRD. We searched MEDLINE, CINAHL, PsycINFO, and the Web of Science Core Collection. Publications eligible for inclusion were English-language primary empirical qualitative studies or the qualitative component of mixed methods studies examining adults’ experiences with TRD or with specific treatment options for TRD. Two reviewers independently screened and extracted data, as well as critically appraised included studies using the Standards for Reporting Qualitative Research (SRQR) instrument. This review was guided by integrative meta-synthesis. Data analysis consisted of a staged coding process similar to grounded theory. The protocol was registered in PROSPERO prior to the search (record ID: CRD42022356813). Sixteen studies were included from screening 18,568 results. Two studies focused on the overall experience of TRD and 14 explored experiences of specific treatments such as ketamine. Patients described the depressive symptoms they experienced, a sense of futility and desperation to find an effective treatment, and their experiences with new, sometimes experimental, therapies including deriving benefits beyond the clinical. Overall, few studies have examined the patient experience of TRD, reflecting the clinical complexity of this patient population. As most literature coalesced around experiences of specific treatments, greater examination of the overall experience of TRD is needed to inform clinical practice, and administrative and funding policy decisions for interventions that may be effective for this patient population. PROSPERO registration number: CRD42022356813.

Research on the New Era’s Road for Reforming School Sports Instruction

Background: The emphasis on holistic development in school has significantly changed in recent years, placing equal emphasis on academic success and physical and mental well-being. This change has led to a critical analysis of the teaching of sports in schools, which has historically placed a strong emphasis on competitive and performance-oriented goals. Growing worries about the health, involvement, and general development of students highlight the need for reform in school sports instruction. Purpose: The purpose of this study is to examine and assess current reform efforts in school Sports instruction in light of the emerging educational paradigm. Finding workable solutions to raise the standard of sports instruction, increase student engagement, and promote a more inclusive and comprehensive approach to physical education are the goals. Method: Using a mixed-methods approach, the study combines qualitative interviews with quantitative surveys. Information was gathered from a wide range of educational institutions' instructors, students, and policy officials. Analyzing survey data on existing sports curriculum, instructional strategies, and student attitudes toward physical education comprised the quantitative component. In-depth interviews were a part of the qualitative component, which aimed to provide insights into the difficulties and achievements faced by reforming schools. Findings: The study presents a number of important conclusions: First, the necessity of switching from conventional, competition-focused models to more inclusive and diversified sports programs that accommodate a range of interests and ability levels is becoming increasingly apparent. Second, the incorporation of contemporary pedagogical strategies that encourage higher levels of engagement and enjoyment—like cooperative learning and student-centered activities—marks effective reforms. Third, there are still issues like scarce resources and opposition to change, but creative solutions and helpful legislation have made progress toward getting past these obstacles. Overall, the study emphasizes how crucial it is for educators to continue their professional development and how systemic support is required to maintain successful reforms in the teaching of sports in schools. This study offers insightful information to stakeholders, educators, and policymakers that want to improve.

"There is a lot of shame that comes with this": A qualitative study of patient experiences of isolation, embarrassment, and stigma associated with overactive bladder.

Beyond causing physical discomfort, overactive bladder (OAB) is distressing to patients across a variety of psychosocial domains. In this qualitative component of a larger mixed methods study, we explore patients' lived experience with OAB to understand how this condition impacts individuals on a personal and social level, as well as their experiences interacting with the health care system. A total of 20 patients and 12 physicians completed a questionnaire and semi-structured interview. The interview guide, developed in an iterative fashion by the authors, included questions about treatment decision making as well as experiences living with or treating OAB; this manuscript focuses on the questions probing lived experiences and interactions between patients and physicians. The interviews were recorded, transcribed and inductively coded and analyzed according to the principles of interpretive description to develop themes. Analysis of patient and physician interviews yielded five key themes: isolation due to OAB diagnosis, social stigma associated with noticeable OAB symptoms, embarrassment from interactions with the health care system, feeling invalidated and dismissed by physicians, and OAB patients as a "vulnerable" population with "desperation" for cure. OAB causes patients marked distress beyond their physical symptoms; it causes feelings of isolation from friends and family and makes them feel embarrassed to discuss their condition with loved ones and physicians alike. Efforts to destigmatize OAB, validate patient experiences, and improve access to OAB care may help diminish the psychosocial burden of OAB.

The Implementation of the Advocacy Intervention for Midlife and Older Women Who Have Experienced Intimate Partner Violence: Protocol for a Randomized Controlled Trial.

Midlife and older women who experience intimate partner violence (IPV) often have less access to supports and services than younger women. There is far less focus on research and supports for midlife and older women compared to younger women experiencing IPV, and often, neither elder abuse nor IPV services meet their needs. Few interventions are available to meet the needs of midlife and older women. The goal of this randomized controlled trial is to test the effectiveness of an advocacy intervention for midlife and older women who experience IPV and to learn from the experiences of those who implement and participate in the program. This trial is a 2-arm, unblinded, parallel, pragmatic randomized controlled trial with a qualitative component. Eligible participants will be women who live in the Maritime provinces of Canada (New Brunswick, Nova Scotia, and Prince Edward Island), who are in midlife and older (aged approximately ≥50 years), and who are currently in a relationship with an abusive partner or have recently left an abusive partner. Facilitators will be trained to deliver the intervention. The intervention will be entirely virtual and will consist of 2 components: (1) an empowerment component, which will involve sharing resources and information with the women; and (2) a social support component, which will include providing support and encouragement to women for 12 weeks. Quantitative effectiveness data will be collected from all trial participants at baseline, 3 months after the intervention, and 9 months after the intervention about the incidence and severity of IPV, physical and mental health, and safety behaviors and strategies. Qualitative interviews will be conducted with the facilitators and intervention group participants. Control group participants will receive a static, nontailored version of the advocacy intervention for midlife and older women (AIM) intervention materials after baseline data collection. A total of 12 facilitators have been trained to deliver the AIM intervention to trial participants. Participant recruitment and data collection will be completed in January 2025. Data analysis will continue throughout the data collection period, and the results will be disseminated by December 2025. This research will result in the adaptation and testing of a program to support and empower midlife and older women in the Maritime provinces of Canada who experience IPV. International Standard Randomized Controlled Trial Registry ISRCTN30646991; https://doi.org/10.1186/ISRCTN30646991. DERR1-10.2196/57886.

Factors influencing healthcare access for persons with disabilities in Kakamega County, Kenya during COVID-19: A qualitative study

INTRODUCTION Access to healthcare for persons with disabilities is an indicator of the overall effectiveness of the healthcare system in terms of equity, accessibility and the right to health. This study explores factors affecting access to healthcare among persons with disabilities in Kakamega County in the context of COVID-19. MATERIALS AND METHODS Materials used in this study are part of a larger study that looked at access to healthcare and its effect on the quality of life of persons with disabilities in Kakamega County. In this paper, we present data generated from the qualitative component of the study that comprised 7 focus group discussions, 15 in-depth interviews, and 8 key informants who provided contextual information on health services for persons with disabilities. Data was coded and analysed thematically. RESULTS The study established key barriers to healthcare access for persons with disabilities during the COVID-19 pandemic period ranging from availability, affordability, discrimination, accommodation, assistive devices, and appropriateness of healthcare. In addition, the results show that these obstacles are not limited to the pandemic, but represent everyday challenges that persons with disability experience; but were exacerbated during the pandemic. CONCLUSION AND RECOMMENDATIONS This study highlights the need for disability-friendly infrastructure in healthcare facilities, subsidized medical costs, and the provision of assistive technologies to improve healthcare access for persons with disabilities. We also recommend increasing community and provider awareness of disability rights, enforcing existing laws and policies, and ensuring equal employment opportunities to support full social participation for individuals with disabilities.

Assessment of the Viability of Community-Based Health Insurance Schemes in the Ziguinchor Department from 2016 to 2018 in the Context of Universal Health Coverage (Senegal)

<i>Introduction</i>: This study examines the viability of community-based health insurance schemes in the Ziguinchor department of Senegal from 2016 to 2018, within the context of universal health coverage. Health insurance schemes have emerged as a promising solution to extend social health protection to informal sector workers and rural populations. However, despite political support, these structures face persistent challenges in terms of enrollment, member retention, and management. The study aims to assess the viability of these schemes, as well as the perceptions of various stakeholders on mutual health insurance. <i>Methodology</i>: The study adopted a mixed approach, combining quantitative and qualitative methods, based on the theoretical framework developed with the support of the International Labor Office (ILO). This framework evaluates the viability of health insurance schemes according to four dimensions: institutional, technical, functional, and financial/economic. A questionnaire with 87 questions was used to collect quantitative data on these aspects from the seven health insurance schemes in the Ziguinchor department. For the qualitative component, focus groups and individual interviews were conducted with various actors, including beneficiaries, non-beneficiaries, community leaders, scheme managers, and healthcare providers. <i>Results</i>: The study's findings reveal a complex situation for the health insurance schemes in the Ziguinchor department. Institutionally, the schemes have a solid foundation with legal status, internal regulations, and affiliation to a departmental union. Technically, membership is voluntary and family-based, with control mechanisms in place, although their effectiveness is limited. Functional viability shows positive signs with a membership growth rate of 20.18%, but the overall penetration rate remains low at 16.99%, and the premium collection rate is very low, averaging 26.78%. The financial situation is particularly of concern: no scheme can meet its short or long-term debts, and the average claims ratio is excessively high at 282%. As for stakeholder perceptions, they are mixed: while the schemes are generally considered beneficial, significant practical difficulties are identified, including lack of information, funding problems, and procedural complexity. <i>Conclusion</i>: The study highlights the complexity of the role of health insurance schemes in the quest for universal health coverage. Despite undeniable strengths, the schemes face considerable challenges in terms of functional and financial viability. Corrective measures are necessary, including strengthening management capacities, innovating premium collection methods, and improving communication. An evolution of the model is also suggested, potentially towards greater integration into a national social protection system or the development of innovative public-private partnerships.

CARD-SARC: mixed-method study to develop a disease-specific health-related quality of life tool for cardiac sarcoidosis

Abstract Introduction Sarcoidosis is a rare inflammatory condition caused by the formation of lumps (granulomas) of abnormal tissue in any organ, and can affect physical, functional, mental, social and economic aspects of life. People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. HRQoL is the main concern for people living with sarcoidosis. However, measuring HRQoL in people with CS is difficult as existing tools focus on other forms of sarcoidosis (for example, lung, eye or skin involvement) or for specific cardiac symptoms (for example, atrial fibrillation, angina or heart failure), but not specifically for CS. Purpose To develop a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of CS on HRQoL. Methods A sequential exploratory mixed-method, multicentre observational cohort study using a clinimetric approach was conducted. The McMaster Framework for evaluative instruments involved three steps (item selection, item scaling and item reduction) which were complemented with recommendations from the consensus-based standards for the selection of health measurement instruments (COSMIN). The item-generation process connected data from quantitative (theory, research findings and systematic review) and qualitative components (qualitative semistructured interviews, clinical observations and experts’ opinion). A simultaneous triangulation (QUAN+qual) method was followed to ensure a comprehensive list of preliminary items. The formatting of items was guided by patient and public involvement (PPI) with a 2-weeks recall period. The item reduction strategy was led by PPI and an international multidisciplinary clinical CS-experts. Results 740 potential items were generated by converging all the different sources and techniques. After removal of duplicates and simultaneous triangulation, a preliminary list with 111 items was reviewed by the CS-expert panel with 26 members (including 11 pulmonologists, 7 cardiologists, 5 CS-patients and 3 specialist-nurses). After a consensus meeting, the CARD-SARC included 61 relevant items in six sections for pilot-testing: "functioning", "social, leisure and occupation", "emotional", psychological", "physical" and "healthcare/self-care". Conclusions This study combined a robust methodology with active PPI engagement to develop the first disease-specific HRQoL tool for CS. Each data source was planned independently, however the input from PPI members was critical during the simultaneous triangulation for item-generation. The contributions of CS-experts (members of the PPI group and clinical multidisciplinary experts) enhanced the content validity of the CARD-SARC. The CARD-SARC has the potential to influence clinical management and treatment options, future research and health-economic stakeholders’ decisions for CS.

Identifying the zero-dose and under-immunized children in Bangladesh: Approaches and experiences.

This paper presents and elaborates on empirical methods and approaches used to identify Zero-Dose (ZD) and Under-immunized (UI) children as well as the communities that these children reside in within Bangladesh. This paper also describes demand- and supply side-barriers that lead to children being ZD and UI in the country. Time period for the study was December 2022-May 2023. The study methodology encompassed secondary data analysis using data from national surveys, primary data collection and analysis via a lot quality assurance sampling (LQAS) survey and also, qualitative data collection and analysis. Study population included caregivers of children aged 4.5 months (4 months 15 days) to 23 months for the LQAS survey. The qualitative component included policymakers, program managers and service providers working in immunization as well as mothers in the selected study areas who had a living child aged less than 2 years as the study population. Our data analysis confirms existence of ZD and UI children in areas which were categorized into haor (wetlands), hilly, char (sandy/silty land surrounded by water), coastal, plain land and urban slums. Determinant analysis showed that the mother's level of education, antenatal visits made, and access to media were significantly associated with children being ZD or UI. Reproductive autonomy emerged as a key factor that had prominent impact on a child being ZD. The qualitative analysis indicated the importance of population migration, health workforce shortages and lack of access to transportation as prominent barriers to immunization. Notably, the methods and approaches used in this study are both effective and easily replicable to identify ZD and UI children. The drivers of ZD and UI along with the barriers to immunization provide potential areas for intervention by policy-makers and can apprise about interventions to be tested in future implementation research.

Employee’s Security and Health Augmentation in the Hotel Sector

The vibrant and quick-paced environment that defines the hotel sector is defined by a strong emphasis on employee welfare. This study examines the various aspects of worker health and safety in the context of the hospitality sector with the goal of identifying problems, prevalent behaviors, and appropriate remedial measures. The study uses a mixed-methods approach, combining quantitative analysis of safety event data with qualitative interviews with important industry players. In-depth interviews with hotel managers, staff members, and safety specialists are conducted as part of the qualitative component to elucidate the myriad difficulties faced by hotel staff in upholding their health and safety. The effects of irregular work schedules and sleep patterns, workplace stress, and ergonomic considerations all emerge as major themes. The study also examines how well the current training and safety practices work, looking for flaws and potential improvement areas. The study examines historical safety event data from a wide range of hotels on the quantitative front. The goal of this analysis is to spot trends, prevalent accident causes, and geographic regions with a higher prevalence of safety concerns. The results offer a data-driven framework for creating focused interventions and preventive actions. The research also examines how technology can support initiatives to increase employee safety in hotels. We investigate the possibilities for real-time monitoring systems, wearable technology, and enhanced training simulations to improve safety awareness and reactivity. A series of suggestions for enhancing employee health and safety in the hotel business are provided as part of the study's conclusion. The incorporation of technical solutions, specialized training programs, and changes to policy are all included in these suggestions. The hotel business may cultivate a safer and healthier work environment by resolving the issues mentioned, enhancing overall employee well-being and assisting in the industry's long-term success.

Designing a Human Resource Empowerment Model for Pharmacists in Pharmacies in Tehran

Background: One of the most effective strategies to gain a competitive advantage in the current business environment is to enhance the efficiency of employees within organizations. The purpose of this research was to design a human resource empowerment model for pharmacists in pharmacies in Tehran. Methods: The research's statistical population includes two qualitative and quantitative components. In the qualitative part, 35 elite pharmacists from universities, industry, and the Ministry of Health were included, while the quantitative part involved a statistical sample of 220 individuals. For data analysis, the Grandad process of Kolmogorov-Smirnov statistical tests, independent one-sample t-test, exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were used. SPSS 25 and AMOS 24 software were used to analyze the research data Results: The findings showed that in the final development model of empowering pharmacists and personnel in Tehran courts, causal factors include psychological characteristics and training. The core category includes cultural and moral competence, as well as professional and technical competence. Background factors include commitment and skill. Intervening factors include moral values. Strategies include efficiency and speed. The consequences include creativity, innovation, and social responsibility.Results: The findings showed that in the final development model of empowering pharmacists and personnel in Tehran courts, causal factors include psychological characteristics and training. The core category includes cultural and moral competence, as well as professional and technical competence. Background factors include commitment and skill. Intervening factors include moral values. Strategies include efficiency and speed. The consequences include creativity, innovation, and social responsibility. Conclusion: It can be concluded that continuous training workshops should be organized for pharmacists in Tehran pharmacies to enhance their specialized knowledge. Periodic in-service courses should be provided to these individuals based on their professional activities. The organization should consider social activities and social behaviors as focal points.

Constellation of the Five Constant Virtues in English Translations of <i>The Analects</i>

The five constant virtues (<i>rén</i>, <i>yì</i>, <i>lǐ</i>, <i>zhì</i>, and <i>xìn</i>) are central to Confucian philosophy and have grown in influence over time, shaping not only traditional moral teachings but also contemporary practices in business management and personal development. However, limited research has explored how these virtues are translated and conceptualized in English versions of <i>The Analects</i>. This study aims to address this gap by examining how the five constant virtues are formed, related, and legitimized across four major English translations, spanning different historical periods. To achieve this, a mixed-methods approach is employed, integrating both qualitative and quantitative analyses. First, a multi-parallel corpus is established, enabling a detailed quantitative examination of how the five constant virtues are expressed across different translations. This analysis highlights variations in the rendering of these key concepts in each text. In parallel, Legitimation Code Theory’s (LCT) constellation analysis is applied for the qualitative component of the study. This approach explores the relationships among the virtues and how translators have conceptualized and structured these interrelations. Results indicate a reduction in variation over time, suggesting a stabilization in how the virtues are conceptualized. While translations consistently represent simpler pairings of virtues, differences emerge when more complex constellations involving all five elements are considered. These findings reveal how philosophical perspectives and temporal contexts shape translation, impacting the way Confucian virtues are legitimized and structured.

The use and usefulness of the Peninsula Health Falls Risk Assessment Tool (PHFRAT) process in residential aged care: a mixed methods study across 25 aged care facilities

BackgroundFalls remain a persistent problem in residential aged care (RAC) facilities. Fall screening and assessment tools such as the Peninsula Health Falls Risk Assessment Tool (PHFRAT) are widely used to inform falls risk and guide fall prevention interventions. However, it is unclear how it is used in practice and whether clinicians believe it supports resident care. This study aimed to measure the extent of use of PHFRAT to understand clinicians’ perceptions of its value and usefulness.MethodsThis mixed method study involved an analysis of PHFRAT assessment from 25 RAC facilities in New South Wales, Australia, and interviews with seven RAC staff about how PHFRAT information is used in practice. In the quantitative component, descriptive statistics were applied to PHFRAT data to summarise how RAC staff use the PHFRAT including the completeness and content of the three parts. In the qualitative component, thematic analysis techniques were applied to interview data.ResultsThe sample included 215 RAC residents with 703 PHFRATs, of which 617 documented fall prevention interventions. Among these 617 PHFRATs, 593 (96.1%) included strategies related to staff assistance and 283 (45.9%) recorded strategies related to device provision. While nearly all residents (96.74%) received at least one PHFRAT assessment over the study period, many PHFRAT assessments were incomplete (part 1: 11.5% of information missing; part 2: 10.8%; part 3: 17.1%). There were few variations in fall interventions prescribed to individual residents by their fall risk level. Interviews with RAC staff indicated that PHFRAT assessments are the responsibility of registered nurses with limited input from other staff or residents. While the structured process was viewed positively in guiding risk assessment and intervention assessment, a lack of input from others prevented strategies from being tailored to residents’ specific needs and preferences. A shortage of resources, lack of communication, and limited staff education were identified as the main barriers to PHFRAT guideline implementation.ConclusionThe PHFRAT provides a useful structure for clinicians to assess falls risk factors and plan falls prevention strategies. In the future, increased multidisciplinary input into fall prevention strategy development may improve the comprehensiveness of fall prevention plans.

A national DREEM: exploring medical and dental students’ perceptions on their learning environment across Hungary

BackgroundHungarian medical schools attract a diverse student body, enrolling numerous international and Hungarian students annually. The learning environment, encompassing all facets of their academic experience, significantly influences the overall educational experience at the medical schools. As the first nationwide survey, this study aimed to assess and compare the perceptions of international and Hungarian medical and dental students regarding their learning environment across the four medical schools in Hungary.MethodsThe Dundee Ready Education Environment Measure (DREEM) tool was used to get a better insight into the perceptions of international and Hungarian medical and dental students on their learning environment (LE). The questionnaire was distributed via social media platforms and the Neptun Educational System across the four medical schools in Hungary. To gain deeper insights into the participants’ perceptions, a qualitative component was also added to the survey, comprising five open-ended questions. The research was carried out between April and October 2022. To analyse quantitative data, IBM SPSS was used, while the transcription and exploration of the qualitative data was performed using the Sketch Engine software.ResultsA total of 1164 valid responses were received. The results illuminate similarities and differences in perceptions of the learning environment between international and Hungarian medical and dental students. As anticipated, international students’ perceptions were somewhat less favourable compared to their domestic counterparts, who are generally more accustomed to the workings of the Hungarian higher educational system (total DREEM score was 118.1 for the former, and 122.6 for the latter student population). Notably, significant differences were observed in perceptions of teachers and the overall atmosphere.ConclusionThe total score of the DREEM questionnaire was interpreted as “more positive than negative” for both international and Hungarian students, consistent with findings from other DREEM surveys, suggesting overall satisfaction with the learning environment. However, regular and ongoing evaluation of the learning environment is recommended in order to identify areas for improvement, ensure high standards of education, and continuously enhance the overall student experience.

"They Have to Make an Effort Too": What Decliners Can Teach Us About HIV Cure/Remission-Related Clinical Trials? Results from a French Qualitative Study.

Only one study to date has focused on people living with HIV (PLWH) who refused to participate in a HIV cure/remission-related clinical trial (HCCT)-"decliners" hereafter-that included analytical treatment interruption (ATI). Exploring why these persons refuse may provide valuable information to ensure more ethical recruitment and support in HCCTs within the bigger picture of improving HIV cure research. The qualitative component of the AMEP-EHVA-T02/ANRS-95052 study, called AMEP-Decliners, documented the experiences of French PLWH who refused to participate in EHVA-T02/ANRS-VRI07, a phase II randomized, placebo-controlled HCCT with ATI. AMEP-Decliners comprised semi-structured individual interviews with six decliners in two HIV care sites in France between September 2022 and March 2023. The interviews documented their expectations regarding HCCTs, reasons for refusal, and perceived factors that might have led them to participate. Audio files were transcribed, and an inductive thematic analysis was performed. Surprisingly, the main reason for refusal was not ATI but the trial monitoring. Besides the frequency of appointments, respondents emphasized the incompatibility with their active life. One underlying reason for refusal was that participating would have meant "break[ing] the carefree attitude about the disease," reflecting the substantial psychological burden associated with participation. Finally, respondents perceived that the trial's clinical team did not sufficiently recognize their "normal life" and the level of commitment required to participate, leading them to call for greater involvement by the team: "they have to make an effort too." Results from decliners' discourses highlighted that two levels of commitment to participation must be considered when developing HCCTs: psychological burden and logistical constraints. We suggest allowing home examinations and flexible appointment times, prioritizing face-to-face invitations in order to address the psychological burden associated with HCCT participation, and explaining the reasons for monitoring constraints when they cannot be alleviated. Further studies are necessary to confirm our results.