Qualitative Items Research Articles

Rural Family Physician Perspectives on Wellness and the Role of Training in Supporting Physician Wellness.

Research evaluating the well-being of rural family physicians is limited, resulting in minimal understanding of how to prepare family medicine residents to succeed in rural practice postresidency. Our study aimed to investigate factors associated with maintaining wellness within rural family medicine practices and highlight interventions that rural family physicians identify as important to promote wellness among those seeking future employment in rural settings postresidency. Forty-eight rural family physicians completed an online survey with qualitative and multiple-choice items including the Mini-Z about physician demographics, burnout, and wellness. We conducted data analysis using NVivo 12 software for qualitative analyses and R 3.6.1 software for descriptive statistics. The majority of participants reportedly maintained wellness in rural family practice (maintenance of wellness=79.17%; denied burnout=62.26%). Burnout rates were similar to the national burnout rates for family physicians (37.74% vs 46%). Participants identified multiple residency interventions that could be implemented to prepare rural family physicians to succeed. This study highlights factors that are associated with the maintenance of wellness among rural family physicians. This is the first study to investigate rural family physician perspectives on residency interventions that may have positive outcomes on wellness postresidency.

Loneliness, social isolation, and social support in older adults with active cancer during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic has had a considerable impact on mental health. The social distancing and stay-at-home orders have likely also impacted loneliness, social isolation, and social support. Older adults, particularly those with comorbidities such as cancer, have a greater potential to be impacted. Here we assessed loneliness, social isolation, and social support in older adults undergoing active cancer treatment during the pandemic. Materials and methodsA mixed methods study in which quantitative data and qualitative response items were collected in parallel was conducted in 100 older adults with cancer. Participants completed a survey by telephone with a series of validated questionnaires to assess the domains of loneliness, social isolation, and social support as well as several open-ended questions. Baseline demographics and geriatric assessments were summarized using descriptive statistics. Bivariate associations between social isolation and loneliness and social support and loneliness were described using Spearman correlation coefficients. Conventional content analysis was performed on the open-ended questions. ResultsIn a population of older adults with cancer, 3% were noted to be severely lonely, although 27% percent screened positive as having at least one indicator of loneliness by the University of California, Los Angeles (UCLA) Three Item Loneliness Scale. There was a significant positive correlation between loneliness and social isolation (r = +0.52, p < 0.05) as well as significant negative correlation between loneliness and social support (r = −0.49, p < 0.05). There was also a significant negative correlation between loneliness and emotional support (r = −0.43, p < 0.05). There was no significant association between loneliness and markers of geriatric impairments, including comorbidities, G8 score or cognition. DiscussionReassuringly, in this cohort we found relatively low rates of loneliness and social isolation and high rates of social support. Consistent with prior studies, loneliness, social isolation, and social support were found to be interrelated domains; however, they were not significantly associated with markers of geriatric impairments. Future studies are needed to study if cancer diagnosis and treatment may mediate changes in loneliness, social isolation, and social support in the context of the pandemic as well as beyond.

Extensiveness of Higher Education Development Programme on Enabling Institutional Linkage to Ensure Quality University Graduates in the Northern Zone Tanzania

Institutional linkages has been a demand for all universities in the world. Higher Education Development Programme (HEDP) was meant to cater for this fundamental purpose. This study therefore aimed at finding out the extensiveness of HEDP on enabling institutional linkages of universities in the Northern Zone Tanzania. The study was anchored to the Value-Added-Theory. Convergent design under the mixed research paradigm lead the study. The target population for the study was 18,601 respondents from eight (8) Universities in the Northern Zone of Tanzania. This comprised of 5,118 final year bachelor degree students, 483 lecturers, 8 DVC-academics, 12,292 alumni and 100 employers. The study sample comprised of 697 respondents from which 511 were final year bachelor degree students, 48 lecturers, 4 DVC academics, 124 alumni and 10 employers. Sampling techniques included stratified random, purposive and automatic inclusion. Data collected through questionnaires, indepth interview guides and document analysis guides. Validity of quantitative data collection instruments was ensured through content and face validity while for qualitative was ensured through explanation of the purpose of study and ensuring equal time for each interview. Internal consistency of Likert type items was estimated through Cronbach Alpha, while the dependability of qualitative items was ensured through triangulation. Quantitative data was analyzed by using descriptive statistics where frequencies, percentages, and means were determined. Qualitative data was analyzed through transcription of texts, generate themes, interpret, discuss and making conclusions. The study found that, HEDP is to some extent known to students and alumni for its purpose of establishing linkages. The study concluded that HEDP has to the lower extent achieved the goal of ensuring institutional linkages. The study recommended that universities should conduct periodic review and reform programmes to cater for the needs of the current demands of 21st century soft skills.

A mixed methods investigation of college student mental health during the first year of the COVID-19 pandemic

Objective Researchers collaborated with undergraduate minority students to quantitatively and qualitatively investigate college students’ mental health during the first year of the COVID-19 pandemic. Participants Participants were two convenience samples of diverse college students surveyed in June (n = 128; M age = 21.7, SD = 1.7) and December (n = 242; M age = 20.3, SD = 1.7) of 2020. Methods This study administered items from the California Health Interview Survey and open-ended qualitative items via Qualtrics. Results Across both waves, students reported significant mental health challenges and psychological distress. Students surveyed in December were three to four times more likely to report depression and anxiety. Female and older students reported heightened odds of mental health challenges. Qualitative findings elaborated on contributing factors. Conclusion During the pandemic, college students have experienced pronounced mental health challenges, potentially exacerbated by academic, professional, relational, and environmental stressors and uncertainty.

Treatment use and satisfaction in Australian women with endometriosis: a mixed-methods study.

To document the frequency of conventional and complementary treatments used by Australian women with endometriosis and the perceived efficacy of these treatments, and to qualitatively explore women's treatment satisfaction. We do not adequately understand whether Australian women with endometriosis are satisfied with their medical care. Using a mixed-methods design, 532 women with self-reported endometriosis were recruited from the community. Participants were asked about their medication, complementary and self-care treatment use, as well as perceived efficacy on a 0 (not effective) to 10 (extremely effective) numeric rating scale, and open-ended qualitative survey items about treatment satisfaction. Ninety-seven percent of women used medication for pain relief (mean perceived efficacy=5.05) and 89% used complementary/self-care strategies (mean perceived efficacy=3.70), with medication rated as significantly more effective (P < 0.001). Content analysis of the qualitative data identified that 36% of women were dissatisfied with treatment, 34% were somewhat satisfied and 24% were satisfied. We identified qualitative themes relating to: (i) barriers to treatment, which included lack of access, stigma and disappointment with medical professionals who were perceived as uncaring, unhelpful and, in some cases, psychologically damaging; (ii) the need for holistic, interdisciplinary care; and (iii) patient knowledge, advocacy and resilience in endometriosis management. Our findings reveal important limitations in the current Australian healthcare model, including the need for patient-centred interdisciplinary care that treats the biopsychosocial needs of people with endometriosis, and widespread pain education, spanning medical training to community awareness.

School Personnel Perceptions of Video Conference Individualized Education Program Meetings

Due to the COVID-19 pandemic, many schools in the U.S. pivoted to provide services to students using technology to mitigate the need for face-to-face interactions. In addition to providing instruction using distance technology, it was necessary for schools to conduct much of their other business in a way that limited face-to-face interactions, including Individualized Education Program (IEP) meetings for students who receive special education services. This study sought to better understand the extent to which school personnel believe they will continue to use a video conference format for IEP meetings, even without the existence of school policy restricting face-to-face events. Additionally, barriers and facilitators related to video conference IEP meetings were explored. A survey was completed by school professionals ( n = 292) that included responses to Likert-scale items related to video conference IEP meetings as well as open-ended qualitative items to better understand respondent perceptions. Results suggest school personnel generally believe that video conference IEP meetings can be beneficial and should be offered as an option to IEP teams. In addition, qualitative data related to barriers and facilitators have been provided. Implications for school personnel and future research have also been described.

\u201cAn uncomfortable topic\u201d: Health professionals' perspectives on child protection capacities, training offers and the potential need for action in Germany

BackgroundChild maltreatment, due to its high prevalence and often long-lasting (health and/or psycho-social) consequences, is one of the main reasons for global health inequalities. The medical field offers many opportunities to support affected children. This gives physicians and other health professionals the opportunity to provide protective measures and therapies to affected children at an early stage. However, the level of training concerning child protection is often too low among health professionals. This can affect the quality of care as well as providing the appropriate treatment and thus, the long-term (health) burden. The present work aims to survey the state of knowledge and capacities of health professionals regarding child protection in medicine and elicit health professionals' perspectives who absolved a child protection online course on a potential need for action in Germany.MethodsFrom June 2016 until February 2021, 3,360 health professionals were interviewed. Using quantitative and qualitative items, the questionnaire assessed demographic and professional background information as well as assessments regarding the awareness of child protection, abilities in child protection among health professionals and training offers in medicine.ResultsThe analysis indicates that the topic of child protection in medicine is not as present as the high prevalence of child maltreatment would imply. The majority (94.0%; n = 3.159) of the health professionals stated that they need more knowledge and capacities regarding child protection in medicine. More than half of the health professionals assessed the importance of the issue of child protection as low among health professionals. The reasons cited included child protection as an uncomfortable topic, an unwillingness among managers, and a lack of training on the topic.ConclusionsThere is too little awareness and importance regarding child protection in the medical field in Germany. Hence, it is difficult to ensure adequate care for those affected. Child protection topics should be mandatory in the training curricula of all health professionals, and quality standards for prevention and intervention should be implemented in medical institutions. Furthermore, networking in child protection has to be improved, and medical campaigns should address the topic to sensitize health professionals and society to the issue and to destigmatize the topic.

Learning in the Time of COVID: Undergraduate Experiences of a Mid-Semester Transition to Virtual Learning due to the COVID-19 Pandemic

Background The COVID-19 pandemic caused an unprecedented mid-semester transition to virtual learning. Instructors and students had to adapt to new ways of delivering and receiving course material. Objective The present investigation examined whether course format and sense of belongingness were associated with learning satisfaction during the COVID-19 pandemic, as well as racial/ethnic or gender identity differences in academic experiences during this time. The current study also explored student perceptions of instructor support, changes in workload, and changes in learning. Method Undergraduate students ( N = 157) responded to quantitative and qualitative items regarding their academic experiences during the first semester of the pandemic in an online survey. Results Blended courses were associated with poorer outcomes than solely synchronous and asynchronous courses. There were no racial differences in academic experiences; however, women had more positive academic experiences than men. Greater academic and campus belongingness predicted better academic experiences. Students perceived clear, frequent instructor communication as vital to their success. Conclusion Students’ experiences with virtual learning varied depending on instructor and student factors. Teaching Implications Instructors can improve their students’ experiences with virtual learning by providing frequent, clear communication, resources on effective study and time management skills, and a sense of community.

How can we improve information for people affected by cancer? A national survey exploring gaps in current information provision, and challenges with accessing cancer information online

ObjectiveDespite improved recognition regarding the importance and association between provision of high quality information for people affected by cancer and improved outcomes and experiences; gaps and unmet needs are still reported. As oncology health information provision increasingly moves online, understanding how service users experience and manage misinformation is important. Determining patient and carer preferences regarding cancer provision is needed to address outstanding gaps. MethodsThis study utilised a purpose-built national cross-sectional survey distributed via social media to assess perspectives regarding cancer information in Australia. Quantitative and qualitative (open text) items assessed respondents’ perspectives regarding current inforation preferences and gaps, and experiences with accessing information online. ResultsA total of 491 people affected by cancer completed the survey. Respondents highlighted a preference for information that better addresses the diversity of cancer experience, and is more timely and responsive to personal situation and care context. Despite increasing attention to health literacy standards, complex medical jargon and terminology remains prevalent. Many respondents have concerns about misinformation, and seek improved mechanisms or skills to assist with determining the trustworthiness and relevance of information found online. ConclusionsSurvey responses identified current gaps in information provision for people affected by cancer. Personalised information in formats which are more flexible, accessible, and responsive to user needs are required. Practice ImplicationsEducation and resources to target and improve digital health literacy and combat health misinformation are needed. Novel solutions co-designed by people affected by cancer will ensure that information is provided in a manner that is relevant, timely, and personalised.

Consequences of rare diagnoses for education and daily life: development of an observation instrument

BackgroundÅgrenska, a Swedish national centre for rare diagnoses and health conditions, has arranged courses for families of children with rare diagnoses for over thirty years, and has experienced that the conditions often have complex and varying consequences in the children´s everyday lives, not least in educational contexts. Knowledge of these consequences and of how to adapt the environment and educational methods is often lacking and the children´s educational needs are not met. Many professionals also report a lack of sources of knowledge. Knowledge formation and dissemination about educational consequences of rare diagnoses are thus of utmost importance. For this purpose, a broad observation instrument was constructed in order to gather knowledge on a group level concerning how functional impairments affect school and everyday situations, how consequences vary within each diagnosis and if there are diagnosis-specific features that lead to specific every day and pedagogical consequences.ResultsThe instrument consists of 119 quantitative and 65 qualitative items and covers ten domains: social and communicative ability, emotions and behaviours, communication and language, ability to manage his/her disability and everyday life, activities of daily life, gross and fine motor skills, perception and worldview, prerequisites for learning and basic school abilities. The instrument is intended for use by educational professionals with knowledge of typical development and was content validated against existing instruments. The items were considered relevant as they, with few exceptions, appear in well-known assessment tools. Interrater reliability was based on the observations of six children. Each child was observed by two educators. Interrater reliability was calculated for the quantitative items and items with fixed response options, including yes/no answers, a total of 100 items, which are usually observed during the course. Interrater reliability reached 91%. Factor analysis and Cronbach´s alpha indicated good statistical properties and a multinomial regression gave reasonable results.ConclusionsThe instrument can be used to gather knowledge on a group level of educational and everyday consequences of rare diagnoses. This knowledge can be used to adapt methods and environment to meet the educational needs and create conditions for optimal learning and participation for children with rare health conditions.

A Mixed-Methods Investigation of Migrating Music Teachers’ Job Fit

Abstract The purpose of this study was to explore music teacher migration through the lens of job fit. Using a convergent mixed-methods design, we surveyed music teachers who were in their current positions for at least 2 years and had held a previous position for at least 2 years (N = 74). Participants completed a questionnaire consisting of quantitative measures of current and previous job fit, then responded to qualitative items about the positive and negative aspects of their current and previous jobs. Results indicated that music teachers typically exhibited better fit in their current jobs than in their previous jobs. However, qualitative responses suggested that fulfillment of basic needs may have been more influential in their occupational decisions than job fit. We also determined that job fit involves multiple layers of influence including position features, local contexts, and general contexts. Implications are discussed for in-service music teachers and music teacher education.

Opioid agonist treatment (OAT) experiences and release plans among federally incarcerated individuals with opioid use disorder (OUD) in Ontario, Canada: a mixed-methods study

BackgroundIncarcerated populations experience an elevated prevalence of opioid use disorder (OUD). Federal correctional institutions in Canada have increasingly treated OUD among correctional populations via opioid agonist treatment (OAT) – an evidence based pharmacotherapy that works to reduce drug use and related health harms. However, there is limited evidence regarding incarcerated individuals’ experiences with institutional-based OAT, as well potential OAT-related community release prospects. This information is important for optimal treatment retention and improved health. To address this knowledge gap, we conducted a longitudinal follow-up study examining OAT-related experiences among federally incarcerated individuals before and after community release. This article focuses on the baseline (pre-release) data.MethodsThis mixed-methods study examined OAT-related experiences and release prospects among n = 46 individuals scheduled for community release, recruited from seven federal prisons located in Ontario, Canada. Participants underwent a comprehensive interviewer-administered on-site assessment, including quantitative and qualitative items. Assessment data was furthermore linked to administrative correctional data. Data were analyzed using thematic qualitative and descriptive quantitative approaches.ResultsParticipants had complex histories with opioid use including related negative health outcomes. Experiences with institutional OAT were divergent and provision was not standardized; those with OAT engagement pre-admission did not experience many challenges, whereas those initiating OAT during incarceration experienced barriers such as treatment waitlists and adverse process experiences. Most participants expressed a preference for buprenorphine-naloxone over methadone, but described difficulties accessing it. Participants were keen to transition into community-based treatment, yet envisaged prospective barriers and facilitators concerning successful reintegration and treatment continuity.ConclusionsMajor barriers towards the current administration of OAT in federal correctional systems in Canada exist, including extensive waitlists, non-standardized practices, and challenges accessing preferred OAT formulations; this contributes to sub-optimal treatment. Eliminating waitlists, standardizing OAT provision, providing additional OAT options, and more comprehensive release planning may be essential for treatment retention and positive outcomes.

A National Study of Adult Women Sexually Abused by Clergy: Insights for Social Workers.

Given the paucity of research on the experiences of women who are sexually abused by clergy as adults and the advent of the #ChurchToo movement in 2017, the results of a mixed-methods national study highlight the experiences of those who survived the abuse and report on what factors are most healing in their recovery. Internet-based surveys with both quantitative and qualitative items were completed by 159 respondents. Less than 10 percent reported receiving help and support from their congregation after they reported the abuse, and about half of the respondents were blamed for the abuse and ignored by people in their congregations. In spite of the poor responses from their churches, these respondents reported positive beliefs regarding their ability to recover and heal. Mental health counseling was listed as a primary mechanism for healing. Multiple regression was used to develop a model of resilience. Faith in God was the most salient predictor. Those who survived sexual abuse need social workers who can navigate the complex set of factors and issues at the intersection of religion/spirituality, mental health treatment, and policy advocacy, including the ability to see what has been helpful about religious experiences and what has not.

Below the Surface: Caregivers' Experience of Hospital-to-Home Transitions.

Our aim was to understand the breadth of the hospital-to-home experience from the caregiver perspective using a mixed method approach. Caregivers of children who experienced an inpatient admission (N = 184) completed a hospital-to-home transition questionnaire after discharge. Twenty-six closed-ended survey items captured child's hospitalization, discharge, and postdischarge experiences and were analyzed using descriptive statistics. Four additional free-response items allowed caregivers to expand on specific challenges or issues. A conventional content analysis coding framework was applied to the free responses. Ninety-one percent of caregivers reported satisfaction with the hospital experience and 88% reported they understood how to manage their child's health after discharge. A majority of survey respondents (74%) provided answers to 1 or more of the qualitative free-response items. In the predischarge period, qualitative responses centered on concerns related to finances or available resources and support, communication, hospital environment, and the discharge process. Responses for the postdischarge time period centered on family well-being (child health, other family member health), finances (bills, cost of missed work), and medical follow-up (supplies, appointments, instruction). Caregivers were generally satisfied with their hospital experience; however, incorporating survey items specifically related to family stressors either through closed- or open-ended questions gave a richer context for caregiver-identified concerns. Basing future quality improvement efforts on supporting caregiver needs and identifying stressors before discharge may make for a more robust and successful transition to home.

Mental Health Symptoms and Workplace Challenges among Australian Paramedics during the COVID-19 Pandemic.

Background: Paramedics are vital to the health system response to the COVID-19 pandemic; however, the pressures on this workforce have been intense and challenging. This study reports on mental health symptoms and the working environment among Australian paramedics during the COVID-19 pandemic and explores their experiences of work and wellbeing during this time. Methods: An anonymous, online survey of frontline healthcare workers examined work environment, psychological wellbeing, and contained four open-ended qualitative items. Using a mixed method approach, quantitative data were analysed descriptively and qualitative data were analysed using content analysis. Results: This paper reports findings from 95 paramedics who provided complete quantitative data and 85 paramedics who provided free-text responses to at least one qualitative item. Objectively measured mental health symptoms were common among paramedics, and almost two thirds of paramedics self-reported experiencing burnout. Qualitative analysis highlighted key issues of safety and risk in the workplace, uncertainty and upheaval at work and at home, and lack of crisis preparedness. Qualitative analysis revealed four themes; ‘the pervasiveness of COVID-19 disruptions across all life domains’; ‘the challenges of widespread disruption at work’; ‘risk, uncertainty and feeling unsafe at work’, and ‘the challenges of pandemic (un)preparedness across the health system’. Conclusions: The COVID-19 pandemic resulted in considerable occupational disruption for paramedics and was associated with significant negative impacts on mental health. Findings emphasise the need for more adaptive working conditions, mental health support for paramedics, and enhanced crisis preparedness across the health system for future crises.

The feasibility and acceptability of a classroom-based physical activity program for children attending specialist schools: a mixed-methods pilot study

BackgroundChildren with disabilities often engage in less than the recommended amount of daily physical activity (PA). Classroom-based PA breaks are a favourable method of promoting PA for children. However, evaluations of these programs in specialist schools are scarce, with even less research into their feasibility and acceptability. This may hinder effective implementation and program scalability. This pilot study investigated the feasibility and acceptability of implementing a classroom-based PA break program in Australian specialist school classrooms, using the Australian Joy of Moving (AJoM) program.MethodsForty primary/junior classes and their teachers across five specialist schools implemented the AJoM program for eight weeks as the intervention group within a pilot cluster randomised controlled trial. A mixed-methods design investigated classroom teachers’ (N = 22; 6 males, 16 females) perspectives of the feasibility and acceptability of the program after implementation through semi-structured telephone interviews (n = 7 teachers), qualitative survey responses (n = 18 teachers) and quantitative survey items (n = 19 teachers). Qualitative data were analysed using predominantly deductive thematic analysis. Quantitative data were analysed using descriptive statistics.ResultsClassroom-based PA breaks may be feasible for getting children with disabilities more active at school. However, considerable variation exists in teachers’ perception of the AJoM experience. While several teachers indicate that the program content could be pertinent for their class, common divergences in perceptions of feasibility and acceptability appear to relate to the age and developmental level or needs of the students in the class.ConclusionsThis study provides preliminary evidence for the feasibility and acceptability of implementing classroom-based PA breaks in specialist schools. However, results demonstrate the importance of (1) allowing a high level of flexibility in the design and implementation of programs to meet the varying needs of class groups and (2) providing a large variety of resources to cater to the heterogeneity of the children.Trial registrationThis trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000193178) on 11 February 2019.

Exploring the impact of the United States-based accreditation council for pharmacy education certification on pharmacy education outside the United States

IntroductionThe Accreditation Council for Pharmacy Education (ACPE) offers certification for interested pharmacy programs outside the United States. This study aimed to explore the reported impact of this certification on the quality of pharmacy education among ACPE-certified pharmacy programs outside the US. MethodsThis cross-sectional study was based on highly structured, standardized interviews. A predetermined questionnaire was designed to include both quantitative and qualitative items, which assessed participants' thoughts on the impact of ACPE certification on the quality of pharmacy education as well as programmatic and student learning outcomes. A total of 15 pharmacy colleges and schools outside the US have received the ACPE certification as of July 2020. After IRB approval, these programs were invited to participate in online live interviews, which were scheduled from May to July 2020 via Zoom®, and lasted approximately 45 min each. ResultsAdministrators from 13 programs participated in this study (87% respondent rate). The majority of these international pharmacy programs reported that the ACPE certification had promoted the quality of pharmacy education at their institutions. However, there were different views on how the ACPE certification has affected the operation of these international pharmacy programs. There was little or no impact of the certification on financial resources, such as salaries and development funds. ConclusionDespite being confined to little or no change in certain areas of their programs, all the interviewees believed the ACPE certification had an overall positive impact on the quality of their programs, particularly in the area of assessment, preceptor quality and development, improving teaching and learning methods in both didactic and experiential curricula, and developing an inclusive feedback system to receive input from various stakeholders.

The impact of COVID-19 on teachers' mental health

PurposeThe purpose of this paper is to examine teachers’ experiences with mental health during the COVID-19 pandemic.Design/methodology/approachThe authors administered an online survey to full-time public school teachers simultaneously enrolled in a master’s degree program in education. Out of 455 teachers who were sent the survey, 96 completed it, resulting in a 21.1% survey completion rate. The survey was composed of both quantitative and qualitative items which assessed teachers’ self-perceptions about their mental health before and during the COVID-19 pandemic, as well as their use of mental health resources. Most questions were drawn from the Patient Health Questionnaire-4 (PHQ-4), so focused primarily on symptoms of depression and anxiety.FindingsThe results of the survey indicated that overall, teachers felt an increase in symptoms of anxiety and depression between March 2020 and February 2021. A noteworthy percentage of participants said they were seeking mental health supports.Research limitations/implicationsThis study was conducted with teachers in an alternative certification program, so their experiences might not be widely generalizable to teachers enrolled in traditional pathways to certification.Originality/valueWhile some research has been conducted on mental health, less has been conducted with public school teachers and even less has assessed the impact of the COVID-19 pandemic. This study aims to add to the existing literature about teachers' experiences with anxiety and depression, as well as the specific impact of COVID-19.

A Focus on Ethical Value under the Vision of Leadership, Teamwork, Effective Communication and Productivity

The new economy and the knowledge-based society brought significant changes in all the areas of our daily lives. Also, the COVID-19 pandemic and the COVID-19 crisis implicated tremendous transformations in all the domains, on the one hand, threatening the balance of our society and, on the other hand, challenging the dynamic of the new economy development and the rhythm of the societal modernization. In these delicate times, the all-important relationship between ethics, leadership, teamwork, effective communication, productivity, and performance is brought to the attention, in particular, due to its benefits for our society, taking into consideration the pivotal advancement that a well governed relationship of this type could provide to the knowledge-based economy. The present research describes the implication of ethics in leadership, teamwork, effective communication, and productivity, which includes the application of ethical values as university graduates assume the role of each of the mentioned dimensions of study in the organizations. The absence of research that relates ethics to these four elements simultaneously was noticed. This information is essential to know how these dimensions influence the organizational level. The sample that included 410 university graduates was applied in Baja California, Mexico, and the industrial nucleus of great relevance, bordering California in the United States of America. The data was obtained using a questionnaire. A reliability and validity analysis of the measurement instrument was carried out in terms of the ethical values associated with the dimensions mentioned using the exploratory factor analysis by the principal components method. Qualitative items were also analyzed using the constant comparison method. The results obtained in this research provide a greater perspective and practical knowledge and support of usefulness and practical reality to businesspeople and employees, leaders and university graduates; and also extensive to students, teachers, and human beings in general, in order to be better prepared to give and apply solutions with their consequent ethical and productive achievements desired by all. Additionally, this current research has the purpose to raise the will to understand, at a higher level and at a more in-depth degree of knowledge, the relationship between ethics, leadership, teamwork, effective communication, productivity, and performance, in the attempt to foster a creative and innovative business environment, based on a robust and sustainable business administration and business competencies, capable to position at higher ranks the strengths, opportunities, aspirations and outcomes that today’s new economy is due to offer and diminish the dangerous effects of the COVID-19 pandemic and the COVID-19 crisis in all the domains.

Health professionals' perspectives on child protection capacities, training and need for action

Abstract Background Child maltreatment is because of its prevalence and consequences one of the main reasons for global health inequalities and a major public health problem. The medical field offers many opportunities to support affected children. However, there is often very limited awareness concerning child protection beyond a few engaged professionals. The present work aims to survey the state of knowledge and capacities in view of child protection in the medical field and explores health professionals' perspectives on a potential need for action. Methods From 06/2016 until 02/2021 3,360 health professionals were interviewed. Using quantitative and qualitative items the questionnaire gathered demographic and professional background information as well as assessments regarding the awareness of child protection, capacities in child protection among health professionals and training offers in medicine. Results The analysis indicated that the topic child protection in medicine is not as present as the high prevalence demands it. The majority (94.0%; n = 3,159) of the probands stated that they need more knowledge and capacities regarding child protection in medicine. More than half of the probands assessed the importance of the issue child protection as low among health professionals. The reasons cited included child protection as being an uncomfortable topic, unwillingness among managers, and a lack of training on the topic. Conclusions It turned out that there is too little awareness and importance regarding child protection in the medical field. Hence, it is difficult to ensure an adequate care for those affected. Child protection topics should be made mandatory in the training curricula of all health professionals as well as quality standards for prevention and intervention should be implemented in medical institutions. Key messages Too little attention is paid to child protection in the medical field. More training in child protection and quality standards must be established in the medical field.