Semi-structured Interviews Research Articles

Strategic approaches for pharmaceutical distributors to create brand equity in the unorganized pharma retail industry in emerging economies

Purpose This paper investigates how stockist brand equity is created in the unorganized pharma retail sector in emerging markets despite the absence of any proactive brand-building efforts by distribution firms (stockists). In addition, this study also aims to unravel the sources of stockist brand equity. Design/methodology/approach Drawing from grounded theory, a qualitative research design using semi-structured interviews was conducted, and a theoretical saturation approach was used for this purpose. The retailer–stockist (business-to-business [B2B]) relationship in the Indian pharmaceutical market context was used as the study context. Findings The findings show that in the absence of any brand-building activities, stockists’ sales representatives play an important role in creating stockist brand awareness. In addition, word of mouth from other retailers also plays a minor role. Rational and emotional brand associations which are strong, favorable and unique are created 1) directly by the services provided by stockists, which includes product availability, deliverability, accuracy in billing and batch numbers, credit facilities and discounts, handling issues such as product expiry, and 2) indirectly by the services provided by stockists’ sales representatives which includes their frequency of visits, proactive customer orientation rather than sales orientation, fulfilling commitments and relationship with retailers. The strength of the retailer–stockist (B2B) relationship also depends on retailer-driven factors and other external factors discussed in this study. Social implications Strong stockist brand equity helps build trust and loyalty with pharmacies, ensuring a consistent and timely supply of medicinal products, which will benefit their end consumers or society. Originality/value This study identifies the antecedents determining the strength of the retailer–stockist (B2B) relationship, a precursor for establishing retailer-based stockist brand equity in the unorganized sector. This study also highlights the consequences of establishing strong retailer-based stockist brand equity.

The complexity of integrating global englishes (GE) in ELT: a case study of an English teacher’s investment and identity construction

Purpose Although there is growing critical awareness in ELT around the rise of English as a global language, studies on teachers’ investment in critical pedagogy remain limited in mainstream ELT curricula, and the impact of such investment on teachers’ identities is not clear. To address this gap, with the inclusive paradigm of Global Englishes (GE), the paper presents a case study of an English teacher’s investment in GE at a middle school in China. Design/methodology/approach This study employed a qualitative approach. Semi-structured interview was conducted with the participant – May, focusing on her reported practices and her understanding of her roles during the investment in GE. The interview process was guided by an interview protocol which was designed based on related literature on GE, the theoretical framework, and the research context. A content analysis method was utilized to generate descriptive categories concerning participant’s identities and investment in GE. Findings Analysis of interview data reveals that through investment in GE, May not only constructed her identity as an English teacher, but also explored identities as a student inspirer, and a peer mentor. These identities exploration and construction were primarily driven by her increased cultural and social capital, despite facing challenges such as high-stakes test policies, native-speakerism ideology, institutional requirements, and limited resources. Research limitations/implications Future research incorporating triangulating data such as interviews, and classroom observations, would provide a more comprehensive understanding of English teachers’ identities, and investment in GE. Besides, the findings of this study are primarily from one teacher, they may not fully represent the broader population of English teachers in China. Practical implications The findings have several implications for English teaching and teacher education. First, elementary schools, the lower grades of middle schools (grades 7 and 8), or the after-school programs may have opportunities for teachers to integrate GE in teaching. Second, teacher education programs should be designed to provide more chances that enable student teachers to invest in their learning and teaching of GE. Third, proposals for incorporating GE practices in the classroom must adopt a critical perspective, so as to to expose, deconstruct, and reconstruct power dynamics that influence teachers’ investment in GE. Originality/value The originality of this study lies in its exploration of English teachers’ investment of GE in their teaching, and the impact of this investment on their identities as English teachers. By investigating these aspects, the study addresses the research gaps in English teachers’ practice of integration of GE in mainstream ELT curricula and provides insights on how to encourage English teachers to incorporate a GE-aware perspective in their teaching.

Exploring the open-source impact on Bangladesh academic library service sustainability

Purpose This study investigates the impact of open-source software (OSS) on the sustainability of academic library services in Bangladesh. It aims to understand how OSS can address budget constraints, technological demands and the need for enhanced service delivery in these libraries. Design/methodology/approach An in-depth qualitative research approach was used, involving semi-structured interviews with library administrators, IT staff and librarians from various academic institutions across Bangladesh. Findings The study reveals that OSS adoption is primarily driven by financial imperatives and the need for flexible, customizable solutions tailored to specific institutional needs. Key benefits identified include significant cost savings, improved customization and flexibility of services and enhanced community support and collaboration. However, challenges such as a lack of in-house technical expertise, resistance to change among staff and stakeholders and inadequate IT infrastructure impede successful OSS implementation. Practical implications To harness the full potential of OSS, academic libraries must invest in capacity building through targeted training programs, improve IT infrastructure and foster a culture of collaboration and knowledge-sharing within the library community. These strategies are essential to overcoming existing barriers and ensuring long-term sustainability. Originality/value This research contributes to the understanding of OSS’s role in enhancing the sustainability of academic library services. It provides practical recommendations for academic libraries seeking to leverage OSS for improved service delivery and operational efficiency.

Navigating the digital classroom: a qualitative content analysis of MOOC discourses in Indian e-newspapers

Purpose This paper aims to explore and unravel the contents portrayed in online news discourses on massive open online courses (MOOCs). Considering sociological dimensions and journalistic strategies, this study examines how online news media reflects, shapes and informs narratives about the social acceptance and use of the MOOC model of learning. Design/methodology/approach Using the Gioia methodology as the overarching framework, this study adopted a two-staged qualitative content analysis of 1,162 online news items from the websites of the top seven online English newspapers of India, published between May 2012 and September 2023. In subsequent semi-structured interviews with subject matter experts, broad themes were identified. In addition, this study integrated Van Dijk’s ideological square model with media content theories to comprehensively analyze the intricate complexities in media depictions of MOOCs. Findings While manifest content analysis revealed the emergence of 25 categories, latent content analysis unveiled six broad themes: “announcements, user stages, characteristics, benefits, changing facets, and educational inequalities,” which are associated with the MOOC model. Application of Van Dijk’s model evidenced the usage of a positive self-representation strategy by Indian online news media until mid-2020. The application of media content theories underscored the predominant usage of reframing as a journalistic strategy to maintain reader interest in MOOC-related content in online news items, emphasizing the dynamic nature of media portrayals of social phenomena such as MOOCs. Practical implications The depth of MOOC-related coverage and the increasing number of news articles discussing MOOCs in Indian online media signify a growing acceptance of this educational innovation in society. Insights from emergent themes can aid administrators and platforms to effectively design and deliver future courses. In addition, understanding these themes can guide the development of media strategies to address contextual issues such as educational inequalities arising from MOOCs. This study also focuses on the necessity of upholding journalistic ethics in content dissemination. Originality/value This study provides a comprehensive synthesis of various themes and journalistic strategies adopted by online news media over the last decade in MOOC-based narratives in India. Given the distinctive Indian context, wherein MOOCs are growing rapidly amid widening digital inequalities, this research addresses calls within information systems literature to explore this phenomenon. It pioneers the integration of communication and mass media theories to analyze the complex sociological dynamics in news discourses on MOOCs, offering a novel perspective on the intersection of media representation and educational innovation.

An analysis of the use of 3D game engine technology in visualising sustainability data

Purpose Responding to calls for accountants to engage with modern technologies and explore data visualisation within a three-dimensional (3D) environment, this study aims to explore whether social and environmental accounting (SEA) data visualisation is a promising use case for 3D game engine technology. Design/methodology/approach Drawing on visual perception and embodiment theories, this study uses photo-elicitation, a qualitative research method, to explore the usefulness of two-dimensional (2D) and 3D visualisations of sustainability information in a 3D virtual environment. This study provides three stimuli: numerical data, 2D visualisations and 3D visualisations, and asks open-ended questions regarding future applications. Twelve semi-structured interviews were conducted with academics, preparers and users of sustainability reports to obtain responses to these stimuli. Findings The key finding is that visualisation of SEA information may indeed be a strong use case for 3D game technology, but only for certain data and for certain audiences. Presenting information within a 3D virtual environment offered enhanced engagement and contextual understanding but reduced navigation speed and data clarity. Participants were enthusiastic about the potential of a museum-like experience, incorporating interactivity and community, but felt that the appropriate audience was more likely to be novices than experts. Practical implications This study suggests that deploying 3D game engine technology can be a powerful tool for presenting sustainability information but requires significant resources. The optimum audience is likely to be novices, and a key design principle is to ensure the virtual environment supports, rather than overwhelms, the information presented within that environment. Originality/value This study introduces a novel application of 3D visualisation technology within the SEA context, offering original insights into its potential to enhance user understanding and decision-making capabilities. This study highlights the technology’s value not as a replacement for traditional reporting but as a supplementary educational tool. The study also provides a novel setting for the photo-elicitation method, demonstrating this approach’s utility in a 3D environment.

Experience with Mandatory Reporting of Intimate Partner Violence: An Explorative Qualitative Study of Service Providers and Help-Seeking IPV Victims and IPV Perpetrators

Abstract Purpose This study explored service providers’ and help-seeking intimate partner violence (IPV) victims’ and IPV perpetrators’ experiences with mandatory reporting of intimate partner violence (MR-IPV) in Norway. We examined the following research questions: How do service providers experience work within the context of MR-IPV? How do help-seeking IPV victims and IPV perpetrators experience MR-IPV? Methods This qualitative study used reflexive thematic analysis to identify, analyze and report themes and patterns uncovered in semi-structured interviews with 42 service providers and 6 help-seeking IPV victims and IPV perpetrators, following Braun and Clark’s Qualitative Research in Psychology six phases of reflexive thematic analysis. Results The service providers in this study aimed to establish collaboration with help-seeking IPV victims and IPV perpetrators to avert IPV rather than immediately reporting IPV to the police, thus working within the discretionary space allowed in the Norwegian legislation. Stories concerning breaches of trust related to MR-IPV were prominent in the interviews with both groups of help-seekers. The IPV perpetrators expressed having experienced a breach of trust when the IPV was reported to the police, while most of the IPV victims expressed a breach of trust due to a lack of MR-IPV. Conclusions IPV victims expressed ambivalence linked to a desire for interventions and a fear of not receiving adequate help. These findings highlight the challenges of certain requirements placed on service providers when working within the MR-IPV context; distinguishing between situations in which collaboration is appropriate and situations in which immediate reporting to the police is required.

The Early Career Framework: Why Context Matters for Teacher Professional Development

The Department for Education developed the Teacher Recruitment and Retention Strategy in 2019 for state-funded schools in England as a response to increasing challenges in teacher supply. Core to the strategy was a mandatory, nationally funded, two-year Early Career Framework (ECF) of professional development for Early Career Teachers (ECTs) in state-funded schools. The ECF began in September 2021 and provided a nationally standardised programme of professional development for Year One and Two teachers. This paper presents the findings of qualitative research that contribute to the understanding of the ECF for ECTs' professional development. Semi-structured interviews were used to explore ECTs’ (n = 25) and mentors’ (n = 17) experiences of the first two years of the ECF (2021–2023). System mapping was used to contextualise data, with primary data examined via coding and theme analysis. Using a complexity theory lens, we conclude that the ECF system affects ECTs and mentors in a non-linear way. Feedback loops that effected change were present, but the ECF’s effectiveness was highly context-dependent with tension between structure and flexibility. We contend that future enhancements to the ECF should focus on adaptability, fostering positive feedback loops, and recognizing the context-dependent nature of teacher development.

Truth in the Crossfire: The Case of Ethiopia and Fact-Checking in Authoritarian Contexts

Fact-checking in Ethiopia is doubly challenged. First, because Ethiopia is ruled by an authoritarian government, which restricts the information environment, and second, because the conflict in northern Ethiopia that erupted in November 2020 has made disinformation more rampant, and its implications deadly. But fact-checking in Ethiopia is the product not only of the work of Ethiopian organizations: local fact-checkers international allies and funders also play important roles. This article explores the practice of fact-checking by local organizations and the challenges they encounter in this work in an authoritarian, conflict-affected context. It also serves as a case study shedding light on the interplay between Ethiopian fact-checking organizations and their allies in the international development sector. Local and international organizations have distinct positions within the fact-checking ecosystem and funder (grantee relationships, and funders, at times, compound local organizations’ challenges). This research reflects information gathered through semi-structured interviews with local fact-checkers and their international allies, as well as a qualitative content analysis of publicly available materials and social media channels. Its findings imply that local fact-checking organizations, their funders, and allied international organizations interact in complex ways in challenging environments.

Enhancing students’ authentic mathematical problem-solving skills and confidence through error analysis of GPT-4 solutions

Authentic mathematical problems connect mathematics to real-life scenarios, making mathematics learning more meaningful. However, students often find it challenging to comprehend the complexity and extensive textual descriptions of authentic mathematical problems, resulting in a lack of mathematical confidence. This study aims to investigate whether error analysis learning activity of GPT-4 solutions can enhance the skill of fifth-grade students to solve authentic mathematical problems and foster their mathematical confidence. A quasi-experimental design was employed, involving 59 fifth-grade students from a primary school in northern Taiwan. The experimental group engaged in error analysis learning activity of GPT-4 solutions, while the control group received traditional instruction, with both groups using the same teaching materials. Quantitative assessments were conducted through tests on solving authentic mathematical problems and a mathematical confidence scale, complemented by qualitative data collected via semi-structured interviews. The results revealed that the experimental group showed significant improvement in solving authentic mathematical problems, both in pre- and post-test comparisons within the group and in post-test comparisons between groups. Furthermore, the low-achieving students in the experimental group showed a significant improvement in solving authentic mathematical problems compared to the control group. Additionally, the mathematical confidence of both high- and low-achieving students in the experimental group was significantly higher than that of the control group. This study confirms the effectiveness of GPT-4 in mathematics education, offering new teaching strategies and research directions for educators and researchers.

Gang membership and rehabilitation: an exploration of narrative accounts from violent gang offenders in an English prison

Purpose The majority of gang research has focussed primarily on American samples, with the rehabilitative field being no exception. Therefore, the purpose of this study was to expand the knowledge base regarding the psychology of gang membership by exploring the narrative accounts of convicted street gang members within an English and Welsh prison sample. Design/methodology/approach Using semi-structured interviews with nine convicted male prisoners, data were analysed, systematically coded and themes generated in line with the principles of thematic analysis. Findings Three major themes emerged which depicted how members viewed gang membership. The first theme was around what being a gang member meant to them and the organisation within the gang (e.g. hierarchy and criminal activities). The second theme reflected their motivations for joining a gang with reference to their identity and survival. Lastly, within the third theme, participants spoke about what had motivated them to disengage from the gang, difficulties they faced because of disengagement, and what they felt had helped them in the process of disengagement. Practical implications The study emphasises the importance of avoiding labels and promoting choice as to how individuals refer to themselves, which can help remove stigma and strengthen professional relationships as part of their risk management planning. Policymakers, practitioners and programme developers are advised to reflect on the word “gang” and how this may influence perception of risk and contribute to bias in judgement. The study also provides insight into individuals experiences with rehabilitation initiatives and the logistical challenges of being open with their peer group. Also supports ideas on considering how to create opportunities to ensure those who wish to exit gangs can do so in a safe, legitimate and durable way. Findings could assist in the design of early preventative measures for those identified as being at risk of joining a gang. Offering training to professionals in the community on how to identify and communicate with those vulnerable to joining a gang may support this process. Originality/value Findings add to the limited yet growing evidence base in understanding the psychology of gang membership and helping to support the work undertaken with this cohort.

Unleashing cultural diversity knowledge for improved knowledge sharing and integration: an in-depth qualitative analysis

Purpose This study aims to investigate international students’ experiences through a lens of knowledge management perspective, emphasizing their strategies for knowledge management in tandem with cultural adaptation. The primary objective is to elucidate how international students navigate cultural differences and use knowledge management strategies to augment their learning and integration, thereby supporting their academic progress in a new academic environment. Design/methodology/approach An in-depth qualitative research strategy was used, using semistructured interviews with Pakistani doctoral students who were studying in Australia. A thematic analysis was conducted to identify recurring themes and patterns in the data. Findings The findings reveal that international students adeptly adopt various knowledge management strategies to facilitate cultural adaptation. These strategies encompass embracing otherness through a sense of belonging, engaging in both personal and shared learning experiences, achieving individual success, and using critical inquiry as a guiding framework for observations. Notably, this study underscores the pivotal role played by cultural competence in conjunction with social networks, influencing cultural intelligence and, subsequently, impacting knowledge sharing and integration for academic progress. Practical implications This study’s findings provide practical insights for higher education institutions and policymakers, emphasizing the importance of supporting international students in their cultural adaptation and knowledge management endeavors. These practical implications encompass fostering a welcoming and inclusive environment, supporting intercultural engagement, using technology for enhanced learning and communication and promoting the development of cultural intelligence among international students. Originality/value This study contributes to the literature on international student experiences and knowledge management by providing insights into the strategies used by international students to navigate knowledge of cultural differences to enhance their learning experiences and advance academic progress. These findings contribute to a deeper understanding of the intersection between cultural adaptation and core knowledge management concepts of knowledge sharing and integration in the context of higher education.

Exploring the Perspectives of Older Adults on a Digital Brain Health Platform Using Natural Language Processing: Cohort Study

Background Although digital technology represents a growing field aiming to revolutionize early Alzheimer disease risk prediction and monitoring, the perspectives of older adults on an integrated digital brain health platform have not been investigated. Objective This study aims to understand the perspectives of older adults on a digital brain health platform by conducting semistructured interviews and analyzing their transcriptions by natural language processing. Methods The study included 28 participants from the Boston University Alzheimer’s Disease Research Center, all of whom engaged with a digital brain health platform over an initial assessment period of 14 days. Semistructured interviews were conducted to collect data on participants’ experiences with the digital brain health platform. The transcripts generated from these interviews were analyzed using natural language processing techniques. The frequency of positive and negative terms was evaluated through word count analysis. A sentiment analysis was used to measure the emotional tone and subjective perceptions of the participants toward the digital platform. Results Word count analysis revealed a generally positive sentiment toward the digital platform, with “like,” “well,” and “good” being the most frequently mentioned positive terms. However, terms such as “problem” and “hard” indicated certain challenges faced by participants. Sentiment analysis showed a slightly positive attitude with a median polarity score of 0.13 (IQR 0.08-0.15), ranging from –1 (completely negative) to 1 (completely positive), and a median subjectivity score of 0.51 (IQR 0.47-0.53), ranging from 0 (completely objective) to 1 (completely subjective). These results suggested an overall positive attitude among the study cohort. Conclusions The study highlights the importance of understanding older adults’ attitudes toward digital health platforms amid the comprehensive evolution of the digitalization era. Future research should focus on refining digital solutions to meet the specific needs of older adults, fostering a more personalized approach to brain health.

Hojas y otros productos naturales con fines utilitarios en la cocina tradicional de Costa Rica

The objective is to describe leaves and other plant products obtained from the environment for utilitarian purposes in traditional Costa Rican cuisine. The study is qualitative and is based on semi-structured interviews with 37 people between the ages of 50 and 91, residing in different parts of the country. 59 products widely used more than six decades ago for the storage, conservation, preparation, consumption and transportation of food, as well as for cleaning, disinfection and pest control, were identified. Aspects such as access, functionality, durability, aesthetics and efficiency in different household tasks are considered for their selection. There is a decrease in current application due to changes in lifestyles, urbanization, industrialization and greater use of synthetic materials which, according to the people interviewed, has caused the loss of knowledge in new generations regarding the resources and their familiarization with utilization in the domestic environment. The natural products have value for their practical use in the kitchen, as well as for being biodegradable and favoring the family economy, which is why they have persisted over time, and it is still possible to acquire some of them in their natural state or with artisanal manufacture in markets and local fairs.

The Doctors, Their Patients, and the Symptom Checker App: Qualitative Interview Study With General Practitioners in Germany

Background Symptom checkers are designed for laypeople and promise to provide a preliminary diagnosis, a sense of urgency, and a suggested course of action. Objective We used the international symptom checker app (SCA) Ada App as an example to answer the following question: How do general practitioners (GPs) experience the SCA in relation to the macro, meso, and micro level of their daily work, and how does this interact with work-related psychosocial resources and demands? Methods We conducted 8 semistructured interviews with GPs in Germany between December 2020 and February 2022. We analyzed the data using the integrative basic method, an interpretative-reconstructive method, to identify core themes and modes of thematization. Results Although most GPs in this study were open to digitization in health care and their practice, only one was familiar with the SCA. GPs considered the SCA as part of the “unorganized stage” of patients’ searching about their conditions. Some preferred it to popular search engines. They considered it relevant to their work as soon as the SCA would influence patients’ decisions to see a doctor. Some wanted to see the results of the SCA in advance in order to decide on the patient’s next steps. GPs described the diagnostic process as guided by shared decision-making, with the GP taking the lead and the patient deciding. They saw diagnosis as an act of making sense of data, which the SCA would not be able to do, despite the huge amounts of data. Conclusions GPs took a techno-pragmatic view of SCA. They operate in a health care system of increasing scarcity. They saw the SCA as a potential work-related resource if it helped them to reduce administrative tasks and unnecessary patient contacts. The SCA was seen as a potential work-related demand if it increased workload, for example, if it increased patients’ anxiety, was too risk-averse, or made patients more insistent on their own opinions.

Students’ Perceptions of Factors Contributing to a Happy School Environment in Iran

Abstract Background School is not only a place for acquiring academic skills but also a social environment where students develop emotional abilities and awareness. Prioritizing well-being in schools can foster confidence, satisfaction, and emotional awareness among students, contributing to their lifelong success and mental health. Objective This research hypothesizes that students will emphasize the importance of individual choice, autonomy, and enjoyment in school, along with a desire for more meaningful activities beyond academics. The study aims to investigate adolescents' perceptions of a happy school and the strategies they believe are effective for fostering this environment. Method Employing a purposive sampling approach, the researchers conducted indepth, semi-structured qualitative interviews involving 41 middle and high school students in Iran to explore their perspectives on the factors contributing to their happiness within an educational setting. Through phenomenological data analysis, four principal themes and thirteen subcategories emerged. Result The main themes included: (1) Enhancing overall health; (2) Creating schools with collaborative decisionmaking; (3) Fostering a love of learning; (4) Supporting joy and well-being in school. Conclusions The identified themes provide new, valuable insights for improving school climate, particularly in relation to student happiness and promoting positive mental health and optimal performance among students.

Stigmatization and perceptions of Venezuelan migrants in Peru in the context of Venezuela’s political and economic crisis

This study analyzes the social and individual stigmatization toward Venezuelan immigrants in Peru within the context of the largest migratory movement in Latin America, driven by the political, economic, and humanitarian crisis in Venezuela. The study employs a qualitative approach, using semi-structured in-depth interviews with a diverse sample of 24 participants from major Peruvian cities, including Lima, Arequipa, Cusco, and Trujillo. These in-depth interviews provide insights into the complexity of perceptions toward Venezuelan migrants, ranging from stigmatizing views driven by associations with economic threats and criminality to more positive perceptions that acknowledge the migrants’ adaptability and economic contributions. The findings reveal that while negative stereotypes perpetuate social exclusion and pressures for cultural assimilation threaten the preservation of migrant identities, there are also narratives highlighting resilience and successful integration. The study emphasizes the importance of implementing intercultural education programs, promoting labor integration policies, and collaborating with the media to combat stigma. It concludes that addressing these challenges through a multidimensional, human-rights-based approach can foster greater social cohesion and better integration of migrants, benefiting both the migrant population and Peruvian society.

Health-related quality of life and symptom-specific functional impairment among patients treated with parenterally administered complement inhibitors for paroxysmal nocturnal hemoglobinuria

AbstractThis study describes the health-related quality of life (HRQoL) and symptom-specific functional impairment of patients with paroxysmal nocturnal hemoglobinuria (PNH) in a real-world setting. US-based adults with PNH treated with a parenterally administered complement inhibitor (PACI) for ≥ 6 months completed an online, cross-sectional, observational survey; a subset of patients also participated in semi-structured qualitative interviews. The survey included the PROMIS® 29 + 2 Profile v2.1 (PROMIS 29 + 2) to measure HRQoL. The FACIT-Fatigue, Neuro-QOL Item Bank v2.0 Cognitive Function Short Form, and PROMIS Item Bank v1.0 Dyspnea Functional Limitations 10a Short Form measured symptom-specific functional impairment. For each patient with PNH who completed the online survey, 3 age- and sex-matched adults from the general population (GP) also completed the survey. The HRQoL and functional impairment of the PNH sample were compared to that of the GP sample. The association between HRQoL/functional impairment and fatigue severity for the PNH sample was also investigated. Compared to the age- and sex-matched GP sample, patients treated with PACIs for PNH had significantly worse HRQoL and greater functional impairment for all measured domains (p < 0.05). Within the PNH sample, statistically significant associations (p < 0.05) were observed between fatigue severity and HRQoL/functional impairment for all outcomes except the PROMIS 29 + 2 Sleep Disturbance domain. Interview participants described fatigue-related impairments in their physical, social, and cognitive functioning. Despite receiving treatment for PNH, patients experienced deficits in HRQoL and functional impairment, suggesting that opportunities to improve patient-relevant outcomes through treatment should be identified.

The Role of the Public Health Workforce in Securing Political Commitment for Tackling Childhood Obesity in Local Government

Local government is well placed to provide leadership for the national ambition in England to halve childhood obesity by 2030 and has delegated authority for many policies thought necessary for effective action. However, with currently constrained local government finances, resources may not be prioritized for the wide range of policies and interventions necessary. Thus, local political commitment is vital for directing local government investment to tackle the issue. This qualitative study investigated how political commitment has been demonstrated in local government, the strategies used to build such political commitment, and the role of the public health workforce. Public health staff from 13 local authorities participated in semi-structured telephone interviews using questions informed by a conceptual framework composed of five previously defined levels of political commitment: rhetorical, institutional, operational, embedded, and system-wide. Thematic analysis showed that public health officers secured a political commitment by framing childhood obesity in line with existing priorities to build support among councillors in a position to advocate for the issue. Public health officers also engaged with multiple stakeholders, gathering data and insights to develop operational and embedded commitment. The study shows that effective health promotion practice requires a skilled and committed public health workforce, acting as policy entrepreneurs to secure system-wide political commitment in local government by proactively navigating local governance and policy processes, to build in opportunities for feedback and accountability.

The “insider” ethnographic diagnostic radiographer thinking like “an outsider”

PurposeThe purpose of this paper is to explore how the ethnographic researcher navigates their insider–outsider status and provides a methodological contribution to this important aspect of ethnographic research; this will be framed from the researcher’s perspective using a semi-autoethnographic approach. The ethnographic study being reflected upon explored the culture in a Diagnostic Imaging Department (DID), looking at how radiographers work and what the issues were within their working environment. The original study was carried out within one DID in a District General Hospital in the East of England (Strudwick, 2011).Design/methodology/approachIn the original study, the researcher used ethnography to study the culture in a DID. Observation was carried out for a four-month period. Field notes were recorded and used to formulate topics for the interviews that were to follow. After the observation, the researcher conducted semi-structured interviews with key informants from the DID. Ten key informants were purposefully sampled from the DID to provide a cross-section of opinion from the staff. The data collected were analysed to identify key themes. This paper reflects on the data from the original study to explore the tensions between the insider and outsider researcher role and how this contributes to the way the ethnographic researcher views the environment, reports on their findings and how they feel about the data from their own perspective.FindingsEthnographers carrying out research in their own area of practice need to try to think like an outsider in order to see the environment with a sense of strangeness but also try to make sense of what the participants are thinking and doing. There is a tension between becoming part of the group in order to understand it and looking at the environment as an outsider in order to make a note of what is happening. Findings from the original ethnographic study will be used to illustrate this point and will be used to reflect on the feelings of the researcher, considering her insider and outsider status.Research limitations/implicationsThis study was carried out in one diagnostic imaging department in the east of England.Originality/valueThe author, who is a diagnostic radiographer and radiography educator reflects on how she managed the insider–outsider tension during her ethnographic observation and after the event when reflecting on the data from the original study.

Individual and System Level Factors Contributing to Guideline Non-Adherent Surgical Antibiotic Prophylaxis at a Tertiary Health Care System: A Qualitative Analysis

Background Antibiotics play a crucial role in preventing surgical site infections, yet adherence to Infectious Disease Society of America (IDSA) guidelines varies widely. This qualitative study aimed to explore factors influencing perioperative antibiotic administration and assess the potential impact of a clinical decision support (CDS) tool on guideline adherence. Methods In this qualitative study, perioperative personnel with diverse roles (surgeons, anesthesiologists, certified nurse anesthetists, trainees, and pharmacists) were interviewed using a semi-structured interview format from September 2023 through April 2024. Interviews were then analyzed for codes which were assigned to concepts using the constant comparison method for assessment of factors that were described as barriers or facilitators of guideline adherence. Results After piloting with three interviews, we conducted nine sessions with a total of 17 participants: 7 attending anesthesiologists, 3 resident trainees, 2 perioperative pharmacists, 3 Certified Registered Nurse Anesthetists (CRNAs), and 2 attending surgeons. Key themes emerged: (1) Limited familiarity with Infectious Disease Society of America (IDSA) antibiotic guidelines, (2) Lack of standardization and optimization of antibiotic decision-making process, (3) Challenges with managing beta-lactam allergies, (4) Difficulty optimizing vancomycin timing, and (5) Perceived benefit of a Clinical Decision Support (CDS) tool in enhancing workflow and guideline adherence. Conclusions Non-adherence to antibiotic guidelines in the perioperative setting often results from a lack of structured workflow. Our interviews provide a foundation for developing a clinical decision support tool tailored to provider needs, aiming to improve user satisfaction and promote better adherence to perioperative antibiotic guidelines.