Semi-structured Open-ended Questionnaire Research Articles

Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study

BackgroundLow immunization coverage in India attributes to many factors including sociodemographic factors and people’s behavior. COVID-19 pandemic resulted in disruptions in achieving optimum availability and utilization of immunization services. This study was carried out to find out the immunization status of children in the post COVID era and various factors responsible for non-immunization during the pandemic.MethodsThis cross-sectional study included parents of 225 admitted children aged 1–6 years were interviewed using a semi-structured open-ended questionnaire. Children were classified as completely immunized, partially immunized and unimmunized on the basis of vaccines missed given under first year of life. Reasons for non-immunization and delay/missed vaccination during COVID-19 pandemic were recorded.ResultsOf the 225 children, 162 (72%; 95% CI 66–78%) were completely immunized, 55 (24.4%; 95% CI 19–30%) were partially immunized and 8 (3.6%; 95% CI 1–6%) were unimmunized. Parents with hospital deliveries, higher education level and lesser birth order were more likely to have children with better immunization status (p < 0.05). First dose of measles scheduled at 9 months and 3rd dose of pentavalent vaccine/OPV/Rotavirus vaccine scheduled at 14 weeks were most commonly missed vaccines among partially immunized. Lack of awareness (n = 36, 57.1%; 95% CI 45–70%) was the common reason for partial and non-immunization followed by illness of child (n = 21, 33.3%; 95% CI 21–45%) and COVID-19 pandemic (n = 11, 17.4%; 95% CI 8–27%). Pandemic was reason for delay in 50 (22.2%; 95% CI 17–28%) children. Restrictions of movement (64%; 95% CI 50–78%), fear of being exposed to COVID-19 (52%; 95% CI 38–66%) were the most common reasons for delay during the pandemic. Of the 50 children who had delay due to pandemic, 39 children (17.3%; 95% CI 12–22%) received their catch-up immunization after the pandemic. No child remained completely unimmunized due to COVID-19 pandemic.ConclusionsAlthough COVID-19 pandemic resulted in disruptions in routine immunization services, sociodemographic factors such as awareness for immunization, parental education and various beliefs for immunization were responsible for the children remaining unimmunized or partially immunized after the pandemic.

Seroconversion and Prevalence of Hepatitis B Surface Antigen among Vaccinated Health Care Workers in Ashanti Region, Ghana.

Health care workers (HCWs) constantly stand at a high risk of exposure to the hepatitis B virus because of the nature of their work. Hence, it is mandatory for HCWs to undergo hepatitis B vaccination. However, most HCWs in Ghana do not check their HBsAb titre after completion of their primary vaccination. This study assessed the prevalence of HBsAg and the seroconversion rate among vaccinated health care workers in the Ashanti Region, Ghana. A semistructured open-ended questionnaire was pretested and administered to 424 HCWs. Two (2) ml of blood was drawn and qualitative analyses (HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb) were done on the blood samples. Samples that tested positive to HBsAb were quantified using ELISA. Data obtained were analysed using GraphPad Prism 9. Out of the 424 study participants, 271 (63.9%) were females and 153 (36.1%) were males. Seroconversion (≥1 mIU/mL) and seroprotection (≥10 mIU/mL) through vaccination only among study participants were 67.5% (n/N = 286/424) and 58.0% (n/N = 246/424), respectively. Prevalence of hepatitis B viral infection was 2.4% (n/N = 10/424). Anti-HBc seropositivity was 13.2%, and anti-HBs seronegativity was 24.1%. 2.4% (n/N = 10/424) of study participants were negative to HBsAg but positive to HBcAb. In addition, 8.5% (n/N = 36/424) of the study participants were seroprotected due to exposure and recovery from previous HBV infection. Age, the number of doses received, taking a booster dose, and keeping a vaccination record card were significant factors influencing seroconversion status. This study reaffirms the need for HCWs to undergo a supervised primary hepatitis B vaccination course. Postvaccination serological testing should be done for all HWCs to confirm immunity and reduce their chances of contracting HBV infection.

Understanding Community Participation in Tree Planting and Management in Deforested Areas in Cameroon's Western Highlands.

Deforestation and forest degradation continue to take place at alarming rates in Africa despite global net forest loss reductions. This is prompting large-scale forest restoration involving community volunteers to prevent, halt and reverse the loss of biodiversity for the sustainable development of forest landscapes in Africa. The study explored the motivations, challenges, barriers and negotiation strategies of community volunteers in ecosystem restoration and conservation initiatives in Cameroon's Western Highlands (Mount Bamboutos landscape), given that many such interventions are not achieving desired targets and goals. A total of 134 respondents involving farmers and local implementing NGO workers were interviewed, using semi-structured open-ended questionnaires. One focus group discussion was held with paramount traditional rulers to assess the strength, weaknesses, opportunities and threats (SWOT) of the community-led ecosystem restoration and conservation initiative. The principal components analysis with oblique (Direct oblimin) rotation was used to reduce the number of constitutive items in each dimension of motivation, challenge and barrier to community participation. Linear regression analysis was used to examine how the different dimensions of motivations, challenges and barriers influence community participation. Community participation was initially driven more by environmental motivations given the highly deforested and degraded Mount Bamboutos landscape, but later on driven more by economic and community motivations. Social factors were least expressed and non-significant predictors of participation. Community participation was primarily limited by management, financial, psychological, personal, and information challenges and barriers. Providing financial incentives to cover daily subsistence costs of food and transport was a key negotiation strategy that increased community participation. Conservation organisations should capitalise on environment, community and social motivational appeals during community education and awareness campaigns to increase voluntary community participation. The local knowledge on ecosystem restoration and conservation motivations, challenges, barriers, negotiation strategies, recommendations and SWOT analysis provide relevant baseline information for environment management decision-makers in Cameroon and other Sub-Saharan African countries.

“Road traffic injury could be minimized when individual road users take more responsibility for their safety and the safety of others”: Perception of healthcare workers in Vanuatu

IntroductionAround 1.35 million deaths are caused by Road Traffic Injuries (RTIs) each year. This study aimed to explore the perceptions of Vanuatu's Health Care Workers (HCWs) regarding the existing preventative strategies for RTI. Materials and methodsIn 2020, this study used qualitative approaches to collect data from HCWs using Focus Group Discussions (FGDs). Study participants were self-identified Ni-Vanuatu HCWs who had been serving for more than 6 months in three main hospitals where the study was conducted and purposive sampling was used to gather the study participants. To guide the FGDs, a semi-structured open-ended questionnaire was created. Thematic analysis was used to processed the data obtained, based on predetermined themes that were based on theory while also enabling the data to determine new themes. ResultFrom 5 FGDs with 22 HCWs who were emergency nurses, doctors and public health officers, data saturation was reached. The study yielded five main themes and sixteen subthemes. The relevance and trends of RTI, barriers to effective care, pre-hospital management capacity, barriers to pre-hospital care and addressing RTI were among the key subjects. The findings suggest that addressing health institutional leadership and resources will improve prevention of RTIs. ConclusionPrevention of RTIs is hindered by the lack of health institutional capacities in terms of leadership and resources that include emergency equipment, financial and trained human resources. The health sector should consider developing stronger leadership in road safety to be an essential part of its core business.

Self-Care Practices and Knowledge on Menstrual Hygiene Management among Adolescent girls

Menstrual hygiene management (MHM) is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. The menstruation cycle is treated as something dirty, impure, and contaminated. Girls and women are alienated from society as well as their friends and families during this time of the month. They are forced into harmful social restrictions and have to face the human condition and humiliation. The objective of the study was to measure the knowledge and self-care practices of adolescents on menstrual hygiene. A mixed method of qualitative and quantitative study designed to access the knowledge attitude and self-care practices, social cultural practices food taboos during menstrual hygiene among 459 adolescent girls of urban area in the Government Schools of Kathmandu Valley from 23, August 2019 to May 29, 2020. Semi-structured open-ended questionnaires along with a Likert scale and in-depth interviews were done among selected 92 students based on scoring of the Likert scale, focusing on socio-cultural practices, food beliefs and practices, and feelings and emotions during menstruation. The interview was accompanied by concurrent note-taking in the Nepali language which was later translated to English. The code book was generated and thematic data analysis was conducted. The result showed that 19.72% of students need improvement in attitude towards menstruation. Menstruation is taken as a secretive and indiscriminate management practice. During menstruation, 83.09 % of students used old and used cloths as absorbent, and 46.5 % disposed of their used pads by throwing them with other waste. Change of pad depending upon their bleeding was practiced by 54.9% of the student. More than half of the students i.e. 60.6% students don’t take a bath every day during their periods. Even though all adolescents have facilities of the toilet but they are still facing the problem of water which, is a great obstacle for them to maintain their menstrual hygiene. Sociocultural rituals of the menstrual cycle are hampering the self-esteem of the girl's student, for which there is a needto focus on interventional study and MHM programs that suitably address the problems of adolescent girls.

Organizational Preventative Strategies Undertaken by Dental Clinics in Fiji during COVID-19 Pandemic: A Qualitative Study

Aim: This research aims to determine the organizational preventative strategies implemented by dental clinics in Fiji during the COVID-19 pandemic. Methods: This qualitative study was conducted amongst Dental Officers (Dos) and Dental Managers (DMs) who were working at government dental clinics, private dental clinics, and the School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji. A semi-structured open-ended questionnaire was used for data collection through in-depth interviews via zoom. A manual thematic analysis of the data was conducted. Results: Thirty Dos and 17 DMs participated in this study. 16 themes emerged from data analysis: Major Strategies implemented, Staff perception about strategies in place, Triaging and Screening, Hand hygiene, Waiting room changes, Operational Capacity, Universal precautions, Personal Protective Equipment (PPEs), Disinfection and decontamination protocols, Ventilation, Sterilization, Pre-procedural mouth rinse, Waste management, Vaccination status, Bubbles and Adaptation of Protocols. The Dos were generally satisfied with the strategies implemented by the DMs. The DMs along with other Dos had used various guidance documents to devise tailor-made ones suited for dental clinics in Fiji. Conclusion: Various strategies were adopted from several guidelines and tailor-made Standard Operating Procedures (SOPs) for each workplaces were developed by the various DMs. The majority of Dos were in favor of and satisfied with the protocols in place. Future research can be conducted in other divisions and include other health care professionals as well apart from just Dos and DMs.

A qualitative study on the perceived benefits of back to basics-diabesties session among individuals with type 1 diabetes mellitus and caregivers in India

Abstract Aim: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that makes self-care challenging for T1DM individuals and their caregivers. This qualitative study aimed to explore the perceived benefits of the Back to Basics-Diabesties (B2B) session among T1DM individuals and their caregivers in India. Materials and Methods: The B2B session is a structured intervention provided through telephonic peer counseling, aimed at enhancing the understanding of T1DM that provides practical knowledge of diabetes management, insulin administration, blood glucose monitoring, diet, exercise, and psychosocial aspects of living with T1DM. Overall, more than 1560 participants (T1DM/caregivers/family/friends) have opted for B2B session. A qualitative telephonic interview was conducted (n = 96) using a semistructured open-ended questionnaire to collect data on the perceived benefits of B2B session. The information obtained was then coded, and grouped to form themes. Results: According to T1DM individuals, B2B sessions enhanced diabetes knowledge and confidence, self-management abilities, increased sense of community and peer support, and easy accessibility. Caregivers reported that the B2B session provided emotional support, disease knowledge, shared experiences, practical ideas, and coping strategies. Most widely appreciated salient feature of B2B session was the peer counselors were themselves with T1DM or caregivers of T1DM, which created unbreakable trust among the study participants. Clinical evidence after B2B session showed a 23% of improvement in the glycated hemoglobin (&lt;8%) and nearly 8% of drop in hypoglycemic events and 17% of drop in hyperglycemic episodes. Conclusion: This study shows the benefits of peer counseling, which could help healthcare professionals and policymakers improve diabetes education and support programs for T1DM patients and their caregivers in India.

Ethnobotany of Medicinal Plants Used by Kathariya (Tharu) Community in Kailali District, Nepal

This study aims to document the traditional knowledge on medicinal use of plants by Kathariya (Tharu) community in Kailali district. Kathariya is one of the sub-group of the Tharu community whose culture and language is slightly different from other sub-groups. Traditional healers Guruwa of Kathariya community from five study sites viz. Sisaiya, Tappa, Udasipur, Pawera and Joshipur of Kailali were identified as key informants. Exploratory research design was adopted and interview method was used to collect the primary information through Semi-structured open-ended questionnaire. Altogether 70 species of plants used for medicinal purposes were documented. Sixteen species were found useful in cuts, wounds and swelling which is one of ten health issues categorized in the present study. Thirteen and Twelve species were recorded to be used in abdominal disorders and skin diseases respectively. The community usually mixes powder in measurement of two and half grains of each Barley and Black Pepper during preparations of medicine for oral route of consumption. Based on habit, highest number of plant species belongs to herbs (30 species). Among five study sites, highest number of species was recorded in Udasipur with 35 species. Regarding the parts of plant used, roots and leaves were found to be used often equally, which were represented by 24 species each. Achyranthes aspera, Euphorbia hirta, Azadirachta indica and Clerodendrom infortunatum were the most frequently used species. This study generated preliminary but crucial information which may open the avenue for utilization of biological resources. Further research leading to bio-prospecting is needed to utilize these resources.

Study of emerging avenues in supply chain resilience; the case of integration of additive manufacturing with spare parts procurement

PurposeThe purpose of this research was to study the impacts of adoption of additive manufacturing (AM) for spare parts procurement, specifically in the context of supply chain resilience (SCR) especially regarding efficient spare parts inventory management. Furthermore, key narratives in the adoption of AM toward better SCR are explored.Design/methodology/approachIn-depth interviews with semi-structured open-ended questionnaire were conducted to collect primary qualitative data from 24 supply chain management (SCM) experts. Respondents consisted of experts across various industries. The data were analyzed by thematic content analysis method.FindingsThe results indicated that AM could be a suitable tool to reduce dependence on original equipment manufacturers (OEMs) for spare parts procurement. Data analysis also revealed that AM adoption might lead to significant cost and lead time reduction. Designs protected as intellectual properties (IP), substantive post-processing requirements and material compatibility were revealed to be barriers in adoption.Research limitations/implicationsThe impacts of utilizing AM for procurement of spare parts on the overall resilience of the supply chain were highlighted. Theoretical analysis of the findings was based on theoretical aspects of SCR. This was especially regarding efficient spare parts inventory management. The study results revealed the factors responsible adoption of the AM technology. A novel approach was undertaken to study the effect of AM adoption on “time-to-market” of newly launched products.Practical implicationsThe research provided insights regarding practical applications of AM adoption in spare parts procurement. The study could be beneficial to the early adopters of AM across industries for making managerial decisions. Unfamiliarity of supply chain managers with the AM technology was believed to be a major reason to adopt the technology. The study provided essential inputs regarding challenges and alternate adoption strategies of AM. Thus, the research was believed to be of potential value for creating awareness among supply chain managers regarding AM technology.Originality/valueThe research provided new insights on the impact of AM adoption in the context of SCR toward efficient spare parts inventory management. Various limiting and facilitating factors specific to Indian context were also explored.

Perceptions of public health nursing Team Leaders (TLs) and Team Supervisors (TSs) on nurse’s development in Fiji

BackgroundNurse team leaders are responsible for contributing to managing the quality of service delivery and facility output of their nurses to ensure there is a high quality of care delivered by the health system. This study aimed to explore the perceptions of public health nursing Team Leaders (TLs) and public health nursing Team Supervisors (TSs) on nurses’ development in Fiji.MethodsA qualitative study was used to gather information using in-depth phone interviews among TLs and TSs comprising Chief Midwifery Nursing Officer (CMNO), Director of Nursing (DON), Sub-divisional Nursing Managers (SDNMs), acting SDNMs and Nursing Manager (NM) at Central health division in Fiji. The data was collected through semi-structured open-ended questionnaires and were audio recorded. The data was analyzed using manual thematic analysis process.ResultsThe study comprised of 26 participants, which included 10 TSs and 16 TLs. Four themes were identified for the results amongst TSs and TLs: ethical development; professional development; psychological development; and recommendations. However, nine sub- themes were identified for TSs and eight sub-themes were identified for the result amongst TLs.ConclusionThis study highlighted that TLs and TSs elaborated on the need for the ethical, professional, psychological development, nursing development and also on the importance of policies and guidelines. Professional ethics should be integrated into the Continuous Profession Development (CPD) points that are used to renew yearly nursing licenses as well as exposing the need for having competencies on professional ethics in nurses’ logbooks. Further research is needed to determine the in-depth barriers.

"Once you get cancer you die. There is no way to get saved from cancer." A qualitative exploration of patients' perceptions towards cancer in Fiji.

Understanding patients' perspective to get an insight into cancer, and how best the public health systems can battle with this disease is the way forward in this current world. This study aimed to explore patients' knowledge about common cancers, barriers to assessing cancer information and cancer preventative approaches in Fiji. The study used a qualitative method approach that was conducted among patients who attended Special Outpatients (SOPD) at the four selected health centres in Lautoka Subdivision, Fiji from 1st March to 30th April 2021. A semi-structured open-ended questionnaire was used to guide in-depth interviews. These audio recordings were transcribed and analysed using thematic analysis. All interview transcripts were read and similar words and phrases were assigned numbers which were grouped together to identify themes and sub themes. Twenty-eight patients took part in the in-depth interview and the responses were grouped into four themes including; cancer knowledge, diagnosis of cancer in a close friend/family, barriers of communication and optimizing cancer awareness. Patients' awareness about common cancers and cancer risk factors was low. Many barriers for cancer screening were highlighted including stigmatization, fear, worry, death, lack of information, herbal medicine use, lack of resources and delay in diagnosis. Awareness strategies highlighted by participants included community outreach programs, house to house visits, opportunistic screening, engagement of community health care workers and the concept of a cancer hub centre. It is evident that there is a range of views from patients towards cancer and it is important to understand these perceptions to better guide public health interventions concerning cancer. This puts more focus on the need to invest more in information, education, and communication material for public campaigns that target a variety of people for a wider reach.

The use of myths and taboos in wildlife conservation: The case of Bayelsa-East Senatorial District of Nigeria

The use of myths and taboos in species conservation represent a sustainable in situ means to wildlife protection. This study examined the role of taboos (traditional laws) in wildlife conservation within Bayelsa-East Senatorial District. Data were collected using a combination of semi-structured open-ended questionnaire guide and field observations, as well as species-evidence left behind. Informants for the study were selected from fifteen communities across the Local Government Areas (LGAs) that constitute the district. Local abundance status of the species implicated in the myths and taboos was determined within the various ecological settings, and likert scale was used to evaluate the informants’ perceptions on the taboos in relation to their effectiveness at protecting the identified species. The punishments for non-compliance with the taboos, as well as hypothetical inferences for the species conservation were documented. Ten (10) animal species in nine families were implicated in Bayelsa-East myths and taboos. The taboo animals were in 5 classes within Kingdom Animalia; members of the Class Reptilia (Crocodylus niloticus, Python regius, Python sebae and Varanus niloticus) were the most implicated; followed by Aves (Haliaetus vocifer, Macropygia doreya, Strix nebulosa). Abundance scale revealed that periwinkle (Gastropoda) was very abundant in Nembe and Brass. The informants’ perception on the effectiveness of the taboos (e.g. forbidding of hunting or killing Ekekoru, Python regius) in relation to the species protection revealed that the taboos were strongly effective in protecting the species in Nembe. The taboos in the study area were species specific, hence animals forbidden in Nembe and Brass LGA were not exclusively forbidden in Ogbia communities, and vice versa. The informants confirmed their beliefs and awe in the taboos and forbade abusive use, thus substantiating the taboos’ potential as sustainable tool for wildlife conservation.

“It’s a waste of time coming here, better go to private clinics with wider options for treatment”: patient’s perception on dental services provided in Fiji

BackgroundOral health can influence the quality of an individual’s life. Patient’s perception of the service plays a vital role in understanding the reasons as to why a patient may be satisfied or dissatisfied with the service that they accessed at a dental setting. As no studies have been done in Fiji until now, this study aimed to explore the perceptions of patients on services provided by the largest dental clinic in the Central/Eastern division in Fiji.MethodA qualitative study was used to collect data from patients who visited the Colonial War Memorial Hospital (CWMH) dental clinic in Suva Fiji from 5th August to 31st October, 2020. All patients above the age of 18 of both genders and from any ethnicity who visited the CWMH dental clinic during the period of data collection were included the study. A total of 25 participants were interviewed for this study using the in-depth interview method till data saturation occurred. A semi-structured open-ended questionnaire was used to collect data using face-to-face in-depth interviews. The data were transcribed and analyzed using manual thematic analysis process to gather the themes and sub-themes for the results.ResultsA total of 25 patients were interviewed, with a majority (n = 14) being men and 15 were of I-Taukei background. Five themes emerging from data analysis include: Waiting time before treatment, Cost of Treatment, Accessibility of services, Privacy and confidentiality and Range of treatment options. The patients had an expectation to get the best treatment but face many hurdles while trying to get the treatment that they expect. The shortfalls on the part of this dental clinic caused an onset of negative perception among its users.ConclusionThis study shows an overall dissatisfaction with regards to services delivery among the patients who use the CWMH dental clinic for dental care purposes. The decision makers need to look into the genuine concerns that have been raised by patients in order to create improvements in services delivery and create an array of satisfaction for its patients.

Frontline Health Care Workers' (HCWs) perception of barriers to managing COVID-19 in Fiji.

BackgroundHealth Care Workers (HCWs) are at higher risk of COVID-19 infection with their efforts while protecting the greater community and also exposed to hazards, such as psychological distress, fatigue, and stigma. This study aimed to explore the perception of frontline HCWs on barriers of managing COVID-19 in Fiji.MethodsA qualitative study method was approached to conduct this study among the HCWs who worked on the frontline during the COVID-19 pandemic based at ten purposively selected health facilities in the Suva subdivision in the Central Division of Fiji. The Colonial War Memorial Hospital (CWMH), the Fiji Centre for Communicable Diseases (Fiji CDC), Twomey hospital laboratory, and CWMH laboratory did the main control and most of the operations of other divisions were monitored from these settings. A semi-structured open-ended questionnaire was used to collect data using in-depth interviews. The participants' responses were audio-recorded and were later transcribed and analyzed using thematic analysis.ResultsA total of twenty-nine HCWs took part in the in-depth interview and the responses were grouped into four themes, which include: workload, poor communication, lack of resources, and hindrance to education. It was also found through this study that some of the HCWs felt tired, frustrated, got rude to patients, and found it difficult to handle situations, which affected them mentally and physically stressed.ConclusionManaging the COVID-19 cases has been attributed to the presence of many barriers, such as workload, tiredness, frustration, and sometimes difficult-to-handle situations, and the HCWs were indeed affected mentally and physically. Regular training for HCWs and more awareness programs would help the general public to follow the preventive measures, which reduces the cases and would help the HCWs manage COVID-19 well.

Healthcare workers’ perceptions on diabetic foot ulcers (DFU) and foot care in Fiji: a qualitative study

ObjectivesTo explore the perception of healthcare workers (HCWs) on diabetic foot ulcers (DFU) and foot care in Rotuma, Fiji.DesignUsing a qualitative study design, two focus group discussions (FGDs) were conducted...

Behavioral Preventative Strategies Undertaken by Dental Clinics in Fiji during COVID-19 Pandemic.

ABSTRACTIntroduction:COVID-19 has created a significant impact on dentists and oral health professionals. This research aimed to explore the perspective of dental officers (DOs) and dental managers (DMs) on behavioral preventative strategies and recommendations for preventing the virus transmission in the dental clinics in Fiji.Materials and Methods:This qualitative study was conducted among DOs and DMs who worked in nine private dental clinics, eight government dental clinics, and one School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji between August 9 and September 12, 2021. The participants were selected using purposive sampling method using the inclusion and exclusion criteria. Self-developed semi-structured open-ended questionnaires were used for data collection through in-depth interviews via zoom. Manual thematic analysis of the data was conducted.Results:Thirty DOs and 17 DMs participated in this study. Seven themes emerged from data analysis: Risk perception-COVID-19 versus dentistry; Staff safety, satisfaction, and motivation; Breaking the chain of infection transmission; Adaptability, and acceptance; Shared responsibility; Roles and knowledge; and Importance of good planning. Majority of participants felt that dental professionals are at high risk, and hence, need to take extra precautionary measures. Participants also stated that more care should be provided to patients by accepting the situation and moving forward.Conclusion:This study highlighted the importance of dentists in preventing disease transmission in a dental setting. Continuation with the protocols and strategies gave the participants more sense of protection. The importance of good planning, accepting the situation, and moving forward was highlighted. Future research is recommended in other divisions and other health-care professionals can be included.

Receiving Education in a Different Country: Challenges Encountered by Foreign Students and Proposed Solutions

Abstract Introduction: The purpose of this study is to determine the problems of primary and secondary school teachers about foreign students and propose solutions to these problems. Methods: In the research, qualitative research method was conducted. Primary and secondary school teachers who had at least one foreign student in their class and volunteered to participate in the study in one of the provinces of Middle Black Sea Region of Turkey were included in study group. They were 29 participants in total (15 female and 14 male). The classes of the teachers generally included 1-5 foreign students. As a data collection tool, a semi-structured open-ended questionnaire consisting of 7 questions was used. After data collection, analyses were performed with content analysis method. Results: Findings of the study reveal that the most basic problem experienced by foreign students is the language problem. Students had difficulty in understanding their environment because of this problem and this situation brought problems of adaptation to school, the teacher and classmates. Especially the students whose parents did not know Turkish experience these problems more than others because of the lack of support from their parents. The majority of the teachers mentioned that they could not reach the achievements in the education programs with these students, and they stated that they included additional activities related to reading and writing. Conducting orientations programs, language and literacy courses, family education (especially language teaching to families), providing therapy for children who had a tendency to violence, providing a separate education program for foreign students and providing training by teachers who were their own citizens in separate classes were among the proposed solution obtained as a result of the research. Discussion: The opinions of the teachers were evaluated under the themes of positive opinions about foreign students, the level of achievement of outcomes, additional activities, experienced problems, the way teachers solve problems, and teachers’ suggestions for solutions. The study shows that the first problems of foreign students that need to be solved are language and communication problems. Also, parents are as important as students in teaching foreign students and that parents’ language skills are critical in terms of informing parents and conducting the process with school-family cooperation. Furthermore, it is of great importance that foreign students must not be alienated because of their culture, that they must not be excluded by other students, and that they must primarily be helped to ensure their adaptation and integration into culture and school through activities. Limitations: The study group of the research includes 29 primary and secondary school teachers who had at least one foreign student in their class and volunteered to participate in the study in one of the provinces of Middle Black Sea Region of Turkey. Conclusions: Based on the results obtained throughout the study, it is possible to say that taking into account the given recommendations can contribute to the solution of the problems of foreign students. Further research can be conducted in different context to shed light on different problems of foreign students experience and proposed solutions to these problems.

Perception of mothers about Acute Respiratory Infections (ARIs) and risk factors affecting children Under 5 Years (U5Ys) in Fiji

PurposeTo explore the perception of mothers about Acute Respiratory Infections (ARIs) and their risk factors affecting children Under 5 Years (U5Ys) in Fiji. DesignThis was a qualitative study done in the Integrated Management of Childhood Illness (IMCI) Clinic in Ba Hospital, Fiji. Mothers who had brought in their children with ARIs were selected through a purposive sampling method. A semi-structured open-ended questionnaire was used to guide in-depth interviews. The interviews were transcribed and the thematic analysis was done to look at the themes and sub-themes that emerged. ResultsA total of 30 mothers were interviewed. There were five themes that were derived from the interviews including the mothers' perception of ARIs; treatment methods; perceived barriers; services provided by IMCI clinic; and recommendations and suggestions. The mothers were familiar with the causes, risk factors and able to recognize severity of ARIs based on the local context. They mostly relied on traditional and home remedies for ARIs. Most mothers preferred injections for treatment for their child. There were many perceived barriers of ARIs prevention such as traditional norms and poor social support. Most mothers stayed in rural areas which caused poor accessibility to health care services. Few mothers had issues with poor attitude and skills of health care workers. ConclusionsThere are multiple factors that are barriers in reducing the risks of ARIs. There needs to be policies implemented to support the health of children in the communities as well as social support structures. Practice implicationsThis study provides a clear picture of the perception of the mothers regarding ARIs in children under five years old. With this information at hand, it is easier to answer the question regarding the perceptions of the mothers of ARIs and the risk factors and design tailored interventions to prevent ARIs among children.

Forest Governance Effectiveness of Community- and Government-managed Forests in Cameroon

Effective implementation of forest governance principles such as transparency, participation, accountability, coordination, capacity, user rights protection and security driven by positive government interventions are instrumental for sustainable forest management. The study used satellite-derived data to explore forest loss in community forest (CF) and government-managed forest in Cameroon from 2001 to 2014. The study also examined the extent to which community forest rights are legally recognised and protected and how government interventions undermine or promote CF management effectiveness in Cameroon. The rationale was to understand the forest outcome of different forest management approaches with varied user rights and management objectives. This is considering that community forest managers have been seen as better managers of forests than government agencies, if their full rights are well recognised and protected. We used semi-structured open-ended questionnaires, followed by focus group interviews with CF management institutions and document review for data collection. Forest loss showed significant increasing trends and was higher in CF than in other forest management types from 2001 to 2014. Stakeholder perceptions of CF rights and government intervention or actions varied between CF management institutions. Community forest rights such as rights to full ownership and control, full management, unlimited duration, alienation, and due process and compensation are not legally recognised and/or protected in community forestry in Cameroon, producing negative forest outcomes. Negative government interventions such as imposing excessive bureaucratic obstacles and initial financial investment in the processing of application files for CF applications and commercial user rights of timber harvesting, colluding with local elites, individuals and corrupt municipal and administrative authorities, and retaining full administrative ownership and control of CF land and resources, also produces negative forest outcomes. The non- recognition and protection of higher level CF rights and excessive negative government interventions in CF management contributes to undermining community’s willingness and readiness to prevent deforestation activities and voluntary engagement in conservation activities involving tree planting and management for long term community benefits. Therefore, recognising, strengthening and protecting all the CF rights proposed by the Rights and Resources Initiative and avoiding negative government interventions in CF management are helpful strategies in achieving the expected conservation and local development objectives of CF in Cameroon and in the Congo basin region.

Perception of School Committee Members (SCMs) on Factors Contributing to Overweight and Obesity Among High School Students in Kiribati: A Qualitative Study.

BackgroundSchools are vital settings for overweight and obesity prevention among children and adolescents. School Committee Members (SCMs) are crucial assets to engaging students with overweight and obesity prevention programs. This study aimed to determine factors contributing to overweight and obesity among high school students in Kiribati through the perception of SCMs.MethodsThis prospective qualitative study was conducted in four randomly selected senior high schools in South Tarawa, Kiribati, from August to November 2020. With a purposive selection of 20 SCMs employed at the four high schools, both male and female participants consented to participate in the study. A semi-structured open-ended questionnaire was used for data collection using focus group discussions (FGDs). Data were transcribed and analyzed using the thematic analysis method.ResultsTwenty participants were involved in FGDs with equal number of SCMs (n = 5) who attended FGDs for each school and 45% of them were female participants. Six themes were identified, namely, knowledge, behaviors, perceived status toward overweight and obesity, perceived action benefits, perceived barriers to practices, and proposed strategies to overweight and obesity prevention. These themes reveal that SCMs have a broad understanding and skill set for overweight and obesity causes and effects. However, the aptitude alone is not enough to prevent the occurrence, and thus, proposed feasible plans were voiced for responsible stakeholders to include in policy developments for overweight and obesity prevention.ConclusionThis study recognized that the knowledge-behavior gap is the main reason behind the failure in preventative strategic approaches among adolescents. As role models to students, SCMs and their schools should team up in implementing the public health policies and building mutual awareness and understanding with students and other specialist stakeholders for a more momentous and viable impact.