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Given the aging population, finding solutions to retain optimal cognitive capacity is a research priority. The potential of physical activity to reduce the risk of cognitive decline and to enhance cognitive functioning is established. Combining physical with cognitive activity has been put forward as a potentially even more effective way to promote healthy cognitive aging. Most studies on combined interventions have however been conducted in laboratory settings. This paper reports on a two-phased pilot study evaluating the acceptability and feasibility of a newly developed real-life cognitively enriched walking program for adults aged 65+ years. In Phase I, the feasibility and enjoyability of the cognitive tasks was evaluated by conducting walk-along interviews with older adults (n = 163). In Phase II, the cognitively enriched walking program was piloted in two groups of older adults (n = 19), and the feasibility and acceptability of the program and cognitive tasks was evaluated by means of questionnaires and focus groups. The cognitive tasks (i.e., median scores of ≥3 on a total of 4 (Phase I) and ≥6 on a total of 10 (Phase II) for most of the tasks) and the cognitively enriched walking program (i.e., median scores of ≥7 on a total of 10) were considered feasible and acceptable. Based on the input of the participants, key considerations for a feasible and acceptable program were defined: participants should be sufficiently challenged cognitively and physically, social interaction is an important motivator, cognitive tasks should make use of stimuli reflecting daily life and be conducted in group, the rationale for the tasks should be explained to participants, the frequency of the group sessions should be maximum 2 times a week, and the program should be supervised by a trained coach. These results warrant future research to establish the effectiveness of this program. [ABSTRACT FROM AUTHOR]

Nipa palms, a plant species in mangrove forest, are valuable and beneficial for the local community's economy as well as the conservation in the southern region of Thailand. This study aimed to investigate the use of nipa palms in Khanap Nak and focused on the type of products made from nipa palms and the yield of this plant through focus group discussion and interview with the farmers maintaining nipa palm forest. The results suggested that nipa palms in Khanap Nak can yield for 5–100 years. Apart from the benefits to the community in terms of sustainability, as it prevents erosion, it provides sources for the production of food (molasses, granulated sugar, syrup, and vinegar from sap) and raw materials (roofing material and cigarette paper from leaves and stem), which can generate income to community members. It was found that most of the communities earn 90–130 USD/day from palm sugar production. The quantity of nipa palm products varies in each season, resulting in different prices. In this regard, they can produce high quantity of products made from sap from January to March. However, the production of different types of sugar requires local knowledge and wisdom to ensure good quality. Nipa palm production is the sustainable way to utilize mangrove forest resources, leading to effective conservation and good life quality. Regarding problems and difficulties in farming, it was found that natural disaster is a major threat, such as drought, excessive amount of salt or freshwater in certain periods, and insect pests. [ABSTRACT FROM AUTHOR]

Background. Dietary diversification is considered the proxy indicator of dietary quality and nutrient adequacy during pregnancy. Pregnant women have been considered susceptible to malnutrition because of their increased nutrient demands and thus consuming a variety of foods in their diet plays a lion's role in ensuring adequate nutrient intake. So understanding bottleneck factors associated with dietary diversity practice is very crucial to encouraging adequate dietary diversity practice. Therefore, this paper aimed to assess determinants of dietary diversity practice among pregnant women in the Gurage zone, Southwest Ethiopia. Methods. A community-based cross-sectional analytical study was conducted among 726 pregnant women, 13 key informants, and 27 focus group discussion discussants in the Gurage zone, southwest Ethiopia, from 1 September to 1 November 2021. A face-to-face interviewer-administered questionnaire was used to collect the data. According to the Minimum Dietary Diversity Score for Women (MDD-W) tool, women who consumed more than or equal to 5 of 10 food groups in the previous 24 hours had a diverse diet. Epi data version 3.1 was used for data entry, while SPSSversion 26 was used for analysis. To determine factors associated with dietary diversity, bivariate and multivariable logistic regression models were used to obtain crude odds ratio (COR), adjusted odds ratios (AOR), and 95 percent confidence intervals (CIs). Statistical significance was determined using adjusted odds ratios (AORs) with 95 percent confidence intervals (CIs) and p values less than 0.05. In narrative form, qualitative results were triangulated with quantitative data. Results. The overall prevalence of the adequate dietary diversity practice was found to be 42.1% with 95% CI (48.4–46.1%) and the mean dietary diversity score was 5.30 ± 1.49 standard deviation (SD). Multivariable analysis revealed that primary school level [AOR = 6.471 (2.905, 12.415)], secondary school level (9–12) [AOR = 7.169 (4.001, 12.846)], college and above level [AOR = 32.27 (15.044, 69.221)], women with higher empowerment [AOR = 3.497 (2.301, 5.315)], women with a favorable attitude toward dietary diversity [AOR = 1.665 (1.095, 2.529)], women from wealthier households [AOR = 2.025 (1.252, 3.278)], and having well-secured food status [AOR = 3.216 (1.003, 10.308)] were variables that influence dietary diversity practice. Three FGD and 13 key informant interviews were conducted, and the results of qualitative data generated three major themes. Conclusion. The overall prevalence of adequate dietary diversity practice was found to be low in this study when compared to studies conducted in Ethiopia. Maternal educations, mothers' attitudes toward dietary diversity, women empowerment, food security status, and wealth index level of the household were determinant factors that influence dietary diversity practice in this study. Therefore, programs aimed to improve pregnant women's dietary diversity practice should focus on improving the socioeconomic status and creating a congenial environment to promote women's empowerment. [ABSTRACT FROM AUTHOR]

With a shift in moving towards the 4th industrial revolution, digital storytelling has been identified as a novel way of facilitating teaching and learning. This paper will be aimed at offering an understanding of the experience and perspective of occupational therapy students in using digital storytelling as a reflective tool as an assignment as part of their undergraduate and masters occupational therapy curriculum at a university in South Africa. A descriptive qualitative study was undertaken, and five participants were purposively recruited. Individual semistructured interviews were conducted as well as a focus group with participants. An inductive analysis revealed two themes: Reflections on relevance within the occupational therapy curriculum and Is technology the new direction? The findings conclude that digital storytelling as a medium to showcase reflections on identifying formation was an innovative and novel way of documenting the reflective experiences of occupational therapy students. [ABSTRACT FROM AUTHOR]

Hypertension is a lifelong disease that requires self-management. Additionally, there are disparities in hypertension self-management that disproportionately affect African Americans. Interventions designed in collaboration with older adults have the potential to improve hypertension self-management. The purpose of this design paper is to describe the process in which African American older adults and nurse researchers cocreated an intervention to address stress in the self-management of hypertension. A semistructured interview guide was used to elicit feedback on self-management behaviors to cocreate an intervention with the participants. Participants provided constant iterative feedback on the design used for the intervention. Participants prioritized the content and mode of delivery. African American older adults with hypertension (N=31; 87% women) participated in two focus group sessions. The primary stressors identified by the group that influenced their blood pressure self-management were as follows: (a) measuring blood pressure and using home blood pressure monitors; (b) difficulty communicating with family and friends; (c) sleep management and pain at night; and (d) healthy eating. Based on the participants’ feedback, we created four biweekly (2-hour) group sessions that incorporated their suggestions and addressed their concerns. Health care providers can use this technique to engage African American older adults in participant-centered hypertension self-management. [ABSTRACT FROM AUTHOR]

Aim. To identify the barriers and enablers to the implementation of a national policy to increase and develop the advanced nurse practitioner (ANP) workforce in Ireland. Background. The Department of Health (Ireland) introduced a policy to increase the number of ANPs to 2% of the nursing workforce. Evaluation provides information to inform successful policy implementation and development of ANP roles in healthcare services. Methods. Qualitative descriptive design. Twenty candidate ANPs participated in four focus groups. Nine key stakeholders were also interviewed. Results. Analysis identified four barriers: lack of infrastructural resources; delay in releasing and arranging replacements for candidate ANPs; role resistance from administration, allied healthcare professionals and other nurses; and lack of organisational readiness. The five enablers were: supportive physicians; Nursing and Midwifery Practice Development Units; supportive directors of nursing; role awareness and clarity; and educational preparation. Conclusions. This evaluation identifies barriers and enablers to the implementation of a national policy to increase the critical mass of advanced practitioners within the healthcare services. Evaluation at the implementation phase informed the roll-out of future advanced practice initiatives. Implications for Nursing Management. To support advanced practice development, leadership, infrastructure, and resource planning are needed to harness known enablers and address identified barriers to the implementation and sustainability of these posts. [ABSTRACT FROM AUTHOR]

Internationally, community healthcare is provided by personal health budgets or personalised schemes as part of a consumer-directed care emphasis. Although the introduction of a personalised scheme in Australia has improved the lives of many, people with psychosocial disability (PSD) and their families have experienced many challenges with service integration. Six focus groups with 17 National Disability Insurance Scheme (NDIS) support workers were conducted between June and November 2022. Participants were asked semistructured questions about their engagement with emergency department (ED) clinicians when presenting with a person with PSD and NDIS plan. They were also asked how they contribute to service integration to improve communication practices between the two services. A qualitative, descriptive thematic analysis approach was used. Results indicate there is a need for improved service integration pathways between the ED and NDIS services. The thematic analyses identified five main themes: the ED is harmful and not safe, but nowhere else to go; make the ED safe; further training for ED staff; improving communication across services; and alternatives to the ED. This study reports NDIS support worker's experience when supporting a person they are caring for in the ED. NDIS support workers have an understanding of the needs of the people they care for;their wisdom can contribute greatly to ED clinical responses in crisis care. Recommendations are offered to assist with service integration between the two systems. [ABSTRACT FROM AUTHOR]

Background. Improving the recruitment and retention of healthcare workers in the continuing care sector is critical to ensuring adequate care for older adults, which was highlighted following the COVID-19 pandemic. Purpose. The purpose of this study was to understand the perceptions of prospective registered nurses about working in the continuing care sector and identify workplace attributes that attract prospective nurses to the sector. Methods. A sequential mixed methods study was conducted with nursing students at Ontario Tech University. Focus groups (n = 14) asked students to comment on views about working in the continuing care sector, and job attributes that may attract them to the sector. Focus group data were analyzed using thematic analysis. Subsequently, a cross-sectional survey asked students to respond to elicited choice job scenarios that varied job attributes. The job attributes were shaped by the focus group interview data. To assess respondent's preferences, the survey data (n = 139) were analyzed to generate willingness-to-pay (WTP) values for each job attribute. Results. Focus group interviews suggested that fair compensation, optimal client-to-staff ratios, unionized work environments, comprehensive benefits packages, and flexible work arrangements were important job attributes. In survey results, 18.0% expressed interest in working in the continuing care sector compared to 75.5% in acute care. Regression analysis suggested that higher amounts of paid vacation (WTP: −5.983; 95% CI: −13.749 and −0.037) and higher risk of injury (WTP: 0.684; 95% CI: 0.124 and 1.208) were associated with work in the continuing care sector. Impact. Continuing care workplaces can attract nurses by offering flexible options such as part-time positions and paid vacation and by taking actions that can mitigate the risk of workplace injury, violence, and abuse. Nursing students should be shown the positive aspects of working with older adults and dispel negative perceptions about the continuing care sector. Further research is needed to understand the preferences for work and risk perceptions among currently employed nursing staff. [ABSTRACT FROM AUTHOR]

Background. The goal of qualitative research is to learn more about the opinions and experiences of the subjects being studied in relation to a particular question. There is a paucity of information on opportunities and challenges encountered to conduct qualitative research among the academic staffs in the health sciences. The purpose of this study was to examine the opportunities and challenges of conducting qualitative research among academic staff of health sciences in Ethiopia. Methods. A descriptive qualitative study design was conducted among health sciences academic staffs of selected public universities in Ethiopia. The study was conducted at three universities' health sciences colleges, namely, Addis Ababa University, Dilla University, and Wolaita Sodo University. Data were collected using focus group discussions, in-depth interviews, and key informant interviews. MAXQDA 2020 software was used for coding and data management. A thematic analysis approach was followed to present the results. Both inductive and deductive coding approaches were used. Results. Three main themes have been identified as follows: general research practice, opportunities for qualitative research, and challenges to conduct qualitative research. Participants indicated that the availability of research opportunities will have a good impact on qualitative research engagement. Availability of grants, funding, and other incentives and demand for qualitative research in healthcare were described as opportunities for qualitative research practice. Despite the available opportunities, study participants uncovered different challenges that encountered by health academic staffs in conducting qualitative research. Resource limitations, lack of knowledge, negative attitudes or beliefs, publication, and language issues were raised as main challenges. Conclusion. Qualitative research practices were found to be low among health sciences academics. Lack of resources, training, and expertise, problems associated with publication, a lack of funding, and a shortage of experts were the main challenges in conducting qualitative research in health sciences academic settings in Ethiopia. [ABSTRACT FROM AUTHOR]

Background. Chemotherapy can cause a range of side effects including nausea, vomiting, diarrhea, and infection, which can have a significant impact on an individual's quality of life. Survival outcomes can be impacted when side effects are poorly managed, leading to failure to complete the defined dose of treatment. Objective. This study presents clinicians' experiences with a shared care model involving home-based community nurse (CN) support to improve side-effect management of individuals receiving chemotherapy as an outpatient. Methods. A qualitative study was conducted with CNs, cancer nurses, medical oncologists, and a general practitioner involved in the CN intervention delivered as part of a randomized controlled trial (RCT) aimed at reducing unplanned presentations to hospital of cancer patients receiving outpatient chemotherapy. Semistructured individual and focus group interviews were conducted. Key themes were identified using thematic analysis. Findings. Twenty-three healthcare professionals were interviewed. Three themes were identified: (1) being able to enhance patient-centered care and clinical practice during chemotherapy; (2) importance of effective communication and collaborative relationships between different care settings; and (3) ways to adapt the intervention for implementation in routine clinical practice. Participants reported that it was feasible for CNs to care for this patient group, and their home visits enabled preemptive symptom management. Suggestions to improve and modify the intervention to implement this care model within existing clinical care included a flexible approach, such as a blended delivery with face-to-face visits and telephone calls; a risk- or needs-based approach to prioritize patient groups more likely to benefit from the intervention; and sharing of electronic medical records for more effective collaboration and communication. Conclusions. A CN-delivered shared care model provided a feasible approach to the provision of individualized support for outpatients receiving chemotherapy. This study suggests ways to adapt this care model into existing clinical workflow and structures. This trial is registered with ACTRN12614001113640. [ABSTRACT FROM AUTHOR]

Introduction. During the COVID-19 pandemic, there was a need to promote the most adequate behaviors. It is essential to know what aspects were implemented and what needs to be re-enforced. Objectives. (a) To identify the knowledge and behaviors related with preventive measures, lifestyle habits, sources of information, vaccination, and emotions generated and coping strategies and (b) to explore the personal experiences with respect to the knowledge, attitudes, and practices when facing COVID-19. Design. A convergent mixed method design. Setting and Participants. This study was conducted in the Segrià region (Catalonia, Spain) during the months of January and February 2022, with individuals 18 years old or older. Methods. Based on variables proposed by the WHO and a bibliographic review, an ad hoc electronic survey was utilized for the quantitative part, analyzed through frequency distribution or central tendency and dispersion measurements. For the qualitative part, two focus groups were analyzed through content analysis. Results. The participants (n QUAN = 1,559; n QUAL = 19) were aware about and applied the prevention measures, but when delving into it, deficiencies were detected especially when referring to hand-washing; lifestyles remained healthy; the population trusted the information from professionals (78.8%), but excess of information led to saturation; protection (75.3%) and herd immunity (47.2%) were recognized with vaccination; and the psychological impact (69.5%) was buffered with the activation of positive coping measures (99.1%), although it was maintained in more than half of them. Conclusions. This study showed that prevention measures must be re-enforced, especially hand-washing. Another revealing aspect was psychological impact, which, although coping measures were utilized, was maintained for another two years in most of them. This evidences the need for an intervention centered on this to guarantee the mental health of the population. Implications for Nursing Management. The detection of the current needs of the population provides the information necessary for the design of an adapted intervention and for promoting health education programs to address COVID-19 or other future health situations. [ABSTRACT FROM AUTHOR]

Although grandparents play a significant role in caring for their grandchildren in Asian culture, few studies have examined how grandparents from skipped families care for their children in rural areas. This study aims to explore grandparents' perceptions and experiences in providing care for their grandchildren in rural Thailand, where support is limited. Utilizing a qualitative approach, in-depth interviews and focus group discussions were conducted with 20 grandparents caring for children under 5 years old. The coding of interview transcripts was followed by thematic analysis. In this study, the participants shared their experiences about raising and caring for their grandchildren in rural areas. "We were held in bondage" is the overarching theme. Interviews revealed two main themes: (1) feeling of burden, divided into the following three subthemes: lack of parenting skills, worries regarding grandchildren's health and well-being, and emotional stress and financial/physical strain; (2) maintaining family bonds, which were further divided into the following subthemes: supporting adult children, being parents again, and becoming more loving and bonded. According to the findings, healthcare providers may be able to anticipate the needs of grandparents in rural areas and provide support, culturally relevant interventions, and training programs for grandparents to care for their grandchildren. Further research is essential to explore the dynamics of family bonding and responsibilities in Thai families and to develop interventions supporting these families. [ABSTRACT FROM AUTHOR]

In the present study, the diversity of medicinal plants and associated traditional medicinal knowledge of the rural community in the Ameya district in Ethiopia was assessed and documented. A survey was conducted through semistructured interviews, guided field walks, focus group discussions, and field observations. The snowball and purposeful sampling techniques were employed to select general and knowledgeable informants, respectively. Accordingly, a total of 210 respondents, 156 (74.3%) males and 54 (25.7%) females, were participated in this study. The informants were selected from seven kebeles (the lowest administrative units) following the recommendations of the local community for the availability of traditional medicinal plant use practice. Descriptive statistics, preference ranking, fidelity level, informant consensus factor, and direct matrix ranking were used to analyze and present the data. A total of 78 medicinal plants represented in 70 genera and 40 families were identified. Croton macrostachyus and Dodonaea viscosa were the most preferred species used to treat wounds, whereas Cucumis ficifolius and Phragmanthera macrosolen were the most popular species applied to treat stomachache. Leaves (38%) and roots (20%) were the most predominantly used plant parts for remedial preparation to treat 42 human ailments. The informant consensus factor (ICF) value ranged between 0.45 and 0.81, with the respiratory diseases category scoring the highest ICF value. The fidelity level (FL) value for the medicinal plants ranged from 24 to 95%. Considerable proportions (55.5%) of the medicinal plants were collected from wild habitats. Higher ICF (0.81) and FL (>90%) scores indicate the presence of rich traditional knowledge in the community. This knowledge can be used to select medicinal plants (such as Croton macrostachyus, Cucumis ficifolius, Dodonaea viscosa, and Phragmanthera macrosolen) for further pharmacological and phytochemical studies. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to explore the influencing factors to the practice of cardiovascular disease (CVD) preventive behaviors among rural residents based on socio-ecological model (SEM). Methods. We used a mixed-methods research using the sequential explanatory design. From a total of 109 participants, quantitative data including CVD preventive behavior, self-efficacy, social support, and sense of community were collected using previously developed measurement tools. For quantitative research, descriptive statistics and Pearson correlation analysis were conducted. For quantitative research, descriptive statistics and Pearson correlation analysis were conducted. Questions for qualitative research were constructed based on SEM for the three subareas identified in quantitative research. Qualitative content analysis was conducted on qualitative data collected through focus group interviews from 14 participants. Results. According to quantitative research results, participants had a low level of practice in physical exercise, stress management, and self-checking among seven subdomains. At the individual level, self-efficacy was positively correlated with sleep management, and at the interpersonal level, family support was positively correlated with smoking cessation and support from significant others was positively correlated with stress management. On the other hand, at the community level, sense of community did not show significant correlation with the practice of cardiovascular disease prevention. Next, according to qualitative research results, 8 themes were identified in three levels as obstacles. At the personal level, overwork, loneliness, and lack of knowledge about CVD; at the interpersonal and community level, decreased activities with residents due to increased individualistic tendencies and decreased sense of community; and at the community environmental level, inconvenience of sidewalks, lack of community space, and insufficient functioning of village health clinics. Conclusion. In order to reduce obstacles to health behavior practice to prevent cardiovascular disease, multidimensional efforts are needed in terms of socio-ecological aspects. [ABSTRACT FROM AUTHOR]

This paper reports on and synthesizes new research that examines how a collaborative community response can promote successful aging in place for older adults with hoarding behaviour. Through interviews with older adults with hoarding behaviour, who used a particular community support and a focus group interview with members of the community collaborative that directed supports for this population, our findings suggest that there were valuable outcomes for both groups. These older adults with hoarding behaviour were able to remain in their own homes, their safety was enhanced, their sense of isolation was minimized, empowerment was fostered, and they gained valuable insight into their behaviour. The members of the community collaborative were able to access the expertise of other professionals, maximize their own expertise, and they generated an enhanced understanding of the experience of older adults living with hoarding behaviour in Edmonton. This study is a significant addition to the much too sparse literature about the community planning needs of older adults with hoarding behaviour. It offers knowledge that is integral to theories and principles of better aging in place but attempts to translate this into practice. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to further elucidate the importance of social relationships and social connectedness with aging in place and in developing elder-friendly communities. The process used in this study was inclusive of younger adults (age 40-65) as well as older adults (65+) in order to further understand how they envision a community that could support their own aging in place. A community forum, using the World Café format, was conducted in order to engage community members, 40 years and older, in conversation about the importance of social connectedness in elder-friendly communities. A second purpose of this forum was to obtain data on what would keep aging boomers in their community as they age. Three major themes emerged from qualitative analysis of the forum: social reciprocity, meaningful interactions, and structural needs/barriers. The results of this study reinforce the importance of social connectedness in creating and maintaining elder-friendly communities for older adults, as well as soon-to-be retired individuals, wishing to maintain life connectedness to their community. The study suggests the possibility of using more nontraditional research techniques (such as the World Café process) for gathering community level data. [ABSTRACT FROM AUTHOR]

This study aimed to explore the attitudes of teachers toward type 1 diabetes (T1D) and its management. Teachers working in kindergartens and schools (N = 30) participated in audio-recorded, semi-structured interviews (three focus groups and 20 individual interviews) that were transcribed and analyzed using thematic analysis. We used the theory of the three components of attitude as a framework for the analysis. The three components of attitude emerged during the analysis: knowledge, positive and negative emotions, approaches, and opinions toward diabetes and its management and behavior. The main theme of knowledge included knowledge about diabetes in general and its management. Besides medical treatment, alternative treatment possibilities were mentioned by the participants. The affective component revealed empathy, integrating, and segregating approaches toward children living with diabetes. The behavior component revealed how teachers contribute to the care and integration of children with diabetes in schools. They support children with diabetes by the virtue of their profession. For example, they teach them health awareness and support their integration through peer education and sensitization. The findings indicated that, in addition to diabetes management tasks, teachers could help children with T1D by tutoring them and their peers about health awareness and T1D acceptance. [ABSTRACT FROM AUTHOR]

Background. Community engagement is crucial for effective and sustainable sexual and reproductive health and rights (SRHRs) promotion. Community engagement in community-based health promotion initiatives is contextual and influenced by individual, community, and societal factors. In South Africa, community engagement in SRHR promotion is challenging due to numerous historical and contemporary factors including the socionormative community context and socionormative perceptions regarding SRHR matters. There is little empirical literature to guide community-based practitioners working in health promotion in understanding the contextual influences on community engagement with SRHR promotion generally or in South Africa specifically. Objective. This research aimed to explore the influences on community engagement in community-based SRHR promotion initiatives in the Eastern Cape, South Africa. Methods. An ethnographic and multiqualitative study was conducted in the Eastern Cape, South Africa, involving 78 purposively and conveniently sampled participants. Findings. Three superordinate themes influence community engagement with SRHR promotion in South Africa (i) representations of the issues; (ii) perceived relevance of SRHR issues and SRHR promotion; and (iii) the relational environment, often operating in interactive ways. The themes are presented in a conceptual framework. Conclusions. Influences on community engagement in SRHR promotion in the Eastern Cape of South Africa are highly contextual. The conceptual framework arising from the study's findings could be used in community-based health promotion and primary health care in other settings to develop the understanding of factors influencing community engagement in SRHR or other sensitive or emerging health issues, and inform relevant and appropriate design and implementation of community-based initiatives. [ABSTRACT FROM AUTHOR]

The purpose of this study was to carry out an ethnobotanical and ethnopharmacological investigation on wild edible plants and their value to households in the Tach Gayint district of South Gondar Zone of northwestern Ethiopia. A total of 175 informants (56 women and 119 males) were interviewed for ethnobotanical data, and 25 of them were key informants. Data collection techniques included semistructured interviews, guided field walks, and focus group discussions. Quantitative analytical tools were employed for ethnobotanical methods including preference ranking and direct matrix ranking techniques to analyse the data. 36 species of wild edible plants have been identified in the study area. Of these plant species, shrubs account for 15 (42%), followed by herbs 13 (36%) and trees 8 (22%). Regarding the edible parts, fruits account for 19 (53%) followed by young shoots, leaves, and flowers, 4 (11%) for each. These plant species are eaten raw (86%) or cooked (14%) and most are collected by younger people for herding cattle. According to the preference ranking analysis, the fruit of Opuntia ficus-indica is the most preferred plant species because its sweet taste. Although Cordia africana, the most commonly used multipurpose wild edible plant species, is mostly exploited due to human activity, activities such as the production of charcoal, the gathering of firewood, the construction of homes, and the use of agricultural tools all played a significant role in the plant's eventual extinction. In the study area, agricultural expansion was the main cause of putting wild edible plants in danger. It is best to cultivate and manage edible plants in a backyard garden and to perform more research on popular edible plant species. [ABSTRACT FROM AUTHOR]

People from refugee backgrounds generally have long and stressful journeys that involve involuntarily fleeing their homes and often include dislocation from family and friends. Food is integral to settlement when arriving in a destination country, as it is entwined with self-identity, culture, and connectedness to family and community. The aim of this study was to understand the facilitators and barriers of accessing cultural foods during the settlement journey for families with a refugee background, from the perspectives of workers who support the settlement journey. The study used participatory action research methodology to conduct focus groups with settlement and other workers who regularly interacted with people from refugee backgrounds, spoke English, and preferably self-identified with a refugee background. Participants were recruited through community organisations in Brisbane, Australia, and focus groups were held at workplaces or online. Eight focus groups (n = 32) were conducted between June and October 2021. The main theme was that food security, culture, and mental health were interrelated. When cultural food access, culture, or mental health were maintained or adversely impacted, all three factors were likewise affected. The behaviours around purchasing cultural foods were motivated by the desire to express and validate culture, which in turn improved mental health. It was also found that individual and community support systems sustained access to cultural foods, while social, environmental, institutional, and political structures impacted this access, sometimes detrimentally. This study highlights the need for interventions that foster social capital for families with refugee backgrounds and consider food security, culture, and mental health collectively. In addition, there is a need for increased awareness of the settlement journey, and for cultural inclusivity to be integrated into government policies, by working with communities and providing opportunities for people to express their culture, improve access to cultural foods, and maintain mental health. [ABSTRACT FROM AUTHOR]

Indigenous women encounter increased stressful life experiences such as socioeconomic insecurities as well as inequities in health services and outcomes. These stress inequities, which stem from the historical and ongoing effects of settler colonialism, also worsen health outcomes for those women living with HIV. As a part of a broader research project on the impacts of stress-reducing interventions for indigenous women, this study examines the experiences of the women who facilitated the intervention. This research was conducted to evaluate the impacts of a biweekly stress-reducing intervention conducted in Thunder Bay, Ontario. The facilitators of the intervention participated in a focus group in 2019 where they detailed the reach, effectiveness, adoption, and implementation of the intervention. The results suggest that effective stress-reducing interventions should strive to be accessible and inclusive and that doing so can increase program engagement with the service organization hosting the intervention. Further, the results highlight the strengths and challenges of the intervention, including how it helped foster leadership skills and increased indigenous cultural learning among facilitators. These findings demonstrate the strength of community-led interventions and subsequent opportunities for facilitators to grow as leaders. Further, the study highlights how this style of intervention can also encourage participants to engage in other health and wellbeing programs offered by the community partner hosting the intervention. These findings suggest that interventions aimed at reducing stress among indigenous women facing socioeconomic insecurities, including those living with HIV, are both feasible and beneficial for participants, facilitators, and the nonprofit service organizations delivering them. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop a questionnaire which investigates perspectives regarding healthy aging among old patients with chronic illness. This study used qualitative and quantitative methods, including in-depth interviews, focus groups, and surveys between 2014 and 2016. Participants were recruited from the outpatient department of a medical center and a community healthcare center, 23 for interviews and 332 for surveys. The exploratory factor analysis was applied to identify the domains of the questionnaire and reduce the number of scale items. Criterion validity and reliability were evaluated. The final instrument (19 items) comprised the following four domains affected by disease: physical and psychological changes; living environment changes; social relationship changes; and changes in family life. The instrument explained 62.71% of the total variance in healthy aging perspectives. Criterion validity was supported by a significant correlation of the questionnaire with the World Health Organization Quality of Life scale (r, range: 0.14–0.65). The internal consistency of the questionnaire was 0.8 (Cronbach's α, range: 0.71–0.89). The questionnaire is a valid and reliable instrument useful for examining healthy aging perspectives in older adults with chronic diseases. To enhance healthy aging for older persons with chronic disease, policy makers should acknowledge that elderly with chronic diseases not only have healthcare needs but also need attention regarding their psychological health and social and environmental relationships. The healthy aging perspectives questionnaire (HAPQ) can help clinicians to determine how to approach their older patients with chronic diseases to promote healthy aging. [ABSTRACT FROM AUTHOR]

Introduction. Executive functions (EFs) are strongly linked to attention deficit hyperactivity disorder (ADHD). The pictorial interview of children's metacognition and executive functions (PIC-ME) assesses children's self-perceptions regarding their EF. This study is aimed at describing the cultural adaptation of the PIC-ME to the ultra-Orthodox (UO) Jewish population in Israel. Method. In the first of three stages, 30 occupational therapists, who were experienced in working with children with ADHD from the UO population, completed a questionnaire about the suitability of PIC-ME for the UO community. In the second stage, six therapists participated in a focus group to discuss the recommendations and the adaptations made following the first stage. In the third stage, 20 UO children aged 5–10 participated in the tool validation process. Results. First stage: most of the items of the original tool were found to be appropriate in representing the EFs of UO children and did not need to be adapted. No significant differences were found between the boys' and girls' versions regarding the tool's adaptability. However, most of the therapists suggested that the pictures in both versions needed adaptations. Second stage: additional recommendations led to the development of a final adapted version. Third stage: over 70 percent agreement was found among UO children regarding the clarity of the adapted pictures. No significant differences were found between boys and girls or between age groups. Conclusions. This study presented wide agreement on the necessity for cultural adaptation of the PIC-ME to the UO population and described the adaptation process. Based on its face validity, the UO version may be a useful tool to assess the self-perception of EF among UO children. Further studies are needed to assess its psychometric properties and its usefulness as an outcome measure. The study findings may contribute to the cultural adaptation of other tools for culturally distinct populations. [ABSTRACT FROM AUTHOR]

Introduction. The South African government introduced a reengineered primary healthcare approach to promote universal health coverage. The approach was to ensure equitable, efficient, and quality health services for consumers in private and public healthcare sectors. The transition toward a more comprehensive primary healthcare approach to intervention requires occupational therapists who predominantly worked in private and hospital settings to extend their services to clients who previously would have had little access to such services. This study was conducted to identify the key competencies required by occupational therapists to deliver appropriate primary healthcare services to communities from previously disadvantaged periurban and rural areas. Methods. An exploratory, qualitative study design was used. Through the use of policy documents and data from key informants (n = 5), established therapists (n = 14), and novice occupational therapy graduates (n = 39), the study identified and mapped the stakeholders' perspectives of the competencies required by graduates to practice in periurban and rural settings in KwaZulu-Natal in South Africa. Data was collected using semistructured interviews, a focus group discussion, a document review of the university's curriculum, and the local and global regulatory documents. A framework based on the seven roles of the university's competency framework informed the data analysis process. The seven roles are health practitioner, communicator, collaborator, health advocate, leader and management, scholar, and professional. Findings. Participants highlighted the need for graduates to have adequate knowledge and understanding of the impact of the Department of Health policies and social determinants of health on occupation and the client's health. They also needed to be suitably skilled in culturally sensitive communication, negotiating shared goals with the stakeholders, and managing a department. Graduates needed to be socially accountable and develop services to advocate for their clients. Conclusion. The study offered insights into the essential graduate competencies identified by the stakeholders and recommended measures to prepare rehabilitation graduates for service delivery in primary healthcare contexts. [ABSTRACT FROM AUTHOR]

The purpose of the study is to consider the factors influencing the development of the culture of interpersonal relationships and the effectiveness of the influence of cognitive therapy on improving social adaptation skills. The method of cognitive therapy included several types of activities. The first type of activities included group sessions, during which the weaknesses of the interaction and their correction were identified. The second type was conducted in the format of teaching standard models of interaction between people. The third type of activity aimed to teach children to build a dialogue with each other and express their desires and emotions. Classes were held 3 times a week throughout the year. The study was attended by pupils of 5-7 grades of Zhanuya boarding school and special correctional boarding school No. 7 for children with intellectual disabilities. The results of a randomized study demonstrated an increase in the indicators of teamwork skills, self-control, emotional stability, and independent decision-making. The indicators of cheerfulness, openness, sociability, and logical thinking also improved. But the factor of antisocial behavior decreased. All of these indicators directly affect socialization. This strategy can be applied in practice in various specialized boarding schools and schools for children with intellectual disabilities. [ABSTRACT FROM AUTHOR]

The paper is initiated to design appropriate conservation strategies and breeding scheme for Fogera cattle breed that will be used as a guide for other Ethiopian indigenous cattle breed. Two types of data, on-farm and on-station, were used; the on-farm data was collected from three districts, namely, Fogera, Dera, and Bahir Dar Zuria; those are expected as the home of the breed. A total of 150 farmers, which are knowledgeable and having at least one cattle of Fogera phenotype in their herd, were purposively selected and interviewed. Additionally, farmer’s focus group discussion (FGD) was conducted to capture the historical background, population, and distribution of the breed. SPSS (version 16) and index method was used to analyze the quantitative and scoring data’s, respectively. A meeting at national and regional level was also conducted to evaluate the existing conservation strategy and to identify the major stakeholders for the strategy. The main reasons to conserve Fogera breed are due to presence of interrelated constraints, presence of unique traits of the breed, better attitude of farmers, and decreasing population trend of the breed. Community-based in situ conservation strategy, to ensure the participation of the community, was designed for the breed. With the conservation strategy, related activities like feed development, animal health interventions, market linkage, and development of cooperatives will be implemented to improve the working environment. The stakeholders that are identified as an actor in the strategy should realize their honest participation for the sustainability of conservation and improvement of the breed. [ABSTRACT FROM AUTHOR]

This study explores the palliative care capacity of social workers in Flanders. First, it examines the frequency with which social workers in Flanders are currently performing palliative care tasks. Second, this study assesses their attitudes and competencies regarding the performance of these tasks. Third, as contextual factors also influence this performance, this study explores the level of appreciation experienced by social workers in Flanders. To achieve these objectives, a mixed-methods explanatory sequential design was used. Quantitative data were collected by distributing electronic survey questionnaires on QUALTRICS© to a theoretical sample of social workers in Flemish hospitals, community health clinics, nursing homes, home care, and health insurance services. A total of 499 social workers completed the survey in April and May 2021, of whom 352 met the eligibility criteria and were retained for analysis. Qualitative data were collected based on online focus groups between June and September 2021, in which a total of 24 social workers discussed the main survey results. Transcripts from the focus groups were analysed by using the framework method. The results indicate that the current palliative care capacity of responding social workers in Flanders is limited to tasks related to client assessment and referral, while their potential role extends beyond these tasks. With an expanded role, social workers would be better able to address the social dimensions of care, engage in politicising work, and, in turn, contribute to a holistic and multidimensional approach to palliative care. However, this study illustrates the need to increase the competencies and actual involvement of social workers in tasks associated with this expanded role. [ABSTRACT FROM AUTHOR]

In these perspectives, we share the experiences of eight cochlear implant (CI) recipients who are musicians, and their efforts within and outside of audiological appointments to achieve satisfying music experiences. Their experiences were previously shared in a panel discussion as part of the 3rd Music and Cochlear Implant Symposium hosted at The University of Cambridge, United Kingdom. Following the symposium, the panel members and moderator developed and completed a follow-up questionnaire to facilitate a formal analysis of the following questions: (a) What forms of support for optimizing music exist within clinical CI appointments, including counseling, mapping, assessment, and rehabilitation? (b) What forms of support do CI users who are interested in music desire? (c) What self-initiated approaches can be used to improve music perception, enjoyment, and participation? Using qualitative methodology, the questionnaire data were coded, aggregated into themes, and then into core categories. The primary themes that emerged from the data were (a) limited levels of support for optimizing music outcomes within normal clinical appointments, (b) difficulties in current mapping and assessment in relation to music perception, and (c) limited availability of clinically sponsored training/rehabilitation for music. These CI recipients then recommended clinical protocol changes and described self-initiated rehabilitation. These findings were examined in relation to literature on clinical practices for CI users, auditory rehabilitation, and patient-centered care, emphasizing best practices and barriers to audiological care. The data as related to healthcare trends were conceptualized and developed into a proposed Reciprocal Model for Music Rehabilitation (RMMR). [ABSTRACT FROM AUTHOR]

The conflicts between humans and wild animals with the same resources are common but seldom reported in Ethiopia. This study was carried out to assess the causes, impacts, and mitigation strategies of the local communities with human-wild animal conflict (HWC) in and around Amba forest of Ezha District, Gurage Zone, Ethiopia: implications for wildlife conservation. Cross-sectional study design was applied, and data were collected from November 2019 to July 2020 through a semistructured questionnaire, focus group discussion (FGD), and field observation. A total of 53 respondents were randomly selected. The data were analyzed using SPSS software, and the results were presented using tables, graphs, charts, and text. The study result revealed that human-wild animal conflict exists, and it was seriously occurring at various places, time, and seasons. Papio anubis, Potamochoerus larvatus, Cercopithecus aethiops, Hystrix cristata, and Crocuta crocuta were the main conflicting wild animals, respectively. Abundance of wild animals, presence of forest, crop raiding, expansion of agriculture, and livestock predation were the main causes of conflict in the study area. There was a statistically significant relation between conflict and the cause of conflict (χ2(5)= 17.075, p = 0.004). Psychological and economic impacts were the main impacts encountered. Most of the respondents (86.8%) had applied conflict mitigation strategies, but it was ineffective, although the trend of conflict was increasing. Many of the respondents (41.5%) had a negative attitude toward wild animals, but 58.5% encouraged wild animals' conservation. HWC had increasing trends of conflict, and thus, a negative attitude was developed by the communities on wild animal coexistence and conservation. Therefore, awareness creation, training, and promoting coexistence mechanisms between humans and wild animals are necessary in the study area. [ABSTRACT FROM AUTHOR]

Research related to reception studies on queer representation in fiction within higher education institutions (HEIs) is a vastly unexplored area in Sri Lanka. This study intends to fill the gap in existing research by prioritising the need to factor in receptors' positions and practices in teaching and learning these works. This research aims to understand, deconstruct, and explore the varied positions and practices of receptors (lecturers and students) in the teaching and learning of a selected Sri Lankan English fiction, Funny Boy (1994) by Shyam Selvadurai at local universities. The contextual and pedagogical site selected includes three universities in the Western and Eastern provinces of Sri Lanka. The methodology of the study incorporates a qualitative research design to conduct a reception analysis. The primary data collection methods are in-depth interviews with three lecturers and two students and a focus group discussion with three students. The findings of this research identify and analyse the frames of reference, pedagogies, approaches, and strategies involved in the teaching and learning of the selected fictional work. These enable the analysis of varied reception positions and practices to explore their possibilities of incorporating critical and queer pedagogies to ensure a transformative learning experience within HEIs. [ABSTRACT FROM AUTHOR]

Introduction. Practices of occupational therapists, particularly those supporting older persons with physical impairments, remain overly focused on remediating impairments, and implementation of occupation-centered practices remains fraught with difficulties. In Japan, this issue exists across the continuum from acute care to rehabilitation settings and into the community. This is despite the existence of international models and frameworks that place occupation at the core of the profession. Accordingly, there is a need to better understand how occupational therapists respond to the call for occupation-centered practices across the said continuum of care with this population. The aim of this study was at exploring and understanding occupational therapists' experiences of supporting the resumption of occupations among older persons with physical impairments, in Japan. Methods. Embedded in a constructivist world view, this was a qualitative focus group study. Four focus groups (two in urban areas and one each in rural and semirural areas), consisting of seven or eight occupational therapists with at least three years of relevant practice experience, convened twice to narrate and explore their support of older persons. All were participating voluntarily with confidentiality of their participation being guaranteed by the researchers. They met for a third time to verify emerging analytic results. Data were analysed using a reflective thematic analysis. Results. Identified were three themes, namely, calling forth powers of occupations, imagining client's future, and cocreating plots, which we synthesized into recurring cocreations from emerging opportunities. Discussion. Supporting the resumption of occupations among older persons with physical impairments hinges on repeated processes of identifying possibilities for occupation, followed by actions to bring these (e.g., images of clients' future) into reality. Occupations' healing properties (i.e., occupations' powers) can be used to assist clients in experiencing health and well-being. The results suggest a reframing of occupational therapy practices as recurring processes of recognizing opportunities for occupation, followed by actions whereby these possibilities are turned into reality. Occupational therapy effectiveness might be enhanced when goals and methods are repeatedly and creatively aligned with the evolving plots cocreated between the client, therapist, and stakeholders. [ABSTRACT FROM AUTHOR]

Background and objectives. Edentulism is a major public health concern globally relating to extensive loss of teeth. Due to paucity of study, this research aimed to explore the perception of edentulous patients (EDPs) and dental professionals (DPs) towards care and maintenance given to complete denture prostheses (CDP) in Fiji. Methods. A descriptive qualitative study was conducted among 30 EDPs attending dental prosthetic clinics (DPCs) at the four centres in Fiji and 28 DPs at the four DPCs under purposive sampling. Semi-structured questionnaire with open-ended questions was used for in-depth interview (IDI) with EDPs via telephone and focus group discussion (FGD) with DPs virtually via Zoom. Participant responses were recorded and thematic analysis was used to manually analyze the verbatim transcripts. Results. Five themes were identified as perceptions of EDPs towards care and maintenance of CDP in Fiji: patient perceptions towards CDP, CDP care and maintenance, communication between DPs and EDPs, challenges faced in CDP, and management strategies to CDP care and maintenance. Seven themes were identified as perceptions of DPs: CDP guidelines, post-denture insertion advice, care and maintenance, challenges while treating EDPs, management strategies to challenges faced, communication and teamwork, and recommendations to improving quality of CDP delivery in Fiji. Conclusion. Patients' perception towards care and maintenance of CDP was low. It is highly recommended for EDPs to adhere to CDP advice given by DPs whilst for DPs, it had been recommended to provide written, oral, and visual forms of CDP care and maintenance advice to EDPs for effectiveness. [ABSTRACT FROM AUTHOR]

Background. Nursing home (NH) residents often experience burdensome and unnecessary care transitions, especially towards the end of life. This paper explores provider perspectives on the role that families play in the decision to transfer NH residents to the emergency department (ED). Methods. Multiple stakeholder focus groups (n=35 participants) were conducted with NH nurses, NH physicians, nurse practitioners, physician assistants, NH administrators, ED nurses, ED physicians, and a hospitalist. Stakeholders described experiences and challenges with NH resident transfers to the ED. Focus group interviews were recorded and transcribed verbatim. Transcripts and field notes were analyzed using a Grounded Theory approach. Findings. Providers perceive that families often play a significant role in ED transfer decisions as they frequently react to a resident change of condition as a crisis. This sense of crisis is driven by 4 main influences: insecurities with NH care; families being unprepared for end of life; absent/inadequate advance care planning; and lack of communication and agreement within families regarding goals of care. Conclusions. Suboptimal communication and lack of access to appropriate and timely palliative care support and expertise in the NH setting may contribute to frequent ED transfers. [ABSTRACT FROM AUTHOR]

The interaction of distributed robotics and wireless sensor networks has led to the creation of mobile sensor networks. There has been an increasing interest in building mobile sensor networks and they are the favored class of WSNs in which mobility plays a key role in the execution of an application. More and more researches focus on development of mobile wireless sensor networks (MWSNs) due to its favorable advantages and applications. In WSNs robotics can play a crucial role, and integrating static nodes with mobile robots enhances the capabilities of both types of devices and enables new applications. In this paper we present an overview on mobile sensor networks in robotics and vice versa and robotic sensor network applications. [ABSTRACT FROM AUTHOR]

The main purpose of this research was to explore the lived experience of students who learn postgraduate classes without having prior work experience. To achieve the intended objective, the team of researchers used a qualitative research approach. The phenomenological research design was used to have the real lived experience of novice scholarship students. Data were collected through in-depth interviews, focus group discussion, and unstructured participant observation. The participants were ten postgraduate students who enrolled in the College of Education and Behavioural Sciences at Bahir Dar University. Data analysis was guided by Smith's Interpretative Phenomenological Analysis, and we construct themes based on data we obtain from participants. The study revealed that postgraduate students with no prior work experience have both good and bad experiences. The good experiences were related to the opportunity they have to learn at a young age, and the bad experiences were the challenges they faced as a result of being novices in the work environment. They faced psychological challenges, economic challenges, language-related challenges, lack of information about the world of work, sexual harassment, and other challenges. At the end of the research, we infer implications based on the findings of the research. [ABSTRACT FROM AUTHOR]

Persons with post-COVID-19 conditions have prolonged symptoms and longer-term consequences which can prevent them from returning to previous everyday functioning. Fatigue is the most frequent symptom reported in literature. Occupational therapists (OTs) are specialized in client-centered problem analysis, counseling, and education to recover occupational engagement and performance in everyday life. Since the beginning of the COVID-19 pandemic, OTs have been challenged to respond with services adequate to the needs of this patient group. Energy management education (EME) was initially developed for persons with multiple sclerosis-related fatigue and then made independent of diagnosis suitable to persons living with chronic disease-related fatigue. EME, a structured self-management education, is becoming a part of the new services. This study was aimed at exploring the initial experiences of OTs using the EME protocol and materials with persons with postacute COVID-19 and/or post-COVID-19 condition-related fatigue and gathering their recommendations for improvements and adaptions. One online focus group discussion took place in May 2021 with OTs experienced in using the EME protocol. The topics addressed were the institutional context of the OTs and their experiences during the treatment. A thematic analysis was performed. According to nine OTs working in different settings in Switzerland, the EME protocol is exploitable in both in- and outpatient settings and was judged appropriate by them, even if the EME materials can be improved. The main challenges for the OTs were the short period their patients had lived with fatigue; the discrepancy between self-concept, self-perception, and performance; and the insecurity, fear, and anxiety related to recovery. Further research is needed to include the perspective of EME participants and to measure quantitative outcomes such as fatigue impact, self-efficacy, occupational performance, and quality of life. Until the existing EME protocol is improved, it is applicable to persons with post-COVID-19 condition-related fatigue. [ABSTRACT FROM AUTHOR]

In the modern global economy, members' active participation is critical to the successful implementation of cooperative groups' planned activities. The objectives of this study were to investigate the participation of cooperative members in MPPCs activities and to determine the factors that influence the participation of members in multipurpose cooperatives in the Kindo Koysha district. The study location was chosen for this purpose because no prior in-depth research had been conducted. The multipurpose primary cooperatives were chosen from among the four in the study area based on agro-ecological classifications such as high land, medium land, and low land. The target population of 752 people (M = 594 and F = 158) was chosen using a simple random sample technique with a probability proportional to the size sampling technique (PPS), whereas 106 sample respondents (M = 84 and F = 22) were chosen using (Yamane) implified formula. Primary data were collected using the interview schedule supplied to sample respondents, focus group discussion checklists, and key informant interviews. Secondary data were also collected from several public and unpublished sources. The level of participation in multipurpose cooperatives was measured by computing the participation index score value. The participation of members has been classified as low, medium, or high based on the mean value, which is 40 (37.5%), 50 (47.2%), and 16 (15.1%), respectively. The ordered logit model was utilized for data analysis, and percentages, mean differences, one-way ANOVA, Spearman correlation, and the chi-square test were performed. According to the findings, education level, family size, total annual income, shareholding amount, access to saving and credit, distance from the cooperative service center, access to and utilization of agricultural inputs, services rendered by MPPCs, perceived challenges of MPPCs that discourage membership, and perceived members satisfaction with cooperative services are the determinant factors that affect the level of membership participation. Continuous education and training, encouraging the issue of family planning, diversification of income-generating schemes, encouraging existing members to buy additional shares, creating the best opportunity for saving and credit, need-based supply of agricultural inputs, resolving the internal and external constraints of multipurpose cooperatives, and strengthening the MPPCs through research-based technical support and follow-up are some of the suggested implications. [ABSTRACT FROM AUTHOR]

CAM therapies are often dismissed as "no better than placebo;" however, this belief may be overcome through careful analysis of nonspecific factors in healing. To improve trial methodology, we propose that CAM (and conventional) RCTs should evaluate and adjust for the effects of intrapersonal, interpersonal, and environmental factors on outcomes. However, measurement of these is challenging, and there are no brief, precise instruments that are suitable for widespread use in trials and clinical settings. This paper describes the methodology of a project to develop a set of patient-reported instruments that will quantify the nonspecific or "placebo" effects that are in fact specific and active ingredients in healing. The project uses the rigorous instrument-development methodology of the NIH-PROMIS initiative. The methods include (1) integration of patients' and clinicians' opinions with existing literature; (2) development of relevant items; (3) calibration of items on large samples; (4) classical test theory and modern psychometric methods to select the most useful items; (5) development of computerized adaptive tests (CATs) that maximize information while minimizing patient burden; and (6) initial validation studies. The instruments will have the potential to revolutionize clinical trials in both CAM and conventional medicine through quantifying contextual factors that contribute to healing. [ABSTRACT FROM AUTHOR]

Women in low- and middle-income countries (LMICs) have yet to benefit from recent advances in breast cancer diagnosis and treatment now experienced in high-income countries. Their unique sociocultural and health system circumstances warrant a different approach to breast cancer management than that applied to women in high-income countries. Here, we present experience from the last five years working in rural Bangladesh. Case and consecutive series data, focus group and individual interviews, and clinical care experience provide the basis for this paper. These data illustrate a complex web of sociocultural, economic, and health system conditions which affect womens' choices to seek and accept care and successful treatment. We conclude that health system, human rights, and governance issues underlie high mortality from this relatively rare disease in Bangladesh. [ABSTRACT FROM AUTHOR]

While preceptors are a vital link in student nurse practice education, ongoing support beyond an initial orientation is often lacking. It has been reported in the literature that preceptors experience stress related to difficulties in handling preceptee situations. They are frustrated by negative experiences centered on preceptor-identified hallmarks of unsafe practice including the inability to demonstrate knowledge and skills; attitude problems; unprofessional behavior; and poor communication skills. Their unrealized expectations for novices threaten their commitment to their preceptor role. As part of a larger study testing the effectiveness of podcasts as an ongoing method of preceptor support, this paper addresses the developmental stage of the podcasts. A team of academic and acute care nurse educators developed scripts for eventual filming of four podcasts focusing on unsafe practice issues, designed to provide continual support through web-based availability. The use of podcast technology is consistent with the learning styles of digital natives and is a demonstrated and valuable educational resource to review, reinforce, and clarify difficult concepts. These podcasts were informed through preceptor focus groups to address situational and environmental realism for student behaviors and preceptor responses. [ABSTRACT FROM AUTHOR]

This paper presents the findings of an exploratory study to investigate the challenges faced by people living with HIV/AIDS (PLWHA) in communities in Cape Town, South Africa. The primary goal of the study was to gather data to inform the adaptation of a group risk reduction intervention to the South African context. Qualitative methods were used to examine the experiences of PLWHA. Eight focus group discussions (FGDs) were conducted with 83 HIV-positive participants and 14 key informants (KIs) involved in work with PLWHA were interviewed. Findings revealed that AIDS-related stigma was still pervasive in local communities. This was associated with the difficulty of disclosure of their status for fear of rejection. Also notable was the role of risky behaviours such as lack of condom use and that PLWHA considered their HIV/AIDS status as secondary to daily life stressors like poverty, unemployment, and gender-based violence. These findings have implications for the adaptation or development of behavioural risk reduction interventions for PLWHA. [ABSTRACT FROM AUTHOR]

Evaluation is currently at the heart of the priorities of education systems. It is not limited to learning but affects several aspects: teachers, schools, training, management, education policies, and the system as a whole. There is a need in this area where research is extremely scarce in Morocco and especially in the teaching and education sector. The notion of transposing quality evaluation to the pedagogical side is very difficult and ambiguous. The evaluation of a school is a complex process, with varied practices and multiple actors. The first objective of this work is to present, within a rigorous methodological framework, the validation of pedagogical and administrative quality indicators in schools. This tool is a dashboard with precise indicators for the pedagogical audit of schools and educational institutions adapted to the Moroccan context. To select the best indicators, we used several techniques (structured interviews, focus groups, factor analysis, etc.) with the actors who carry out their activities. We identified three (03) fields and ten (10) criteria with indicators that form the basis of a quality assessment. The fields are management and strategic planning, administrative and sector management, and pedagogical organization. [ABSTRACT FROM AUTHOR]

Beekeeping is one of the livelihood options available to Ethiopian farmers. The objectives of this study were to analyze the level of adoption of modern hive technology by farmers and to identify the variables influencing the adoption of modern beekeeping hive technology in Kacha-Birra Woreda. Primary data were collected from 89 respondents chosen using a multistage sampling process, while qualitative data were collected through focus group discussion and key informant interviews. Data were analyzed using a binary logit regression model and descriptive statistics. According to the results of the model, several factors, such as the educational level of the respondents, the size of the land, the extension, the contact, and the access to financing and market, had a substantial impact on the adoption of modern hive beekeeping technology. It is suggested that the Livestock and Fish Resource Development office develops a strategy to help the community's illiterate members benefit more from the use of contemporary hive beekeeping technologies, develops a strategy to benefit farmers who have large land sizes with modern hive beekeeping technology, establishes extension contact with farmers before technology innovation leads to better adoption of technology, and strongly advises to link a strategy with micro-enterprises. Promotional activities focused on preventing the access to the market of respondents that must ensure their active participation in adoption. [ABSTRACT FROM AUTHOR]

Background. Parkinson's disease (PD) causes difficulties with hand movements, which few studies have addressed therapeutically. Training with action observation (AO) and motor imagery (MI) improves performance in healthy individuals, particularly when the techniques are applied simultaneously (AO + MI). Both AO and MI have shown promising effects in people with PD, but previous studies have only used these separately. Objective. This article describes the development and pilot testing of an intervention combining AO + MI and physical practice to improve functional manual actions in people with PD. Methods. The home-based intervention, delivered using a tablet computer app, was iteratively designed by an interdisciplinary team, including people with PD, and further developed through focus groups and initial field testing. Preliminary data on feasibility were obtained via a six-week pilot randomised controlled trial (ISRCTN 11184024) of 10 participants with mild to moderate PD (6 intervention; 4 treatment as usual). Usage and adherence data were recorded during training, and semistructured interviews were conducted with participants. Exploratory outcome measures included dexterity and timed action performance. Results. Usage and qualitative data provided preliminary evidence of acceptability and usability. Exploratory outcomes also suggested that subjective and objective performance of manual actions should be tested in a larger trial. The importance of personalisation, choice, and motivation was highlighted, as well as the need to facilitate engagement in motor imagery. Conclusions. The results indicate that a larger RCT is warranted, and the findings also have broader relevance for the feasibility and development of AO + MI interventions for PD and other conditions. [ABSTRACT FROM AUTHOR]

Farmers are predominantly adopting two forms of agroforestry, traditional and improved practices, in the midhills of Nepal, but their efficacy on a comparative basis is poorly assessed, so farmers often confuse whether to continue the traditional practice or embrace the improved practice. We carried out a study in six villages of three districts, interviewed 210 farmers adopting each practice, organized six focus group discussions, and interacted with 24 key informants to compare agroforestry practices from income generation and forest conservation perspectives. An individual household adopting the improved practice annually generated 841.60 US$, which was more than two folds of the traditional practitioner. Similarly, the improved practitioner annually fulfilled 84% demand for forest products from the adopted agroforestry practice, whereas the traditional practitioner only fulfilled about 50%. The fodder, fuelwood, and timber productions were found to be significantly higher in the improved practice, whereas leaf litter production was found to be almost similar. The improved practitioners seemed to be self-sustained in forest products, where the traditional practitioners only satisfied half of their requirements from the agroforestry practice. The study concludes that the improved agroforestry practice is more beneficial compared to the traditional practice. Therefore, we suggest the traditional practitioners to modify their ongoing practice to enhance the contribution of agroforestry practice at the local level. [ABSTRACT FROM AUTHOR]

Indigenous people of a given community have their own local specific knowledge on plant use, management, and conservation. The objective of this study was to document medicinal plants used to treat human and livestock ailments in Hulet Eju Enese Woreda. The data were collected using semistructured interviews, focus group discussions, and field observations with local people. A total of 100 informants over the age of 20 years were selected to collect information on medicinal plant use. Descriptive statistics (percentage and frequency), Jaccard's similarity index, independent sample t-test and analysis of variance, informant consensus factor, fidelity level, preference ranking, and direct matrix ranking were computed. A total of 80 medicinal plant species belonging to 75 genera and 52 families were documented. In terms of species diversity, Solanaceae stood first with 5 species followed by Euphorbiaceae and Malvaceae with 4 species each. Out of eighty medicinal plants, 53 species were used to treat only human ailments, 8 species were used to treat only livestock ailments, and the remaining 19 species were used for treating both human and livestock ailments. From the total medicinal plant species, shrub constitutes the largest number with 42.5% species. The most frequently used plant parts were leaves, accounting for 28.9%. The major routes of administration were oral accounts, 81 (57%), followed by dermal, 45 (31.7%), nasal, 6 (4.2%), and others, 10 (7%). In the disease category with the highest informant consensus factor (0.83) value was sudden sickness. There was highest preference (49) for Phytolacca dodecandra to treat rabies. Cordia africana was shown to be the top multipurpose species. This study revealed that the study area was rich in medicinal plants. Agricultural expansion, charcoal making, and firewood collection were considered major threats to medicinal plants. Therefore, awareness creation to the youth and training to the healers play a pivotal role to prevent the loss of indigenous knowledge. [ABSTRACT FROM AUTHOR]

Background. Facility-based death review committee (DRC) of neonatal deaths and stillbirths can encourage stakeholders to enhance the quality of care during the antenatal period and labour to improve birth outcomes. To understand the benefits and impact of the DRCs, this study was aimed at exploring the DRC members' perception about the role and benefits of the newly developed facility-based DRCs in five pilot hospitals in Jordan, to assess women empowerment, decision-making process, power dynamics, culture and genderism as contributing factors for deaths, and impact of COVID-19 lockdown on births. Methods. A descriptive study of a qualitative design—using focus group discussions—was conducted after one year of establishing DRCs in 5 pilot large hospitals. The number of participants in each focus group ranged from 8 to10, and the total number of participants was 45 HCPs (nurses and doctors). Questions were consecutively asked in each focus group. The moderator asked the main questions from the guide and then used probing as needed. A second researcher observed the conversation and took field notes. Results. Overall, there was an agreement among the majority of DRC members across all hospitals that the DRC was successful in identifying the exact cause of neonatal deaths and stillbirths as well as associated modifiable factors. There was also a consensus that the DRC contributed to an improvement in health services provided for pregnant women and newborns as well as protecting human rights and enabling women to be more interdependent in taking decisions related to family planning. Moreover, the DRC agreed that a proportion of the neonatal deaths and stillbirths occurring in the hospitals could have been prevented if adequate antenatal care was provided and some traditional harmful practices were avoided. Conclusions. Facility-based neonatal death review audit is practical and can be used to identify exact causes of maternal and neonatal deaths and is a valuable tool for hospital quality indicators. It can also change the perception and practice of health care providers, which may be reflected in improving the quality of provided healthcare services. [ABSTRACT FROM AUTHOR]

This research was carried out to record and document the medicinal plants and associated indigenous plant use knowledge of the local people in Kelala District of Amhara Region, Ethiopia. Ethnobotanical data were collected by conducting preprepared semistructured interview items with 60 informants. Focus group discussion and guided field walk were also used. Data were analyzed using basic analytical tools and descriptive statistics. Determination of informant consensus factor, fidelity level, and ranking was performed. A total of 82 medicinal plants distributed in 79 genera and 45 families were collected. Of these plants, 43 species were used to treat human ailments, and 33 species were used to treat livestock ailments and the remaining 6 species were used to treat both human and livestock ailments. The majority of medicinal plants were harvested from the wild environments. The family Solanaceae occupied the first rank with seven species followed by Fabaceae, Asteraceae, Cucurbitaceae, Apiaceae, and Euphorbiaceae with four species each. The most frequently used plant parts were leaves (42.2%) followed by seeds (15.2%), roots (8.1%), and fruits (7.6%). Freshly harvested plant parts (72.68%) were mostly used for remedy preparation compared to dried forms (24.74%) whereas crushing, which accounted for 41.12%, and powdering (24.37%) were the most widely used methods of remedy preparation in the study area. Expansion of farmlands by cutting trees heavily threatens medicinal plants and therefore needs due attention. High ranking medicinal plants are good candidates for further research in drug discovery and development. [ABSTRACT FROM AUTHOR]