Since large articulated vehicles have uncertainties in trailer articulation angle as well as dynamic complexity, it is not easy to accurately establish a reliable motion plan. In this paper, two geometric path plans constructed based on the empirical rules of driving experts are presented so that articulated vehicles can automatically perform perpendicular parking on a reverse path. By analyzing the empirical parking methods of professional drivers, these path plans were constructed by appropriately combining several standardized simple basic motions to facilitate implementation in real vehicles. In addition, path plans included appropriate complementary motions to effectively respond to uncertainties arising from articulation angles, etc. The complementary motions developed in this study are based on the results of qualitative analysis on the behavior of articulated vehicles. The usefulness of the proposed articulated vehicle parking method has been proven through hundreds of experimental tests using a 1:10 ratio model automated vehicle.

Background: The global prevalence of anxiety and depressive symptoms in adolescents has increased considerably during the COVID-19 pandemic. Mental health problems may compromise glycemic control in young people with type 1 diabetes; however, evidence of improved glycemic control in adolescents with T1D appeared early during the pandemic. This qualitative study aimed to provide a more in-depth understanding of how the COVID-19 pandemic affected adolescents with type 1 diabetes routines, experiences, T1D management, behaviors, and mental health. Methods: 24 adolescents, aged 15-18 years, with DM1, joined the discussion of focus groups in the context of the summer camp for diabetes. Word frequency and thematic analysis were conducted on adolescents’ narratives. Results: The word Frequency Analysis identified 'friends', 'family', and 'home' as the most frequent terms. Seven themes were identified: (1) COVID-19 and T1D; (2) emotional reactions to the COVID-19 pandemic; (3) changes in daily life; (4) feelings of loss; (5) coping with the COVID-19 pandemic; (6) the COVID-19 pandemic as an opportunity; (7) return to (new) normality. Conclusions The COVID-19 pandemic may have represented a more stressful condition for adolescents with DM1, facing additional challenges compared to their healthy peers. The results offer directions to the diabetes care team for a customized intervention while the consequences of the pandemic on adolescents’ health continue.

The service sector, whose value has started to increase in recent years, has gained momentum with the acceleration of economic developments especially after the 2000s in Turkey. In a world where competition is increasing and social purchase perception is changing, companies started to differentiate in the service sector to create a competitive advantage. Companies that would like to grow in the industry and aspire to a greater proportion need credit to extend. There are many factors to consider in order to allocate the credit. Banks make financial and non-financial analysis to make credit decisions. This study has been prepared to assess the effect of financial and non-financial features of middle segment companies that need credit in the service sector on the credit decision to be allocated by banks. The group of variables that explain the credit decision at the highest level in these companies are non-financial variables.

The article addresses the importance of nutrition in the health of the elderly population and focuses on the qualitative evaluation of menus provided by a social solidarity institution in Portugal, in order to prevent and/or treat malnutrition or the risk of malnutrition in this vulnerable population. The methodology involves the evaluation of four weekly menus, totalling 28 complete daily menus for the elderly, using the “Avaliação Qualitativa de Ementas para a População Idosa” (AQEDI) tool. The assessment grid is organized into six domains (general items, soup, protein suppliers, carbohydrate supplier side, vegetable side and dessert), each composed of various parameters. The results indicate that all menus were classified as "acceptable”, with percentages ranging from 60.73% to 68.84%, and suggests that while the menus are deemed acceptable, there is room for improvement. Recommendations include increasing the presence of eggs and including seasonal fruits daily, avoiding canned fruit. The study emphasizes the need for coordinated efforts within the institution to enhance menu planning, considering both nutritional guidelines and the sensory aspects of food. Coordination efforts within the institution are crucial for preserving positive aspects and addressing inadequacies in menu planning.

Background: Little is known about the decisional background of choosing an appropriate disease model. Therefore, this paper aims, (1) to identify a spectrum of reasons for choosing between animal and non-animal disease models and (2) provides an ethical analysis of these reasons. Methods: 13 researchers from basic and preclinical research were interviewed, the interviews were analyzed qualitatively and the results were categorized. The ethical analysis was based on the principlism approach and a value judgement model. Results: This paper presents 66 reasons why researchers use animal (41 %) or alternative, non-animal disease models (59 %). Most of the reasons were be assigned to the work environment (29 reasons) and scientific standards (22 reasons). Other reasons were assigned to personal attitudes (11 reasons) and animal welfare (4 reasons). Qualitative relevant normative differences are presented in the ethical analysis. Even if few reasons can be rejected outright from an ethical point of view, there are good reasons to give some more weight than others. Conclusions: The spectrum of reasons and its ethical assessment provide a framework for reflection for researchers who may have to choose between animal models and (investing in) alternatives. This can help to reflect on and justify decisions.

The Savu Sea holds significant importance as a conservation area in Indonesia, providing sustenance and livelihoods for local communities. It is situated within the Coral Triangle, a critical hotspot for marine biodiversity worldwide. However, the Savu Sea is currently facing various threats, including overfishing, pollution, and the impacts of climate change. Effective management of this conservation area relies heavily on the active participation of local communities. Therefore, this study aims to address this issue by analyzing how factors within these communities, such as the socio-economic condition of coastal households, environmental awareness, the existence of community-based conservation areas, attitudes towards activities within the conservation area, and participation in multistakeholder institutions, contribute to a positive perception of the benefits provided by the Savu conservation area. To determine the complex causal conditions that influence the outcome of perception, the study employs the Qualitative Comparative Analysis (QCA) method, specifically using crisp set QCA (csQCA). A survey was conducted among 22 coastal villages surrounding the Savu Sea, resulting in the identification of 14 different combinations of pathways that contribute to varying levels of perception regarding conservation. Valuable lessons can be drawn from this study to enhance the design of policies aimed at effectively managing the Savu conservation area.

This empirical research is part of a larger project beginning in 2020 and ongoing until 2023 exploring the impact of the COVID-19 pandemic on young caregivers aged 5-25 years and their families in Canada. Utilizing the social determinants of health as a conceptual framework, this case study emphasizes the voices of professionals offering services to young caregiver clients during the pandemic, and explores their perspectives on the impact of the pandemic on young caregivers and their families. Across three (3) different organizations offering programs and services to young caregiver clients in Ontario, six (6) individual interviews were conducted with directors/program managers and four (4) group interviews were conducted with thirteen (13) staff members who worked directly with young caregivers and their families. Nineteen (19) service providers participated in total. The results of this study highlight five (5) primary themes that emerged through data analysis: i) the role of service providers, ii) the impact of the COVID-19 pandemic on organizations and service providers supporting young caregivers and their families, iii) barriers for service users, iv) helpful resources for service providers and organizations, and v) resources needed/preferred by service providers and organization. The pandemic significantly impacted young caregivers and their families, as reported by professionals, and organizations working with young caregivers and their families were tasked with addressing increased service demands and adapting service delivery to follow public health guidelines.

In an era characterized by the ever-shifting landscapes of the digital realm, this paper intricately examines the interplay between digital culture, cultural dynamics, and beliefs in academia. Utilizing insights from cutting-edge language models, the study uncovers nuanced cultural expressions among Arts and Sciences students navigating the digital domain. Employing qualitative methods including interviews, observations, in-depth literature reviews, and thematic analysis, findings highlight digital interactions' transformative impact on cultural narratives and the potential of digital ethnography as a lens for understanding intricate cultural phenomena. This research enriches digital ethnography and cultural dynamics, offering fresh perspectives on the symbiotic relationship between digital culture and traditional beliefs, underscored by data from a maximum purposeful sampling of thirty (30) participants. Overall, this exploration emphasizes digital culture's dynamic role in shaping and reflecting cultural convictions, contributing to the understanding of cultural dynamics and evolving digital ethnography in the academic landscape.

Global anaesthesia workforce limitations contribute to emigration of skilled anaesthesiologists from lower- to higher-income countries, jeopardizing workforce balance and patient outcomes in Pakistan. This study aims to explore challenges experienced by anaesthesiologists in Punjab, Pakistan’s most populous province, and necessary changes to encourage their retention. We conducted a qualitative study to examine perspectives of anaesthesiologists who chose to serve in Pakistan. We drew data from semi-structured interviews conducted with 25 purposively-sampled consultant anaesthesiologists. We analysed data thematically and distinguished the practice hurdles faced by anaesthesiologists in public and private hospitals of Punjab. The main reasons to work abroad could be broadly categorized under two inductive themes, i.e. practice hurdles in public and private sector. Both had distinct issues which compromised the number and quality of anaesthesia workforce in the country. The key outcomes were workplace security, promotion/incentive issues and gender inequalities in the government sector. The private sector had improper salaries and facilities, anaesthesiologist’s dependency on surgeons for getting work and lack of out-of-theatre practice which minimise the scope and earnings of anaesthesiologist within the country. There is a need to overcome surgeon dependency and hospital manipulation by fixing salary percentages for each surgical case and encouraging direct patient-anaesthesiologist relationships.

Recent dramatic reductions in the timeframe in which genomic sequencing can deliver results means its application in time-sensitive screening programs such as newborn screening (NBS) is becoming a reality. As genomic NBS (gNBS) programs are developed around the world, there is an increasing need to address the ethical and social issues that such initiatives raise. This study therefore aimed to explore the Australian public’s perspectives and values regarding key gNBS characteristics and preferences for service delivery. We recruited English-speaking members of the Australian public over 18 years of age via social media; 75 people aged 23-72 participated in one of 15 focus groups. Participants were generally supportive of introducing genomic sequencing into newborn screening, with several stating that adoption of such revolutionary and beneficial technology was a moral obligation. Participants consistently highlighted receiving an early diagnosis as the leading benefit, which was frequently linked to the potential for early treatment and intervention, or access to other forms of assistance, such as peer support. Informing parents about the test during pregnancy was considered important. This study provides insights into the Australian public’s views and preferences to inform the delivery of a gNBS program in the Australian context.

Philips Visual Patient Avatar represents an alternative method of patient monitoring that, according to computer-based simulation studies, enhances diagnostic accuracy, confidence and reduces workload. After its clinical integration, we assessed pediatric anesthesia providers' perspectives on this technology. This is a single-center qualitative study, conducted at the University Hospital Zurich using in-depth individual interviews. We aimed to identify the advantages and limitations of Visual Patient Avatar in pediatric anesthesia and to assess children and parents' reactions from caregivers' perspective. Thematic analysis was used to identify the dominant themes. Fourteen members of the institution's pediatric anesthesia team were interviewed. The most prevalent themes were: children's positive reactions towards the Visual Patient Avatar (92.9%) and enhanced speed in problem identification (71.4%). Additionally, 50% of participants reported finding the Visual Patient Avatar useful for diverting children's attention during anesthesia induction, and 50% suggested that its vital sign thresholds should be adaptable for different age groups. The study revealed that the Visual Patient Avatar was recognized as a valuable tool in pediatric anesthesia, enabling prompt identification of underlying issues and receiving positive feedback from both children and parents. The most commonly voiced wish for improvement in the study was the ability to customize the Visual Patient Avatar's thresholds for different age groups.

Blood gas analysis plays a central role in modern medicine. Advances in technology have expanded the range of available parameters and increased the complexity of their interpretation. By applying user-centered design principles, it is possible to reduce the cognitive load associated with interpreting blood gas analysis. In this international, multicenter study, we explored anesthesiologists' perspectives on Visual Blood, a novel visualization technique for presenting blood gas analysis results. We conducted interviews with participants following two computer-based simulation studies: the first utilizing Virtual Reality (VR) (50 participants) and the second without VR (70 participants). Employing the template approach, we identified key themes in the interview responses and formulated six statements, which were rated using Likert scales: from 1 (strongly disagree) to 5 (strongly agree) in an online questionnaire. The most frequently mentioned theme was the positive usability features of Visual Blood. The online survey revealed that participants found Visual Blood to be an intuitive method for interpreting blood gas analysis (median 4, IQR 4-4, p<0.001). Participants noted that minimal training was required to effectively learn how to interpret Visual Blood (median 4, IQR 4-4, p<0.001). However, adjustments are necessary to reduce visual overload (median 4, IQR 2-4, p<0.001). Overall, Visual Blood received a favorable response. The strengths and weaknesses derived from these data will help optimize future versions of Visual Blood to improve the presentation of blood gas analysis results.

Appropriate diagnosis, treatment and care contributes to better service engagement, improvements to wellbeing, cost savings, reductions in morbidity and mortality for people with Alcohol Related Brain Damage. In the North-East of England large amounts of alcohol are consumed, reflected in the number of alcohol-related deaths in the region. However, the pathway for people with Alcohol Related Brain Damage to receipt of diagnosis, treatment and care is unknown and could be unwittingly influenced by stigma. Qualitative in-depth semi-structured interviews were completed with 25 health and social care professionals from organisations involved with people with Alcohol Related Brain Damage recruited via snowball-sampling. Interviews were recorded, transcribed verbatim, coded, and analysed. People with Alcohol Related Brain Damage were stigmatised both by society and professionals which inhibited entry into services therefore Alcohol Related Brain Damage remained underdiagnosed and misdiagnosed. There was no dedicated service but silos with revolving doors and underfunded generic care with long waiting lists typically excluding those with alcohol or neurological problems. Professionals need to be challenged on the assumption that Alcohol Related Brain Damage is self-inflicted via training aimed at challenging unconscious bias. Reducing stigmatising processes associated with Alcohol Related Brain Damage could counteract professionals’ reluctance to provide care.

Keywords: Innovation ecosystems, Economic sustainability, Hydrocarbon-based economies, Economic diversification, Qualitative approach

Few studies have examined the pros and cons of integrated TB and HIV service delivery in public healthcare facilities, and even fewer have proposed conceptual models for improved integration. This study intends to fill that vacuum by outlining the development of a facility-based paradigm for integrating TB, HIV and patients services. The design of the proposed model were in stages that involved the evaluation of existing TB-HIV integration model and synthesis of both quantitative and qualitative data from the study sites which were selected public healthcare facilities at both rural and peri-urban settings in Oliver Reginald (O.R) Tambo District Municipality in Eastern Cape, South Africa. Secondary data on 2009-2013 TB-HIV clinical outcomes were obtained from multiple sources for quantitative analysis. Qualitative data involved focus group discussions among patient and heath care staff, which was thematically analysed. The development of a possibly better model and validation of this model show that the district's health system was reinforced by the model's guiding principles, which placed a strong emphasis on inputs, processes, outcomes, and integration effects.The model is adaptable to different healthcare delivery systems but will require support from healthcare stakeholders and professionals to be successful.

Lumpy skin disease (LSD) vaccination and epidemiological distribution remain unknown in some parts of Ethiopia including the Sidama regional state. With this, an assessment of LSD vaccine-related problems and serological study was performed in selected districts of Sidama regional state representing three agroecological zones from September 2021 to June 2022. A cross-sectional study of qualitative and quantitative studies was used. The result showed a few portion of respondents know about LSD (29.2%), and vaccinate their cattle (23.3%). 20.8% of the respondents stated LSD occurrence in their vaccinated cattle while focus group discussion with the professionals stated the possible reasons related to electric power disruption that impacted LSD vaccine cold-chain. The other study was on sero-epedimiology of LSD which showed an overall animal and herd level sero-prevalence of 40.8% and 81%, respectively. Higher and lower sero-prevalence was observed in lowland (48%) and highland (28%) areas, respectively. Furthermore, risk factor analysis showed the existence of a significant association between management systems, breed, and body condition score (BCS) of cattle. In conclusion, both qualitative and quantitative study results showed the need for intervention in terms of community-based awareness creation about LSD clinical signs, vaccination advantages, and options for electric power supply together with the frequently updated information on LSD prevalence.

Enhanced food and nutrition security remains a primary goal for every community. Several interventions have been promoted in dry areas to improve issues on food and nutrition security. However, studies on the level of knowledge, cultural norms, perceptions and attitudes that are key drivers in adoption and uptake to highlight gaps and provide evidence for improvement are limited. This study investigated variables influencing the adoption and implementation of an integrated crop-dairy goat farming system in Elgeyo Marakwet. A descriptive cross-sectional survey entailing qualitative and quantitative approaches among farmers practicing integrated farming was undertaken. A thematic questionnaire was used to collect quantitative data, while key informant interviews and focus groups discussions were used in qualitative research. This study utilized the multi-stage sampling procedure to sample the farmers and sample size was calculated based on Krejcie and Morgan table. Data analysis for quantitative data was done using SPSS software while qualitative data utilized N-vivo software The findings show that farmers have knowledge on the integrated farming system. Age, level of education, land size, gender, perceptions and attitudes influence adoption. Small animals like dairy goats are associated to women in this community hence increasing their participation in access, control and decision making of agricultural resources. The key findings of this study provide baseline data that can form evidence to help inform policy on the indicators contributing to adoption of integrated crop-dairy goat systems to enhance food and nutrition security

This is a case study in the domain of public sector management or management in government, with particular reference to education as a sector as a whole. Bangladesh has shown persistent upward trends in development indicators during the last four decades. In the education sector also, many indicators improved - literacy, the female proportion of literacy, number of educational institutions, etc. Quantity wise investment and indicators increased and improved at all levels and dimensions like primary, secondary, tertiary, technical, and so on. But qualitative improvement remained mysteriously low, despite government intention to increase quality of teaching, learning, and administration. This paper aimed to draw an overall picture of qualitative scenario of the education sector. Analyzing secondary sources like public media, and primary sources like citizen interactions, this qualitative study consolidated the problems of the education sector in a coherent whole. It argues that many problems of education sector are not education problems or budget problems, rather purely and simply ‘management’ problems, and so, can effectively be solved with basic but thorough understanding of the basic technicalities of management as a discipline.

This study explores how young people’s mental health was affected by the COVID-19 pandemic using artwork and semi-structured interviews. This is important to understand so that policy and practice professionals can support those affected, prepare, and respond to future crises, and support young people who are isolated and restricted in other contexts. Co-designed participatory art workshops and interviews were conducted with 16–18-year-olds (N = 21) from the London-based Longitudinal cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP). Artworks and interview transcripts were qualitatively co-analysed with young people. From interviews, six themes were identified: adaptation, restriction, change, challenges, overcoming adversity, and lockdown life. From artwork, four themes were identified; trapped, negative mental wellbeing, positive emotions, and technology. Everyday factors such as home environment, relationships, hobbies, habits, and education or work were key determinants of how challenged and restricted participants felt, and their capacity to overcome this. This implies that young people’s mental health services should collaborate with other sectors to address wider life determinants in a holistic way, and that clearer guidance and support in these areas could mitigate the negative mental health impacts of major environmental changes on young people.

Emergency is a health condition that poses an imminent risk to life. In this context, operations and triage protocols play an important role in the correct functioning of the Emergency Department, a key component of national health systems. The aim of the study was to explore and describe the experiences of a group of patients regarding emergency departments that use the Manchester Triage System, a triage protocol widely adopted in Europe. The research approach used was phenomenography, which allows us to explore in depth the diversity of experiences lived by a group of patients. The data was collected through semi-structured interviews and analysed to identify the categories that allows a qualitative description of patient’s experiences. The results are structured in the following categories: “Healthcare professional roles“, “Waiting time to be cared“, “Triage protocol“ and “Emergency department utilization“. These results can be used to improve the way patients experience emergency situations and to contribute to increasing knowledge about the impact of emergency departments and triage protocols on patients.

Non-pharmaceutical interventions (NPIs), including social distancing, wearing personal protective equipment, and lockdown measures, have been at the forefront of outbreak control in nursing homes. We used a mixed methodology to assess which NPIs nursing homes in the canton of Geneva, Switzerland, followed for their staff and residents during the first wave of the pandemic, between March 1, 2020 and June 1, 2020. For the qualitative component, we interviewed the attending physicians and/or director of each nursing home. Based on in-vivo codes, NPIs for nursing home workers and residents in each nursing home were thematically classified as: maximally restrictive, moderately restrictive, and minimally restrictive. In the quantitative component, we calculated incident rate ratios (IRR) for infection between the three levels of COVID-19-related measures taken in these nursing homes. We found an equal distribution of maximally (n=4), moderately (n=4), and minimally (n=4) restrictive NPIs. The extent of restriction did not show to be significantly associated with the cumulative incidence of COVID-19 cases among residents (maximally restrictive IRR = 3.90, 95%CI 0.82-45.54, p = 0.184; moderately restrictive IRR = 3.55, 95%CI 0.75-41.42, p = 0.212 ; minimally restrictive IRR = reference). Variabilities in NPIs adopted by nursing homes, and the number of COVID-19 cases appear to be randomly affected.

This study investigates how digital alchemy can enhance literature and language teaching through a combination of online and face-to-face learning. It uses constructivist learning theory and the SAMR model to examine how digital tools and resources can transform learner engagement, critical thinking, and creativity. The study gathered data from interviews, focus groups, and document analysis with 30 participants from private HEI schools. The results show that digital alchemy through blended learning allows learners to personalize and collaborate in their exploration of various literary texts. However, the study also identifies some challenges related to resource availability and educator training. The study emphasizes the importance of using digital alchemy in literature and language teaching and suggests some ways for educators, administrators, and policymakers to effectively use digital tools and resources for student-centered teaching methods in the digital era.

Based on the multiple coordination framework of “promising government-effective market-ordered society”, this paper takes 68 cases of adding elevators to old buildings as samples, and selects six conditional variables: approval optimization, financial subsidies, financing innovation, technological innovation, capable people leading and neighborhood committee guidance. Using Crisp-Set Qualitative Comparative Analysis (csQCA), this paper discusses the combination of conditions that affect the success or failure. It is found that: approval optimization and neighborhood committee guidance are sufficient conditions for the success; successful cases can be divided into three types: “political and social dual-drive type”, “market and social dual-drive type” and “ternary co-drive type”; lack of approval optimization, lack of financing innovation, and the existence of capable people leading are necessary conditions for the failure. The failure cases can be divided into “government and market double failure type” and “market failure type”.

The article explores Qualitative Comparative Analysis (QCA), an approach for establishing causal relationships between conditions and outcomes. QCA, applied in case studies and empirical analyses, facilitates generalizations for future research and addresses causal complexity by identifying various causal "recipes" leading to the same outcome. Three widely used QCA variants are Crisp-Set QCA (csQCA), Multi-value QCA (mvQCA), and Fuzzy-Set QCA (fsQCA), each with unique approaches. The article emphasizes the significance of bibliometric analysis in mapping a research field's intellectual structure, revealing key contributions and trends. In QCA, bibliometric analysis identifies leading researchers, affiliations, and influential countries. Results show QCA's widespread adoption across disciplines, with continuous growth in article production since 2013. The favored variant is fsQCA, followed by csQCA, and China notably contributes to QCA-related research. In conclusion, QCA proves a potent tool for discerning complex causal relationships in empirical studies, with its increasing interdisciplinary use indicating substantial potential for advancing scientific knowledge.

Background: Schistosomiasis is the third most important Neglected Tropical Disease, with more than 4 million South Africans being infected. Cases of re-infection with schistosomiasis after being treated using modern medication has opened ways to seeking alternative treatment modalities using medicinal plants. This study aims to explore and understand the way traditional healers diagnose schistosomiasis, the types of traditional medicines they use to treat it in communities with a high prevalence of infection, and to establish whether the unavailability of prescribed anti-schistosomal medicines leads to the use of traditional medicine. Methods: A qualitative exploratory study was conducted using a questionnaire from December 2022 to March 2023 in the iLembe District, KwaZulu-Natal Province, South Africa. In-depth individual interviews were carried out among traditional health practitioners (THPs) involved in managing female urogenital schistosomiasis (FUS). Recorded narrative data was transcribed verbatim, read through thoroughly and coded, and analysed using thematic or content analysis Results: Traditional Health Practitioners provide services to many women who did not want to be treated in the mainstream health care system for their FUS. The disease was perceived and understood the same way by most of the respondents, that being caused by use of fresh water. Various plants species, either alone or in combination, were used to manage bilharzia in women. Senecio serratuloides (Asteraceae) and Hypoxis hemerocallidea (Hypoxidaceae) were prominently used by THPs in FUS management. Conclusion: Traditional Health Practitioners are playing a key role in managing bilharzia in women in rural areas of the iLembe District, this study reported that THPs can diagnose schistosomiasis symptoms based on their knowledge and experience. Respondents indicated that modern conventional treatment was readily available and free in public sector healthcare facilities; however, they consulted patients suffering from FUS. Various traditional herbal medicines are reportedly used by THPs to manage bilharzia in women. Further studies are needed to investigate the views and experiences of clients regarding the success of the treatments used and why they seek care from THPs.

To ensure sustainable production and consumption in the agricultural sector, it is necessary to assess the contribution of each element of the nexus in the agricultural production chain. The aim of this study is to make a quantitative and qualitative analysis of the contributions of each element of the energy, water, waste and land nexus to agricultural products. A composite method approach combining aspects based on input-output model, Location Quotient (LQ) as well as competitive position is adopted. A database of nexus elements over a period from 2009 to 2018 is used for Cameroon, with ten regions considered. The results show proportions of around 0.42% energy, 67.88% water withdrawal, 11.91% harvested area, 97.81% waste for agricultural products. The geolocation of harvested areas shows that the largest portion is in the far north (1,373,829 ha) and the smallest in Adamawa (224,038 ha). Maximum production is in the central region (4,334,095 tons) and minimum in the Adamawa region (915,841 tons). The central, littoral and west regions are more representative of agricultural products. The analysis of the competitive position of agricultural products contributes to a better orientation of national strategies for agricultural sustainability according to existing potentials.

Fibromyalgia syndrome (FMS) is a nonarticular rheumatic syndrome which presents as chronic musculoskeletal pain, stiffness and body aches. FMS affects approximately 2.5% of the population, mostly women. FMS causes physical and psychological problems and reduces quality of life. The objective of this study is to identify qualitative evidence about experiences of women diagnosed with FMS about their sexuality. Methods: Metasynthesis of qualitative studies. The search included articles published between 2000 and June 2023 on the PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. Results: 450 articles were found through the initial search, of which, only 9 fulfilled the criteria and were included in the thematic synthesis. From this analysis, three main themes emerged: (1) “I want to, but I can’t”: FMS causes a shift in feminine sexuality. (2) Resetting sex life and intimacy. (3) Taking charge of a “new sexuality.” Conclusions: Women with FMS suffer from limitations of their sexuality that affect their partner. Pain, stiffness and a loss of desire make sexual encounters difficult. Becoming aware of this and striving not to lose their sexuality is key to coping with this problem. Women and their sexual partners can change roles and encourage communication, games, foreplay or touching. The use of lubricants, physical exercise and complementary therapies, along with social, professional and partner support, are key to coping with FMS.

In this paper, a class of nonlinear ordinary differential equations with impulses at variable times is considered. The existence and uniqueness of solution are given. At the same time, modifying the classical definitions of continuous dependence and Ga^teaux differentiability, some results on continuous dependence and Ga^teaux differentiable of solution relative to the initial value also are presented in new topology sense. For the autonomous impulsive system, the periodicity of solution is given. As an application, properties of solution for a type of controlled nonlinear ordinary differential equation with impulses at variable times is obtained. These results are foundation to study optimal control problems of systems governed by the differential equations with impulses at variable times.

Abstract: Background: Exercise Training at work has the potential to improve employees’ produc-tivity, health, and well-being. However, exercise interventions to healthcare workers in hospitals may be challenged by a high time pressure and the ongoing workflow with patient care. Objective: The aim was to identify barriers and facilitators for participation in exercise training during work in a hospital department. Methods: Eight semi-structured interviews were conducted with hospital employees of different staff groups, who participated in 12 weeks exercise twice weekly. The data analysis was a thematic approach based on the Theoretical Domains Framework and the COM-B factors in the Behavior Change Wheel. Results: Barriers and facilitators varied between different groups. Barriers included limited structure, busyness, and a discouraging culture. Facilitators in-cluded gaining a feeling of community, psychological and physical well-being. Seven contextual subthemes were vital for successful implementation of exercise in a hospital setting. Conclusions: The informants appreciated exercise training during work and wished to participate. Inpatient departments’ informants had difficulties participating in the intervention, whilst those with more administrative tasks found it easier. This study identified barriers and facilitators vital for a successful implementation of an exercise training intervention in a hospital department to improve health, wellbeing, and productivity amongst hospital employees. It explains how future interventions can improve reach, adoption, and implementation of exercise training interventions for hospital staff.

Type 1 diabetes imposes a complex and challenging routine on patients and caregivers. Therefore, considering individual experiences and personal facilitators to promote assertive interventions is crucial. However, no studies have addressed these perspectives in the Brazilian adult population. We aimed to identify psycho-behavioral characteristics perceived as facilitators for coping with the condition. We used a biographical method to conduct semi-structured, face-to-face, in-depth interviews for each participant. Transcripts were analyzed using inductive thematic analysis. Participants (n = 22) were aged 18–57 years (mean: 30.2, standard deviation (SD): 8.7), and the duration since diagnosis was approximately 20.6 years (SD: 4.6). Twelve (54.4%) were women, 13 (59.1%) used insulin pumps, 14 (63.6%) had at least a college degree, and 13 (59.1%) had HbA1C (glycated hemoglobin) levels above 58 mmol/mol (7.5%). Five major themes emerged: 1) peer learning, 2) ownership, 3) welcoming experiences, 4) equity, and 5) reframe the path (P.O.W.E.R.). All themes appeared in the lived experiences shared by participants with HbA1C levels below 58 mmol/mol (7.5%). Improved glycemic control can be achieved, and the challenges encountered in diabetes care within similar socioeconomic contexts can be addressed, by an interdisciplinary care team that takes P.O.W.E.R into consideration when providing person-centered care strategies.

Background: Food insecurity is an ongoing problem in the U.S. with implications for health problems and social disadvantages. Past food insecurity intervention studies have targeted barriers to accessing healthy food. Although, information barriers have not been adequately addressed by food insecurity interventions. Methods: This qualitative study involved testing a text message as an informational nudge through interviews among adults in the southwest U.S. (n = 10). Interview questions focused on the message content, persuasiveness, relevancy, clarity, and details that participants liked and disliked. A qualitative content analysis of interview responses then highlighted any necessary modifications to the text message. Results: Interview responses highlighted that the message conveyed details about how to access food assistance resources. The message was perceived as informative, clear, and friendly. Participants highlighted the need for better spacing in the message layout, more details about the Supplemental Nutrition Assistance Program (SNAP), and why SNAP is relevant. Conclusion: Text message readability and informativeness were common concerns raised during interviews. Participant-informed modifications to the text message were applied in preparation for using the message in a food insecurity intervention. Future food insecurity research efforts should similarly test novel interventions to ensure the intervention is acceptable for the target population.

Purpose: When it comes to improving citizen service delivery standard and processes, or broadly, management in government (MIG), many reform programs and improvement efforts are ongoing across different ministries, departments, and agencies. This paper is part of a larger empirical research where we are interested to know what those programs and projects are, and how they are doing, and what the gaps are. Design/methodology/approach: Analyzing the publicly available data on the government portal and donors’ website, this article provides an overall idea of current reforms in various places of government. In parallel, field research was conducted through visiting agency offices, observing office environment and mechanisms, and interviewing public managers who are working at district and sub-district level offices of directorates or agencies.Findings: As a trend, state-led development process and the traditional mode of administration have moved to New Public Management based quality and performance approach. All donors have their own strategy framework document like ‘Country Assistance strategy’, ‘Country Operations and Business Plan’, Logical Framework Document, Focus or Priority Streams, etc. Many of the projects are sectoral and agency or ministry specific and have an inherent limitations, due to ‘cadre’ based organizational structural arrangement. So, it is common ‘not to own the projects’, rather ‘using the fund as much as possible anyway within the given project duration’. When the fund ends, implementing units, either government or NGOs, abandon the projects. That is why many projects are actually half done without significant and sustained direction.Originality/value: We can conclude that the typical ‘top-down’ or ‘trickle down’ conception is still dominant in design and implementation of reforms programs and service quality efforts. So, how to reach systemically at the bottom where public managers provide services to citizens, needs even more deliberation.

Open science, accessibility and knowledge sharing, especially of articles and monographs stemming from a publicly funded research, seem to be quite a positive direction in the development of science and have received almost unanimous approval from a scientific community. However, when it comes to data sharing, the data obtained by qualitative methodology deserve special attention and treatment. Although FAIR principles provide ways to anonymise the data and interlocoutors (as explained in Celjak et al 2020) individuals coming from smaller communities or even communities of practice can sometimes be easily regcognized by members of the same communitiy, especially if the data refers to audio files! The researcher is obliged to thoroughly describe the ways in which the data will be managed and used, and if it will state that the data will be managed in line with FAIR principles, this will inevitably impact the narratives collected. The prerogative to make all the data open will inevitably lead to autocesorship i.e. in creating a kind of FAIRy Tales for the future, interlocutors will share with researchers. Having all that in mind I argue for a more vigilant approach when embracing the idea that all the data should be made FAIR. Not all the data should be made FAIR because this could, in the end, compromise the research process itself. Some data must remain in the space of trust created between main actors in the research process. These data should be treated with CARE principles.

The behaviour and bifurcations of solutions to three-dimensional (three-phase) quadratic polynomial dynamical systems (DSs) are considered. The integrability in elementary functions is proved for a class of autonomous polynomial DSs. The occurrence of bifurcations of the type twisted fold is discovered on the basis and within the frames of the elements of the developed DS qualitative theory. The discriminant criterion applied originally to two-phase quadratic polynomial DSs is extended to three-phase DSs investigated in terms of their coefficient matrices. Specific classes of D- and S-vectors are introduced and complete description of the symmetry relations inherent to the DS coefficient matrices is performed using the discriminant criterion.

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualised lifestyle factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority children with obesity comorbidity. Families of Black, Asian and Minority Ethnicities (BAME) in the Northeast of England (n=180) were contacted, and families with a child diagnosed with obesity and comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems, respiratory disorder, or polycystic ovarian disease) were interviewed (n=11). Semi-structured interviews and qualitative thematic analysis included parents’ perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity. Parents’ perspectives and experience revealed eleven themes centred around living with a child with obesity, risks and impact of obesity diseases; access to lifestyle nutritional and physical activity, and ethnicity specific barriers. Parents revealed social disadvantage, fear of victimisation by social services, perceptions on their cultural and religious traditions when dealing with nutrition and exercise, and child’s weight racial stigmatisation. Parents reported closer bonding with their children than health authorities to protect from obesity consequences. Work pressure, time, and lack of professionals’ guidance were seen as barriers to healthy lifestyle, while support from friends and family bond in adopting healthy lifestyle behaviours were facilitators. Parents reported no awareness of health service provision of nutritional and physical activity obesity prevention programmes. Minority ethnic communities’ perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle nutrition and physical activity interventions are needed beyond those administered by the primary healthcare system.

Measuring the impact of land use regulation on the land market involves identifying and classifying relevant impact factors related to the land market. The objective of this study was to identify land market impact factors in the context of the introduction of land use regulation in Nepal. A desktop review was carried out to identify preliminary set of impact factors, which were reclassified through intuitive analysis based on the degree of thematic closeness. Perspective-based impact factors were identified through the qualitative analysis of primary data collected through semi-structured interviews with the Nepalese land market stakeholders. These independently derived impact factors were compared with the desktop literature review impact factors resulting in fourteen land market impact factors across four dimensions, including transaction cost, valuation, mortgage availability, taxation, and compensation across the economic dimension; lot size, subdivision restrictions, and coordination across the institutional dimension; awareness, expectation and proximity across the social dimension; and risk reduction, quality of residential land, and suitability of zoning classification across the environmental dimension. There was significant overlap and commonality across factors identified from both the literature review and semi-structured interviews. The land market impact factors determined in the study may be adapted and generalized across other countries and could be utilized to better understand the impacts of land policy decisions on urban planning and development. Further research is recommended on the process to operationalize the use of these factors to quantify the impact of land use regulation on different land markets.

Recent years have witnessed significant advances in reinforcement learning (RL), which has registered remarkable success in solving various sequential decision-making problems in machine learning. Most of the successful RL applications, e.g., the games of Go and Poker, robotics, and autonomous driving, involve the participation of more than one single agent, which naturally fall into the realm of multi-agent RL (MARL), a domain with a relatively long history, and has recently re-emerged due to advances in single-agent RL techniques. Although, typically, the communication protocol between agents is manually specified and not altered during training, recently, some papers have shown signs of trying to emerge a communication between agents on the one hand and, on the other hand, to understand what is exchanged between agents. So, there is a growing body of literature on this topic which includes qualitative and quantitative studies and the ones that apply mixed methods. This study presents the scoping review of the methodological strategies undertaken in a total of 16 research articles. The results present the critical appraisal of quantitative methods in terms of validity and reliability and for qualitative methods considering four trustworthiness factors. In the end, relevant insights are further explored with implications and reflections on how they can benefit one's research in the field.

Purpose: Post-pandemic management of COVID-19 infections and any emergent outbreaks is as an endemic disease remains a public health concern. Vaccine hesitancy may continue to hamper efforts to respond any new disease outbreaks and future epidemics. This qualitative study aimed to explore factors influencing covid-19 vaccine acceptance and hesitancy in Kenya too gain deeper insights on this issue. Methods: The study was implemented in Western Kenya using key informant interviews. Fourteen (14) key informants were purposively selected for the study. All interviews were transcribed and analyzed using thematic analysis. Interpretation of findings was done within the framework of the Health Belief Model. Key findings: Knowledge was a critical factor in combatting misinformation and fostering vaccine acceptance among participants in this study. Misinformation included rumors that the vaccine lowers immunity and was intended for population control. Cues to action included influence from political and opinion leaders and observing the loss of life among unvaccinated individuals. Perceived barriers to vaccine uptake included fear of vaccine safety, side effects, long waiting times at that time of our study, fear of contracting the COVID-19 at vaccination sites, family/spousal influence on vaccine uptake and fear of the unknown with the vaccine. Conclusion: Findings from this study provides insight into areas for targeted strategies for managing Covid-19 vaccinations and future pandemics. Within the framework of the Health Belief Model, this study identified salient barriers and facilitators of COVID-19 vaccine hesitancy that may be helpful to inform future pandemic response.

Irregular female migration to Europe is a growing phenomenon, as more and more women are fleeing their countries of origin due to gender inequality and violence. During the migration process, women experience physical, psychological and social problems that affect their sex lives. The aim of our study is to describe and understand how irregular migrant wom-en living in humanitarian reception centers experience their sexuality at different stages of the migration process. This qualitative phenomenological study collected data through a sixteen in-depth interviews with irregular migrant women between January and February 2023. Data anal-ysis was carried out using ATLAS-ti 23.0 software, from which three themes were extracted: 1) The sexual reality of sub-Saharan women, 2) In search of a better life: take the risk or surrender, and 3) The migrant sexual revolution. The sexual reality of sub-Saharan women is subject to a complex normative order. The migratory process has severe consequences on migrant women's sex life. The sexual needs of irregular migrant women admitted to humanitarian reception cen-ters undergo a process of change that must be understood by healthcare providers in order to make improvements to care provision.