National heatwave plans are aimed at reducing the avoidable human health consequences due to heatwaves, by providing warnings to and improving communication between relevant stakeholders. The aim of this study was to assess the perceptions of key stakeholders within plans in Belgium and the Netherlands on their responsibilities, the partnerships, and the effectiveness of the local implementation in Brussels and Amsterdam. Key informant interviews were held with stakeholders that had an important role in development of the heatwave plan in these countries, or its implementation in Brussels or Amsterdam. Care organisations, including hospitals and elderly care organisations, had a lack of familiarity with the national heatwave plan in both cities, and prioritised heat the lowest. Some groups of individuals, specifically socially isolated individuals, are not sufficiently addressed by the current national heatwave plans and most local plans. Stakeholders reported that responsibilities were not clearly described and that the national plan does not describe tasks on a local level. We recommend to urgently increase awareness on the impact of heat on health among care organisations. More emphasis needs to be given to the variety of heat risk groups. Stakeholders should be involved in the development of updates of the plans.

This study investigates the prevalence, causes, and spatial distribution of Abandoned, Lost, or Discarded Fishing Gears (ALDFGs) in the Gulf of Gabès, a critical fishing area in Tunisia. Five main fishing gear types—benthic trawls, encircling nets, longlines, gillnets, and trammel nets were analyzed for their loss rates and contributing factors. The study involved extensive surveys among local fishermen using geographic information system (GIS) tools for spatial mapping. The findings reveal varying loss rates among different gear types, with longlines experiencing the highest losses (59%), followed by trammel nets (45%), gillnets (40%), trawls (38%), and encircling nets (36%). Causes of gear loss include entanglement on obstructions, conflicts with other fishing gears, entanglement with marine animals, adverse weather conditions, and intentional dumping at sea. The study highlights the challenges posed by the consistent increase in regional fishing efforts. Spatial distribution mapping indicates two significant concentrations of ALDFGs, correlating with specific fishing activities and depths. The study emphasizes the importance of addressing gear losses as a threat to marine biodiversity and ecosystem health. Recommendations for mitigation include improving boat equipment, raising awareness among fishermen, implementing effective waste management, and exploring economic incentives for ALDFG recovery. This research contributes essential insights for fisheries management, environmental conservation, and sustainable practices in the Gulf of Gabès. Collaborative efforts are crucial to developing and implementing strategies that minimize the impact of ALDFGs on the marine environment while supporting the socio-economic interests of fishermen.

Background/Objectives: The present study aimed to identify information from health research that used mixed-method data collection, considering the approach of face-to-face interviews and telephone interviews (MMFT), with a more specific focus on identifying its themes, objectives, designs, populations involved and implementation process. Methods: A scoping review was developed, with systematic searches applied in March 2024, in five databases (Pubmed; Scielo; Scopus and Web of Science), Google Scholar and reference lists. The inclusion criteria were based on the strategy "Participants" (observational epidemiological studies, with no restrictions as to where they were carried out, sampling technique or sample profile); "Concept” (use of MMFT in data collection) and “Context” (studies carried out in the health area, with no restrictions on the theme/subject). The review process was conducted by three researchers who worked independently. Results: from the initial 1,515 potential references, the synthesis of this review was composed of data from seven original studies, highlighting: cross-sectional design, involvement of adults and/or elderly people without specific health conditions, variability between data collection strategies and complementary use of online approaches. Conclusions: based on the evidence generated, it is recommended that future studies assess aspects of the MMFT approach in terms of response rate, cost reduction and increasing the speed with which health surveys are carried out.

Cross-industry clusters are important for the economic prosperity of a region. However, studies are lacking to address competitive clusters among the aviation and tourism industries. Thus, this paper considers the case of both industries in terms of clusters and synergies formed. This research aim is to provide an understanding of both industries' protagonists' involvement in contributing to knowledge insights on the establishment of synergies or clusters among the two industries. Cyprus is highly dependent on tourism and aviation because they facilitate connectivity. The research is filled with semi-structured interviews with the main players and organizations of the airline and tourism industries (government bodies, airports, airlines, tour operators, and hotels). The results are indicative and suggest that, in a small geographical context, the notion of clusters involves a synergetic relationship among tourism stakeholders. Airlines’ role is important because it has an effect on all stakeholders involved in tourism.

During the COVID-19 pandemic, conducting face-to-face medical residency interviews was challenging due to infection prevention precautions, social distancing and travel restrictions. Virtual interviews were implemented by the Saudi Commission for Health Specialties (SCFHS) as an alternative process for residency matching while striving to maintain the same quality standards. This national survey was conducted to assess the satisfaction and perceptions of faculty members’ virtual interviews performance in the assessment for the medical training residency programs. Among the participating 173 faculty members (34.1%) did not have previous experience with video-conferencing. Zoom application was the most commonly used platform (65.9%). Most (89.6%) of the faculty perceived virtual interviews as “adequate” for the candidates to express themselves, while almost half of the faculty (53.8%) agreed that virtual interviews allowed them to accurately reach an impression about the candidates. Overall, 73.4% of faculty felt comfortable ranking the virtually interviewed candidates. We conclude that the acceptance of participating faculty members in the first Saudi medical residency training matching cycle virtual interviewing event was well perceived. This study provides evidence for future application and research of virtual interviews in residency candidates' assessment, especially after the pandemic crisis resolves.

The digital twin (DT) research field is experiencing rapid expansion, yet the research in industrial practices in this area remains poorly understood. This paper aims to address this knowledge gap by sharing feedback and future requirements from the manufacturing industry. The methodology employed in this study involves an examination of a survey that received 99 responses and interviews with 14 experts from 10 prominent UK organisations, most of which are in the defence industry in the UK. The survey and interviews explored topics such as DT design, return on investment, drivers, inhibitors, and future directions for DT development in manufacturing. The study findings indicate that DTs should possess characteristics such as adaptability, scalability, interoperability, and the ability to support assets throughout their entire life cycle. On average, completed DT projects reach the break-even point in less than two years. The primary motivators behind DT development were identified to be autonomy, customer satisfaction, safety, awareness, optimisation, and sustainability. Meanwhile, the main obstacles include a lack of expertise, funding, and interoperability. The study concludes that the federation of twins and a paradigm shift in industrial thinking are essential components for the future of DT development.

As with every new technology, safety demonstration is a critical component of bringing products to market and gaining public acceptance for cultured meat and seafood. This manuscript develops research priorities from the findings from a series of interviews and workshops with governmental scientists and regulators from food safety agencies in fifteen jurisdictions globally.  The interviews and workshops aimed to identify the key safety questions and priority areas of research. Participants raised questions about which aspects of cultured meat and seafood production are novel, and the implications of the paucity of public information on the topic. Novel parameters and targets may require the development of new analytical methods or adaptation and validation of existing ones, including for a diversity of product types and processes. Participants emphasized that data sharing of these efforts would be valuable, similar to those already developed and used in the food and pharmaceutical fields. Contributions to such databases from the private and public sectors would speed general understanding as well as efforts to make evaluations more efficient. In turn, these resources, combined with transparent risk assessment, will be critical elements of building consumer trust in cultured meat and seafood products.

This qualitative research study is a part of a larger research project exploring the experiences of young caregivers aged 5-26 years and their families navigating the COVID-19 pandemic between 2020 to 2023. Data was collected from 14 young caregivers who participated in baseline interviews. The central research question guiding this study: What was, is, and will be the impact of changing public health restrictions on young caregivers and their families during the pandemic and pandemic recovery? Seven themes emerged through analysis: 1) Navigating Care During the Height of Public Health Restrictions, 2) Neighbourhood and Built Environment During the Pandemic, 3) Perceptions Towards COVID and Public Health Restrictions/Efforts, 4) The Impact of Public Health Restrictions on Relationships, 5) Mental Health Challenges of Being a Young Caregiver During a Pandemic, 6) Navigating Formal Services and Supports and 7) Recommendations from Young Caregivers. The findings from this empirical research suggest that young caregivers found it easier to navigate their caregiving responsibilities when public health restrictions and work-from-home mandates were initially implemented, however, this later changed due to challenges in finding respite from caregiving, maintaining social connections with friends, creating personal space at home, and finding adequate replacements of programs once offered in-person.

Introduction: Family medicine physicians take care of a diverse population of patients with a variety of acute and chronic diseases. These patients include family, friends, and acquaintances who may ask for direct medical care or help in accessing healthcare products and services, within or outside of officially approved procedures. This is ethically challenging due to an ambiguous medical code of ethics, but it is commonly accepted as normal behavior by society. Clinical ethics and the moral code of conduct together define how physicians should deal with such requests. However, Saudi physicians, like most individuals in Saudi society, are governed by the societal code of conduct when dealing with requests and favors from others. The aim of this study is to explore family medicine physicians’ perspectives regarding the benefits, difficulties, and ethics of responding to medical care requests and/or favors from family, relatives, friends, and acquaintances and to make recommendations. Methods: The study sample consisted of junior and senior family medicine physicians working in primary healthcare centers affiliated with the Ministry of Health in Saudi Arabia. In-depth semi-structured interviews were conducted to collect data. Using Social Exchange Theory, this qualitative study explores how family medicine physicians perceive and handle requests for medical favors from family members and others. Results: Semi-structured interviews were conducted with 19 family medicine physicians with clinical experience ranging from 3 to 20 years. Data analysis identified three themes: perceived benefits and costs of cultural and social connectedness, shortcomings in patient management and healthcare systems, and recommendations to address challenges between physicians and patients who are relatives. Discussion and conclusion: The study shows that treating others outside of normal access to healthcare services presents several ethical, moral, and professional challenges. Therefore, policy adaptation requires understanding this intricate dilemma and improving laws, system regulations, and guidelines for physicians and community members to improve access to care, reduce system abuse, empower providers, and enhance community awareness and compliance.

In Taiwan, remote healthcare was initially limited to telemedicine services, and the systematic development of remote care was relatively delayed. It was not until 2007 that the Department of Health of the Executive Yuan first initiated the 'Remote Care Pilot Program,' followed by the 'Remote Care Service Improvement and Quality Enhancement Plan' in the subsequent year. In 2010, Taiwan officially launched the 'Remote Health Care Services Development Plan' and established a dedicated project office, marking the comprehensive start-up of remote care services. This stage saw significant contributions from artificial intelligence aids and ICT remote transmission technologies, greatly promoting the application of smart healthcare in home care. This study aims to explore the strategic gaps in the application of smart healthcare in home remote care. By analyzing gaps in 'legal regulations,' 'economic factors,' 'user behavior habits,' 'policy and culture,' and 'environment and technology,' this study employs a mixed-methods approach. Particularly, it uses the Analytic Hierarchy Process (AHP) to construct a weighted ranking of these strategic gaps. Through in-depth interviews with doctors and smart healthcare experts and the collection of 16 valid AHP questionnaire samples, which cover both industry and academia with a balanced distribution, the survey results are ensured to be representative and reliable. The findings indicate that 'legal regulations' are considered the most critical strategic gap that needs to be addressed first, followed by 'user behavior habits.' This suggests that when designing smart healthcare applications, greater consideration needs to be given to user acceptance and habits. By systematically analyzing and addressing these strategic gaps, this study not only provides solutions to issues in the application of smart healthcare in home remote care but also offers valuable references for future research and practice, aiming to make home remote care services more comprehensive and efficient.

Background: Sexualized substance use (SSU) is the practice of psychotropic substance usage, before or during sexual intercourse in order to increase sexual pleasure and arousal. It has a strong association with sexually transmitted infections (STIs). The present study aimed to assess the knowledge gaps regarding SSUs among the community health mobilizers by interviewing them regarding their knowledge, attitudes, and practices through qualitative approach. Methodology: In-depth interviews (IDIs) were conducted with a total of nineteen community health mobilizers engaged in counselling of sexualized substance users. A semi-structured open-ended questionnaire with socio-demographic information and probes related to SSU was administered. Informed consent was taken from each participant prior to data collection. Results: Gender-wise distribution indicated that 47% of the community mobilizers are men, followed by transgender persons (32%), and women (21%). Responses of participants highlighted that alcohol consumption was the most observed form of SSU. The findings indicated that drug administration through injection was most common, followed by sniffing and swallowing. Sources of drug pro-curement enlisted by participants included peddlers, peer groups, sexual parties, medical and liquor stores. Only 63% of participants had fair knowledge about STIs such as HIV, viral hepatitis, syphilis, and gonorrhoea. All were familiar with the administration of naloxone injections and the locations of nearby hospitals where patients could be transported in the event of an overdose. Conclusions: The in-depth interviews among the study participants reflected substantial know-ledge gaps related to various areas associated with SSU, which highlights the need for periodic workshops and training for upgradation of existing knowledge and practices among community health mobilizers. This will help to broaden their knowledge of different types of SSUs, the latest substances of abuse, the diseases caused by high-risk sexual practices, and additional health and psychological issues associated with SSUs, which would ultimately help in better counseling and management of sexualized substance users. It may also play a crucial role in the strengthening of capacity-building systems and engagements at the community level. This study may be used as formative research by researchers and policy makers to develop study protocols for multi-centric community-based studies among community health mobilizers and sexualized substance users across the country for further validation and exploration.

Promoting diet and physical activity is important for women with recent gestational diabetes mellitus (GDM) and their partners to reduce the risk of future type 2 diabetes (T2D). The study aimed to understand how motivation for changing diet and physical activity behaviors among women with recent GDM and their partners was experienced after participation in the Danish Face-it intervention. Fourteen couple interviews were conducted. Data analysis followed reflexive thematic analysis. Guided by self-determination theory and interdependence theory, we identified four themes affecting couples’ motivation for health behavior change: 1) The need for relatedness after delivery, 2) Promoting competence and autonomy for health behavior change, 3) Individual and mutual preferences for health behaviors, and 4) The health threat of future T2D as a cue to action. We found that the couples in general perceived the Face-it intervention as useful and motivating. Using couple interviews increased our understanding of how the women and partners influenced each other’s perspectives after a GDM-affected pregnancy and thus how targeting couples as opposed to women alone may motivate health behavior change.

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.

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 research paper aimed to explore the impact of childhood and adolescent experiences on the leadership development of Emirati women in the United Arab Emirates (UAE). Using a qualitative research methodology, the study utilized in-depth narrative semi-structured interviews, document analysis, and diary writing to understand the complex issue of leadership development. Findings indicate that childhood and adolescent experiences, including family upbringing, education, culture, and societal expectations, have significant impacts on the leadership development of Emirati women. Specifically, family upbringing and cultural values shape Emirati women's leadership aspirations and behaviors, while education and societal expectations provide opportunities and barriers for women's leadership development. The implications of these findings for policymakers and practitioners seeking to promote women's leadership development in the UAE are discussed.

Iturbide is located in the Northeast of Mexico, it has a rich native and exotic flora, however, there are no ethnobotanical records, therefore, it requires attention in the documentation of traditional practices and uses of its botanical resources. In 2021, twelve field trips were carried out, applying 110 semi-structured interviews. Plant samples were collected, identified and deposited in an herbarium. We used the Chi-square test to compare ethnobotanical uses with respect to others reported in Mexico. To determine the cultural importance, three ethnobotanical indices were applied (UVI, ICF and FL). We recorded 250 species with ethnobotanical uses associated with 121 genera and 83 families, including 140 native and 110 exotic species. The most common plant families were Asteraceae, Lamiaceae, and Fabaceae. The main uses were ornamental, medicinal and food. The species with the highest UVI values ​​were Lepidium peruvianum, Ocimum basilicum and Rosmarinus officinale. The multifunctionality of the native and exotic flora demonstrates the extensive knowledge associated with botanical resources. Examples, the role of ornamental plants, with a direct impact on human well-being, the resilience of healers and traditional inhabitants by using different species for the treatment of various ailments. or indigenous edible plants in the daily diet.

Off-grid electrification planning increasingly recognizes the importance of productive use of electricity (PUE) to promote community value creation and (financial) project sustainability. To ensure a sustainable and efficient integration in the community and energy system, PUE assets must carefully be evaluated to match both the community needs and the residential electricity demand patterns. We propose a novel methodology interlinking qualitative interviews, statistical analysis, and energy system modelling to optimize decision-making for PUE integration in off-grid energy systems in rural Madagascar by aligning relevant PUE effectively with anticipated residential electricity demand patterns based on socio-economic determinants of the community. We find that a possible contribution of the PUE to reducing the electricity costs depends signifi-cantly on three factors: 1. the residential electricity consumption patterns that are influenced by the socio-economic composition of the community, 2. the degree of flexibility of i) PUE assets and ii) operational preferences of the PUE user, and 3. the capacity of community members to finance and operate PUE assets. Our study demonstrates that significant cost reductions for PUE-integrated off-grid energy systems can be achieved by applying our proposed methodology. When matching PUE and residential consumption patterns, the integration of PUE assets in residential community energy system can reduce the financial risk of operators, provided the PUE enterprise operates reliably and sustainably. We highlight that the consideration of local value chains and co-creation approaches are essential to ensure the energy system is addressing the community’s needs, creates value for the community, enhances the project´s financial sustainability, and is achieving the overall objectives of decentralized energy system planning.

Women have been leading organizations and communities for centuries, but their journeys in leadership have sometimes been challenging. This paper aims to reflect on women's positive and negative experiences in leadership roles and understand the factors contributing to their successes and challenges.To explore these issues, we will draw on various academic literature, including studies on gender and leadership and case studies of women in leadership positions. We will also examine the cultural and social factors that affect women's experiences in leadership, including bias and discrimination, societal expectations, and work-life balance challenges.One key theme from this analysis is the importance of role models and support networks in helping women succeed in leadership roles. Women with access to mentorship, sponsorship, and peer networks are more likely to thrive in their roles and overcome the challenges they may face. However, lacking female role models and mentors can make it difficult for women to advance in their careers and contribute to feelings of isolation and imposter syndrome.Another important theme is the need for organizations and society to address systemic biases and discrimination that prevent women from reaching their full potential. This can include initiatives such as unconscious bias training, flexible work arrangements, and policies that support gender diversity and inclusion.In conclusion, this paper highlights women's positive and negative experiences in leadership roles and emphasizes the need for ongoing efforts to support and empower women in leadership. By addressing the challenges women face and building a culture of inclusion and support, organizations and society can help unlock the full potential of women leaders and create a more equitable and just world.