scholarly journals Antibiotic stories: a mixed-methods, multi-country analysis of household antibiotic use in Malawi, Uganda and Zimbabwe

2021 ◽  
Vol 6 (11) ◽  
pp. e006920
Author(s):  
Justin Dixon ◽  
Eleanor Elizabeth MacPherson ◽  
Susan Nayiga ◽  
Salome Manyau ◽  
Christine Nabirye ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Antibiotic Use ◽  
Health Providers ◽  
Survey Tool ◽  
Healthcare Settings ◽  
Patterns Of Use ◽  
Rural And Urban ◽  
Key Stakeholders ◽  
Country Analysis ◽  
Health Programming

BackgroundAs concerns about the prevalence of infections that are resistant to available antibiotics increase, attention has turned toward the use of these medicines both within and outside of formal healthcare settings. Much of what is known about use beyond formal settings is informed by survey-based research. Few studies to date have used comparative, mixed-methods approaches to render visible patterns of use within and between settings as well as wider points of context shaping these patterns.DesignThis article analyses findings from mixed-methods anthropological studies of antibiotic use in a range of rural and urban settings in Zimbabwe, Malawi and Uganda between 2018 and 2020. All used a ‘drug bag’ survey tool to capture the frequency and types of antibiotics used among 1811 households. We then undertook observations and interviews in residential settings, with health providers and key stakeholders to better understand the stories behind the most-used antibiotics.ResultsThe most self-reported ‘frequently used’ antibiotics across settings were amoxicillin, cotrimoxazole and metronidazole. The stories behind their use varied between settings, reflecting differences in the configuration of health systems and antibiotic supplies. At the same time, these stories reveal cross-cutting features and omissions of contemporary global health programming that shape the contours of antibiotic (over)use at national and local levels.ConclusionsOur findings challenge the predominant focus of stewardship frameworks on the practices of antibiotic end users. We suggest future interventions could consider systems—rather than individuals—as stewards of antibiotics, reducing the need to rely on these medicines to fix other issues of inequity, productivity and security.

scholarly journals Exploring Farmers’ Reasons for Antibiotic Use and Misuse in Pig Farms in Brazil

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 331
Author(s):  
Rita Albernaz-Gonçalves ◽  
Gabriela Olmos ◽  
Maria José Hötzel
Keyword(s):  
Social Factors ◽  
Antibiotic Use ◽  
Behavioral Changes ◽  
Foreign Markets ◽  
Treatment Length ◽  
Key Stakeholders ◽  
Prevention And Treatment ◽  
Pig Farms ◽  
Unrestricted Access ◽  
And Behavior

Stressful management that makes farmed pigs susceptible to infections is associated with high antibiotic use (AMU) and resistance (AMR). Pig farmers are key stakeholders to support the international agenda pushing AMU restrictions. We interviewed 58 pig farmers on AMU/AMR, biosecurity, veterinary assistance, disease prevention and treatment, aiming to understand practices and attitudes towards the AMU/AMR problem. Farmers described a reliance on antibiotics to prevent and treat disease while neglecting biosecurity measures. We identified inappropriate AMU practices (high use of broad-spectrum antibiotics, incorrect dosage or treatment length) and unrestricted access to antibiotics, which encouraged imprudent AMU. Nevertheless, most farmers considered this AMU legitimate to guarantee herd productivity and showed unpreparedness and resistance to changing AMU practices, perceiving limitations (economic, sanitary and inspection) more easily than alternatives to reduce AMU. Agro-industries and foreign markets were mentioned, and internal consumers dismissed as potential motivators for behavioral changes. Importantly, farmers’ economic, technical and social factors may limit their autonomy to change practices. We conclude that the observed distancing of pig farmers from the AMU/AMR problem limits the efficiency of policies aiming for a prudent AMU. Our study indicates a need for education, training and behavior change nudging that should include other stakeholders beyond farmers.

scholarly journals Caregiver-Centered Care Health Workforce Competencies: Developing Consistent Support for Family Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 15-15
Author(s):  
Jasneet Parmar ◽  
Sharon Anderson ◽  
Lisa Poole ◽  
Wendy Duggleby ◽  
Jayna Holyroyd-Leduc ◽  
...  
Keyword(s):  
Health System ◽  
Family Caregivers ◽  
Health Providers ◽  
Care Providers ◽  
Modified Delphi ◽  
Healthcare Settings ◽  
Delphi Approach ◽  
People With Dementia ◽  
Health And Social Care ◽  
Centered Care

Abstract Family caregivers [FCGs] are the backbone of the health system. They provide over 80% of the care for people with dementia, chronic illnesses and impairments. Despite evidence of their contributions and consequences of caregiving, support for FCGs has not been a health system priority. Education to prepare health providers to effectively identify, engage, assess, and support FCGs throughout the care trajectory is an innovative approach in addressing inconsistent system of supports for FCGs. We report on development and validation of the Caregiver-Centered Care Competency Framework to help with curricular design and subsequent evaluation of effectiveness of care providers working within healthcare settings to engage and support FCGs. We used a three round modified Delphi approach. An expert panel of 42 international, national, and provincial stakeholders agreed to participate. In the first 2 rounds, multi-level, interdisciplinary participants, rated the indicators in terms of importance and relevance. In the 3rd round consensus meeting, participants validated the six competency domains, including indicators in small group sessions. Thirty-four experts (81%) participated in the round 1, 36 (85.7%) in round 2, and 42 people (100%) in round 3. There was stable consensus across all three rounds, 96.07% of participants rated the indicators as essential or important (Round 1, 95.81%; Round 2, 94.15; Round 3, 98.23%). FCG research has been primarily focussed on educating FCGs to provide care. These competencies will shape the design of educational curricula and interdisciplinary training programs aimed at supporting the health and social care workforce to provide caregiver-centered care.

Is the future of work experience online? An examination of stakeholder attitudes towards online internships.

2021 ◽  
Author(s):  
Amy Irwin ◽  
Joy Perkins ◽  
Leah Hillari ◽  
Darja Wischerath
Keyword(s):  
Mixed Methods ◽  
Work Experience ◽  
Flexible Work ◽  
Online Study ◽  
Key Stakeholders ◽  
Internship Experience ◽  
Employer Perceptions ◽  
Research Gap ◽  
Additional Support ◽  
Stakeholder Attitudes

PurposeThe world of work is becoming digital, a process accelerated by the recent COVID-19 pandemic and resultant remote working guidelines. Online internships have become more popular in this context, and yet there remains a lack of research investigating how these internships are perceived across stakeholders. The purpose of this paper was to begin to address this research gap by exploring academic, student and employer perceptions of online internships with a focus on employability.DesignThe research explored 156 stakeholders (53 students, 50 academics, 53 employer / professionals) perceptions via a mixed-methods online study encompassing quantitative responses to internship vignettes, alongside open-ended questions designed to explore stakeholder attitudes in more depth.FindingsStakeholder groups reported similar attitudes towards online internships. Overall, online internships were viewed as valid, flexible, work experience, linked to skill development and likely to enhance student employability. However, concerns were raised regarding communication protocols and development, intern isolation and a lack of organisational immersion.ImplicationsBased on our research we make three recommendations to continue to enhance and develop the online internship experience; ensure multiple methods of regular communication between student and organisation, attempt virtual immersion in the organisation, and assign each intern additional support beyond their immediate supervisor.OriginalityBased on a holistic and novel analysis of key stakeholders’ viewpoints, this paper provides much needed insights and evidence on how to design and quality assure effective online internship practice.

scholarly journals How Do They Feel About It? Testing a New Mixed Methods Survey Tool to Assess Collective Emotional Status

2020 ◽  
Author(s):  
Michael Schwab ◽  
Vasileios Margaritis
Keyword(s):  
Public Health ◽  
Mixed Methods ◽  
Adult Population ◽  
Emotional Responses ◽  
Public Health Problem ◽  
Prima Facie ◽  
Emotional Status ◽  
Self Assessment ◽  
Survey Tool ◽  
Public Health Professionals

Emotions are now widely accepted as important elements of qualitative research, in studies of individuals and communities. However, collective emotional status—what a community feels about a given situation or proposition—can be challenging to assess. In this study, we examined the validity and acceptability of a new mixed methods survey tool, primarily qualitative, to address this challenge—the Assessment of Collective Emotional Status (ACES). The tool begins with an adjustable set of questions about emotion, to draw respondents’ attention to their own feelings. These are followed by an emotional self-assessment, in which respondents select and prioritize five emotional responses to a standardized stimulus, drawing from a new taxonomy of emotion words. In this study, the stimulus was a proposition that gun violence should be approached as a public health problem. We tested the tool in an international survey of public health professionals, mostly in the US and Europe (n=160). Qualitative and quantitative data were collected on knowledge and importance of emotion, adequacy of the taxonomy, emotional responses to the stimulus, and use of the tool. Scores were high for knowledge and importance of emotion. Perceived adequacy of the taxonomy was also high, especially with Black and Hispanic respondents, signifying good construct validity. The total weighted frequency of emotions in response to the stimulus was highest for encouraged (92.2%), open (78.8%), hope (77.2%) and interest (77.2%). Qualitative data yielded six themes—on knowledge of emotion, the taxonomy, responses to the stimulus, and use of the tool, which many respondents found easy and interesting to use. This study demonstrates the prima facie validity and acceptability of the ACES with an educated adult population.

scholarly journals Delays in lung cancer management pathways between rural and urban patients in North Queensland: a mixed methods study

2018 ◽  
Vol 48 (10) ◽  
pp. 1228-1233 ◽  
Author(s):  
Rishabh Verma ◽  
Shivanshan Pathmanathan ◽  
Zulfiquer A. Otty ◽  
John Binder ◽  
Venkat N. Vangaveti ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Cancer Management ◽  
Rural And Urban

Mixed Methods Research Online

2015 ◽  
pp. 411-432
Author(s):  
Theodora Issa ◽  
David Pick
Keyword(s):  
Mixed Methods ◽  
Business Ethics ◽  
Research Methods ◽  
Research Design ◽  
Mixed Methods Research ◽  
Online Survey ◽  
Practical Relevance ◽  
Mixed Methods Design ◽  
Survey Tool ◽  
Sensitive Issues

Contributing to the ongoing debate in research on sensitive issues such as business ethics, this chapter provides a discussion of mixed methods research design, examining the processes and challenges of developing and deploying an online survey tool using technology within an interpretive mixed methods design. This chapter provides pointers on how to deploy this approach through technology to research business ethics using the example of researching ethical mindsets and its components, including spirituality and aesthetics. It is found that mixed methods research is an effective approach because it allows often sensitive issues (i.e. business ethics, aesthetics, spirituality) relating to questioning individuals' inner values and ethical propensities, which are usually subtle and difficult to measure and analyze constructs. While this tool was developed in the Australian context, it has the potential to form a foundation for wider examination and research in business ethics. The chapter contributes to the collective discussion of research methods using a framework that has both practical relevance and theoretical rigor.

Mixed Methods Research Online

2015 ◽  
pp. 19-40
Author(s):  
Theodora Issa ◽  
David Pick
Keyword(s):  
Mixed Methods ◽  
Business Ethics ◽  
Research Methods ◽  
Research Design ◽  
Mixed Methods Research ◽  
Online Survey ◽  
Practical Relevance ◽  
Mixed Methods Design ◽  
Survey Tool ◽  
Sensitive Issues

Contributing to the ongoing debate in research on sensitive issues such as business ethics, this chapter provides a discussion of mixed methods research design, examining the processes and challenges of developing and deploying an online survey tool using technology within an interpretive mixed methods design. This chapter provides pointers on how to deploy this approach through technology to research business ethics using the example of researching ethical mindsets and its components, including spirituality and aesthetics. It is found that mixed methods research is an effective approach because it allows often sensitive issues (i.e. business ethics, aesthetics, spirituality) relating to questioning individuals' inner values and ethical propensities, which are usually subtle and difficult to measure and analyze constructs. While this tool was developed in the Australian context, it has the potential to form a foundation for wider examination and research in business ethics. The chapter contributes to the collective discussion of research methods using a framework that has both practical relevance and theoretical rigor.

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