The Perceptions of Families of Comatose Patients in the Intensive Care Unit: A Qualitative Study

Background: There are specific challenges regarding the perceptions of families of comatose patients in Intensive Care Units (ICUs). Identifying these perceptions may attract the cooperation of families with nurses and provide better care for patients. This study aimed to explore the perceptions of families of comatose patients in ICUs. Methods: This was a qualitative content-analysis study. Seventeen families with comatose patients were recruited by the purposive sampling technique. The necessary data were generated by semi-structured interviews, continued until data saturation, and concurrently analyzed by an inductive content analysis method. Results: Four main categories were manifested, including shock and disbelief, the effort for adaptation, exhaustion, and burnout, as well as hope and support. Conclusion: The obtained results signified the importance of nurses’ awareness concerning the family members’ perceptions of their comatose patient status in ICUs. The relevant findings reflected the need for nurses to pay attention to the feelings and emotions of the families of these patients.

Promoting Health in a Rural Community in the Basque Country by Leveraging Health Assets Identified through a Community Health Diagnosis

Salutogenesis focuses on factors that generate health and is a useful construct for identifying factors that promote health and for guiding activities to this end. This article describes health assets identified in a community diagnosis and how to leverage them with actions for improvement to deepen the understanding of this concept and its impact on health promotion. An intervention strategy was designed following the principles of participatory action research (PAR). The study was carried out in Mañaria (Basque Country, Spain) using semi-structured and in-depth interviews, participant observation, desk review, and photographs, alongside different participatory strategies. Twenty-six women were interviewed, 21 of whom were community inhabitants, and five were key informants who worked in public or private institutions. Participant recruitment stopped when data saturation was reached. Data were analysed through discourse analysis, progressive coding, and categorisation. Six meta-categories emerged, and for each of these categories, health assets were identified together with actions to improve the community’s health. The latter were presented by the community to the authorities to trigger specific actions towards improving the health of the community. Identification of health assets led to different actions to improve the health of the community including improving the existing physical and social environments, personal and group skills, and the promotion of physical, social, emotional and cultural well-being.

Asymmetric Interfaces in Epitaxial Off-Stoichiometric Fe3+xSi1−x/Ge/Fe3+xSi1−x Hybrid Structures: Effect on Magnetic and Electric Transport Properties

Three-layer iron-rich Fe3+xSi1−x/Ge/Fe3+xSi1−x (0.2 < x < 0.64) heterostructures on a Si(111) surface with Ge thicknesses of 4 nm and 7 nm were grown by molecular beam epitaxy. Systematic studies of the structural and morphological properties of the synthesized samples have shown that an increase in the Ge thickness causes a prolonged atomic diffusion through the interfaces, which significantly increases the lattice misfits in the Ge/Fe3+xSi1−x heterosystem due to the incorporation of Ge atoms into the Fe3+xSi1−x bottom layer. The resultant lowering of the total free energy caused by the development of the surface roughness results in a transition from an epitaxial to a polycrystalline growth of the upper Fe3+xSi1−x. The average lattice distortion and residual stress of the upper Fe3+xSi1−x were determined by electron diffraction and theoretical calculations to be equivalent to 0.2 GPa for the upper epitaxial layer with a volume misfit of −0.63% compared with a undistorted counterpart. The volume misfit follows the resultant interatomic misfit of |0.42|% with the bottom Ge layer, independently determined by atomic force microscopy. The variation in structural order and morphology significantly changes the magnetic properties of the upper Fe3+xSi1−x layer and leads to a subtle effect on the transport properties of the Ge layer. Both hysteresis loops and FMR spectra differ for the structures with 4 nm and 7 nm Ge layers. The FMR spectra exhibit two distinct absorption lines corresponding to two layers of ferromagnetic Fe3+xSi1−x films. At the same time, a third FMR line appears in the sample with the thicker Ge. The angular dependences of the resonance field of the FMR spectra measured in the plane of the film have a pronounced easy-axis type anisotropy, as well as an anisotropy corresponding to the cubic crystal symmetry of Fe3+xSi1−x, which implies the epitaxial orientation relationship of Fe3+xSi1−x (111)[0−11] || Ge(111)[1−10] || Fe3+xSi1−x (111)[0−11] || Si(111)[1−10]. Calculated from ferromagnetic resonance (FMR) data saturation magnetization exceeds 1000 kA/m. The temperature dependence of the electrical resistivity of a Ge layer with thicknesses of 4 nm and 7 nm is of semiconducting type, which is, however, determined by different transport mechanisms.

A Qualitative Investigation of the Perceptions of Complementary and Alternative Medicine Among Adults in Hawaiʻi

Background: Complementary and alternative medicine (CAM) is defined as a group of diverse medical and healthcare practices outside of conventional medicine modalities. The use of CAM is steadily increasing despite gaps in the scientific evidence supporting its use and the challenges of its regulation and integration into conventional healthcare practices. In this context, perceptions concerning CAM become important. The purpose of this study is to identify the perceptions of CAM among adult residents of Hawaiʻi.Methods: Two researchers conducted audio-recorded interviews at the University of Hawaiʻi Mānoa (UHM) campus. Participants were over the age of 18, spoke English fluently, and self-identified as Hawaiʻi residents. Interviews were conducted to the point of data saturation and audio recordings were transcribed verbatim. Researchers collaboratively developed a codebook and used NVivo 12 to analyze transcripts. New codes were added as required. Inter-rater reliability was determined by calculating Cohen’s kappa coefficient. Key themes were identified by both researchers individually and then discussed and evaluated together.Results: Participants were mostly female, white, and affiliated with UHM. Perceptions were categorized as positive, negative, and neutral. The majority of participants had positive perceptions of CAM with few reporting negative perceptions. The positive perceptions were related to CAM’s perceived effectiveness, the desirability of CAM compared to conventional medicine, and CAM’s ability to foster well-being. Negative perceptions were attributed to the lack of scientific evidence and ineffective outcomes of CAM use. Neutral perceptions of CAM related to its safety and natural characteristics. Conclusions: The finding of this study revealed mainly positive perceptions of CAM revealed among Hawaiʻi residents. Use of CAM is on the rise despite CAM lacking empirical evidence demonstrating efficacy. With insufficient data and understanding, CAM users place themselves at risk for harmful herb-herb and herb-drug interactions. These findings have implications for healthcare providers of both conventional medicine and CAM traditions.

Patterns and Predictors of Off-Label Drug Prescribing in Psychiatric Practice: A Qualitative Study

Off-label drug prescribing (OLDP) must be based on strong scientific evidence to make sure that patients get the optimum therapeutic outcomes. Adherence to the prerequisites is determined by the physicians’ attitude and knowledge. In this context, the present study was conducted with the goal of investigating psychiatrists’ perceptions of the use of OLDP in their clinical practice. A total of 14 psychiatrists were interviewed using a semi-structured interview guide. Thematic content analysis was performed. Data saturation was achieved at the 12th interview. Six major themes and fifteen subthemes emerged from qualitative interviews. Among the major themes were knowledge and concepts about the off-label drugs, attitude and current practice of prescribing off-label drugs, and rationale of prescribing and suggestions for reducing the use of off-label drugs. Almost all of the respondents interviewed provided detailed comments concerning the OLDP concept, depicted an optimistic approach and deemed that OLDP is quite common in psychiatry. Off-label usage of benzodiazepines such as clonazepam, diazepam and lorazepam in mania, depression, and obsessive–compulsive disorder were commonly reported. It was observed that the majority of the respondents did not inform the patients before prescribing off-label drugs. The present findings revealed that respondents had awareness; however, they depicted diverse attitudes towards prescribing off-label drugs. Further education and sensitization in regions with impoverished knowledge would certainly assist in preventing the risks associated with the use of OLDP.

"I feel too lethargic to do physical activity": Perceptions of Iranian adults on the barriers to perform regular physical activity

Background: Despite the intention to perform physical activity (PA), a number of individuals cannot manage to have PA program on a regular basis. In this study we explored the barriers of regular PA behavior among healthy adults in Tabriz, Iran. Methods: This qualitative study with a conventional content analysis approach, was carried out from June to September 2020. Nineteen 30-59 years old individuals, were purposefully (purposive sampling) selected to participate in the study. The participants were formerly registered as "physically inactive" in the health records of Tabriz Health System. Individual semi-structured interviews were conducted until data saturation. Data were managed using MAXQDA-10 software. Results: The barriers of regular PA that emerged from our data were being listless and lethargic, non-supportive environment, disintegration in PA education chain, and restrictive social norms. Conclusion: Our findings uncover several PA barriers that are less discussed in the literature. Poor level of regular PA among adults in Iran, as a developing context, is rooted in perceptions with social and economic origins, which should be taken into account by public health policy makers while planning PA promotion programs in such communities. To promote regular PA among healthy adults in developing countries, regular PA programs should be tailored to bridge the gap between their recognition of PA barriers and subsequent behavior change through creating group dynamics highlighting the measures to diminish the behavior.

Examining the Values Allocated to the Natural Environment: Non-human beings in focus: The Case of Some Selected Districts in East Gojjam Zone

Value is a worth given to something either for its consequential utility for the valuers or a worth given for its own sake. While the former way of evaluation is called extrinsic value, the latter is called intrinsic value. Any kind of approach we adapt to anything emerges from a kind of value we allocate to the thing in question, i.e., kind of value people attribute to the natural environment in general and to non-human, in particular, determine people's treatment, evaluation, action and attitude toward the being in focus. Supposing that the ever-increasing environmental crisis is anthropogenic, this paper is trying to examine the kind of value allocated to the environment and non-human beings in East Gojjam. A qualitative approach and case study design were employed to achieve the objective. Both Primary and secondary dated dates were collected. To collect data, focus group discussion, semi-structured interview, key informant interview, and document review were employed as data collecting instruments. Hence, the participants: officials and exports from the office of wildlife protection, office of natural resource management as well as the office of forest enterprise, local people and religious leaders were purposively selected, and the sample size was determined by data saturation. Finally, the collected data was analyzed thematically. The research found out that the kind of value ascribed to environments is extrinsic. Treating animals and plants as the mere means for the manifold end of human being paves the way for human beings to have untrammeled intervention in the environment.

Choosing and Managing Aged Care Services from Afar: What Matters to Australian Long-Distance Care Givers

This research aims to identify the factors that influence caregivers’ decisions about the aged care providers they select for their elder relatives when caring from a distance and what they value once they have engaged a service. Adult long-distance carers for older relatives living within Australia were purposively sampled and they participated in audio-recorded interviews. A thematic analysis was employed to investigate the data. A sample of 13 participants enabled data saturation with no new major themes identified in the final three interviews. Participants were 50 to 65 years (Mean = 59.8) and mostly (77%) female. Four themes emerged relating to selection of care providers: (1) availability of care, (2) financial arrangements, (3) proximity and location, and (4) reputation of care provider. Five themes detailed valued qualities of care: (1) vigilant monitoring and responsivity, (2) communication with family, (3) flexibility and proactiveness of care, (4) staffing, and (5) access to appropriate and holistic care to maintain wellbeing. Long-distance caregivers face barriers in selecting and managing aged care services from afar within a complex Australian aged care system. They strongly value regular, proactive communication about the wellbeing of their relatives and may be particular beneficiaries of communication and assistive monitoring technologies.

AN EXPLORATORY STUDY OF THE USAGE OF ELECTRONIC PLATFORM FOR CONSERVATION MARKETING AMONG EDUCATION ENVIRONMENTAL CENTRES (EEC) IN MALAYSIA

With limited funding, conservationists are far from able to assist all threatened species. Even though online marketing has been increasingly used by conservationists to raise funds and awareness on the need to reduce biodiversity loss, the major issue is reaching the target audience and influencing their behaviour, especially if the target audience is a profit-making entity. To date, a comprehensive theoretical investigation on online conservation marketing pertaining business expectation, preferences, experience and satisfaction is still in its infancy and remains unanswered. Therefore, to fulfil this gap, this qualitative study is executed, in which 19 in-depth interviews was adopted until data saturation is achieved. The participants are those who worked in relationship marketing field and have experienced online conservation marketing activities. The study explores and profiles the experiences and satisfaction of businesses based on their previous online conservation marketing and the expectation and preferences of businesses for future online conservation marketing. Based on the research findings, even before the first Covid-19 outbreak in Malaysia, many businesses in the country were involved in at least one online conservation marketing strategy with an Environmental Education Centre (EEC) and many were satisfied with the EEC online marketing strategies and services. However, most businesses have less expectations and low preferences towards the future online conservation marketing by the EEC. This study assists conservation organisations in retaining the financial support from businesses and enhancing public conservation awareness through businesses. This study is aligned with Malaysia National Key Economic Areas (NKEA) no 4, under Entry Point Project 4 (EPP 4) and also NKEA no 6, under EPP 12.

Assessing Crisis Management Competencies: A Case Study of Pasir Gudang City Council

In this modern era of globalisation, the role of leaders and employees in handling crises and problems is very important. This study aims to gather as much understanding as possible through different perspectives.This study was conducted using qualitative methods involving eight informants in a number of in-depth interviews until data saturation has been reached. During the interview sessions, questions were asked based on the preparation of an interview protocol. Data analysis discovered four main themes related to crisis management competencies, namely “excellent work culture”, “dynamic thinking competency learning”, “efficient organisational production”, and “responsive governance development”.Overall, the data acquisition indicates that crisis management competencies give further understanding to employees on how to deal and handle upcoming crisis and to prepare it from happening in the future. At the same time, the management and employees need to implement organisational learning as a process to formulate strategies and improve the service quality to external parties such as customers and stakeholders.