Qualitative research in evidence‐based practice: a valuable partnership

Alternative work arrangements: Individual, organizational and environmental outcomes

Flexible working models are widely used around the world. Furthermore, several countries are currently transitioning to a 4-day workweek. These working models have significant effects on organizational behavior and the environment. The study investigates the employees' attitudes and behaviors toward flexible working and 4-day workweek and the impact on the environment. The semi-structured interview method was used in the study to determine employee attitudes and behaviors; the carbon footprint calculation method was used to determine the environmental impact of a 4-day workweek. According to the study's findings, it has been discovered that there would be a positive impact on socialization, happiness, stress factor, motivation, personal time, mental health, comfort, work-life balance, time-saving, willingness, positive working environment, personal time, and physical health. Furthermore, a 4-day workweek reduced commuting emissions by 20%, resulting in a 6,07 kg tCO2e reduction per person. As a result, the study attempted to draw attention holistically to the positive effects of the flexible working model and 4-day workweek. The study is intended to serve as a tool for decision-makers and human resource managers.

Why do veterinarians ask for antimicrobial susceptibility testing? A qualitative study exploring determinants and evaluating the impact of antibiotic reduction policy

For public health reasons, increasing attention has focused on more rational use of antimicrobials in farm animals. Guidance concerning the prescription of antibiotics and antimicrobial susceptibility testing (antibiograms in this case) are beneficial tools to help control the development of antimicrobial resistance. Nevertheless, even though there are already several qualitative studies analysing the determinants of antimicrobial prescription and use in veterinary medicine, little is known about decision-making concerning the use of antibiograms. The aim of this study was to provide a better understanding of veterinarians' motivations and role-players' influence concerning the choice of whether to ask for an antibiogram in the bovine, porcine, poultry and equine sectors in France. We concurrently evaluated the impact of a new French decree (2016) requiring an antibiogram before certain critically important antimicrobial agents can be used in veterinary medicine. Semi-structured interviews with veterinarians were conducted in France. Thematic analysis was used to analyse transcripts. In all, we surveyed 66 veterinarians. Use of antibiograms in veterinary medicine was multifactorial - 46 factors grouped into 11 categories were identified - and differed between animal sectors: use was almost systematic in poultry, frequent in pigs and rare in both the bovine and equine sectors. The decree has not increased the use of antibiograms but has induced a change in prescriptions due to field constraints and the time needed to obtain the results of antibiograms. Respondents see the decree as an aid in promoting responsible and rational use of antibiotics, fostering the use of alternatives. Our findings provide the basis of veterinarians' position regarding antibiogram use and antimicrobial resistance, pointing out levers to facilitate the use of antibiograms in veterinary medicine (for example communication on the benefits of this test and external financial support). Furthermore, the evaluation of the impact of the decree aimed at reducing the use of critically important antibiotic highlights key factors for a successful change in regulations, such as advance planning, precise and adapted communication, and demonstration of the measure's legitimacy. These results will be useful in guiding representative veterinary bodies and regulatory authorities during their decision-making, communication, and policy and regulation choices to combat antimicrobial resistance.

The importance of communication in promoting voluntary participation in an experimental trial: A qualitative study based on the assessment of the gamma-interferon test for the diagnosis of bovine tuberculosis in France

Understanding the factors leading each stakeholder to participate in an experimental trial is a key element for improving trial set-up and for identifying selection bias in statistical analyses. An experimental protocol, validated by the European Commission, was developed in France to assess the ability of the gamma-interferon test in terms of accuracy to replace the second intradermal skin test in cases of suspected bovine tuberculosis. Implemented between 2013 and 2015, this experimental trial was based on voluntary participation. To determine and understand the motivation or reluctance of farmers to take part in this trial, we carried out a sociological survey in France. Our study was based on semi-structured interviews with the farmers and other stakeholders involved. The analysis of findings demonstrated that shortening the lock-up period during tuberculosis suspicion, following the use of a gamma-interferon test, was an important aim and a genuine challenge for the animal health stakeholders. However, some farmers did not wish to continue the trial because it could potentially have drastic consequences for them. Moreover, misunderstandings and confusion concerning the objectives and consequences of the trial led stakeholders to reject it forcefully. Based on our results, we offer some recommendations: clear and appropriate communication tools should be prepared to explain the protocol and its aims. In addition, these types of animal health trials should be designed with the stakeholders’ interests in mind. This study provides a better understanding of farmer motivations and stakeholder influences on trial participation and outcomes. The findings can be used to help design trials so that they promote participation by farmers and by all animal health stakeholders in general.

Evidence and Evidence-Based Practices: Are We There Yet?

The purpose of this article is to move the field of intellectual and closely related developmental disabilities (IDD) towards a better understanding of evidence and evidence-based practices. To that end, we discuss (a) different perspectives on and levels of evidence, (b) commonly used evidence-gathering strategies, (c) standards to evaluate evidence, (d) the distinction between internal and external validity, and (e) guidelines for establishing evidence-based practices. We also describe how the conceptualization and use of evidence and evidence-based practices are changing to accommodate recent trends in the field.

Nutrition education and counselling as strategic interventions to improvehealth outcomes in adult outpatients with HIV: a literature review

Malnutrition poses a significant risk for people living with HIV and accelerates disease progression. This is because adequate nutrition is essential for optimal immune function. This article discusses research on the role and use of nutrition education or counselling as a strategic intervention to improve health outcomes through better health behaviour in adult outpatients with HIV. Ten studies (five quantitative and five qualitative) met the inclusion criteria of the literature review. The findings of the studies related to the following outcomes of nutrition interventions: increases in fat-free and lean body mass; offsetting the adverse effects of HIV infection in patients with a low CD4 cell count; significant improvement in dietary patterns with resultant greater adherence to HIV medications and fewer side effects; and agreement on the importance of addressing the nutrition concerns. The article discusses the five prominent themes that emerged from the literature review: 1) ethical issues in HIV/AIDS research; 2) the role of health and culture in nutrition interventions; 3) HIV stigma and its impact on nutrition interventions; 4) the socioeconomics of HIV and AIDS; and 5) food security and emotional wellbeing among persons with HIV. Although the evidence base is limited and raises questions about key aspects of the quality of the research conducted to date, the overall results show that providing HIV-positive adults with culturally relevant and practical nutrition strategies can improve health outcomes, health behaviour and quality of life. Current and future nutrition interventions for persons with HIV disease should be targeted, sustainable, and rigorously evaluated. There is an urgent need for research on this topic in developing countries, particularly African ones, which are some of the most affected by HIV.

A focused ethnographic study of Alberta cattle veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance programs

The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance.