Exploring SWOT analysis – where are we now?: A review of academic research from the last decade

Nature-based social prescribing programmes: opportunities, challenges, and facilitators for implementation

BACKGROUND

Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems.

METHODS

This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany's health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP.

RESULTS

We identified five overarching themes for developing, implementing, and evaluating NBSP: Capacity Building; Accessibility and Acceptability; Networks and Collaborations; Standardised Implementation and Evaluation; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation.

CONCLUSIONS

NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to different contexts. This research could help inform the development and evaluation of NBSP programmes to support planetary health from local and global scales.

Present status and application prospects of green chitin nanowhiskers: A comprehensive review

Petrochemical resources are non-renewable, which has impeded the development of synthetic polymers. The poor degradability of synthetic polymers poses substantial environmental pressure. Additionally, the high cost of synthetic biopolymers with excellent degradation performance limits their widespread application. Thus, it is crucial to seek green, sustainable, low-cost polymers as alternatives to petrochemical-based synthetic polymers and synthetic biopolymers. Chitin is a natural and renewable biopolymer discovered in crustacean shells, insect exoskeletons, and fungal cell walls. Chitin chains consist of crystalline and amorphous regions. Note that various treatments can be employed to remove the amorphous region, enhancing the crystallinity of chitin. Chitin nanowhiskers are a high crystallinity nanoscale chitin product with a high aspect ratio, a large surface area, adjustable surface morphology, and biocompatibility. They discover widespread applications in biomedicine, environmental treatment, food packaging, and biomaterials. Various methods can be utilized for preparing chitin nanowhiskers, including chemical, ionic liquids, deacetylation, and mechanical methods. However, developing an environmentally friendly preparation process remains a big challenge for expanding their applications in different materials and large-scale production. This article comprehensively analyzes chitin nanowhiskers' preparation strategies and their drawbacks. It also highlights the extensive application in different materials and various fields, besides the potential for commercial application.

Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy for pancreatic cystic lesions: current status and future prospects

Pancreatic cystic lesions (PCLs) have increased in prevalence due to the increased usage and advancements in cross-sectional abdominal imaging. Current diagnostic techniques cannot distinguish between PCLs requiring surgery, close surveillance, or expectant management. This has increased the morbidity and healthcare costs from inappropriately aggressive and conservative management strategies. Endoscopic ultrasound (EUS) needle-based confocal laser endomicroscopy (nCLE) allows for microscopic examination and delineation of the surface epithelium of PCLs. Landmark studies have identified characteristics distinguishing various types of PCLs, confirmed the high diagnostic yield of EUS-nCLE (especially for PCLs with an equivocal diagnosis), and shown that EUS-nCLE helps to change management and reduce healthcare costs. Refining procedure technique and reducing procedure length have improved the safety of EUS-nCLE. The utilization of artificial intelligence and its combination with other EUS-based advanced diagnostic techniques would further improve the results of EUS-based PCL diagnosis. A structured training program and device improvements to allow more complete mapping of the pancreas cyst epithelium will be crucial for the widespread adoption of this promising technology.

The development strategies of amateur table tennis matches in China based on the SWOT-AHP model: a case study in Shanghai

Given the significance of amateur sports matches in health promotion and city culture construction. It is essential to systematically analyze the organizational mode of city amateur matches and propose development strategies. This study aimed to investigate the sustainable development strategies for city amateur matches in China. This study adopted a hybrid model of combined SWOT and the AHP analysis, using the Shanghai City Amateur Table Tennis Matches (ATTM) as a case study. Results showed that 20 factors of the SWOT analysis were included, and the ranking of weights of the SWOT group are Strengths, Opportunities, Weaknesses and Threats, respectively, and the strategic vector (θ, ρ) are (74.21°, 0.5861). ATTM should adopt the S-O pioneering strategy and leverages its advantages and opportunities to promote further development. The findings indicate that ATTM with advanced organizational mode, has good internal strengths and external opportunities, which can enlighten the development of amateur table tennis matches for other regions and countries. Future research should apply the hybrid model to a broader range of events and conduct comparative analyses across countries and regions.

Stakeholder engagement to introduce a standardised register for improved inpatient care of newborns and sick children in Bangladesh

Background

Despite a global decrease of 59% in under-five mortality rates from 1990 to 2021, child survival remains a pressing issue. This holds true for Bangladesh, as well. In response, the Government of Bangladesh introduced a standardised register for strengthening the inpatient management of newborns and sick children in 2021.

Methods

We employed a comprehensive four-phase stakeholder engagement process to implement an inpatient register for newborns and sick children. The first stage included identifying and prioritising potential stakeholders at the national and district levels. We identified eight organisations involved in newborn and child health and selected 24 participants from various other sectors for workshops aimed at raising awareness about the register's introduction. These stakeholders also participated in the register's design, development strategies planning, and implementation phases. These phases were led by the 'National Newborn Health and IMCI programme' with support from various partners. A technical working group reviewed existing registers and helped prepare training materials. Feedback from each workshop was crucial in finalising the register.

Results

The Government of Bangladesh has recognised the need for an indoor register for newborns and sick children, which was to be established in collaboration with development partners. This initiative can enhance the quality of care for sick children and increase service provider accountability. Due to its successful implementation, it will continue to be used in the Kushtia and Dinajpur districts, with plans for a nationwide scale-up. The Government has allocated funds in the next health sector programme for orientation and register printing. A strengths, weaknesses, opportunities, and threats (SWOT) analysis of the stakeholder engagement process highlighted strengths such as a context-specific approach and collaborative engagement, as well as challenges such as time resource requirements.

Conclusions

Implementing an inpatient register for newborns and sick children through stakeholder engagement can effectively improve child health care services. Aside from challenges such as resource intensiveness and stakeholder commitments, success depended on the organising authority's expertise in relationship building, budget allocation, time management, and workforce dedication. Therefore, strategic planning, staff recruitment, networking, and budgeting are crucial for successful stakeholder engagement and health care initiatives.

Linking farmers' perceptions and management decision toward sustainable agroecological transition: evidence from rural Tunisia

Global food systems face sustainability challenges like undernourishment, inequity, resource degradation, and pollution. Food production and consumption drive environmental change with greenhouse gas emissions, biodiversity loss, and land-system shifts. The climate change crisis has intensified concerns about the ecological impact of these systems. Sustainable food networks, such as community-supported agriculture, are promoting sustainable production and consumption through short supply chains. International bodies like the Food and Agriculture Organization (FAO) and the Consultative Group for International Agricultural Research (CGIAR) are also spearheading initiatives for more equitable and sustainable food systems. In Tunisia, where dryland areas predominate, the ongoing implementation of the Agroecology Initiative provides the context for this study, which explores the drivers and barriers of agroecological transformation in this challenging environment. The research focuses on stakeholder engagement, with a gender perspective to explore farmer perceptions. The study, conducted in the northwest of Tunisia in 2022-2023, involved focus groups, workshops, surveys, and questionnaires with various stakeholders. Findings highlight farmer organizations' potential in promoting sustainable farming, with clear goals, diversified systems, and collaborations. However, challenges such as input scarcity, water shortage, low income, and marketing must be addressed. Results also indicate that over 90% of farmers who received assistance with agroecological practices reported a change in their ideas and practices. Fifty seven percent of the workshops participants identified the olive oil value chain as having the greatest potential for agroecological transformation, but it faces constraints such as climate, lack of policy incentives, training, funding, and difficulty in adopting technical innovations. Women's inclusion in agriculture, environmental, social, and economic challenges were also highlighted. Despite these obstacles, key drivers for agroecological transition were identified. These include the compatibility of many agroecological practices with existing farmer capabilities, their cultural and economic benefits, and the positive outcomes for environmental sustainability and health. The study advocates for a socio-technical systems analysis to address the root causes hindering Tunisia's agroecological transformation. A participatory approach is crucial to understanding priorities and developing a sustainable and resilient food system. Furthermore, the research underscores the importance of considering diverse farmer perspectives and tailoring strategies to support this critical transition effectively.

Evaluating ChatGPT-4's historical accuracy: a case study on the origins of SWOT analysis

In this study we test ChatGPT-4's ability to provide accurate information about the origins and evolution of SWOT analysis, perhaps the most widely used strategy tool in practice worldwide. ChatGPT-4 is tested for historical accuracy and hallucinations. The API is prompted using a Python script with a series of structured questions from an Excel file and the results are recorded in another Excel file and rated on a binary scale. Our findings present a nuanced view of ChatGPT-4's capabilities. We observe that while ChatGPT-4 demonstrates a high level of proficiency in describing and outlining the general concept of SWOT analysis, there are notable discrepancies when it comes to detailing its origins and evolution. These inaccuracies range from minor factual errors to more serious hallucinations that deviate from evidence in scholarly publications. However, we also find that ChatGPT-4 comes up with spontaneous historically accurate facts. Our interpretation of the result is that ChatGPT is largely trained on easily available websites and to a very limited extent has been trained on scholarly publications on SWOT analysis, especially when these are behind a paywall. We conclude with four propositions for future research.

An epidemiological qualitative/quantitative SWOT-AHP analysis in order to highlight the positive or critical aspects of dental implants: A pilot study

OBJECTIVES

In recent years, dental implants are increasing in popularity due to their high success rate, demonstrated functionality, and aesthetic treatment results. Scientific research is very active in proposing improvements in the quality and survival of implants, taking into consideration various aspects. The objective of this study was to provide a holistic epidemiologic view of the state of dental implants, using a systematic approach based on a multimethod SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and AHP (analytical hierarchical process) qualitative-quantitative analysis to identify the characteristics that can determine their success or failure.

MATERIALS AND METHODS

The study used the hybrid method of SWOT-AHP.

RESULTS

Analysis of the results showed that among strengths, the skill of the dentist was considered the most important factor, followed by the success of dental implants in the old people; among weaknesses, bruxism and chronic diseases were highlighted; for opportunities, biomechanical behavior, in terms of good mechanical strength and good tribological resistance to chemical and physical agents in the oral cavity, were considered the most important factors; finally, among threats, medical liability and biomechanical problems had equal weight.

CONCLUSIONS

This study applied a multimethod SWOT-AHP approach to bring out favorable or critical evidence on the topic of dental implants. In accordance with the result of the strategic vector identified in the Twisting zone Adjustment type section, showed that implant surgery is a widespread technique but always needs improvement to increase the likelihood of success and reduce the complications that can lead to implant failure.

Identifying Gaps in Pelvic Pain Education: A Scoping Review and Structured Analysis of Obstetrics and Gynecology Training Milestones

OBJECTIVE

Several clinical practice guidelines on the evaluation and management (EM) of chronic pelvic pain (CPP) have been published; however, it is not known whether obstetrics and gynecology (OBGYN) educational milestones are aligned with current practice recommendations. Therefore, this scoping review and structured analysis aims to identify gaps between clinical guidelines for the EM of CPP and OBGYN training milestones published by educational authorities like the Accreditation Council for Graduate Medical Education (ACGME) and the AAGL.

DATA SOURCES

The literature search was performed in MEDLINE, PubMed Central, and Bookshelf on the PubMed interface from January 2018 to September 2022. Peer-reviewed publications were included if they were a systematic review of recent practice guidelines and focused on female CPP. Publications that focused on a single pelvic pain condition or focused on a specific treatment were excluded.

METHODS OF STUDY SELECTION

Two reviewers extracted the data and appraised the study quality following the Critical Appraisal Skills Programme Checklist for systematic reviews. Four articles met inclusion criteria for thematic analysis. A reflexive thematic analysis via the inductive approach was performed to develop clinical themes common to all review articles and presumed important in the EM of CPP. Pelvic pain experts and Delphi methodology was used to assess validity and relevance of each theme in OBGYN training. Validated themes were used in a strengths weaknesses opportunities threats (SWOT) analysis of the ACGME and the AAGL Milestones used for training OBGYN residents and fellows. A SWOT analysis is an organizational tool used to analyze processes in terms of strengths, weaknesses, opportunities for improvement, and threats to implementing a potential change.

TABULATION, INTEGRATION, AND RESULTS

Twelve clinical themes were conceptualized and achieved ≥ 90% consensus as being important in the EM of CPP. Clinical themes pertained to pathophysiology, biopsychosocial approach, trauma-informed care, history and physical examination, diagnostic testing, multimodal/multidisciplinary management, pain education, and medical and surgical management. SWOT analysis showed that the ACGME Milestones lacked milestones specific to CPP, while the AAGL Milestones had 6 CPP-focused competencies with multiple milestones. Milestones on trauma-informed care and application of biopsychosocial assessment were notably absent.

CONCLUSION

OBGYN educational milestones published by the ACGME and the AAGL are not yet aligned with current clinical guidelines for the EM of CPP.

Development strategy of early childhood music education industry: An IFS-AHP-SWOT analysis based on dynamic social network

Early childhood music education has garnered recognition for its unique contribution to cognitive, emotional, and social development in children. Nevertheless, the industry grapples with numerous challenges, including a struggle to adapt traditional educational paradigms to new curriculum reforms, and an excessive emphasis on skill training at the expense of nurturing a love for music and aesthetics in children. To navigate these challenges and explore growth strategies for the early childhood music education industry, we initiated a comprehensive approach that involved distributing surveys to practitioners and parents and engaging experts for insightful discussions. Consequently, we proposed an analytical method based on dynamic social networks in conjunction with Intuitionistic Fuzzy Sets (IFS), Analytic Hierarchy Process (AHP), and Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, collectively referred to as IFS-AHP-SWOT. This integrated methodology synergizes the capabilities of dynamic social networks, IFS, AHP, and SWOT analysis to offer a nuanced perspective on industry development strategies. The findings underscore that institutions within the early childhood music education industry need to adopt a development strategy that leverages their strengths and opportunities to foster sustainable growth. Ultimately, this research aims to provide critical decision-making support for industry practitioners, policymakers, and researchers, contributing significantly to the ongoing discourse on strategic development in the early childhood music education industry.

Formal nursing focused academic practice partnerships for advancing nursing research and scholarship: a scoping review protocol

INTRODUCTION

This scoping review protocol will be used to map the evidence regarding structure and organization of formal nursing undergraduate focused academic practice partnerships in Canada and globally.

DESIGN

This scoping review will adhere to guidance provided by Chapter 11 of the JBI Manual for Evidence Synthesis: Scoping Reviews guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension checklist.

METHODS

Evidence will be eligible for inclusion if published in English, within the last 10 years, and available in full text. Databases will be searched for published literature and unpublished grey literature.

DISCUSSION

This protocol provides guidance on conducting a scoping review on formal nursing undergraduate focused academic practice partnerships. The review will enhance understanding of the structure and organization of formal nursing undergraduate focused academic practice partnerships, informing the design and work of future partnerships. This protocol is registered in the Open Science Framework https://doi.org/10.17605/OSF.IO/JCTRM.

Integration of simulation-based education in anaesthesiology specialist training: Synthesis of results from an Utstein Meeting

BACKGROUND

Despite its importance in education and patient safety, simulation-based education and training (SBET) is only partially or poorly implemented in many countries, including most European countries. The provision of a roadmap may contribute to the development of SBET for the training of anaesthesiologists.

OBJECTIVE

To develop a global agenda for the integration of simulation into anaesthesiology specialist training; identify the learning domains and objectives that are best achieved through SBET; and to provide examples of simulation modalities and evaluation methods for these learning objectives.

DESIGN

Utstein-style meeting where an expert consensus was reached after a series of short plenary presentations followed by small group workshops, underpinned by Kern's six-step theoretical approach to curriculum development.

SETTING

Utstein-style collaborative meeting.

PARTICIPANTS

Twenty-five participants from 22 countries, including 23 international experts in simulation and two anaesthesia trainees.

RESULTS

We identified the following ten domains of expertise for which SBET should be used to achieve the desired training outcomes: boot camp/initial training, airway management, regional anaesthesia, point of care ultrasound, obstetrics anaesthesia, paediatric anaesthesia, trauma, intensive care, critical events in our specialty, and professionalism and difficult conversations. For each domain, we developed a course template that defines the learning objectives, instructional strategies (including simulation modalities and simulator types), and assessment methods. Aspects related to the practical implementation, barriers and facilitators of this program were also identified and discussed.

CONCLUSIONS

We successfully developed a comprehensive agenda to facilitate the integration of SBET into anaesthesiology specialist training. The combination of the six-step approach with the Utstein-style process proved to be extremely valuable in supporting content validity and representativeness. These results may facilitate the implementation and use of SBET in several countries.

TRIAL REGISTRATION

Not applicable.

"Eat Enough"-A nurse-led intervention to enhance hospitalized older adults' protein and energy nutrition

PURPOSE

To develop an intervention enhancing hospitalized older adults' nutrition.

METHODS

For the first time, a mixed-methods design with data triangulation was applied according to the six-step model of Corry et al. to elaborate on a complex nursing intervention in the form of a logic model. Patients who were aged ≥80 years and hospitalized for at least 5 days were included. Sample size for quantitative practice analysis was 135 older adults, whereas 22 older inpatients participated in interviews and observations for needs analysis and generated data for key principles.

FINDINGS

The intervention "Eat Enough" encompasses nursing team culture and comprises six actionable targets to deliver needs-based support and reach required protein and energy intake for hospitalized older adults by sensitizing nurses and the interprofessional team. Facilitating nutritional intake would be supported by an advanced practice nurse who considers the medical and nursing care plan and therapy.

CONCLUSIONS

The intervention "Eat Enough" demonstrates that nurses play a key role in interprofessional teams to enhance older adults' nutrition in hospital. The pipeline model displays how the actionable targets can be achieved, and how awareness raising can influence the context-leading to raised calories and protein requirement coverages and shorter length of stay.

IMPLICATIONS FOR CLINICAL PRACTICE

By identifying risk factors of malnutrition and strengthening nurses' responsibilities, the intervention "Eat Enough" could significantly enhance nutrition among hospitalized older adults. However, the logic model should be tested and implemented in future research.

The "Planning Health in School" Programme (PHS-pro) to Improve Healthy Eating and Physical Activity: Design, Methodology, and Process Evaluation

Few interventions have successfully promoted healthy eating and active living among children with effective changes in anthropometric health outcomes. Well-designed interventions involving multiple strategies to convert the knowledge already available into action are needed for preventing childhood obesity. In this study, an educational programme called "Planning Health in School" (PHS-pro) was designed, implemented and evaluated to contribute to the prevention of obesity in childhood. The PHS-pro aimed at improving the eating behaviours and lifestyles of Portuguese grade-6 children towards healthier nutritional status. This paper describes and evaluates the PHS-pro concerning: (i) the research design within the theoretical framework grounded on "The Transtheoretical Model" and the stages of change; (ii) the educational components and the application of the participatory methodology to engage children to meet their needs, as active participants in their change process; and (iii) the process evaluation of the intervention. The implementation of the PHS-pro took into account the views and inputs of the participants for evaluating the educational components that should be considered in the designing of interventions aiming to be effective strategies. From the health promotion perspective, this study is important because it examines new approaches and pathways to effectively prevent overweight and obesity in children.

Genetics and athletic performance: a systematic SWOT analysis of non-systematic reviews

Exercise genetics/genomics is a growing research discipline comprising several Strengths and Opportunities but also deals with Weaknesses and Threats. This "systematic SWOT overview of non-systematic reviews" (sSWOT) aimed to identify the Strengths, Weaknesses, Opportunities, and Threats linked to exercise genetics/genomics. A systematic search was conducted in the Medline and Embase databases for non-systematic reviews to provide a comprehensive overview of the current literature/research area. The extracted data was thematically analyzed, coded, and categorized into SWOT clusters. In the 45 included reviews five Strengths, nine Weaknesses, six Opportunities, and three Threats were identified. The cluster of Strengths included "advances in technology", "empirical evidence", "growing research discipline", the "establishment of consortia", and the "acceptance/accessibility of genetic testing". The Weaknesses were linked to a "low research quality", the "complexity of exercise-related traits", "low generalizability", "high costs", "genotype scores", "reporting bias", "invasive methods", "research progress", and "causality". The Opportunities comprised of "precision exercise", "omics", "multicenter studies", as well as "genetic testing" as "commercial"-, "screening"-, and "anti-doping" detection tool. The Threats were related to "ethical issues", "direct-to-consumer genetic testing companies", and "gene doping". This overview of the present state of the art research in sport genetics/genomics indicates a field with great potential, while also drawing attention to the necessity for additional advancement in methodological and ethical guidance to mitigate the recognized Weaknesses and Threats. The recognized Strengths and Opportunities substantiate the capability of genetics/genomics to make significant contributions to the performance and wellbeing of athletes.

Preventive Education Outreach on Social Media: The Quest to Enroll Community Members in a Child Sexual Prevention Workshop

Social media is a frequently used tool in health promotion efforts although less so for the prevention of child sexual abuse (CSA). This is due, in part, to the lack of standardized branding guides for community-based efforts in how to craft messages related to CSA prevention. This study examined the use of Twitter (now "X") as a means of promoting participation in the adult-focused Stewards of Children CSA prevention workshop, prior to and following the implementation of a standardized branding guide. The exposure, reach, and engagement of the top tweets and top media tweets were examined over 24-months pre- and post-implementation of a five-point branding guide. Engagement was descriptively compared to the number of adults who enrolled in the Stewards of Children workshop. As evidenced by the increase in tweet impressions and the number of adults trained, it is likely the implementation of the branding guide was beneficial in promoting participation in the Stewards of Children workshop. Though participation in a program does not inherently suggest behavior change, getting participants to enroll is a crucial first step. The findings emphasize the potential of using social media to ultimately promote behavior change in the field of CSA prevention and beyond.

Evaluating the Effectiveness of a Psychological and Adventure-based Multicomponent Therapeutic Program for Victims of Intimate Partner Violence: A Pilot Study

Intimate partner violence (IPV) is a global health problem with different negative consequences for women's mental health. This pilot study aims to evaluate the efficacy of a multicomponent intervention for battered women using a comparison group design to analyze improvement in self-esteem, self-concept, self-efficacy, body dissatisfaction, and depression. The intervention consisted of an eight-session multicomponent intervention program based on the combination of group psychological therapy and adventure activities. The study sample originally consisted of 34 women IPV victims. Self-report psychological assessment was conducted during the pre-test and post-test while interviews were conducted during the post-test among the experimental group. The results of this pilot study suggest the efficacy of the cognitive-behavioral multicomponent intervention on self-esteem, self-efficacy, and depression in the IPV victims from the experimental group. We conclude that these findings support the efficacy of this psychological intervention program. Practical implications and suggestions are also discussed.

Bicycle industry as a post-pandemic green recovery driver in an emerging economy: a SWOT analysis

The COVID-19 pandemic has exposed socioeconomic vulnerabilities around the world. After fighting the coronavirus for more than 1 and a half years now, the countries are recovering from the epidemic with the help of cutting-edge medical research. The policymakers are implementing stimulus packages for post-pandemic economic recovery. However, sustainable "green recovery" plans are yet to get adequate attention. Sustainable investment in green industries can create green jobs, promote a low-carbon economy, and foster long-lasting economic growth in the post-pandemic world. COVID-19 affected countries with emerging economies call for even more focus on such investments. In Bangladesh, the bicycle industry - a growing low-carbon industry - has been showing promising potential for growth since the beginning of the pandemic. Both the local and global markets of Bangladeshi bicycles have seen substantial growth during the epidemic. In this paper, we analyze the potential of the Bangladeshi bicycle industry as an effective green recovery driver. We conduct semi-structured interviews with relevant experts and professionals, analyze their opinions, and perform a "strengths, weaknesses, opportunities, and threats (SWOT)" analysis. The analysis reveals valuable insights regarding post-pandemic sustainable economic and environmental recovery which will be beneficial to the policymakers of Bangladesh and similar developing countries.

Learning Competency Framework and Approach for the Displaced Rohingya Children Living in Bangladesh: A Critical Review

This article is based on a critical review of the Learning Competency Framework and Approach (LCFA) developed for providing education to the Rohingya refugee children living in refugee camps in Bangladesh. A sectoral approach was adopted to develop the LCFA under the leadership of United Nations Children's Fund (UNICEF). To review the LCFA, a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis was used as an analytical tool. The SWOT analysis showed that the major strengths of the LCFA include its emphasis on pedagogical aspects, the inclusion of content on life skills, and the scope of engaging communities in the implementation phase. However, the major limitations of the LCFA comprised of lack of contents on post-traumatic mental wellbeing, child abuse, trafficking, and technology. In addition, the volume of content seemed too heavy concerning the duration of the levels. It was not clear if the LCFA was a research-based output, other than consultations. Several challenges were identified by this critical review in implementing the LCFA in the Rohingya refugee camps in Bangladesh. These include a lack of understanding of the Rohingya children's needs, including historical, physical (both geographical and infrastructural), and livelihood, the barrier to comprehending their language and culture, and existing resource constraints for implementing this framework. Considering the Rohingya people's perspectives, this review makes suggestions to ensure the whole education process becomes more operational, effective, successful and sustainable.

Assessing humanitarian supply chain operations in the aftermath of the Kermanshah earthquake

Purpose

The main objective of this study is to consider how to benefit efficiently from the significant potential of humanitarian operations by individuals. For this purpose, this study aims to assess failure factors in humanitarian supply chain operations after the Kermanshah earthquake considering the role of all parties, focusing on individuals who did not wish to work with formal organisations on the whole. In the aftermath of the Kermanshah earthquake, which occurred on 12 November 2017, improvised groups of Iranian civilians from all over the country played an important role in humanitarian supply chain operations as individuals. Although most of these groups sincerely intended to help the affected society, victims could not benefit properly from these significant potential humanitarian actions. On the contrary, these potential actions caused some issues during humanitarian operations, such as blocking roads, inappropriate last-mile distribution, wasting resources and so on.

Design/methodology/approach

This research study considers mixed methods, including an on-site survey, semi-structured interviewing and a questionnaire designed for statistical analyses. The analysis included 140 responses to the questionnaire, semi-structured interviews with 32 affected families, interviews with 5 emergency managers from the Housing Foundation of the Islamic Republic of Iran and on-site survey reports.

Findings

This study presents a framework for humanitarian supply chain management to deal with future disasters in the same area or areas with similar characteristics to the case study. In general, the results of this study demonstrate that the nature of humanitarian supply chain operations makes it impossible to consider that these operations are free of challenges. However, several influential factors, such as training humanitarian actors and integrated management, might considerably increase the efficiency of humanitarian operations by individuals.

Originality/value

This study highlights the influential factors of inappropriate humanitarian operations by individuals, derived from an analysis of the Kermanshah case and literature review. The authors suggest a framework to benefit from the significant potential of individuals with wide-ranging experiences and proficiency, for future cases similar to the case study.

A Novel Policy Alignment and Enhancement Process to Improve Sustainment of School-Based Physical Activity Programming

The purpose of the current study was twofold: (1) to evaluate the strength and comprehensiveness of district wellness policies in one central Michigan intermediate school district (ISD; 16 districts), and (2) to pilot a novel policy alignment and enhancement process in one district within the ISD to improve sustainment of district-wide physical activity (PA) programming. Policy evaluation and alignment were determined using WellSAT 3.0. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework was used to guide a seven-step policy alignment and enhancement process. Initial evaluation of the PA policy for the ISD revealed a strength score of 19/100 (i.e., included weak and non-specific language) and 31/100 for comprehensiveness (i.e., mentioned few components of the Comprehensive School Physical Activity Program). For the pilot school district, initial strength scores were 19/100 and 38/100 for comprehensiveness (exploration). An alignment of the tailored PA policy with current practices resulted in a 100% increase in strength (score of 38/100), and 132% increase in comprehensiveness (score of 88/100; preparation). However, district administrators encountered barriers to adopting the tailored policy and subsequently integrated the PA requirements into their curriculum guide and school improvement plan (implementation and sustainment). Future research should examine the effectiveness of our EPIS-informed policy evaluation, alignment, and enhancement process to promote widespread increases in student PA.

A SWOT analysis of contemporary gaps and a possible diagnostic tool for environmental health in an upper-middle income country: a case study of South Africa

This study evaluated the state of environmental health in the Republic of South Africa using the strengths, weaknesses, opportunities, and threats (SWOT) analysis framework. The internal and external factor evaluations were conducted by reviewing existing literature searched using a combination of keywords and boolean functions. The weighted score for the strengths and weaknesses was 0.79 and 1.04, respectively. The external factor evaluations findings revealed that environmental health has an equal amount of threats and opportunities, however, the threats outweigh the opportunities. The total weighted score for the internal and external factor evaluations was 1.83 and 2.25, respectively, which were below the average value of 2.5. The internal-external factors matrix indicated that environmental health in the Republic of South Africa needs to be refocused and re-aligned to public health protection. Failure to address the weaknesses and threats and optimise the strengths and opportunities may further weaken the provision of environmental health services.

Where Is the Way Forward for New Media Empowering Public Health? Development Strategy Options Based on SWOT-AHP Model

(1) Background: In recent years, new media and the integration of sport and medicine have promoted the rapid integration and development of the two fields of health and, to a certain extent, the pursuit of public health knowledge and the promotion of health concepts. However, the overall development process is at an early stage and the aim of this paper is to make an empirical analysis of its development through a SWOT-AHP model and give corresponding recommendations. (2) Methods: The SWOT-AHP model was constructed to quantitatively and qualitatively analyse the four dimensions of strengths, weaknesses, opportunities and threats obtained through the Delphi method, with regard to development and to determine the strategic direction of its development. (3) Results: The strategic azimuth θ is -13.243° and the strategic coefficient p is 0.53699, in the diversification zone. (4) Conclusions: New media, as a fast track to empowering the integration of sport and medicine for health, is a field with a bright future, but its own strengths and external threats coexist and should be maximised to overcome the disruptions caused by external threats through a variety of measures.

Financial Measures to Reduce Carbon Emissions in Britain, Japan and the United States: A SWOT Analysis

To mitigate global warming, China, the world's largest greenhouse gas emitter, has set the goals of achieving carbon peak by 2030 and carbon neutrality by 2060, and financial measures could play an important role. To avoid unnecessary costs, China could learn from the experience of other countries to better understand the potential role of financial measures in achieving carbon emission reduction goals. Hence, this article adopts a SWOT analysis to compare the financial measures taken by Britain, Japan and the United States in the process of carbon emission reduction in the last twenty years. This article finds that government funds and financial innovation have contributed markedly to carbon emission reduction in those three countries. With the help of the SWOT analysis, we recommend that China take financial measures to help achieve carbon peaking and carbon neutrality goals from four aspects: formulating proper policy, regulating carbon trading market, strengthening international cooperation, and promoting innovation.

Assessment of COVID-19 vaccination-related medical waste management practices in Bangladesh

The COVID-19 pandemic forces people to be vaccinated as early as possible. The COVID-19 vaccination program certainly raised the medical waste volume all over the world, including in Bangladesh. Numerous recent reports showed a fragile medical waste management system in Bangladesh; during the pandemic, the situation became worse. In addition, the nation-wide ongoing COVID-19 vaccination processes have been posing an extra burden to the existing biomedical waste management in the country. Failing to proper management of this waste might be a threat to human and environmental health. Therefore, the study investigated the current COVID-19 vaccine waste management practices in Bangladesh and made a comparison to the proposed standard operating procedures of international organizations and vaccine waste management practices of two other countries (USA and India). The study was carried out through a mixed methodological approach such as qualitative and quantitative, including a questionnaire survey in 15 Upazila of 4 Districts (Dhaka, Narayanganj, Manikganj, and Gazipur) of Bangladesh. The article focused on a nation-wide legitimate COVID-19 vaccination waste estimation, strength, weakness, opportunity, and threat (SWOT) analysis and drivers, pressure, state, impact, and response (DPSIR) framework analysis to identify the present state of medical waste management in the study area. The study found an excellent segregation system (100%) but very poor waste handling (35.5%) along with very poor syringes and sharps disposal method (open burning without buried 46.6%) and poor vials disposal method (without disinfection/open dump 52%) of vaccine waste. It is estimated that about 58 and 257.85 tonnes of syringes (with needles and packaging) and vaccine vials (Sinopharm 2 doses) waste have been generated since the mass-vaccination program started. Upon SWOT analysis, good separation techniques, poor waste management (ex-situ), enough space for management, and environmental and human health concerns were mostly identified as a strength, weakness, opportunity, and threat, respectively. Finally, a DPSIR framework was prepared for vaccine waste generation and its consequences in the studied area. This study will be useful to prepare a suitable vaccination waste management system in Bangladesh.

How to feed the cities? Co-creating inclusive, healthy and sustainable city region food systems

People drive transitions. Current urban living conditions, specifically food systems, challenge the health, wellbeing and coherence of individuals and whole societies, and for effective change toward resilient communities, people need to reinvent the way they produce, distribute and consume food. Consequently, in their communities' people are creating foodscapes and governing the transition toward sustainable local food systems. Here, we introduce a conceptual framework to develop this transformation through empowering the urban multi-stakeholder society as the agent of this process. To do so, we reviewed scientific evidence and experiences from seven selected City Regions (Albacete, Baku, Dresden, Izmir, Ljubljana, Megara, and Valparaiso) as case studies and conducted a SWOT analysis to explore the capacity of food systems to enhance multi-functionality of urban landscapes, with special focus on social cohesion and quality of life. We grasp existing policies; hone them and leverage policies and strategies toward human-centered actions for future proofing food systems.

The Legibility Efficacy of Historical Neighborhoods in Creating a Cognitive Map for Citizens

Nowadays, historical neighborhoods in Iran are in a state of decay due to the lack of spatial legibility with respect to their organic spatial layout. Hence, the level of interaction among people and their perception of the environment has gradually diminished. Historical neighborhoods no longer possess their former prosperity and function, and citizens prefer to inhabit neighborhoods with newer configurations to meet their demands. The aim of this study was to investigate the role of the spatial legibility of historical neighborhoods in creating a suitable cognitive map for citizens. Quantitative and qualitative methods were applied using a questionnaire and simulation test instruments. In addition, in order to analyze the spatial configuration of the target areas, the Space Syntax method was implemented using Depthmap 10. The findings indicated that landmarks and navigation signs were identified as the most important factors affecting legibility from the viewpoint of users. Furthermore, the correlation between integration and connectivity illustrated that the studied areas possessed poor spatial legibility due to the organic texture of their spatial configurations. Accordingly, solutions such as enhancing the interaction between highly integrated streets and identified landmarks were emphasized to ameliorate the legibility of these spaces. The present study contributes to sustainable urban design with respect to the rejuvenation of historical districts by proposing a set of pragmatic alterations of urban spatial configurations. This research may be fruitful for urban designers, planners and managers seeking to revitalize historical neighborhoods.

Carving out a Niche in the Sustainability Confluence for Environmental Education Centers in Cyprus and Greece

Given the environmental issues that today’s societies confront, such as climate change, waste management, ecosystem deterioration, etc., environmental education is becoming increasingly important. Adoption of environmental education as an integral part of the educational system is required for the Environmental Education Center (EEC) to be able to provide knowledge, skills, and values so that society can become active and environmentally responsible through awareness-raising. According to the scholarly published research, EECs can positively affect local communities and create an environmentally friendly culture. In addition, given that EECs can even play a significant part in the development of lifelong learning activities at the education and sustainable development nexus, it is considered critical to establishing future potentials and dynamics. Thus, aiming to analyze EECs’ strengths, weaknesses, opportunities, and threats (SWOT analysis) within our complex and ever-evolving world, educators, students, and other fellow citizens in Cyprus and Greece participated in a survey in which they were asked to fill in a questionnaire, specifically developed for each group category. The findings of this study provide a deeper understanding of the implications arising as a result of effective environmental education absence, as well as the importance of a holistic approach through EECs. Moreover, it offers the research community a solid framework for future innovation in citizen engagement and training.

Factors affecting the implementation of a complex health intervention to improve insulin management in primary care: A SWOT analysis

Background

In South Africa, initiating and managing insulin in primary care for people living with type 2 diabetes (PLWD) is a major challenge. To address these challenges, a multidisciplinary team from the University of Pretoria (South Africa) developed the Tshwane Insulin project (TIP) intervention.

Aim

To determine internal and external factors, either facilitators or barriers, that could influence the implementation of the TIP intervention and propose strategies to ensure sustainability.

Setting

Tshwane District, Gauteng province, South Africa.

Methods

We used the SWOT framework to qualitatively analyse the strengths, weaknesses, opportunities, and threats influencing the implementation of the TIP intervention. Four field researchers and three managers from the TIP team participated in an online group discussion. We also conducted semi-structured interviews with healthcare providers (HCPs) (seven nurses, five doctors) and patients with type 2 diabetes (n = 13).

Results

Regardless of the identified weaknesses, the TIP intervention was accepted by PLWD and HCPs. Participants identified strengths including app-enabled insulin initiation and titration, pro-active patient follow-up, patient empowerment and provision of glucose monitoring devices. Participants viewed insulin resistance and the attitudes of HCPs as potential threats. Participants suggested that weaknesses and threats could be mitigated by translating education material into local languages and using the lived experiences of insulin-treated patients to address insulin resistance. The procurement of glucose monitoring devices by national authorities would promote the sustainability of the intervention.

Conclusion

Our findings may help decision-makers and health researchers to improve insulin management for PLWD in resource-constrained settings by using telehealth interventions.

How Can Biodigesters Help Drive the Circular Economy? An Analysis Based on the SWOT Matrix and Case Studies

The use of biodigesters and the circular economy (CE) has been gaining attention in recent years. Both biodigesters and CE have the potential to minimize negative impacts—not only environmental, but also economic and social. However, little attention has been paid to the relationship between biodigesters and CE. Therefore, the objective of this paper is to identify and analyze the implications of the use of biodigesters in the light of a CE concept. To do this, a SWOT matrix was developed based on the opinion of experts and two case studies were conducted in companies operating in different sectors in Brazil. The results showed that the use of biodigesters can drive CE through biogas, which is a renewable energy source, closing the cycle of organic materials, increasing the economic power of companies and small producers, improving basic sanitation in remote areas, and stimulating industrial symbiosis. However, this study identified barriers in the use of biodigesters in the context of CE, such as lack of government incentives and composting being shown to be more cost-effective than the use of biodigesters for the treatment of solid waste.

Introducing pulse oximetry in routine IMCI services in Bangladesh: A context-driven approach to influence policy and programme through stakeholder engagement

Background

Pneumonia is the leading cause of under-five child deaths globally and in Bangladesh. Hypoxaemia or low (<90%) oxygen concentration in the arterial blood is one of the strongest predictors of child mortality from pneumonia and other acute respiratory infections. Since 2014, the World Health Organization recommends using pulse oximetry devices in Integrated Management of Childhood Illness (IMCI) services (outpatient child health services), but it was not routinely used in most health facilities in Bangladesh until 2018. This paper describes the stakeholder engagement process embedded in an implementation research study to influence national policy and programmes to introduce pulse oximetry in routine IMCI services in Bangladesh.

Methods

Based on literature review and expert consultations, we developed a conceptual framework, which guided the planning and implementation of a 4-step stakeholder engagement process. Desk review, key informant interviews, consultative workshops and onsite demonstration were the key methods to involve and engage a wide range of stakeholders. In the first step, a comprehensive desk review and key informant interviews were conducted to identify stakeholder organisations and scored them based on their power and interest levels regarding IMCI implementation in Bangladesh. In the second step, two national level, two district level and five sub-district level sensitisation workshops were organised to orient all stakeholder organisations having high power or high interest regarding the importance of using pulse oximetry for pneumonia assessment and classification. In the third step, national and district level high power-high interest stakeholder organisations were involved in developing a joint action plan for introducing pulse oximetry in routine IMCI services. In the fourth step, led by a formal working group under the leadership of the Ministry of Health, we updated the national IMCI implementation package, including all guidelines, training manuals, services registers and referral forms in English and Bangla. Subsequently, we demonstrated its use in real-life settings involving various levels of (national, district and sub-district) stakeholders and worked alongside the government leaders towards carefully resuming activities despite the COVID-19 pandemic.

Results

Our engagement process contributed to the national decision to introduce pulse oximetry in routine child health services and update the national IMCI implementation package demonstrating country ownership, government leadership and multi-partner involvement, which are steppingstones towards scalability and sustainability. However, our experience clearly delineates that stakeholder engagement is a context-driven, time-consuming, resource-intensive, iterative, mercurial process that demands meticulous planning, prioritisation, inclusiveness, and adaptability. It is also influenced by the expertise, experience and positionality of the facilitating organization.

Conclusions

Our experience has demonstrated the value and potential of the approach that we adopted for stakeholder engagement. However, the approach needs to be conceptualised coupled with the allocation of adequate resources and time commitment to implement it effectively.

Measuring Strengths, Opportunities, Aspirations, and Results: Psychometric Properties of the 12-Item SOAR Scale

Strengths, Opportunities, Aspirations, and Results (SOAR) is a strengths-based framework for strategic thinking, planning, conversations, and leading that focuses on strengths, opportunities, aspirations, and results. The SOAR framework leverages and integrates Appreciative Inquiry (AI) to create a transformation process through generative questions and positive framing. While SOAR has been used by practitioners since 2000 as a framework for generating positive organizational change, its use in empirical research has been limited by the absence of reliable and valid measures. We report on the reliability, construct validity, and measurement invariance of the SOAR Scale, a 12-item self-report survey organized into four first-order factors (Strengths, Opportunities, Aspirations, and Results). Data from a sample of 285 U.S. professionals were analyzed in Mplus using confirmatory factor analysis and exploratory structural equation modeling. The Four-Factor first-order exploratory structure equation modeling (ESEM) had the best model fit. Measurement invariance tests found the scalar invariance of the SOAR Scale across gender and education groups. Implications are discussed for using the SOAR Scale to build resilience at the individual, the team, and the organizational levels.

Medical internship training during the COVID-19 pandemic – A case of ‘sacrificial pawns’ or not?

Background

Newly qualified medical practitioners in South Africa (SA) are part of the frontline health care workers who face Africa’s most severe coronavirus disease 2019 (COVID-19) pandemic. The experiences of interns during the pandemic reflect SA’s preparedness to respond in a crisis and inform strategies that could be adopted to balance training and service in resource-challenged contexts.

Aim

To explore the strengths, weaknesses, opportunities and threats posed during the first wave of the COVID-19 pandemic as reflected on by interns within the clinical training platforms in SA.

Setting

Public hospitals in KwaZulu-Natal.

Methods

An online questionnaire consisting of eight open-ended questions based on the SWOT framework related to personal and professional perspectives to clinical training during the COVID-19 pandemic was developed using SurveyMonkey. All data were collected remotely via social media platforms. Data were thematically analysed.

Results

Forty-six interns reflected on personal and systemic challenges as the major threats and weaknesses in intern training during the COVID-19 pandemic. Extrapolating on strengths and opportunities, there were three overarching learnings interns reflected on. These related to being a medical professional, communities of practice and the development and enhancement of clinical and non-clinical competencies. Existing challenges in the environment exacerbated the threats posed by COVID-19 and innovative strategies related to improving support, feedback, broadening the intern curriculum and online training.

Conclusion

Although the clinical environment where interns learn and work is often stressful and overpowered by high service burdens, there are unique opportunities to enhance self-directed learning and graduate competencies, even in the midst of the COVID-19 pandemic.

Irish Para Report Card on Physical Activity of Children and Adolescents With Disabilities

For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D-), Sedentary Behaviors (D-), Family & Peers (C), School (C-), Community & Environment (B-), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities.

Anatomy of a Business Case

A business case plan (BCP) provides a structured framework for evidence-based, transparent business decisions. It is an essential tool that when written well will provide you with the means to translate the cost and benefits of nursing practice proposals, often related in anecdotal terms, into quantifiable, evidence-based terms outlining return on investment and business advantages of investing in nursing initiatives. The BCP should include an analysis of the problem and associated needs, the proposed solutions with options, goals for success, implementation, and evaluation plans, as well as a risk-adjusted cost-benefit analysis. It contains the necessary information to allow decision makers to make well-informed decisions regarding resource allocation. As clinical experts seeking to compete for finite resources in the health care arena, nursing leadership must bridge the language gap between nursing and business finance. This article outlines the required elements of the BCP to provide you with a practical working definition of each element to support your future initiatives in the business of health care improvement.

Acceptability of and intention to use the Unified Protocol delivered in group format in the Spanish Public Health System

BACKGROUND

The high prevalence of emotional disorders leads to a high demand for mental care which results in high costs and long waiting lists in public mental health settings. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is a recent emotion-regulation-based intervention that can be a cost-effective solution in public mental health settings due its transdiagnostic approach and the possibility to apply it in group format. However, the acceptability by mental healthcare professionals (MHCPs) delivering the UP in group format has not been explored.

METHODS

Thirty-three MHCPs, grouped into MHCPs without previous experience and MHCPs with experience in delivering the UP, were asked about aspects of acceptability and intention to use. Quantitative analysis was carried out to explore MHCPs acceptability. Furthermore, qualitative opinion about UP were collected through a SWOT (strengths, weaknesses, opportunities, threats) analysis to explore MHCPs opinion of delivering the UP intervention in a group format, within the Spanish Public Mental Health System.

RESULTS

The results showed high scores in all acceptability dimensions and intention to use in the future. SWOT analysis showed strengths and opportunities focusing on its transdiagnostic nature and the cost-effective benefits of group treatment, and weaknesses and threats related to the limited material and human resources.

CONCLUSIONS

Findings indicate high acceptability of the UP by MHCPs working within the Spanish Public Mental Health System and also identified areas for improvements. In order to enhance the dissemination and implementation of the UP, it is essential to consider MHCPs' perceptions and to be open to their suggestions.

Circular Approaches in Small-Scale Food Production

Globally, food production is one of the main water and energy consumers. Having in view the growing population on global scale, a higher efficiency of food production is needed. Circular approaches offer a large potential to enhance the efficiency of food production and have a long tradition in the food production process of mankind. However, industrial farming has interdicted traditional cycle-closed farming approaches leading to a variety of environmental challenges. The contribution illustrates the basics of traditional gardening and farming approaches and describes how their characteristics are adapted in innovative modern farming systems like aquaponic, permaculture, urban farming, as well as recovered traditional farming systems. The approach to combine traditional farming methods with modern ones will provide multiple benefits in the future to ensure food security. There is to be underlined that such a strategy holds a substantial potential of circular flux management in small scale food production. This potential could be transposed to a larger scale also, particularly in terms of agroforestry and integrated plant and animal husbandry or integrated agriculture and aquaculture. In this way, small-scale food production holds a large potential for the future implementation of the water-energy-food security nexus.

Perceptions about the Future of Integrating Emerging Technologies into Higher Education—The Case of Robotics with Artificial Intelligence

Emerging technologies (ETs) will most likely have a strong impact on education (starting with higher education), just like they have already had in so many economic and social areas. This paper is based on the results obtained in the project “My Future Colleague Robot”, an initiative that aimed to improve the competence of university teaching staff regarding the introduction of ETs in teaching practices at university level. In this paper, we identified the strengths and weaknesses, opportunities, and threats that are related to the adoption in higher education of the combination of two ETs: robotics together with artificial intelligence (AI). Additionally, we analyzed the perceptions of university-level teaching staff about the potential of introducing ETs in education. The empirical data presented here were collected using written essays from 18 university teachers and students. Deductive and inductive approaches with thematic analysis were used for the data analysis. The findings support the idea that previous ET-related experience can support positive attitudes and the implementations of ETs in university teaching; in this study, university teachers had optimistic expectations towards ETs, accepting them as part of teaching practice development, while discussion about the negative effects of ETs was negligible.

A literature review on total quality management (models, frameworks, and tools and techniques) in higher education

Purpose

The purpose of this paper is to analyze the evolution of total quality management (TQM) models, frameworks, and tools and techniques in higher education (HE) over the last thirty years from 1991 till 2020, based on a literature review

Design/methodology/approach

30 articles from 52 journals were used to perform this detailed literature review. For the detailed analysis, the focus was only on articles related to TQM in higher education and specifically related to models, frameworks and tools and techniques. The study has investigated the growth of research articles, research streams, research methodologies, models and frameworks in the higher education sector and tools and techniques related to those.

Findings

This review addresses the progress and gaps in the application of TQM in HE, including the shift in global research in this area from the USA and Europe to Asia in recent years. The articles have been classified into four research methodologies and two research streams which have been reviewed in detail. The findings include reasons for multiple models/frameworks in HE proposed by researchers over the years and the importance of tools and techniques used in TQM implementation.

Originality/value

This study, which tries to bring a perspective to the main trends in TQM application to higher education wrt models, frameworks, tools and techniques over the last thirty years, is expected to add to the body of knowledge in this area and help future researchers to focus on the relevant areas identified in this paper.

Scoping opinion: Speech and language therapists' views on extending their role to the urgent ear, nose and throat pathway

BACKGROUND

In the UK, there is increasing pressure on ear, nose and throat (ENT) clinicians and departments, which is anticipated to amplify in the coming months and years due to the coronavirus disease 2019 pandemic and other workforce pressures. In the context of a national drive to advance practice of Allied Health Professionals to address some key challenges facing the National Health Service, we explored whether UK speech and language therapists (SLTs) felt it is possible to utilize and extend their existing skills to patients on the urgent 2-week wait (2ww) ENT pathway.

AIMS

To explore SLTs' views of extending their role to work with patients referred on the ENT 2ww pathway.

METHODS & PROCEDURES

Two separate focus groups were conducted using nominal group technique to generate and rank benefits and challenges of the proposed extension of role. Participants were invited to take part through Clinical Excellence Networks relevant to head and neck cancer and voice sub-specialties. Participants were competent in performing nasendscopy in at least a highly specialist role in voice or head and neck subspecialties.

OUTCOMES & RESULTS

Nine SLTs from England, Wales and Northern Ireland attended two focus groups. All were employed in band 8 roles in head and neck and/or voice. Eight were competent to Royal College of Speech and Language Therapists' scoping level 3. Important benefits of the proposed novel service delivery model were generated and ranked by participants, with both groups identifying improved quality and efficiency of service for patients among the most important. Disadvantages were then generated and ranked across the two groups with potential for misdiagnosis ranked as the most important by both.

CONCLUSIONS & IMPLICATIONS

Participants responded that extending the SLT role into assessment of 2ww patients would provide benefits for quality of care, healthcare efficiency and the SLT workforce. The identified disadvantages require addressing if the proposed SLT-led model of service delivery is piloted in the UK. These include practical matters such as referral and prescribing rights, alongside wider implications such as support, governance, indemnity, acknowledgement and remuneration for the extended role. Nationally agreed competencies and training for the role are required if this model is to be successful.

WHAT THIS PAPER ADDS

What is already known on this subject? International studies have shown that SLTs provide safe and effective assessment for routine ENT referrals with dysphonia and dysphagia, reducing ENT waiting lists in the process (Payten et al., 2020; Seabrook et al., 2019). The current study is the first, to the authors' knowledge, to explore views of the profession regarding SLTs' involvement in assessing patients on the more urgent ENT 2ww pathway in the UK, particularly in the primary care setting. What this study adds The greatest benefits of SLTs assessing patients with dysphonia and dysphagia in the 2ww wait clinic were felt to be for patients through prompt, holistic consultation from a clinician with expert knowledge in their disorder. The greatest disadvantages were posed for the workforce such as potential to miss diagnoses, risk of litigation and the increased burden of responsibility. While advantages are clear for service users, the disadvantages must be addressed if such a model is to be implemented. Clinical implications of this study Expert SLTs communicated strongly that SLTs would be a beneficial addition to the 2ww assessment clinic for patients with dysphonia and dysphagia. For this role to be piloted and implemented successfully, their concerns around increased responsibility, potential for litigation and missed diagnoses need to be addressed. If the SLT role is to be extended to the 2ww clinic, robust training, competencies, supervision, guidance and recognition are necessary to support clinicians in this role and protect patients. Some practical matters such as referral and prescription rights also require exploration.

Integrating virtual realities and psychotherapy: SWOT analysis on VR and MR based treatments of anxiety and stress-related disorders

The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments.Abbreviations: AR: Augmented Reality; MR: Mixed Reality; RCT: Randomised Controlled Trial; SWOT: Strengths, Weaknesses, Opportunities, and Threats; VR: Virtual Reality; VR-EBT: Virtual Reality Exposure-Based Therapy.

What’s not to like about evidence-based management: a hyper-rational fad?

Purpose

A topic currently receiving significant academic and practitioner attention is called evidence-based management. The purpose of this paper is to suggest that this approach is sometimes over-sold and may be a fad. Additionally, evidence-based management fails to fully recognize the importance of tacit knowledge, what Kahneman calls system 1. Evidence-based management does provide tools to better use what Kahneman calls system 2, rationality. Decision-makers need to take advantage of both rational and beyond rational processes.

Design/methodology/approach

This is an essay, it is not a report of a study. At this point in time, this paper needs thinking, reflection, pondering, more than a data-based study.

Findings

Advocates promote evidence-based management in part to help avoid fads, yet evidence-based management itself has many of the characteristics of a fad. Evidence-based management is based on an objective rational view of the world and suggests highly rational methods of decision-making. However, a rational fact-based might not give sufficient credit to instinct and feelings. Decision-makers should take into account facts, evidence, when making decisions, but not ignore intuition, hunches and feelings. This study is learning that decisions use a galaxy of approaches, with both cognitive and affective flexibility.

Research limitations/implications

As with any opinion-based paper, this lacks empirical support. Proponents ask us to believe in evidence-based management. Neither we, the authors of this paper, nor the proponents of evidence-based management can empirically support the ideas offered. An additional limitation is that the paper is written in one language, English. Translation into another language might yield different meanings.

Practical implications

There are advantages for scholars and practitioners to look at the best available evidence. There can be disadvantages in overlooking non-quantifiable factors.

Social implications

Those who use evidence-based management should also take into account feelings, ethics, aesthetics, creativity, for the betterment of society. To solve wicked problems one needs more than facts and rational analysis.

Originality/value

The overwhelming majority of those writing about evidence-based management are supporters. This study offers a different view. This paper brings new ideas and new thinking to both the extensive fad literature and the huge evidence-based management literature. Evidence-based management is discussed widely. Google Scholar lists more than two million papers in 2019, 2020 and 2021 on evidence-based management. Readers of this journal should critically evaluate this popular set of ideas.

Innovative Contract Solutions for the Provision of Agri-Environmental Climatic Public Goods: A Literature Review

Lack of public funding and environmental deterioration are promoting the search for innovative mechanisms enabling to boost farmers’ provision of agri-environmental climate public goods. This work aims to contribute to the current debate by highlighting the role of innovative contractual solutions through a systematic review of more than 60 articles. The review analyses the potential of result-based and collective contracts as innovative solutions compared to action-based instruments, which are those currently most used. The design of innovative contracts and other mechanisms, e.g., auction and screening contracts, can reduce the policy failures due to asymmetric information. The paper emphasises the trade-off between an accurate design of agri-environmental schemes and the related administrative burden, highlighting the need for a better understanding of the role of mechanisms design into the policy cycle. Some new instruments were not analysed in the review, due to the scarcity of literature, and there is the need of more case studies providing information on the effectiveness of instruments when implemented in different contexts. We fill the gap in empirical evidence through a SWOT analysis that evaluates the effectiveness and acceptability of innovative instruments for policy purposes.

Sustainable development goals assessment of Erzurum province with SWOT-AHP analysis

Sustainable development is one of the issues that many developed and developing countries focus on in the world. The sustainability of human and natural resources is of great importance for securing the world and humanity's common future. In this context, this study aims to evaluate the socio-economic structure of Erzurum with analytical hierarchy process (AHP) and digitized strengths, weaknesses, opportunities and threats analysis considering sustainable development goals (SDGs). The items included in the Agenda 21 report of the United Nations and 17 SDGs determined by the United Nations were taken into consideration in this endeavour. In line with expert opinions, the strengths, weaknesses, opportunities and threats created by the sustainable development goals for Erzurum province were analysed statistically with the AHP. Priority and weighted values of each sub-criterion were calculated. According to this analysis, "the richness of natural, cultural and historical resources for tourism potential" ranks first among the strengths of the province regarding sustainable development goals. Weaknesses include "insufficient investment and entrepreneurial culture". However, "priority region status for development" criterion stands out as the most important opportunity. Threats include "loss of labour force due to migration from agricultural areas" criterion. After the statistical analysis, the quantitative results of made for the best realization of sustainable development for the area were assessed to specify new goals and strategies. Suggestions were offered to define opportunities and strengths, threats and weaknesses with new-build strategies and to make the plans accordingly.

Engaging Stakeholders in the Design of One Health Surveillance Systems: A Participatory Approach

Many One Health surveillance systems have proven difficult to enforce and sustain, mainly because of the difficulty of implementing and upholding collaborative efforts for surveillance activities across stakeholders with different values, cultures and interests. We hypothesize that only the early engagement of stakeholders in the development of a One Health surveillance system can create an environment conducive to the emergence of collaborative solutions that are acceptable, accepted and therefore implemented in sustainable manner. To this end, we have designed a socio-technical framework to help stakeholders develop a common vision of their desired surveillance system and to forge the innovation pathway toward it. We implemented the framework in two case studies: the surveillance of antimicrobial resistance in Vietnam and that of Salmonella in France. The socio-technical framework is a participatory and iterative process that consists of four distinct steps implemented during a workshop series: (i) definition of the problem to be addressed, (ii) co-construction of a common representation of the current system, (iii) co-construction of the desired surveillance system, (iv) identification of changes and actions required to progress from the current situation to the desired situation. In both case studies, the process allowed surveillance stakeholders with different professional cultures and expectations regarding One Health surveillance to gain mutual understanding and to reconcile their different perspectives to design the pathway toward their common vision of a desired surveillance system. While the proposed framework is structured around four essential steps, its application can be tailored to the context. Workshop facilitation and representativeness of participants are key for the success of the process. While our approach lays the foundation for the further implementation of the desired One Health surveillance system, it provides no guarantee that the proposed actions will actually be implemented and bring about the required changes. The engagement of stakeholders in a participatory process must be sustained in order to ensure the implementation of co-constructed solutions and evaluate their effectiveness and impacts.