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1. Reflect upon how the conditions for social workers engaged in mental health work can improve in a Zimbabwean context. What do you think must be the first step? 2. What are the benefits of multidisciplinary work within a mental health environment? 3. How can traditional approaches function together with Western approaches to mental health care treatment in Zimbabwe? 4. How can stories be a way of improving mental health challenges among people suffering from mental distress?
Due to climate change, sustainability has become a crucial topic in product development, while addressing it is associated with many challenges. Based on a literature review, those challenges are collected and clustered into nine categories and sub-categories defined for this purpose. Additionally, a research project is analysed. The exhibited challenges such as data availability versus influenceability, a lack of unified sustainability criteria, and decision-making trade-offs underscore the need for refined methodologies and collaboration in sustainability-oriented design. The differently sourced challenges are compared and the new challenges arising from the research project are sorted into the categories. Finally, possible reasons are discussed for why within the project only challenges from four out of nine categories are encountered.
This study explored the enablers and challenges influencing the performance of community health volunteers (CHVs) in Machakos County, Kenya, during the COVID-19 pandemic.
Background:
The COVID-19 pandemic disrupted healthcare systems globally, with particularly severe impacts in developing countries. Community health workers (CHWs) played a critical role in crisis communication, community engagement, case detection, referrals, and maintaining care continuity. However, limited evidence exists on the factors enabling and hindering their performance during the pandemic.
Methods:
This study employed a convergent mixed-methods design, integrating focus group discussions (FGDs), in-depth interviews (IDIs), and structured data extraction from the Kenya Health Information System (KHIS). Analysis of the data was guided by Agarwal et al.’s conceptual framework for measuring community health workforce performance with the quantitative data being analyzed using descriptive statistics, while qualitative data being analyzed through thematic analysis.
Findings:
CHVs effectively disseminated COVID-19 information, addressed vaccine hesitancy, and mobilized communities, supported by training, supervision, and community recognition. Their efforts led to significant improvements in healthcare services, including increased household visits, immunizations, and maternal health referrals. Despite their contributions, CHVs faced challenges such as delayed stipends, limited resources, and occasional community stigma, which hindered performance. Social support networks, community appreciation, and priority healthcare access emerged as key enablers, fostering resilience and motivation. Improved reporting mechanisms also highlighted CHVs’ expanded roles during the pandemic.
Conclusion:
This study underscores the critical role of CHVs in sustaining healthcare services during the COVID-19 pandemic, despite facing financial, logistical, and social barriers. Their resilience and adaptability led to significant improvements in key health services, supported by effective supervision and training. Strengthening systemic support, integrating CHVs into long-term strategies, and enhancing community recognition are essential to maximize their impact in future health challenges.
This Social Policy and Society themed section examines a number of key social policy challenges in relation to the role that taxation measures and choices play, or can play, in shaping responses to them. Although the role of taxation is frequently recognised in assessments of these issues, it remains under-explored within social policy scholarship. The themed section offers an opportunity to explore the relevance of taxation policy design and choices to these challenges and contribute to the ongoing social policy debate on these issues.
Political legitimacy entails a process of evaluation and eventually of judgment concerning whether or not, and to what extent, the exercise of political power (institutions, leadership, policies, and results) meets the conditions required by legitimacy. Despite the importance of the contribution of law to legitimacy, legitimacy cannot be purely and simply identified with and reduced to law. This is, in part, the case because law functions as an expression and vector of two other components of political legitimacy: values and consent. As such, this chapter is organized into three parts. First, I examine the meaning of values and consent and of their relationship in general. Second, I refer to the challenges that can be associated with values and consent. Third, I show how values and consent, provided that they are not the captives of these challenges, can operate as sources and criteria of evaluation and judgment of political legitimacy.
With the widespread democratic decline and the rise of autocratic regimes, global humanitarian assistance efforts have often fallen short of expectations. Historical humanitarian assistance efforts have changed, becoming less effective, or disappearing. Given the direction that global health crisis risks are taking today, it is crucial that diplomatic, structural, logistical, security, and operational questions be asked and appropriate global solutions sought for the future management of pandemics and climate change crises.
Palliative care is a critical component of healthcare, yet its integration into Nigeria’s health system remains limited. Despite the growing burden of life-limiting illnesses, palliative care is underdeveloped, primarily restricted to tertiary institutions. This review examines the evolution of palliative care in Nigeria, key milestones, persistent challenges, and future directions for strengthening its implementation.
Methods
This narrative review synthesized historical records, policy documents, and literature on palliative care in Nigeria. It examined leadership roles, institutional efforts, and government policies influencing Palliative care growth, while highlighting implementation gaps and opportunities.
Results
Palliative care in Nigeria has evolved from early grassroots efforts to structured institutional services. Key milestones include the establishment of the Hospice and Palliative Care Association of Nigeria (HPCAN), and policy advancements such as the National Policy and Strategic Plan for Hospice and Palliative Care. Despite these developments, challenges persist, including inadequate funding, workforce shortages, limited opioid access, policy implementation gaps, and socio-cultural barriers. Leadership engagement, targeted policy advocacy, and comprehensive capacity-building are essential to overcoming these barriers.
Significance of Results
Sustained efforts are needed to fully integrate palliative care into Nigeria’s healthcare system. Strategic interventions, including enhanced policy implementation, funding mechanisms, workforce development, and community engagement, are critical for ensuring equitable access to PC services. Strengthening collaborations between the government, healthcare institutions, and international partners will accelerate progress, ultimately improving the quality of life for patients with life-limiting illnesses.
Describe how children can take different paths in development and reach similar destinations; understand the developmental differences between children as a set of strengths and challenges that are highly sensitive to environmental context; explore how events in children’s lives can trigger a cascade of later consequences.
This paper aims to enhance our understanding of the challenges teachers engaged in Education for Sustainability (EfS) in New Zealand face when using social media for professional learning. An online questionnaire, including open-ended questions, was distributed to Enviroschools lead teachers nationwide to investigate these challenges. The study identifies key barriers, including time constraints, information overload, concerns about privacy and trust, and the perceived misalignment between the hands-on nature of EfS and the virtual nature of social media. Participants expressed a strong preference for face-to-face learning, emphasising its value for meaningful collaboration and practical engagement. The study highlights the need for systemic support to address these barriers. It suggests that integrating teacher professional learning through social media into teachers’ working hours could significantly enhance their engagement in professional learning for EfS.
In this chapter, we review approaches to model climate-related migration including the multiple goals of modeling efforts and why modeling climate-related migration is of interest to researchers, commonly used sources of climate and migration data and data-related challenges, and various modeling methods used. The chapter is not meant to be an exhaustive inventory of approaches to modeling climate-related migration, but rather is intended to present the reader with an overview of the most common approaches and possible pitfalls associated with those approaches. We end the chapter with a discussion of some of the future directions and opportunities for data and modeling of climate-related migration.
The concept of connectivity appeared in several disciplines in the 1950s and 1960s, but did not enter geomorphology until the 1980s. The concept has led to profound insights into the behaviour of systems, and has had significant applications in management. Connectivity may be defined as a structured set of relationships between spatially and/or temporally distinct entities), or as the degree to which a system facilitates (or impedes) the movement of matter and energy through itself. The former definition focuses on the structure of the system, and the latter on the functioning of it. The two definitions give rise to the separate concepts of structural and functional connectivity. A fundamental difference between structural and functional connectivity lies in the fact that, whereas the former can be relatively easily measured, and a variety of tools exists to do so, the latter tends to be inferred from system behaviour, so that measurement is somewhat indirect. Notwithstanding the compelling arguments in favour of studying connectivity, the ability to apply the ideas of connectivity science in any discipline requires a number of challenges to be addressed.
In this chapter, the history and development of the concept of connectivity in geomorphology is presented. It further provides an overview of connectivity terminology, the underlying concepts and identifies the benefits of connectivity thinking for geomorphological research and applications. We further pursue the question of whether connectivity can be considered as key concept in geomorphology and address general key challenges in using connectivity to understand complex geomorphic systems.
The COVID-19 pandemic showed the vital role of Emergency Medical Teams (EMTs) in international surge responses. The EMTs with their internationally skilled team members were able to meaningfully support countries facing the pandemic, especially those who were suffering from scarcity in the quality and quantity of workforce and financial resources within their health systems. This report summarizes the main operational challenges faced by UK-Med and The Polish Center for International Aid (PCPM) Emergency Medical Teams, based on experiences from their 32 COVID-19 deployments. In particular, the paper discusses the hindrances related to Ministries of Health expectations and the changing roles of EMTs during deployments.
Nurses, as the largest group of frontline responders, play a crucial role in managing catastrophic incidents and addressing the health needs of affected populations. This study aims to identify and analyze the challenges faced by emergency nurses in Palestine who work in active conflict zones.
Methods
A quantitative, descriptive study design was employed. The research was conducted across emergency departments in 7 hospitals located in the West Bank. Data were collected from 171 nurses using a sociodemographic questionnaire and a challenge-specific questionnaire, developed and validated through literature review and expert consultations.
Results
The study revealed that 70% of the nurses were aged between 25-29 years, with 51% being male and 60% married. Most respondents (95%) held a bachelor’s degree, 72% had received advanced cardiac life support (ACLS) training, and 68% had advanced trauma life support (ATLS) training. Additionally, 76% of the nurses were informed about critical cases before the patients arrived at the hospital. The main challenge during emergencies, as the results mention, are inadequate numbers of nurses and physicians (60%). There was a significant concern regarding whether the number of nurses was sufficient to manage the demands and pressures specific to active conflict environments, with 62% of those in nursing feeling unsafe.
Conclusions
The scope of emergency nurses’ challenges in managing several hospitals in areas of armed conflict was examined in this study. The resulting overview of their duties, difficulties, and experiences serves as a useful tool and presents crucial details for future emergency nursing workforce readiness. To perform effectively in armed conflict situations, emergency nurses complete a variety of preparatory courses; however, the necessary education and training should be carefully designed in accordance with their actual roles and responsibilities in these circumstances.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
The majority of paediatric surgery carried out is for minor procedures in fit and healthy children and can be performed as day-case procedures. A large quantity of this work is performed in non-specialist hospitals. Children and families need to be able to access high-quality services close to home, and delivering care locally, where possible to do so safely, can add to the patient and parent experience. A non-specialist centre should have arrangements and local guidance for treating and managing simple surgical emergencies in the paediatric population, along with the ability to resuscitate and stabilise critically ill children of all ages before transfer to a tertiary specialist centre for either paediatric critical care or surgery. Continual education and training within regional networks are vital in maintaining skills and confidence of staff in non-specialist centres, and standardisation along with protocols is helpful in the anaesthetic management, analgesic plan, preassessment and critical transfers of children in a non-specialist centre.
Working collaboratively with others is inevitable in a business context. In larger organisations, the increasing complexity of business processes requires combinations of abilities and knowledge that a single person is unlikely to have. Even if one person could technically do everything, it would take too long.
As business operations and organisations have expanded globally, the spread of, and access to, expertise has increased. The expansion and global reach of organisations has created more complex tasks and decision-making that teams can help overcome. We are now seeing an increase in geographically dispersed and culturally diverse work groups that are connected via the digital communication technologies that make virtual group engagement and networking possible.
As most businesses aim for growth, the amount of work is increasing. Yet, time frames are shortening. Thus, collaborative activities, whether it be two people, larger groups or even multiple organisations, are a necessary feature of modern organisations. Collaboration will require you to draw on your active listening, emotional intelligence and relationship-building skills to ensure success.
The Outlook chapter presents the achievements and challenges of what we can now call international counterterrorism law. Outside the context of armed conflict, sectoral treaties govern international terrorism involving a range of tactics and targets, notably hostage-taking, bombings, hijackings, and nuclear terrorism as well as attacks on foreign diplomats and, under a treaty approaching universality, the financing of international terrorism. But the distinction with terrorism in a situation of armed conflict in these treaties should have been drawn far more sharply. Under international humanitarian law, the definitions of terrorism in armed conflict are clear.
Despite significant advancements in the development of psychotropic medications, increasing adherence rates remain a challenge in the treatment and management of psychiatric disorders. The purpose of this study is to qualitatively explore the challenges underlying medication adherence and strategies to improve it among adolescents with psychiatric disorders in Malaysia. This qualitative research design presents results from 17 semi-structured interviews with adolescent psychiatric patients, aged 11 to 19 years old, from public hospitals across Peninsular Malaysia. The data collected from interviews were transcribed and processed through thematic analysis using the NVivo 11 software. A total of three main themes concerning medication adherence were identified: (1) challenges; (2) coping strategies and (3) protective factors. In this study, thirteen subthemes emerge as challenges underlying medication adherence experienced by adolescent psychiatric patients. The coping strategies identified in this study fall under three broad subthemes which are problem-focused strategies, emotion-focused strategies and maladaptive strategies. This study also highlights social support and positive medicinal effects as protective factors for non-adherence issues in adolescent psychiatric patients. In conclusion, this study supports the notion that adherence is a multi-factorial phenomenon. This study can inform future development of interventions and targeted health promotion programmes in enhancing adherence.
This article examines the alignment of bilateral investment treaties (BITs) with domestic development policies. The analysis reveals the presence of considerable disparity between Ethiopian BITs and the country's domestic development policies and the importance of ensuring consistency between the two. The potential options to resolve this disparity can be combined on a case-by-case basis, depending on different challenges, such as bargaining power, political commitment, procedural requirements and resistance from other treaty partners. The changing dynamics of global politics and the growing backlash against BITs have created a conducive environment for such reform.