BACKGROUND: Advanced practice physiotherapy (APP) models of care are promising to alleviate pressure in emergency departments (EDs) where physiotherapists\' new roles include being a first-contact practitioner and leading the overall care and management of patients with minor musculoskeletal disorders (MSKDs) to alleviate ED physicians\' caseload.
OBJECTIVE: To explore patients\' acceptability, experience, satisfaction, and perception of a new APP-led model of care in the ED.
METHODS: Patients presenting to the ED with a minor MSKD and who agreed to participate in a multicenter, pan-Canadian randomized controlled trial assessing the efficacy and costs of an APP model of care were invited to participate in this qualitative study. Semi-structured interviews were performed to identify themes related to their experiences with this model. Verbatim transcripts were coded and analysed using an inductive thematic analysis.
RESULTS: 11 patients participated and three themes were identified: 1- They were satisfied with the care received within the model; 2- They found APPs to have the appropriate skill set to manage MSKDs and to assume medical-delegated tasks; 3- Timely access to care was a key factor in the acceptability of this model and participants believed physiotherapists were appropriate first-contact practitioners. One participant proposed that the APP model of care should also offer follow-up care.
CONCLUSIONS: Participants had a positive experience of care in this new model. These results support the implementation of APP models of care in EDs as the participants appear receptive to new roles for APPs.

OBJECTIVE: To explore their perceptions and attitudes toward condom use and the underlying reasons for the low usage frequency among Chinese older adults.
METHODS: A qualitative study design utilizing interpretive phenomenological analysis was employed. Data were collected through field observation and face-to-face in-depth interviews among older adults aged 50 years or above and having engaged in sexual activities within the previous year.
RESULTS: Three main themes emerged: perceiving unnecessary due to misconceptions and low awareness, interactive stereotypes rooted in sociocultural beliefs, and stigmatized social norms including gender inequity and economic unbalance.
CONCLUSIONS: Tailored interventions focusing on addressing misconceptions, increasing awareness, and reducing culturally ingrained stereotypes and stigma surrounding condom use are essential to promote condom use among older adults in order to prevent HIV transmission in China.

BACKGROUND: Cervical cancer is the fourth most frequent cancer among women, with 90% of cervical cancer-related deaths occurring in low- and middle-income countries like Cameroon. Visual inspection with acetic acid is often used in low-resource settings to screen for cervical cancer; however, its accuracy can be limited. To address this issue, the Swiss Federal Institute of Technology Lausanne and the University Hospitals of Geneva are collaborating to develop an automated smartphone-based image classifier that serves as a computer aided diagnosis tool for cancerous lesions. The primary objective of this study is to explore the acceptability and perspectives of women in Dschang regarding the usage of a screening tool for cervical cancer relying on artificial intelligence. A secondary objective is to understand the preferred form and type of information women would like to receive regarding this artificial intelligence-based screening tool.
METHODS: A qualitative methodology was employed to gain better insight into the women\'s perspectives. Participants, aged between 30 and 49 were invited from both rural and urban regions and semi-structured interviews using a pre-tested interview guide were conducted. The focus groups were divided on the basis of level of education, as well as HPV status. The interviews were audio-recorded, transcribed, and coded using the ATLAS.ti software.
RESULTS: A total of 32 participants took part in the six focus groups, and 38% of participants had a primary level of education. The perspectives identified were classified using an adapted version of the Technology Acceptance Model. Key factors influencing the acceptability of artificial intelligence include privacy concerns, perceived usefulness, and trust in the competence of providers, accuracy of the tool as well as the potential negative impact of smartphones.
CONCLUSIONS: The results suggest that an artificial intelligence-based screening tool for cervical cancer is mostly acceptable to the women in Dschang. By ensuring patient confidentiality and by providing clear explanations, acceptance can be fostered in the community and uptake of cervical cancer screening can be improved.
BACKGROUND: Ethical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°4) and Cameroonian National Ethics Committee for Human Health Research (N°2022/12/1518/CE/CNERSH/SP). NCT: 03757299.
Globally, cervical cancer is the fourth most frequent cancer among women. However, 90% of all deaths caused by cervical cancer occur in low-and middle-income countries. Methods traditionally used in settings like Cameroon to detect cervical cancer unfortunately lack accuracy. Therefore, researchers at the Swiss Federal Institute of Technology Lausanne and the University Hospitals of Geneva are developing an artificial intelligence-based computer aided diagnosis tool to detect pre-cancerous lesions using a smartphone application. The aim of this study was to explore the acceptability and perspectives regarding an AI-based tool for cervical cancer screening for women in Dschang, a city in the west of Cameroon. A qualitative methodology was conducted with six focus groups and a total of 32 participants. The main concerns highlighted by the study are related to privacy, trust in the ability of the healthcare providers, accuracy of the tool as well as the potential negative impact of smartphones. In conclusion, our results show that a computer aided diagnosis tool using artificial intelligence is mostly acceptable to women in Dschang, as long as their confidentiality is preserved, and they are provided with clear explanations beforehand.

OBJECTIVE: This study aims to understand a major result of ComCor, an online epidemiological study conducted to identify the circumstances of COVID-19 infection in France from 2020 to 2022: One third of respondents reported ignoring the circumstances of their infection.
METHODS: We conducted a qualitative study through semi-structured interviews, diagnosed in spring or summer 2021. Interviews were audio recorded, transcribed, and thematically analyzed.
RESULTS: Fifty interviews were conducted. Half of the participants in Qualicor were able to identify several at-risk situations, most often involving their entourage (family, friends, colleagues), but were uncertain as to which specific situation was the source of infection. Less than one quarter strongly suspected a specific situation without certainty, a similar proportion were unable to identify any circumstances, and only two people were certain about the origin of the infection. Several factors contributed to this lack of knowledge: a desire to conceal these circumstances (in a few rare cases), limitations of the questionnaire, lack of knowledge about how the virus is transmitted, selective perception of at-risk situations, co-existence of several possible sources of infection, and the difficulty of taking an objective view of certain circumstances of transmission.
CONCLUSIONS: Our study shows the benefits of a mixed approach designed to better understand the perception of Covid 19 contamination circumstances in the French population. It also highlights the need to strengthen or improve communication on modes of virus transmission, especially airborne transmission, and the importance of maintaining certain preventive behaviors after vaccination.

The lumpy skin disease (LSD) vaccination status and epidemiological distribution remain unknown in some parts of Ethiopia, including the Sidama regional state. In this study, a serological survey of LSD was performed using a specific virus neutralization assay in selected districts of the Sidama regional state representing three agroecological zones from September 2021 to June 2022. Moreover, an assessment of community awareness and LSD vaccine-related problems was conducted using a questionnaire. Our results showed an overall animal and herd level seroprevalence of 40.8% (95%CI = 35.8, 45.8) and 81% (95%CI = 77, 85), respectively. High and low seroprevalence were observed in lowland (48%) and highland (28%) areas, although they were not statistically significant. However, risk factors such as management systems and breeds showed substantial differences in their LSD prevalence. The results obtained through the questionnaire showed that a small portion of respondents (29.2%) know about LSD and vaccinate their cattle (23.3%) against this disease. Only 20.8% of the respondents stated that there was LSD occurrence in their vaccinated cattle. In conclusion, both qualitative and quantitative study results showed the need for intervention in terms of community-based awareness creation about LSD clinical signs and vaccination advantages together with the frequently updated information on LSD prevalence.

(1) Background: The maltreatment of child labourers is a major public health concern. There is a dearth of research in Bangladesh on the intentional maltreatment of child labourers. This study explored the risk factors for the maltreatment of child labourers in rural Bangladesh based on the knowledge and understanding of experts; (2) Methods: Seventeen interviews were conducted with experts who were sampled using a purposeful approach. A thematic analysis was performed to analyse data using NVivo; (3) Results: Child labourers were exposed to maltreatment due to their demographic, their young age, dropping out of school, health complications, and excessive dependency on employers. Socio-cultural adversities such as corporal punishment practices, social stratification, and family disorganization pose risks of experiencing maltreatment. Economic poverty is also a factor. Child labourers were found to be victimized if they worked in violence prone sectors. Significantly, the unregulated market structure and the lack of monitoring has also led to the exploitation of children in the workplace. Gaps in public policies were also identified as risk factor for the maltreatment of child labourers; (4) Conclusion: There is a need for adequate evidence-based research on the determinants of the maltreatment of child labourers to formulate adequate policy.

Besides being vectors of the onchocerciasis parasite, blackflies are a source of nuisance in onchocerciasis-endemic communities. We investigated the experience of residents in the Ntui Health District (Cameroon) regarding blackfly nuisance and assessed their perceptions of a novel \"Slash and Clear\" (S&C) intervention for blackfly control. Focus group discussions were conducted before and after S&C implementation (respectively, in February 2022 and December 2023). Blackflies were known to emerge from the river areas and cause disease. To prevent blackfly bites, the population often covered their body with protective clothing and applied various substances (kerosene, oil, or lemon) to their skin. Post-intervention data showed reduced blackfly nuisance, and the willingness to sustain blackfly control in the long-term was unanimous among community leaders and members, including the village volunteers who implemented the S&C intervention. In conclusion, blackfly nuisance is evident in the Ntui onchocerciasis focus of Cameroon and led to a panoply of coping practices, some of which could be detrimental to their health. Implementing S&C for blackfly control is well accepted and could sustainably alleviate the nuisance caused by blackflies while simultaneously breaking the onchocerciasis transmission cycle.

BACKGROUND: Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to enhance their capacity and service quality. This study evaluates CHW training in Fiji, aiming to identify areas for improvement.
METHODS: A qualitative study was conducted, encompassing a review of national policies on CHW training, six focus group discussions, and interviews with CHWs and their supervisors across Fijian subdivisions. This study was collaboratively designed with Fiji\'s Ministry of Health and Medical Services (MOHMS). Data was transcribed, coded, and thematically analysed using the Community Health Workers Assessment and Improvement Matrix (CHW-AIM).
RESULTS: While CHW training policies in Fiji are well-established, discrepancies exist between the policy and its implementation. Challenges include inconsistent training for new recruits, limited resources, and variability in training content and frequency of training across divisions, especially concerning noncommunicable disease (NCD) training.
CONCLUSIONS: To enhance the CHW training program in Fiji, a restructuring and standardisation of both pre-service and in-service training is necessary, tailored to the needs of each division. Investment in ongoing capacity building, alongside the development and revision of training guidelines, particularly for managing NCD complications in the community, is crucial. Implementing these changes will enable CHWs in Fiji to be better equipped for providing essential community-based care.

BACKGROUND: The burden of severe maternal morbidity is highest in sub-Saharan Africa, and its relative contribution to maternal (ill) health may increase as maternal mortality continues to fall. Women\'s perspective of their long-term recovery following severe morbidity beyond the standard 42-day postpartum period remains largely unexplored.
METHODS: This woman-centred, grounded theory study was nested within the Pregnancy Care Integrating Translational Science Everywhere (PRECISE) study in Kilifi, Kenya. Purposive and theoretical sampling was used to recruit 20 women who experienced either a maternal near-miss event (n=11), potentially life-threatening condition (n=6) or no severe morbidity (n=3). Women were purposively selected between 6 and 36 months post partum at the time of interview to compare recovery trajectories. Using a constant comparative approach of line-by-line open codes, focused codes, super-categories and themes, we developed testable hypotheses of women\'s postpartum recovery trajectories after severe maternal morbidity.
RESULTS: Grounded in women\'s accounts of their lived experience, we identify three phases of recovery following severe maternal morbidity: \'loss\', \'transition\' and \'adaptation to a new normal\'. These themes are supported by multiple, overlapping super-categories: loss of understanding of own health, functioning and autonomy; transition in women\'s identity and relationships; and adaptation to a new physical, psychosocial and economic state. This recovery process is multidimensional, potentially cyclical and extends far beyond the standard 42-day postpartum period.
CONCLUSIONS: Women\'s complex needs following severe maternal morbidity require a reconceptualisation of postpartum recovery as extending far beyond the standard 42-day postpartum period. Women\'s accounts expose major deficiencies in the provision of postpartum and mental healthcare. Improved postpartum care provision at the primary healthcare level, with reach extended through community health workers, is essential to identify and treat chronic mental or physical health problems following severe maternal morbidity.

OBJECTIVE: This paper explores how frontline nurses experienced the onset of the coronavirus disease (COVID-19) pandemic to provide appropriate care during a global health crisis.
METHODS: A qualitative descriptive phenomenological study. The sample consisted of 13 frontline nurses from Turkey, working in intensive care units, inpatient clinics and emergency unit. Data were collected online through face-to-face interviews based on a semi-structured interview guide. Data were analysed using thematic analysis.
RESULTS: Nurses experienced certain difficulties in the continuous use of protective personal equipment, communication both with patients and colleagues, administrative processes. Besides, they experienced exhaustion, reduced job satisfaction and certain physical complaints.
CONCLUSIONS: Hospital administrators and health policy makers should effectively manage human and hospital resources effectively and solve nurses\' problems in times of crisis, such as pandemics.
CONCLUSIONS: Understanding the challenges faced by frontline nurses during the onset of the COVID-19 pandemic may help healthcare practitioners and policy makers to implement targeted interventions, support mechanisms and resource allocation strategies that enhance the well-being of frontline nurses and optimise patient care delivery during health crises.