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In emergency departments, effective communication is of utmost importance to ensure the safety of patients. However, communicating can be quite challenging when dealing with high-stress situations. This study aims to assess the efficacy of coaching workshops, informed by a transtheoretical coaching model, in managing communication challenges perceived by emergency nurses and enhancing their communication skills.

The study involved seven emergency room nurses working at a public hospital in Morocco. The data were gathered through various instruments, including observation grids, interviews and pre- and post-test questionnaires.

The study identified prevalent challenges in communication among nurses, notably difficulties in accurately interpreting messages when faced with confrontational attitudes from colleagues or superiors. Additionally, some nurses exhibited asymmetrical communication patterns, prioritizing their own perspectives over others' during interactions. The findings revealed a statistically significant disparity between pre- and post-test scores (P = 0.017). The nurses’ mean score has improved by 5.14 after attending the four workshop coaching experience, passing from 5.71 in the pre-test to 10.85 in the post-test.

This is the first study in Morocco to evaluate the effectiveness of coaching workshops guided by a transtheoretical coaching model in improving communication skills and overcoming communication barriers among working emergency nurses.

The COVID-19 pandemic dramatically affected the fire service: stay-at-home orders and potential exposure hazards disrupted standard fire service operations and incident patterns. The ability to predict incident volume during such disruptions is crucial for dynamic and efficient staff allocation planning. This work proposes a model to quantify the relationship between the increase in “residential mobility” (i.e. time spent at home) due to COVID-19 and fire and emergency medical services (EMS) call volume at the onset of the pandemic (February – May 2020). Understanding this relationship is beneficial should mobility disruptions of this scale occur again.

The analysis was run on 56 fire departments that subscribe to the National Fire Operations Reporting System (NFORS). This platform enables fire departments to report and visualize operational data. The model consists of a Bayesian hierarchical model. Text comments reported by first responders were also analyzed to provide additional context for the types of incidents that drive the model’s results.

Overall, a 1% increase in residential mobility (i.e. time spent at home) was associated with a 1.43% and 0.46% drop in EMS and fire call volume, respectively. Around 89% and 21% of departments had a significant decrease in EMS and fire call volume, respectively, as time spent at home increased.

A few papers have investigated the impact of COVID-19 on fire incidents in a few locations, but none have covered an extensive number of fire departments. Additionally, no studies have investigated the relationship between mobility and fire department call volumes.

The prevalence of pediatric anxiety disorders is on the rise but youth have challenges in accessing specialty evidence-based mental health care. As a result, families turn to their pediatric primary care provider (PCP) for assessment and management of anxiety. To increase PCPs’ abilities to manage anxiety, the Extension for Community Healthcare Outcomes (“Project ECHO”) was used. The purpose of this study is to explore the impact of Project ECHO on participating PCPs’ knowledge, self-efficacy and interventions surrounding the assessment and management of anxiety.

Data were collected pre- and post-course across five cohorts. Participants completed a clinical knowledge test, ratings of self-efficacy and self-reported frequencies of in-office interventions. Satisfaction was also measured.

Attendance remained strong, and participants rated high satisfaction. From pre- to post-course, participants demonstrated increased knowledge on almost all objective questions. Participants reported increased self-efficacy across all domains. Finally, participants endorsed increased use of several in-office interventions.

This study highlights the importance of Project ECHO as a continuing education model to enhance PCPs’ abilities and confidence in the assessment and management of anxiety. Future continuing education endeavors should consider Project ECHO as a means of increasing PCPs’ capacity to manage mental health conditions.

To the best of the authors’ knowledge, this is the first study that applied the Project ECHO model to pediatric anxiety as a mechanism of increasing knowledge, self-efficacy and in-office interventions with PCPs.

Perceived discrimination in medical setting is associated to adverse healthcare outcomes. Yet, few tools exist for assessing such discrimination among patients in Portugal. This study aimed to validate the Discrimination in Medical Settings (DMS) scale for the Portuguese Roma population, explore their experiences of healthcare discrimination and analyze the association between perceived discrimination, health perception and healthcare trust.

In this cross-sectional study, 84 Roma adults (60,7% women) completed the DMS, along with microaggression assessments, health perception and healthcare trust evaluations.

The seven-item DMS scale yielded a one-factor structure that explained 71.80% of variance, with strong reliability (a = 0.89). The average DMS-measured perceived discrimination was 2.46. Discrimination correlated inversely with health perception and was strongly negatively associated to trust in healthcare.

The DMS scale exhibited reliability, single-dimensionality and validity among the Roma. High perceived discrimination in medical settings among Portuguese Roma was notably associated with individual health perception and healthcare trust.

The correctional system continues to face challenges with responding to and managing methamphetamine use among incarcerated individuals. This study aims to uncover what resources and policies could better help correctional workers deal with these challenges. The authors also examined methamphetamine’s impact on correctional work and staff well-being.

An online survey was distributed to correctional workers (n = 269) in Manitoba, Canada, featuring questions about their experiences related to methamphetamine use in populations under their care, what supports are needed to adequately address the concern, and the potential effects on self and their occupational responsibilities. Using NVivo software, survey responses were analysed using an emergent theme approach.

Correctional workers believed policies and protocols for managing methamphetamine use and withdrawal are currently inadequate. Correctional workers reported having monthly contact with incarcerated individuals experiencing methamphetamine withdrawal, posing safety concerns to them and other incarcerated individuals. Respondents proposed more education and training on managing incarcerated people withdrawing from methamphetamines, related to the symptoms of use and withdrawal and how to support persons detoxing. Increased human and material resources were reported as being needed (e.g. more nurses onsite and better screening devices). Respondents also desired more medical intervention, safe living spaces for methamphetamine users and programming to support addiction.

The current study unpacks correctional workers’ perspectives, support desires and their experiences managing methamphetamine use amongst incarcerated people. The authors discuss the required knowledge to respond to gaps in prison living, re-entry and related policy needs.

Notwithstanding their potential benefits especially for individuals with low health literacy, users are still somewhat skeptical about the reliability of healthcare chatbots. The present study aims to address this challenge by investigating strategies to enhance users’ cognitive and emotional trust in healthcare chatbots. Particularly, this study aims to understand the effects of chatbot design cues in increasing trust and future chatbot use intention for low health literacy users.

We conducted two experimental studies with a final sample of 327 (Study 1) and 241 (Study 2). Three different chatbots were developed (Chatbot design: Bot vs Male-doctor vs Female-doctor). Participants were asked to have a medical consultation with the chatbot. Participants self-reported their health literacy scores. The PROCESS model 7 was used to analyze the hypotheses.

The results showed that the female-doctor cues elicited greater cognitive and emotional trust, whereas the male-doctor cues only led to greater cognitive trust (vs bot-like cues). Importantly, this study found that users’ health literacy is a significant moderating factor in shaping cognitive and emotional trust. The results indicated that both the female and male-doctor cues’ positive effects on cognitive trust were significant for those with lower levels of health literacy. Furthermore, the positive effect of the female-doctor cues on emotional trust was also significant only for those whose health literacy level was low. The increased cognitive and emotional trust led to greater future intention to use the chatbot, confirming significant moderated mediation effects.

Despite the strong economic and educational benefits of healthcare chatbots for low health literacy users, studies examining how healthcare chatbot design cues affect low health literate users surprisingly remained scarce. The results of this study suggest that healthcare chatbots can be a promising technological intervention to narrow the health literacy gap when aligned with appropriate design cues.

The development of zero-carbon buildings (ZCBs) is beneficial to the society and biodiversity. Despite the benefits of ZCBs, there are challenges limiting its development in construction industry. The current study seeks to examine the technology-related factors affecting the development of ZCB in Lagos Nigeria.

The study designed a questionnaire to achieve the main objective. Data were collected using non-probability and snowballing sampling methods. Questionnaires were distributed, and 272 valid responses were collected. Thereafter, data were analysed using mean value, percentage, frequency distribution, normality test, Kruskal Wallis test and Kendall’s coefficient of concordance.

The results from data analysis showed that, “less technical expertise in new technological advancements”, “research outcomes are not translated effectively into technology innovations”, “high cost of maintenance on ZCB”, “poor knowledge on renewable technologies” and “industry’s ability to embrace ZCB technologies (policy initiatives and industry practices)” were the topmost five technology-related factors hindering development of ZCBs in Lagos, Nigeria. Also, the results from the study show a statistically significant degree of agreement between various groups of construction organisations in Lagos, Nigeria concerning the technology-related factors hindering the development of ZCBs.

The study contributed to more effective ZCB studies by drawing attention to technology-related factors hindering the development of ZCBs in construction industry. An understanding of these challenges can help construction stakeholders, organisations, policymakers and governments in devising strategies targeted at minimising these challenges and fostering the development of ZCBs in the construction sector. The identified results on technological barriers to ZCBs development can guide targeted interventions and policy adjustments, promoting more effective implementation of ZCBs in Lagos Nigeria and serving as a model for addressing similar challenges in other developing countries. Recommendations for future research on ZCBs were also highlighted.

This study aims to fully assess the readiness for Lean Six Sigma (LSS) and Quality Performance Improvement (QPI) in an Italian Public Healthcare ecosystem.

Drawing from previously established survey development and adaptation protocols, a replication study was carried out; Lean, Six Sigma and QPI were extracted and validated through confirmatory factor analysis in an Italian Public Healthcare setting, with a sample of health professionals from the Campania region.

This study reports the adaptation of an existing scale for measuring LSS and QPI in an Italian public healthcare organisation. This analysis extracts six conceptual domains and constitutes an original adaptation of an existing scale to assess the readiness to adopt Lean, Six Sigma and Quality Performance in Italian Public Health Organizations. The constructs show strong levels of internal consistency, as demonstrated by each item factor loading and each subscale reliability.

Managers, policymakers and academics can employ the proposed tool to assess the public healthcare ecosystem’s capability to implement LSS initiatives and strategies to improve quality performance.

This is one of the first studies to assess cross-regional organisational readiness for LSS and QPI in an Italian Public Healthcare environment at this scope and level.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.

A total of 22 immigrants were recruited from the Open School of Immigrants in Piraeus, Attica, Greece, to participate in focus group discussions. The discussions were audio recorded and thematically analyzed. Three major themes were developed: pathways to health care, nutrition management and experiences related to food shortages.

Most of the participants identified internet as the most commonly used way to obtain health advice; they also stated that unexpected ill-health is usually accompanied by feelings of fear, anxiety and loneliness. Immigrants, who had visited a public hospital in Greece, identified the language barrier as the most challenging issue, followed by the long waiting lists. Fear and anxiety of hospital visits was an important factor in their decision to vaccinate against COVID-19. Lack of time, high cost of healthy food and lack of knowledge were the most common obstacles to a healthy diet. One in two immigrants reported that they have faced food insecurity issues in the past. Stress, psychological distress and irritation were reported, due to food shortages, especially during the first few years of arriving in Greece. The exclusion of some foods, reduced portion sizes and buying cheaper foods were among the coping strategies to address food shortages.

The study offers an insight into immigrant’s experiences, practices and feelings about managing health issues and could be useful for health-care practitioners, researchers and policymakers.