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The aim of this study is to assess healthcare workers' behavior on the congenital hypothyroidism screening program implementation based on a framework protocol and its associated factors.

A cross-sectional study was conducted using the multistage random sampling method in recruiting health clinic workers and purposive sampling techniques for hospital workers. The demographics, providers' characteristic, occupational profile, attitude, perceived behavior control (PBC), knowledge, behavioral intention and adherence to protocol were gathered using validated and reliable self-administered questionnaires.

Partial intention to adhere to protocol was 25.7%. Weak attitude (adjusted odds ratio [AOR]: 5.48, 95% confidence interval [CI]: 3.32–9.06), low PBC score (AOR: 0.91, 95% CI: 0.86–0.95) and low knowledge score (AOR: 0.85, 95% CI: 0.75–0.96) were associated with partial intention to adhere to protocol. In the self-rated adherence assessment, 92.6% of participants from health clinics, 79.1% from pediatric and 61.1% from pathology were found not adhering to protocol. There was a significant association between intention and adherence to protocol.

Documentations and observations in assessing program implementation were limited to perform in the present study. Using self-rated instruments and focusing on healthcare workers alone did not provide a comprehensive assessment.

Availability of a training module at site and regular refreshing course training should be made available to harness knowledge, attitude and behavioral perception in implementing the program activities.

Integrating the Logical Framework Approach in assessing program implementation and application of the Theory of Planned Behavior and Attitude, Subjective Norms, Self-Efficacy Model in this study were beneficial.

Efficient delivery of integrated healthcare requires solid alliances and collaboration with stakeholders on a regular basis. Due to coronavirus disease 2019 (COVID-19), it has become necessary to explore new ways of delivering integrated healthcare, and virtual clinics have offered one solution and are likely to continue due to the uncertainty with COVID-19. This study aims to explore clinicians’ experiences of how efficient virtual elective knee clinics (VEKC) are in an orthopaedic setting in comparison to traditional face-to-face clinics.

The study utilised a mixed-methods study to obtain qualitative and quantitative data. This involved an anonymous online survey in addition to in-depth qualitative interviews conducted with a purposive sample of multidisciplinary colleagues who work with the VEKC in an acute hospital.

Three overarching themes and nine sub-themes emerged in the qualitative analysis. Overall, clinicians in both the quantitative and qualitative aspects of the study highlighted several ways that virtual clinics are efficient from both the patient and health service perspective. However, participants also highlighted barriers in relation to virtual clinics not being suitable for certain cohorts of patients and pathologies.

This is the first study in Ireland to provide valuable insights into the experiences of multidisciplinary clinicians using VEKC and their efficiency compared to traditional face-to-face clinics.

The paper seeks to bridge the already familiar benefits of 3D printing (3DP) to the rehabilitation of cultural heritage, still based on the use of complex and expensive handcrafted techniques and scarce materials.

A compilation of different information on frequent anomalies in cultural heritage buildings and commonly used materials is conducted; subsequently, some innovative techniques used in the construction sector (3DP and 3D scanning) are addressed, as well as some case studies related to the rehabilitation of cultural heritage building elements, leading to a reflection on the opportunities and challenges of this application within these types of buildings.

The compilation of information summarised in the paper provided a clear reflection on the great potential of 3DP for cultural heritage rehabilitation, requiring the development of new mixtures (lime mortars, for example) compatible with the existing surface and, eventually, incorporating some residues that may improve interesting properties; the design of different extruders, compatible with the new mixtures developed and the articulation of 3D printers with the available mapping tools (photogrammetry and laser scanning) to reproduce the component as accurately as possible.

This paper sets the path for a new application of 3DP in construction, namely in the field of cultural heritage rehabilitation, by identifying some key opportunities, challenges and for designing the process flow associated with the different technologies involved.

Delirious mania is an understudied psychiatric disorder with a mortality rate as high as 75%. Previous case studies suggest that electroconvulsive therapy (ECT) may be an effective treatment for delirious mania, though this procedure may not always be a viable option. We describe the case of a 20-year old patient, with no previous psychiatric history, who developed delirious mania over the course of four months. ECT was not a viable option for this patient due to his religious beliefs, so alternative treatment modalities were explored. After failing trials of risperidone and olanzapine, significant improvements in symptoms were exhibited with a trial of clozapine. We propose that clozapine may be an effective option in cases of delirious mania, when ECT is not a viable option. Additional research is still necessary to understand the pathology of this condition and potential treatment modalities.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

Depression and insomnia are very significant pathologies in cancer patients as they contribute to the patient's overall cure and quality of life. Moreover, untreated depression and ongoing insomnia are associated with decreased immune responses and lower survival rates. With all disease states and especially with cancer, close attention to drug-drug interactions and the potential impact on the efficacy of therapy is paramount. One area of particular interest due to the lack of well-done clinical trials is drug-drug interaction(s) between antidepressants and cancer treatment. Pharmacokinetics of a certain drug allows for prediction of certain drug interactions based on chemical properties of the agents involved. If the agents depend on their metabolites for activity, active drug level will be decreased through this enzyme inhibition. In this paper, we looked at the cytochrome-P450 drug interactions between antidepressants and sleep aids with Selective Estrogen Receptor Modulators (SERM). Newer SERM metabolisms are less influenced by interactions with medications used to treat depression. However, tamoxifen metabolism could be severely altered by several antidepressants. This has direct consequences as patients on tamoxifen and antidepressant can have double the risk of relapse to cancer in two years. We discussed those interactions and made recommendations for clinical use.

The purpose of this paper is to examine network failures and the main reasons why network organizations, intentionally developed by a group of actors to pursue specific goals, become unfruitful and fail in their goals and expectations of creating collective value. The goal of this paper is thus to contribute a better understanding of the reasons network organizations encounter problems in their dynamics that prevent them from reaching the expected outcomes.

The study is firstly based on a literature review finalized to identify the main variables considered as potentially impacting on network failures. Secondly, the paper is based on a survey conducted on 189 strategic networks that highlighted difficulties in achieving their goals. An analysis of the 24 questionnaires returned generated the results discussed. The empirical study concerns strategic networks intentionally created and signed by Italian SMEs according to a specific law designed to promote the development of inter-firm cooperation (“network contracts”).

The results of the research highlight the role of specific key items related to individual, structural, legitimacy, interaction and governance variables in explaining failures in network organizations. According to the data, failure can occur immediately before the network start-up, resulting in a blocked network or in a subsequent developmental stage, resulting in a dormant network. The empirical research demonstrated that the items affecting network failure differ between blocked and dormant networks. The authors explain such differences, considering them according to the expected goals declared by the two different types of networks.

The question of why networks fail is relevant in times of disruption and digitalization when new forms of organization are needed to link businesses and various stakeholders and thereby develop innovative and sustainable ideas for an entrepreneurial future. However, very few studies have examined network failure. The study contributes to this field of research by investigating the dynamics of networks intentionally developed to reach shared goals. The findings can be useful to both companies that decide to start up a strategic network and the policymakers that promote, finance and monitor inter-firm collaboration.

The purpose of this paper is to address the concept of participatory research (PR) in terms of its values and challenges in project work.

A participative research approach was used in which researchers worked collaboratively with key stakeholders involved in the development of a digital network model for expert diagnostics. The approach involved research and data gathering in six work packages: first, participation at workshops, including the presentation of a preliminary research agenda; second, presentation of a revised research agenda; third, interviews with project managers and steering committee members; fourth, feedback sessions; fifth, participation at a project conference, including additional feedback sessions; and sixth, concluding interviews with project managers.

The findings suggest that PR might strengthen project work through challenging interview questions and clear feedback. PR might empower the project manager by illuminating challenges and possibilities in the project process.

Project managers may use PR as one strategy to empower project work.

Despite the vast research on projects and project management, researchers and practitioners are still looking for ways to advance project work. This paper contributes with knowledge on how PR may advance project work.

This paper aims to investigate the role that Italian third sector organizations have in the process of social and administrative categorization of newly arrived migrants living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/Aids) or hepatitis b. In Italy, free access to health is provided to all migrants and residence permits for medical treatment is granted for migrants living with a “serious illness” since the 1990s. The case of HIV/Aids and hepatitis b shows how this political openness, however, clashes with the tightening of migration policies.

The study is based on ethnographic research conducted between 2014 and 2016 within an associative centre that deals with the socio-health care of newly arrived migrants in Rome. In addition to the participant observations, the study is based in semi-structured interviews conducted with 10 health-care providers (nurses, health-care assistants and socio-cultural mediators) and doctors and with 22 migrants coming from Sub-Saharan Africa and living with HIV/AIDS (10) and hepatitis b (12).

In Italy, the two infections have been identified as top diseases among migrant populations in the country but if HIV/Aids is always considered as a “serious illness”, hepatitis b is considered as a public health priority only in the case of a treatment prescription. These aspects have an important impact on the interactions between medical and social professionals and migrants affected by HIV/AIDS and hepatitis b, contributing differently to the creation of legal categories assigned to migrants.

The case of HIV/Aids and hepatitis b shows how the political openness of the public health system, clashes with the tightening of migration policies and analyse the role of the third sector has in this issue.

Women who use drugs are one of the most maligned, misunderstood and maltreated groups in contemporary culture and society. Despite this, little public outcry nor empathy is given. As a woman who uses drugs, the author examines what lies behind this neglect. A post-structuralist approach is taken in order to examine the categories of meaning assigned to bodies under the twin ruling structures of prohibition and patriarchy. This is done with the intent to better understand and challenge the process of (masculinist) knowledge-making and practices surrounding women who use drugs that treats us as mere objects of knowledge. Furthermore, this chapter draws from feminist auto-ethnography, as the author uses own personal experiences as a woman who uses drugs, a feminist and a drug user advocate as a lens through which to give form to this analysis. Ultimately, the author argue that it is time to let go of outdated, unjust and prejudicial images by challenging established norms and practices, test and apply new theories and negotiate different identities outside of those currently available to women who use drugs. In undertaking this piece, the author hopes that the critical reflections contained within this chapter can ‘cause some trouble’, by being politically useful for the growing movement surrounding women who use drugs.