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The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.

The purpose of this paper is to highlight the prominent cognitive biases that influence Lean practices in organisations that have a multi-cultural work environment which will aid the organisational managers and academics in enhancing the understanding of the human thought process and mitigate them suitably.

A multiple case study was conducted in organisations that were previously committed to Lean practices and had a multi-cultural work environment. This research was conducted on five companies based on 99 in-depth semi-structured interviews and seven process observations that sought to establish the system-wide cognitive biases present in a multi-cultural Lean environment.

The novel findings indicate that nine new biases influence Lean implementation and practices in a multi-cultural environment. This study also found strong connectivity between Lean practices and 45 previously identified biases that could affect positively or negatively the lean methodologies and their implementation. Biases were resilient enough that their influence on Lean in multi-cultural workplaces, even with transient populations, did not demonstrate cultural differentiation.

Like any qualitative research, constructivism and narrative analyses are subjected to understanding based on knowledge gained on the subject, and data may have been interpreted differently. Constructivist co-recreation of process scenarios based result limitations is therefore acknowledged. The interactive participation in exploring the knowledge sought after and interaction that could have a probable influence on the participant need to be acknowledged. However, the research design, multiple methods of data collection, generalisation based on data collection and analysis methods limit the effects of these and findings are reliable to a greater extent.

The results can provide an enhanced understanding of biases and insights into a new managerial approach to take remedial steps on biases’ influence on Lean practices that can result in improved productivity and well-being from a business process perspective. Understanding and mitigating the prominent biases can aid Lean manufacturing processes and support decision makers and line managers in improving lean methodologies’ effectiveness and productivity. The biases can be negated and used to implement decisions with ease. The influence of biases and the model could be used as a basis to counter implementation barriers.

To the best of the authors’ knowledge, this is the first study that connects the cognitive perspectives of Lean business processes in a multi-cultural environment to identify the cognitive biases that influence Lean practices in organisations that were previously committed to Lean practices. The novel findings indicate that nine new biases and 45 previously identified biases influence Lean implementation and practices in a multi-cultural environment. The second novelty of this study shows the connection between cognitive biases, Lean implementation and practices in multi-cultural business processes.

This paper aims to uncover characteristics of physical spaces that evoke feelings of welcome and belonging in a diverse student population in an academic library.

The photovoice method was used to allow research participants an active role in shaping research questions and collecting and analyzing data.

The research reveals that space design significantly influences students' feelings of physical safety, emotional well-being and safety and ownership (or sense of belonging) in academic library spaces, thereby emphasizing the importance of considering space design in promoting student well-being and inclusiveness.

This research used photovoice methodology to engage underrepresented student communities in providing input into the design of library spaces.

This study aims to explore the effect of mental health in terms of depression, anxiety, stress, fear of COVID-19 and quality of life (QoL) on the reluctance to be vaccinated in a population of Palestinian adults living in occupied Palestinian territories and Israel.

The authors recruited 1,122 Palestinian adults who consented to participate in the study; 722 were females, and the mean age of the sample was 40.83 (SD 8.8). Depression, anxiety, and stress scale (DASS), World Health Organization QoL-BREF, FCov-19 and reluctance to the vaccine scale were administered; hierarchical regression analysis was applied to test vaccine reluctance as a dependent variable, and mental health, fear of COVID-19 and QoL as independent variables. This study hypothesized influence of such variables on the vaccine choice with differences due to the participants’ geographical locations.

Findings showed an effect of mental health, particularly depression, QoL and fear of COVID on vaccine reluctance, with depression and fear of COVID in the West Bank and Gaza, while in Israel, QoL played a role in vaccination choices.

The future needs to be comprehended more thoroughly to discover mutations and fluctuations over time in vaccine hesitancy and the increasing role of psychological distress, diminished QoL and fear of Covid-19. Online recruitment might not have allowed the study to include the most disadvantaged strips of the Palestinian population.

Human rights perspectives must be considered in public health and public mental health policies to ensure the QoL and well-being for the Palestinian population during and following the pandemic.

The crumbling of the Palestinian health-care system exacerbated the sense of dread among the population and made them less likely to vaccinate. The pandemic-like spread of Covid-19 prompts a plea for the global community to actively advocate for the urgent re-establishment of equity, autonomy and durability of the medical infrastructure in the occupied territories and equal entitlements for the Palestinians in Israel.

The results demonstrated the importance for public mental health to consider the multiple levels implied in the vaccine refusal in Palestine and Israel among the Palestinian population.