Culture of care: the question of animal agency in laboratory animal science.

Background: A majority of the current debates in experimental animal science research focus to a large extent on the significance and implementation of the 3Rs principle according to Russell and Burch. In this context, not least due to the EU Directive 2010/63/EU, the concept of a culture of care has become more prevalent. Although animals are essential actors in the field of laboratory science, the discussion around animal agency, as well as the resulting consequences for laboratory animal science, is currently unconsidered. Methods: The purpose of this qualitative survey was to identify the perception and understanding of professional workers in laboratory animal science regarding the culture of care in general and aspects of animal agency in particular. Using a non-standardized qualitative survey method (topic-oriented, guideline-based expert interviews), persons involved in animal experimentation in different groups (management, science, regulation, and care) were interviewed. Results: Overall, the results of the qualitative survey showed that animal agency plays a subordinate role in the question of a culture of care in animal research. Although not all groups explicitly applied the construct of animal agency or comparable terminology for this, there were links to the theoretical construct. Overall, the interviews showed a recognized network between humans and animals and that animals can interact dialogically in research. This is justified, for example, by the transfer of emotions from carers or scientists to animals. Nevertheless, a differentiated reflection of an animal's agency remains disregarded. Conclusion: The present qualitative survey approached the understanding of a culture of care among experts in the field of animal research. Animal agency does occur in the theoretical reception of the culture of care model. However, it is not conclusively established in everyday practice. Rather, the results lead to the assumption that strategies are being implemented to largely fade out animal agency.

Role of Ethics in Developing AI-Based Applications in Medicine: Insights From Expert Interviews and Discussion of Implications.

BACKGROUND: The integration of artificial intelligence (AI)-based applications in the medical field has increased significantly, offering potential improvements in patient care and diagnostics. However, alongside these advancements, there is growing concern about ethical considerations, such as bias, informed consent, and trust in the development of these technologies. OBJECTIVE: This study aims to assess the role of ethics in the development of AI-based applications in medicine. Furthermore, this study focuses on the potential consequences of neglecting ethical considerations in AI development, particularly their impact on patients and physicians. METHODS: Qualitative content analysis was used to analyze the responses from expert interviews. Experts were selected based on their involvement in the research or practical development of AI-based applications in medicine for at least 5 years, leading to the inclusion of 7 experts in the study. RESULTS: The analysis revealed 3 main categories and 7 subcategories reflecting a wide range of views on the role of ethics in AI development. This variance underscores the subjectivity and complexity of integrating ethics into the development of AI in medicine. Although some experts view ethics as fundamental, others prioritize performance and efficiency, with some perceiving ethics as potential obstacles to technological progress. This dichotomy of perspectives clearly emphasizes the subjectivity and complexity surrounding the role of ethics in AI development, reflecting the inherent multifaceted nature of this issue. CONCLUSIONS: Despite the methodological limitations impacting the generalizability of the results, this study underscores the critical importance of consistent and integrated ethical considerations in AI development for medical applications. It advocates further research into effective strategies for ethical AI development, emphasizing the need for transparent and responsible practices, consideration of diverse data sources, physician training, and the establishment of comprehensive ethical and legal frameworks.

Current challenges in accessibility to ophthalmological care in Ukraine.

OBJECTIVE: Aim: The purpose of the study is to identify challenges in the organization and access to ophthalmic services through the analysis of expert opinion of practitioners and government officials. PATIENTS AND METHODS: Materials and Methods: Materials developed during expert interviews with practitioners and government officials were used in the study. We also used materials worked out within the project ID 22120107 supported by Visegrad Fund. CONCLUSION: Conclusions: Despite all the challenges in access to high-quality ophthalmology services, practitioners and government officials have common opinions on how to improve the organization of eye services, how to make care more inclusive and effective, so that the development of blindness and visual impairment does not cause a burden on the state and society.

How do behavioral public policy experts see the role of complex systems perspectives? An expert interview study.

Amidst the global momentum of behavioral insights (BI), there has been a shift from mostly nudge-based BI applications to systemic approaches. This is particularly pressing in public health, where interacting issues regularly produce unanticipated consequences. Regardless, little is known about adopting complex systems approaches in behavioral public policy. This study aims to capture current practices of international BI experts on the definition, application, drivers, and hindering factors in adopting complex systems approaches in public policy. Semi-structured individual expert interviews (n = 12) of international BI experts with extensive experience in educating, cooperating with, and/or advising public servants were analyzed with inductive content analysis. While the working definition of BI aligned with published definitions, experts varied in their descriptions of complex systems approaches and its significance for public policy, including socioecological aspects, systematic BI use across policy stages, recognizing intertwined behavior, and lack of ready-made solutions. They emphasized the importance of systems approaches, identifying drivers (e.g. need for a broader focus) and hindrances (e.g. pressure for quick results). Embracing complex systems in behavioral public policy provides a holistic perspective, extending beyond simple nudges, sometimes presumed as universally applicable. While complexity perspectives would align with policymakers' worldview, applications require more work to tailor to local situations and to evaluate. Recognizing that, given their distinct expertise content, BI expertise can be quite different from complex systems expertise. The field would benefit from clear descriptions and specialized training for effective integration and advocacy for these approaches.

In recent years, the use of behavioral insights (BI) in public policy, including health policy, has been shifting from nudges to more comprehensive approaches. This study examines how international BI experts view the use of complex systems approaches in behavioral public policy. Through interviews with 12 experts advising public servants, we found that while BI definitions align with earlier published definitions, experts interpret and apply complex systems approaches differently. Some consider socioecological factors, advocate applying the systematic use of BI throughout the policy cycle, and for some using complex systems approaches means considering intertwined nature of behavioral phenomena and that there are no one-size-fits-all solutions. Experts stress the importance of a systems approach, identifying drivers (e.g. need for a broader focus, experience-based expertise) and hindering factors (e.g. advisory settings, pressure for quick results) in its implementation. This study presents BI's evolving role in public policy, highlighting the need for complex systems approaches to address multifaceted societal challenges.

Incidental pulmonary nodule management in Canada: exploring current state through a narrative literature review and expert interviews.

Background and Objective: Incidental pulmonary nodules (IPNs) are common and increasingly detected with the overall rise of radiologic imaging. Effective IPN management is necessary to ensure lung cancer is not missed. This study aims to describe the current landscape of IPN management in Canada, understand barriers to optimal IPN management, and identify opportunities for improvement. Methods: We performed a narrative literature review by searching biomedical electronic databases for relevant articles published between January 1, 2010, and November 22, 2023. To validate and complement the identified literature, we conducted structured interviews with multidisciplinary experts involved in the pathway of patients with IPNs across Canada. Interviews between December 2021 and May 2022 were audiovisual recorded, transcribed, and thematically analyzed. Key Content and Findings: A total of 1,299 records were identified, of which 37 studies were included for analysis. Most studies were conducted in Canada and the United States and highlighted variability in radiology reporting of IPNs and patient management, and limited adherence to recommended follow-up imaging. Twenty experts were interviewed, including radiologists, respirologists, thoracic surgeons, primary care physicians, medical oncologists, and an epidemiologist. Three themes emerged from the interviews, supported by the literature, including: variability in radiology reporting of IPNs, suboptimal communication, and variability in guideline adherence and patient management. Conclusions: Despite general awareness of guidelines, there is inconsistency and lack of standardization in the management of patients with IPNs in Canada. Multidisciplinary expert consensus is recommended to help overcome the communication and operational barriers to a safe and cost-effective approach to this common clinical issue.

Determining design criteria for indoor positioning system projects in hospitals: A design science approach.

Objectives: Indoor navigation systems (indoor positioning systems) can improve orientation for patients in hospitals and help employees to track assets. Many hospitals would like to implement indoor positioning systems but do not know how. To support them in doing this, and to gain knowledge about the requirements for indoor positioning system implementation, our research identifies the design criteria relevant to indoor positioning system implementation projects. Methods: A design science research process is built to design and evaluate an artifact. For this, five indoor positioning system developers and five hospital IT management representatives from various hospitals and companies in Germany are interviewed. Further, controlled experiments are conducted in Germany, using an ultrasound-based indoor positioning system. Results: We determined and tested indoor positioning system functions, evaluated indoor positioning system performance criteria, and identified the operating conditions in hospitals. Our results show that indoor positioning system functions should provide a benefit to a hospital's daily operations, that some performance criteria are more important than others, and that operating conditions are important, e.g., radiation. Conclusion: As a theoretical contribution, we show how design science research can be applied to the context of indoor positioning systems in hospitals. In addition, we make a practical contribution in that our propositions can be used for future indoor positioning system developments.

[Interprofessional collaboration of general practitioners and nurses in primary care: A qualitative study]. / Interprofessionelle Zusammenarbeit von Hausärzt_innen und Pflegefachpersonen in der Primärversorgung.

Interprofessional collaboration of general practitioners and nurses in primary care: A qualitative study Abstract. Background: There is a need to strengthen interprofessional collaboration of general practitioners and home care nurses in the primary care of people with chronic diseases and long-term care needs. Aim: This study investigated a) how general practitioners and nurses in Germany perceive their collaboration in primary care and b) which development perspectives of collaboration exist from their point of view. Methods: Expert interviews were conducted with seven general practitioners and eight home care nurses. The data were analysed using thematic-structured qualitative content analysis. Results: The interviewees from both professional groups report that their collaboration is hindered by poor mutual accessibility. At the same time, they emphasise their appreciation of the professional exchange with the other professional group. Nevertheless, the perceptions of the professional competence of home care nurses differ. To improve their cooperation, the interviewees recommend the establishment of interprofessional meetings and cooperation in spatial proximity for regular professional exchange. They expect this to lead to a joint development of trust and competence and to an expansion of the area of responsibility of home care nurses in primary care. Conclusions: Binding communication structures, cooperation in spatial proximity and an expansion of the area of responsibility of home care nurses offer high potential for strengthening primary care in Germany.

Who With Whom: Matching Therapist and Client in Correctional Institutions.

The current study investigated variables that are being considered when assigning psychotherapists to individuals convicted of sexual and violent offences. Its main aim is to inform practitioners and researchers alike of potentially beneficial combinations between therapist and client and infer hypotheses for future studies. A mixed-methods approach, combining interviews and a follow-up questionnaire, was employed. Nineteen interviews with forensic practitioners working in socio-therapeutic facilities in Germany were conducted. Relevant matching criteria were extracted from all interviews. 1.) Capacities of therapist, 2.) therapist's professional background, 3.) (severity of) clinical disorder, 4.) personal fit, and 5.) fit of client into existing groups emerged as top five matching criteria. Directive therapists were viewed as a good match for antisocial or psychopathic offenders. Opinions diverged regarding personality similarity or complementarity in client-therapist dyads. A flexible matching approach may offer unique strengths to enhance treatment outcome. Implications and ideas for future research are discussed.

[Physician assistants as a future model in primary care: Experiences, needs, potentials and barriers]. / Physician Assistants als Zukunftsmodell in der hausärztlichen Versorgung ­ Erfahrungen, Bedarfe, Potenziale und Hürden.

INTRODUCTION: In the coming decades, demographic change will dramatically increase health care needs, especially for general practitioners (GPs). However, there is a shortage of young primary care physicians, with signs of (impending) underuse already becoming apparent in rural and structurally weak areas. Innovative care concepts are needed to counteract this development and ensure the future of primary care. In addition to medical assistants (MFA), academically trained physician assistants (PAs) could be considered for more demanding delegation tasks and be involved in direct patient care under the responsibility of a physician in the practice team. In England, the Netherlands and the USA, PAs have been a part of the health care systems for many years. RESEARCH QUESTIONS: 1) What are the potentials for delegation/possibilities for PAs working in primary care practices in contrast to medical assistants? 2) What structural requirements are necessary to regularly integrate PAs in primary care practices? METHODS: After preliminary interviews with PA experts and primary care researchers and practitioners (n=29), four expert interviews (n=4) with GPs and PAs were performed in a case analysis in order to elicit experiences with PAs in family practice. Based on this, three focus groups were conducted with GPs and practice staff (n=15) to discuss the extent, the need and the willingness to delegate physician services to PAs, as well as existing barriers. After transcription, analyses were performed using qualitative content analysis according to Mayring. RESULTS: The participants acknowledged the potential to reduce physician workloads and showed a high willingness to delegate tasks. Practical examples suggest that a clearly defined delegation of medical tasks to PAs, e.g. participation in infection consultations, is possible after only a few weeks working in family practices. Thus, the cooperation between GPs, PAs and medical assistants can be successful. Uncertainties exist regarding the legal possibilities and limits of delegation as well as the current and future financial reimbursement of PAs. DISCUSSION: The legal and financial framework for the utilization of PAs in ambulatory care should be reliably clarified as well as transparently communicated so that the considerable potentials of delegating tasks to academically trained staff, e.g. PAs, especially in the GP sector, can be exploited in the future. CONCLUSION: Participation of PAs in the GP team could be key to overcoming the often threatening or already existing under-provision of medical care in structurally weak regions.

Improving Well-Being in Schools - Lessons Learned from IoT Experts.

The Internet of Things (IoT) is a source of knowledge about the surrounding environment and people in such an environment. The insights collected by IoT can provide the knowledge needed to improve people's health and overall well-being. Schools are one environment where IoT is scarcely applied, yet, it is expected that this is where children and teenagers spend most of their time. Drawing on previous findings, this paper presents preliminary results from qualitative inquiry investigating how and what IoT-based solutions could support health and well-being in elementary educational settings.

Expert's View on Central Components of the Actional Model of Older People's Coping with Health-Related Declines: A Pilot Study with Professional Caregivers.

Abri & Boll (2022) proposed the "Actional Model of Older People´s Coping with Health-Related Declines" to explain the use of various action alternatives of older persons for dealing with diseases, functional declines, activity limitations, and participation restrictions. It draws on a broad knowledge base: an action-theoretical model of intentional self-development, models of the use of assistive technologies (ATs) and medical services, qualitative studies on reasons for using or not-using ATs, and quantitative studies on older people's health-related goals. The present study aims to gather evidence to further refine this model by additionally relying on expert knowledge from professional caregivers serving older people. Six experienced geriatric nurses working in mobile care services or residential care facilities were interviewed about key components of the above model in relation to 17 older people aged 70 to 95 with stroke, arthrosis, or mild dementia. The results revealed additional goals of reducing or preventing health-related discrepancies beyond those already included in the model (e.g., moving without pain, doing things alone, driving a car again, social return). Moreover, new motivating or demotivating goals for using certain action possibilities were found (e.g., to be at home, to be alone, to rest, to motivate other older people). Finally, some new factors were identified from the biological-functional (e.g., illness, fatigue), technological (e.g., pain inducing ATs, maladaptive devices), and social contexts (e.g., lack of staff time) that are likely to promote or hinder the use of certain action possibilities. Implications for refining the model and future research are discussed.

Artificial Intelligence Teaching as Part of Medical Education: Qualitative Analysis of Expert Interviews.

BACKGROUND: The use of artificial intelligence (AI) in medicine is expected to increase significantly in the upcoming years. Advancements in AI technology have the potential to revolutionize health care, from aiding in the diagnosis of certain diseases to helping with treatment decisions. Current literature suggests the integration of the subject of AI in medicine as part of the medical curriculum to prepare medical students for the opportunities and challenges related to the use of the technology within the clinical context. OBJECTIVE: We aimed to explore the relevant knowledge and understanding of the subject of AI in medicine and specify curricula teaching content within medical education. METHODS: For this research, we conducted 12 guideline-based expert interviews. Experts were defined as individuals who have been engaged in full-time academic research, development, or teaching in the field of AI in medicine for at least 5 years. As part of the data analysis, we recorded, transcribed, and analyzed the interviews using qualitative content analysis. We used the software QCAmap and inductive category formation to analyze the data. RESULTS: The qualitative content analysis led to the formation of three main categories ("Knowledge," "Interpretation," and "Application") with a total of 9 associated subcategories. The experts interviewed cited knowledge and an understanding of the fundamentals of AI, statistics, ethics, and privacy and regulation as necessary basic knowledge that should be part of medical education. The analysis also showed that medical students need to be able to interpret as well as critically reflect on the results provided by AI, taking into account the associated risks and data basis. To enable the application of AI in medicine, medical education should promote the acquisition of practical skills, including the need for basic technological skills, as well as the development of confidence in the technology and one's related competencies. CONCLUSIONS: The analyzed expert interviews' results suggest that medical curricula should include the topic of AI in medicine to develop the knowledge, understanding, and confidence needed to use AI in the clinical context. The results further imply an imminent need for standardization of the definition of AI as the foundation to identify, define, and teach respective content on AI within medical curricula.

Organic Juice Processing Quality from the Processors' Perspective: A Qualitative Study.

Organic food quality is based on processing. While the EU organic production regulation focuses on agricultural production, private standards provide more detailed information about further processing. For the development of organic processing, practitioner perspectives can provide valuable input. To get insight into practitioner perspectives, we conducted semi-structured expert interviews with nine employees of seven partly organic juice processing companies from Germany and Austria. Interview topics were (i) quality of organic juice processing in general, (ii) assessment of specific processing techniques, (iii) product quality of organic juice and (iv) flow of information between producer and consumer. We conducted a thematic analysis. We found that the experts' understanding of process quality mostly includes more aspects than the EU organic production regulation. It covers the whole food chain plus aspects of social and environmental sustainability. The experts prefer directly bottled juice of local raw materials but chiefly accept juice made from concentrate of exotic raw materials because of environmental concerns. Organic juice is preferred when it is cloudy and natural fluctuations are interpreted as an indicator of natural quality. The experts report that consumer information is challenging because of low food literacy. Raising this might help reduce the number of processed juices on the market.

Influencing health behaviour using smart building interventions for people with dementia and mild cognitive impairment: expert interviews and a systematic literature review.

PURPOSE: Behaviour can have an influence on (coping with) chronic conditions such as dementia. Assistive technology can stimulate the daily behaviour of people with dementia, but the mechanisms through which this happens are unclear. Therefore, this paper focuses on potential behaviour change mechanisms, that can be employed in smart building interventions for people with dementia or MCI. METHODS: This research uses expert interviews with medical experts (n = 9) and a systematic literature review of smart building interventions stimulating health behaviour (n = 12). RESULTS: Results show how facilitation, incentive motivation (i.e., feedback), observational learning and self-efficacy are most promising according to medical experts; if they are appropriately personalised towards needs, preferences as well as abilities. The literature review shows how most of the examined research uses facilitation and incentive motivation to stimulate behaviour. Although positive results are reported in all studies, methodological quality could be improved. CONCLUSION: For the design of smart building interventions for people with MCI or dementia, facilitation and incentive motivation seem to be promising behaviour change mechanisms. Outcome expectation, observational learning and self-efficacy could reinforcing the aforementioned mechanisms. Future research should focus on how different (environmental, digital) cues can be personalized and can adapt over time, as dementia progresses.IMPLICATIONS FOR REHABILITATIONAssistive technology for people with dementia can have an effect on (health) behaviour, which may in turn influence coping strategies or quality of life.Behaviour change mechanisms can inform the design of assistive technology such as smart building interventions.Facilitation, Incentive Motivation, Observational Learning and Self-efficacy seem promising behaviour change mechanisms for people with dementia or MCI.In any intervention for people with dementia, personalized and adaptable cues are of vital importance.

Insights on the Current State and Future Outlook of AI in Health Care: Expert Interview Study.

BACKGROUND: Artificial intelligence (AI) is often promoted as a potential solution for many challenges health care systems face worldwide. However, its implementation in clinical practice lags behind its technological development. OBJECTIVE: This study aims to gain insights into the current state and prospects of AI technology from the stakeholders most directly involved in its adoption in the health care sector whose perspectives have received limited attention in research to date. METHODS: For this purpose, the perspectives of AI researchers and health care IT professionals in North America and Western Europe were collected and compared for profession-specific and regional differences. In this preregistered, mixed methods, cross-sectional study, 23 experts were interviewed using a semistructured guide. Data from the interviews were analyzed using deductive and inductive qualitative methods for the thematic analysis along with topic modeling to identify latent topics. RESULTS: Through our thematic analysis, four major categories emerged: (1) the current state of AI systems in health care, (2) the criteria and requirements for implementing AI systems in health care, (3) the challenges in implementing AI systems in health care, and (4) the prospects of the technology. Experts discussed the capabilities and limitations of current AI systems in health care in addition to their prevalence and regional differences. Several criteria and requirements deemed necessary for the successful implementation of AI systems were identified, including the technology's performance and security, smooth system integration and human-AI interaction, costs, stakeholder involvement, and employee training. However, regulatory, logistical, and technical issues were identified as the most critical barriers to an effective technology implementation process. In the future, our experts predicted both various threats and many opportunities related to AI technology in the health care sector. CONCLUSIONS: Our work provides new insights into the current state, criteria, challenges, and outlook for implementing AI technology in health care from the perspective of AI researchers and IT professionals in North America and Western Europe. For the full potential of AI-enabled technologies to be exploited and for them to contribute to solving current health care challenges, critical implementation criteria must be met, and all groups involved in the process must work together.

Structures for the care of people with dementia: a European comparison.

BACKGROUND: Dementia is a disease that impacts people with dementia, their families, and the healthcare system. In 2018, the number of people with dementia in the EU, the European Free Trade Association (EFTA), and the UK was estimated to be 9.1 million. National dementia strategies and publications by organisations such as Alzheimer Europe outline how dementia-specific care should be designed. This study aims to provide insights into existing formal care structures, models of good practise, and gaps in dementia-specific care for people with dementia in 17 European countries. METHODS: The research is based on guided interviews with country-specific care experts. A mixed-methods approach with a combination of open and closed questions was used. All interviews were recorded and transcribed verbatim based on the transcription rules of Kuckarts (2010). For data evaluation, the qualitative content analysis model of Mayring (2014) was used. RESULTS: In all 17 countries, efforts for dementia-friendly care and models of good care practise exist. However, there are large differences between European countries regarding the spread of dementia-specific services. In nine countries (Bulgaria, Finland, Italy, Liechtenstein, Luxembourg, the Netherlands, Norway, Sweden, the UK), there are already nationwide structures, while in five countries (Belgium, Greece, Ireland, Portugal, Romania), services are only available in certain regions. In three countries (Austria, Denmark, Germany) dementia-specific outpatient services are widespread nationwide, whereas inpatient services are not. Simultaneously, in all countries, areas with major care gaps exist. Several European states have an urgent need for action concerning the expansion of the provision of dementia-specific services, the reduction of regional differences regarding the provision of care, the elimination of barriers to access to care, the dementia-friendliness of services, and the participation of people with dementia and their relatives in care and research. CONCLUSIONS: To reduce the existing structural inequalities in care between and within European countries, and to establish quality-related minimum standards in the care of people with dementia, transnational concepts are needed. The EU, in cooperation with care planners, research institutions, care providers, and patient organisations, should develop European care guidelines or dementia plans that contain concrete measures, schedules, and budgets.

Promoting blue-collar employees' work ability: A qualitative study on occupational health practitioners' perspective on feasible interventions.

BACKGROUND: Work in the industrial sector underlies deep structural changes triggered by demographic and societal transformations. These developments require tailored measures for maintaining employees' work ability by reacting to new demands and overcoming barriers in organizational implementation. Previous research lacks in considering practitioners' perspective in terms of tailoring effective interventions to the workplace conditions of blue-collar employees. OBJECTIVE: This study aims to enrich the understanding of work ability by using the job-demands-resources (JDR)-theory and the work ability house concept as basis and considering aspects of organizational measures' feasibility. METHODS: Data results from observations of the collaboration between occupational health professionals and supervisors on the shop-floor and n = 18 semi-structured interviews with different occupational health stakeholders. A participatory and qualitative approach characterizes this study. RESULTS: The study participants report on how increasing organizational demands of efficiency and uncertainty affect workability promotion of blue-collar employees. Furthermore, the findings imply aspects regarding feasible interventions. For designing effective interventions, specifically psychosocial aspects such as work intensification, job uncertainty, work-life-conflicts, and inter-personal trust need to be addressed. Measures need to be aligned better to the industrial setting with specific focus on decision-makers' interests and intra-organizational collaboration. CONCLUSION: Further research should investigate interrelationships between relevant psycho-social job demands and resources. Moreover, additional aspects, which are related to measures implementation in the organizational sphere, need to be identified. Practical implications connect organizational sciences with the workability theory and the job-demands-resources (JDR)-theory by focusing more on psychological work design and intra-organizational collaboration.

Indicator-driven data calibration of expert interviews in a configurational study.

Expert interviews can provide interesting data for the use in qualitative comparative analysis (QCA) to investigate complex social phenomena. To guide the challenging task of data calibration from qualitative data sets, techniques have already been suggested for the transformation of qualitative data into fuzzy sets. The current article follows existing guidelines and extends them with a system for indicator-based data calibration of expert interviews. While the underlying data set is confidential due to its corporate setting, in this article the analysis of the data is made transparent and hence reproducible for potential follow-up studies. First, the process of data collection is described, and the final data sample is characterized. Consequently, a system for indicator-based data calibration is presented and the calibration results for the empirical sample are provided in form of the set membership of cases and truth tables. ʉۢ Data collection from expert interviews is described for a configurational setting ʉۢ A combined indicator-based system is used for the calibration of qualitative data.

[Approaches to increase HPV vaccination rate in Germany - challenges and opportunities. A qualitative study]. / Ansätze zur Steigerung der HPV-Impfquote in Deutschland ­ Hindernisse und Chancen: Eine qualitative Studie.

BACKGROUND: In Germany, the prevalence of infections with the human papilloma virus (HPV) among women and men is high. High-risk HPV types can lead to certain types of cancer (e. g., cervical cancer). Vaccination against HPV infections associated with cancer and genital warts was introduced in Germany in 2007. Currently, HPV vaccination is recommended for girls and boys by the German Standing Committee on Vaccination. The vaccination rate, however, remains rather low, with rates below 50% in 15-year-old girls and of about 5% in 15-year-old boys in 2019. This suggests that new approaches are urgently needed to increase HPV vaccination coverage in Germany in the coming years. OBJECTIVES: This qualitative study aimed at identifying opportunities and challenges related to the application and implementation of different approaches designed to increase HPV vaccination uptake among male and female adolescents in Germany according to expert views. MATERIALS AND METHODS: From April to July 2020, 43 experts from the field of HPV vaccination in Germany were interviewed using a semi-standardized interview guide. The audiotaped interviews were transcribed and analyzed using qualitative content analysis by Udo Kuckartz. RESULTS AND CONCLUSION: According to the experts interviewed the following would be the most promising approaches to increase HPV vaccination rates in Germany: educational measures, school vaccination programs, increasing participation in the adolescent health check-up "J1", reminder and recall systems. The most reasonable solution would be to pursue several approaches simultaneously. According to the experts, more political support with implementing strategies and reducing bureaucratic obstacles as well as an increase in cooperation between relevant stakeholders is required to achieve the effective implementation of these strategies.

Climate change and health within the South African context: A thematic content analysis study of climate change and health expert interviews.

BACKGROUND:  Climate change presents an unprecedented and urgent threat to human health and survival. South Africa's health response will require a strong and effective intersectoral organisational effort. AIM:  Exploratory interview outcomes are used to advance practice and policy recommendations, as well as for broad input in the development of a draft national framework for a health risk and vulnerability assessment (RVA) for national departments. SETTING:  Nationally in South Africa. METHOD:  Twenty key expert interviews were conducted with South African experts in the field of climate change and health. Interview data was analysed by means of thematic content analysis. RESULTS:  Findings suggest that previously poor communities are most at risk to the impacts of climate change on health, as well as those with underlying medical conditions. Climate change may also serve as a catalyst for improving the healthcare system overall and should serve as the conduit to do so. A draft climate change and health RVA should take into account existing frameworks and should be implemented by local government. It is also critical that the health and health system impacts from climate change are well understood, especially in light of the plans to implement the (South African) National Health Insurance (NHI) scheme. CONCLUSION:  Practice and policy initiatives should be holistic in nature. Consideration should be given to forming a South African National Department of Climate Change, or a similar coordinating body between the various national departments in South Africa, as health intercepts with all other domains within the climate change field.