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Exploring Physiotherapists' Role in Work-Focused Health Care and Fit Note Use:Barriers, Facilitators, and Recommendations
Get PDFObjectives The Fit Note (FN) may help people return to work and avoid prolonged sickness absence. However, its utilisation by physiotherapists is not understood. This study explored physiotherapists' views and practices regarding work-focused health care and FN use. Design A mixed methods study involving an online survey followed by six online focus groups. Participants United Kingdom (UK) physiotherapists (n = 401) working in a variety of settings responded to the survey. Sixteen also participated further in the focus groups. Results Participants (89%) viewed supporting patients to stay-in or return-to-work as part of their role, yet only 31% regularly issued FNs. Key themes were developed: physiotherapists recognise work as integral to care, and those issuing FNs do so in line with guidance, recommending strategies to help patients remain in or return to employment. Barriers included organisational, individual factors, such as limited recognition of physiotherapists’ role and lack of confidence or knowledge, and perceived patient barriers including lack of awareness. Facilitators included training, organisational support, and a multidisciplinary approach to work-related issues. Conclusion This study, the largest of its kind in the UK, indicates that physiotherapists regard work and health as integral to their professional responsibilities; however, FN implementation remains inconsistent. Qualitative findings reveal organisational, practitioner, and perceived patient barriers. Recommendations include improved mentorship and consistent digital FN access across all clinical settings. Further research should explore task-shifting consequences and patient perspectives. Contribution of the paper • This study represents the largest UK investigation to date examining physiotherapists’ (n=401) perspectives on FN implementation, using a mixed-methods approach. • Although physiotherapists consider work-related issues integral to their practice, the study identifies barriers to FN implementation at multiple levels, including confidence gaps, systemic constraints, and concerns regarding scope-of-practice. • The study provides actionable, multi-level recommendations to address the identified barriers, such as structured training, organisational support systems including mentorship programmes, and policy guidance to clarify scope-of-practice. Additionally, it highlights areas for future research, including patient perspectives and task-shifting
Climate Change and Violent Extremism in Northeastern Kenya:Towards an Integrated Response
Get PDFThis report analyses the relationship between climate change and violent extremism (VE) in Garissa and Wajir counties in northeastern Kenya. Drawing on qualitative fieldwork—including 16 focus group discussions, 18 key informant interviews, and stakeholder workshops—the study identifies 11 pathways through which climate change may influence vulnerabilities to VE. These pathways cluster around four interrelated dynamics: the destruction of livelihoods, increased migration and shifts in pastoral mobility, the erosion of social structures, and the exacerbation of governance challenges. The findings suggest that climate change operates as a threat multiplier, intensifying economic insecurity, social fragmentation, and perceptions of marginalisation while simultaneously undermining communities’ capacity to adapt to environmental stress. The report argues that addressing these intertwined risks requires more integrated policy responses that bridge climate adaptation, peacebuilding, and preventing/countering violent extremism (P/CVE) efforts at both national and county levels
Academy primary teachers’ perceptions of wellbeing via self-determination theory
Get PDFThis study explores how academy primary school teachers in England view their autonomy, competence, and relatedness, and whether the academy environment supports these wellbeing-related needs better than maintained schools. Five primary educators from academy schools, aged 25 to 53, responded to an online advert and took part in semi-structured interviews. Reflexive thematic analysis was used to analyse the data, revealing four themes: Fading autonomy, Empowering growth, Isolated practice, and Trust me, I know my class. Teachers reported positive views on professional development, with academy schools providing chances for teacher growth and leadership. Educators felt restrictions on independence appeared due to strict adherence to schemes which overlook the creativity of teachers and the needs of learners: factors presumed to influence teachers’ happiness and contentment. Academy trusts’ lack of shared practice was regarded as a failure to support relatedness and minimise workload pressures. The implications of these findings are that academies need to create more opportunities for collaboration to improve the welfare of teachers by creating supportive systems. Classrooms need to be places where autonomy and trust are encouraged. Teachers should be able to use their professional judgement, where an atmosphere is created that meets the needs of educators and students alike
The role of deferred action in demystifying the “black box” of human resource management during economic crises
No full textPurpose This research investigates how and why human resource (HR) adjustments are made during times of significant crisis and analyses choices HR managers make to enhance business performance during crises. Design/methodology/approach Qualitative data (23 interviews and four years' financial performance data) were gathered from multiple sources. Organisational documents were also used as secondary data. Collective analysis was undertaken of the above Jordanian banks' data on their performance especially those that survived the global financial crisis. Findings The findings reveal that before the crisis, the investigated banks had made HR policy choices that emphasised flexibility to respond to changes in the business environment during the crisis. We also unveil the role that cultural and economic pressures played in decisions about the deployment and adjustment of HR policies. Finally, HR departments played the role of business partners and employee champions during the crisis. Research limitations/implications Findings confirm the relevance of HR as a business partner and an employee champion. We demonstrate how soft and hard human resource management (HRM) practices can be used to drive firm performance, especially as HR function tends to be viewed less as an organisational asset and more as an administrative cost. Originality/value We uncovered the role of deferred HR action in organisations' crisis response strategies, finding that a combination of soft and hard practices enhances performance under such conditions. We contribute to a new dimension of HR flexibility: policy flexibility and highlight the role played by societal, cultural and economic pressures in the decisions these firms made about their HR practices
Comparison of plyometric repeated sprint and plyometric aerobic training on physical performance in youth soccer players
Get PDFHigh-intensity interval training (HIIT) and repeated-sprint sets (RSS) are established conditioning methods in soccer, yet their integration with plyometric training among highly trained youth soccer players remains underexplored. This study investigated the effects of an 8-week program combining plyometric training with either RSS (PLYO-RSS) or HIIT (PLYO-HIIT) on physical fitness in young soccer players. Twenty-nine male players (14-15 years) were randomly assigned to PLYO-RSS (n = 14) or PLYO-HIIT (n = 15). Both interventions lasted 20 minutes per session and replaced part of regular soccer training. Physical fitness assessments included countermovement jump (CMJ), 15-s repeated vertical jumps (15''RJ), five-jump test (5JT), 10 m and 30 m sprint, maximal aerobic speed (MAS), VO2max, and repeated sprint performance (total sprint time, best sprint, fatigue index). Physiological markers (lactate, rating of perceived exertion, and HRmax) were also monitored. Significant improvements over time were observed in muscle power, sprint speed, aerobic capacity, and repeated-sprint ability (p ≤ 0.001; η²p = 0.339-0.489). However, no main effects or group × time interaction effects were observed, indicating no evidence of differential responses between the two training modes. In conclusion, integrating plyometric training with either RSS or HIIT effectively enhances physical fitness in highly trained youth soccer players, offering flexible options for training prescription. [Abstract copyright: © 2026. The Author(s).
Comparison of plyometric repeated sprint and plyometric aerobic training on physical performance in youth soccer players
Get PDFHigh-intensity interval training (HIIT) and repeated-sprint sets (RSS) are established conditioning methods in soccer, yet their integration with plyometric training among highly trained youth soccer players remains underexplored. This study investigated the effects of an 8-week program combining plyometric training with either RSS (PLYO-RSS) or HIIT (PLYO-HIIT) on physical fitness in young soccer players. Twenty-nine male players (14-15 years) were randomly assigned to PLYO-RSS (n = 14) or PLYO-HIIT (n = 15). Both interventions lasted 20 minutes per session and replaced part of regular soccer training. Physical fitness assessments included countermovement jump (CMJ), 15-s repeated vertical jumps (15''RJ), five-jump test (5JT), 10 m and 30 m sprint, maximal aerobic speed (MAS), VO2max, and repeated sprint performance (total sprint time, best sprint, fatigue index). Physiological markers (lactate, rating of perceived exertion, and HRmax) were also monitored. Significant improvements over time were observed in muscle power, sprint speed, aerobic capacity, and repeated-sprint ability (p ≤ 0.001; η²p = 0.339-0.489). However, no main effects or group × time interaction effects were observed, indicating no evidence of differential responses between the two training modes. In conclusion, integrating plyometric training with either RSS or HIIT effectively enhances physical fitness in highly trained youth soccer players, offering flexible options for training prescription. [Abstract copyright: © 2026. The Author(s).
Exploring Proof of Concept for a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome:Multi-Method Study
Get PDFPolycystic ovary syndrome (PCOS) is a common chronic hormonal condition affecting 8-13% of women and individuals assigned female at birth. Symptoms may include subfertility, menstrual, skin and metabolic problems, with long-term health risks including diabetes and cardiovascular disease. PCOS has a significant negative impact on mental health, quality of life and wellbeing. We explored proof of concept for a web-based self-management support intervention 'Hope PCOS' designed to reduce anxiety and depression and increase positive wellbeing for women living with PCOS. To pilot the intervention to test feasibility for web-based recruitment and delivery, acceptability and potential to reduce anxiety and depression and increase positive wellbeing. Women with PCOS were recruited via social media with support from a patient advocacy charity and offered places on a six-session cohort of the intervention. In a pre-post design participants reported depression (PHQ-9), anxiety (GAD-7), wellbeing (Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)), hope (State Hope Scale (SHS)) and gratitude (Gratitude Questionnaire (GQ-6)) at baseline and six weeks. All participants who accessed 3 or more sessions were invited to a follow-up qualitative interview to explore user experience. Data from 8 interviews were thematically analysed and pre-post data explored with descriptive statistics. Sixty-three eligible women responded and were given access to the intervention. Three withdrew, leaving a baseline sample of N=60, aged 20-58 (median 30) years. Forty-eight of the 60 started, of whom 44% (22/48) completed at least three sessions and 27% (14/48) completed all six. Eight women (aged 25-38, median 29) years who completed all sessions reported acceptability and experiences in exit interviews, including prioritising self-care, developing a self-management mindset, setting motivating goals, improved mental health, self-compassion, reduced shame, openness about PCOS, preparedness for future health concerns, and continuing practice to consolidate behaviour change. Eleven women aged 25-43 (median 31) years, who completed 1-6 sessions (median 6), completed pre-and post-intervention outcomes. Descriptive quantitative analysis indicated decreases in anxiety and depression and increases in hope agency, hope pathways and gratitude. There was a meaningful (≥3 points) increase in wellbeing. Among patients with baseline and follow-up data, 73% (8/11) met clinical caseness for depression at baseline and 36% (4/11) post intervention. We explored proof of concept. Recruitment and delivery online was feasible. We detected early signs of acceptability and potential benefits for anxiety, depression, and positive wellbeing that warrant testing in a controlled trial. Future research should assess feasibility of a randomised controlled trial to evaluate effectiveness, acceptability and cost-effectiveness. Not applicable as this was an exploratory proof of concept study
Entrepreneurial Success:Key Challenges Faced by Malaysian Women Entrepreneurs in the Aged Care Industry
No full textWomen entrepreneurship is on the rise in Malaysia due to government support. However, financial, sociocultural, environmental, and individual factors handicap women’s entrepreneurial success in Malaysia. Even though women’s personality attributes such as tenderness, empathy, patience, and care fit with the need of the aged care industry, their involvement in this industry is minimal when compared to other businesses. The entry of Malaysian women as an aging care center operator may help the Malaysian government overcome the looming challenge of the aging population. This study investigates the challenges women entrepreneurs face in achieving entrepreneurial success in the aged care industry. Ten women entrepreneurs who were running aged care centers in Malaysia were interviewed. Semi-structured interviews were utilized to gather data, and Saldaña (2018) structured inductive data analysis methodology was used to analyze the data. A success model for women entrepreneurs in the service industry is proposed by identifying women entrepreneurs’ critical challenges in the aged care industry. Despite many challenges, the centers are still sustainable and depict women entrepreneurs’ potential to excel in this industry. This carries implications for the industry, policymakers, investors, and society. The present study proposes a business model for women entrepreneurs, a novel contribution to the mainstream literature
Reliability of the audit committee in weak institutional environments:Evidence from Nigeria
No full textRelying on institutional theory, this article presents external stakeholders’ perspectives on the factors that influence audit committees’ independence and reliability in a weak institutional context. We conducted 37 semi-structured interviews with two critical external stakeholder groups (27 experienced professional investors and 10 senior regulatory officials) in the Nigerian banking sector. Our study finds that the independence of audit committee members, being an ‘a posteriori’ rather than an ‘a priori’ accountability verification, bears institutional contextual bias. Consequently, we unpack five factors (allegiance to the dominant owner; poor professional conduct; corruption; nepotism and opportunism; and impunity) that influence external stakeholders’ perception of the reliability of the audit committee’s independence in Nigeria
How do avatar characteristics affect applicants' interactional justice perceptions in artificial intelligence‐based job interviews?
No full textArtificial intelligence (AI)-based job interviews are increasingly adopted in organizations' recruitment activities. Despite their standardization and flexibility, concerns about fairness for applicants remain a critical challenge. Taking a perspective on interface design, this research examines the role of avatar characteristics in shaping perceptions of interactional justice in AI-based job interviews. Through a scenario-based study involving 465 participants, the impact of avatar characteristics—specifically, appearance, linguistic style, and feedback informativeness—on applicants' perceptions of interpersonal justice and informational justice was investigated. The findings indicate that avatars characterized by a warm and cheerful appearance, coupled with an affective expression style and informative feedback, significantly enhance perceptions of interpersonal justice and informational justice. These insights offer valuable practical guidance for avatar design in AI-based job interview systems.</p