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Background: Physical Activity 4 Everyone (PA4E1) is a whole-school physical activity program, with demonstrated efficacy (2012–2014). PA4E1 was adapted (scaled-up) and tested in a scale-up trial (2017–2020). This process evaluation study of the scale-up trial had 2 aims. First, to describe the acceptability, appropriateness, and feasibility of PA4E1 in the scale-up trial, from the perspective of school staff involved in the program management and delivery. Second, to generate themes that may explain school staff assessments of acceptability, appropriateness, and feasibility. Methods: Data were collected at various time points throughout the 2-year implementation phase. Online surveys were collected from In-School Champions, Head Physical Education teachers, Principals, and Physical Education teachers (quantitative data). Focus groups and interviews were conducted with In-School Champions, Principals, and Physical Education teachers (qualitative data). Existing published data on website engagement, adaptations, modifications, and the scale-up trial primary outcome (implementation of physical activity practices) were triangulated with the quantitative and qualitative during analysis, to generate themes. Results: School staff delivering PA4E1 reported it was highly acceptable, appropriate, and feasible. Seven themes were generated relating to acceptability, appropriateness, and feasibility. The themes related to how the program was funded, the delivery modes of implementation support, the identification of easy-wins, the recruitment of the right in-school champion, facilitating principal buy-in, mitigating the impact of school staff turnover, and engaging the whole school. Conclusions: Recommendations are made to inform future adaptations for PA4E1 and potentially school-based physical activity programs more generally. The findings may inform future scalability assessments of the suitability of programs for scale-up. [ABSTRACT FROM AUTHOR]

BACKGROUND: Venous thromboembolism (VTE) is a preventable medical condition which has substantial impact on patient morbidity, mortality, and disability. Unfortunately, adherence to the published best practices for VTE prevention, based on patient centered outcomes research (PCOR), is highly variable across U.S. hospitals, which represents a gap between current evidence and clinical practice leading to adverse patient outcomes. This gap is especially large in the case of traumatic brain injury (TBI), where reluctance to initiate VTE prevention due to concerns for potentially increasing the rates of intracranial bleeding drives poor rates of VTE prophylaxis. This is despite research which has shown early initiation of VTE prophylaxis to be safe in TBI without increased risk of delayed neurosurgical intervention or death. Clinical decision support (CDS) is an indispensable solution to close this practice gap; however, design and implementation barriers hinder CDS adoption and successful scaling across health systems. Clinical practice guidelines (CPGs) informed by PCOR evidence can be deployed using CDS systems to improve the evidence to practice gap. In the Scaling AcceptabLE cDs (SCALED) study, we will implement a VTE prevention CPG within an interoperable CDS system and evaluate both CPG effectiveness (improved clinical outcomes) and CDS implementation. METHODS: The SCALED trial is a hybrid type 2 randomized stepped wedge effectiveness-implementation trial to scale the CDS across 4 heterogeneous healthcare systems. Trial outcomes will be assessed using the RE2-AIM planning and evaluation framework. Efforts will be made to ensure implementation consistency. Nonetheless, it is expected that CDS adoption will vary across each site. To assess these differences, we will evaluate implementation processes across trial sites using the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework (a determinant framework) using mixed-methods. Finally, it is critical that PCOR CPGs are maintained as evidence evolves. To date, an accepted process for evidence maintenance does not exist. We will pilot a Living Guideline process model for the VTE prevention CDS system. DISCUSSION: The stepped wedge hybrid type 2 trial will provide evidence regarding the effectiveness of CDS based on the Berne-Norwood criteria for VTE prevention in patients with TBI. Additionally, it will provide evidence regarding a successful strategy to scale interoperable CDS systems across U.S. healthcare systems, advancing both the fields of implementation science and health informatics. TRIAL REGISTRATION: Clinicaltrials.gov - NCT05628207. Prospectively registered 11/28/2022, https://classic. CLINICALTRIALS: gov/ct2/show/NCT05628207 .

(1) Background: A significant proportion of cancer survivors report experiencing a cognitive fog that affects their ability to think coherently and quickly, and reason with clarity. This has been referred to as cancer-related cognitive impairment (CRCI). CRCI has extensive impacts on the daily lives of people living with or beyond cancer, including occupational, social, and psychological functioning. Oncology health professionals report feeling under-resourced to effectively assess the needs of an individual with CRCI and then provide optimal care and referral. (2) Methods: The objective of this project is to develop and provide an initial validation of the first purpose-built unmet needs assessment for CRCI: the Unmet Needs Assessment of Cancer-Related Cognitive Impairment Impact (COG-IMPACT). We will use a multiple-stage, co-design, mixed-methods approach to develop and provide an initial validation of the COG-IMPACT. (3) Results: The primary anticipated result of this research is the production of the COG-IMPACT, the first purpose-built unmet needs assessment for CRCI. The assessment could be used by health professionals to understand the unmet needs and facilitate optimal care and referral for cancer survivors, by survivors to elucidate their supportive needs and advocate for their care, and by researchers to examine the correlates of unmet needs relating to CRCI, as well as how best to support people with CRCI.

Peer support specialists (peers) who have the lived experience of, and are in recovery from, mental health challenges are increasingly being integrated into mental health care as a reimbursable service across the US. This study describes the ways peers were integrated into Help@Hand, a multi-site innovation project that engaged peers throughout efforts to develop and offer digital mental health interventions across counties/cities (sites) in California. Using a mixed methods design, we collected quantitative data via quarterly online surveys, and qualitative data via semi-annual semi-structured phone interviews with key informants from Help@Hand sites. Quantitative data were summarized as descriptive findings and qualitative data from interviews were analyzed using rapid qualitative analysis methods. In the final analytic phase, interview quotes were used to illustrate the complex realities underlying quantitative responses. 117 quarterly surveys and 46 semi-annual interviews were completed by key informants from 14 sites between September 2020 and January 2023. Peers were integrated across diverse activities for support and implementation of digital mental health interventions, including development of training and educational materials (78.6% of sites), community outreach (64.3%), technology testing (85.7%), technology piloting (90.9%), digital literacy training (71.4%), device distribution (63.6%), technical assistance (72.7%), and cross-site collaboration (66.7%). Peer-engaged activities shifted over time, reflecting project phases. Peer-provided digital literacy training and technology-related support were key ingredients for project implementations. This study indicates the wide range of ways peers can be integrated into digital mental health intervention implementations. Considering contextual readiness for peer integration may enhance their engagement into programmatic activities.

Prior work on leadership in information systems development (ISD) teams has assumed that all developers are treated equally by their team leader and ignored the possibility that differentiated leader-member exchange (LMX) may be an important instrument for team leaders to influence self-organizing, agile ISD teams. We conducted a concurrent mixed methods inquiry to understand how LMX differentiation is associated with developer satisfaction in agile ISD teams and through which team processes agile ISD teams address LMX differentiation. We ran a multilevel, multistage survey of 1,894 software developers in 217 teams and an embedded case study of five ISD teams drawing on qualitative data from 40 interviews of developers and team leaders. Two focus groups (one with 10 developers and one with 10 team leaders) helped to substantiate the meta-inferences from the quantitative and qualitative studies. The results showed that LMX differentiation was positively associated with developer satisfaction, especially in teams with high-quality team-member exchange (TMX). We identify three team processes (i.e., collectivization of resources, visible appreciation of privileges, and freeing up leader capacities) that are enacted through agile ISD practices and allow ISD teams to leverage benefits from LMX differentiation for all their members. [ABSTRACT FROM AUTHOR]

Since the creation of social media platforms, sport researchers have used relationship marketing as a conceptual and theoretical framework for studies on social media in sport. While many of these studies have contributed to our understanding of relationship building on social media, there is much room for advancement. This special-issue commentary provides a brief overview of the scholarship on relationship marketing and social media in sport and then suggests areas for advancement. It ends with specific recommendations for moving from using relationship marketing as a framework to testing the theory in sport social media research and expanding on its application to understanding relationship building on social media in sport. [ABSTRACT FROM AUTHOR]

Trauma-informed communities establish cross-sector coalitions that advocate for the use of trauma-informed practices. Whether and how communication occurs within newly established trauma-informed communities is unclear. We collected qualitative data and social network data from six trauma-informed community partnerships that received funding to build community capacity to address trauma across a range of special populations in Los Angeles county. We identified three communication network sub-types and highlight contributions of network leadership in setting the tone for cross-partnership communication. While partnership leaders shared the goal of strengthening cross-organizational communication, social network results illustrated a need to develop strategies that target these goals.

Large-scale text data from public sources, including social media or online platforms, can expand urban planners’ ability to monitor and analyze urban conditions in near real-time. To overcome scalability challenges of manual techniques for qualitative data analysis, researchers and practitioners have turned to computer-automated methods, such as natural language processing (NLP) and deep learning. However, the benefits, challenges, and trade-offs of these methods remain poorly understood. How much meaning can different NLP techniques capture and how do their results compare to traditional manual techniques? Drawing on 90,000 online rental listings in Los Angeles County, this study proposes and compares manual, semi-automated, and fully automated methods for identifying context-informed topics in unstructured, user-generated text data. We find that fully automated methods perform best with more-structured text, but struggle to separate topics in free-flow text and when handling nuanced language. Introducing a manual technique first on a small data set to train a semi-automated method, however, improves accuracy even as the structure of the text degrades. We argue that while fully automated NLP methods are attractive replacements for scaling manual techniques, leveraging the contextual understanding of human expertise alongside efficient computer-based methods like BERT models generates better accuracy without sacrificing scalability.

BACKGROUND: School leaders play an integral role in the use of implementation strategies, which in turn support special education teachers in the implementation of evidence-based practices (EBPs). In this convergent mixed methods study, we explored school leaders perceptions of the facilitators and barriers to EBP implementation, particularly for students receiving special education, as well as the importance and feasibility of 15 implementation strategies. METHOD: School leaders (N  =  22, principals, assistant principals, school psychologists, etc.) participated in a semistructured interview that included three parts-qualitative questions, quantitative ratings of strategies importance and feasibility, and discussion of the top three implementation strategies. Data strands were analyzed independently and then integrated to generate meta-inferences. RESULTS: The qualitative data identified facilitators such as access to resources about the intervention (e.g., professional development) and collaboration and teamwork, while barriers centered on lack of school supports, culture/climate, and organizational factors (e.g., lack of communication). The quantitative data indicated that the implementation strategy provide ongoing consultation/coaching was rated as important and feasible. Monitor the progress of the implementation effort was rated as important but less feasible, while conduct educational meetings and change the environment were rated as feasible, but less important. Build partnerships to support implementation was rated as less important and feasible. There was convergence and divergence in mixed methods findings. CONCLUSION: This study underscores the critical need to increase school leaders knowledge and skills related to implementation science to better leverage implementation strategies that address the confluence of relevant implementation determinants.

Using a Family Stress Model framework, we used quantitative and qualitative methods to investigate the impact of the pandemic on Latinx pregnant and parenting adolescents and their families. Participants were 406 adolescents (ages 14–19) in the southwestern U.S. who participated in a school-based relationship education program for pregnant and parenting adolescents. In the quantitative analysis, we compared self-reported mental health (depressive symptoms, worry, parental stress), coparental relationships (conflict and communication), and parenting of adolescents who participated prior to the pandemic (N = 357; 83.6% female; 84.7% Latinx) with those who participated during the pandemic (N = 49; 74.6% female; 87.8% Latinx). Unexpectedly, the pandemic-period cohort reported fewer depressive symptoms, less parental stress, more frequent coparental communication, and more positive coparental communication and conflict management than the pre-pandemic cohort. For the qualitative analysis, we conducted focus groups and individual interviews with 21 adolescent parents (95.2% female; 90.5% Latinx) from the pandemic-period cohort and analyzed the data using thematic analysis. Participants reported many negative effects of the pandemic, including increased economic and health stress, yet also discussed reduced pressure with school and more time with family members. These findings have important implications for enhancing the well-being of adolescent parents and their children after the pandemic. [ABSTRACT FROM AUTHOR]

The rural youth exodus has mostly been explained with the pull of the city. In this mixed-method study, we explore whether young people also experience a push to leave the rural community due to a lack of psychosocial thriving. The quantitative analysis of the Ungdata-survey among young people aged 13–16 years (n = 141,058) shows that girls imagine leaving more than boys, and also fare worse on many indicators for psychosocial well-being. There is a linear decline in girls' psychosocial well-being the less centrally they live. We call this the gendered district effect. Contrary to expectations, we find that rural girls without higher education aspirations are those who least want to stay in the rural community. It is likely that a lower degree of psychosocial well-being is part of the reason that more girls in rural areas wish to leave their homeplace. The qualitative analysis of the rural village of Smallville (n = 21) explores this, showing that girls commonly wanted to leave to escape a toxic social environment, which also offered few status-filled work opportunities in the village. The girls were more affected by the rural community's restricting social norms, leaving girls with poor self-images and the wish to leave. [ABSTRACT FROM AUTHOR]

Inappropriate urinary tract infection diagnosis in patients with neurogenic bladder may result from ambiguous symptoms experienced by these patients and contributes to antibiotic overuse. Characterization of patient-reported signs and symptoms may help providers more appropriately diagnose urinary tract infections. A previous study collected signs and symptoms recorded in electronic medical records of patients with neurogenic bladder due to spinal cord injury/disorder, multiple sclerosis, and Parkinson’s disease with at least one urinary tract infection diagnosis between 2017–2018 at four medical centers. In this study, 23 veterans from this cohort with urinary tract infection diagnoses in the previous year participated in focus groups conducted May 2021– May 2022. Transcripts were coded using mixed deductive and inductive coding. Qualitative data were compared to electronic medical records data to give a comprehensive picture of signs and symptoms. Both providers and patients attributed nonspecific symptoms like urine changes to urinary tract infection, but there was discordance between patients and providers in the identification of other signs and symptoms. Several patients described providers disregarding symptoms other than fever or chills. Optimizing urinary tract infection care for patients with neurogenic bladder could involve improving patient-provider communication about urinary tract infection signs and symptoms and emphasizing thorough elicitation and evaluation of all signs and symptoms. [ABSTRACT FROM AUTHOR]

Aims: Research has associated lack of parental care, physical abuse, and parental substance abuse to homelessness, with the presence of two or more such factors dramatically increasing one's chances of becoming homeless as an adult. Less clear is which (cumulation of) factors may mediate the difference between transitional and recurrent homelessness. Methods: Quantitative analysis of four risk factors—addiction, weak social network, criminal activity, psychopathology—among 69 transitionally and recurrently homeless (RH) adults, followed by in‐depth qualitative analysis of adverse childhood experiences (ACEs) among 30 selected participants. Results: RH participants had higher cumulative risk and a higher prevalence and broader range of ACEs than transitionally homeless participants, with the prevalence of childhood physical abuse marking the greatest difference between the two groups. Recurrent homelessness was also correlated with addiction to hard drugs, criminal activity, and weak social networks. Conclusion: Longitudinal and intervention studies in larger groups are needed to assess causality. [ABSTRACT FROM AUTHOR]

A gap remains between developing risk prediction models and deploying models to support real-world decision making, especially in high-stakes situations. Human-experts' reasoning abilities remain critical in identifying potential improvements and ensuring safety. We propose a thick data analytics (TDA) framework for eliciting and combining expert-human insight into the evaluation of models. The insight is 3-fold: (a) statistical methods are limited to using joint distributions of observable quantities for predictions but often there is more information available in a real-world than what is usable for algorithms, (b) domain experts can access more information (e.g., patient files) than an algorithm and bring additional knowledge into their assessments through leveraging insights and experiences, and (c) experts can re-frame and re-evaluate prediction problems to suit real-world situations. Here, we revisit an example of predicting temporal risk for intensive care admission within 24 hr of hospitalization. We propose a sampling procedure for identifying informative cases for deeper inspection. Expert feedback is used to understand sources of information to improve model development and deployment. We recommend model assessment based on objective evaluation metrics derived from subjective evaluations of the problem formulation. TDA insights facilitate iterative model development toward safer, actionable, and acceptable risk predictions. [ABSTRACT FROM AUTHOR]

This mixed methods study investigates conceptions of gender both in and outside of the media among a sample of 11- and 12-year-olds. Data from a quantitative survey and qualitative writing responses were collected and analyzed from 54 sixth graders at a U.S public elementary school. Results show that the majority held inclusive views of gender, indicating a recognition of gender inequities in media and society and a desire to challenge traditional gender norms. However, perhaps due to gender-typed content, stronger perceptions of the similarity of the people appearing in YouTube videos, commercials, video games, music videos, and movies to the self were associated with more stereotypical views about gender roles and norms in a weak but statistically significant correlation. This may suggest that accepting media representations as accurately reflecting oneself can still be linked to endorsing more traditional roles and norms, even within a sample with generally quite open conceptions of gender. Impact summary: Prior State of Knowledge: Gender stereotypes are present in media used by adolescents, and most existing research finds a small association between media use and stereotypical beliefs about gender. Perceived realism and perceived similarity of characters to the self may help explain that association. Novel Contributions: In a sample of U.S. adolescents, there is mixed methods evidence of inclusive views of gender. Yet, perceptions of media characters in select media as similar to the self were weakly but significantly correlated with more stereotypical views of gender. Practical Implications: Self-reflection about identification processes can be encouraged by caregivers as well as media literacy educators. To work toward gender justice, content creators should avoid stereotypes in commercials, music videos, movies, video games, and YouTube content popular with early adolescents. [ABSTRACT FROM AUTHOR]

In the highly competitive field of publishing in economics journals, methods often become fads sometimes to the detriment of framing meaningful research agendas and of research ethics. In recent times, empirical work based on primary data collection has gained traction. Randomized controlled trials entail not just primary data collection but also interventions involving human subjects. Field research involving data collection is also expensive, raising a number of concerns. In this special symposium we explore questions of research agendas and research ethics, and argue fo rthe acceptance of broader methodological approaches, greater inclusion in the publication process and for a reflection at the disciplinary level of practices related to field research. [ABSTRACT FROM AUTHOR]

Economics has long shunned qualitative research methods, such as interviews, focus groups and observational studies, in preference for quantitative methods, such as empirical analysis of secondary data and field experiments. Moreover, recent years, with advances in econometric theory, have seen a notable increase in the size and quality of data sets that are needed to publish quantitative research in leading journals. This has the effect of significantly increasing the 'entry costs' for researchers interested in studying economic development. Crucially, it also limits the topics that can be studied. In particular, it focuses attention on issues and countries where large data sets exist or can be collected. In this paper, we argue that by putting too much weight on internal validity, economics has adopted a too narrow definition of 'rigour' and would benefit from embracing qualitative and mixed methods research. To illustrate our point, we pay particular attention to the informal economy. The informal economy is understudied by economists because of the lack of available quantitative data. We show that this fundamentally impacts our understanding of the wider economy. Qualitative research can enrich our understanding by providing a more complete and nuanced view of the economy. [ABSTRACT FROM AUTHOR]

The watchdog role is central to the democratic legitimacy of journalism and is also perceived as an essential part of journalists' role performance by the public. So far, the expectations on journalists' watchdog role performance have been studied as a static concept resulting in limited knowledge of the underlying dynamics in audience demand and expectations for this type of journalism. We argue that the demand for watchdog journalism is dynamic and varies according to changes in the broader context and across audience characteristics. We take a multi-method approach to examine the demand for watchdog journalism during the COVID-19 pandemic in Denmark. First, we use data from three representative surveys (n≈1.000 in each), including a panel component (n = 336), to demonstrate that the demand for watchdog journalism increased over time, especially among opposition voters, as the political context offered more political conflict and contested policy solutions. Second, a qualitative analysis of answers to an open-ended question in the surveys examines how the audience believes the watchdog role should be performed. We show that the demand for different functions of journalists' critical reporting varies over time and that the form used by journalists when conducting critical reporting is extremely important to the audience. [ABSTRACT FROM AUTHOR]

Ensuring hospitalized patients' comfort requires understanding differences in comfort and adaptation to discomfort, as well as the role of the built environment therein. Shortcomings in this understanding result from limitations of existing research methods. Therefore the potential of a mixed methods research design to investigate when and why experiences of and adaption to (dis)comfort differ among hospitalized patients was explored. A convergent mixed methods case study was conducted in two hospital wards of a Belgian hospital. Qualitative data included interviews with 19 patients about their experiences and information about the patients at the two wards during the fieldwork; quantitative data included sensor measurements of indoor environmental quality parameters (i.e. illuminance and indoor temperature), a questionnaire among 238 patients about their assessment of the indoor conditions, and simulations of these conditions. Joint displays allowed comparing situations in which characteristics related to the patients or their setting differed in an integrated way. The displays provide an intermediate step between purely qualitative descriptions of comfort and adaptation and purely quantitative models that predict both. Scenarios that the joint displays allow identifying inform about characteristics that could improve these models, and about roles of the built environment in experiences. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this mixed methods study sought to investigate the preferences and challenges towards fourth industrial revolution (FIR) technologies adoption at hotels in Malaysia. Design/methodology/approach: The study adopted partially-mixed concurrent quantitative-dominant mixed methods. The quantitative part of the study examined the preferred FIR technologies for hotels; whiles the qualitative part explored the challenges towards their adoption. Findings: The results revealed that Internet of things, big data, cloud computing, artificial intelligence and cyber physical systems were the preferred FIR technologies for hotels. The findings revealed significant relationships between respondents' socio-demographic characteristics (age, gender, working experience, etc.) and preferred FIR technologies. Penultimately, challenges that affect the adoption of FIR technologies including investment cost, migration cost, trust, etc., were discussed. Originality/value: In effect, findings from this study provide valuable information for policy makers (i.e. hotel owners, management, technology providers and future researchers). Most especially, the study unearths specific FIR technologies preferred by the hospitality and tourism industry. Also, the significant interplay of these preferences vis a vis respondents' socio-demographic characteristics, as well as challenges influencing their adoption also have major implications for policy makers. Another valuable contribution of this study lies in the research method utilised, since most studies on technology adoption either use quantitative or qualitative. These contributions for theory and practice have been thoroughly discussed. [ABSTRACT FROM AUTHOR]

The growth of non‐standard employment has emerged as a crucial factor that contributes to delays and difficulties in young people's transitions to adulthood. Previous studies have demonstrated the importance of multidimensional measures of precariousness. This paper aims to investigate the phenomenon of precariousness holistically, using an original database of respondents in Spain from 20 to 34 years of age. Using a mixed‐methods approach, we explore young people's understandings of precariousness and examine its key determinants and consequences. The findings illustrate the multidimensional nature of feelings of precariousness, with economic insecurity and work conditions being core elements. Our results point to precarity stemming from a combination of inextricably intertwined objective and subjective components, as well as work and economic dimensions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic rattled educational institutions to implement an online internship arrangement with their industry partners. Journalism felt the same experience, at least in the Philippines where the government had mandated online learning given full school closures for 566 schooldays. This mixed methods study documented the case of a Philippine journalism school, its interns and its news media industry partners on how two rounds of online internship arrangements happened. The study integrated quantitative results from an internship evaluation sheet (N = 129) with qualitative findings from key informant interviews (N = 11) with journalist-mentors and from interns' reflection papers (N = 110). The situated learning and boundary theories, plus the inclusive education concept, provided the theoretical lenses for this paper. It was found that the pandemic-tailored online internship became an inclusive education setup that had normalized telework as the situated, bounded learning milieu of the interns. Should future natural and man-made disruptions come, journalism schools can resurface the lessons of conducting crisis-tailored online internships to reduce worrisome negative outcomes that a pandemic like COVID-19 wrought. [ABSTRACT FROM AUTHOR]

In this paper, mixed methods research is presented and discussed in the context of research on reflective writing for the professional development of pre-service teachers. First, we present prominent theoretical frameworks to analyze reflective writings. Second, we review relevant methodological approaches of research on reflective writings in teacher education, such as qualitative, quantitative and mixed methods. Third, we present a study from our research lab combining qualitative content analysis and linguistic analyses as an example for a concurrent mixed method approach. The results of the qualitative content analysis indicated that 198 reflective writings of pre-service teachers were primarily descriptive and on a low level. Computational linguistic analyses revealed that affective and cognitive terminology utilization in reflective writing differed significantly across the different levels of reflection, with a higher frequency of such terms correlating with deeper levels of reflection. Thus, essential challenges and opportunities of implementing such a mixed method study to analyze reflective writings are illustrated and discussed. Finally, we conclude the paper by discussing on how mixed methods approaches might be further advanced in the field of reflective writing research in teacher education. [ABSTRACT FROM AUTHOR]

Globally, ex-post legislative evaluations are becoming increasingly important for understanding how laws function in practice and identifying their limitations and their effects upon stakeholders. This study delves into the impact of ex-post legislative evaluations within the Dutch healthcare system. Building upon insights from previous literature, we aim to refine existing ideas within the field through empirical data. Utilising the realist evaluation method, we examine three distinct case studies followed by a cross-case analysis. Our research underscores that the impact of these evaluations extends beyond policy and politics to the broader societal arena. Our findings also point towards opportunities for strengthening the impact of ex-post legislative evaluations within this broader societal arena. Specifically, we identify strategic phases within the evaluation process through which we aim to maximise impact. Finally, the study emphasises the importance of context awareness, the strategic utilisation of research quality as well as interactional factors for enhancing impact. [ABSTRACT FROM AUTHOR]

Introduction: This study explored the extent to which an interactive computer play system, Bootle Blast, supports motor learning in a clinical context and examined clinicians' perceptions of their therapeutic role in the system's use as an intervention tool. Methods: In this observational sequential explanatory mixed methods study, five children with cerebral palsy [mean age 9.4 years (SD, 0.5), Gross Motor Function Classification System Levels I-III] used Bootle Blast during a single videorecorded therapy session with their treating clinicians (physical therapists, occupational therapists, and therapy assistants). Children played one Bootle Blast mini game independently (without clinician involvement) before clinicians carried out therapy sessions with the game as per usual care. The type and extent of motor learning strategies (MLS) delivered by Bootle Blast and clinicians were rated from video recordings by a trained assessor using the 22-item Motor Learning Strategies Rating Instrument. Semi-structured interviews with clinicians were conducted to gain insights into MLS use and clinicians' perceived role during Bootle Blast use. Interviews were audio recorded, transcribed verbatim, and analyzed independently by two researchers using thematic analysis. Quantitative and qualitative data were merged and reported using narrative and joint display approaches. Results: Bootle Blast provided eight MLS, with clinicians adding or enhancing another eight. Four themes reflected clinicians' perspectives: (1) Bootle Blast disguises therapy as play, (2) clinicians give Bootle Blast the human touch; (3) home use of Bootle Blast is promising; and (4) Bootle Blast is not always the right fit but some shortcomings could be addressed. Agreement was found for nine MLS and disagreement for four MLS when quantitative and qualitative findings were merged. Discussion: Bootle Blast delivers several MLS as part of game play and clinicians can enhance and provide additional MLS to suit the child's needs/abilities. Further game refinements that were identified in this study may optimize its clinical use. [ABSTRACT FROM AUTHOR]

Introduction: The educational system in Costa Rica, as regulated by Law #7727, which governs Alternative Conflict Resolution and Promotion of Social Peace must consider the interplay of various factors influencing classroom conflicts and the management strategies employed by teachers. Consequently, it becomes imperative to identify the most effective conflict resolution practices applicable within this context. To achieve this, a thorough procedure based on mixed methods was employed to analyze and interpret both classroom conflict behaviors and teachers' strategic responses. Method: This study employed an indirect observational methodology, from a mixed methods approach. Data was collected through a focus group comprised of teachers. Following the connect framework, the procedure was conducted in three phases: QUAL-QUAN-QUAL. Two analytical techniques were implemented. A lag sequential analysis was used to explore potential behavioral patterns. The results of this analysis informed a polar coordinate analysis, which generated a visual representation of the relationships between codes. Results and discussion: A focus group addressed four questions, yielding satisfactory data quality control results (kappa values: 0.80, 0.77, 0.76, 0.82). In polar coordinate analysis, the 37 observational instrument categories were designated as focal behaviors. Each of the 37 analyses treated all categories as conditioned behaviors. The analysis identified 342 activation/inhibition relationships between focal and conditioned behaviors. Of these, 195 were statistically highly significant, distributed across quadrants: Quadrant I (106), Quadrant II (36), Quadrant III (16), Quadrant IV (36). Significant gaps in understanding of conflict were identified, along with disparities in the resources and competencies necessary for successful conflict resolution among the observed educators. Specifically, teachers frequently employed techniques informed by intuition rather than deliberate strategy learned in their training. Consequently, the study advocates for enhancing teachers' cognitive and emotional competencies to optimize conflict management within the classroom and bolster their adaptive coping mechanisms. [ABSTRACT FROM AUTHOR]

Up to 175 conditions influencing interprofessional practices have been identified. Still, little is known about to what extent these conditions interact, influence communication, and vary across professional groups and settings. We explored these knowledge gaps by examining communication among staff in home care and home nursing units in two Danish municipalities, Herning and Holstebro. Conditions were categorized into two types (programme and context) and two levels (professional and organizational). Structural Equation Modeling was used with a sample of 395 staff and 21 managers to analyze the condition categories’ interactions, influences on communication, and variations by unit type and municipality. Context conditions strongly influenced programme conditions on the professional and organizational levels. Organizational-level context conditions had no significant influence, organizational-level programme conditions had a weak influence, and professional-level programme and context conditions had moderate influences on communication. Lastly, professional-level programme conditions had the biggest influence on communication for staff in home care units and in Holstebro. In contrast, professional-level context conditions had the biggest influence on communication for staff in home nursing units and in Herning. These findings offer unique insights into conditions’ interactions, influences, and variances, contributing to our understanding of what makes communication work and for whom. [ABSTRACT FROM AUTHOR]

Background/Objectives: Empathy and emotional regulation (susceptibility and resistance) play an important role in a nurse's well-being and the provision of high-quality care. This phenomenon has not yet been studied in the context of nurses working in neuroscience. This study aimed to explore the perceptions related to empathy among nurses working in neuroscience contexts. Methods: Employing a mixed-methods approach, we conducted an online quantitative survey with 211 nurses working in various neuroscience settings using the Balanced Emotional Empathy Scale (BEES) and 15 online semistructured qualitative interviews to delve deeper into empathetic experiences. The mean and measures of dispersion, such as standard deviation, were used to analyze the quantitative data. Thematic analysis investigated qualitative data, and data triangulation was performed. Results: The quantitative findings revealed no significant differences in empathy or emotional regulation across the different neuroscience settings but highlighted an increase in susceptibility related to young age (under 29) and years of service (first 5 years). The interviews brought to light the challenges nurses face in highly emotional situations and the strategies they employ to manage empathy and maintain professional detachment, such as self-care strategies, awareness development, and team support. One hindering factor is managers. Conclusions: The findings of this study underscore the essential role of empathetic capability in nursing care in neuroscience. The experience of younger nurses and the first 5 years of employment are elements to be considered by managers for burnout risk. Nurses demonstrate susceptibility and resistance and maintain a balance in dealing with high-emotional-stress situations. The implications of these findings are significant and should guide future research and practice in the field of neuroscience nursing. [ABSTRACT FROM AUTHOR]

Introduction: Prenatal mental health problems are associated with morbidity for the pregnant person, and their infants are at long-term risk for poor health outcomes. We aim to explore how the SARS-CoV-2 pandemic affected the mental health of pregnant people in the United Kingdom (UK), and to further identify resilience factors which may have contributed to varying mental health outcomes. We also aim to examine the quality of antenatal care provided during the pandemic in the UK and to identify potential inadequacies to enhance preparedness for future events. Methods: During June-November 2020, we recruited 3666 individuals in the UK for the EPPOCH pregnancy cohort (Maternal mental health during the COVID-19 pandemic: Effect of the Pandemic on Pregnancy Outcomes and Childhood Health). Participants were assessed for depression, anxiety, anger and pregnancy-related anxiety using validated scales. Additionally, physical activity, social support, individualized support and personal coping ability of the respondents were assessed as potential resilience factors. Results: Participants reported high levels of depression (57.05%), anxiety (58.04%) and anger (58.05%). Higher levels of social and individualized support and personal coping ability were associated with lower mental health challenges. Additionally, pregnant individuals in the UK experienced higher depression during the pandemic than that reported in Canada. Finally, qualitative analysis revealed that restrictions for partners and support persons during medical appointments as well as poor public health communication led to increased mental health adversities and hindered ability to make medical decisions. Discussion: This study revealed increased mental health challenges among pregnant individuals in the UK during the SARS-CoV-2 pandemic. These results highlight the need for reassessing the mental health support measures available to pregnant people in the UK, both during times of crisis and in general. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions We developed MARVIN, an artificial intelligence (AI)‐based chatbot that provides 24/7 expert‐validated information on self‐management‐related topics for people with HIV. This study assessed (1) the feasibility of using MARVIN, (2) its usability and acceptability, and (3) four usability subconstructs (perceived ease of use, perceived usefulness, attitude towards use, and behavioural intention to use).In a mixed‐methods study conducted at the McGill University Health Centre, enrolled participants were asked to have 20 conversations within 3 weeks with MARVIN on predetermined topics and to complete a usability questionnaire. Feasibility, usability, acceptability, and usability subconstructs were examined against predetermined success thresholds. Qualitatively, randomly selected participants were invited to semi‐structured focus groups/interviews to discuss their experiences with MARVIN. Barriers and facilitators were identified according to the four usability subconstructs.From March 2021 to April 2022, 28 participants were surveyed after a 3‐week testing period, and nine were interviewed. Study retention was 70% (28/40). Mean usability exceeded the threshold (69.9/68), whereas mean acceptability was very close to target (23.8/24). Ratings of attitude towards MARVIN's use were positive (+14%), with the remaining subconstructs exceeding the target (5/7). Facilitators included MARVIN's reliable and useful real‐time information support, its easy accessibility, provision of convivial conversations, confidentiality, and perception as being emotionally safe. However, MARVIN's limited comprehension and the use of Facebook as an implementation platform were identified as barriers, along with the need for more conversation topics and new features (e.g., memorization).The study demonstrated MARVIN's global usability. Our findings show its potential for HIV self‐management and provide direction for further development. [ABSTRACT FROM AUTHOR]

The article integrates interdisciplinary insights in an analytical framework and aims to examine what factors matter more for happiness than income in China from a sociological perspective. The study emphasizes the importance of social contexts and adopts a mixed‐methods approach. Quantitative analysis of the 2015 Chinese General Social Survey data shows that intentional activities, social attitudes, and social comparison are significantly associated with Chinese people's happiness after economic circumstances and sociodemographic characteristics have been taken into account as control variables. In addition, qualitative analysis of in‐depth interviews helps to contextualize the quantitative findings and to enrich the understanding of why these factors rather than income would play a more significant role in making people happy in China. This study demonstrates the value of investigating happiness across disciplinary boundaries and makes an empirical contribution to examining subjective well‐being in contemporary society. [ABSTRACT FROM AUTHOR]

AbstractThe inclusion of people with disabilities can facilitate sustainable peace after civil war. To shed a novel light on the relationship between war-to-peace transitions and disability, we map approaches to impairments in 286 worldwide intra-state political agreements, before considering the experience of Lebanon. Through a rigorous mixed methods research design, we show that war-to-peace transitions entrench the marginalisation of people with disabilities. Political agreements reproduce oversimplified understandings of disability; emphasise war-related physical impairments over non-physical and congenital ones; and prioritise support for former combatants. In Lebanon, disability-related legislation suffers from similar blind spots and remains unimplemented because of lack of financial resources, of weak capacity and cooperation among responsible local and international agencies, and of the features of the local political settlement. We discuss some significant implications for the lives of people with disabilities and their families, before providing recommendations to promote inclusive war-to-peace transitions.POINTS OF INTERESTPeace processes provide a crucial window of opportunity to build more inclusive societies.At a global level, civil war peace agreements overlook people with disabilities.Even when they mention impairments, peace accords adopt over­simplified understandings of disability, prioritise war-related physical impairments over non-physical and congenital ones, and emphasise interventions in support of former combatants.In Lebanon, lack of financial resources, weak capacity and cooperation among responsible local and international agencies, and local political dynamics further constrain the implementation of disability-focused policies.Globally, discourses on transition between civil war and a peaceful and just future, remain ableist and disempowering.Peace processes provide a crucial window of opportunity to build more inclusive societies.At a global level, civil war peace agreements overlook people with disabilities.Even when they mention impairments, peace accords adopt over­simplified understandings of disability, prioritise war-related physical impairments over non-physical and congenital ones, and emphasise interventions in support of former combatants.In Lebanon, lack of financial resources, weak capacity and cooperation among responsible local and international agencies, and local political dynamics further constrain the implementation of disability-focused policies.Globally, discourses on transition between civil war and a peaceful and just future, remain ableist and disempowering. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Hematopoietic cell transplant (HCT) survivorship care includes recommendations for post‐HCT revaccination to restore immunity to vaccine‐preventable diseases (VPDs). However, not all survivors agree to be vaccinated. No existing studies have comprehensively reported barriers and facilitators to adult HCT survivors completing revaccination.A cross‐sectional survey of 194 adult HCT survivors was analyzed using convergent mixed methods. The analysis used various statistical methods to determine the prevalence of barriers and facilitators and the association between revaccination and the number and specific type of barriers and facilitators. Content analysis was applied to open‐ended item responses. Integrated analysis merged quantitative and qualitative findings.The most frequent barriers included the inability to receive live vaccines because of immunosuppression, identifying a suitable community location for administering childhood vaccines to adults, and delayed immune recovery. The most frequent facilitators were having healthcare insurance and a clear calendar of the revaccination schedule. Complete revaccination rates were lower with each additional reported barrier (OR = 0.58; 95% CI 0.459–0.722) and higher with each additional reported facilitator (OR = 1.31; 95% CI 1.05–1.63). Content analysis suggested that most barriers were practical issues. One significant facilitator highlighted by respondents was for the transplant center to coordinate and serve as the vaccination location for revaccination services. Merged analysis indicated convergence between quantitative and qualitative data.Practical barriers and facilitators played a consequential role in revaccination uptake, and survivors would like to be revaccinated at the transplant center. [ABSTRACT FROM AUTHOR]

Background: During COVID-19, scientists advising policymakers were forced to deal with high uncertainty and risks in an environment of unknowns. Evidence on which policies and measures were effective in responding to the pandemic remains underdeveloped to answer the key question 'what worked and why?'. This study aims to provide a basis for studies to go further to answer this critical question, by starting to look efficacy or how countries ensured that health services remained available and what measures were enacted to protect and treat their populations and workers. Methods: We applied a three-phase sequential mixed methods design. In phase one, we started with a qualitative content analysis of the EU Country Profile reports to retrieve and analyse data on COVID-19 responses taken by 29 countries in the European region. Phase two is the step of data transformation, converting qualitative data into numerical codes that can be statistically analysed, which are then used in a quantitative cross-national comparative analysis that comprises phase three. The quantifying process resulted in a numerical indicator to measure the 'response efficacy' of the 29 countries, which is used in phase three's association of the response measure with country performance indicators that were derived from European Centre for Disease Control (ECDC) COVID-19 case and death rate data. Results: Through comparing the frequency of COVID-19 measures taken, we found that many countries in the European region undertook similar actions but with differing effects. The cross-national analysis revealed an expected relationship: a lower COVID-19 response efficacy appeared to be related to a higher case and death rates. Still, marked variation for countries with similar response efficacy indicators was found, signalling that the combination and sequence of implementation of COVID-19 responses is possibly just as important as their efficacy in terms of which response measures were implemented. Conclusions: Many European countries employed similar COVID-19 measures but still had a wide variation in their case and death rates. To unravel the question 'what worked and why?', we suggest directions from which more refined research can be designed that will eventually contribute to mitigate the impact of future pandemics and to be better prepared for their economic and human burden. [ABSTRACT FROM AUTHOR]

The global fashion industry is undergoing rapid digitisation in which new Industry 4.0 technologies are changing the way fashion is designed and produced. The Australian fashion industry is considered to be slow in adopting these new technologies. The purpose of this research study is to investigate the current acceptability of Industry 4.0 technologies and the barriers to adoption within Australia. Data from forty-nine fashion organisations were obtained using a technology acceptance model (TAM) survey and a series of ten semi-structured interviews. The TAM survey results indicate that the industry accepts Industry 4.0 technologies to be useful and somewhat easy to use; however, technologies such as autonomous robotics, sensor and digital twin technologies are currently underutilised. Providing further insight, the interviews highlighted the key barriers to be the lack of industry leadership, misaligned knowledge and skills within higher education, and issues in the accessibility and scalability of technical skills and capabilities. [ABSTRACT FROM AUTHOR]

Background: Compared to the general population, people living in prison are at an increased risk to experience negative (mental) health outcomes. Moreover, delinquency and drug use have many risk factors in common. A need exists for increasing the knowledge about health needs, drug use patterns and the coverage of drug-related interventions in prison within Europe. The current protocol describes the design of a study about wellbeing, drug use and related care in prison. Methods/design: A multicentre mixed method design is implemented in five European countries (Belgium, Cyprus, Greece, Lithuania and Luxembourg). Qualitative and quantitative data collection tools are combined in order to generate complementary and comprehensive results. First, a cross-sectional survey among people living in prison is conducted. This survey is based on a model questionnaire, the European Questionnaire on Drug use among people living in Prison, developed by the European Monitoring Centre for Drug and Drugs Addiction. Second, people living in prison and people who have been recently released from prison are involved in qualitative semi-structured face-to-face interviews. The main topics of interest are the use of drugs and other health related topics such as loneliness, anxiety, depression, infectious diseases, suicide and treatment. Third, data regarding health and social reintegration measures in prison is collected through a quantitative survey addressed to the prison authorities. Discussion: This study protocol presentes a European study which aims to assess drug use among people living in prison and recently released people who use drugs as well as the existing care services in prisons. Hereby, factors related to the prison environment and their needs, both inside and outside prison are taken into account. Importantly, this study protocol describes a methodology which is developed to be executed in different prison settings within different countries simultaneously. Accordingly, for each country the protocol is adjustable to specific national legal requirements, regional differences and distinct local regulations of prison administrations. However, extensive modularity inevitably comes with significant limitations of comparability and generalizability of the results. [ABSTRACT FROM AUTHOR]

Background: Internationally, there has been a move towards fostering diverse healthcare workforces that are representative of the patient populations they serve. Selection criteria for academic-clinicians often aim to capture skills and attributes that demonstrate both clinical and academic excellence. Currently, it is not known whether the selection criteria for early academic-clinical careers advantage or disadvantage certain ethnic or socioeconomic groups. The UK has a structured route of integrated clinical academic training with entry level training for newly qualified doctors administered through the 'Specialised Foundation Programme' which provides protected time for research within the first two years of postgraduate clinical training. In this study, we aim to identify what selection criteria are used within the UK Specialised Foundation Programme, and how these relate to demographic factors. Methods: We will perform a mixed methods study consisting of a document analysis of person specifications and selection criteria used in the 2024 UK Specialised Foundation Programme, and a national cross-sectional survey of current medical students in the UK. We will obtain the person specifications, selection criteria, white space (open ended questions used during shortlisting) and interview questions and mark schemes from each Specialised Unit of Applications via information available on their websites or through Freedom of Information requests. Our survey will collect information relating to demographic data, selection criteria, and perceptions of specialised foundation programme selection. Discussion: International literature has demonstrated inequity in academic markers used in selection of post-graduate clinicians and that disadvantages caused by selection can compound over time. As such it is important to understand what inequity exists within the selection of early academic-clinicians, as this can help inform more equitable selection practices and help nurture a more diverse academic-clinical workforce. [ABSTRACT FROM AUTHOR]

Introduction: The increasing prevalence of shiftwork among young adults poses significant health risks, primarily due to its disruptive effects on sleep, nutrition and physical activity. Addressing these risks necessitates the development of tailored, evidence‐based resources to support these key health behaviours. Participatory research approaches, engaging those with relevant lived experience (i.e., co‐design) are a novel and effective approach in developing these resources. As such, the aim of the present study was to explore whether sleep, nutrition and physical activity resources for young shiftworkers could be developed using participatory, co‐design approaches and how co‐designers would rate both the approaches used and the resulting resources. Methods: A participatory approach engaged co‐designers (young, experienced or previous shiftworkers; workplace health and safety specialists; science communicators and academic experts) to complete 2–3 online questionnaires and participate in 1–2 online workshops, to co‐design sleep, nutrition and physical activity resources for young shiftworkers. Following resource development, co‐designers assessed both the participatory approach and the resulting resources, through an online questionnaire, which included the Public and Patient Engagement Evaluation Tool (PPEET). Results: Co‐designers (n = 48) participated in the development of sleep, nutrition and physical activity resources for young shiftworkers. Co‐designers evaluated the participatory approach positively, with a mean rating across all PPEET items of 4.7 (±0.2) on a 5‐point Likert scale. Co‐designers also provided positive ratings for the resources, with the majority (91.7%) either agreeing or strongly agreeing that they were user‐friendly, valuable and informative for young shiftworkers and would serve as a credible source of health information. Conclusion: By adopting a novel participatory approach, we successfully co‐designed sleep, nutrition and physical activity resources for young shiftworkers. Participatory approaches, including co‐design, should be considered when developing health interventions for shiftworkers, given the value of embedding lived experience to address their unique lifestyle challenges. Patient or Public Contribution: Co‐designers and/or people with relevant lived experience were involved in all project activities: conceptualisation, design, recruitment, data collection, data analysis, knowledge translation and output generation. [ABSTRACT FROM AUTHOR]

Transition to kindergarten is an important developmental milestone for children and families. This study explored factors associated with kindergarten readiness focusing on the impact of a summer kindergarten transition program. A mixed-method design was employed, and the qualitative data from interviews with 16 randomly selected kindergarten teachers and the quantitative data of assessment scores of 320 kindergarteners were analyzed. Compared with children who were eligible but did not participate in the transition program, those who participated in the program had significantly more family engagement and stronger home-school relations. Smaller class sizes were associated with children's higher readiness scores in both academic achievement and social-emotional development. Larger school enrollment was associated with children's higher readiness scores in academic achievement, more family engagement, and stronger home-school relations. Higher school poverty was associated with children's lower readiness scores in social-emotional development. The findings can be used to inform program development and policymaking. [ABSTRACT FROM AUTHOR]

Approaches to integrating mixed methods into medical research are gaining popularity. To get a holistic understanding of the effects of behavioural interventions, we investigated religious fasting using a triangulation of quantitative, qualitative, and natural language analysis. We analysed an observational study of Bahá'í fasting in Germany using a between-method triangulation that is based on links between qualitative and quantitative analyses. Individual interviews show an increase in the mindfulness and well-being categories. Sentiment scores, extracted from the interviews through natural language processing, positively correlate with questionnaire outcomes on quality of life (WHO-5: Spearman correlation r = 0.486, p = 0.048). Five questionnaires contribute to the first principal component capturing the spectrum of mood states (50.1% explained variance). Integrating the findings of the between-method triangulation enabled us to converge on the underlying effects of this kind of intermittent fasting. Trial registration: NCT03443739 [ABSTRACT FROM AUTHOR]

Culturally Responsive Teaching (CRT) provides a framework for teachers to include students' ethnic-cultural identities in class, aiming to tackle issues of educational and societal inequity. This quasi-experimental mixed methods intervention study tested whether pre-service teachers attending a seminar based on an ethnic-cultural identity school intervention, the Identity Project, would show greater CRT self-efficacy and more positive beliefs about teaching in ethnic-culturally diverse classes, compared to a control group. Repeated measures ANCOVAs of survey data from 606 pre-service teachers in Germany indicated a stronger T1-T2 increase in confidence for interacting with ethnic-culturally diverse students and engaging in culture- and ethnic-related conversations in the intervention group. No significant time-by-group interactions emerged for other CRT facets. A content analysis of brief texts of pre-service teachers in the intervention group revealed they became more self-reflective about their own beliefs, learned about CRT practices for their own teaching, and gained confidence for including issues of ethnicity and culture in class. Yet, the complexity of ethnic-cultural diversity-related topics left some pre-service teachers feeling overwhelmed about how to adequately address ethnic-cultural diversity in the classroom. Overall, the Identity Project seminar raised pre-service teachers' awareness and self-efficacy for engaging in CRT in the future. [ABSTRACT FROM AUTHOR]

Self-objectification, defined as an excessive focus on one's physical appearance over non-observable qualities, has attracted considerable attention from feminist scholars. In the current research, we hypothesized that cultural tightness (i.e., strong social norms and severe sanctions against norm-deviant behavior) predicts and increases self-objectification among women. This hypothesis was confirmed across four studies via a mixed-method approach, including archival and ecological data (Study 1), a large-scale survey (Study 2, N = 4,083), and two controlled experiments (Studies 3a and 3b, N = 858). Specifically, we found higher self-objectification among women living in China in provinces with tighter cultures as reflected by the search queries for cosmetic surgery terms online (Study 1), Chinese female college students who perceived tighter culture in daily life (Study 2), and both US Americans (Study 3a) and Chinese female participants (Study 3b) who were temporarily induced to support cultural tightness (vs. cultural looseness). Across the studies, the effect of cultural tightness on self-objectification was observed among women, but this effect was reduced (Study 2) or even absent (Studies 3a and 3b) among men. Collectively, these findings establish a relationship between cultural tightness and women's tendency to self-objectify, and advance understanding of the cultural roots of self-objectification and potential targets for intervention. [ABSTRACT FROM AUTHOR]

Aggression and violence against educators and school personnel have raised public health concerns that require attention from researchers, policymakers, and training providers in U.S. schools. School aggression and violence have negative effects on school personnel health and retention and on student achievement and development. In partnership with several national organizations, the American Psychological Association (APA) Task Force on Violence Against Educators and School Personnel administered two national, multi-informant, cross-sectional surveys. Time 1 data were collected in 2020–2021 from 14,966 respondents; participants reflected on their experiences of violence and aggression before COVID-19 and during COVID-19 restrictions in this survey. One year later, in 2022, 11,814 respondents completed the Time 2 survey after COVID-19 restrictions ended. Participants included teachers, school psychologists, social workers, counselors, staff members, and administrators from all 50 states and Puerto Rico. Rates of violence and aggression directed against educators by students, parents, colleagues, and administrators were substantial before COVID-19, were lower during COVID-19 restrictions, and returned to prepandemic levels or higher after COVID-19 restrictions. After COVID-19 restrictions, 22%–80% of respondents reported verbal or threatening aggression, and 2%–56% of respondents reported physical violence at least once during the year, varying by stakeholder role and aggressor. Rates of intentions to quit the profession ranged from 21% to 43% during COVID-19 restrictions (2020–2021) and from 23% to 57% after COVID-19 restrictions (2021–2022), varying by stakeholder role. Participants across roles reported substantial rates of anxiety and stress, especially during and after COVID-19 restrictions, and identified specific training needs. Implications for theory, research, training, and policy are presented. Public Significance Statement: Aggression and violence against educators and school personnel and educator shortages are public health and educational issues that require attention, particularly in the context of recent trends surrounding COVID-19. This study describes new results that highlight violence and aggression before the COVID-19 pandemic (2019–2020), during COVID-19 restrictions (2020–2021), and after COVID-19 restrictions (2021–2022) for teachers, school psychologists, school social workers, counselors, school staff members, and administrators. Recommendations are provided to promote school safety and advance the field in theory, research, training, and policy. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, distance learning became the predominant teaching method at most universities, exposing students and teachers alike to novel and unexpected challenges and learning opportunities. Our study is situated in the context of higher physics education at a large Swedish university and adopts a mixed-methods approach to explore how students perceive shifts to distance learning. Quantitative student survey responses comparing distance learning during the pandemic with previous in-person learning are analyzed with k-means cluster analysis and with a random-intercept multilevel linear model. Combined analyses produce a consistent picture of students who report having experienced the greatest challenges. They are on average younger, report being less autonomous in their learning, and find it harder than peers to ask questions to the instructor. They are also less likely to have access to a place where they can study without interruptions. Variation across courses is small with students being largely subjected to the same set of challenges. Qualitative data from semi-structured focus group interviews and open-ended questions supports these findings, provides a deeper understanding of the struggles, and reveals possibilities for future interventions. Students report an overall collapse of structure in their learning that takes place along multiple dimensions. Our findings highlight a fundamental role played by informal peer-to-peer and student-instructor interactions, and by the exchange of what we refer to as "structural information." We discuss implications for teachers and institutions regarding the possibility of providing support structures, such as study spaces, as well as fostering student autonomy. [ABSTRACT FROM AUTHOR]

Balanced energy protein (BEP) supplementation in pregnancy is recommended in the context of undernutrition for the reduction of small‐for‐gestational age neonates and stillbirths. To inform an effectiveness trial, we evaluated the acceptability of a packaged, ready‐to‐eat fortified BEP product among women of reproductive age and their health care providers (HCPs) in rural Bangladesh and explored the feasibility of adhering to daily supplementation. We implemented a formative study using focus groups discussions with women (n = 29) and HCPs (n = 17) to introduce the product and investigate components of acceptability. A "trials of improved practice" activity was conducted in subset of women (n = 16) to evaluate adherence to BEP over a 2‐week period, followed by focus group discussions to identify challenges with adherence and strategies employed. Contributors to BEP acceptability included the product's sensory attributes, such as taste, smell and texture; the attractive packaging and informative labelling; and the perceived benefits of use. Participants also identified household and community level factors influencing the adoption of BEP, such as trust in the provider, cultural beliefs on supplement use in pregnancy, and family member tasting and approval. Over the 2‐week period, women consumed over 80% of the supplements provided to them and identified strategies for adherence, including visual aids and reminders from family members or providers. HCPs recommended targeted communication messages for mothers‐in‐law to foster a supportive home environment. Findings informed changes to the BEP product to improve acceptability and shaped the content of communication messages to optimise adherence in a forthcoming effectiveness trial. Key messages: The balanced energy protein (BEP) product introduced in this formative study was well accepted by women of reproductive age and their health care providers (HCPs), especially with regards to the overall taste, product packaging and labelling, and perceived benefits. Acceptability may be influenced by cultural beliefs around nutritional supplement use during pregnancy, and factors such as family members' approval of the product, and trust in the provider of BEP supplements.Women who consumed the product over 2 weeks had high daily adherence and identified strategies such as reminders from family members and/or providers and visual aids in the home to enhance regular use. HCPs recommended communication messages that encouraged buy in from husbands and mothers‐in‐law.Findings from this study informed changes to the BEP product format to improve acceptability and shaped the content of communication messages to encourage adherence in a forthcoming effectiveness trial. [ABSTRACT FROM AUTHOR]

Ethnographic fieldnotes can contain richer and more thorough descriptions of social phenomena compared to other data sources. Their open-ended and flexible character makes them especially useful in explorative research. However, fieldnotes are typically highly unstructured and personalized by individual researchers, which make them harder to use as a method for data collection in collaborative and mixed methods research. More precisely, the unstructured nature of ethnographic fieldnotes presents three distinct challenges: 1) Organizability—it can be difficult to search and sort fieldnotes and thus to get an overview of them, 2) Integrability—it is difficult to meaningfully integrate fieldnotes with other more quantitative data types such as more such as surveys or geospatial data, and 3) Computational Processability—it is hard to process and analyze fieldnotes with computational methods such as topic models and network analysis. To solve these three challenges, we present a new digital tool, for the systematic collection, processing, and analysis of ethnographic fieldnotes. The tool is developed and tested as part of an interdisciplinary mixed methods pilot study on attention dynamics at a political festival in Denmark. Through case examples from this study, we show how adopting this new digital tool allowed our team to overcome the three aforementioned challenges of fieldnotes, while retaining the flexible and explorative character of ethnographic research, which is a key strength of ethnographic fieldwork. [ABSTRACT FROM AUTHOR]