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IntroductionSocietal perceptions and lack of understanding of autism spectrum disorder can be stigmatizing for autistic individuals and their families. This may be particularly the case for individuals who meet criteria for profound autism. Despite the considerable service needs of this marginalized group, there is little data on the prevalence of profound autism, nor on the experiences of those with profound autism and their families.MethodsThe current study leveraged a mixed-methods approach to address these gaps. First, the prevalence of profound autism was examined in six samples-three from the United States and three from Western Europe. Second, inductive thematic analysis was used to code interviews from 20 caregivers of profoundly autistic adults.ResultsThe prevalence of profound autism varied widely across the six samples-from 11% to 48%. There were also notable differences between samples in prevalence by gender, race, and ethnicity. Two overarching themes were identified via inductive thematic analysis: Community Perceptions of Autism and Family Support Needs and Advocacy Challenges. Though caregivers were not directly asked about stigmatization during interviews, 85% of caregivers reported at least one instance of perceived stigma.DiscussionFuture research should continue to examine the unique needs and stigmatization experiences of profoundly autistic individuals and their families across the life course.

Though many initiatives and monetary benefits are incorporated under RNTCP/NTEP, many patients might incur some out-of-pocket expenditure (OOP) related to diagnosis, treatment, and hospitalization. Such costs lead to further poverty and default. This study estimated OOP costs. A cross-sectional mixed method study was conducted in 2020. Data were collected from two selected UHCs (both public and private sectors) from all eight administrative zones. A total of 278 newly registered drug-sensitive tuberculosis patients at different stages of treatment were enrolled, and 18 IDIs were done after obtaining the consent. Among 278, 231 (83%) were seeking the treatment from the public sector and 47 (17%) from the private sector. The average direct, indirect, and total costs were Rs. 8812, Rs. 4825, and Rs. 13,637, respectively. Extra food and supplements are the major field of expenditure for those enrolled in the public sector. Higher costs were incurred by the private sector patients. Longer distances, a long waiting time, belief systems, and unavailability of facilities or drugs were the common reasons for not visiting the public sector. IDI results also supported the cost heads. The majority of the expenses occurred at the private settings before diagnosis. IDIs suggested to changes in the programmatic approach toward migrants, industrial workers, and women. [ABSTRACT FROM AUTHOR]

Understanding older adults' driving behavior based on their personal assessment, along with challenges they encounter when driving will support community leaders and policymakers to develop effective supportive strategies for their safety on the road. This study uses a mixed methodology approach, including a survey and an interview to examine older drivers' perceptions and concerns regarding their driving habits. Collecting data from cities in Texas and Nevada, to achieve diverse perspectives on older adults who live in environments with different land use patterns and road geometry. Using the survey to understand the older adults' self-evaluated driving skills, where most consider themselves very good drivers even though they have some challenges, based on the roads, their reflexes changing over the years, and the impact of their physical and cognitive health. Supplementing the survey results with the interview allows the study to identify older drivers' major challenges including adverse weather, construction sites, and in-vehicle distractions. Supporting that visual and cognitive challenges are limiting older adults' driving patterns (e.g., not driving at night). To avoid any conflicts with aggressive drivers, the older adults are passively driving, and if accessible, utilizing in-vehicle technologies to increase their safety. However, older drivers suggested that all drivers, particularly younger drivers, should have access to more educational materials. They recommended that older adults' licensing requirements should be evaluated based on their health condition rather than age. Participants' concern regarding roadway infrastructure elements and driver behavior can be resolved through improvements in road design and driver education. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to conduct a process evaluation of Supporting Family Doctors to Address Elder Abuse (SAFE) intervention, a training program, and clinical guidelines developed to assist the family doctor in intervening in elder abuse (EA). Method: 160 family doctors answered pre-and post-training questionnaires on knowledge of EA, attitude, subjective norms, and the perceived behavioral control to intervene in EA, followed by semi-structured interviews post-intervention with a purposive sample of family doctors who participated in the SAFE intervention (N = 39). Results: There is a significant increase in mean scores of the knowledge, attitude, and subjective norms six months post-intervention (p < 0.001). The mean scores of perceived behavioral control of family doctors to intervene in EA decreased but were statistically insignificant (p > 0.05). Qualitative data explained the observed effect and process underlying the knowledge transfer and implementation of the SAFE intervention. Knowledge improvements due to awareness enhancement led to empowerment and confidence as the training program was effectual and comprehensive. Family doctors' self-reflection and empathy toward older adults contribute to attitude changes. Family doctors are better coordinated and receive support in intervening in EA. However, various roadblocks affect their perceived ability to intervene in EA and enhancement strategies necessary to assist family doctors to intervene in EA efficiently. Conclusion: The SAFE intervention was feasible and effective in improving family doctors' competency to intervene in EA. However, findings showed that doctors' capacities must go hand in hand with empowering older adults, creating awareness among community members, and pushing for law and policy reforms. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, many organisations worldwide asked their employees to accept a temporary salary reduction to manage the financial consequences of the unprecedented event. In this paper, we use a CEO's salary reduction announcement to all employees and investigate whether a behaviour change intervention using five selected Behaviour Change Techniques (BCTs) increases expat employees' overall willingness to accept a temporary salary reduction. We use mixed qualitative and quantitative methods, including survey and experiment, to test our hypotheses and frame our results. The results show that, while the direction of impact was positive, respondents were overall not significantly more likely to accept a temporary salary reduction. However, a significant effect was found for the individual BCT 'Modelling'. Participants were significantly more likely to accept a pay cut if they knew their senior management took a larger cut than asked of participants. The outcomes of this study suggest that the availability of a financial buffer and the strength of the employer–employee relationship play a, possibly more important, role in employees' willingness to accept a pay reduction. In addition, leadership matters as this study shows that people are more willing to accept a salary reduction when senior management leads the way. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion The purpose of this study was to evaluate an intervention designed to encourage therapists in a municipality mental health services team to collaborate with their clients when writing journal notes. The team was part of a low‐threshold mental health service for children, adolescents and their parents. The therapists offered individual therapeutic sessions with children, adolescents and parents, as well as family sessions. The therapists documented their encounters in the clients' electronic health records.The study used a convergent mixed methods design. First, the quality and quantity of documented therapist–client interactions were measured before and after the intervention using the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI). Cross‐tabulation and logistic regression analyses were used to examine potential differences in the recording of therapists' approaches before and after intervention. Second, we explored the therapists' experiences of participating in this project by conducting individual in‐depth interviews. Qualitative interviews were analysed by systematic text condensation. Finally, the quantitative results from assessing the journal notes were contextualised with the qualitative results from the interviews.The number of journal notes describing therapist approach and client response increased by 25% points after the intervention. In the interviews, the therapists acknowledged the intervention's relevance to their practice. However, they invited only a limited number of clients to co‐create journal notes. The clients welcomed the invitation.Collaborative documentation challenges established journal documentation practices and may strengthen the client's voice. This study provides suggestions for strengthening the intervention in the future full‐scale studies. [ABSTRACT FROM AUTHOR]

There is increasing interest in incorporating game design elements in workplace learning, known as instructional gamification. Despite initial positive indications, there is still a need for a deeper understanding of how organisational stakeholders play a role in implementing instructional gamification. This study employed an explanatory sequential mixed-methods approach to identify and understand stakeholders' instructional gamification design preferences and how these preferences might impact their endorsement of instructional gamification. A survey of 231 individuals at a software company was conducted to gather data on stakeholders' preferences for instructional gamification. This was followed by in-depth interviews with eight employees to further enhance the understanding of stakeholders' instructional gamification design preferences. The quantitative findings revealed four interrelated factors concerning the instructional gamification design preferences of the three stakeholder groups. However, the qualitative findings revealed that the stakeholder groups interpreted the items differently. By integrating the quantitative and qualitative findings, the study provides a comprehensive understanding of the factors that enable or hinder stakeholders' endorsement of instructional gamification in workplace learning. The study also presents four design propositions that facilitate stakeholder endorsement of gamified learning artifacts. The findings have both theoretical and practical implications for designing and implementing instructional gamification in workplace learning environments. [ABSTRACT FROM AUTHOR]

According to the Dialogical Self Theory, there is a multiplicity of I-positions within the self in a dialogical relationship. Psychodrama refers to these positions as inner parts within the self. We propose an integration of both to create an intervention centered on unscripted intrapersonal role-playing of the I-positions for the purpose of meaning-making. We want less dominant or silenced I-positions to be heard and included in the dialogue. We illustrate this approach with a group of 24 adult participants who engaged in a reflective dialogue process to potentially change their attitudes and perspectives toward an exemplary topic of technological advancement. A mixed-method approach is applied to investigate the potential benefits of this intervention. In pre-and post-intervention, a questionnaire is used to gather self-reported attitudes with Likert-scale and open-ended questions to assess explicit attitudes and perspectives related to our exemplary case. We used a statistical test and thematic analysis to compare the results before and after the intervention. The qualitative results show a shift in perspectives. However, the quantitative results do not show statistical significance regarding attitude change. Furthermore, integrating quantitative and qualitative results shows a convergence of the findings in one group of participants while divergence in the other. Despite these results, the proposed interventional approach promises various potential applications. [ABSTRACT FROM AUTHOR]

Background and objective: Cancer-related fatigue (CRF) affects the quality of life after breast cancer. In a previous study, we developed a 72-item questionnaire that assesses CRF from a holistic point of view; named the Holistic Assessment of CRF (HA-CRF) questionnaire. The current study assessed the face and content validity of the HA-CRF questionnaire. Methods: Using a mixed-method approach, ten breast cancer survivors (BCS) did a cognitive walkthrough of the HA-CRF via an app followed by a semi-structured interview about relevancy and essentiality (qualitative). In addition, ten health care professionals (HCPs) assessed the relevancy, clarity, and essentiality of each item via a questionnaire (quantitative). Results: BCS indicated minor textual improvement for four items and six items were not completely clear. The app was considered easy to use and the HC-CRF was on average completed in 18 minutes. The HA-CRF questionnaire provided openness about fatigue and gave the feeling of being heard. The items were helpful and induced self-awareness. HCPs indicated 71% of items being very clear or minor revisions proposed by the minority, with 64% of items being essential and 92% considered relevant. Conclusions: The HA-CRF showed good face and excellent content validity. Further research is needed to assess its ability to monitor in daily life. [ABSTRACT FROM AUTHOR]

This study aims to examine the relationship among key factors including health care, mental health, attitude, social support, quality of life, life satisfaction and active aging to investigate factors that relate to active aging in the Thai elderly and to develop a new model of Thai active aging. Data for the quantitative research were collected using questionnaires and analyzed using descriptive statistics, explanatory factor analysis, and multiple regression analysis. The qualitative research sample consisted of thirty elders. The data were analyzed using content analysis. The results of this study indicate that all important factors related to the active aging of Thai elderly are at a high level such as previous active aging, quality of life, life satisfaction and adjusted active aging. From exploratory factor analysis, it was found that nine elements could be separated that reflect the adjusted active aging of Thai elderly people. In addition, the result indicated four variables that affect the adjusted active aging of the Thai elderly, health care, mental health, attitude and social support. This study creates a new model to serve as a guideline for the government or private sector to use in managing the Thai elderly. [ABSTRACT FROM AUTHOR]

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This study investigates the communication skills expected of recent construction engineering graduates as portrayed in job ads and conveyed by employers. A content analysis of 100 job ads showed that teamwork, leadership, and interpersonal communication skills were the specific categories of communication skills listed most frequently. Subsequent interviews with 11 employers showed that although they considered the written communication skills of recent college graduates as sufficient, they found that many recent graduates had insufficient skills in assertiveness, email communication, relationship building, and audience adaptation, indicating that additional coursework or assignments in oral communication skills would benefit construction engineering majors. [ABSTRACT FROM AUTHOR]

It has been almost 90 years since William Stephenson's 1935 letter to Nature that opened the door for Q methodology [Q]. Criticisms and excitement ensued and continue into the present within and outside of the Q research community. Yet, any research community contains researchers with different positionalities about the methodology's philosophical framework, and best practices regarding data collection and/or data analysis. A relatively recent Q study indicated differences of opinion among Q methodologists when it comes to data analysis and its philosophical framework. Twenty years ago, Hurd and Brown uncovered four divergent viewpoints about the Q community's view of the future of Q. Thus, especially with Q's growing popularity, it seemed time to repeat that study with some change to the subjective statements used within the data collection phase, as many changes have occurred especially regarding technological advances for data collection and data analysis. Two viewpoints were uncovered, Tradition and Community, with a focus on the theoretical framework provided by Stephenson and the welcoming nature of the Q community, and Unorthodox with Expansion of Q, with a yearning to expand Q both physically and theoretically including a willingness to move beyond Stephenson's vision. The discussion and conclusion focus on the implications of these perspectives and their shared consensus for the future of Q methodology as well as implications for other research methodologies. In other words, this study provides a demonstration of complementarity for understanding the behavior of all types of research communities. [ABSTRACT FROM AUTHOR]

Background: In Senegalese high-burden regions, the existing package of interventions is insufficient to reach the malaria elimination goal. Asymptomatic carriers of Plasmodium contribute significantly to malaria persistence and are not targeted by current interventions. The systematic treatment of all individuals in a community (mass drug administration, MDA) is a relevant intervention to tackle asymptomatic infections. The intervention can only be effective with a high participation of the population and, therefore, depends largely on its acceptability. This study aims to investigate the prospective acceptability of MDA in the Kedougou region to inform its potential use in a future strategy. Methods: Following a 7-construct theoretical framework, prospective acceptability of MDA implemented in the rainy season was studied. In four villages, a sequential mixed design, from qualitative to quantitative, was used. In November 2021, interviews with healthcare professionals and focus groups with villagers were conducted. Findings from thematic analysis informed the development of a questionnaire administered to individuals aged ≥ 15 years in March 2022. Based on the questionnaire, an acceptability score was constructed and associations with socio-demographic factors were investigated using a linear mixed model. Results: The 7 interviews, the 12 focus groups, and the questionnaire administered to 289 individuals demonstrated a good acceptability of MDA. Two potential barriers were identified: the contradiction of taking a medication without feeling sick and the occurrence of side effects; and four facilitators: the perception of malaria as a burden, a good understanding of MDA, a good perceived effectiveness, and the resulting economic benefits. The average acceptability score was 3.5 (range from -7 to + 7). Young adults aged 15 to 21 had a lower acceptability score compared to the other age groups, indicating an additional barrier to acceptability (β = -0.78 [-1.67;0.1]). Conclusion: MDA is a priori acceptable to communities of Kedougou region in Senegal. Sensitization campaigns co-constructed with the communities, especially targeting young adults, are essential to ensure good acceptability. [ABSTRACT FROM AUTHOR]

Purpose: To provide real-world data on patient perceptions and experiences with subcutaneous (SC) versus intravenous (IV) daratumumab. Patients and Methods: This was a cross-sectional, mixed-method (qualitative/quantitative) survey conducted in France, Germany, Spain and the United Kingdom involving multiple myeloma (MM) patients who switched from IV to SC daratumumab in the last 12 months (qualitative phase) or 24 months (quantitative phase [26 months in the UK]) prior to enrollment in the study. Results: Nine patients (mean age 65 years) participated in the qualitative phase and 113 patients (mean age 65.1 years) in the quantitative phase. Qualitative study results provided insights for the quantitative study and highlighted the benefits of switching from daratumumab IV to daratumumab SC as an improvement and a satisfactory change in patients' treatment journey. Quantitative survey showed that patients were significantly less anxious, stressed and nervous before SC injections than IV infusions (mean score: 1.3, 1.1, 1.4 versus 2.1, 2.0, 2.0 respectively, p< 0.001), and significantly more reassured, ready/well-prepared, usual self and relieved (mean score: 3.8, 4.3, 3.7, 3.6 versus 3.0, 3.6, 3.1, 3.0 respectively, p< 0.001). Immediately after SC first injection, 96.5% patients were feeling well or very well versus 77.9% immediately after IV first infusion (p< 0.001). 97.3% patients were satisfied with their SC treatment versus 89.4% for the IV injection (p< 0.001). Patients spent significantly less time in hospital for an SC injection of daratumumab than for an IV infusion, 1.5 hours and 5.0 hours respectively (p< 0.001). In the UK, the differences between the two administration forms were less visible, likely because of confounding factors including a longer time passed since the switch from the IV to the SC form and administration of the survey. Conclusion: In line with results from other studies, the SC form of daratumumab had less impact on patients' emotional burden than the IV form. [ABSTRACT FROM AUTHOR]

Growing concerns for loneliness, social isolation, and the health of young adults point to the importance of the dating context. This study aimed to identify and examine quality dating experience (QDE) and poor dating experience (PDE) relative to the well-being of religious college students identified as members of the Church of Jesus Christ of Latter-day Saints, including gender differences. Focus group (n = 58) and online survey (n = 515) participants came from introductory psychology courses at a large religious institution. A mixed-methods design was used to qualitatively identify quality and poor dating themes and then, using these themes, examine the dating experience using quantitative data from an online survey questionnaire. Focus group thematic analyses revealed patterns of gender similarity (e.g., compatibility, safety concerns, hyper-focus on marriage) and disparity (e.g., monetary value, date activity details) for both QDE and poor dating experience (PDE). Quantitative survey results highlighted substantial relationships between QDE, PDE, and wellness variables including mood, life satisfaction, depressive symptoms, anxiety, stress, loneliness, physical health symptoms, and perceived peer support. Interestingly, men had statistically stronger (p < .05) relationships between PDE and 3 health variables: depressive symptoms, peer support, and interpersonal conflict. This suggests that men may have more adverse health profiles than women when undergoing PDEs in a more traditional religious context. Results supported QDE and PDE as influential variables that go beyond the simple metric of dating frequency to capture a more comprehensive perspective of health among religious college students, including gender differences. [ABSTRACT FROM AUTHOR]

Internships are widely promoted high-impact practices that can have positive impacts on students' academic and post-graduate success, yet how specific features facilitate these outcomes is understudied. Instead, internships are often studied in terms of mere participation, without recognizing that these experiences are complex pedagogic spaces shaped by professional cultures and decisions about instructional design. In this sequential mixed-methods study we use sociocultural learning theory to interpret data from online surveys (n = 435) and focus groups (n = 52) with students at five institutions. Stepwise linear regression analyses of demographic and programmatic variables associated with intern satisfaction, developmental value, and career adaptability indicated that first-generation status, sex, race and income level, and supervisor behaviors were significantly associated with satisfaction and development. Analyses of qualitative data revealed that features of positive (clear communication, availability, feedback) and negative (unavailability, inattention to learning) supervision impacted student experiences. These findings reveal that internships should be designed with careful attention to task scaffolding, student autonomy and supervisor assistance, depending on the professional context and situation. These results highlight the need for colleges and employers to design internships as mentored and culturally shaped learning spaces, provide supervisor training, and consider the cultural backgrounds of students when matching them to internships. [ABSTRACT FROM AUTHOR]

This research aims to explore the interaction between digital transformation and organizational culture in the Society 5.0 structuring in Turkey. The study's sample comprises business owners, senior managers from medium and large enterprises, academicians, and public employees, selected through purposeful sampling methods. Employing an explanatory-sequential design of mixed methods, data collection involved conducting surveys among these distinct sample groups. The quantitative analysis component of this study incorporates exploratory factor analysis, confirmatory factor analysis, correlation analysis, and Structural Equation Modeling (SEM). In the qualitative analysis section, the content analysis method was employed to pose semi-structured questions during interviews with 46 individuals. Code relationship analysis was applied to the data. All data were analyzed using SPSS 25, AMOS 24, and MAXQDA 20 software. According to the results of the quantitative study, digital transformation and organizational culture have a mutual influence. This influence is visible at all levels, with all dimensions and subdimensions influencing one another. On the other hand, the qualitative analysis demonstrated that Society 5.0 and its sub-dimensions influence both digital transformation and organizational culture, as well as their sub-dimensions. Furthermore, it was determined that understanding Society 5.0 necessitates digital transformation as well as a shift in organizational culture. Finally, organizations need to consider the developments within the scope of Society 5.0 and change their organizational structures accordingly. [ABSTRACT FROM AUTHOR]

By utilizing a mixed-method approach that combines a quantitative analysis of 10,183 retrieved records of non-uploaded cases, and a qualitative in-depth interview of ten judges and five judge assistants, the current study investigated the pattern of selective uploading, and explored the possible reasons for non-disclosure. We found that the estimated upload rate based on the number of the uploaded and the non-uploaded cases for criminal cases is higher than that reported by previous studies. In addition, there are considerable variations across the type of crimes, the location of courts, and the year of adjudication regarding the patterns of non-disclosure. The in-depth interviews revealed that there are four common scenarios where a case can be assigned to the "Other" group for the reason of non-disclosure: (1) circumstances involving unconcluded cases; (2) cases containing sensitive information that can be used for illegal purposes; (3) cases that involve specially granted circumstances that lead to a mitigated punishment; or (4) simple technical difficulty. [ABSTRACT FROM AUTHOR]

Though many initiatives and monetary benefits are incorporated under RNTCP/NTEP, many patients might incur some out-of-pocket expenditure (OOP) related to diagnosis, treatment, and hospitalization. Such costs lead to further poverty and default. This study estimated OOP costs. A cross-sectional mixed method study was conducted in 2020. Data were collected from two selected UHCs (both public and private sectors) from all eight administrative zones. A total of 278 newly registered drug-sensitive tuberculosis patients at different stages of treatment were enrolled, and 18 IDIs were done after obtaining the consent. Among 278, 231 (83%) were seeking the treatment from the public sector and 47 (17%) from the private sector. The average direct, indirect, and total costs were Rs. 8812, Rs. 4825, and Rs. 13,637, respectively. Extra food and supplements are the major field of expenditure for those enrolled in the public sector. Higher costs were incurred by the private sector patients. Longer distances, a long waiting time, belief systems, and unavailability of facilities or drugs were the common reasons for not visiting the public sector. IDI results also supported the cost heads. The majority of the expenses occurred at the private settings before diagnosis. IDIs suggested to changes in the programmatic approach toward migrants, industrial workers, and women.

Abstract Background In Senegalese high-burden regions, the existing package of interventions is insufficient to reach the malaria elimination goal. Asymptomatic carriers of Plasmodium contribute significantly to malaria persistence and are not targeted by current interventions. The systematic treatment of all individuals in a community (mass drug administration, MDA) is a relevant intervention to tackle asymptomatic infections. The intervention can only be effective with a high participation of the population and, therefore, depends largely on its acceptability. This study aims to investigate the prospective acceptability of MDA in the Kedougou region to inform its potential use in a future strategy. Methods Following a 7-construct theoretical framework, prospective acceptability of MDA implemented in the rainy season was studied. In four villages, a sequential mixed design, from qualitative to quantitative, was used. In November 2021, interviews with healthcare professionals and focus groups with villagers were conducted. Findings from thematic analysis informed the development of a questionnaire administered to individuals aged ≥ 15 years in March 2022. Based on the questionnaire, an acceptability score was constructed and associations with socio-demographic factors were investigated using a linear mixed model. Results The 7 interviews, the 12 focus groups, and the questionnaire administered to 289 individuals demonstrated a good acceptability of MDA. Two potential barriers were identified: the contradiction of taking a medication without feeling sick and the occurrence of side effects; and four facilitators: the perception of malaria as a burden, a good understanding of MDA, a good perceived effectiveness, and the resulting economic benefits. The average acceptability score was 3.5 (range from -7 to + 7). Young adults aged 15 to 21 had a lower acceptability score compared to the other age groups, indicating an additional barrier to acceptability (β = -0.78 [-1.67;0.1]). Conclusion MDA is a priori acceptable to communities of Kedougou region in Senegal. Sensitization campaigns co-constructed with the communities, especially targeting young adults, are essential to ensure good acceptability.

Abstract Aim To develop a transitional care model for autoimmune rheumatic disease patients based on the needs analysis. Method Mixed Method, Explanatory sequential design (QUAN-qual) has been conducted. Quantitative data were collected through medical record and structured interviews. Qualitative study has been done through Focused Group Discussion (FGD), based on problems met in previous quantitative study. We have done the coding processed, followed by determining categories and themes to reach the intercoder agreement with peer-debriefing. Analysis of the final results of research was assisted by the external auditor to form a model of care. Result The quantitative data collection from 27 patients showed that the transition age was 18–19 year-old, age of onset 4–17 year-old, 23 patients (85, 2%) with SLE, 4 patients (14.8%) with JIA. Two patients (7.4%) had different diagnosis from the pediatric clinic, 1 patient (3.7%) had no diagnosis from previous clinic. Drug switching during transition occurred in 14 patients (51.9%) and 3 patients (11.1%) has no known medication history. Data regarding disease activity at initial diagnosis were not available in 26 patients (96.3%). The combined FGD analysis found several key words related to “the need of change” in RSCM autoimmune rheumatic transitional care. Conclusion A development of transitional care model for autoimmune rheumatic disease consist of documents about service algorithm, transfer documents, systematic work protocols with education check list has been done.

Many older adults are increasingly embracing digital technology in the Republic of Korea. This study investigated the relationship between the digital skills of Korean older adults and their perceived health status and digital technology application for health promotion. This mixed-method study comprised a community survey of 434 older adults aged ≥65 in two cities in South Korea, followed by focus group interviews. Five types of digital skills, ‘operational internet skills’, ‘information navigation skills’, ‘social skills’, ‘creative skills’, and ‘mobile skills’, were measured using the LSE digital skill measurement instrument. Multivariable analysis identified the influence of digital skills on health-related outcomes. Among them, ‘social skills’ associated positively with self-rated health (β 0.37, 95%CI 0.08, 0.65). ‘Information navigation skills’ contributed positively to the use of digital technology and the internet for a healthy lifestyle in terms of improving eating habits (β 0.43, 95%CI 0.09, 0.77), accessing healthcare (β 0.53, 95%CI 0.21, 0.85), and accessing long-term care services (β 0.45, 95%CI 0.11, 0.79). Thematic analysis revealed that the study participants use Korean language-based resources such as Naver and Kakao Talk for social connection to promote a healthy lifestyle. This study concludes that encouraging initial and sustained use of the internet and enhancing digital skills among Korean older adults can promote active and healthy aging.

Abstract Background Satisfaction is defined as the perceived fulfillment of patient or client needs and desires through the delivery of healthcare services. In developed countries, more than 60% of women have been screened for cervical cancer. However, only 12% of women in sub-Saharan Africa have been screened for precancerous cervical lesions. There is limited evidence on client satisfaction with cervical cancer screening services (CSCCSS) in Ethiopia, particularly, there is no study conducted by mixed method in the Amhara region. Objective The study aimed to assess clients’ satisfaction with cervical cancer screening services and influencing factors among women screened in Debre Markos town public health facilities in Northwest Ethiopia, 2022/23. Methods A convergent parallel mixed methods design was conducted in Debre Markos town’s public health facilities from October 10th, 2022 to January 10th, 2023. For the quantitative wing, a total of 401 cervical cancer screening service users were selected using a systematic random sampling technique. Data were collected using an interviewer-administered structured questionnaire. Clients were interviewed on exit in a private area far from the screening unit and the data were entered into Epi-data version 4.6.0.2, then exported to STATA version 14 for analysis. A binary logistic regression model was fitted to identify factors associated with client satisfaction with cervical cancer screening services. The qualitative data were collected through in-depth and key informant interviews using a semi-structured topic guide. The data were analyzed using a thematic analysis approach with Open code software (version 4.0.2.3). Result The quantitative wing revealed that overall, 65% (95% CI: 60–69) of respondents were satisfied with the cervical cancer screening services they received. Gender of the provider (AOR: 6.11, 95% CI: 3.23–11.55, p-value = 0.000), waiting time (AOR: 4.77, 95% CI: 1.32–17.31, p-value = 0.017), clients’ knowledge (AOR: 0.26, 95% CI: 0.12–0.59, p-value = 0.001), and clients’ attitude (AOR: 6.43, 95% CI: 3.43–12.03, p-value = 0.000) were significantly associated with CSCCSS. Qualitative result The thematic analysis revealed three themes. Theme 1: facility-related barriers (shortage of skilled manpower, shortage of infrastructure, providers’ skill gap, unavailability of full service, leadership problem, long waiting time). Theme 2: client-related barriers (poor knowledge and attitude, gender preference). Theme 3: facility-related facilitators (free service, presence of supportive partners). Conclusion According to the findings of this study, two-thirds of clients were satisfied with cervical cancer screening services, which was lower than the national target of 80%. Long waiting time, male gender of the service provider, unfavorable attitude, and good knowledge of clients were identified as significant factors negatively affecting client satisfaction with cervical cancer screening.

Resistance to adopting patient safety culture practices or technologies can hinder improvements in patient safety. This study contributes to enhancing the understanding of patient safety culture (PSC) assessment by identifying the specific factors that render some PSC dimensions invalid and offering actionable recommendations for improvement in healthcare settings. Primary data were gathered using a mixed method of explanatory sequential design, with quantitative data collection and analysis followed by qualitative data collection and analysis. The study was conducted in the leading Private Hospital XYZ, one of the private hospital groups internationally accredited with Joint Commission International with a 110-patient bed capacity. Among the 12 dimensions, only feedback communication about error, handoffs and transitions, and teamwork across units were determined to be valid and reliable. Therefore, eight dimensions, including communication openness, continuous improvement, frequency of error reported, management support, overall patient safety, supervisor/manager expectation, and staffing were explored further through a focus group discussion (FGD). Delving into quantitative and qualitative insights has identified critical nuances that extend beyond mere quantitative metrics. The qualitative insights gleaned from healthcare professionals through the FGD illuminated the nuanced human aspects of safety culture that traditional measurements may overlook. Keywords: anonymous reporting, management of communication, mixed method, patient safety culture Abstrak Mengapa Penilaiannya Gagal? Menyelidiki 8 Dimensi yang Tidak Valid dari Budaya Keselamatan Pasien: Penelitian Mixed Method. Penolakan untuk mengadopsi praktik atau teknologi budaya keselamatan pasien dapat menghambat peningkatan keselamatan pasien. Penelitian ini bertujuan untuk meningkatkan pemahaman tentang penilaian budaya keselamatan pasien (Patient Safety Culture [PSC]) dengan mengidentifikasi faktor-faktor spesifik yang menyebabkan beberapa dimensi PSC tidak valid, dan memberikan rekomendasi yang dapat ditindaklanjuti untuk perbaikan di lingkungan pelayanan kesehatan. Data primer dikumpulkan dengan menggunakan mixed method of explanatory sequential design, dengan pengumpulan dan analisis data kuantitatif diikuti dengan pengumpulan dan analisis data kualitatif. Penelitian dilakukan di Rumah Sakit Swasta terkemuka XYZ, salah satu grup rumah sakit swasta yang terakreditasi internasional Joint Commission International dengan kapasitas 110 tempat tidur pasien. Diantara 12 dimensi, hanya dimensi feedback communication about error, handoffs and transitions, dan teamwork across units, yang memenuhi syarat valid dan reliabel. Oleh karena itu, 8 dimensi yaitu communication openness, continuous improvement, frequency error reported, management support, overall patient safety, supervisor/manager expectation, dan staffing didalami lebih lanjut dalam focus group discussion (FGD). Melalui penggalian wawasan kuantitatif dan kualitatif, telah teridentifikasi deskripsi penting yang melampaui metrik kuantitatif. Wawasan kualitatif yang diperoleh dari para profesional di bidang kesehatan melalui FGD telah menyingkap aspek-aspek budaya keselamatan yang bernuansa manusiawi, yang mungkin terlewatkan oleh pengukuran tradisional. Kata Kunci: budaya keselamatan pasien, manajemen komunikasi, metode campuran, pelaporan anonim

Purposes Aiming at the performance conflict between optimization parameters in prior optimization method, a hybrid optimization model based on MOEA/D is proposed, which integrates CNN and genetic algorithm into MOEA/D framework to balance the correlation and complexity between various objective functions. Methods First, the deep learning method is used as a supplement to the conventional fluid mechanics analysis method to establish a highly reliable CNN response prediction model for airfoil aerodynamic characteristics, which can be used to quickly evaluate the aerodynamic parameters of airfoil. Then, the response model and genetic operator are interpolated into the MOEA/D framework to construct a multi-objective hybrid optimization model based on MOEA/D. And the lift drag ratio and moment coefficient of a NACA high lift airfoil under cruise condition are taken as the optimization objectives for testing. Finally, through the analysis of aerodynamic performance and flow field structure of the airfoil on the Pareto front, the distribution law of different airfoil configurations on the front is studied, which further guides the designer to explore the potential basic airfoil in the airfoil selection.

Abstract Background The COVID-19 pandemic has posed significant challenges to nations worldwide, affecting various sectors of society. Women’s HIV harm reduction centers, which provide critical services, have also been affected by these difficulties. This study aimed to examine the challenges of the COVID-19 pandemic on the services offered by women’s HIV harm reduction centers from the perspective of clients. Methods A convergent mixed-method design was utilized to gain in-depth insights into the challenges of COVID-19 on the services provided by women’s HIV harm reduction centers, counseling centers, and night shelters that cater to women at risk, such as drug users, sex workers, and the homeless population, in three provinces (Tehran, Khuzestan, and Kermanshah) in Iran. The study was conducted from January to May 2023. The quantitative aspect of the study employed a cross-sectional method with a sample size of 430 individuals. A researcher-developed questionnaire was used to assess a range of services. The qualitative part of the study involved traditional content analysis and included 32 individual interviews. The integration of qualitative and quantitative results was performed during the interpretation phase to provide a comprehensive understanding of the challenges of COVID-19 on women’s HIV harm reduction centers. Results In the quantitative phase, the mean age of women was 39.0 ± 10.2 years. 165 women reported a history of COVID-19, which accounts for 38.4% of the total. More than half of them (n = 102, 61.8%) recovering at home. The majority of women (n = 365, 84.9%) mentioned receiving the COVID-19 vaccine. COVID-19 diagnostic tests were conducted for 74.2% (n = 319) of women. Women expressed higher satisfaction with the services (HIV prevention services, and accommodation services) before the COVID-19 pandemic compared to the satisfaction during the pandemic. The qualitative analysis identified emerging challenges related to the COVID-19 pandemic in two categories: personal challenges and mismanagement of services, comprising nineteen subcategories. Conclusion The findings of this study highlight the adverse impact of the COVID-19 pandemic on the services provided by women’s HIV harm reduction centers, in contrast to the pre-pandemic period. To mitigate these negative effects, it is crucial to implement preventive measures and practical solutions. This may involve addressing the personal and management challenges of the centers.

Abstract Background The COVID-19 pandemic posed significant challenges for managers overseeing women's harm reduction centers. This study seeks to capture managers' perspectives on the service providing in women's harm reduction centers during the COVID-19 pandemic. Methods This convergent mixed-method study conducted in three provinces of Iran: Tehran, Khuzestan, and Kermanshah. The study was carried out between January and May 2023. In the quantitative part, the researchers utilized reports from 10 center managers. A researcher-designed questionnaire was employed to collect data on a wide range of services and referrals provided by the centers. The qualitative part of the research involved conventional content analysis and included 12 individual interviews. Two directors from the Ministry of Health and ten managers of women’s harm reduction centers participated in the interviews. During the interpretation phase, the researchers compared the quantitative and qualitative findings to obtain a comprehensive understanding of the topic. Results During the quantitative stage of the study, it was observed that all the managers were women, with an average age of 40.7 ± 7 years. More than half of the managers had obtained a postgraduate education (n = 6, 60%), and a majority of them were married (n = 7, 70%). Additionally, 40% of the managers (n = 4) were working as contractors. During the non-COVID-19 period, there were higher coverage by centers and residents, more referrals of non-injecting drug users and sex workers, and a higher number of group counseling sessions in all three provinces compared to the COVID-19 period. The qualitative analysis revealed two primary themes: "challenges" and "capabilities." Conclusions During the COVID-19 pandemic, providing some services and client referrals decreased in the centers, and center managers faced increased challenges. Many of these challenges were in the communication, executive, management, structure, education, financial, civilization, facilities, and socio-cultural sectors. Managers used their skills to manage and control these challenges. It is important to focus on these challenges and managerial capabilities to effectively handle future crises.

Abstract Background We implemented a contextualized innovative mentorship program in the Clinical Master in Family Medicine (CMFM) program established in April 2020 at Arabian Gulf University. In this paper, we describe the process of this program and derive the major challenges faced by trainees and related corrective actions and their outcomes on high-risk trainees for optimal performance. Methods We conducted a mixed-method longitudinal study of 80 trainees, analyzing information extracted from the Moodle learning platform about five key performance indicators as well as the contents (quantitative and qualitative) of mentoring meeting reports submitted through a validated online form between 2020 and 2022. We analyzed frequencies and themes of challenges and compared trainees' performance according to time and level of risk. Results The follow-up of all 80 trainees in two cohorts (40 for each cohort) shows that most are female (93.75%) and the mean age is 30.00 ± 2.19 years with a ratio of mentors to mentees of 1 to 5. Meetings are conducted through phone calls, virtually, and face-to-face in 62%, 29%, and 8.3% respectively. The mean number and duration of meetings are 30.88 ± 2.31 and 20.08 ± 9.50 min respectively. Time management is the most reported challenge (41.3%), followed by health, social, and psychological-related issues in 7.6%, 4.6%, and 3% respectively. We extracted four main themes related to trainees, settings of training, e-Portfolio, and the COVID-19 pandemic. The mentorship program captured 12 trainees at high risk for low academic progress (12%) of whom six graduated on time and the remaining had to repeat a few courses the following terms. The performance of the program is stable over time (mean GPA of 3.30 (SE = 0.03), versus 3.34 (SE = 0.05) for cohorts 1 and 2 in the two years respectively, (P = 0.33). However, it is slightly lower among high-risk trainees compared to the remaining (GPA = 3.35 (SE = 0.03) versus 3.14 (SE = 0.08), P = 0.043) though above the minimum of the threshold of 3 out of 4, required for the master's degree. Conclusion The mentorship program captured the struggling trainees and permitted to implement pertinent corrective actions timely, particularly in the context of a two-year intensive CMFM program during the COVID-19 pandemic.

Context: Despite the Weekly Iron folic acid supplementation (WIFS) program, the prevalence of anaemia among adolescent girls remains high. Phase 1 Indian Council of Medical Research (ICMR) task force study conducted in 2016 in Kallur showed that the IFA provision rate for adolescent girls was 72% but the consumption rate was only 15% in the Kallur area. The present study was done to identify the gaps for the difference between provision and consumption rate of weekly IFA tablets among adolescent girls using the WHO conceptual framework in home-based settings. Materials and Methods: This crosssectional study with a mixedmethod design was conducted from October 2020 to December 2021. Quantitative data were collected from 972 adolescent girls and their parents using a structured pretested questionnaire, whereas qualitative exploration was done by focus group discussions. Descriptive analysis and bivariate analysis were used to analyse the quantitative data. Qualitative data were analysed and integrated with quantitative results. Results: The overall number of girls who were aware of Iron Folic acid therapy (IFAT) was 704 (72%). However, only 132 (13%) adolescent girls were found to be adherent to IFA therapy. Multivariable regression analysis revealed that side effects encountered on intake of IFAT (Odds ratio (OR) =0.5, P = 0.009) were associated with higher rates of nonadherence, whereas regular supply (OR = 13.6, P = 0.000), health education to parents (OR = 2.76, P = 0.002), and experiencing benefits (OR = 1.72, P = 0.006) were associated with higher rates of adherence. These were substantiated by qualitative findings. Conclusions: Ignorance on the impact of anaemia on adolescent health, fear of side effects, unpleasant effects experienced on intake of Iron folic acid (IFA), and inadequate counselling determines the adherence to weekly IFA supplements among adolescent girls.

Abstract Background Intimate partner violence (IPV) is the most common form of violence against women. Postpartum IPV refers to any type of IPV that occurs up to one year after childbirth and has many adverse impacts on mothers and their children. Considering the lack of sufficient information on the prevalence and factors related to IPV after childbirth in Iran, this study aimed to evaluate the frequency and severity of IPV, its different forms, and psychosocial factors related to IPV, as well as to explore how IPV is perceived among mothers one year after childbirth. Methods An explanatory sequential mixed-methods design was used to conduct this study in two phases. The first phase is a cross-sectional study that will be performed on postpartum mothers who have a one-year-old child referred to health care centers in the southern region of Tehran, Iran, with the aim of determining the prevalence of IPV and its related factors. The second phase is a qualitative conventional content analysis study with the purpose of exploring women’s experiences and perceptions of IPV and its preventive or protective factors. Purposive sampling will be used. Based on the results of the quantitative phase, mothers who are at the two ends of the IPV spectrum (based on their total Conflict Tactics Scale (CTS-2) scores) will be selected, and in-depth and semistructured interviews will be conducted with them. Finally, the researchers will provide an interpretation of the quantitative results using qualitative data. Discussion This is the first study that uses a mixed methods approach to explain different dimensions of IPV, its related factors, and mothers' perceptions of it. By providing a better understanding of this phenomenon, it is hoped that the results of this research will be used by policymakers and officials of educational and cultural systems to plan and provide effective interventions, enact laws, and present educational and cultural programs to prevent IPV after childbirth. Ethical code IR.TUMS.FNM.REC1400.200.

This paper describes the development and validation of the multidimensional Teacher Well-being Inventory underlined by a rational-empirical approach using teacher samples from China. A 20-item multidimensional instrument on teacher well-being was established with good psychometric characteristics. The results yielded five dimensions, which comprises of physical, emotional/psychological, cognitive, social, and spiritual well-being. This concise measurement targets assessing the most salient well-being scenarios of teachers at work. This validated measurement can serve as a more robust gauge for promoting well-being literacy and functioning of individual teachers, students and schools in response to the OECD 2030 agenda of building the wellness society. [ABSTRACT FROM AUTHOR]

Many older adults are increasingly embracing digital technology in the Republic of Korea. This study investigated the relationship between the digital skills of Korean older adults and their perceived health status and digital technology application for health promotion. This mixed-method study comprised a community survey of 434 older adults aged ≥65 in two cities in South Korea, followed by focus group interviews. Five types of digital skills, 'operational internet skills', 'information navigation skills', 'social skills', 'creative skills', and 'mobile skills', were measured using the LSE digital skill measurement instrument. Multivariable analysis identified the influence of digital skills on health-related outcomes. Among them, 'social skills' associated positively with self-rated health (β 0.37, 95%CI 0.08, 0.65). 'Information navigation skills' contributed positively to the use of digital technology and the internet for a healthy lifestyle in terms of improving eating habits (β 0.43, 95%CI 0.09, 0.77), accessing healthcare (β 0.53, 95%CI 0.21, 0.85), and accessing long-term care services (β 0.45, 95%CI 0.11, 0.79). Thematic analysis revealed that the study participants use Korean language-based resources such as Naver and Kakao Talk for social connection to promote a healthy lifestyle. This study concludes that encouraging initial and sustained use of the internet and enhancing digital skills among Korean older adults can promote active and healthy aging. [ABSTRACT FROM AUTHOR]

Background: Satisfaction is defined as the perceived fulfillment of patient or client needs and desires through the delivery of healthcare services. In developed countries, more than 60% of women have been screened for cervical cancer. However, only 12% of women in sub-Saharan Africa have been screened for precancerous cervical lesions. There is limited evidence on client satisfaction with cervical cancer screening services (CSCCSS) in Ethiopia, particularly, there is no study conducted by mixed method in the Amhara region. Objective: The study aimed to assess clients' satisfaction with cervical cancer screening services and influencing factors among women screened in Debre Markos town public health facilities in Northwest Ethiopia, 2022/23. Methods: A convergent parallel mixed methods design was conducted in Debre Markos town's public health facilities from October 10th, 2022 to January 10th, 2023. For the quantitative wing, a total of 401 cervical cancer screening service users were selected using a systematic random sampling technique. Data were collected using an interviewer-administered structured questionnaire. Clients were interviewed on exit in a private area far from the screening unit and the data were entered into Epi-data version 4.6.0.2, then exported to STATA version 14 for analysis. A binary logistic regression model was fitted to identify factors associated with client satisfaction with cervical cancer screening services. The qualitative data were collected through in-depth and key informant interviews using a semi-structured topic guide. The data were analyzed using a thematic analysis approach with Open code software (version 4.0.2.3). Result: The quantitative wing revealed that overall, 65% (95% CI: 60–69) of respondents were satisfied with the cervical cancer screening services they received. Gender of the provider (AOR: 6.11, 95% CI: 3.23–11.55, p-value = 0.000), waiting time (AOR: 4.77, 95% CI: 1.32–17.31, p-value = 0.017), clients' knowledge (AOR: 0.26, 95% CI: 0.12–0.59, p-value = 0.001), and clients' attitude (AOR: 6.43, 95% CI: 3.43–12.03, p-value = 0.000) were significantly associated with CSCCSS. Qualitative result: The thematic analysis revealed three themes. Theme 1: facility-related barriers (shortage of skilled manpower, shortage of infrastructure, providers' skill gap, unavailability of full service, leadership problem, long waiting time). Theme 2: client-related barriers (poor knowledge and attitude, gender preference). Theme 3: facility-related facilitators (free service, presence of supportive partners). Conclusion: According to the findings of this study, two-thirds of clients were satisfied with cervical cancer screening services, which was lower than the national target of 80%. Long waiting time, male gender of the service provider, unfavorable attitude, and good knowledge of clients were identified as significant factors negatively affecting client satisfaction with cervical cancer screening. [ABSTRACT FROM AUTHOR]

With increasing diversity of consumers in the marketplace, marketers have begun to embrace inclusive marketing practices. However, there is still a lack of research on the topic, making it difficult for managers to understand how to design and execute effective campaigns. This study aims to fill this gap by identifying the key factors that contribute toward an impactful inclusive marketing campaign. The study used a sequential mixed-methods approach and first conducted interviews with 29 LGBTQIA+ and non-LGBTQ consumers to gain insights into their perceptions of effective inclusive campaigns. In the study's second phase, ten industry experts provided inputs for the Fuzzy DEMATEL method to identify critical factors for an effective campaign. The findings revealed seven essential factors: social acceptance of the community, use of community-specific symbols, authentic communication about community issues, top management's approach, inclusive hiring practices, brand history, and legal market structure, which were then grouped into social, communication-related, brand-related, organization-specific, and other macro-level categories. The study fills an important gap in the inclusive marketing literature and can serve as a practical guide for marketers to design and implement inclusive campaigns. [ABSTRACT FROM AUTHOR]

Purpose: Digital lean implementation can solve the dual problem of stagnating quality and rising costs in healthcare. Although technology adoption in healthcare has increased in the post-COVID world, value unlocking using technology needs a well-thought-out approach to achieve success. This paper provides a prescriptive framework for successfully implementing digital lean in healthcare. Design/methodology/approach: This study uses a mixed-method approach to achieve three research objectives. Whilst it uses a narrative review to identify the enablers, it uses qualitative thematic analysis techniques to categorise them into factors. The study utilises the delphi method for the thematic grouping of the enablers in the broader groups. The study used an advanced ordinal priority approach (OPA) to prioritise these factors. Finally, the study uses concordance analysis to assess the reliability of group decision-making. Findings: The study found that 20 identified enablers are rooted in practice factors, followed by human resource management (HRM) factors, customer factors, leadership factors and technology factors. These results further counter the myth that technology holds the utmost significance in implementing digital lean in healthcare and found the equal importance of factors related to people, customers, leadership and best practices such as benchmarking, continuous improvement and change management. Originality/value: The study is the first of its kind, providing the prescriptive framework for implementing digital lean in healthcare. The findings are useful for healthcare professionals and health policymakers. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has posed significant challenges to nations worldwide, affecting various sectors of society. Women's HIV harm reduction centers, which provide critical services, have also been affected by these difficulties. This study aimed to examine the challenges of the COVID-19 pandemic on the services offered by women's HIV harm reduction centers from the perspective of clients. Methods: A convergent mixed-method design was utilized to gain in-depth insights into the challenges of COVID-19 on the services provided by women's HIV harm reduction centers, counseling centers, and night shelters that cater to women at risk, such as drug users, sex workers, and the homeless population, in three provinces (Tehran, Khuzestan, and Kermanshah) in Iran. The study was conducted from January to May 2023. The quantitative aspect of the study employed a cross-sectional method with a sample size of 430 individuals. A researcher-developed questionnaire was used to assess a range of services. The qualitative part of the study involved traditional content analysis and included 32 individual interviews. The integration of qualitative and quantitative results was performed during the interpretation phase to provide a comprehensive understanding of the challenges of COVID-19 on women's HIV harm reduction centers. Results: In the quantitative phase, the mean age of women was 39.0 ± 10.2 years. 165 women reported a history of COVID-19, which accounts for 38.4% of the total. More than half of them (n = 102, 61.8%) recovering at home. The majority of women (n = 365, 84.9%) mentioned receiving the COVID-19 vaccine. COVID-19 diagnostic tests were conducted for 74.2% (n = 319) of women. Women expressed higher satisfaction with the services (HIV prevention services, and accommodation services) before the COVID-19 pandemic compared to the satisfaction during the pandemic. The qualitative analysis identified emerging challenges related to the COVID-19 pandemic in two categories: personal challenges and mismanagement of services, comprising nineteen subcategories. Conclusion: The findings of this study highlight the adverse impact of the COVID-19 pandemic on the services provided by women's HIV harm reduction centers, in contrast to the pre-pandemic period. To mitigate these negative effects, it is crucial to implement preventive measures and practical solutions. This may involve addressing the personal and management challenges of the centers. [ABSTRACT FROM AUTHOR]

Background: Electronic portfolios (e-portfolios) are valuable tools to scaffold workplace learning. Feedback is an essential element of the learning process, but it often lacks quality when incorporated in ePortfolios, while research on how to incorporate feedback into an ePortfolio design is scarce. Objectives: To compare the ease of use, usefulness and attitude among three feedback formats integrated in an ePortfolio: open-text feedback, structured-text feedback and speech-to-text feedback. Methods: In a mixed method designed experiment, we tested with 85 participants from different healthcare disciplines, three feedback formats in an ePortfolio prototype. Participants provided feedback on students' behaviour after observing video-recorded simulation scenarios. After this, participants completed a questionnaire derived from the Technology Acceptance Model (TAM). The experiment ended with a semi-structured interview. Results: Structured-text feedback received highest scores on perceived ease of use, usefulness, and attitude. This type of feedback was preferred above open-text feedback (currently the standard), and speech-to-text feedback. However, qualitative research results indicated that speech-to-text feedback is potentially valuable for feedback input on-premise. Respondents would use it to record short feedback immediately after an incident as a reminder for more expanded written feedback later or to record oral feedback to a student. Implications: Structured-text feedback was recommended over open-text feedback. The quality of the speech-to-text technology used in this experiment, was insufficient to use in a professional ePortfolio but holds the potential to improve the feedback process and should be considered when designing new versions of ePortfolios for healthcare education. [ABSTRACT FROM AUTHOR]

This study aims to identify the influence of Generation X and Generation Y on green buying behavior in the Indian context. Based on social cognitive theory and the generational cohort theory, the authors test the impact of Perceived Environmental Responsibility and Social Media Information Sharing on the relationship between Generation X and Y cohorts and their green buying behavior. This study uses the Quan-Qual approach to triangulate the results. A structured questionnaire was used to collect data from 427 respondents, and the hypotheses were tested with covariance-based structural equation modeling using AMOS software (AMOS 26 software). To probe further into the findings, in-depth interviews were conducted with 60 respondents from Gen X and Gen Y cohort groups, and the data were analyzed using NVIVO software. The findings reveal that the Gen X cohort seems to engage more in green buying behavior compared to the Gen Y cohort. Also, Social Media Information Sharing mediates the green buying behavior for Gen X and moderates it for Gen Y. Moreover, the qualitative inquiry confirms that the Perceived Environmental Responsibility of both Gen X and Gen Y cohorts does not significantly impact their green buying behavior. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic posed significant challenges for managers overseeing women's harm reduction centers. This study seeks to capture managers' perspectives on the service providing in women's harm reduction centers during the COVID-19 pandemic. Methods: This convergent mixed-method study conducted in three provinces of Iran: Tehran, Khuzestan, and Kermanshah. The study was carried out between January and May 2023. In the quantitative part, the researchers utilized reports from 10 center managers. A researcher-designed questionnaire was employed to collect data on a wide range of services and referrals provided by the centers. The qualitative part of the research involved conventional content analysis and included 12 individual interviews. Two directors from the Ministry of Health and ten managers of women's harm reduction centers participated in the interviews. During the interpretation phase, the researchers compared the quantitative and qualitative findings to obtain a comprehensive understanding of the topic. Results: During the quantitative stage of the study, it was observed that all the managers were women, with an average age of 40.7 ± 7 years. More than half of the managers had obtained a postgraduate education (n = 6, 60%), and a majority of them were married (n = 7, 70%). Additionally, 40% of the managers (n = 4) were working as contractors. During the non-COVID-19 period, there were higher coverage by centers and residents, more referrals of non-injecting drug users and sex workers, and a higher number of group counseling sessions in all three provinces compared to the COVID-19 period. The qualitative analysis revealed two primary themes: "challenges" and "capabilities." Conclusions: During the COVID-19 pandemic, providing some services and client referrals decreased in the centers, and center managers faced increased challenges. Many of these challenges were in the communication, executive, management, structure, education, financial, civilization, facilities, and socio-cultural sectors. Managers used their skills to manage and control these challenges. It is important to focus on these challenges and managerial capabilities to effectively handle future crises. [ABSTRACT FROM AUTHOR]

Background: We implemented a contextualized innovative mentorship program in the Clinical Master in Family Medicine (CMFM) program established in April 2020 at Arabian Gulf University. In this paper, we describe the process of this program and derive the major challenges faced by trainees and related corrective actions and their outcomes on high-risk trainees for optimal performance. Methods: We conducted a mixed-method longitudinal study of 80 trainees, analyzing information extracted from the Moodle learning platform about five key performance indicators as well as the contents (quantitative and qualitative) of mentoring meeting reports submitted through a validated online form between 2020 and 2022. We analyzed frequencies and themes of challenges and compared trainees' performance according to time and level of risk. Results: The follow-up of all 80 trainees in two cohorts (40 for each cohort) shows that most are female (93.75%) and the mean age is 30.00 ± 2.19 years with a ratio of mentors to mentees of 1 to 5. Meetings are conducted through phone calls, virtually, and face-to-face in 62%, 29%, and 8.3% respectively. The mean number and duration of meetings are 30.88 ± 2.31 and 20.08 ± 9.50 min respectively. Time management is the most reported challenge (41.3%), followed by health, social, and psychological-related issues in 7.6%, 4.6%, and 3% respectively. We extracted four main themes related to trainees, settings of training, e-Portfolio, and the COVID-19 pandemic. The mentorship program captured 12 trainees at high risk for low academic progress (12%) of whom six graduated on time and the remaining had to repeat a few courses the following terms. The performance of the program is stable over time (mean GPA of 3.30 (SE = 0.03), versus 3.34 (SE = 0.05) for cohorts 1 and 2 in the two years respectively, (P = 0.33). However, it is slightly lower among high-risk trainees compared to the remaining (GPA = 3.35 (SE = 0.03) versus 3.14 (SE = 0.08), P = 0.043) though above the minimum of the threshold of 3 out of 4, required for the master's degree. Conclusion: The mentorship program captured the struggling trainees and permitted to implement pertinent corrective actions timely, particularly in the context of a two-year intensive CMFM program during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

While some food, agricultural, natural resources, and human science (FANRHS) experts participate in a variety of outreach opportunities, many face barriers to public interaction such as lack of incentive, knowledge, or confidence. This study examined scientists' and Extensionists' outreach experiences as guests on science podcasts. Results showed the guests had minimal formal science communication training yet were highly educated individuals and involved with informal education. Future research should examine how peer-modeling can be used to recruit more scientists to science communication opportunities and how institutions can improve training for outreach such as podcasts. [ABSTRACT FROM AUTHOR]

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The main goal of the current research is to investigate and analyze the attitude of local residents towards the sustainable development of rural tourism to identify the opportunities and challenges of this type of tourism, which has been done with the case study of the villages of Alborz province. The research method is mixed, which uses the qualitative method of the research object in the first stage and the quantitative survey method in the second stage. The approach of the present research is sequential exploratory. The data collection tools are semi-structured interviews in the first stage and questionnaires in the second stage. According to the research findings in the qualitative phase, the experts and informants were selected using the purposeful sampling method, and finally, by aggregating 31 interviews, 134 raw propositions were extracted, which were extracted using the three-axis coding method in the form of open codes. They were classified as central and selective. Finally, among 134 raw propositions, 70 open codes, 21 core codes, and six selective codes were obtained. In the quantitative stage, analyzes were performed using SPSS26 and SmartPLS3 soft-ware. According to the quantitative findings of the obtained values, it was found that among the dimensions, the socio-cultural dimension has high values. According to the research results, the sus-tainable development of rural tourism will contribute to the qualitative development, organization, and management of rural tourism and attract investment in the tourism industry. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is the most common form of violence against women. Postpartum IPV refers to any type of IPV that occurs up to one year after childbirth and has many adverse impacts on mothers and their children. Considering the lack of sufficient information on the prevalence and factors related to IPV after childbirth in Iran, this study aimed to evaluate the frequency and severity of IPV, its different forms, and psychosocial factors related to IPV, as well as to explore how IPV is perceived among mothers one year after childbirth. Methods: An explanatory sequential mixed-methods design was used to conduct this study in two phases. The first phase is a cross-sectional study that will be performed on postpartum mothers who have a one-year-old child referred to health care centers in the southern region of Tehran, Iran, with the aim of determining the prevalence of IPV and its related factors. The second phase is a qualitative conventional content analysis study with the purpose of exploring women's experiences and perceptions of IPV and its preventive or protective factors. Purposive sampling will be used. Based on the results of the quantitative phase, mothers who are at the two ends of the IPV spectrum (based on their total Conflict Tactics Scale (CTS-2) scores) will be selected, and in-depth and semistructured interviews will be conducted with them. Finally, the researchers will provide an interpretation of the quantitative results using qualitative data. Discussion: This is the first study that uses a mixed methods approach to explain different dimensions of IPV, its related factors, and mothers' perceptions of it. By providing a better understanding of this phenomenon, it is hoped that the results of this research will be used by policymakers and officials of educational and cultural systems to plan and provide effective interventions, enact laws, and present educational and cultural programs to prevent IPV after childbirth. Ethical code: IR.TUMS.FNM.REC1400.200. Plain English summary: Intimate partner violence is the most common form of violence against women, with a higher prevalence in Asian and Eastern Mediterranean countries, including Iran. The period after childbirth is a stressful and anxiety-provoking event due to the increased physical, psychological, social, and economic needs of parents, leading to intimate partner violence. Studies show that women who experience violence after childbirth face many physical, sexual, and emotional problems. Additionally, it will have a negative impact on their baby. Many factors can lead to intimate partner violence, among which psychological factors are among the most important. Therefore, we decided to perform a study in two phases with the aim of determining the prevalence and factors related to intimate partner violence. In the first phase, we will study Iranian women who have a one-year child living in southern Tehran city and ask them to complete questionnaires related to intimate partner violence. In the second phase, we will conduct an interview with women who have experienced violence after childbirth to obtain more information about the factors involved. [ABSTRACT FROM AUTHOR]